Eplasty [JOURNAL]
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200 papers
Conservative Management of a Bullous Hematoma in the Case of von Willebrand Disease and Hemophilia A.
Marku L, Rajjoub H, Climov M … +1 more , Uygur HS
Eplasty · 2025 · PMID 40800222
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Producing an Interesting Etiology of Delayed Breast Cellulitis.
Norcini R, Marku L, Rajjoub H … +1 more , Woodberry K
Eplasty · 2025 · PMID 40800221
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From Tooth to Phalanx: The First Reported Case of Causing Osteomyelitis of the Proximal Phalanx.
Korah H, Popp M, Bercu C … +1 more , Berger A
Eplasty · 2025 · PMID 40778249
() species, typically associated with oral infections, are known for their role in causing root canal infections and endodontic abscesses. Here, the authors present the first and only reported case of osteomyelitis in a...
() species, typically associated with oral infections, are known for their role in causing root canal infections and endodontic abscesses. Here, the authors present the first and only reported case of osteomyelitis in a long bone following a phalanx injury and subsequent dental procedure. In this case, the infection presented in the right fifth proximal phalanx of a 16-year-old boy. Despite initial conservative management and multiple negative bacterial cultures, symptoms persisted, prompting surgical intervention with debridement, biopsy, culture, and polymerase chain reaction analysis. This case underscores the aggressive and elusive nature of , highlighting challenges in diagnosis and the importance of considering the species in cases of osteomyelitis, particularly in those with a dental history.
Fluorescein Dye-Assisted Tangential Excision and Skin Grafting in Hand Burns: Achieving Optimal Cosmetic and Functional Outcomes.
Singh D, Wong JH, Parsa AA … +1 more , Parsa FD
Eplasty · 2025 · PMID 40778248
BACKGROUND: Burned hands require special attention and prompt treatment because of their vital functional importance. With fluorescein dye, it is possible to visualize vascular dermal layers to assist with the removal of...
BACKGROUND: Burned hands require special attention and prompt treatment because of their vital functional importance. With fluorescein dye, it is possible to visualize vascular dermal layers to assist with the removal of nonviable skin through tangential excision. METHODS: Within 24 to 48 hours after a burn, 5 mg of fluorescein dye was injected intradermally and a Wood light was used to determine burn depth. Under anesthesia, an Air Brown (Zimmer Biomet) or castroviejo dermatome and a free-hand or Humby knife was used to excise the burned skin. Split-thickness layers approximately 0.015 inches thick were removed until strong fluorescence was noted. RESULTS: Observation indicators were used to assess the quality of the skin graft outcomes. No cases of infection, seromas, hematomas, or contractures were seen. Additionally, patients experienced reasonable cosmetic and functional outcomes within weeks to months following grafting. CONCLUSIONS: Excision and split-thickness skin grafting with fluorescein dye and tangential excision can achieve desirable results and restore both cosmetic and functional outcomes.
Clinical Profile and Outcome of Acute Burn Care in a Tertiary Care Center of Western Nepal.
Giri P, Kunwar S, Khadka K … +5 more , Pandey P, Pokhrel S, Shrestha D, Shrestha D, Gurung NV
Eplasty · 2025 · PMID 40778247
BACKGROUND: Burns are a global public health problem that enormously impact Nepal's health system. The treatment of burns is a challenging job for developing and underdeveloped countries. Major burn injuries are associat...
