Posterior "Open Book" approach for type 1 internal hemipelvectomy.

Introduction: Internal limb-sparing hemipelvectomy is currently the preferred surgical option for resection of pelvic tumours. Obtaining an acceptable functional outcome through the standard ilioinguinal or iliofemoral incisions, only compounds the already challenging dissection, resection and reconstruction of these extensive en-bloc extirpative oncologic operations.

Surgical Technique: We describe a novel surgical approach to the lateral pelvis that minimises injury to the gluteal muscles, spares the gluteal vessels and provides a broad yet shallow operative field conducive to microsurgery with sizeable vasculature in close proximity to facilitate any microsurgical reconstruction.

Outcome Analysis of Metacarpal and Phalangeal Fixation Techniques at Bellevue Hospital.

Purpose: Phalangeal fractures represent a significant portion of upper extremity injuries but are not well studied as a single entity. We define our approach at a level 1 trauma center and determine whether plating or lag screws (ie, rigid fixation) have superior functional outcomes compared with Kirschner wire fixation for phalangeal or metacarpal fractures.

Methods: We performed a systematic review of all surgically managed hand fracture cases at Bellevue Hospital during 2012 and 2013.

Risk Factors for Delays in Adjuvant Chemotherapy following Immediate Breast Reconstruction.

Background: Concerns exist that immediate breast reconstruction may delay adjuvant chemotherapy initiation, impacting oncologic outcomes. Here, the authors determine how postoperative complications impact chemotherapy timing, and identify factors associated with greater risk for delays.

Methods: Retrospective chart review identified patients undergoing immediate breast reconstruction and adjuvant chemotherapy at a single institution from 2010 to 2015.

Targeted Nrf2 activation therapy with RTA 408 enhances regenerative capacity of diabetic wounds.

Aims: Though unmitigated oxidative stress in diabetic chronic non-healing wounds poses a major therapeutic challenge, currently, there are no effective pharmacological agents. We targeted the cytoprotective Nrf2/Keap1 pathway, which is dysfunctional in diabetic skin and the regenerative environment in the diabetic wound. We assessed the efficacy of a potent Nrf2-activator, RTA 408, a semi-synthetic oleanane triterpenoid, on accelerating diabetic wound healing.

Limb-sparing sarcoma reconstruction with functional composite thigh flaps.

Introduction: Innervated muscle transfer can improve functional outcomes after extensive limb-sparing sarcoma resections. We report our experience using composite thigh flaps for functional reconstruction of large oncologic extremity defects.

Patients And Methods: Between 2011 and 2014, four limb-sparing oncologic resections (3 lower extremities, 1 upper extremity) underwent immediate functional reconstruction with composite thigh free flaps in three males and one female.

Adipose Tissue-Preserved Skin Graft: Applicability and Long-Term Results.

Background: Composite grafts consisting of adipose tissue and skin have been reported in the literature but have been restricted to areas smaller than 4 to 5 cm. The senior author (D.T.

Determining the Oncologic Safety of Autologous Fat Grafting as a Reconstructive Modality: An Institutional Review of Breast Cancer Recurrence Rates and Surgical Outcomes.

Background: The increasing use of autologous fat grafting in breast cancer patients has raised concerns regarding its oncologic safety. This study evaluated patient outcomes and tumor recurrence following mastectomy reconstruction and autologous fat grafting.

Methods: Retrospective chart review identified patients who underwent mastectomy followed by breast reconstruction from 2010 to 2015.

Impact of Evolving Radiation Therapy Techniques on Implant-Based Breast Reconstruction.

Background: Patients undergoing implant-based reconstruction in the setting of postmastectomy radiation therapy suffer from increased complications and inferior outcomes compared with those not irradiated, but advances in radiation delivery have allowed for more nuanced therapy. The authors investigated whether these advances impact patient outcomes in implant-based breast reconstruction.

Methods: Retrospective chart review identified all implant-based reconstructions performed at a single institution from November of 2010 to November of 2013.

Nonhealing Ulcers in Patients with Tophaceous Gout: A Systematic Review.

General Purpose: To provide information from a review of the literature about chronic ulcers associated with tophaceous gout.

Target Audience: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

Learning Objectives/outcomes: After participating in this educational activity, the participant should be better able to:1.

Does the Timing of Chemotherapy Affect Post-Mastectomy Breast Reconstruction Complications?

Introduction: In this study we evaluated how the timing of chemotherapy for breast cancer affects post-reconstruction complications to determine whether there is an optimal time for breast reconstruction after chemotherapy.

Patients And Methods: A retrospective review identified 344 breast cancer patients who underwent chemotherapy with mastectomy and autologous/prosthetic reconstruction from 2011 to 2014. A control group of 127 breast cancer patients who underwent mastectomy and autologous/prosthetic reconstruction without chemotherapy was also identified from the same period.

Hyperbaric Oxygen Therapy: Exploring the Clinical Evidence.

General Purpose: To provide information about hyperbaric oxygen therapy (HBOT), its mechanisms, indications and safe applications based on clinical evidence.

Target Audience: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

Learning Objectives/outcomes: After participating in this educational activity, the participant should be better able to:1.

The Impact of Two Operating Surgeons on Microsurgical Breast Reconstruction.

Background: Given the complexity of microsurgical breast reconstruction, there are many opportunities to improve both surgical efficiency and outcomes. The use of two operating surgeons has been employed, but the outcomes are unproven. In this study, the authors compare the outcomes of patients undergoing microsurgical breast reconstruction with one operating surgeon to those with two surgeons.

Analysis of Flap Weight and Postoperative Complications Based on Flap Weight in Patients Undergoing Microsurgical Breast Reconstruction.

 Higher body mass index (BMI) has been shown to increase postoperative complications in autologous breast reconstruction. However, the correlation with flap weight is unknown. Here, we explore the relationship of flap weights and complication rates in patients undergoing microvascular breast reconstruction.

An Assessment of Gender Differences in Plastic Surgery Patient Education and Information in the United States: Are We Neglecting Our Male Patients?

Background: The number of total cosmetic procedures performed yearly has increased by more than 274% between 1997 and 2014, according to the American Society for Aesthetic Plastic Surgery. However, the vast majority of plastic surgery procedures are still targeted toward women, with little attention toward men.

Objectives: This study sought to quantify the extent of gender discrepancies observed in online plastic surgery marketing in this country.