Dermal Sensory Regenerative Peripheral Nerve Interface for Reestablishing Sensory Nerve Feedback in Peripheral Afferents in the Rat.

Background: Without meaningful, intuitive sensory feedback, even the most advanced myoelectric devices require significant cognitive demand to control. The dermal sensory regenerative peripheral nerve interface (DS-RPNI) is a biological interface designed to establish high-fidelity sensory feedback from prosthetic limbs.

Methods: DS-RPNIs were constructed in rats by securing fascicles of residual sensory peripheral nerves into autologous dermal grafts, with the objectives of confirming regeneration of sensory afferents within DS-RPNIs and establishing the reliability of afferent neural response generation with either mechanical or electrical stimulation.

Regenerative peripheral nerve interface free muscle graft mass and function.

Background: Regenerative peripheral nerve interfaces (RPNIs) transduce neural signals to provide high-fidelity control of neuroprosthetic devices. Traditionally, rat RPNIs are constructed with ~150 mg of free skeletal muscle grafts. It is unknown whether larger free muscle grafts allow RPNIs to transduce greater signal.

Comparing Prepectoral Versus Subpectoral Tissue Expander Placement Outcomes in Delayed-Immediate Autologous Breast Reconstruction.

Background: Delayed-immediate breast reconstruction has traditionally involved placement of tissue expanders (TE) in the subpectoral (SP) position. Development of acellular dermal matrices has renewed interest in the prepectoral (PP) pocket, which avoids extensive muscle manipulation. We compare complication rates between PP and SP TE placement in autologous delayed-immediate breast reconstruction.

Simplifying Arterial Coupling in Microsurgery-A Preclinical Assessment of an Everter Device to Aid with Arterial Anastomosis.

Background:  A novel arterial everter device was engineered to simplify microvascular coupling of arteries by reliably securing the stiff, muscular wall of arteries over coupler pins. We compare microvascular coupling with the everter device to manual suturing for arterial anastomoses in a live large animal model.

Materials And Methods:  In this preliminary study, bilateral external femoral arteries of five male swine were exposed and sharply divided.

Closed-Loop Continuous Hand Control via Chronic Recording of Regenerative Peripheral Nerve Interfaces.

Loss of the upper limb imposes a devastating interruption to everyday life. Full restoration of natural arm control requires the ability to simultaneously control multiple degrees of freedom of the prosthetic arm and maintain that control over an extended period of time. Current clinically available myoelectric prostheses do not provide simultaneous control or consistency for transradial amputees.

An Evaluation of the Choice for Contralateral Prophylactic Mastectomy and Patient Concerns About Recurrence in a Reconstructed Cohort.

Background: Rising contralateral prophylactic mastectomy rates are a subject of national concern. This study assessed (1) factors critical to patients when deciding on contralateral prophylactic mastectomy and (2) patients' quality of life related to concerns about recurrence after unilateral or bilateral breast reconstruction.

Methods: Patients with stage 0 to III breast cancer who underwent unilateral mastectomy or contralateral prophylactic mastectomy and breast reconstruction at a single institution between 2000 and 2012 were identified.

Acute Calcific Tendinitis of the Index Finger in a Child.

Background: Calcific tendinitis is characterized by calcium hydroxyapatite crystal deposition within tendons and is a common cause of musculoskeletal pain in adults. Its clinical manifestations may be acute, chronic, or asymptomatic. Acute calcific tendinitis is self-resolving condition that is rarely reported in the pediatric population and may be overlooked for more common processes, leading to unnecessary treatment.

The Use of Dermal Skin Substitutes for the Treatment of the Burned Hand.

The hand is commonly affected in burn injuries. Joints and extensor tendons are vulnerable given their superficial location. Durable coverage that permits relative frictionless tendon gliding and minimizes scar contracture is required to optimize functional outcomes.

The Early Years of Practice: An Assessment of Operative Efficiency and Cost of Free Flap and Implant Breast Reconstruction at an Academic Institution.

