Bupivacaine Extended-Release Liposomal Injection Versus Bupivacaine HCl for Early Postoperative Pain Control Following Wrist Operations: A Prospective, Randomized Control Trial.

Purpose: This study evaluated pain control after wrist operations using a long-acting local anesthetic, liposomal bupivacaine, compared with the standard local anesthetic, bupivacaine HCl.

Methods: Patients undergoing elective carpometacarpal joint arthroplasty and proximal row carpectomy were eligible. Those meeting inclusion criteria were enrolled before surgery and were randomized to receive an intraoperative injection of liposomal bupivacaine or bupivacaine HCl.

Antimicrobial Irrigation and Technique during Breast Augmentation: Survey of Current Practice.

Unlabelled: Breast augmentation is among the most common procedures performed in the United States. Though bacterial contamination of breast prostheses is associated with adverse sequelae, there are no universally accepted guidelines and limited best practice recommendations for antimicrobial breast pocket irrigation. We designed a survey to identify pocket irrigation preferences and antimicrobial techniques during implant-based breast augmentation among American Society of Plastic Surgeons (ASPS) members.

Flexor Tenosynovectomy for Recurrent Carpal Tunnel Syndrome: A Retrospective Case Series of 108 Hands.

The etiology of recurrent carpal tunnel syndrome (CTS) is unclear, and outcomes following secondary surgery in this demographic have been poorer than primary surgery. Fibrosis and hypertrophy have been identified in the flexor tenosynovium in these patients. The authors use flexor tenosynovectomy (FTS) for recurrent CTS after primary carpal tunnel release and present a review of these patients.

Pocket Irrigation and Technique During Reconstructive Surgery: An American Society of Plastic Surgery Survey of Current Practice.

Background: Expander-to-implant is the most common breast reconstruction procedure in the United States. Irrigation with triple antibiotic solution (TAS), as described by Adams et al in 2006, has become standard of care to lower bacterial bioburden. However, several alternative solutions have been implemented with the literature lacking a consensus regarding use (Plast Reconstr Surg.

Passot-Type Immediate Breast Reconstruction Obviates the Use of Aceullular Dermal Matrix in Grades 2 and 3 Ptosis.

Purpose: Acellular dermal matrices (ADMs) are commonly used for immediate breast reconstruction after skin-sparing mastectomy (SSM). Regnault grades 2 and 3 ptotic breasts feature significant mastectomy flap redundancy that may be incorporated into the reconstruction. This allows surgeons to use patients' de-epithelialized inferior dermal pedicle instead of ADM.

Vertical Inset of the Latissimus Dorsi Flap Improves Reconstruction Aesthetics by Reducing Scar Burden in the "Social Breast".

Purpose: The skin paddle of the latissimus dorsi flap is typically inset horizontally (HILD) in breast reconstruction. We describe our experience with the vertical inset of the latissimus dorsi (VILD) and its aesthetic benefit.

Methods: We performed a case-control study comparing the most recent cases of both VILD and HILD.

Progressive Surgical Autonomy Observed in a Hand Surgery Resident Clinic Model.

Objective: Resident clinics (RCs) are intended to catalyze the achievement of educational milestones through progressively autonomous patient care. However, few studies quantify their effect on competency-based surgical education, and no previous publications focus on hand surgery RCs (HRCs). We demonstrate the achievement of progressive surgical autonomy in an HRC model.

Barbed Ribbon Device for Progressive Tension Closure Reduces Seroma After Breast Reconstruction.

Purpose: Implant-based breast reconstruction is fraught with complications related to seroma formation. Soft tissue stabilization with progressive tension closure (PTC) has been shown to decrease seroma formation after various procedures but is less suitable for mastectomy flap stabilization. We evaluate the incidence of seroma in breast reconstruction using bioabsorbable barbed ribbon devices (BRDs) as a novel approach to PTC.

Progressive Surgical Autonomy in a Plastic Surgery Resident Clinic.

Background: Resident clinics are thought to catalyze educational milestone achievement through opportunities for progressively autonomous surgical care, but studies are lacking for general plastic surgery resident clinics (PSRCs). We demonstrate the achievement of increased surgical autonomy and continuity of care in a PSRC.

