-
External auditory canal reconstruction following subtotal auricular resection with a tragal lobule wrap flap
Abstract Different etiologies may lead to total auricular and external auditory canal wall ablation. These include burns, tumors, trauma,
and malformations. Reconstruction of the canal wall and maintaining its patency pose as a great challenge in plastic surgery.
Inability to do so may lead to a serious hearing impairment. To date, different procedures aim at restoring this patency and
include skin grafts and local flaps. Unfortunately, skin grafts are associated with a high contracture rate. Local flaps are
associated with donor site morbidity. We present a case of an 85-year-old man who underwent auricular ablation due to squamous
cell carcinoma which included the external auditory canal. Sparing the tragal and lobular areas within the surgical margins
using frozen section-controlled margins, we were able to reconstruct the canal wall. The tragal lobular wrap flap provides
a valuable and consistent long-lasting method for auricular canal reconstruction and postauricular amputation wound coverage.
Level of evidence: Level V, therapeutic study.
- Content Type Journal Article
- Category Ideas and Innovations
- Pages 1-5
- DOI 10.1007/s00238-012-0727-x
- Authors
- Amir Inbal, The Department of Plastic and Reconstructive Surgery, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Yoav Barnea, The Department of Plastic and Reconstructive Surgery, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Jerry Weiss, The Department of Plastic and Reconstructive Surgery, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
-
Combined use of homologous fascia lata graft and acellular dermal substitute for the repair of a complex abdominal wound
Abstract Full-thickness abdominal wall defects complicated with bowel exposure require a stable reconstruction that may be achieved
with mesh repair, muscle rotational flaps, pedicled flaps, freeflaps or any combination of these techniques. We present a
case report of a complex abdominal wound caused by a gunshot trauma in an elderly patient. His general health condition and
local disruption of the left rectus, external, internal oblique and transverse abdominis muscles prevent local flaps or major
surgical reconstruction procedures. The combined use in multiple stages of a homologous fascia lata graft, negative pressure
therapy and acellular dermal substitute template followed by skin graft allowed stable wound healing.
Level of Evidence: Level V, therapeutic study
- Content Type Journal Article
- Category Case Report
- Pages 1-5
- DOI 10.1007/s00238-012-0726-y
- Authors
- Cesare Tiengo, Division of Plastic and Reconstructive Surgery and Burn Unit, Padova University Hospital, Padova, Italy
- Alex Pontini, Division of Plastic and Reconstructive Surgery and Burn Unit, Padova University Hospital, Padova, Italy
- Bruno Azzena, Division of Plastic and Reconstructive Surgery and Burn Unit, Padova University Hospital, Padova, Italy
-
Dual-Sided Polytetrafluoroethylene mesh in Immediate Prosthetic Breast Reconstruction following Treatment of Severe Fibrocystic Mastopathy
Abstract Breast reconstruction is well established, with various options, and every effort should be employed in order to recreate
a natural breast symmetry while preserving safety and quality of life for patients. In recent years, immediate breast reconstruction,
using either prostheses or autogenous tissue, has gained wider acceptance. Whenever possible, immediate breast reconstruction
should be recommended, allowing that the reconstruction is made at the time of mastectomy under the same anesthesia. This
technical evolution allows better preservation of the skin and pectoral muscles, reducing the feeling of mutilation and emphasizing
the indication of immediate reconstruction. In this work, the authors present a clinical case of breast reconstruction of
a 35-year-old patient with severe fibrocystic mastopathy, who has been submitted to subcutaneous mastectomy and immediate
breast reconstruction with breast implants using a dual-sided polytetrafluoroethylene mesh, in the lower pole of the breast,
highlighting the importance and success of this type of material, being a good option in cases of breast reconstruction when
there is an inadequate coverage of the implants by the pectoralis muscle.
Level of Evidence: Level V, therapeutic study.