BACKGROUND: Burns are a global public health problem that enormously impact Nepal's health system. The treatment of burns is a challenging job for developing and underdeveloped countries. Major burn injuries are associated with high mortality in Nepal. However, extensive service is being provided, along with the gradual establishment of dedicated burn care units. This study aimed to determine the demographics of burn patients presented to the authors' center and the outcomes of acute burn care. METHODS: This was a retrospective, descriptive, cross-sectional study of burn patients admitted from September 2022 to November 2023. RESULTS: The study included 101 patients ranging in age from 6 months to 77 years, with a median age of 27.8 years. The highest incidence of burns was among the male patients (56.4%), followed by the female patients (43.6%). Children under 15 years old comprised 45.5% of the admitted patients, and scald burns were the most common cause of burns in this group. The incidence of flame burns was highest among the working-class population and older adults. The total body surface area of the admitted patients ranged from 5% to 90%, with a mean of 15.22%. A total of 46.5% of the patients underwent operative management, of whom 36.2% required multiple surgeries. Hospital-stay duration ranged from 1 to 83 days, with a mean stay of 13.9 days. The study showed a 7.9% mortality rate. CONCLUSIONS: The number of patients hospitalized due to burns is increasing, especially in the winter season. It mostly affects younger age groups, with the most common cause being scald burn. The mortality rate is found to increase as the extent of burn increases.
Treatment of Phantom and Residual Limb Pain in Amputees With Targeted Muscle Reinnervation.
Cox C, Chen A, Baum G … +3 more , Ibrahim AF, Hernandez E, MacKay B
Eplasty · 2025 · PMID 40778246
BACKGROUND: Many amputees are left with chronic localized pain, centralized pain, and phantom limb pain or sensation, often resulting from neuromas in the residual limb. Historically, there is no reliably effective inter...
BACKGROUND: Many amputees are left with chronic localized pain, centralized pain, and phantom limb pain or sensation, often resulting from neuromas in the residual limb. Historically, there is no reliably effective intervention for pain associated with neuroma-related residual or phantom limb pain. Targeted muscle reinnervation (TMR) is a surgical procedure first described in 2002 that involves the transfer of residual nerves from amputated limbs to new muscle targets. TMR has been shown to significantly reduce neuroma pain and facilitate the use of prostheses. METHODS: A prospective study was conducted of 61 patients who underwent TMR for neuroma treatment or prevention between 2017 and 2022. Primary outcomes included overall, phantom, and residual limb pain recorded using the Visual Analog Scale (VAS), as well as Patient-Reported Outcomes Measurement Information System (PROMIS) forms for Pain Intensity, Quality, Interference, and Behavior. Retrospective data was collected for a propensity-matched cohort of non-TMR amputees to compare pain outcomes. RESULTS: TMR was performed for 25 upper extremity and 35 lower extremity amputations, and 5 patients underwent TMR on multiple limbs. Significant reductions were observed in overall limb pain (-3.2 points), phantom limb pain (-2.6 points), and residual limb pain (-3.0 points) for the TMR cohort. Mean PROMIS scores for TMR patients were 49.7 for Pain Intensity, 54.0 for Pain Quality, 55.3 for Pain Interference, and 56.1 for Pain Behavior. At the 8.4-month follow-up, 43.8% of TMR patients (vs 84% of controls) remained on neuromodulators, opioids, or both, for pain control. CONCLUSIONS: TMR improved phantom and residual limb pain in amputees, as evidenced by clinically and statistically significant reductions in pain with reduced need for long-term opioids and/or neuromodulators. These findings support the current understanding of TMR but underscore the need for continued investigation to comprehensively assess the potential of this promising technique in improving the functional outcomes and quality of life in the amputee population.
Use of Continuous Topical Oxygen Therapy to Treat Lower-Extremity Surgical Wound Dehiscence: A Retrospective Review.
Kormylo E, Cole W, Wielgomas J
Eplasty · 2025 · PMID 40778245
BACKGROUND: There is not a singular "gold standard" therapy for managing surgical wound dehiscence (SWD); rather, the goal is expediting wound closure. This study examines the feasibility of using a continuous topical ox...
