659 results match your criteria: "BG Trauma Center Ludwigshafen.[Affiliation]"

Clavicle height asymmetry: A common problem for planning reduction mammoplasties - A correlational study.

J Plast Reconstr Aesthet Surg

December 2024

Department of Hand and Plastic Surgery, Thurgau Hospital Group, Frauenfeld, Switzerland; Division of Hand, Plastic and Aesthetic Surgery University Hospital, LMU Munich, Germany.

The distance between the mid-clavicle and nipple (MCN) is crucial in planning reduction mammoplasties. MCN has been shown to be superior in achieving nipple-areola complex symmetry. However, there is great variability in clavicle anatomy.

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Implementation Strategies and Ergonomic Factors in Robot-assisted Microsurgery.

J Robot Surg

January 2025

BG Trauma Center Ludwigshafen, Department for Plastic, Hand and Reconstructive Surgery, Department of Plastic Surgery for the Heidelberg University, Ludwig-Guttmann-Straße 13, 67071, Ludwigshafen, Germany.

Robot-assisted surgery represents a significant innovation in reconstructive microsurgery, providing enhanced precision and reduced surgeon fatigue. This study examines the integration of robotic assistance in a series of 85 consecutive robot-assisted microsurgical (RAMS) operations. It aims to evaluate changes in the integration of RAMS during the implementation phase in a single institution.

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Background: Loss of muscle mass and strength in patients who have experienced severe burns is dramatic and associated with subsequent functional impairment. Past work has shown that exercise and oxandrolone, an anabolic steroid, individually improve muscle function and muscle mass in severely burned patients. This study aims to evaluate the effect of oxandrolone treatment combined with resistance exercise on muscle atrophy and investigate the protein synthesis and mitochondrial biogenesis pathways in a hindlimb suspension model.

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Introduction: Despite randomized controlled trials (RCTs) largely supporting volar locking plates (VLPs) for the management of distal radius fractures (DRFs), surgeons often opt for non-invasive interventions such as casting. This study used the fragility index (FI), reverse fragility index (rFI), and fragility quotient (FQ) to assess the statistical robustness of RCTs assessing the efficacy of VLP in DRF management.

Methods: PubMed, Embase, and MEDLINE were queried for RCTs evaluating VLP versus casting for DRFs published from January 1st, 2000-June 30, 2024.

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Robot-assisted microsurgery: a single-center experience of 100 cases.

J Robot Surg

December 2024

Department of Hand, Plastic and Reconstructive Surgery, Department of Hand and Plastic Surgery, BG Trauma Center Ludwigshafen, Heidelberg University, Ludwig Guttmann-Straße 13, 67071, Ludwigshafen, Germany.

The adoption of robot-assisted microsurgery (RAMS) is a cutting-edge advancement in the realm of microsurgery. The Symani Surgical System is CE approved and has recently gained FDA approval. It provides tremor elimination, motion scaling and improved ergonomics.

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Hands-On Robotic Microsurgery: Robotic-Assisted Free Flap Reconstruction of the Upper Extremity.

J Clin Med

December 2024

BG Trauma Center Ludwigshafen, Department of Hand, Plastic and Reconstructive Surgery, Heidelberg University, Ludwig-Guttmann-Straße 13, 67071 Ludwigshafen, Germany.

: Robot-assisted microsurgery (RAMS) has been introduced into the field of plastic surgery in recent years. It potentially offers enhanced precision and control compared to traditional methods, which is crucial for complex microvascular tasks in free flap reconstructions. We aim to analyze our experiences with robotic-assisted microsurgery in the field of upper extremity free flap reconstruction.

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Ergonomic Considerations in Robotic-assisted Microsurgery.

J Craniofac Surg

January 2025

Department for Plastic, Hand, and Reconstructive Surgery, BG Trauma Center Ludwigshafen, and Department of Plastic Surgery, University of Heidelberg, Ludwigshafen Germany.

Objective: Microsurgery necessitates precision and skill, with conventional methods often leading to surgeon discomfort due to prolonged static postures. The introduction of robot-assisted microsurgery using the Symani surgical system and a three-dimensional exoscope aims to enhance surgical precision while mitigating these ergonomic issues.

Methods: This prospective, single-center clinical study involved 50 preclinical training sessions and 87 robot-assisted microsurgical procedures at the authors' institution, covering a wide array of interventions from free flap reconstructions to nerve and lymphatic surgeries.

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Protein as a preoperative predictor - Impact of hypoalbuminemia on 30-day outcomes of breast reduction surgery.

J Plast Reconstr Aesthet Surg

January 2025

Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA. Electronic address:

Article Synopsis
  • * An analysis of over 7,000 breast reduction cases revealed that patients with low albumin levels had significantly more comorbidities, a higher body mass index, and were more likely to be Black or African American.
  • * The study found that those with hypoalbuminemia experienced nearly double the rate of postoperative complications and readmissions compared to those with normal albumin levels, highlighting the importance of preoperative nutritional evaluations.
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The availability of common patient-reported outcome measures in hand surgery across Europe.