Objective The purpose of this study was to evaluate the short-term costs, and financial implications of improvements in operative efficiency of free flap and implant-based breast reconstruction within an academic practice. Methods The billing records of 162 patients who underwent postmastectomy implant-based or free flap breast reconstruction by two newly hired microsurgeons at an academic institution during the 2011, 2012, and 2013 fiscal years were reviewed. Actual data on professional revenue, relative value units (RVUs), and facility costs for the first stage of reconstruction as well as costs of postoperative complications were assessed.

Successfully Integrating Research into Plastic Surgery Training Programs.

Successful integration of research into the educational mission of a plastic surgery residency program requires the support and dedication of the faculty members to create a culture that promotes innovation, discovery, and advancement of the field of plastic surgery. Dedicated research time during plastic surgery training is beneficial to both the resident and training program. Regardless of whether residents plan to pursue an academic career or enter private practice, participating in research provides an opportunity to develop skills to think critically and mature professionally.

Regenerative Peripheral Nerve Interface for Prostheses Control: Electrode Comparison.

Background: This study compared epimysial patch electrodes with intramuscular hook electrodes using monopolar and bipolar recording configurations. The purpose was to determine which strategy transduced muscle signals with better fidelity for control of myoelectric prostheses.

Methods: One of the two electrode styles, patch (n = 4) or hook (n = 6) was applied to the left extensor digitorum longus muscle in rats.

Providing a sense of touch to prosthetic hands.

Each year, approximately 185,000 Americans suffer the devastating loss of a limb. The effects of upper limb amputations are profound because a person's hands are tools for everyday functioning, expressive communication, and other uniquely human attributes. Despite the advancements in prosthetic technology, current upper limb prostheses are still limited in terms of complex motor control and sensory feedback.

Comprehensive breast reconstruction in an academic surgical practice: an evaluation of the financial impact.

Background: This study assessed the financial implications of providing all forms of breast reconstruction at a single academic institution with insurance as the primary mode of reimbursement.

Methods: Billing records of 152 patients who underwent postmastectomy breast reconstruction offered at the University of Michigan for the 2012 fiscal year were reviewed. Professional and facility revenue, cost, and earnings for the first stage of reconstruction were calculated by applying actual collections and charges.

Analysis of publication bias in the literature for distal radius fracture.

Purpose: Distal radius fractures are the most commonly treated fracture, and their management remains complex. We aimed to evaluate the presence of publication bias in the literature on distal radius fracture management and to identify specific study variables that may influence the reporting of positive outcomes.

Methods: We conducted a systematic review on all available journal articles to find primary articles reporting on the management of distal radius fractures.

Schwannoma of the hand in an infant: case report.

Schwannomas (neurilemmomas) are the most common benign tumors of peripheral nerves and originate from the myelinating cells of the nerve sheath. We present a case of congenital schwannoma of the hand.

Estradiol-treated mesenchymal stem cells improve myocardial recovery after ischemia.

Background: Stem cell therapy is a promising treatment modality for injured cardiac tissue. A novel mechanism for this cardioprotection may include paracrine actions. Our lab has recently shown that gender differences exist in mesenchymal stem cell (MSC) paracrine function.

Proestrus female rats are more resistant to right ventricular pressure overload.

Multiple studies of left ventricular dysfunction suggest that females may be more resistant to ischemia or endotoxemia. However, sex differences in right ventricular (RV) responses to pressure overload and/or endotoxemia have not been elucidated. We hypothesized that females would maintain better RV function during acute pressure overload (APO), endotoxemia, or a simultaneous insult from both processes.

Females exhibit relative resistance to depressive effects of tumor necrosis factor-alpha on the myocardium.

Background: Tumor necrosis factor-alpha (TNF-alpha) plays a critical role in myocardial dysfunction following acute injury. It is unknown, however, if a gender-specific response to TNF infusion exists in isolated rat hearts. Elucidating such mechanisms is important to understanding the myocardial gender differences during acute injury.