Concept: Reconstructive surgery
Diastasis of the rectus abdominis muscles (DRAM) is characterised by thinning and widening of the linea alba, combined with laxity of the ventral abdominal musculature. This causes the midline to “bulge” when intra-abdominal pressure is increased. Plastic surgery treatment for DRAM has been thoroughly evaluated, though general surgical treatments and the efficacy of physiotherapy remain elusive. The aim of this systematic literature review is to evaluate both general surgical and physiotherapeutic treatment options for restoring DRAM in terms of postoperative complications, patient satisfaction, and recurrence rates.
In plastic surgery, skin damage induced by ischemia/reperfusion (I/R) is a multifactorial process that often occurs. Methane gas has been reported to be a new therapeutic gas for attenuating I/R injury. In this study, we assessed the effects of methane-rich saline (MRS) in regulating apoptosis on skin flap I/R injury.
To provide an overview of current approaches to penile reconstructive surgery in Peyronie disease (PD), and to discuss the challenges in restoring normal penile size and function.
Women who have undergone female genital mutilation rarely have access to the reconstructive surgery that is now available. Our objective was to assess the immediate and long-term outcomes of this surgery.
Resorbable screw fixation for orthognathic surgery is widely used in oral and maxillofacial surgery and has several advantages. However, surgeons are concerned about using resorbable screws in orthognathic surgery because of possible postoperative complications such as relapse, screw fracture, and infection. The purpose of this study was to evaluate the skeletal stability of bicortical resorbable screw fixation after sagittal split ramus osteotomies for mandibular prognathism.
Injuries are inherent to the sport of American football and often require operative management. Outcomes have been reported for certain surgical procedures in professional athletes in the National Football League (NFL), but there is little information comparing the career effect of these procedures.
The premasseter space is a recognized, sub-superficial musculoaponeurotic system (SMAS) soft-tissue space overlying the lower masseter immediately anterior to the parotid. The performance, safety, and effectiveness of composite face lifts are enhanced when the space is used. This has drawn attention to the need for better understanding of the premasseter anatomy above the space.
The hamstring tendons, gracilis and semitendinosus are widely used in ligament and reconstructive surgery. Their accessory bands or insertions are technical pitfalls during harvesting.
INTRODUCTION: Penile girth enhancement by the injection of Vaseline is an existing practice. Many cases develop severe complications that need surgery. AIM: To report on the reconstructive surgical solutions of the complications of Vaseline self-injection and the outcomes. To develop a modification of a one-step reconstruction method involving the use of pedicled scrotal flaps. MAIN OUTCOME MEASURES: The complications and their surgical solutions were classified as regards severity and difficulty. The outcomes were observed and a newly introduced one-step surgical method was investigated. METHODS: Seventy-eight consecutive patients (87.2% of them with a history of imprisonment) were divided into three groups. In group A, aesthetic penile defects or phimosis caused by the Vaseline necessitated circumcision or local excision. In group B, the whole penile skin was involved, and total skin removal and two- or (a newly modified) one-step reconstructive surgery were performed. In group C, both the whole penile skin and the scrotum were involved: complete skin removal and skin grafting or skin pedicled flap transplantation were carried out. RESULTS: In five cases in group B, postoperative skin necrosis made a second operation necessary. There was one intraoperative urethral injury, where a urethral fistula developed and a second urethral reconstruction was performed. There was no major complication with the newly developed one-stage pedicled flap procedure. At the end of the therapy, all the cases were healed. All of the patients reported successful sexual intercourse after the operations and 91% were satisfied with the result. CONCLUSIONS: The complications depend mainly on the amount of Vaseline injected, the hygienic circumstances, and the personal tolerability. In the worst cases, only radical skin removal and skin transplantation can solve the problem. The newly developed one-step arterial branch-preserving scrotal skin flap reconstruction appears to be a suitable and cost-effective solution for these patients.
BACKGROUND: The sheer number of accepted inferior turbinoplasty techniques emphasizes the fact that there is no general agreement on which approach yields optimal results, nor are there data available that describes prevalent techniques in turbinate surgery among plastic surgeons. OBJECTIVE: The aim of this study was to identify practice patterns among plastic surgeons who perform inferior turbinoplasty during rhinoplasty. METHODS: Members of the American Society of Plastic Surgeons were invited to participate in an anonymous, Internet-based survey containing questions related to personal preferences and outcomes in inferior turbinate surgery. RESULTS: A total of 534 members of the American Society of Plastic Surgeons participated in the survey. Most (71.7%) trained in an independent plastic surgery program with prerequisite training in general surgery. More than half (50.6%) had more than 20 years of operative experience; only 15.2% reported performing greater than 40 rhinoplasties per year. The 5 most preferred inferior turbinate reduction techniques were outfracture of the turbinates (49.1%), partial turbinectomy (33.3%), submucous reduction via electrocautery (25.3%), submucous resection (23.6%), and electrocautery (22.5%). Fewer than 10% of the respondents reported the use of newer techniques such as radiofrequency thermal ablation (5.6%), use of the microdebrider (2.2%), laser cautery (1.1%), or cryosurgery (0.6%). Mucosal crusting and desiccation were the most frequently reported complications. CONCLUSIONS: The results of this survey provide insights into the current preferences in inferior turbinate reduction surgery. Plastic surgeons are performing more conventional methods of turbinate reduction rather than taking advantage of the many of the more novel technology-driven methods.