Propeller Flap Reconstruction Following Pilonidal Cyst Excision: A Single-Center Experience With Same-Day Discharge.

Introduction: Reconstruction following pilonidal cyst resection must balance risk of recurrence, healing time, and resumption of functional routine. Propeller flaps provide a reliable and effective reconstructive option. This study highlights our experience with propeller flap reconstruction following pilonidal cyst resection and demonstrates the efficacy of same-day discharge.

Can Mentorship Shatter the Glass Ceiling in Academic Microsurgery? A National Survey of Microsurgery Fellowship-Trained Women.

Background: The "leaky pipeline" phenomenon has caused women to remain underrepresented at higher levels of academic plastic surgery. No study has considered the availability of mentorship within any subset of academic plastic surgery. The purpose of this study was to evaluate the current representation of women in academic microsurgery and to determine the impact of mentorship on career progression.

Evaluating the Role of Mentorship in Career Advancement: A Survey of Women in Academic Hand Surgery.

Purpose: Despite the increasing percentage of women within the American Society for Surgery of the Hand, women remain underrepresented within leadership in academic hand surgery. Although this disparity in leadership representation may be improving, we aimed to investigate the role mentorship plays in advancing women in academic hand surgery.

Methods: This is a survey-based, mixed-methods study.

Modern Approaches to Pedicled Latissimus Dorsi Flap Breast Reconstruction with Immediate Fat Transfer.

The latissimus dorsi flap with immediate fat transfer is a viable option for fully autologous breast reconstruction in patients who are not candidates for free flap reconstruction. Technical modifications described in this article allow for high-volume and efficient fat grafting at the time of reconstruction to augment the flap and mitigate complications associated with the use of an implant.

Direct-to-Implant versus Immediate Free Flap Reconstruction after Nipple-Sparing Mastectomy: A Propensity Score-Matched Analysis.

Background: Both direct-to-implant (DTI) and immediate free flap (FF) breast reconstruction following nipple-sparing mastectomy (NSM) have been described in the literature. However, there is a paucity of comparative studies between these two techniques. Furthermore, existing studies do not control for factors influencing ischemic complications.

A Look Back: A Single Surgeon's Experience Using Virtual Surgical Planning in Adult Orthognathic Surgery.

The evolution of virtual surgical planning (VSP) in the last 2 decades has led to improved precision and efficiency for orthognathic surgery, both pre- and intraoperatively. This study evaluates a single surgeon's experience with this technology over the past 6 years. Patients undergoing orthognathic surgery using VSP with the senior author between 2015 and 2021 were retrospectively reviewed.

Saphenous Vein Interposition Grafts in Lower Extremity Reconstruction: Appraisal of Technique and Case Series.

Vascular microanastomosis is technically challenging in patients with calcified recipient and donor vessels. Inside-to-outside suturing can prevent plaque rupture and ensure full-thickness intimal approximation. Although this is the preferred technique for anastomosis of atherosclerotic vessels, direct connection of calcified arteries necessitates outside-to-inside suturing on one side of the anastomosis.

Patient-Centred Outcomes Following Open Carpal Tunnel Release: A Systematic Review of the Current Literature.

Patients' individual interpretations of their own health outcomes are becoming increasingly important metrics in defining clinical success across all specialties, especially in hand surgery. However, there is a relative paucity of data using validated health-related quality of life (HR-QoL) assessments for carpal tunnel release (CTR). The purpose of this study was to review published outcomes on traditional open CTR to formally assess the current need for more accurate, validated assessment tools to evaluate CTR-specific HR-QoL.

Expanding Criteria for Limb Salvage in Comorbid Patients with Nonhealing Wounds: The MedStar Georgetown Protocol and Lessons Learned after 200 Lower Extremity Free Flaps.

Background: Lower extremity salvage in the setting of nonhealing wounds requires a multidisciplinary approach for successful free tissue transfer. Patients with comorbidities including diabetes mellitus and peripheral vascular disease were previously considered poor candidates for free tissue transfer. However, amputation leads to functional decline and severely increased mortality.

Are US Plastic Surgery Residents Equipped to Face the Opioid Epidemic? A National Survey.

The United States opioid epidemic is among this century's most profound threats to public health and demands that all physicians consider their role in reversing its trajectory. Previous literature demonstrated that plastic surgery trainees lack vital practices that promote opioid stewardship. However, it is not understood why this practice gap exists.

Intraoperative Utility of the Implantable Doppler in Lower Extremity Reconstruction: A Matched Case-control Study.

Unlabelled: Patients with diabetes mellitus and peripheral vascular disease have high rates of thrombogenic vessels. The implantable (Cook) Doppler in lower extremity reconstruction can optimize microsurgical outcomes in this population.