- Content Type Journal Article
- Category Ideas and Innovations
- Pages 1-5
- DOI 10.1007/s00238-012-0724-0
- Authors
- Gustavo Coelho, Plastic, Reconstructive & Maxillo-Facial Surgery Department, Centro Hospitalar de Vila Nova de Gaia, Oporto, Portugal
- Luís Azevedo, Plastic, Reconstructive & Maxillo-Facial Surgery Department, Centro Hospitalar de Vila Nova de Gaia, Oporto, Portugal
- Horácio Zenha, Plastic, Reconstructive & Maxillo-Facial Surgery Department, Centro Hospitalar de Vila Nova de Gaia, Oporto, Portugal
- Maria da Luz Barroso, Plastic, Reconstructive & Maxillo-Facial Surgery Department, Centro Hospitalar de Vila Nova de Gaia, Oporto, Portugal
- Augusta Cardoso, Plastic, Reconstructive & Maxillo-Facial Surgery Department, Centro Hospitalar de Vila Nova de Gaia, Oporto, Portugal
- Horácio Costa, Plastic, Reconstructive & Maxillo-Facial Surgery Department, Centro Hospitalar de Vila Nova de Gaia, Oporto, Portugal
-
Combined prosthetic incisional hernioplasty and panniculectomy—a 5-year single-centre experience
Abstract
Background Ventral incisional hernia patients develop limitation in physical activities as the hernia enlarges, leading to alteration
in their lifestyle, quality of life, aesthetic deformities, and occasionally to complications. Cosmetic improvement of the
abdomen, an important objective of hernia repair, can be achieved when hernia repair is combined with panniculectomy. The
authors undertook this study to review their experience of the integration of hernia repair and panniculectomy to improve
the understanding and treatment of this condition.
Methods A retrospective analysis of the records of patients who underwent abdominal hernia repair with panniculectomy from 2005 to
2010 was undertaken. The records were reviewed for patient demographics, hernia etiology, risk factors for recurrence, previous
surgeries, previous approach, type of repair, incision approach, complications, length of hospital stay, and duration of follow-up.
Surgical management included mesh hernia repair and pannus excision.
Results Of the total 45 patients, mean age was 42.37 years and mean follow-up was 24.4 months. Twelve patients had recurrent hernias.
Most of the patients underwent retrorectus underlay mesh repair [39 (86.67 %)], while 6 (13.33 %) underwent onlay mesh technique.
Six (13.33 %) patients developed minor skin necrosis, while one (2.22 %) had skin flap necrosis requiring debridement and
skin grafting, three (6.67 %) hernias recurred, one (2.22 %) had seroma formation, and one (2.22 %) developed sacral pressure
sore.
Conclusion This technique provides both functional and aesthetic benefits and generally meets the needs of the patients. It is safe,
with a low risk of postoperative complications.
Level of Evidence: Level IV, therapeutic study.
- Content Type Journal Article
- Category Original Paper
- Pages 1-7
- DOI 10.1007/s00238-012-0720-4
- Authors
- Shashank Lamba, Department of Plastic Surgery, Christian Medical College, Vellore, 632004 Tamil Nadu, India
- Ashish Kumar Gupta, Department of Plastic Surgery, Christian Medical College, Vellore, 632004 Tamil Nadu, India
- Sukriya Nayak, Department of General Surgery, Christian Medical College, Vellore, 632004 Tamil Nadu, India
- Elvino Barreto, Department of Plastic Surgery, Christian Medical College, Vellore, 632004 Tamil Nadu, India
-
Successful salvage of exposed breast implants in previously irradiated patients using local fasciocutaneous flaps
Abstract Radiotherapy is used commonly in the treatment of breast cancer but can damage the surrounding tissues. For patients who have
had implant-based breast reconstruction, this may result in tissue breakdown with exposure of the prosthesis. We present two
cases in which an implant has become exposed following radiation therapy and been successfully salvaged with local fasciocutaneous
flaps. The patients were aged 50 and 59 and had excellent results after at least 24-months follow-up. We aim to show that
in selected patients local flaps remain a useful option in implant salvage in the irradiated breast.
Level of Evidence: Level V, therapeutic study.