Methods: A retrospective review of all patients seen in a PSRC from October 1, 2010, to October 1, 2015, was conducted.

Autologous Fat Grafting to the Breast Using REVOLVE System to Reduce Clinical Costs.

Background: With the increasing popularity of fat grafting over the past decade, the techniques for harvest, processing and preparation, and transfer of the fat cells have evolved to improve efficiency and consistency. The REVOLVE System is a fat processing device used in autologous fat grafting which eliminates much of the specialized equipment as well as the labor intensive and time consuming efforts of the original Coleman technique of fat processing. This retrospective study evaluates the economics of fat grafting, comparing traditional Coleman processing to the REVOLVE System.

The Present Status of Global Mission Trips in Plastic Surgery Residency Programs.

Objective: The present status of global mission trips of all of the academic Plastic Surgery programs was surveyed. We aimed to provide information and guidelines for other interested programs on creating a global health elective in compliance with American Board of Plastic Surgery (ABPS) and Accreditation Council for Graduate Medical Education Residency Review Committee (ACGME/RRC) requirements.

Design: A free-response survey was sent to all of the Plastic Surgery Residency program directors inquiring about their present policy on international mission trips for residents and faculty.

The Effect of Progressive-Tension Closure on Donor Site Seroma Formation in Delayed Latissimus Dorsi Flaps for Breast Reconstruction.

Background: Autologous tissue flaps play an integral part in breast reconstruction. The latissimus dorsi myocutaneous flap is an effective and aesthetic method of immediate breast reconstruction, although a high rate of donor site seroma formation has plagued this procedure. Many techniques to reduce donor site seromas have been undertaken.

Impact of liposome bupivacaine on the adequacy of pain management and patient experiences following aesthetic surgery: Results from an observational study.

Background: Despite the efficacy of opioid analgesics for postsurgical pain, they are associated with side effects that may complicate recovery. Liposome bupivacaine is a prolonged-release formulation of bupivacaine approved for intraoperative administration at the surgical site for postsurgical analgesia.

Objectives: To evaluate the effect of a single intraoperative administration of liposome bupivacaine on postsurgical pain, opioid use and opioid-related side effects in subjects undergoing breast surgery and/or abdominoplasty.

Silicone breast implants can save lives.

The authors present a case in which a patient sustained 2 shotgun wounds at close range, resulting in a ruptured silicone breast implant and no other injuries.

Circumvertical mastectomy incision: refinement in the surgical scar of implant-based breast reconstruction.

Different surgical incisions have been proposed for skin-sparing mastectomy in an attempt to better disguise the remaining scar. These techniques are more hidden than the Stewart incision but can still leave scars in visible places and can restrict the natural shape of the upper pole. They can also add complexity and time to the mastectomy, requiring extensive retraction that could damage the salvaged skin flaps to perform an adequate mastectomy.

Classification and management of seromas in immediate breast reconstruction using the tissue expander and acellular dermal matrix technique.

Tissue expander (TE)/acellular dermal matrix (ADM)-based breast reconstruction used in immediate postmastectomy breast reconstruction, although a popular technique, is not without complications.Although seroma formation is recognized and reported in the literature as a complication, little information addresses seroma(s) management. We conducted a retrospective review of 100 consecutive TE/ADM immediate reconstructions during a 2-year period, performed by a single surgeon.

Infrared surface temperature monitoring in the postoperative management of free tissue transfers.

Background: Early identification of failing free flaps may allow for potential intervention and flap salvage. The predictive ability of flap temperature monitoring has been previously questioned. The present study investigated the ability of an infrared surface temperature monitoring device to detect trends in flap temperature and correlation with anastomotic thrombosis and flap failure.

Giant basal cell carcinoma surgical management and reconstructive challenges.

Basal cell carcinoma is exceedingly common, but tumors >5 cm in size or giant basal cell carcinomas (GBCCs) are rare. We retrospectively review 10 GBCCs in 8 patients treated by aggressive surgical excision and reconstruction in a single operative procedure. With the exception of 1 chest lesion, all GBCCs involved the face or scalp.