Laparoscopic-Assisted Relocation of the Umbilicus With Umbilicoplasty in Complex Abdominal Wall Reconstruction.

Patients with complex abdominal wall pathology often present with significant distortion of their umbilicus. Ventral and umbilical hernias often create widening or protrusion of the umbilicus, while obesity and laxity of the skin and subcutaneous tissue of the abdominal wall further exacerbates the deformity. The primary goal of hernia repair is always reduction of the hernia with a tension-free repair; however, an important secondary goal is esthetic improvement of the abdominal wall.

Rigid External Distractors in Midface Fractures: A Review of Relevant and Related Literature.

Introduction: Literature discussing the use of rigid external distraction devices in midfacial trauma is limited. Rigid external distraction devices have been described for use in craniofacial surgery, allowing for distraction and stabilization of bony segments. In complex facial trauma, bony fragments are often comminuted and unstable, making traditional approaches with internal fixation difficult.

Treatment of Osteomyelitic Bone Following Cranial Vault Reconstruction With Delayed Reimplantation of Sterilized Autologous Bone: A Novel Technique for Cranial Reconstruction in the Pediatric Patient.

Craniosynostosis, a deformity of the skull caused by premature fusion of ≥1 cranial sutures, is treated surgically via endoscopic approaches or cranial vault remodeling. Postoperative infection is rare. Management of postoperative surgical site infections often involves culture-directed intravenous antibiotics and debridement, with removal of osteomyelitic bone and hardware in refractory cases.

Effect of Weekly Specialized Surgeon-led Bedside Wound Care Teams on Pressure Ulcer Time-to-heal Outcomes: Results From a National Dataset of Long-term Care Facilities.

Introduction: Delayed healing of pressure ulcers (PUs) in long-term care facilities (LTCFs) is associated with increased morbidity and expense.

Objective: The authors hypothesize that guideline-based, weekly coordinated care using specialized wound care surgeon-led bedside teams (SLBTs) may improve PU time-to-heal (TTH) outcomes when compared with usual care (UC).

Materials And Methods: Using a deidentified United States nationwide database, the authors retrospectively compared TTH outcomes of PUs diagnosed in LTCFs treated by either weekly SLBTs or UC.

Nasal Dorsal Augmentation with Freeze-Dried Allograft Bone: 10-Year Comprehensive Review.

Background: The aim of this study was to evaluate freeze-dried cortical allograft bone for nasal dorsal augmentation. The 42-month report on 18 patients was published in 2009 in Plastic and Reconstructive Surgery with 89 percent success at level II evidence, and this article is the 10-year comprehensive review of 62 patients.

Methods: All grafts met standards recommended by the American Association of Tissue Banks, the U.

A Single-Center Review of Facial Fractures as the Result of High-Speed Projectile Injuries.

Gunshot injuries to the face that result in fractures of the underlying skeleton present a challenge in management. The goal of this study was to evaluate patterns of facial fractures as a result of gunshot injuries and strategies for management. A retrospective review of facial fractures resulting from gunshot injuries in a level 1 trauma center was performed for the years 2000 to 2012.

Intracranial Migration of Hardware 16 Years Following Craniosynostosis Repair.

The techniques used to fixate osteotomized segments of bone have evolved alongside the treatment of craniosynostosis. The use of nonresorbable metal plates and screws offered a method of rigidly stabilizing repositioned segments of bone. Several reports specify the tendency for these fixation systems to "migrate" transcranially.

A Single-Center Review of Palatal Fractures: Etiology, Patterns, Concomitant Injuries, and Management.

Palatal fractures are frequently associated with facial trauma and Le Fort fractures. The complex anatomy of the midfacial skeleton makes diagnosing and treating these injuries a challenge. The goal of this study was to report our experience with the presentation, concomitant injuries, and management of palatal fractures at a level I trauma center in an urban environment.

Research productivity and gender disparities: a look at academic plastic surgery.

Objectives: The h-index has utility in examining the contributions of faculty members by quantifying both the amount and the quality of research output and as such is a metric in approximating academic productivity. The objectives of this study were (1) to evaluate the relationship between h-index and academic rank in plastic surgery and (2) to describe the current gender representation in academic plastic surgery to assess whether there are any gender disparities in academic productivity.

