Eplasty [JOURNAL]
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200 papers
Effects of Screening Hemoglobin A1C on Complications in Implant-Based Breast Reconstruction.
Capito AE, Potturi N, Canzoneri CN … +6 more , Applebaum MA, Hamlin S, Choi J, Lozano AJ, Ji W, Moyer KE
Eplasty · 2024 · PMID 40463921
BACKGROUND: Many institutions have implemented universal hemoglobin A1c (HbA1c) screening for all preoperative patients in an effort to reduce rates of surgical complications. However, the usefulness of HbA1c screening f...
BACKGROUND: Many institutions have implemented universal hemoglobin A1c (HbA1c) screening for all preoperative patients in an effort to reduce rates of surgical complications. However, the usefulness of HbA1c screening for predicting complications after implant-based breast reconstruction has yet to be determined. The purpose of this study was to investigate the predictive value of HbA1c screening on postoperative complications following implant-based breast reconstruction. METHODS: A retrospective cohort study of patients who underwent implant-based breast reconstruction at a single institution was conducted. All patients required an HbA1c screening preoperatively. Patients were categorized into 2 groups: normal HbA1c (<5.7%) or abnormal HbA1c (≥5.7%). The 2 groups were propensity score matched for baseline characteristics and compared for complication rates after the first- and second-stage procedures. RESULTS: In this study, 203 patients who underwent first-stage breast reconstruction were divided into normal HbA1c (n = 135) and abnormal HbA1c (n = 68) cohorts. A propensity score weighted analysis demonstrated increased risk of incisional dehiscence in the abnormal group ( = .050). Ninety-nine patients who underwent second-stage breast reconstruction were divided into normal HbA1c (n = 55) and abnormal HbA1c (n = 44) cohorts. The abnormal HbA1c group demonstrated marginally higher rates of implant loss ( = .059). Otherwise, no statistically significant differences were noted in rates of surgical site infection, seroma or hematoma formation, or implant rupture. CONCLUSIONS: Patients with abnormal HbA1c on preoperative screening demonstrated higher rates of incisional dehiscence after first-stage breast reconstruction and higher rates of implant loss following second-stage breast reconstruction. Obtaining routine preoperative HbA1c screening should be considered as an adjunct to guide discussions about surgical risk for patients undergoing breast reconstruction.
Bilateral Nipple Piercings and Subsequent Methicillin-Resistant Staphylococcus Aureus Breast Abscess Formation.
Miller NW, Koenig ZA, Woodberry KM
Eplasty · 2024 · PMID 40463920
BACKGROUND: Breast infections associated with nipple piercings present a unique puzzle for clinicians because of the lack of sterile regulations surrounding the procedure. As a result, providers must consider wider range...
BACKGROUND: Breast infections associated with nipple piercings present a unique puzzle for clinicians because of the lack of sterile regulations surrounding the procedure. As a result, providers must consider wider ranges of infectious etiologies and have a low threshold for initiating broad spectrum antibiotic therapy and operative intervention to prevent detrimental complications. METHODS: The authors present the case of a 39-year-old female who developed a methicillin-resistant right-breast abscess approximately 7 weeks following bilateral nipple piercings. RESULTS: Management included ultrasound-guided aspiration for the diagnosis and confirmation of the abscess, incision and drainage in the operating room, and both intravenous and oral antibiotic therapy. The patient recovered appropriately without recurrence of infection 6 weeks postoperatively. CONCLUSIONS: Given the rise in intimate body piercings, it is imperative to document complications to improve clinician treatment protocols and guide governmental bodies to make this practice as safe as possible.
Single-Stage Metacarpal Lengthening for Traumatic Metacarpal Malunion: A Case Report and Surgical Technique.
McLaughlin M, Collins DP, Doarn MC … +1 more , Collins DW
Eplasty · 2024 · PMID 40463919
A novel technique that requires a single-stage operation utilizing an intramedullary device is presented for metacarpal lengthening in setting of traumatic malunions. The patient desired surgical correction due to malrot...
A novel technique that requires a single-stage operation utilizing an intramedullary device is presented for metacarpal lengthening in setting of traumatic malunions. The patient desired surgical correction due to malrotation with full fist formation and a 25-degree extensor lag. Following single-stage lengthening with osteotomy, bone graft, and intramedullary screw, length was restored and the patient had full passive range of motion. The patient's graft site incorporated well with robust callus formation with mild resorption and collapse. Clinically, he maintained appropriate rotation and had a 5-degree extensor lag with the ability to make a composite fist. The patient was satisfied with his result and returned to normal activities.