BACKGROUND: There is not a singular "gold standard" therapy for managing surgical wound dehiscence (SWD); rather, the goal is expediting wound closure. This study examines the feasibility of using a continuous topical oxygen (cTOT) device as part of a treatment algorithm to treat SWD of the lower extremity. METHODS: A single-center, retrospective analysis of lower-extremity SWD treated with cTOT was conducted via a retrospective chart review. Data were collected for a period of 8 months from January to August 2024. All SWD received the standard of care in addition to cTOT. Patients were seen weekly for evaluation until complete wound closure. RESULTS: Nine patients were included in this case review. The mean patient age was 52.6 years. SWD occurred after a variety of interventions. All patients' SWD grade was either 3 or 4 according to the World Union of Wound Healing Society Sandy Grading System. The average time from starting TOT to the SWD healing was 52.6 days. In addition, the average estimated SWD surface area based on the wound measurement at the start of delivering TOT was 19.5 cm. The average time to wound healing for all patients was 70 days. After excluding 1 outlier, the average time to wound healing was 59.5 days. CONCLUSIONS: The positive outcomes exhibited in this case series suggest that cTOT is an effective treatment in the management of SWD in patients, regardless of specific surgical intervention. Furthermore, all the SWDs treated with cTOT progressed to wound closure without further need for surgery, hospitalization, or other costly procedures.
Triple-Positive Breast Cancer in a 27-Year-Old Male-to-Female Patient.
Ho KC, Huffman KN, O'Connor MJ … +4 more , Sparks P, Bozigar C, Sterbling H, Hansen N
Eplasty · 2025 · PMID 40778244
INTRODUCTION: There is a paucity of literature describing breast cancer prevention and screening guidelines in transgender patients. As more patients undergo gender-affirming care, breast cancer screening guidelines must...
INTRODUCTION: There is a paucity of literature describing breast cancer prevention and screening guidelines in transgender patients. As more patients undergo gender-affirming care, breast cancer screening guidelines must be solidified for transgender patients. While there are no published incidence rates of breast cancer in the transgender population, case reports continue to underscore the prevalence of breast cancer in transgender females. METHODS: A 27-year-old transgender woman with a family history of breast cancer and personal gender-affirming hormone therapy for 9 years was diagnosed with stage 3 invasive ductal carcinoma. The patient presented with a palpable breast lump and had never undergone breast imaging. CONCLUSIONS: Breast cancer risk in transgender patients with long-term hormone therapy use is not well understood. Individuals, both male and female, with a family history of breast cancer; increased cumulative lifetime estrogen and progesterone use; or mutations in , , , , or genes have an increased risk for breast cancer. Hormonal treatment is often used alongside gender-affirming surgeries for development of female secondary sex characteristics in male-to-female patients. Although hormone therapy can have gender-affirming benefits, the increased lifetime exposure to estrogen and progesterone can increase the risk of breast cancer. Mammography guidelines for transgender patients vary by age, familial and genetic risk, as well as duration of hormone therapy. Three current organizations have published mammographic screening guidelines for transgender patients: the University of California San Francisco, the World Professional Association for Transgender Health, and the American College of Radiology. Future research should focus on substantiating these guidelines with greater data to produce evidence-based recommendations to guide the care of transgender patients.
Extraction of a TASER 7 Barb Embedded in the Supraorbital Frontal Bone: A Clinical Case Report.
Scott BB, Arellano JA, Liu HY … +1 more , Egro FM
Eplasty · 2025 · PMID 40778243
Hand-held conducted energy devices, such as the TASER 7 (Axon Enterprise, Inc), are commonly used by law enforcement as a method of "non-lethal" force. However, their use may result in serious injuries. The authors repor...
Hand-held conducted energy devices, such as the TASER 7 (Axon Enterprise, Inc), are commonly used by law enforcement as a method of "non-lethal" force. However, their use may result in serious injuries. The authors report a case where a TASER 7 barb became embedded in the left supraorbital frontal bone during a field incident. Initial removal attempts were unsuccessful when the cylindrical cartridge broke off. Ultimately, the barb was successfully removed at bedside with a Kocher clamp and firm, constant in-line traction under local anesthesia at a tertiary hospital. This case highlights the potential complications associated with conducted energy devices and provides a bedside removal technique that avoids the need for operative intervention.
Opioid Prescription Patterns in Hand Surgery: A Medicare Part D Analysis.
Wang SM, Zeng SL, Wu V … +5 more , Emovon EO, Hernandez JA, Tian WM, Feltner C, Mithani SK
Eplasty · 2025 · PMID 40778242
BACKGROUND: The opioid crisis continues to be a significant public health concern in the United States, with postoperative prescriptions contributing to the problem. Older adults face increased risks from opioid use, yet...