Methods: Patients undergoing lower extremity free flap reconstruction who did not have an implantable Doppler probe placed were matched with patients who received an implantable Doppler probe.

Melting the Plastic Ceiling: Where We Currently Stand on Measures to Support Women in Academic Plastic Surgery.

Background: Previous studies have provided recommendations for increasing female leadership in academic plastic surgery. This study quantifies the extent to which these recommendations have been met in plastic surgery residency programs and identifies remaining institutional barriers to the advancement of women in academic plastic surgery.

Methods: An electronic survey was designed to quantify select recommendations for promoting female leadership in academic plastic surgery.

Perforator Variability of the Anterolateral Thigh Flap Identified on Computed Tomographic Angiography: Anatomic and Clinical Implications.

Background:  The anterolateral thigh (ALT) flap is a useful flap with minimal donor site morbidity. Preoperative computed tomographic angiography (CTA) for lower extremity reconstruction can determine vessel integrity and plan for recipient vascular targets. This study reviews lower extremity CTAs to further characterize ALT vascular anatomy and associated clinical implications thereof.

Free Tissue Transfer with Distraction Osteogenesis and Masquelet Technique Is Effective for Limb Salvage in Patients with Gustilo Type IIIB Open Fractures.

Osteocutaneous reconstruction can be challenging because of concomitant injuries and limited donor sites. There is a paucity of data on limb salvage outcomes following combined soft-tissue reconstruction and bone transport or Masquelet procedures. The authors reviewed a consecutive series of open tibia fracture patients undergoing soft-tissue reconstruction with either distraction osteogenesis or Masquelet technique.

Transversus Abdominis Plane Blocks in Microsurgical Breast Reconstruction: A Systematic Review and Meta-analysis.

Background:  Transversus abdominis plane (TAP) blocks have been shown to significantly reduce pain and narcotic consumption following major abdominal surgeries. This study investigates the literature on their use in microsurgical breast reconstruction.

Patients And Methods:  A systematic review of TAP blocks in autologous breast reconstruction was performed.

Larger free flap size is associated with increased complications in lower extremity trauma reconstruction.

Background: Free flap reconstruction after lower extremity trauma remains challenging with various factors affecting overall success. Increasing defect and flap size have been demonstrated to be a surrogate for overall injury severity and correlated with complications. In addition, larger free flaps that encompass more tissue theoretically possess high metabolic demand, and may be more susceptible to ischemic insult.

Revisiting the Reverse Sural Artery Flap in Distal Lower Extremity Reconstruction: A Systematic Review and Risk Analysis.

Background: The reverse sural artery flap (RSAF) is a popular option for patients with distal lower extremity defects who are not ideal candidates for free flap reconstruction. This is the first systematic review and pooled analysis of surgical characteristics, risk factors, and outcomes of the RSAF.

Methods: A systematic literature review was conducted.

Noninvasive Monitoring of Allograft Rejection Using a Novel Epidermal Sampling Technique.

Despite promising short- and long-term results to date in vascularized composite allotransplantation (VCA), acute rejection remains the most common major complication in recipients. Currently, diagnosis of acute rejection relies on clinical inspection correlated with histopathological analysis. However, disagreement exists regarding the value of full-thickness skin and mucosal biopsies and histopathology remains semiquantitative, subject to sampling bias, and prone to intra- and inter-observer variabilities.

Reconstruction of Gustilo Type IIIC Injuries of the Lower Extremity.

Background: Gustilo type IIIC open tibia fractures are characterized by an ischemic limb requiring immediate arterial repair. In this patient population, the decision between primary amputation and limb salvage can be challenging. This study aims to evaluate the reconstructive outcomes of patients with Gustilo type IIIC injuries.

Comparing Outcomes for Fasciocutaneous versus Muscle Flaps in Foot and Ankle Free Flap Reconstruction.

Background:  The distal lower extremity poses unique reconstructive challenges due to its requirements for durability of the load-bearing plantar surface and for thin, pliable contour in the dorsal foot and ankle region. This study compares outcomes between muscle and fasciocutaneous flaps in patients with foot and ankle defects.

Methods:  A retrospective review of soft tissue free flaps used for traumatic foot and ankle defects was performed.

Is There a Preferred Incision Location for Nipple-Sparing Mastectomy? A Systematic Review and Meta-Analysis.

Background: The incidence of nipple-sparing mastectomy is rising, but no single incision type has been proven to be superior. This study systematically evaluated the rate and efficacy of various nipple-sparing mastectomy incision locations, focusing on nipple-areola complex necrosis and reconstructive method.

Methods: A systematic literature review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines identifying studies on nipple-sparing mastectomy where incision type was described.