Efficacy of Acellular Dermal Matrix Type in Treatment of Capsular Contracture in Breast Augmentation: A Systematic Review and Meta-Analysis.

Background: Capsular contracture is a known complication of breast augmentation and is among the top reasons for revisional breast augmentation procedures. The use of acellular dermal matrix (ADM) has been shown to reduce the rate of capsular contracture in breast reconstruction and augmentation, theorizing that it acts as a protective barrier between the implant capsule and inflammatory process responsible for capsular contracture. The role of ADM in treatment of capsular contracture has been investigated in numerous studies, with a variety of ADMs.

Intraoperative Optical and Fluorescence Imaging of Blood Flow Distributions in Mastectomy Skin Flaps for Identifying Ischemic Tissues.

Summary: Insufficient blood flow causes mastectomy skin flap necrosis in 5 to 30 percent of cases. Fluorescence angiography with the injection of indocyanine green dye has shown high sensitivities (90 to 100 percent) but moderate specificities (72 to 50 percent) in predicting mastectomy skin flap necrosis. However, a number of challenging issues limit its wide acceptance in clinical settings, including allergic reaction, short time-window for observation, and high cost for equipment and supplies.

Parenting in Plastic Surgery Residency.

Background: In 1994, Mackinnon advocated that plastic surgery residents should have accessible child care to promote a productive return to work. Decades later, lack of adequate child care remains a dilemma for trainees. The authors' survey aims to evaluate childrearing during plastic surgery training.

Generation of reproductively mature offspring from the endangered green and golden bell frog using cryopreserved spermatozoa.

Amphibians are becoming increasingly reliant on captive breeding programs for continued survival. Assisted reproductive technologies including gamete cryopreservation and IVF can help reduce costs of breeding programs, provide insurance against extinction and assist genetic rescue in wild populations. However, the use of these technologies to produce reproductively mature offspring has only been demonstrated in a few non-model species.

Prepectoral Breast Reconstruction: A Fad or Here to Stay?

Prepectoral breast reconstruction has rapidly gained attention as a new technique for implant-based breast reconstruction. It is essentially a modernization of an old technique made possible by the use of marketable products, primarily dermal matrices and cohesive silicone gel implants. The rapid dissemination of its benefits, not only to physicians, but also to the general public and referring physicians, leading to widespread adoption, is in part due to a combination of marketing and social media/Internet influences.

Noncontact Speckle Contrast Diffuse Correlation Tomography of Blood Flow Distributions in Burn Wounds: A Preliminary Study.

Introduction: Tissue injuries are often associated with abnormal blood flow (BF). The ability to assess BF distributions in injured tissues enables objective evaluation of interventions and holds the potential to improve the acute management of these injuries on battlefield.

Materials And Methods: We have developed a novel speckle contrast diffuse correlation tomography (scDCT) system for noncontact 3D imaging of tissue BF distributions.

-Selective Synthesis and Coordination Chemistry of Pyridine-Phosphaalkenes: Five Ligands Produce Four Distinct Types of Ru(II) Complexes.

Pyridine-phosphaalkene (PN) ligands were prepared in an -selective fashion using phospha-Wittig methodology. Treatment of these five ligands, varying only in their 6-substituent with RuCl(PPh), produced four distinct types of coordination complexes: pyridine-phosphaalkene-derived , cyclized , and six-coordinate and . Prolonged heating of in THF resulted in C-H activation of the Mes* group and cyclization to give featuring a bidentate pyridine-phospholane ligand bound to the metal center.

Noncontact speckle contrast diffuse correlation tomography of blood flow distributions in tissues with arbitrary geometries.

A noncontact electron multiplying charge-coupled-device (EMCCD)-based speckle contrast diffuse correlation tomography (scDCT) technology has been recently developed in our laboratory, allowing for noninvasive three-dimensional measurement of tissue blood flow distributions. One major remaining constraint in the scDCT is the assumption of a semi-infinite tissue volume with a flat surface, which affects the image reconstruction accuracy for tissues with irregular geometries. An advanced photometric stereo technique (PST) was integrated into the scDCT system to obtain the surface geometry in real time for image reconstruction.

Microcystic Adnexal Carcinoma of the Nipple.

Background: Microcystic adnexal carcinoma (MAC) is a rare infiltrative cutaneous tumor, but with its locally aggressive nature, high rate of recurrence, and rare metastatic potential, it is an important clinical entity to consider when faced with a nipple lesion. These tumors are frequently misdiagnosed based on superficial biopsy alone.

Case Report: This case of a 15-year-old girl with MAC of the nipple demonstrates the importance of having a high index of suspicion in order to obtain a diagnosis, to determine the extent of disease, and to achieve adequate resection before reconstruction.

Massive Localized Lymphedema: Analysis of Intraoperative Care.

Massive localized lymphedema (MLL) is rare, but as the prevalence of obesity in adults rises, it can be foreseen that cases will increase in prevalence. These patients are unable to ambulate and have uncontrollable rash and skin breakdown. Operative management for MLL is offered when nonsurgical measures are ineffective.

Dermal Regenerative Template as a Cost-Effective Alternative for Complex Scalp Reconstruction.

Background: Use of dermal regeneration template (DRT) is well documented in the literature for complex wounds ranging from the scalp, trunk, and lower extremity.

Methods: A retrospective cohort study was performed of the use of dermal regeneration template and skin grafting. A literature review was performed of all studies where DRT was used for scalp reconstruction.