- Content Type Journal Article
- Category Case Report
- Pages 1-4
- DOI 10.1007/s00238-012-0718-y
- Authors
- Nicholas G. Rabey, Department of Plastic and Reconstructive Surgery, Cambridge University Hospitals NHS Trust, Addenbrooke’s Hospital, Cambridge, CB2 0QQ UK
- Charles M. Malata, Department of Plastic and Reconstructive Surgery, Cambridge University Hospitals NHS Trust, Addenbrooke’s Hospital, Cambridge, CB2 0QQ UK
-
The Morel-Lavallee lesion: a review and a proposed algorithmic approach
Abstract Morel-Lavallee lesions (MLL) are rarely diagnosed posttraumatic sequel. They follow closed degloving injuries due to accumulation
of blood and debris in the subcutaneous plane. Though they are not uncommon, they are rarely diagnosed which results in delay
in their treatment. Diagnosis is through a combination of clinical examination, history, and imaging studies. MRI is the diagnostic
modality of choice. Different treatments have been used for their management like compression therapy, sclerosant injection,
pulse lavage, and open debridement. These treatments have met with varying success. Treatment protocols vary when managing
acute and chronic MLL. The knowledge of such lesions hastens their diagnosis and treatment.
- Content Type Journal Article
- Category Review
- Pages 1-6
- DOI 10.1007/s00238-012-0725-z
- Authors
- Sandeep Dawre, Department of Plastic and Reconstructive Surgery, Christian Medical College, Vellore, 632004 India
- Shashank Lamba, Department of Plastic and Reconstructive Surgery, Christian Medical College, Vellore, 632004 India
- Sreekar H, Department of Plastic and Reconstructive Surgery, Christian Medical College, Vellore, 632004 India
- Soumya Gupta, Department of Plastic and Reconstructive Surgery, Christian Medical College, Vellore, 632004 India
- Ashish Kumar Gupta, Department of Plastic and Reconstructive Surgery, Christian Medical College, Vellore, 632004 India
-
The innervated first dorsal metacarpal artery island flap for reconstruction of post-traumatic thumb defect
Abstract
Background Various surgical techniques contribute to repair distal defects of the fingers, especially the thumb as traumatic loss diminishes
or eliminates the thumb prehensile abilities and may affect overall hand function.
Methods Ten innervated first dorsal metacarpal artery (FDMCA) island flaps were performed and evaluated postoperatively. The function
of the thumb and the cosmetic appearance were documented for all patients.
Results The flap survived with good cosmetic results in all cases. Grasping and pinching activity as well as cortical orientation
was achieved for all flaps.
Conclusion It appears that the FDMCA flap is one of the best solutions for cover of simple or complex skin loss of the thumb. Its technical
performance is easy, and it gives durable, sensate, and stable skin cover.
Level of Evidence: Level 4, therapeutic study.
- Content Type Journal Article
- Category Original Paper
- Pages 1-6
- DOI 10.1007/s00238-012-0719-x
- Authors
- Ramy Magdy Makkar, Department of Surgery, Cairo University, Cairo, Egypt
-
Unusual complication of otoplasty: spasmodic torticollis
Abstract Otoplasty for prominent ears is the most commonly performed cosmetic operation in children. Otoplasty might result with several
complications such as infection, necrosis, outer ear canal stenosis, exposition of sutures, insufficient correction, and overcorrection.
This is the first case report of spasmodic torticollis as a complication following an otoplasty procedure.
Level of Evidence: Level V, diagnostic study.
- Content Type Journal Article
- Category Case Report
- Pages 1-3
- DOI 10.1007/s00238-012-0723-1
- Authors
- Gurkan Kayabasoglu, Department of Otolaryngology, Unye State Hospital, Ordu, Turkey
-
The use of the Deaver retractor for port insertion in expander breast reconstruction
The use of the Deaver retractor for port insertion in expander breast reconstruction
- Content Type Journal Article
- Category Letter to the Editor
- Pages 1-2
- DOI 10.1007/s00238-012-0722-2
- Authors
- Katia Sindali, Department of Plastic Surgery, St Thomas’ Hospital NHS Trust, Westminster Bridge Road, London, SE1 7EH UK
- Declan Collins, Department of Plastic Surgery, St Thomas’ Hospital NHS Trust, Westminster Bridge Road, London, SE1 7EH UK
- Reza Alamouti, Department of Plastic Surgery, St Thomas’ Hospital NHS Trust, Westminster Bridge Road, London, SE1 7EH UK
- Mark Ho-Asjoe, Department of Plastic Surgery, St Thomas’ Hospital NHS Trust, Westminster Bridge Road, London, SE1 7EH UK
-
Assessment and interpretation of capillary refill in clinical evaluation of flap perfusion are subject to a lag time
Abstract
Background A reliable assessment of the vascular perfusion of flaps in the postoperative period can be challenging. Clinical assessment
of capillary refill is an integral component of this evaluation.