J Hand Surg Eur Vol

November 2024

Department of Hand, Replantation, and Microsurgery BG Klinikum Unfallkrankenhaus Berlin and Chair of Hand, Replantation, and Microsurgery at the Charité University Medicine Berlin.

Many European healthcare systems emphasize value-based care to improve outcomes and control costs. Assessing function and satisfaction in hand surgery relies on patient reported outcome measures. This study evaluates the use of these outcome measures across Europe, focusing on diversity and language validation.

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The study investigated the impact of nonsteroidal anti-inflammatory drugs (NSAIDs) on burn-induced coagulopathy in severely burned patients. Patients with a greater than 20% TBSA were identified in the TriNetX research network and categorized into receiving or not receiving NSAIDs in the first week after the burn. The statistical significance of the rate of burn-induced coagulopathy, mortality and sepsis in the week following injury was analysed.

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Walking Ability After Microsurgical Reconstruction of Pediatric Popliteal Pterygium Syndrome-A Case Report.

J Pers Med

November 2024

Department of Hand Surgery, Peripheral Nerve Surgery and Rehabilitation, Clinic of Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Department of Hand- and Plastic Surgery, University of Heidelberg, 69117 Heidelberg, Germany.

Background: Popliteal pterygium syndrome (PPS) is a rare congenital disorder characterized by orofacial, cutaneous, musculoskeletal, and genital anomalies. Surgical interventions are necessary to address the severe knee flexion contracture and equinovarus deformity, but there are no established treatment guidelines.

Methods: We present the case of a one-year-old patient with PPS and discuss the challenges in managing the knee deformity.

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Pain Remission Following Delayed Targeted Muscle Reinnervation in Amputees.

Microsurgery

November 2024

Division of Plastic and Reconstructive Surgery, Department of General Surgery, Massachusetts General Hospital, Harvard University, Boston, Massachusetts, USA.

Introduction: Targeted muscle reinnervation (TMR) has demonstrated efficacy for treatment of neuropathic pain. This study aims to identify patients for whom delayed TMR may be most effective and to identify associated factors for favorable pain outcomes in this patient population.

Methods: An analysis was conducted on prospectively enrolled amputee patients who underwent delayed TMR at a tertiary care center from 2017 to 2024.

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Epineural Scarring Visualization and Noninvasive Quantification of a Severe Posttraumatic Complication: An Experimental Magnetic Resonance Neurography Study.

Invest Radiol

November 2024

From the Department of Neuroradiology, Neurological University Clinic, Heidelberg University Hospital, Heidelberg, Germany (M.B., M.F., K.K.-J., M.O.B., S.H., M.B., D.S.); and Department of Hand, Plastic, and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany (M.A., M.M.-S., S.C.D., T.K., U.K., L.H., A.H.B.).

Aim: Peripheral nerve scarring is a severe yet common complication following nerve injury or surgery that can lead to impaired nerve function, including chronic pain and sensory or motor deficits. In this study, we aimed to establish high-resolution magnetic resonance neurography (MRN) to accurately visualize and monitor de novo-formed epineural fibrotic adhesions (EFAs) of the sciatic nerve in a rat nerve injury model.

Methods: Employing an established model to induce overshooting EFA, the study included 3 experimental groups of animals (n = 6 each): a positive control group (PC), an intervention group (IG), and a sham group.

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Lost in translation: the lack of agreement between surgeons and scientists regarding biomaterials research and innovation for treating bone defects.

BMC Med

November 2024

Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD, 4000, Australia.

Background: With over 2 million grafts performed annually, bone ranks second only to blood in the frequency of transplants. This high demand is primarily driven by the persistent challenges posed by bone defects, particularly following trauma or surgical interventions such as tumour excision. The demand for effective and efficient treatments has increased exponentially in the twenty-first century.

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Diabetic foot ulcers (DFUs) are a significant challenge in the clinical care of diabetic patients, often necessitating limb amputation and compromising the quality of life and life expectancy of this cohort. Minimally invasive therapies, such as modular scaffolds, are at the forefront of current DFU treatment, offering an efficient approach for administering therapeutics that accelerate tissue repair and regeneration. In this study, we report a facile method for fabricating granular nanofibrous microspheres (NMs) with predesigned structures and porosities.

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Outcome comparison of the most commonly employed wound coverage techniques in patients with massive burns ≥50% TBSA - A systematic review and meta-analysis.

Burns

December 2024

Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany. Electronic address:

Introduction: Early wound coverage is one of the most essential factors influencing the survival of extensively burned patients, especially those with a total body surface area (TBSA) burned greater than 50 %. In patients with limited donor sites available for autografting, techniques such as the Meek micrograft procedure or cultured epidermal allografts (CEA) have proven to be viable alternatives. In this systematic review and meta-analysis, we analyzed the outcomes of different wound coverage techniques in patients with massive burn injuries ≥ 50 % TBSA in the past 17 years.