BACKGROUND: The opioid crisis continues to be a significant public health concern in the United States, with postoperative prescriptions contributing to the problem. Older adults face increased risks from opioid use, yet prescribing practices for hand surgery in the Medicare population remain understudied. This research aims to elucidate opioid prescription patterns among hand surgeons treating Medicare patients, focusing on national trends, regional variations, and gender differences. METHODS: A retrospective analysis was conducted using data from the Centers for Medicare and Medicaid Services Medicare Part D Prescription Drug Program Prescribers Public Use File for hand surgeons from 2015 to 2019. National trends, regional variations based on US Census Bureau divisions, state-level differences, and gender disparities in opioid prescribing patterns were examined. Key metrics included opioid prescribing rates, proportion of opioid claims to total claims, average prescription duration, and total opioid claims per surgeon. RESULTS: From 2015 to 2019, a total of 1752 hand surgeons were identified in the Medicare Part D database with a 5-year average of 231 405 opioid claims, comprising 53% of all claims made by hand surgeons. The median opioid prescribing rate decreased from 61.4% in 2015 to 55.3% in 2019. The proportion of opioid claims to total claims fell from 55.4% to 48.27%, and the average prescription duration decreased from 6.3 to 4.67 days. Significant regional and state-level variation was identified. Overall, the South had higher numbers of opioid prescriptions per hand surgeon and prescribed for more days compared with all other regions, but the Midwest and West regions had larger proportions of opioid claims. CONCLUSIONS: Despite an overall decrease in opioid prescribing by hand surgeons for Medicare patients from 2015 to 2019, significant regional and gender-based variations persist. These findings underscore the need for standardized guidelines, improved prescriber education, and better integration of monitoring programs.
Technique to Reduce Wound Size: The Double-Opposing Purse-String and Horizontal Continuous Closure Algorithm.
Mostovych AL, Patel LR, Garg K … +4 more , Carr QL, Peake M, Cantrell R, Wilhelmi BJ
Eplasty · 2025 · PMID 40778241
BACKGROUND: Surgical reconstruction of complex wounds requires considerable planning to ensure optimal patient outcomes. A conservative approach utilizing the lower tiers of the reconstructive ladder is preferred, especi...
BACKGROUND: Surgical reconstruction of complex wounds requires considerable planning to ensure optimal patient outcomes. A conservative approach utilizing the lower tiers of the reconstructive ladder is preferred, especially in patients with comorbidities lending to a higher risk of poor wound healing. A simplified, low-risk solution with a double-opposing purse-string suture (PSS) and horizontal continuous closure technique may be particularly helpful in reducing the need for more complex techniques of wound reconstruction in select patient populations. METHODS: A retrospective chart review was performed on all patients who underwent reconstruction with the double-opposing PSS technique (N = 57) by the senior author (B.J.W.) at the University of Louisville between 2019 and 2022. RESULTS: A total of 46 patients and 57 wounds underwent the double-opposing PSS and horizontal continuous closure technique as directed by the algorithm. The average defect size before and after was 61 and 12 cm, respectively. A 2-tailed paired test analysis was performed to explore the relationship between the pre- and post-closure defect size ( = .0003, (44) = 3.9, 95% CI). A total of 21 wounds required a skin graft, meaning 63% of the wounds were successfully closed without the use of skin graft as a result of the double-opposing PSS technique. In addition, of those 21 wounds, the skin grafts, as well as the donor site sizes, were smaller. CONCLUSIONS: This approach to wound closure demonstrates usefulness in reducing the size of or need for skin grafts in complex wound patients, particularly in those with comorbidities. The majority of patients underwent successful closure of their complex defects in various areas (eg, face, extremities) with this technique. Residual defects requiring skin graft allowed for a smaller graft and, thereby, donor site. Ultimately, this technique reduces the risk of complex complications by simplifying and reducing wound size.
Pedicled Vastus Lateralis and Tensor Fascia Lata Flap for Aortic Graft Salvage.
