The Hand Surgeon Consultation Improves Patient Knowledge in a Hand Surgery Mission to Honduras.

Background: The purpose of this study was to assess impact of the surgeon consultation and informed consent process on patient education in an international hand surgery mission compared with a US academic hand surgery practice. These two groups were selected to evaluate communication difficulties in a surgical mission setting compared with standard of care in a high-income country.

Methods: A multi-part survey was administered to patients presenting to a hand surgery mission during March 2012 and new patients of a university hand center in a 3-month period during 2011.

Macrostomia: a spectrum of deformity.

Background: Macrostomia is a rare facial cleft, with an incompletely described pathogenesis. This series highlights cases of isolated macrostomia presenting with several distinct phenotypes. We examine phenotypic differences in macrostomia patients, to further elucidate the etiopathogenesis.

Nasal aesthetics: a cross-cultural analysis.

Background: Plastic surgeons often approach nasal aesthetic evaluation with the aid of seemingly objective measurements. However, ideal measurements of an attractive nose, as suggested in the literature, might not apply on a cross-cultural basis. Given these controversies, this study aimed to investigate the cultural and ethnic impact on nasal shape preferences.

The effects of A1 pulley release after flexor tendon repair in a cadaveric model.

Background: Decreasing rupture rates after flexor tendon repair is accomplished by increasing the strength of the repair and by decreasing the forces across tendons during rehabilitation. The authors sought to determine whether A1 pulley release affects work of flexion after a zone 2 flexor tendon repair.

Methods: Four fresh-frozen cadaveric hands were thawed to room temperature.

The effects of edema and self-adherent wrap on the work of flexion in a cadaveric hand.

Purpose: Early motion protocols after flexor tendon repair often require hand therapy in edematous digits. Self-adherent wraps are used in the postoperative period to reduce edema. The purpose of this study was to determine whether the presence of a self-adherent wrap affected the work of flexion during early motion protocols.

A proposal for the timing of management of patients with melanoma presenting during pregnancy.

The treatment of melanoma during and immediately after pregnancy poses a significant challenge to surgeons, oncologists, and patients alike. With the overall increase in incidence of melanoma in the United States and worldwide, it is likely that more surgeons will be faced with management decisions regarding pregnant patients with melanoma. We report on five patients who presented to the Yale Melanoma Unit with melanoma during their pregnancy.

Tunnelled tensor fascia lata flap for complex abdominal wall reconstruction.

This study describes the treatment of two patients with recurrent, infected abdominal wall defects using bilateral delayed and tunnelled pedicled tensor fascia lata (TFL) myofascial flaps. TFL flaps were elevated and delayed for 4 weeks in both cases. In the second case, Parietex Composite mesh was positioned underneath the TFL flap and allowed to incorporate.

Cadaveric allograft for wound closure after resection of squamous cell carcinoma in patients with recessive dystrophic epidermolysis bullosa: a report of 32 resections and repairs in 2 patients.

This is a review of the management of squamous cell carcinoma in 2 adult patients with recessive dystrophic epidermolysis bullosa. The 2 have undergone 32 excisions of squamous cell carcinoma of the skin and soft tissue with subsequent reconstruction. Multiple strategies for wound closure have been described in this population.

Distribution of orofacial clefts and frequent occurrence of an unusual cleft variant in the Rift Valley of Kenya.

Objective: To investigate the pattern and distribution of nonsyndromic orofacial clefts among patients in the Rift Valley region of northwestern Kenya.

Methods: Subjects were categorized anatomically for occurrence of an atypical cleft lip variant (ACL), typical cleft lip (CL), cleft lip and palate (CLP), or cleft palate (CP), and family history of orofacial clefts. Tribal ethnicity data were obtained from both cleft and noncleft clinic attendees.

Histiocytic sarcoma in a 3-year-old male: a case report.

We describe a pediatric patient with histiocytic sarcoma involving the T6 and L4 vertebral bodies and the lungs. His tumor progressed during chemotherapy designed for Langerhans' cell histiocytosis and sarcoma. High-dose radiation, on the other hand, was effective.

Bridging tendon defects using autologous tenocyte engineered tendon in a hen model.

Tendon defects remain a major concern in plastic surgery because of the limited availability of tendon autografts. Whereas immune rejection prohibits the use of tendon allografts, most prosthetic replacements also fail to achieve a satisfactory long-term result of tendon repair. The tissue engineering technique, however, can generate different tissues using autologous cells and thus may provide an optimal approach to address this concern.

Repairing large porcine full-thickness defects of articular cartilage using autologous chondrocyte-engineered cartilage.

Large full-thickness defects of articular cartilage remain a major challenge to orthopedic surgeons because of unsatisfactory results of current therapy. Many methods, such as chondrectomy, drilling, cartilage scraping, arthroplasty, transplantation of chondrocytes, periosteum, perichondrium, as well as cartilage and bone, have been tried to repair articular cartilage defects. However, the results are far from satisfactory.