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Background: Reduction mammoplasty is popular among people of various age groups, yet the impact of age on postoperative outcomes remains debated.

Methods: The American College of Surgeons National Surgical Quality Improvement Program (2008-2021) was queried to identify adult female patients who underwent reduction mammoplasty. Patients were categorized into 10-year age brackets (i.

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Article Synopsis
  • This study investigates postoperative outcomes across different racial and ethnic groups to identify disparities and compare them with socioeconomic factors using a large registry dataset from the American College of Surgeons.
  • The research analyzed over 7 million patients, highlighting that White, Asian, and Native Hawaiian or Pacific Islander patients generally have better surgical outcomes than Black or African American and American Indian or Alaska Native patients.
  • Findings indicate significant disparities in health outcomes linked to race, with socioeconomic factors such as wealth and healthcare access playing a crucial role; further research is needed to understand and address these issues.
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Preventive Paradox? Postoperative Outcomes After Risk-Reducing Mastectomy and Direct-to-Implant Breast Reconstruction.

Clin Breast Cancer

December 2024

Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Trauma Center. BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany. Electronic address:

Background: Risk-reducing mastectomy (RRM) with direct-to-implant (DTI) breast reconstruction is becoming increasingly important in breast cancer prevention. While the oncological benefits of RRM-DTI are well documented, there is a paucity of studies investigating its perioperative safety.

Methods: The ACS-NSQIP database (2008-2022) was queried to identify all patients who underwent RRM-DTI.

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Neuroma morphology: A macroscopic classification system.

Muscle Nerve

December 2024

Division of Plastic and Reconstructive Surgery, Department of General Surgery, Massachusetts General Hospital, Harvard University, Boston, Massachusetts, USA.

Article Synopsis
  • The study examines the relationship between the physical traits (morphology) of neuromas and the symptoms they cause, aiming to create a classification system to help understand their clinical implications.
  • A total of 45 neuroma specimens from 27 patients were analyzed, revealing that atypical neuromas were linked to higher pain levels and were more common in patients with conditions like diabetes and peripheral vascular disease.
  • The proposed classification system shows strong reliability and may help surgeons and researchers improve their understanding of neuroma development and its connections to patient health factors, though further research is needed in this area.
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: Aseptic loosening is one of the leading causes of stem revision. Einzel Bild Röntgen Analyse-Femoral Component Analysis allows for the detection of distal stem migration, which is used as a predictive factor for implant longevity. This study aims to demonstrate the migration behavior of a cemented collared anatomical stem.

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Loss of Functional Independence after Plastic Surgery in Older Patients: American College of Surgeons National Surgical Quality Improvement Program Database.

Plast Reconstr Surg Glob Open

September 2024

From the Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany.

Background: Maintenance of functional independence is an important patient-centered outcome. As the evidence on loss of independence (LOI) in older patients undergoing plastic surgery is lacking, this study investigates the extent of LOI, identifying factors associated with LOI.

Methods: The 2021-2022 American College of Surgeons National Surgical Quality Improvement Program database was searched to identify patients (>65 years old) who underwent plastic surgery and provided data on their functional independence.

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Background: With advancements in burn treatment and intensive care leading to decreased mortality rates, a growing cohort of burn survivors is emerging. These individuals may be susceptible to frailty, characterized by reduced physiological reserve and increased vulnerability to stressors commonly associated with aging, which significantly complicates their recovery process. To date, no study has investigated burns as a potential risk factor for frailty.

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Neuroma-to-Nerve Ratio: Does Size Matter?

Neurosurgery

September 2024

Division of Plastic and Reconstructive Surgery, Department of General Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Background And Objectives: Anatomic features of neuromas have been explored in imaging studies. However, there has been limited research into these features using resected, ex vivo human neuroma specimens. The aim of this study was to investigate the influence that time may have on neuroma growth and size, and the clinical significance of these parameters.

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A single-center retrospective comparison of muscle versus cutaneous free flaps for posterior elbow defect reconstruction.

J Plast Reconstr Aesthet Surg

October 2024

Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Heidelberg University, Ludwig-Guttmann-Strasse 13, 67071 Ludwigshafen, Germany; Department of Hand and Plastic Surgery, Heidelberg University, Heidelberg, Germany. Electronic address:

Introduction: Comparative data on free flap outcomes for elbow defect reconstruction are still lacking. This study aimed to compare complication rates of free muscle flaps (MFs) versus cutaneous flaps (CFs) for posterior elbow reconstruction.

Methods: In a single-center retrospective analysis, patients who underwent posterior elbow reconstruction with free MFs and CFs from 2000 to 2021 were analyzed.

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