A Mobile Craniofacial Surgery Unit: Reconstructing Casualties of War in Ukraine.

This paper describes the development and implementation of a mobile craniofacial surgical unit designed to address complex posttraumatic craniofacial deformities in both civilian and military casualties resulting from Russia's invasion of Ukraine. Restricted air space, limited possibilities for transportation of personnel and equipment, frequent interruption of power and water supply, and constant threat of injury to patients and medical personnel from missile and drone strikes, precludes reliable and safe delivery of tertiary care. The Canada Ukraine Surgical Aid Program (CUSAP) addressed these challenges by establishing a mobile craniofacial surgery unit, operating just outside of the war zone.

Fat Necrosis in Single Perforator Deep Inferior Epigastric Artery and Superficial Epigastric Artery Perforator Free Flaps: A Prospective Randomized Study.

Background: The deep inferior epigastric perforator (DIEP) flap is the standard of care in autologous breast reconstruction. The superficial inferior epigastric artery perforator flap (SIEA) is an alternative reconstructive option, with the compromise of less donor-site morbidity but variable perfusion to subscarpal fat zones. Fat necrosis is a known complication from marginal perfusion variability.

Arterialization of the Venous System for Acute and Chronic Ischemia of the Hand: A Case Series With Prospective Duplex Ultrasound Assessment.

Ischemia of the hand is a debilitating condition. In many cases, the cause of ischemia is diffuse atherosclerosis with no distal vessels available for bypass. In these situations, options are limited to restore perfusion, and there is a potential role for arterialization of the venous system to relieve ischemic pain and avoid amputation.

Timing of Postmastectomy Reconstruction Does Not Impair Breast Cancer-Specific Survival: A Population-Based Study.

Background: Debate remains over the optimal timing of breast reconstruction after mastectomy. Immediate reconstruction has demonstrated superior psychosocial and aesthetic outcomes, but might delay adjuvant therapy. Conversely, delayed reconstruction allows for timely initiation of adjuvant therapy, but with potentially inferior aesthetic results.

Accuracy of medical models made by consumer-grade fused deposition modelling printers.

Background: Additive manufacturing using fused deposition modelling (FDM) has become widely available with the development of consumer-grade three-dimensional printers. To be useful in maxillofacial surgery, models created by these printers must accurately reproduce the craniofacial skeleton.

Objective: To determine the accuracy of consumer-grade FDM printers in the production of medical models compared with industrial selective laser sintering (SLS) printers.

Amyotrophic lateral sclerosis presenting as upper limb weakness in a 35 year old female: a case report.

Chiropractors regularly assess and provide treatment for a variety of neuromuscular complaints. Many of these respond well to conservative care however some represent conditions that must be referred for further evaluation. This article chronicles the management of a patient who presented with upper limb weakness and was subsequently diagnosed with amyotrophic lateral sclerosis (ALS).

Practice profiles in breast reduction: a survey among Canadian plastic surgeons.

Background: Breast reduction is an increasingly common procedure performed by Canadian plastic surgeons. Recent studies in the United States show that use of the inferior/central pedicle inverted T scar method is predominant. However, it is unknown what the practice preferences are among Canadian plastic surgeons.

Immediate postmastectomy reconstruction is associated with improved breast cancer-specific survival: evidence and new challenges from the Surveillance, Epidemiology, and End Results database.

Background: Although immediate breast reconstruction is increasingly offered as part of postmastectomy psychosocial rehabilitation, concerns remain that it may delay adjuvant therapy or impair detection of local recurrence. No single population-based study has examined the relationship between immediate breast reconstruction and breast cancer-specific survival.

Methods: By using data from the US National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) registries, breast cancer-specific survival was compared for female unilateral mastectomy patients who did or did not undergo immediate breast reconstruction.

Barriers to breast reconstruction after mastectomy in Nova Scotia.

Background: Breast reconstruction after mastectomy is associated with social, psychological and physical benefits. Barriers to breast reconstruction in the United States include age, stage of disease, socioeconomic status and geographic location; however, little is known about the effects of these factors in the Canadian context of a universal health care system. We sought to determine the rate of breast reconstruction in Nova Scotia, identify characteristics influencing access to the procedure and describe the rates of different reconstructive options.

MOC-PSSM CME article: Breast reconstruction.

Learning Objectives: After studying this article, the participant should be able to: 1. Understand the various techniques available to reconstructive breast surgeons. 2.

Validation of a questionnaire for measuring morbidity in breast hypertrophy.

Background: There is a growing body of evidence suggesting that body mass index and predicted breast resection weight may not be appropriate criteria for determining insurance eligibility for breast reduction surgery. Eligibility should ideally be based on need. However, no method for determining need in patients seeking reduction surgery currently exists.

Symptoms and related severity experienced by women with breast hypertrophy.

Background: Breast hypertrophy is a common condition that can be associated with significant morbidity. Symptoms emphasized in the literature include physical problems such as pain, intertrigo, and exercise restrictions. The purpose of this study was to explore the suffering experienced by women with breast hypertrophy and to evaluate the importance of different symptoms.

Breast volume determination in breast hypertrophy: an accurate method using two anthropomorphic measurements.

Background: Precise determination of breast volume facilitates reconstructive procedures and helps in the planning of tissue removal for breast reduction surgery. Various methods currently used to measure breast size are limited by technical drawbacks and unreliable volume determinations. The purpose of this study was to develop a formula to predict breast volume based on straightforward anthropomorphic measurements.

Textured surface breast implants in the prevention of capsular contracture among breast augmentation patients: a meta-analysis of randomized controlled trials.

Background: Capsular contracture is a common complication associated with the use of breast implants. Numerous randomized controlled trials addressing the efficacy of textured surface breast implants in reducing capsular contracture have yielded nonuniform results. This meta-analysis addresses the use of textured breast implants in the prevention of capsular contracture.

Prospective study of outcomes after reduction mammaplasty.

Background: The purpose of this study was to prospectively assess changes in overall health-related quality of life and breast-related symptoms in women undergoing reduction mammaplasty, and to compare preoperative and postoperative health-related quality of life with that of the normal population.

Methods: Fifty-six patients were evaluated preoperatively and 6 months postoperatively with three questionnaires: the Short Form-36 Health Survey, the Symptom Inventory Questionnaire, and the Rosenberg Self-Esteem Scale. Surgeons completed preoperative patient assessment forms, operative note forms, and postoperative patient assessment forms.

Endoscopic harvest of four muscle flaps: safe and effective techniques.

The recent explosion of endoscopic techniques in plastic surgery has led to the successful harvest of a number of useful muscle flaps. The gracilis, rectus femoris, external oblique, and gastrocnemius muscles can all be harvested safely and reproducibly using endoscopic techniques. The aim of this study was to identify a safe and effective technique for endoscopic muscle flap harvest.