Outpatient Prosthetic-Based Reconstruction during COVID-19 Pandemic Possible in Selected Patients without Increased Complications.

Background: Following the reopening of elective surgery, the authors' division transitioned from inpatient admission to same-day discharge for immediate prosthetic breast reconstruction in an effort to decrease the hospital's clinical burden and minimize potential coronavirus disease of 2019 exposure. This study aims to compare complication rates following this acute transition for patients who had inpatient and outpatient mastectomy with immediate alloplastic reconstruction.

Methods: A retrospective chart review was performed on patients who underwent mastectomy with immediate prosthetic reconstruction.

Technique of Abdominal Wall Tissue Expansion for the Treatment of Massive Complicated Ventral Hernias.

Abdominal wall tissue expansion is a unique technique that seeks to augment and expand both the fascial and subcutaneous tissues/skin layers to achieve durable closure of otherwise challenging ventral hernias. In addition to allowing primary fascial closure in a majority of cases, this technique enables reduced tension on the closure, potentially decreasing the recurrence rate. This article describes the senior author's surgical technique for abdominal wall tissue expansion in massive complicated ventral hernias.

Oncoplastic breast surgery: Achieving oncological and aesthetic outcomes.

Background And Objectives: Oncoplastic reconstruction allows more patients to become candidates for breast-conserving surgery (BCS). Oncologic resection of a breast lesion is combined with plastic surgical techniques to improve aesthetic results. Choosing the best oncoplastic method is essential to optimize outcomes, improve cosmesis, and minimize postoperative complications.

Delayed hypersensitivity reaction to acellular dermal matrix in breast reconstruction: the red breast syndrome?

Background: Acellular dermal matrix (ADM) has become a valuable tool in reconstructive breast surgery, in part because it has been considered to be a non-reactive and non-immunogenic entity. However, some patients who undergo breast reconstruction with ADMs develop postoperative erythema overlying their ADM grafts. The etiology of this phenomenon is poorly understood.

Infectious Complications Leading to Explantation in Implant-Based Breast Reconstruction With AlloDerm.

Objective: The role for acellular dermal matrix in implant-based breast reconstruction-providing coverage of the inferolateral border of the underlying prosthesis and allowing control over the inframammary fold-has become increasingly popular. Although AlloDerm (LifeCell, Branchburg, NJ) is free of cellular components responsible for the antigenic response, its processing does not guarantee sterility. In this study, we examine the infectious complications in tissue expander/implant-based reconstruction with AlloDerm.

Patient satisfaction in postmastectomy breast reconstruction: a comparative evaluation of DIEP, TRAM, latissimus flap, and implant techniques.

Background: Despite a growing literature on patient satisfaction in breast reconstruction, few studies have compared perforator flaps with the more commonly practiced methods. The authors compared four reconstructive techniques and identified factors influencing patient satisfaction.

Methods: All patients undergoing postmastectomy breast reconstruction between 1999 and 2006 at a single academic institution were included in our study.

Nipple-sparing mastectomy: evaluation of patient satisfaction, aesthetic results, and sensation.

The purpose of this study is to describe our experience with nipple-sparing mastectomy and immediate reconstruction, with particular attention to patient satisfaction, aesthetic results, and nipple sensation. Immediate reconstruction was performed on 17 breasts in 10 patients, using either implants or autologous tissue flaps. Assessment of outcomes was performed through patient interviews, a self-reported patient satisfaction survey and review of postoperative photographs.

Impact of regional referral centers for microsurgical breast reconstruction: the New England perforator flap program experience.

Background: Development of new, microsurgical techniques for breast reconstruction has led to more natural and durable reconstruction while minimizing morbidity. Despite these advances, institutions are slow to integrate subspecialized programs because of the additional resources required. In February 2004, our institution developed a microsurgery program for perforator flap breast reconstruction.

Delayed division of the thoracodorsal nerve: a useful adjunct in breast reconstruction.

Breast reconstruction utilizing the latissimus dorsi musculocutaneous flap with an underlying breast implant is a well-established technique. Postoperative shoulder limitation is usually limited if at all noticeable. The muscle itself may, however, remain active in the new anterior position.

Eliminating the vertical scar in breast reduction-Boston modification of the Robertson technique.

Background: Surgeons often advise patients with large ptotic breasts to undergo a Wise pattern reduction (WPR) mammaplasty using an inferior pedicle technique with consideration of a free-nipple graft.

Objective: We describe the Boston modification of the Robertson technique (BMRT), which allows for the elimination of the vertical scar using a low horizontal scar mammaplasty with a broad central-inferior pedicle.

Methods: We retrospectively reviewed the surgical characteristics of 239 patients who underwent mammaplasty using the BMRT technique (n = 145) and compared these with patients undergoing WPR (n = 94).

Salvage treatment of an irradiated, infected lumbosacral wound.

A 60-year-old male with lumbosacral multiple myeloma received 5100 cGy of external-beam radiation, thalidomide, and Decadron. He subsequently underwent excision of the epidural tumor, decompressive L4, L5, and S1 laminectomies, and bilateral L4-5 and L5-S1 medial facetectomies. The patient developed osteoradionecrosis, cerebrospinal fluid leak, wound infection, and sepsis.