Current Issue : April - June Volume : 2013 Issue Number : 2 Articles : 5 Articles
Achieving a level of technical skill and confidence in surgical operations is the main goal of plastic surgical training. Operating\r\nrooms were accepted as the practical teaching venues of the traditional apprenticeship model. However, increased patient\r\npopulation, time, and ethical and legal considerations made preoperation room practical work a must for plastic surgical training.\r\nThere are several plastic surgical teaching models and simulators which are very useful in preoperation room practical training and\r\nthe evaluation of plastic surgery residents. The full thickness skin with its vascular network excised in abdominoplasty procedures\r\nis an easily obtainable real human tissue which could be used as a training model in plastic surgery...
Cleft lip or palate (CL/P) is a common facial defect present in 1 : 700 live births and results in substantial burden to patients.\r\nThere are more than 500 CL/P syndromes described, the causes of which may be single-gene mutations, chromosomopathies, and\r\nexposure to teratogens. Part of the most prevalent syndromic CL/P has known etiology. Nonsyndromic CL/P, on the other hand,\r\nis a complex disorder, whose etiology is still poorly understood. Recent genome-wide association studies have contributed to the\r\nelucidation of the genetic causes, by raising reproducible susceptibility genetic variants; their etiopathogenic roles, however, are\r\ndifficult to predict, as in the case of the chromosomal region 8q24, the most corroborated locus predisposing to nonsyndromic\r\nCL/P. Knowing the genetic causes of CL/P will directly impact the genetic counseling, by estimating precise recurrence risks, and\r\nthe patient management, since the patient, followup may be partially influenced by their genetic background. This paper focuses\r\non the genetic causes of important syndromic CL/P forms (van der Woude syndrome, 22q11 deletion syndrome, and Robin\r\nsequence-associated syndromes) and depicts the recent findings in nonsyndromic CL/P research, addressing issues in the conduct\r\nof the geneticist....
Objectives. To find clinical decisions on cleft treatment based on randomized controlled trials (RCTs). Method. Searches were\r\nmade in PubMed, Embase, and Cochrane Library on cleft lip and/or palate. From the 170 articles found in the searches, 28 were\r\nconsidered adequate to guide clinical practice. Results. A scarce number of RCTs were found approaching cleft treatment. The\r\nexperimental clinical approaches analyzed in the 28 articles were infant orthopedics, rectal acetaminophen, palatal block with\r\nbupivacaine, infraorbital nerve block with bupivacaine, osteogenesis distraction, intravenous dexamethasone sodium phosphate,\r\nand alveoloplasty with bone morphogenetic protein-2 (BMP-2). Conclusions. Few randomized controlled trials were found\r\napproaching cleft treatment, and fewer related to surgical repair of this deformity. So there is a need for more multicenter\r\ncollaborations, mainly on surgical area, to reduce the variety of treatment modalities and to ensure that the cleft patient receives\r\nan evidence-based clinical practice....
The absence of the palmaris longus (PL) has been shown to vary based on body side, gender, and ethnicity. In prior studies,\r\nhomogenous ethnic populations have been shown to have differences in rates of absence. However, no study thus far has analyzed\r\nthe differences in palmaris longus prevalence in a multiethnic population.We prospectively collected data on 516 patients visiting\r\nthe outpatient hand clinics at LAC+USC Medical Center and Keck Medical Center. Analysis of the data was then performed\r\nfor variables including ethnicity, laterality, and gender. There were no differences in the absence of the PL based on laterality\r\nor gender. Ethnically, there was no difference between white (non-Hispanic) and white (Hispanic) patients, with prevalence of\r\n14.9% and 13.1%, respectively. However, African American (4.5%) and Asian (2.9%) patients had significantly fewer absences\r\nof the PL than the Caucasian, Hispanic reference group (P = 0.005 and P = 0.008, resp.). African Americans and Asians have\r\na decreased prevalence of an absent PL. The Caucasian population has a relatively greater prevalence of an absence of the PL.\r\nThis epidemiological study demonstrates the anatomic variation in this tendon and may be taken into account when planning an\r\noperation using tendon grafts....
Background. To evaluate the use, indications, and short-term outcomes for human acellular dermis. Methods. We retrospectively\r\nreviewed patients having human acellular dermis placed for ventral hernia repair from January 2008 through October 2009.\r\nDemographic information, operative details, and outcomes of patients with and without recurrences were compared; a P value\r\n<0.05 was considered significant. Results. 115 patients met inclusion criteria. The average age was 60 years (range, 24ââ?¬â??89). The\r\ntechnique of repair included primary repair with overlay of mesh in 76%, bridge repair in 13%, and underlay in 11%. Average\r\ncost of mesh per operation was $3,709 (range $191ââ?¬â??10,630). Open repairs were performed in 90% of patients with addition of\r\ncomponent separation in 12%. At an average of 13 months, 58 patients were available for followup (50%), with a 47% recurrence\r\nrate. The morbidity rate was 48% and the mortality rate was 2%. Technique of repair was the only significant risk factor for\r\nrecurrence with bridge repairs associated with a higher rate of recurrence (P < 0.05). Conclusions. The use of biologic grafts\r\nfor ventral hernia repair is becoming more popular especially in clean cases. Although followup is limited, there remains a high\r\nrecurrence rate associated with the use of human acellular dermis...
Loading....