Brummund D, Chang A, Vasudevan V … +2 more , Shao T, Salgado C
Eplasty · 2025 · PMID 40678172
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Rare Benign Tumor: Elastofibroma Dorsi.
Frunza A, Avram L
Eplasty · 2025 · PMID 40678171
Abstract loading — click title to view on PubMed.
Artificial Intelligence in Hand and Upper Extremity Surgery Education: Accuracy and Validity of ChatGPT-4o Versus UpToDate as a Learning Tool for Trainees.
Bercu C, Rosner B, Chaudhry A … +3 more , Korah H, Bernal I, Berger A
Eplasty · 2025 · PMID 40661100
BACKGROUND: The use of artificial intelligence (AI) in medical education has risen rapidly. Trainees can ask ChatGPT-4o (OpenAI) clinical questions and receive management recommendations. Previous studies have assessed t...
BACKGROUND: The use of artificial intelligence (AI) in medical education has risen rapidly. Trainees can ask ChatGPT-4o (OpenAI) clinical questions and receive management recommendations. Previous studies have assessed the accuracy of ChatGPT, but none have examined hand and upper extremity surgery. This study aimed to evaluate the accuracy of ChatGPT-4o compared to UpToDate (Wolters Kluwer) and categorize the validity of sources provided by ChatGPT-4o. METHODS: Five hand and upper extremity surgery cases were entered into ChatGPT-4o. An UpToDate article was selected for each case. Two hand surgeons and 5 medical students completed a survey comparing the resources. Resources were rated on a scale from 1 to 3, with 1 indicating incomplete information and not useful; 2 indicating semi-complete information and somewhat useful; and 3 indicating a complete answer and useful for management. ChatGPT-4o references were scored on a validity scale of 0 to 2. RESULTS: Hand and upper extremity surgeons rated ChatGPT-4o and UpToDate as semi-complete and somewhat useful, with median scores of 2.00 and 2.50, respectively. No significant differences were found between resources. Medical students found ChatGPT to provide semi-complete information and be somewhat useful overall, and rated UpToDate more often as providing a complete answer and being useful. However, no statistically significant differences were found between the resource ratings. Of the 25 references provided by ChatGPT, 28% were accurate, 6% were somewhat accurate, and 66% were inaccurate. CONCLUSIONS: The findings indicate overall comparable perceived usefulness of ChatGPT-4o and UpToDate by hand/upper extremity surgeons and trainees. ChatGPT-4o holds promise as an educational tool; however, accuracy concerns remain.
Case Series of Reconstruction Applying NovoSorb Biodegradable Temporising Matrix: Preliminary Practice and Findings in the United Kingdom.
Tam SSC, Taylor K, Patel P … +2 more , Goon P, Khatib M
Eplasty · 2025 · PMID 40661099
BACKGROUND: Biodegradable temporizing matrix (BTM) is a novel synthetic dermal matrix for wound reconstruction and an alternative to biological dermal substitutes such as Integra (Integra LifeSciences). It provides a sca...
BACKGROUND: Biodegradable temporizing matrix (BTM) is a novel synthetic dermal matrix for wound reconstruction and an alternative to biological dermal substitutes such as Integra (Integra LifeSciences). It provides a scaffold for dermal regeneration and acts as a temporizing device prior to skin graft application, reducing the need for autologous tissue donor sites such as local or free-flap transfer. METHODS: This retrospective case series involved 12 patients whose surgery was completed with BTM from October 2021 to February 2023. The inpatient stay, subsequent procedures, and any complications were also reviewed. RESULTS: The median time for inpatient stay was 3.5 days, and patients who required skin grafts after full BTM integration were treated as a day case. Only 1 case had the complication of postoperative infection. CONCLUSIONS: The study supports the application of BTM products to heal wounds with exposed bone or tendon. This is considered a low-risk option to reduce complications and improve reconstructive and cosmetic outcomes, particularly in the head and neck region.
Good Outcomes After a Severity Triad: Systemic Complications, Bacterial and Fungal Infections in 3 Patients With Major Burns.