Statewide Prevalence of Congenital Hand Anomalies: A 6-Year Review of Patients Presenting to Mississippi's Only Children's Hospital.
Corder BN, Benedict KC, Buie HG … +3 more , Moak RM, McCandless MG, Walker ME
Eplasty · 2024 · PMID 40463918
BACKGROUND: Incidence and prevalence data for congenital upper extremity anomalies in the literature are scarce due to lack of reporting requirements, absence of a centralized database, and insufficient referral networks...
BACKGROUND: Incidence and prevalence data for congenital upper extremity anomalies in the literature are scarce due to lack of reporting requirements, absence of a centralized database, and insufficient referral networks. As the state's only pediatric hospital and congenital hand clinic, the University of Mississippi Medical Center (UMMC) is uniquely positioned to report the per capita rate of congenital upper extremity anomalies. METHODS: Pediatric patients presenting from 2015 to 2020 were identified using International Classification of Diseases codes in the UMMC electronic medical record. Exclusion criteria included age older than 18 years at presentation and defects secondary to trauma. Diagnoses included polydactyly, syndactyly, reduction defects, club hand malformations, and syndromes with upper limb anomalies. Demographic data were collected including age, race, sex, maternal age, family history of extremity anomalies, geographic location, and insurance status. Geographic trends were identified, and results were presented in incidence of disease per 10,000 births. RESULTS: A total of 477 pediatric patients presented with a congenital upper extremity anomaly from 2015 to 2020. The average rate of congenital upper extremity anomalies in Mississippi was 21.5 per 10,000 births. The 3 most common upper extremity anomalies were polydactyly (13.1 per 10,000 births), congenital trigger thumb (2.67 per 10,000 births), and syndactyly (1.66 per 10,000 births). The polydactyly group was further divided into preaxial (1.98 per 10,000 births) and postaxial (10.9 per 10,000 births) polydactyly. There was a male predominance in presentation with 60.4% (n = 288) of patients being male. CONCLUSIONS: In the past 5 years, only New York State has published similar findings delineating the incidence of congenital hand anomalies through their Birth Defect Registry. The prevalence of upper extremity defects presenting to UMMC from 2015 to 2020 was 21.5 per 10,000 births; however, 5 specific counties had a significantly higher prevalence, ranging from 53.65 to 63.97 per 10,000 births. To develop effective programs to comprehensively treat these pediatric patients, accurate reporting and data collection mechanisms are critical.
A Case of Upper Extremity Gangrene Likely Secondary to Mucormycosis.
Cortes R, Ghose S, Chao J … +1 more , Ignatiuk A
Eplasty · 2024 · PMID 39502138
Abstract loading — click title to view on PubMed.
Aftermath of Sulfur Mustard Poisoning.
Milner SM
Eplasty · 2024 · PMID 39502137
Abstract loading — click title to view on PubMed.
Efficacy and Safety of Barbed Sutures for Capsulorrhaphy in Implant-Based Breast Reconstruction.
Tyle MR, Nester M, McLaughlin M … +8 more , Olafson A, Le NK, Whalen K, Juybari C, Coughlin E, Mhaskar R, Smith PD, Dayicioglu D
Eplasty · 2024 · PMID 39474008
BACKGROUND: A common postoperative challenge following implant-based breast reconstruction surgery is lateral or inferior displacement of the implant, which ultimately requires surgical intervention to shape the pocket f...