Methods Ten consecutive patients undergoing abdominoplasty were studied. The resected pannus was brought to the back table and assessed
for capillary refill every 5 min. The time elapsed from complete resection until the last refill was observed and recorded.
Results Our findings somewhat surprisingly show that capillary refill continues for an average of 75 min in an abdominoplasty specimen
after its complete separation from its blood supply.
Conclusion We believe that capillary refill is testing the patency of the capillary microcirculation rather than the actual perfusion
of the flap. This limits the value of capillary refill in the clinical evaluation of flaps.
Level of Evidence: Level III, diagnostic study.
- Content Type Journal Article
- Category Original Paper
- Pages 1-4
- DOI 10.1007/s00238-012-0721-3
- Authors
- Lars Johan Sandberg, Mercy Catholic Medical Center, Philadelphia, PA, USA
- Chris D. Tzarnas, Plastic Surgery Section, Temple University, Philadelphia, PA, USA
-
Pulp tissue anchor repair for the zone I flexor tendon injury: introduction of a new and cost-effective technique
Abstract
Background Flexor digitorum profundus tendon (FDP) injury in zone I is one of the common findings in the hand examination when a patient
presents with a hand trauma. Various repair techniques have been described in the literature with its own advantages and disadvantages.
In this article, the senior author describes a new pulp tissue anchor repair for the zone I FDP injuries.
Methods After a careful dissection of the proximal end of the tendon, a fish-mouth incision is made on the distal pulp of the finger.
A modified Kessler stitch is placed in the terminal end of the tendon.Then, the suture is passed through the periosteum and
the fibrous bands of the pulp using the wide-bore needle. A knot is secured in the fish-mouth incision, and the skin is closed.
Results This technique was used in closed FDP avulsions (n = 19), two-stage tendon repairs using palmaris longus (n = 24), with the remainder being open injuries (n = 70). There were 18 patients who presented with a flexion contracture at the distal interphalangeal joint level and two
cases of rupture in zone I divisions.
Conclusion The technique described is cost effective as there is no need for the use of drills, K-wires, suture anchors or intraoperative
imaging. Furthermore, it is simple and quick to perform. The repair is strong, and risk of infection is minimal as bony cortices
are not breached. Minimal assistance is required, and all these factors combine to reduce the cost of the procedure.
Level of Evidence: Level IV, therapeutic study.
- Content Type Journal Article
- Category Original Paper
- Pages 1-4
- DOI 10.1007/s00238-012-0713-3
- Authors
- M. A. Hussain, Plastic Surgery Department, Queen Alexandra Hospital, NHS Trust Portsmouth, Portsmouth, UK
- S. Mui, Plastic Surgery Department, Queen Alexandra Hospital, NHS Trust Portsmouth, Portsmouth, UK
- A. Pandya, Plastic Surgery Department, Queen Alexandra Hospital, NHS Trust Portsmouth, Portsmouth, UK
- E. Tan, Plastic Surgery Department, Queen Alexandra Hospital, NHS Trust Portsmouth, Portsmouth, UK
- A. N. Pandya, Plastic Surgery Department, Queen Alexandra Hospital, NHS Trust Portsmouth, Portsmouth, UK
-
Vacuum closure as a skin-graft dressing: a comparison against conventional dressing
Abstract
Background Grafting condition is one of the important determinants of skin-graft take. The technique of Vacuum-Closure has been claimed
to improve the same and thereby graft take. However, there are few comparative studies against the conventional dressing technique
evaluating its effectiveness in skin grafting. The present study was undertaken to compare Vacuum-closure with conventional
dressing over freshly laid split-skin grafts.
