Transfacial Two-pin External Mandibular Distraction Osteogenesis: A Technique for Neonatal Airway Obstruction from Robin Sequence.

Unlabelled: Surgical management in those with moderate-to-severe airway obstruction includes tongue-lip adhesion, tracheostomy, and/or mandibular distraction osteogenesis. This article describes a transfacial two-pin external device technique for mandibular distraction osteogenesis, utilizing minimal dissection.

Methods: The first percutaneous pin is transcutaneously placed just inferior to the sigmoid notch parallel to the interpupillary line.

Long-term Health Outcomes of New Persistent Opioid Use After Surgery Among Medicare Beneficiaries.

Objective: We examined long-term health outcomes associated with new persistent opioid use after surgery and hypothesized that patients with new persistent opioid use would have poorer overall health outcomes compared with those who did not develop new persistent opioid use after surgery.

Background: New persistent opioid use is a common surgical complication. Long-term opioid use increases risk of mortality, fractures, and falls; however, less is known about health care utilization among older adults with new persistent opioid use after surgical care.

Influence of faculty diversity on resident diversity across surgical subspecialties.

Background: Disparities among women and individuals from racial/ethnic minority groups persist in surgical specialties at all training levels. We hypothesized that these populations are underrepresented in surgical specialties, and that diversity in faculty is correlated with diversity in trainees.

Methods: Linking aggregate data from the Association of American Medical Colleges (AAMC) Faculty Roster and the Graduate Medical Education (GME) Track databases, we evaluated self-reported gender and racial/ethnic composition of faculty and residents across six surgical specialties.

Alternative Tendon Coaptations to the Pulvertaft Weave Technique: A Systematic Review and Meta-Analysis of Biomechanical Studies.

Background: The Pulvertaft weave technique (PT) is frequently used during tendon repairs and transfers. However, this technique is associated with limitations. In this systematic review and meta-analysis, quantitative and qualitative analyses were performed on in vitro, biomechanical studies that compared the PT with alternative techniques.

Optimizing Treatment of Hand Infections: Is MRSA Coverage Always Necessary?

Unlabelled: Multiple publications have highlighted the prevalence of methicillin resistant (MRSA) as a cause of hand infections. We hypothesized that these publications have shifted the empiric treatment of hand infections. The aim of this study was to identify the current standard of care, the most common causative bacteria, and factors leading to extended length of stay for hand infection patients at a suburban hospital to improve treatment and establish an optimized care protocol.

Contralateral prophylactic mastectomy and implications for breast reconstruction.

Contralateral prophylactic mastectomy (CPM) rates have continued to rise in the United States, impacting all stakeholders including plastic and reconstructive surgeons. Multiple factors may be influencing this trend, including patient decision-making characteristics, knowledge about breast cancer disease and prognosis, advances in genetic testing and enhanced imaging capabilities, sociodemographic factors, and access to specialty surgical services such as breast reconstruction. In this review, the authors shed light on the current state of CPM and summarize the literature analyzing its increasing prevalence in the United States, as well as outline future directions for study and dissemination of knowledge from providers to patients surrounding this important and complex treatment decision.

Upper extremity reconstruction following open surgical repair of giant arteriovenous fistula aneurysm: clinical case and systematic review of the literature.

Background: Nearly 30% of arteriovenous fistulas (AVFs) located in the upper extremity for hemodialysis access result in short- and long-term adverse effects, such as rupture, necessitating emergent surgical management and extensive soft-tissue reconstruction. With this systematic review, we aimed to compile all reported open surgical techniques used for complicated AVF repair in the upper extremity, the respective soft-tissue reconstructive outcomes, and vascular patency rates at final follow-up.

Methods: Using Ovid Medline/PubMed databases, we conducted a review of the English-language literature on AVF aneurysm surgical management in the upper extremity, filtered for relevance to open surgical technique and outcomes in vascular patency after aneurysmal repair at long-term follow-up (≥6 months postoperatively).

's Interaction With the Ectodysplasin Signaling Pathway During the Patterning of Dentition.

In these studies, we explored for the first time the molecular relationship between the paired-domain-containing transcription factor, , and the ectodysplasin () signaling pathway during mouse incisor formation. Mice that were deficient in both and were generated, and the status of dentition analyzed in all progeny using gross evaluation and histomorphometric means. When compared to wildtype controls, mice lack mandibular incisors.

Preoperative Opioid Use and Mortality After Minor Outpatient Surgery.

This study evaluates the risk of preoperative opioid exposure on all-cause mortality after outpatient surgery.

Stem Cells Regenerating the Craniofacial Skeleton: Current State-Of-The-Art and Future Directions.

The craniofacial region comprises the most complex and intricate anatomical structures in the human body. As a result of developmental defects, traumatic injury, or neoplastic tissue formation, the functional and aesthetic intricacies of the face and cranium are often disrupted. While reconstructive techniques have long been innovated in this field, there are crucial limitations to the surgical restoration of craniomaxillofacial form and function.

Innovative Molecular and Cellular Therapeutics in Cleft Palate Tissue Engineering.