BACKGROUND: A common postoperative challenge following implant-based breast reconstruction surgery is lateral or inferior displacement of the implant, which ultimately requires surgical intervention to shape the pocket for improved symmetry. Capsulorrhaphy is traditionally performed with smooth sutures, but the use of barbed sutures has proven to be more efficient and effective in other plastic surgery procedures. This study aimed to demonstrate the safety and efficacy of barbed sutures for breast reconstruction implant capsulorrhaphy. METHODS: A retrospective cohort study was performed including all consecutive patients who underwent capsulorrhaphy by the senior author utilizing barbed sutures and, for comparison, another colleague utilizing smooth sutures from the years 2018-2021. RESULTS: Twenty-eight patients were identified who underwent barbed suture capsulorrhaphy (a total of 36 breasts operated on), which was compared with 20 patients who had smooth suture capsulorrhaphy (a total of 34 breasts operated on). The average ages of the barbed and smooth suture cohorts were 55 and 53 years old ( = 1.00), respectively. The average BMI of the barbed and smooth suture cohorts were 26.7 and 25.0 kg/m ( = .15), respectively. The reoperation rates for both groups were similar at 5%. Overall complication rate was 13.9% in the barbed suture group and 8.8% in the smooth suture group, which was not statistically significant ( = .71). Patients with barbed sutures did not have an increased risk of complications compared with those who received smooth sutures (OR 1.67 (0.37-7.59), = .51). CONCLUSIONS: In conclusion, performing implant-based breast reconstruction capsulorrhaphy with barbed sutures is a safe and effective procedure as compared with smooth sutures.
Coincidence of Brachial Plexus Upper Trunk and Long Thoracic Nerve Injuries in 50 Patients With Winged Scapula: Improvements in Shoulder Stability and Functional Movements After Decompression and Neurolysis.
Nath RK, Somasundaram C
Eplasty · 2024 · PMID 39474007
BACKGROUND: Injuries to the long thoracic nerve (LTN) and upper trunk of the brachial plexus (UTBP) can occur simultaneously and cause scapular winging and shoulder instability. The literature has not documented the conc...
BACKGROUND: Injuries to the long thoracic nerve (LTN) and upper trunk of the brachial plexus (UTBP) can occur simultaneously and cause scapular winging and shoulder instability. The literature has not documented the concurrent occurrence of UTBP and LTN injuries in these patients. We show an upper trunk injury in patients whose preoperative electromyography (EMG) did not show injury to the UTBP. METHODS: We screened patients with traumatic brachial plexus injuries and associated nerve injuries and identified 50 patients (29 men and 21 women; 31 right side and 19 left side; mean age 34 years, range 16-63 years) with winged scapula and shoulder instability who had undergone neurolysis and decompression of the UTBP and LTN with the lead author and surgeon, R.K.N. We measured and compared the compound motor action potentials (CMAPs) of the upper limb nerves before and after neurolysis during intraoperative neurophysiological monitoring (IONM) and compared it with surgical outcomes. RESULTS: After surgery, IONM showed a significant increase in CMAPs for all 4 muscles: serratus anterior (295 ± 291 to 886 ± 937), supraspinatus (237 ± 216 to 618 ± 423), deltoid (344 ± 446 to 936 ± 1015), and biceps (492 ± 656 to 1109 ± 1230, < .0001). The CMAPs of the 4 upper extremity (UE) muscles showed a positive correlation before and after surgery (R = 0.6, 0.28, 0.59, 0.57, respectively; < .0001). Preoperatively, all patients had severe to moderate scapular winging and 15° - <170° in active range of motion (shoulder forward flexion and abduction). Scapular winging, shoulder flexion, and abduction improved significantly in 98% (n = 49) of the patients with a postoperative average of 168° ± 11° and 165° ± 16°, respectively, compared with the preoperative average of 127° ± 30° and 122° ± 29°, respectively, ( < .0001) with a mean follow-up of 1.3 years. Postoperatively, no patient experienced a worsening of their preoperative symptoms. CONCLUSIONS: Our article presents the first documented occurrence of a long thoracic nerve injury coinciding with a brachial plexus upper trunk lesion in 50 patients with scapular winging whose preoperative EMG did not show injury to the UTBP. Neurolysis of the UTBP and LTN immediately increased the nerve conduction to the UE muscles evaluated intraoperatively.
Have We Really Shifted to an Evidence-Based Practice? A Qualitative Analysis of Primary Breast Augmentation.
Scarafoni EE, Cingozoglu CAC
Eplasty · 2024 · PMID 39474006
BACKGROUND: Primary breast augmentation remains the most frequently performed aesthetic surgery worldwide. Advances in this surgery have been incredible, not only from a surgical technique point of view but also since th...