Methods Consecutive patients undergoing split-skin grafting were randomized into cases and controls. The grafts in controls were covered
by a conventional dressing consisting of vaseline gauze and cotton pads. Those in cases were covered by a vacuum-closure assembly
and connected to a wall-suction of 80 mm Hg continuously for four days. The percentage of graft take was assessed at nine
days and at two weeks and duration of the dressing were compared between the two groups. The difference in cost of the dressing
was noted down.
Results Sixty four patients underwent split skin grafting of 71 wounds. Forty three of them were males and twenty nine were females.
The grafted wounds included fresh surgically created wounds, traumatic wounds, acute and chronic burn wounds, post-inflammatory
wounds and diabetic wounds. Thirty five of the grafts were cases and 36 were controls. Final graft take at two weeks in the
study group ranged from 70-100 per cent with an average of 95.29 per cent graft take (SD: 5.9) while the control group showed
a graft take ranging between 0-100 percent with an average graft take of 85.89 percent (SD: 25.1) Duration of dressing of
the grafts was 11.63 days in cases as against 15.11 days in controls. The differences were statistically significant. The
additional cost of the vacuum-closure assembly for an average sized ulcer was 6.27 pounds.
Conclusion Negative pressure dressing increases the amount of graft take and should be used particularly when the wound bed and grafting
conditions seem less-than-ideal for a complete graft take. Negative-pressure dressing can be economically and effectively
assembled using locally available materials.
Level of Evidence: Level I, therapeutic study.
- Content Type Journal Article
- Category Original Paper
- Pages 1-6
- DOI 10.1007/s00238-012-0698-y
- Authors
- Kiran Petkar, CMC Vellore, Vellore, Tamil Nadu, India
- Prema Dhanraj, CMC Vellore, Vellore, Tamil Nadu, India
- H. Sreekar, CMC Vellore, Vellore, Tamil Nadu, India
-
Thumb-in-palm deformity with bowstringing; an unusual case
Abstract A spastic thumb can be abusively interpreted as a congenital trigger thumb. This case report describes the rare presentation
of bowstringing in a spastic patient after earlier release of the first annular pulley. It is important to recognize bowstringing
because of therapeutical consequences.
Level of Evidence: Level V, diagnostic study.
- Content Type Journal Article
- Category Case Report
- Pages 1-3
- DOI 10.1007/s00238-012-0690-6
- Authors
- Nicoline de Haas-Appeldoorn, Department of Plastic, Reconstructive and Hand Surgery, Isala Clinics, P.O. box 10400, 8000 GK Zwolle, The Netherlands
- Peter Houpt, Department of Plastic, Reconstructive and Hand Surgery, Isala Clinics, P.O. box 10400, 8000 GK Zwolle, The Netherlands
-
Tumour mitotic rate—a poor predictor of sentinel lymph node status in cutaneous melanoma: should we select using staging criteria?
Abstract
Background Selection for sentinel lymph node biopsy (SLNB) in cutaneous melanoma is currently based on histopathological variables specified
in prognostic staging criteria. In 2009, these criteria were updated replacing Clark level with the tumour mitotic rate (TMR)
when defining thin T1 tumours. This study aimed to determine the histopathological variables independently predictive of sentinel
lymph node involvement and discusses which variables should influence our selection for SLNB.
Methods One hundred and fifty-three patients with primary invasive localized cutaneous melanoma who underwent SLNB between 2003 and
2007 were reviewed from a prospectively collected database. We performed a multivariate binary logistic regression analysis
to ascertain which variables independently predict sentinel status.
Results SLNB positivity rate was 17.3%. No patient with a thin T1 tumour was SLNB positive. Breslow thickness was the only independent
predictor of sentinel lymph node (SLN) status to reach significance (x
2, 10.555; p, 0.001). TMR and ulceration were not independent predictors of sentinel node status (x
2, 0.988; p, 0.320 and x
2, 2.082; p, 0.149, respectively).
Conclusion Breslow thickness is the only variable that is consistently reported as an independent predictor of SLN status. The use of
TMR and ulceration in staging criteria is intended to establish prognosis, not select for SLNB. Given the important implications
of a positive SLNB on surgical management, accurate selection is imperative. Selection based solely on Breslow thickness,
rather than staging criteria, may be valid. However, there is an urgent need for a well-designed large multi-centre analysis
to validate this. Until then, we continue to select for SLNB within a multidisciplinary team accounting for multiple factors.
