Contemporary Trends in Reconstruction for Patients With Sarcoma of the Breast.

Introduction: Breast sarcomas are rare, heterogeneous malignancies often associated with prior radiation and require a multidisciplinary approach, including a comprehensive reconstruction plan. We analyzed reconstructive outcomes in a large cohort of patients with breast sarcomas and provide a contemporary treatment algorithm.

Methods: We retrospectively reviewed patients who underwent breast reconstruction after surgical treatment for breast sarcoma at our institution between January 2010 and December 2023.

Remote Incisions as an Alternative to Mastectomy Scars for Breast Tissue Expander-to-Implant Exchange: A Propensity Score-Matched Analysis.

Background: Two-stage prosthetic breast reconstruction involves the exchange of tissue expanders for implants, but complications of this procedure can necessitate revision surgeries and implant removal. The choice between remote incision (RI) and traditional access via existing mastectomy scars (MS) for this exchange remains underexplored. RIs offer potential benefits by placing the incision at a region of higher quality tissue, prompting our comparative analysis of complications between RI and MS.

Surgical and Ophthalmologic Outcomes of Reconstruction in Patients Treated With Eye-Sparing Surgery and Radiation Therapy for Tumors of the Lacrimal Drainage Apparatus.

Introduction: Tumors involving the lacrimal drainage apparatus can be effectively treated with oncologic eye-sparing resection, immediate reconstruction, and adjuvant radiation. The extirpative technique is well described, whereas the reconstructive approach and outcomes are limited and largely anecdotal. The present study describes the largest series in the literature evaluating outcomes after reconstruction after globe-preserving oncologic resection.

Fenestration Improves Acellular Dermal Matrix Biointegration: An Investigation of Revascularization with Photoacoustic Microscopy.

Background: Acellular dermal matrices have revolutionized alloplastic breast reconstruction. Furthering our knowledge of their biointegration will allow for improved design of these biomaterials. The ideal acellular dermal matrix for breast reconstruction would provide durable soft-tissue augmentation while undergoing rapid biointegration to promote physiologic elasticity and reduced infectious complications.

Third Molar Eruption and Hardware Fungal Infection Following Treatment of Mandibular Angle Fracture.

Appropriate management of lower 3rd molars is crucial to successful treatment of mandibular angle fractures. A unique case of a patient who presented for initial management of a left mandibular angle fracture with an unerupted lower 3rd molar was discussed in this study. After treatment with open reduction and internal fixation of the fracture, the lower 3rd molar erupted and the patient subsequently developed fungal osteomyelitis and hardware failure.

Effects of Collagenase Digestion and Stromal Vascular Fraction Supplementation on Volume Retention of Fat Grafts.

Objective: The use of autologous fat as a soft tissue filler has increased over the past decade in both reconstructive and aesthetic surgeries. Enhancement of autologous fat grafts with the addition of the stromal vascular fraction (SVF) has been reported to improve long-term volume retention. Stromal vascular fraction is most commonly isolated using enzymatic digestion, but it is unknown what effect the digestion process has on the adipocytes and SVF cells that comprise the graft.

Abdominal Wall Allograft: Preclinical Biomechanical Investigation of a Novel Reconstructive Adjunct.

Introduction: Acellular dermal matrices have revolutionized abdominal wall reconstruction; however, device failure and hernia recurrence remain significant problems. Fascia grafts are a reconstructive adjunct with increased tensile strength compared with acellular dermal matrices; however, clinical use is limited by insufficient donor material and donor site morbidity. To this end, we investigate the biomechanical properties of human abdominal wall allografts (AWAs) consisting of the anterior rectus sheath from xiphoid to pubis.

Tissue Monitoring with Three-Wavelength Light Emitting Diode-Based Near-Infrared Spectroscopy.

 Flap monitoring with near-infrared spectroscopy (NIRS) facilitates early detection of vascular compromise. However, standard NIRS devices that employ two wavelengths of light to assess tissue oxygenation (StO) are susceptible to artifact from background noise and demonstrate significant variability in the clinical setting. As the number of wavelengths detected by a NIRS device is increased, the precision of StO measurements can be improved and additional chromophores other than oxyhemoglobin and deoxyhemoglobin can be measured.

Evaluation of Sidestream Darkfield Microscopy for Real-Time Imaging Acellular Dermal Matrix Revascularization.

Background: Acellular dermal matrices (ADMs) serve as a regenerative framework for host cell integration and collagen deposition to augment the soft tissue envelope in ADM-assisted breast reconstruction-a process dependent on vascular ingrowth. To date noninvasive intra-operative imaging techniques have been inadequate to evaluate the revascularization of ADM.

Methods: We investigated the safety, feasibility, and efficacy of sidestream darkfield (SDF) microscopy to assess the status of ADM microvascular architecture in 8 patients at the time of tissue expander to permanent implant exchange during 2-stage ADM-assisted breast reconstruction.

Posttraumatic Midface Pain: Clinical Significance of the Anterior Superior Alveolar Nerve and Canalis Sinuosus.

Background: Posttraumatic midface pain secondary to injury of the anterior superior alveolar nerve (ASAN) is characterized as pain localized to the central and lateral incisors, canines, and maxilla. This nerve is susceptible to injury and subsequent formation of neuromas after midface trauma. Surgical intervention requires an accurate and precise understanding of the course of the ASAN.

CASE REPORT Complex Wound Closure of Partial Sacrectomy Defect With Human Acellular Dermal Matrix and Bilateral V to Y Gluteal Advancement Flaps in a Pediatric Patient.

Objective: Sacrectomy creates a large, complex tissue defect that presents a reconstructive challenge for plastic surgeons. Several myocutaneous flaps have been described for reconstruction following sacral tumor extirpation; however, current publications focus on the reconstructive options applicable to adults. We present a method of reconstruction following sacral tumor extirpation in a pediatric patient.

Short-term application of doxorubicin chemotherapy immunosuppressive side effects for composite tissue allotransplantation.

Background: Adjuvant chemotherapy is often required for the treatment of bone cancers after tumor resection, which often results in a large continuity defect. The immunosuppressive side effects could instead be exploited to allow immediate reconstruction with a composite tissue allograft (CTA) that would provide for replacement of tissues. We used a short course of doxorubicin to achieve a novel method of immunosuppression in a rat model undergoing CTA to create an immunological environment for allograft survival.

Temporal frequency channels are linked across audition and touch.

Temporal frequency is a fundamental sensory dimension in audition and touch. In audition, analysis of temporal frequency is necessary for speech and music perception; in touch, the spectral analysis of vibratory signals has been implicated in texture perception and in sensing the environment through tools. Environmental oscillations impinging upon the ear are generally thought to be processed independently of oscillations impinging upon the skin.

Abdominal rescue after entrapment of the aftercoming head.

Entrapment of the aftercoming head during breech delivery is generally perceived as a complication that must be resolved by a vaginal extraction procedure. The successful rescue by classical cesarean section described in this report was performed for entrapment of the deflexed fetal head following delivery of the body and the arms.