Bordeanu-Diaconescu EM, Grosu-Bularda A, Frunza A … +5 more , Grama S, Andrei MC, Neagu TP, Lascar I, Hariga CS
Eplasty · 2025 · PMID 40661098
Burn injuries resulting from domestic explosions involving liquefied petroleum gas present complex challenges in clinical management. We present 3 cases of patients with severe burn injuries, highlighting diverse present...
Burn injuries resulting from domestic explosions involving liquefied petroleum gas present complex challenges in clinical management. We present 3 cases of patients with severe burn injuries, highlighting diverse presentations and complications encountered during their treatment. Despite significant morbidity, all patients demonstrated favorable outcomes, emphasizing the importance of comprehensive management strategies. Challenges included inhalation injury, microbial infections, thromboembolic complications, and acute kidney injury. Aggressive treatment modalities, including bronchoscopy-guided therapy, targeted antimicrobial therapy, and vigilant infection control, effectively addressed these complications. Multidisciplinary collaboration and adherence to evidence-based guidelines optimized outcomes. Continued research and innovation are needed to further enhance care and improve long-term outcomes for patients with severe burns.
UAD Flap: A Contemporary Alternative to the Conventional Sural Flap for Distal Leg Wound Reconstruction.
Amiruddin MU, Hassan A, Sikandar HS … +2 more , Razzaq T, Siyyam M
Eplasty · 2025 · PMID 40661097
BACKGROUND: The reconstruction of soft tissue near the heel area is challenging, especially after wheel-spoke injuries. Different varieties of the reverse sural artery flap technique are routinely used in complex locoreg...
BACKGROUND: The reconstruction of soft tissue near the heel area is challenging, especially after wheel-spoke injuries. Different varieties of the reverse sural artery flap technique are routinely used in complex locoregional areas for reconstructive surgery. METHODS: This study proposes an innovative surgical method involving the use of a rotation-advancement fasciocutaneous flap based on peroneal artery perforators. In this study, 30 patients with soft-tissue defects in the lower third of the leg, including defects in the ankle and heel areas, were treated with this flap. RESULTS: The study included 19 women and 11 men. The mean age of the patients was 27.60 years. The most common cause of the defect was wheel-spoke injury due to a road traffic accident. In the authors' experience, the flap survival rate was approximately 100%. Four patients had only marginal necrosis of the distal tip, and 2 patients had minor wound infections; these patients were managed cautiously until their healing was complete. CONCLUSIONS: For distal leg reconstruction, the authors recommend the UAD flap over the traditional sural flap because of its lower donor-site morbidity and better aesthetic appearance.
Misconceptions in Plastic Surgery: Crowdsourcing Public Perceptions of Plastic Surgery Urban Myths.
Baranwal N, Persad-Paisley EM, Shinde N … +5 more , Spake C, Menville JE, Mehrzad R, Sobti N, Kalliainen LK
Eplasty · 2025 · PMID 40661096
BACKGROUND: Understanding public misconceptions about plastic surgery can inform plastic surgeons of the knowledge gaps among their patients and non-plastic surgeon colleagues about the field. This deepened understanding...
BACKGROUND: Understanding public misconceptions about plastic surgery can inform plastic surgeons of the knowledge gaps among their patients and non-plastic surgeon colleagues about the field. This deepened understanding may aid in optimizing patient satisfaction and health outcomes. The objective of this study was to investigate the extent to which laypeople agree with common plastic surgery urban myths. METHODS: A Likert scale-based survey of 10 popular plastic surgery myths was distributed via Amazon Mechanical Turk. Descriptive analyses and multinomial logistical regressions were performed to assess associations between respondent demographics and the likelihood of agreeing with each myth. RESULTS: A total of 2000 completed surveys were included in this study. Of the respondents, 41% believed that hand dominance is associated with a larger ipsilateral breast, 40% believed that underwire bras cause breast cancer, and 59% believed that typing causes carpal tunnel syndrome. Respondents who were male or younger than 35 years were more likely to believe in inaccurate myths. Health care workers had higher odds of agreeing with the claims that plastic surgery uses plastic (odd ratio [OR] = 2.49 [95% CI, 1.82-3.41]; <.001) and that plastic surgery is almost always cosmetic (OR = 1.85 [95% CI, 1.32-2.61]; < .001). Participants who underwent a plastic surgery procedure or consultation were generally more likely to agree with the listed myths. CONCLUSIONS: The general public and non-plastic-surgeon health care workers appear to have misconceptions about the scope and practice of plastic surgery. Open-ended patient-physician communication and patient-centered educational resources can potentially overcome plastic surgery misconceptions, thereby optimizing patient health outcomes and satisfaction.