BACKGROUND: Primary breast augmentation remains the most frequently performed aesthetic surgery worldwide. Advances in this surgery have been incredible, not only from a surgical technique point of view but also since the appearance of new technologies and the better understanding of the interactions between the patient, the breast implant, the usual bacterial flora, and surgical maneuvers. However, there are still several instances of surgical procedure or postoperative medical indications that differ remarkably from one surgeon to another and may even be totally opposite. Due to the lack of a clinical practice guide for performing a primary augmentation mastoplasty, it is important to compare surgeon's procedures and decisions with scientific evidence. METHODS: An anonymous survey composed of 25 multiple choice questions was designed to assess current practice in primary breast augmentation among active members of the Argentinian Society of Plastic Surgery. In January 2020, it was distributed via email. The results of the surveys were compiled by 2 independent reviewers and contrasted with current medical evidence. RESULTS: A total of 146 surveys were completed by members of the Argentinian Society of Plastic Surgery. CONCLUSION: Many differences were found in the behavior of the surgeons surveyed, as well as a lack of correlation between the evidence based on medicine and the usual medical practices or indications. These results should serve as the basis for the realization of a clinical practice guide from a scientific society of plastic surgeons.
Reconstructive Management of a Severe Mentosternal Contracture in a Resource-Limited Setting: A Case Report from Ghana, West Africa.
Benson R, Rego E, Benneh A … +1 more , Lee ES
Eplasty · 2024 · PMID 39474005
This case report describes the surgical management of a severe mentosternal contracture in a 49-year-old woman in Ghana, West Africa, secondary to an acid burn injury. With limited resources, the treatment involved scar...
This case report describes the surgical management of a severe mentosternal contracture in a 49-year-old woman in Ghana, West Africa, secondary to an acid burn injury. With limited resources, the treatment involved scar excision and full-thickness skin grafting in a single operation performed solely under local anesthetic infiltration, with no use of oral, inhaled, or parenteral anesthetic or sedating agents. As we were unable to find any documented cases performed under only local anesthesia, this case highlights a simplified reconstructive and anesthetic approach to managing complex, disabling burn contractures in low-income countries, particularly where advanced reconstructive options and monitored anesthesia care are not readily available.
Clinical, Electrophysiological, and Intraoperative Analysis and Postoperative Success of Revision Surgery for Persistent and Recurrent Carpal Tunnel Syndrome.
Jones Q, Hill EE, Li A … +4 more , Pereira C, Dave D, Robker J, Jones NF
Eplasty · 2024 · PMID 39474004
BACKGROUND: This paper reviews the signs and symptoms of recurrent or persistent carpal tunnel syndrome and examines some of the causes of failed primary carpal tunnel release. METHODS: A retrospective review of the surg...
BACKGROUND: This paper reviews the signs and symptoms of recurrent or persistent carpal tunnel syndrome and examines some of the causes of failed primary carpal tunnel release. METHODS: A retrospective review of the surgical findings and outcomes of 29 consecutive patients who underwent 30 revision carpal tunnel operations was performed. Patient outcomes were recorded at a minimum of 1 year postoperatively. RESULTS: Thirty hands in 29 consecutive patients underwent a second operation by a single surgeon. The average time interval from the first carpal tunnel release to the revision surgery was 5.7 years. Twenty-three patients experienced recurrent symptoms, and 7 had persistent symptoms. On preoperative examination, 77% demonstrated abductor pollicis brevis muscle weakness, 67% demonstrated a positive Phalen sign, and 63% demonstrated ring finger "sensory splitting." Incomplete release of the transverse carpal ligament and circumferential fibrosis were the most common intraoperative findings, totaling 20 cases each; intact antebrachial fascia (8 cases), volar subluxation of the median nerve (5 cases), compression of the median nerve by palmaris longus (4 cases), flexor tenosynovitis (4 cases), and aberrant anatomy (1 case) were also observed. Nine patients (34%) had complete resolution of symptoms after the revision carpal tunnel release. Fifteen patients (58%) had improvement in symptoms, and 2 patients did not report improvement. CONCLUSIONS: We have found the Phalen sign, comparison of the strength of the abductor pollicis brevis muscle, and subjective "splitting" of the ring finger sensation to be the most helpful findings in establishing the diagnosis. Persistent carpal tunnel syndrome is almost always secondary to incomplete division of the transverse carpal ligament.
Not a Jersey Finger - A Case of a Closed Traumatic Rupture of the Small Finger Flexor Digitorum Profundus Tendon at the Lumbrical Origin.