Clefts of the lip and/or palate are the most prevalent orofacial birth defects occurring in about 1:700 live human births worldwide. Early postnatal surgical interventions are extensive and staged to bring about optimal growth and fusion of palatal shelves. Severe cleft defects pose a challenge to correct with surgery alone, resulting in complications and sequelae requiring life-long, multidisciplinary care.

Higher Amounts of Opioids Filled After Surgery Increase Risk of Serious Falls and Fall-Related Injuries Among Older Adults.

Background: Despite increasing numbers of older adults undergoing surgery and the known risks of opioids, little is known about the potential association between opioid prescribing and serious falls and fall-related injuries after surgery.

Objective: To determine the incidence and risk factors of serious falls and fall-related injuries after elective, outpatient surgery.

Design: Retrospective cohort study of 20% national sample of Medicare claims among beneficiaries ≥ 65 years of age with Medicare Part D claims and who underwent elective outpatient surgery from January 1, 2009, through December 31, 2014.

Optimizing non-opioid pain control after implant-based breast reconstruction: a review of the literature and proposed pain control algorithm.

Despite the intense focus on the opioid epidemic and its known association with surgical procedures, there is a paucity of evidence-based literature on pain management in implant-based breast reconstruction (IBR). Herein, we present an updated review of the literature aimed at identifying pain treatment protocols to minimize narcotic use and its associated potential addiction in IBR. A comprehensive review of the published English literature was conducted using Ovid Medline/PubMed Database without timeframe limitations.

Functioning Free Muscle Transfer for Brachial Plexus Injury: A Systematic Review and Pooled Analysis Comparing Functional Outcomes of Intercostal Nerve and Spinal Accessory Nerve Grafts.

Background:  The aim of this study was to compare postoperative elbow flexion outcomes in patients receiving functioning free muscle transplantation (FFMT) innervated by either intercostal nerve (ICN) or spinal accessory nerve (SAN) grafts.

Methods:  A comprehensive systematic review on FFMT for brachial plexus reconstruction was conducted utilizing Medline/PubMed database. Analysis was designed to compare functional outcomes between (1) nerve graft type (ICN vs.

Alloplastic Auricular Reconstruction: Review of Implant Types, Adverse Events, and Aesthetic Outcomes.

Importance: Alloplastic implants have been applied successfully in reconstruction of the external ear, either for congenital microtia or traumatic injury.

Objective: The objective of this study was to conduct a comprehensive systematic review of alloplastic implant materials utilized in the reconstruction of the external ear stratified by indication, specific implant type, postoperative complications, and aesthetic outcomes.

Evidence Review: A comprehensive systematic review of published literature on alloplastic external ear reconstruction data was conducted utilizing Medline/PubMed database without timeframe limitations in June 2019.

Optimizing Postoperative Pain Control in Autologous Breast Reconstruction: A Systematic Review.

Background:  Pain management approaches in autologous breast reconstruction have become a topic of great interest in the era of enhanced recovery after surgery protocols, as well as the opioid epidemic. The management of postoperative pain is of critical importance for women undergoing breast reconstruction; however, these protocols have yet to be synthesized and compared in the primary literature. Herein, we present a systematic review of approaches to provide optimal pain control while minimizing narcotic use and its associated potential negative sequelae in autologous breast reconstruction.

Using Digital Profileplasty for Surgical Planning.

This paper describes a method for setting up an automated and reliable digital profileplasty technique for use in Adobe Photoshop. Digital imaging software can be used to extrapolate more exact measurements during profileplasty. The digital profileplasty technique is helpful to provide intraoperative guidance during surgery.

Regenerative Peripheral Nerve Interfaces for Prevention and Management of Neuromas.

Symptomatic neuromas are a common cause of postamputation pain that can lead to significant disability. Regenerative peripheral nerve interface surgery is performed to treat symptomatic neuromas and prevent the development of neuromas. This review delineates the clinical problem of postamputation pain, describes the limitations of the available treatment methods, and highlights the need for an effective treatment strategy that leverages the biologic processes of nerve regeneration and muscle reinnervation.

Artificial Intelligent Virtual Assistant for Plastic Surgery Patient's Frequently Asked Questions: A Pilot Study.

Background: Artificial Intelligent Virtual Assistants (AIVA) is a segment of artificial intelligence that is rapidly developing. However, its utilization to address patients' frequently asked questions remains unexplored.

Methods: We developed an AIVA to answer questions related to 10 frequent topics asked by plastic surgery patients in our institution.

High-pressure injection injury: a case report and systematic review.

High-pressure delivery devices for paint and other substances can lead to severe injuries of the hand without immediate surgical debridement. We present a case of a high-pressure paint gun injury treated surgically with full resolution of function. A systematic review of the literature details outcomes of similar injuries.

A rare cause of unilateral hypoglossal nerve palsy: case report of intraneural ganglion cyst of the hypoglossal nerve and review of the literature.

Benign lesions of the soft tissue arising in the periarticular space, such as a ganglion cyst, can cause compression of adjacent nerve fascicles passing in the nearby joint space. Intraneural ganglion cysts involving the cranial nerves are particularly rare, with only a few previous cases reported in the literature.