Fundamentals of Microsurgery: A Novel Simulation Curriculum Based on Validated Laparoscopic Education Approaches.

Background:  Microsurgical techniques have a steep learning curve. We adapted validated surgical approaches to develop a novel, competency-based microsurgical simulation curriculum called Fundamentals of Microsurgery (FMS). The purpose of this study is to present our experience with FMS and quantify the effect of the curriculum on resident performance in the operating room.

Virtual Interviews for the Independent Plastic Surgery Match: A Modern Convenience or a Modern Misrepresentation?

Objective: The virtual interview for residency and fellowship applicants has previously been utilized preliminarily in their respective processes. The COVID-19 pandemic forced many programs to switch to a virtual interview process on short notice. In the independent plastic surgery process, which was underway when the pandemic started, applicants had a heterogeneous experience of in-person and virtual interviews.

Patient-Reported Outcomes and Factors Associated With Patient Satisfaction After Surgical Treatment of Facial Nonmelanoma Skin Cancer.

This study measures patient-reported outcomes and identifies factors associated with patient satisfaction after excision of facial nonmelanoma skin cancer in the veteran population.

Historical review of Dakin's solution applications.

Dakin's solution and the Carrel-Dakin method were developed and integrated into clinical practice in the early 20th century, which were found to aid in effective wound healing and infection. This historical review briefly outlines highlights with regard to the history of infection management, wartime amputation, and wound treatment dating back to Galen through the early 20th century. This paper extensively reviews and discusses the historic use of Dakin's solution, which was developed almost a century ago, in both wartime settings and in the civilian sector as well.

Impact of a Novel Preoperative Patient-centered Surgical Wellness Program.

Objective: The objective of this study was to evaluate if a preoperative wellness bundle significantly decreases the risk of hospital acquired infections (HAI).

Background: HAI threaten patient outcomes and are a significant burden to the healthcare system. Preoperative wellness efforts may significantly decrease the risk of infections.

Tourniquet Use in Wide-Awake Carpal Tunnel Release.

Carpal tunnel syndrome is a common cause of upper extremity discomfort. Surgical release of the median nerve can be performed under general or local anesthetic, with or without a tourniquet. Wide-awake carpal tunnel release (CTR) (local anesthesia, no sedation) is gaining popularity.

Age at Diagnosis as a Relative Contraindication for Intervention in Facial Nonmelanoma Skin Cancer.

This study examines the utility of excising facial nonmelanoma skin cancer in very elderly patients.

The Veterans Affairs Medical Center's Contribution to Plastic Surgery Education.

This population-based study evaluates the levels of case minimums met by plastic surgery residents in Veterans Affairs hospitals.

Assessing the Necessity of Stopping Antithrombotic Agents Before Wide-Awake Hand Surgery.

This review of 304 carpal tunnel release procedures examines the necessity of stopping antithrombotic medications prior to carpal tunnel release surgery.

Evidence-Based Performance Measures: Quality Metrics for the Care of Patients Undergoing Breast Reconstruction.

The American Society of Plastic Surgeons commissioned the Breast Reconstruction Performance Measure Development Work Group to identify and draft quality measures for the care of patients undergoing breast reconstruction surgery. Two outcome measures were identified. The first desired outcome was to reduce the number of returns to the operating room following reconstruction within 60 days of the initial reconstructive procedure.

Utility of Tongue Stitch and Nasal Trumpet in the Immediate Postoperative Outcome of Cleft Palatoplasty.

Background: Postoperative airway obstruction is a feared complication following cleft palate repair. The aim of this study was to evaluate the effectiveness of tongue stitches and nasal trumpets that have been used in an attempt to prevent this complication.

Methods: An 8-year (2005 to 2013) retrospective review of palatoplasties performed at a tertiary care center was conducted.

The cost of intraoperative plastic surgery education.

Purpose: Within the surgical community, it is commonly accepted that the length and cost of a surgical case increase when a resident physician participates. Many accountable care organizations, however, believe the opposite, that is, resident assistance enhances efficiency and diminishes operative time. The purpose of this study is to determine the opportunity cost to the attending surgeon for intraoperative teaching during index plastic surgery cases.

Effect of Vacuum Assisted Closure Therapy on early systemic cytokine levels in a swine model.

Vacuum Assisted Closure (V.A.C.

Refractive indices of human skin tissues at eight wavelengths and estimated dispersion relations between 300 and 1600 nm.

The refractive index of human skin tissues is an important parameter in characterizing the optical response of the skin. We extended a previously developed method of coherent reflectance curve measurement to determine the in vitro values of the complex refractive indices of epidermal and dermal tissues from fresh human skin samples at eight wavelengths between 325 and 1557 nm. Based on these results, dispersion relations of the real refractive index have been obtained and compared in the same spectral region.

A case of mitochondrial myopathy and cleft palate.

Objective: To present a child born with both mitochondrial myopathy and cleft palate, outlining medical complications of this dual diagnosis-the first reported case in English literature.

Methods: A preterm Caucasian boy presented to the cleft palate clinic at birth for evaluation of a secondary cleft palate. Multiple anomalies were also identified, including rib fusions, ventricular septal dyskinesis, and mild hypotonia.

Reexamining contraindications for minimally invasive mitral valve surgery.

Historically, contraindications to minimally invasive or robotic mitral valve surgery have included prior mastectomy, thoracic reconstruction, or chest radiation. However, we believe that by granting flexibility in the choice of skin incision site while performing careful dissection, surgeons can provide these patients the outstanding results afforded by a minithoracotomy. We present a patient who had undergone a prior mastectomy and radiation treatment in whom we performed a minimally invasive mitral valve repair through a right-sided minithoracotomy using the previous mastectomy incision.

Laparoscopic omental harvest for flap coverage in complex mediastinitis.

Mediastinitis is one of the most serious complications of cardiac surgery. The standard of care in mediastinitis includes thorough sequential debridement, flap coverage, and culture-directed antibiotics. The most frequently utilized muscles for flap reconstruction include the rectus abdominus and the pectoralis major.

Hemodynamic effects of the vacuum-assisted closure device on open mediastinal wounds.

Background: Application of the Vacuum-Assisted Closure device (VAC) to open sternal wounds has negative hemodynamic effects. We hypothesized that the interposition of a muscle flap attenuates these negative hemodynamic effects.

Materials And Methods: After institutional approval, monitoring lines were placed in anesthetized, ventilated pigs.

Comparative healing of surgical incisions created by a standard "bovie," the Utah Medical Epitome Electrode, and a Bard-Parker cold scalpel blade in a porcine model: a pilot study.

A comparative study of skin incision healing using a standard "bovie" and a new design electroscalpel, Utah Medical Products Epitome Electrode (Midvale, UT), was conducted in a porcine model. Wounds were evaluated objectively at 14 and 28 days after surgery using wound bursting strength measurements and histologic wound scoring. Each electrosurgical device was compared with wound healing of cold scalpel incisions as the gold standard using the same criteria.