Germann AM, Stanley SS
Eplasty · 2024 · PMID 39474003
A 55-year-old right-handed male presented acutely with inability to flex at the distal interphalangeal (DIP) joint of the right small finger after feeling a pop while moving heavy furniture. Avulsion of the flexor digito...
A 55-year-old right-handed male presented acutely with inability to flex at the distal interphalangeal (DIP) joint of the right small finger after feeling a pop while moving heavy furniture. Avulsion of the flexor digitorum profundus (FDP) tendon at its insertion, or "jersey finger," was suspected. During operative exploration, the insertion on the distal phalanx was intact, and the rupture was noted proximally at the level of the lumbrical origin. There are cases in the literature describing attritional ruptures of the tendon proximally due to metacarpophalangeal or intercarpal arthrosis, but this is the first case of a closed, proximal tendon rupture due solely to trauma. Imaging may be helpful to diagnose the level of tendon rupture. We propose surgeons perform an A1 pulley incision to determine the level of rupture prior to planning the surgical exposure for tendon repair.
Effect of Tissue Expanders Filled With Saline Versus Air on Longitudinal Breast Reconstruction Outcomes.
Shaheen M, Goli R, Yesantharao P … +3 more , Arquette C, Makarewicz N, Nazerali RS
Eplasty · 2024 · PMID 39474002
BACKGROUND: Intraoperative expansion with air, as compared with saline, has been associated with fewer first-stage complications in 2-stage expander-implant breast reconstruction. However, longitudinal reconstructive out...
BACKGROUND: Intraoperative expansion with air, as compared with saline, has been associated with fewer first-stage complications in 2-stage expander-implant breast reconstruction. However, longitudinal reconstructive outcomes, postoperative medication use indicating pain or discomfort, as well as patient-reported outcome measures after intraoperative air versus saline fill have not yet been investigated. METHODS: This is a retrospective cohort investigation of 69 patients who underwent 2-stage expander-implant prepectoral breast reconstruction with acellular dermal matrix in 2017 and 2018. Patients underwent intraoperative tissue expander (TE) fill with air or saline during stage 1 of reconstruction and underwent expander-implant exchange in stage 2. Air versus saline cohorts were compared with regards to time to definitive reconstruction and postoperative pain/opioid use. RESULTS: Of the 69 patients studied, 47 (68.1%) had tissue expanders filled with air and 22 (31.9%) filled with saline. In multivariable regression analysis, air-filled TEs were associated with significantly lower odds of requiring an opioid prescription refill (adjusted odds ratio [aOR] = 0.27; = .009) and breast pain (aOR = 0.10; < .001). The use of air instead of saline TEs also had no adverse impact on the length of time or number of office visits between stages. CONCLUSIONS: Intraoperative air versus saline TE fill appears to impact longitudinal reconstructive outcomes in expander-implant based reconstruction. Our results demonstrated that air-filled TEs were associated with significantly lower odds of opioid refills and breast pain. Our study also indicates that timing and office visits between stages do not appear to be affected by TE fill medium.
Soft Tissue Support as an Adjunct to Implant-Based Cosmetic Breast Surgery: A 500+ Case Experience.
Chiemi J, Kelishadi SS
Eplasty · 2024 · PMID 39474001
BACKGROUND: Intraoperative techniques to maximize control are crucial to achieving an aesthetic result in cosmetic breast surgery with implants. The authors describe their experience with the use of polydioxanone (PDO) i...
BACKGROUND: Intraoperative techniques to maximize control are crucial to achieving an aesthetic result in cosmetic breast surgery with implants. The authors describe their experience with the use of polydioxanone (PDO) internal support matrix in a high volume of primary augmentation, primary mastopexy augmentation, and revision augmentation cases. METHODS: A high-volume (n = 522) single-surgeon experience followed patient outcomes in consecutive cases from September 2020 to June 2023. All patients received smooth-shelled silicone gel breast implant augmentation surgeries with PDO mesh as an adjunct. Each case used at least 1 sheet of PDO mesh, with a small set (n = 9) receiving 2 sheets. Patients were followed (range 6-37 months), with 6 months minimum follow-up to assess outcomes. RESULTS: PDO mesh is associated with decreased malposition in primary augmentation with smooth implants and improved scarring in primary and revision augmentations involving a mastopexy. Augmentations performed with PDO mesh as an adjunct allowed for the use of larger implant volumes with less concern over poor soft tissue stores and compromised skin quality to hold the weight of the implant. CONCLUSIONS: PDO mesh is a safe and effective adjunct to smooth silicone gel implants to obtain greater pocket control and optimal aesthetic results in cosmetic breast surgeries.
