Use of Financial Hardship as a Metric for Assessing Financial Toxicity in Surgical Trauma Patients.

Background: Financial toxicity is the detrimental impact of health care costs that must be mitigated to achieve universal health coverage. Catastrophic health expenditure (CHE) is widely used to measure financial toxicity but does not capture patient perspectives of unaffordable health care costs. Financial hardship (FH), a patient-reported outcome measure, is currently underutilized but may be an important adjunct metric.

Don't Play It by Ear: Technical Considerations to Optimize Outcome and Procedural Safety of Congenital Microtia Reconstruction in a Dextrocardia Patient With Situs Inversus Totalis, Butterfly Vertebra, and Hemivertebra.

Background: Microtia can occur as a standalone condition or as part of a genetic syndrome. We report the first case of microtia presenting in a patient with dextrocardia, situs inversus totalis, butterfly vertebra, and hemivertebra, and we present technical recommendations for optimizing anaesthetic and surgical harmony in this extraordinary case.Patients with situs inversus dextrocardia should be checked for signs of Kartagener syndrome.

A Rare Case of Cleft Palate Associated With Tongue Hamartoma: A Case Report and Systematic Review.

Introduction: Palate development involves a genetic regulation through a complex molecular mechanism that may be disrupted by environmental factors, resulting in impaired fusion and cleft palate formation. An encounter with a case of cleft palate due to dorsal tongue hamartoma prompted us to perform this systematic review.

Objective: To review the clinical profile and management approach for a case with cleft palate and tongue hamartoma.

A Century With Craniopagus Twin Separation Surgeries: Nihilism to Optimism.

Craniopagus conjoined twins are extremely rare, reported 1 in 2.5 million live births. To date, 62 separation attempts in 69 well-documented cases of craniopagus twins have been made.

First Successful Separation of Craniopagus Twins in India-Plastic Surgical Considerations.

Separation of total vertical craniopagus with shared venous sinuses poses multiple challenges. Provision of soft-tissue cover to the exposed brains at the time of total separation is one of them, due to the large size of the defect and paucity of local tissues. Staged separation of twins is advised with partial venous and parenchymal disconnection in the first stage and total separation in the second stage.

Vascular anomalies: diagnostic features and step-wise approach.

The first part of this review article emphasized correct nomenclature, classification systems, and imaging algorithm of vascular anomalies. The second part of the review discusses the individual entities, highlighting the characteristic clinico-radiological features of the commonly encountered ones. A step-wise algorithmic approach is also proposed for the evaluation of a suspected case of vascular anomaly.

Effectiveness of a microsurgery training program using a chicken wing model.

Microsurgical skills are essential for plastic surgeons in the modern times. Chicken wing model for microsurgery training offers an easy and cost-effective alternative to the traditional live rat model. A prospective study was conducted over a period of 6 months.

Examination in the Time of COVID-19-MCh Plastic Surgery Examination: How Did We Do It?

Many aspects of life have been changed, after the starting of the pandemic. Modifications and improvisation in our day-to-day activities is now a new norm. During the pandemic period, continuation academic activities and conductance of examination is difficult but essential.

Versatility of the Pedicled Latissimus Dorsi Myocutaneous Flap in Reconstruction of Upper Limb and Trunk Soft Tissue Defects.

The purpose of the study was to share our indications, technique, outcome, and complications associated with the pedicled latissimus dorsi myocutaneous flap (LDMF) for reconstructing various upper limb and trunk soft tissue defects. We reviewed the prospectively collected data of the patients who underwent reconstruction of upper limb/trunk soft tissue defects with pedicled LDMF between January 2016 and March 2019. By analyzing the clinical scenarios, the location of flap inset, the arc of rotation, reach of the flap, and associated complications, we put forward few significant findings from our experience.

Factors Affecting High Caries Risk in Children With and Without Cleft Lip and/or Palate: A Cross-Sectional Study.

Objective: The aim of the study was to analyze the caries protective factors, salivary parameters, and microbial counts in high caries risk children with cleft lip and/or palate (CL/P).

Design: This was a cross-sectional study.

Setting: This study was conducted in a tertiary health care teaching hospital in New Delhi, India.

Revisiting the Trapezius Flap as a Reconstructive Option for Cervico-Occipital and Thoracic Spine Regions.

Reconstruction of complex soft tissue defects around the cervico-occipital and thoracic spine regions is a challenging task. We want to share our experience with trapezius flap for the reconstruction of these complex cases. A retrospective analysis of patients who underwent reconstruction using trapezius flaps from January 2016 to June 2019 was performed.

Scalp Avulsion Injuries and Replantation: Is Deep Temporal Artery an Alternate Option?

Scalp avulsion injuries are usually attributed to entrapment of long hair or clothing in agricultural or industrial machinery or traffic accidents. Though rare, these injuries may be dangerous, and resulting cosmetic defect and alopecia lead to social stigma and poor self-esteem. Early intervention in the form of microvascular repair and replantation prevent morbidity and improve outcome.

Reconstruction of post-traumatic upper extremity soft tissue defects with pedicled flaps: An algorithmic approach to clinical decision making.

Purpose: Pedicled flaps are still the workhorse flaps for reconstruction of upper limb soft tissue defects in many centers across the world. They are lifeboat options for coverage in vessel deplete wounds. In spite of their popularity existing algorithms are limited to a particular region of upper limb; a general algorithm involving entire upper limb which helps in clinical decision making is lacking.

The role of plastic and reconstructive surgeon in trauma care: Perspectives from a Level 1 trauma centre in India.

Background: As the morbidity and mortality due to trauma are ever increasing, there is proportionally growing need of trauma care facilities across the country. In the context of expanding designated trauma care facilities, the role of plastic and reconstructive surgeon needs to be analysed and defined at least at a Level 1 trauma centre.

Materials And Methods: We included the patients who were operated under the department of plastic, reconstructive & burns surgery at a Level 1 urban trauma centre between January 2016 and December 2017.

Improved outcomes of scar revision with the use of polydioxanone suture in comparison to polyglactin 910: A randomized controlled trial.

Scars have multiple cosmetic and functional sequelae, and revision surgeries are an attempt to ameliorate these effects. Reduction of spread of the revised scar is one of the main objectives of revision procedures. Provision of prolonged dermal support to wound can theoretically reduce spread of the scar.

Thoracoumbilical Flap: Anatomy, Technique, and Clinical Applications in Upper Limb Reconstruction in the Era of Microvascular Surgery.

Purpose: Microvascular reconstruction is the standard of care for salvage of soft tissue defects in complex upper extremity due to their distinct advantages over the pedicled flaps. However, in the era of microsurgery, pedicled flaps have an acceptable significant role for reconstruction of complex soft tissue defects. The authors aim to demonstrate the versatility of pedicled thoracoumbilical flap (TUF) in selected clinical scenarios.

Preputial flap as an adjunct to groin flap for the coverage of electrical burns in the hand.

High voltage electrical contact to hand result in injuries at multiple levels that may require more than a single flap for effective coverage. We present here a simple technique to utilise preputial flap as an adjunct to groin flap in cases where simultaneous coverage was required at more than one site in hands. In the past two years, 15 patients with unilateral involvement of hands due to electrical contact injury underwent this procedure.