Geospatial Inefficiencies Associated With Digital Replantations at High-Volume Centers and Optimal Allocation Model for Centralization of Replantations.

Purpose: Digit replantation can improve dexterity, functionality, patient satisfaction, and pain following amputation, but rates continue to fall nationally. This study aimed to describe the effects of travel time and distance as barriers to high-volume hospitals, identify geospatial inefficiencies in the presentation of patients to replantation care, and provide an optimal allocation model in which cases are redistributed to select centers to reduce geospatial redundancies and optimize outcomes.

Methods: We reviewed the California Office of Statewide Health Planning and Development hospital discharge database to identify cases of digital amputation and determine outcomes of replantation.

Panniculectomy: Practical Pearls and Pitfalls.

Panniculectomy is an increasingly common operation, given the current obesity epidemic and the increasing prevalence of bariatric surgery. At first glance, it could be considered a technically simple operation; however, this procedure can be fraught with complications, given the patient population and high demands placed on compromised abdominal tissue. Sufficient attention must be given to the nuances of patient optimization and surgical planning to maximize safe and ideal outcomes.

Acellular Dermal Matrices: Applications in Plastic Surgery.

Modern advances in tissue engineering have transformed the plastic surgeon's management strategies across a wide variety of applications. Comprehension of the fundamentals of biologic constructs is critical to navigating the available armamentarium. It is essential that plastic surgeons become familiar with some of the existing methods for utilizing biologics as well as the advantages and limitations to their use.

Smoking may be a harbinger of early failure with ultraporous metal acetabular reconstruction.

Background: Smoking is considered a risk factor for surgical complications in total hip arthroplasty (THA) and has been linked to a higher rate of aseptic loosening in uncemented acetabular components. Acetabular reconstruction with newer ultraporous metals in both complex primary and revision THA has increased survivorship but it is unclear whether smoking affects survival of these implants.

Questions/purposes: We reviewed our early experience with THA using ultraporous acetabular components to assess the incidence and etiology of early failure and examine if any preoperative variables, including smoking, related to failure.