Nitinol Compression Staple Versus Headless Compression Screw Fixation for Scaphoid Waist Fractures.
Kurland AM, Congiusta DV, Ignatiuk A … +3 more , Kirschenbaum AE, Vosbikian MM, Ahmed IH
Eplasty · 2024 · PMID 39474000
BACKGROUND: There are a variety of ways to surgically manage patients with scaphoid waist fractures. The purpose of this study is to compare the rate of union achieved with a nitinol compression staple versus that of a h...
BACKGROUND: There are a variety of ways to surgically manage patients with scaphoid waist fractures. The purpose of this study is to compare the rate of union achieved with a nitinol compression staple versus that of a headless compression screw in the treatment of scaphoid waist fractures. METHODS: We performed a retrospective review of patients with middle-third scaphoid fractures treated surgically. Patients were stratified into 2 groups based on fixation device: a nitinol compression staple or headless compression screw (HCS). Primary outcome was radiographic union. Secondary outcomes included time from surgery to union, development of avascular necrosis (AVN), complication rate, and need for revision. RESULTS: Forty-one patients were included in the final analysis. The median follow-up time was 5.7 months. Twenty patients were treated with staples, 21 with HCS. Thirty-seven patients achieved union. All who failed to unite were treated with HCS. Eight patients had postoperative complications, including postoperative AVN, all of whom were in the HCS cohort. This treatment group had a higher rate of revision surgery as well. Staples required less time to achieve union and fewer weeks of immobilization. Postoperative scapholunate angles were similar between the groups. CONCLUSIONS: Fixation of scaphoid waist fracture with nitinol compression staples is at least as likely to achieve union as fixation with HCS in patients without prior surgical intervention. This treatment also demonstrated equivalent or better secondary outcomes, including postoperative AVN, complication and revision rates, time to union, and weeks immobilized.
Use of Dermal Substrate for the Treatment of Pediatric Deep Partial-Thickness Burns.
Bergus KC, Schwartz DM, Patterson KN … +3 more , Srinivas S, Fabia R, Thakkar RK
Eplasty · 2024 · PMID 39473999
BACKGROUND: Dermal substrates (DS) are native skin substitutes applied to facilitate wound healing in burn patients, either as definite treatment or to prepare wound beds for grafting. Our study aimed to characterize wou...
BACKGROUND: Dermal substrates (DS) are native skin substitutes applied to facilitate wound healing in burn patients, either as definite treatment or to prepare wound beds for grafting. Our study aimed to characterize wound healing after DS application among pediatric patients with deep partial-thickness burns. METHODS: We retrospectively reviewed patients <18 years old at our American Burn Association-verified pediatric burn center from 2015-2023 who underwent burn excision and application of either DS alone or DS with subsequent autografting. All patients were treated with a single DS containing fetal bovine dermal repair scaffold. We collected demographic data, injury details, operative procedures, and postoperative wound complications. We compared patients with χ and Fisher exact tests. RESULTS: Among 205 patients, 84.4% healed with treatment with DS alone and 15.6% required autografting after DS application. Median age at DS application was 3.0 years. Most patients were male (60.0%) and White (63.9%). Patients most commonly had scald (47.8%) or flame burns (32.2%). Median total body surface area burned was 6.0% (IQR 3.0%, 10.3%). Patients needing autografting after DS placement healed a median of 50% (IQR 28.1%, 77.5%) of their original wound surface area after DS application. Complications were overall low in both groups. Patients who only required DS had lower rates of wound infection (2.9% vs 12.5%, = .029) and scar contracture compared with those who required subsequent autografting (5.8% vs 15.6%, = .045). CONCLUSIONS: Children with deep partial-thickness burn injuries treated with DS alone had a high proportion of wound healing and low rates of complications. Although some patients may require subsequent autografting after DS application, the proportion of the wound requiring autografting was half of the size of the original wound. Our findings can help surgeons counsel pediatric burn patients and their families about expectations following DS application for deep partial-thickness burns.