Muscle Hernia Repair at Fascia Lata Autograft Donor Site.
Dominguez TA, Viviano S, Wang D
Eplasty · 2025 · PMID 40661095
BACKGROUND: The fascia lata autograft is a versatile material utilized in a wide variety of soft tissue reconstructive procedures. Our case highlights an instance in which harvesting fascia lata resulted in a symptomatic...
BACKGROUND: The fascia lata autograft is a versatile material utilized in a wide variety of soft tissue reconstructive procedures. Our case highlights an instance in which harvesting fascia lata resulted in a symptomatic vastus lateralis muscle herniation at the donor site that required 2 surgical revisions. METHODS: In this case, a patient developed a thigh muscle hernia at a fascia lata graft donor site. The hernia required a secondary surgical reconstruction utilizing a mesh underlay for the fascial defect repair. RESULTS: There has been no recurrence of the hernia 1 year after reconstruction, and the patient is able to ambulate normally and with minimal pain. CONCLUSIONS: Use of a fascia lata autograft can result in debilitating donor-site morbidity in certain patients. Prompt reconstruction of residual fascial defects at the time of graft harvest is ideal. However, in this patient, reconstruction with a prosthetic mesh reinforcement several years after symptomatic herniation led to significant improvement in quality of life. Cases of lateral thigh pain with associated bulge also benefit from early magnetic resonance imaging or ultrasound imaging to diagnose fascia defects or distinguish other etiologies.
Piscine-Derived Acellular Dermal Matrix in Upper Extremity Reconstruction.
Shahriari S, Whisonant C, Kuhn J … +7 more , Chavez T, Harrison J, McDonald C, Schwartz A, Suddock J, Mikola E, Borah G
Eplasty · 2025 · PMID 40661094
BACKGROUND: Wound reconstruction involving exposed critical structures, especially in medically complex patients and in those who are at high risk of loss to follow-up, presents a unique challenge to surgeons. The use of...
BACKGROUND: Wound reconstruction involving exposed critical structures, especially in medically complex patients and in those who are at high risk of loss to follow-up, presents a unique challenge to surgeons. The use of acellular dermal matrix (ADM) has augmented our ability to address these wounds safely and with minimal morbidity. A piscine ADM, the Kerecis Omega3 Wound, has shown promise in the treatment of chronic wounds and burns. In this study, we describe the use of the Omega3 Wound in reconstruction of upper extremity wounds, including those with exposed critical structures. METHODS: From 2019 to 2021, 11 consecutive patients with upper extremity wounds, including 9 with exposed critical structures, were queried. Clinical data was tabulated to evaluate outcomes. RESULTS: Etiology of the wounds included burns, trauma, infection, and oncologic resection. Wound surface area was 150 ± 42 cm. Time to incorporation of the Omega3 Wound was 2 weeks, and the vital structures of previously critical wounds were covered with granulation tissue. Clinically and histologically, the ADM became granulation tissue once incorporated. The average time from application to discharge was 6 days, with 3 patients discharged on the day of application. Skin grafting was subsequently performed at an outpatient surgical center, with 3 weeks as the average time to skin grafting. CONCLUSIONS: The Omega3 Wound allows for complete biologic integration and vascularized wound coverage that accepts a skin graft. Patients can be discharged after application and managed at outpatient facilities. This ADM is safe and well tolerated by patients (including those who are diabetic and immunocompromised) for coverage of upper extremity wounds with exposed critical structures.
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