Reconstruction of Acquired Defects of the External Genitalia: A 24-Patient, Single-Institution Experience.

Purpose: Patients undergoing resection of the external genitalia are often faced with significant deformity and decreased quality of life. Plastic surgeons are tasked with the challenge of reconstructing these defects to minimize morbidity and increase patients' quality of life. The authors have set out to investigate the efficacy of local fasciocutaneous and pedicled perforator flaps in external genital reconstruction.

Same-Day Mastectomy and Immediate Prosthetic Breast Reconstruction: A 12-Year National Database Analysis and Early Postoperative Outcomes.

Background: Coronavirus disease of 2019 and rising health care costs have incentivized shorter hospital stays after mastectomies with immediate prosthetic reconstruction. The purpose of this study was to compare postoperative outcomes following same-day and non-same-day mastectomy with immediate prosthetic reconstruction.

Methods: A retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program database from 2007 to 2019 was performed.

Standardized Perioperative Protocol and Routine Ketorolac Use for Head and Neck Free Flap Reconstruction.

Unlabelled: No consensus exists on ideal perioperative management or anticoagulation regimen for free flap reconstruction of the head and neck. Perceived benefits from antiplatelet therapy need to be balanced against potential complications. Ketorolac, a platelet aggregation inhibitor and a parenteral analgesic, was introduced as part of a standardized perioperative protocol at our institution.

Chaperone Use During Plastic Surgery Physical Examinations: Nationwide Provider Practices and Impact of Level of Training.

Background: Medical chaperones often play an important role during physical examinations, providing patient comfort and serving as medicolegal witness. The purpose of this study was to evaluate and compare practices regarding chaperone use by plastic surgery attendings and trainees.

Methods: A voluntary survey was distributed to members of the American Council of Academic Plastic Surgeons.

Assessment of Opioid-Prescribing Practices in Breast Augmentation: Future Directions for Prescribing Guidelines.

Background: The United States (US) is in the mid of an opioid epidemic propagated, in part, by prescription opioids. With excess overprescribing documented in a variety of surgical procedures, several societies have recommended opioid-prescribing guidelines. Considering the scope and postoperative pain associated with aesthetic plastic surgery procedures, earnest evaluation into opioid-prescribing practices for breast augmentation was conducted.

Orbital Floor and Maxillary Reconstruction With Titanium Mesh and Anterolateral Thigh Free Flap.

A 57-year-old woman with a 15-year history of a slowly growing fibrous dysplastic maxillary bony tumor underwent total left maxillectomy with subsequent maxillary reconstruction with anterolateral thigh single perforator free flap and orbital floor reconstruction with a titanium mesh implant.

Google Glass in the Operating Room: The Plastic Surgeon's Perspective.

New technologies and innovations are common in the delivery of modern health care. Google Glass is one such device gaining increased attention in medical specialties. The authors surveyed residents and attending physicians in the Department of Plastic Surgery, MedStar Georgetown University Hospital, on their experience using Google Glass in the operating room.

Lateral Approach to the Popliteal Artery for Free Tissue Transfer to the Lower Extremity.

Free tissue transfer to the proximal leg and knee requires appropriate recipient vessel selection. The popliteal vessels have historically been unpopular choices, due to their remote location often necessitating vein grafts, and need for prone positioning. In this report, we describe a lateral approach to the above-knee popliteal vessels, which was utilized for 2 cases of free tissue transfer to the lower extremity.

Interdisciplinary treatment of post-concussion and post-traumatic headaches.

Introduction: Chronic headaches following concussion are debilitating and difficult to treat. Commonly employed initial therapeutic modalities include pharmacologic, physical, and psychological interventions. Despite these efforts, a subset of patients with chronic pain remains.

Salmonella osteomyelitis of the hand in an infant with sickle cell disease.

Salmonella osteomyelitis involving the hand is a rare, but potentially morbid, complication of sickle cell disease in children. This entity can be difficult to distinguish from the more frequent presentation of dactylitis, but accurate diagnosis is critical to direct proper treatment. We report on a 15-month-old patient with sickle cell disease who ultimately developed osteomyelitis of 1 hand after an acute vasoocclusive episode caused 4 extremity dactylitis.

Modified fixation of acrylic cranioplasty in the setting of titanium allergy.

Cranioplasty can be performed using a number of materials ranging from autologous tissue to metallic or acrylic alloplastic implants. In this report, we present a unique case of revision cranioplasty in a patient with titanium allergy using a prefabricated, custom-made polymethylmethacrylate implant and a modified fixation technique without plates or screws.

Upper Eyelid Coloboma Repair Using Accessory Preauricular Cartilage in a Patient With Goldenhar Syndrome: Technique Revisited.

We present an unusual case of upper eyelid coloboma repair in a patient with Goldenhar syndrome. We describe the use of a modified Cutler-Beard flap with concurrent inlay graft using cartilage from a preauricular appendage. This technique provides the benefits of autologous tissue, while minimizing donor site morbidity and reducing the risk of upper eyelid retraction.

Multidisciplinary approach to soft-tissue reconstruction of the diabetic Charcot foot.

Background: Diabetics are prone to foot ulceration as a result of local tissue ischemia, immune impairment, and biomechanical derangement in the setting of neuropathy. Healing ulcers in the setting of Charcot neuroarthropathy is challenging, as the skeletal changes usually signify advanced disease.

Methods: Records were reviewed for all patients with the diagnosis of Charcot neuroarthropathy and ulceration treated over a 7-year period.

Porcine acellular dermal matrix (strattice) in primary and revision cosmetic breast surgery.

Background: Although acellular dermal matrix materials have been in use for over a decade in primary and secondary breast reconstruction and in some cosmetic breast surgery, little has been published on the outcomes of these materials for cosmetic applications.

Methods: A retrospective institutional review board-approved review was conducted of all patients who had a specific acellular dermal matrix, Strattice, used for cosmetic breast surgery performed by the senior author (S.L.

Genetic and epigenetic influences of twins on the pathogenesis of craniosynostosis: a meta-analysis.

Background: The pathoetiology of craniosynostosis is not well understood. It likely results from a combination of genetic and epigenetic phenomena, such as intrauterine constraint from multiple gestations. Information on craniosynostosis in twins is limited to case reports and series.

Effects of glimepiride and glyburide on glucose counterregulation and recovery from hypoglycemia.

Severe hypoglycemia, the most serious side effect of sulfonylurea therapy, has been reported to occur more frequently with glyburide than glimepiride. The present studies were undertaken to test the hypothesis that a differential effect on glucagon secretion may be involved. We performed hyperinsulinemic hypoglycemic (approximately 2.