Regenerative Peripheral Nerve Interfaces for the Management of Symptomatic Non-extremity Neuropathic Pain and Neuromas.
Baranwal N, Menville JE, Persad-Paisley EM … +2 more , Sobti N, Kalliainen LK
Eplasty · 2024 · PMID 39473998
INTRODUCTION: Regenerative peripheral nerve interfaces (RPNI) can be used to mitigate neuropathic pain resulting from nerve injury or neuroma formation following trauma, surgery, or amputation. Most of the current litera...
INTRODUCTION: Regenerative peripheral nerve interfaces (RPNI) can be used to mitigate neuropathic pain resulting from nerve injury or neuroma formation following trauma, surgery, or amputation. Most of the current literature discusses the utility of RPNI for the treatment of neuropathic pain in the upper and lower extremities; however, RPNI can also improve neuropathic pain in non-extremity regions. Our objective was to characterize and describe patient cases of non-extremity RPNIs. METHODS: We retrospectively reviewed medical records of patients treated with RPNIs for non-extremity neuropathic pain by the senior author at a single institution between February 2020 and October 2023. CASES: Seven patients were treated with RPNI in non-extremity regions. For 1 patient, RPNI was performed prophylactically following discovery of injured peripheral nerves during a surgery and the patient did not report any neuropathic pain in the related regions afterwards. Six patients presented with nerve pain in multiple regions, including the scalp, face, trunk, and groin, that began either after a trauma or previous surgery. The nerve pain of 5 patients completely resolved after the creation of an RPNI. DISCUSSION: The creation of an RPNI is relatively straightforward and can relieve or prevent peripheral nerve pain caused by injured nerves. While RPNIs have mainly been used for the treatment or prevention of neuromas in extremities, this case series demonstrates efficacy in non-extremity areas as well. Surgeons can, therefore, consider RPNI for patients who have neuropathic pain due to suspected nerve injury that has been refractory to other treatments.
Can ChatGPT Be Used as a Research Assistant and a Patient Consultant in Plastic Surgery? A Review of 3 Key Information Domains.
Campolo JA, Kwon DY, Henderson PW
Eplasty · 2024 · PMID 39473997
BACKGROUND: Chat Generative Pretrained Transformer (ChatGPT), a newly developed pretrained artificial intelligence (AI) chatbot, is able to interpret and respond to user-generated questions. As such, many questions have...
BACKGROUND: Chat Generative Pretrained Transformer (ChatGPT), a newly developed pretrained artificial intelligence (AI) chatbot, is able to interpret and respond to user-generated questions. As such, many questions have been raised about its potential uses and limitations. While preliminary literature suggests that ChatGPT can be used in medicine as a research assistant and patient consultant, its reliability in providing original and accurate information is still unknown. Therefore, the purpose of this project was to conduct a review on the utility of ChatGPT in plastic surgery. METHODS: On August 25, 2023, a thorough literature search was conducted on PubMed. Papers involving ChatGPT and medical research were included. Papers that were not written in English were excluded. Related papers were evaluated and synthesized into 3 information domains: generating original research topics, summarizing and extracting information from medical literature and databases, and conducting patient consultation. RESULTS: Out of 57 initial papers, 8 met inclusion criteria. An additional 2 were added based on the references of relevant papers, bringing the total number to 10. ChatGPT can be useful in helping clinicians brainstorm and gain a general understanding of the literature landscape. However, its inability to give patient-specific information and act as a reliable source of information limit its use in patient consultation. CONCLUSION: ChatGPT can be a useful tool in the conception of and execution of literature searches and research information retrieval (with increased reliability when queries are specific); however, the technology is currently not reliable enough to be implemented in a clinical setting.
Use of the Trapezius Myocutaenous Flap for Shoulder Reconstruction.
Firlik T, Means O, Fahrenkopf M
Eplasty · 2024 · PMID 39233709
Abstract loading — click title to view on PubMed.
Cost Effective, Simple, and Reliable Intraoperative Breast Sizer for Selecting Implant Volume in Breast Reconstruction With Double-Drape, Double-Donut: Standard Lap Pad.
Cantrell RA, Mostovych AL, Prewitt C … +3 more , Fell C, Shockley SM, Wilhelmi BJ
Eplasty · 2024 · PMID 39233708
Abstract loading — click title to view on PubMed.
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