Design: The h-index was used to evaluate the research contributions of plastic surgeons from academic departments in the United States.

Pain control following breast augmentation: a qualitative systematic review.

Breast augmentation is among the most popular plastic surgery procedures in the United States. Postoperative pain management following breast surgery has traditionally involved intravenous and oral narcotics. However, pain control is not always adequately achieved through these means and may cause unwanted side effects, including headache, nausea, vomiting, constipation, altered mental status, sleep disturbance, and respiratory depression.

Platysma-based myocutaneous clavicular island flap for intraoral reconstruction.

The clavicular myocutaneous island flap, with circulation provided by the platysma and superficial cervical fascia, was first performed by Paul Tessier in 1970, taking his motivation from the prior experience of John Barron with subcutaneous island flaps. A manuscript written by Dr. Tessier on his experience of 120 cases using the flap (which we will refer to as the BT, or Barron-Tessier flap) has been translated and is presented, as well the experiences of Matthews and Wolfe, who learned the procedure from Dr.

Analysis of comprehensibility of patient information regarding complex craniofacial conditions.

Purpose: Health care consumers are increasingly turning to the Internet for information regarding medical and surgical procedures. When an elective procedure is under consideration, the Internet is often the first resource used by a patient. Caregivers of craniofacial patients are typically overwhelmed during the surgical planning process.

Tongue suture placement after cleft palate repair.

Objective: Postoperative airway obstruction is a complication of cleft palate repair. A technique to control the airway is to place a suture through the tongue at the conclusion of the palate repair, but it is not uniformly adopted by surgeons. Although it has been frequently performed, the use and effectiveness of the tongue suture have not been studied.

Nasal dorsal augmentation with freeze-dried allograft bone.

Background: Properly prepared freeze-dried bone has been used with impunity by orthopedic surgeons since 1992 without a single report of disease transmission. The aim of this study was to evaluate freeze-dried cortical allograft bone for nasal dorsal augmentation.

Methods: Freeze-dried human cortical bone was obtained from DCI Donor Services, Nashville, Tennessee.

Salvage of exposed breast implant using capsular flaps.

Objective: Extrusion represents potential complications associated with the use of breast implants. Attempts to salvage the exposed implants are rarely successful when poor tissue coverage or radiotherpy is present and therefore removal of implant and wound healing are mandatory. In these refractory complicated cases the use of capsular flaps can represent a useful tool to save the implant and achieve definitive healing.

The effect of anchoring sutures on medicinal leech mortality.

Objective: The implementation of leech therapy for surgical flaps is not always logistically easy or comfortable for patients or healthcare providers. We examine different methods of placing sutures in the medicinal leech, Hirudo medicinalis, to make the implementation of leech therapy easier.

Methods: Sixteen leeches were randomly divided into 3 groups: a control group, a deep anchoring suture group, and a superficial anchoring suture group.

The Arrhinias.

The Arrhinias consist of three groups of malformations: the Total Arrhinias (T-AR), the Hemi-Arrhinias (H-AR, often called Hemi-Nasal Ageneses) and the Proboscis Lateralis (P.L.) This work deals with 51 cases of Arrhinias gathered within 35 years (8 T-AR, 25 H-AR, and 18 P.

Cleft lip and palate: review.

The most common craniofacial malformation in the newborn is the orofacial cleft, consisting of cleft lip with or without cleft palate and isolated cleft palate. Given its prevalence it is important to understand the etiology of the deformity, medical management prior to surgical correction, surgical techniques and timing.

Craniofacial distractor applicator.

Craniofacial distraction can be planned using cephalograms, computed tomography, medical models, and other forms of anatomic data. However, it is often difficult to translate this plan to the patient. Specifically, it is difficult to obtain true parallel placement of bilateral midface and mandibular distractors.

Distraction osteogenesis of the cleft maxilla.

Distraction osteogenesis is a method of enhancing bony deficiencies of the hypoplastic cleft maxilla. Whether it is the result of inherited growth deficiency or of iatrogenic causes from operative intervention, 20 to 25% of cleft maxilla patients require maxillary advancement. Traditionally, this has been done by standard orthognathic surgery at varying LeFort levels.