Prolonged Allograft Survival in a Patient With Chronic Immunosuppression: A Case Report and Systematic Review.

A 41-year-old man with past medical history of kidney-liver transplantation requiring chronic immunosuppression presented 2 years posttransplant with a necrotizing soft tissue infection of his right thigh. Serial debridement to remove necrotic tissue was performed, and a Matrix HD Allograft Fenestrated (RTI Surgical, Alachua, FL) was applied. At 5-months post grafting, the patient demonstrated fully vascularized and intact skin.

A Novel Noncontact Diffuse Correlation Spectroscopy Device for Assessing Blood Flow in Mastectomy Skin Flaps: A Prospective Study in Patients Undergoing Prosthesis-Based Reconstruction.

Unlabelled: A new advanced technology, noncontact diffuse correlation spectroscopy, has been recently developed for the measurement of tissue blood flow through analyzing the motions of red blood cells in deep tissues. This technology is portable, inexpensive, and noninvasive, and can measure up to 1.5-cm tissue depth.

Noncontact 3-D Speckle Contrast Diffuse Correlation Tomography of Tissue Blood Flow Distribution.

Recent advancements in near-infrared diffuse correlation techniques and instrumentation have opened the path for versatile deep tissue microvasculature blood flow imaging systems. Despite this progress there remains a need for a completely noncontact, noninvasive device with high translatability from small/testing (animal) to large/target (human) subjects with trivial application on both. Accordingly, we discuss our newly developed setup which meets this demand, termed noncontact speckle contrast diffuse correlation tomography (nc_scDCT).

Diabetic Mastopathy: A Systematic Review of Surgical Management of a Rare Breast Disease.

Diabetic mastopathy is a benign condition of the breast that typically manifests in patients with diabetes mellitus. Lymphocytic mastopathy is the term used to describe this condition in patients without diabetes mellitus. Most patients undergo excisional biopsy, but the use of mastectomy, even in cases of diffuse, bilateral disease, is rarely reported.

Nipple Pathology in Total Skin-Sparing Mastectomy: Implications for Immediate Reconstruction.

Purpose: The management of occult tumor involvement of the nipple during total skin-sparing mastectomy (TSSM) and immediate reconstruction is not well addressed in the literature. We reviewed our experience with positive nipple core biopsies, comparing outcomes of different management options.

Methods: Mastectomy and implant/expander reconstructions over a 5-year period were reviewed.

Detection of Biofilm in Wounds as an Early Indicator for Risk for Tissue Infection and Wound Chronicity.

Wounds are dynamic environments in which dead tissue, exudate, and the bacterial bioburden interact in a complex manner among themselves and with the tissue of the host. Bacteria organize into biofilms, reducing their susceptibility to elimination by the host immune response and antimicrobials. Early detection of biofilms in wounds is crucial to successful chronic wound management; and although many techniques have developed to identify planktonic counterparts in viable wounds, few have been able to quickly and accurately identify bacterial biofilms.

Intraoperative management of free flaps: current practice.

Objectives: Intraoperative management of hemodynamic instability during microvascular flap reconstruction is often based on anecdotal experience. Randomized controlled trials are difficult to perform when overall success rates are high. This study seeks to determine current practices for management of intraoperative hypotension during microsurgical free tissue transfer.

Oral rehydration solutions for burn management in the field and underdeveloped regions: a review.

Burn injuries are the fourth most common type of trauma worldwide, and the appropriate care of burn injuries in resource-limited settings such as the battlefield, underdeveloped nations, or in mass casualtiesremains a significant challenge. Rehydration constitutes the primary treatment of the systemic effects of burns and is a major factor in patient recovery. The standard of care for the replenishment of fluid and electrolyte losses in burn injury remains intravenous fluid therapy, but oral rehydration solution therapy (ORST) demonstrates beneficial utility in saving the lives of burn patients when they are applied in the acute phase of burn injuries, especially when intravenous rehydration is unavailable or inaccessible.

Comparison of sterile versus nonsterile acellular dermal matrices for breast reconstruction.

Background: Acellular dermal matrix (ADM) has been associated with an increased incidence of complications after implant-based breast reconstruction. Recently, sterile ADM has been introduced in an attempt to minimize these complications. To analyze the impact of this product on patient outcomes, we created a database of patients undergoing implant-based breast reconstruction.

Infectious complications associated with the use of acellular dermal matrix in implant-based bilateral breast reconstruction.

Background: The use of acellular dermal matrix (ADM) has become a routine practice in implant-based breast reconstruction. Bilateral mastectomy is becoming more popular in cases of unilateral breast cancer. ADM has been associated with an increased incidence of complications.

Risk factors for adverse outcome following skin-sparing mastectomy and immediate prosthetic reconstruction.

Background: Attempts to identify risk factors for adverse outcome following skin-sparing mastectomy and immediate prosthetic reconstruction have yielded inconsistent results, and no clear patient selection criteria have emerged. The authors identified patient- and procedure-related characteristics that predict unfavorable postoperative outcomes. Knowledge of these risk factors will facilitate preoperative patient screening to reduce the rate of implant loss and other postoperative complications.

Patient satisfaction after Nd:YAG laser-assisted lipolysis.

Laser-assisted lipoplasty has potential attractive advantages over traditional liposuction, though review of the literature reveals some variation in outcomes. The patient's perspective regarding the procedure and outcome is described from the results of a survey administered to sequential patients undergoing laser-assisted lipoplasty in an office setting. The average perception of reduction in size is 3.