The Epidemiology of Mandibular Fractures in the United States, Part 1: A Review of 13,142 Cases from the US National Trauma Data Bank.

Purpose: To date, no studies have analyzed the national demographics of mandibular fractures in the United States. This report is part 1 of a 2-part series characterizing the modern demographics, epidemiology, and outcomes of mandibular fractures in the United States. The purpose of this study was to characterize mandibular fractures in relation to age, gender, mechanism of injury, and anatomic location of fracture.

Novel technique for skin grafting parastomal wounds using a negative-pressure dressing.

Grafting parastomal wounds remains a challenging procedure because of frequent contamination, difficulty isolating the grafted area from the stoma, and an unfavorable environment for skin graft take. The use of negative-pressure dressings has been shown to improve skin graft take by removing excess fluid between the graft and the wound bed, thereby accelerating engraftment. The benefits of negative-pressure dressing around a stoma, however, may be hindered by vacuuming stool into the dressed area.

Risk factors for death in elderly patients with facial fractures secondary to falls.

Background: Craniomaxillofacial trauma is associated with severe injuries and disability. There are no recent reports analyzing the demographics of facial trauma in elderly patients. Our objective was to review the demographics, outcomes, and risk factors associated with death in elderly patients with facial fractures in a single-institution level I trauma center.

Development of consensus guidelines for venous thromboembolism prophylaxis in patients undergoing microvascular reconstruction of the mandible.

Background: The purpose of this study was to determine how guidelines for venous thromboembolism prophylaxis can be applied to patients undergoing microsurgical reconstruction of the mandible.

Methods: Retrospective review of our institutional use of thromboprophylaxis and the associated outcomes in 114 patients (58 free fibular flaps and 56 osteocutaneous radial forearm flaps).

Results: Twenty-two patients (19.

Prevention of venous thromboembolism in body contouring surgery: a national survey of 596 ASPS surgeons.

Introduction: Venous thromboembolism (VTE) has been identified as a major public health issue. Postbariatric body contouring surgery represents a major challenge for VTE prophylaxis due to the presence of multiple risk factors and broad areas of dissection that potentially increase the risk of postoperative bleeding.

Aim: To define current VTE prophylaxis practices among surgeons of the American Society of Plastic Surgeons, performing postbariatric body contouring surgery in the United States.

Approach to venous thromboembolism prophylaxis: are we evolving fast enough in plastic surgery?

Venous thromboembolism has become a target for research by the American Society of Plastic Surgery. The current article reviews the steps that plastic surgeons and the American Society of Plastic Surgery have taken for creating guidelines in our field. We summarized the current reported incidences of venous thromboembolism in various plastic surgical procedures, and reviewed the current efforts that the society is taking to address the burden of this deadly preventable disease.

Autologous bone grafting with adjunctive use of acellular dermal matrix for alveolar cleft defects: early outcomes.

Background And Purpose: Alveolar bone grafting remains the standard for alveolar cleft repair. Compromised oral and/or nasal closure may impede healing and result in graft failure or persistent fistulae. Incorporating acellular dermal matrix into these repairs may protect the bone graft during mucosal healing by providing an additional layer of soft tissue coverage.

FGF-2 enhances vascularization for adipose tissue engineering.

Background: Current therapies for soft-tissue reconstruction include autologous tissue flaps and alloplastic implants. Although autologous fat transplantation using a minimally invasive cannula harvest has less donor-site morbidity than tissue flaps, there is a variable degree of fat resorption over time. Preadipocytes isolated from harvested fat are better able to withstand the mechanical trauma from the suction cannula and subsequently may result in improved cell survival and generation of new fat tissue after transfer to another anatomic site.

Immunologic approaches to composite tissue allograft.

This article discusses the immunologic principles and the most promising immunologic approaches for composite tissue allograft tolerance. We have previously reviewed some of the pharmacologic approaches for composite tissue allo-transplantation. In this review, we will summarize the range of options that may address the challenge of transplantation in reconstructive surgery.

Postoperative video debriefing reduces technical errors in laparoscopic surgery.

Background: Because of the learning curve required to master laparoscopic procedures, there is a growing concern that patient safety may be compromised due to technical errors by a novice surgeon. We evaluated the effect of videotape debriefing on the performance of a complex laparoscopic procedure.

Methods: Twenty-four surgical residents performed a laparoscopic jejunojejunal anastomosis under the supervision of a single laparoscopic surgeon.

Comparison of biodegradable conduits within aged rat sciatic nerve defects.

Background: Considering that little is known about the peripheral nerve regenerative capacity of elderly patients, the authors studied nerve regenerative capacity in aged rats and compared the effect of three synthetic nerve guides with different material characteristics and porosity. The authors hypothesized that the use of a biodegradable composite nerve guide (CultiGuides) would promote nerve regeneration and functional recovery in a manner similar to treatment with autografts or U.S.

Pharmacologic approaches to composite tissue allograft.

This article discusses the pharmacologic approaches and the most promising new compounds for composite tissue allograft tolerance. Although some approaches rely on a combination of immunosuppressive agents that act synergistically against rejection, other strategies use immunologic manipulation, including major histocompatibility complex matching, induction of chimerism, and use of monoclonal antibodies to abrogate the immune response. There is still a need, however, to reproduce these findings in species phylogenetically closer to humans.

A novel perfluoroelastomer seeded with adipose-derived stem cells for soft-tissue repair.

Background: There is a need for engineered soft tissue in reconstructive surgery, particularly after tumor removal. An ideal implant that will provide structural support and a favorable environment for growing cells is a key element in the process of tissue engineering. Nonbiodegradable materials that become well incorporated within the new tissue are a good solution, but many such materials do not have a surface favorable for cell adherence and proliferation.

Monitoring skeletal muscle and subcutaneous tissue acid-base status and oxygenation during hemorrhagic shock and resuscitation.

Gastric tonometry correlates with the severity of blood loss during shock. However, tonometry is cumbersome, has a slow response time, and is not practical to apply in the acute resuscitation setting. We hypothesized that subcutaneous tissue (SC) and skeletal muscle (SM) pH, pCO2, and pO2 changes are comparable with changes seen in bowel tonometry during shock and resuscitation.

Bladder mucosa pH and Pco2 as a minimally invasive monitor of hemorrhagic shock and resuscitation.

Background: Continuous monitoring of pH, Pco2, and Po2 using fiberoptic sensor technology has been proposed recently as a clinical monitor of the severity of shock and impaired tissue perfusion. Surrogates of gut tissue perfusion such as gastric tonometry, although cumbersome, have been used to indirectly quantify the degree of gut ischemia. The purpose of this study was to demonstrate the feasibility of monitoring bladder mucosa (BM) and to compare urinary bladder mucosa and proximal jejunum mucosa interstitial pH and Pco2 during hemorrhagic shock and resuscitation.