Level of Evidence: Level II, Prognostic/Risk Study.
- Content Type Journal Article
- Category Original Paper
- Pages 1-6
- DOI 10.1007/s00238-012-0714-2
- Authors
- Aidan M. Rose, Department of Plastic and Reconstructive Surgery, NHS Tayside, Ninewells Hospital, Dundee, DD19SY UK
- Matthew Hough, Department of Plastic and Reconstructive Surgery, NHS Tayside, Ninewells Hospital, Dundee, DD19SY UK
- David A. Munnoch, Department of Plastic and Reconstructive Surgery, NHS Tayside, Ninewells Hospital, Dundee, DD19SY UK
-
The use of an onlay cranioplasty and subtemporalis fascial pockets in the prevention of temporal hollowing following fronto-orbital remodelling
The use of an onlay cranioplasty and subtemporalis fascial pockets in the prevention of temporal hollowing following fronto-orbital remodelling
- Content Type Journal Article
- Category Ideas and Innovations
- Pages 1-3
- DOI 10.1007/s00238-012-0712-4
- Authors
- Alex J. Davies, Department of Plastic Surgery, Frenchay Hospital, Frenchay Park Road, Bristol, BS16 1LE UK
- Nigel S. G. Mercer, Department of Plastic Surgery, Frenchay Hospital, Frenchay Park Road, Bristol, BS16 1LE UK
- Michael R. Carter, Department of Neurosurgery, Frenchay Hospital, Bristol, UK
-
The ‘rectangular palm’ sign in ulnar nerve paralysis
The ‘rectangular palm’ sign in ulnar nerve paralysis
- Content Type Journal Article
- Category Letter to the Editor
- Pages 1-2
- DOI 10.1007/s00238-012-0716-0
- Authors
- Nola Lloyd, The Circle Hand Clinic, Oakley Green, Windsor, SL4 4LH UK
- Donald Sammut, The Circle Hand Clinic, Oakley Green, Windsor, SL4 4LH UK
-
A precise excision technique for schwannomas
Abstract Schwannomas (or neurilemmomas) are the most common primary neural tumours occurring in the hand and wrist, arising from cells
of the Schwann sheath. Th ey are benign and slow-growing, but nerve compression symptoms may arise if diagnosis is delayed
and tumour growth progresses unchecked. The tumour is typically enclosed by a well-defined epineural capsule, which arises
in close proximity to adjacent nerve structures. Treatment of choice is surgical excision. The current technique, primary
extra-capsular excision, puts nerve fibres at great risk of damage, making patients prone to post-operative sensory and motor
deficits. The senior author describes a simple technique that significantly reduces the risk of nerve injury, whilst still
achieving complete resection, with excellent recovery and no residual long-term neurological sequelae. The case revolves around
a 40-year-old male, right-hand dominant truck driver who presents following a 12-month history of increasing painless mass
on the volar aspect of his right hand. The outcome following this simple technique was that the patient made an excellent
recovery with no residual long-term neurological sequelae. Our aim is to raise awareness and discussion regarding this novel,
simple technique as a serious alternative to the extra-capsular approach, which is currently the most preferred method.
- Content Type Journal Article
- Category Ideas & Innovations
- Pages 1-4
- DOI 10.1007/s00238-012-0715-1
- Authors
- Muhammad Ali Hussain, The Department of Plastic, Reconstructive and Hand Surgery, The Canberra Hospital, Canberra, ACT 2605, Australia
- Hardeep Jhattu, The Department of Plastic, Reconstructive and Hand Surgery, The Canberra Hospital, Canberra, ACT 2605, Australia
- Atisha Pandya, Department of Plastic and Reconstructive Surgery, Queen Alexandra Hospital, Portsmouth, NHS, UK
- Queenie Chan, The Department of Plastic, Reconstructive and Hand Surgery, The Canberra Hospital, Canberra, ACT 2605, Australia
- Wg Cdr Ankur Pandya, Department of Plastic and Reconstructive Surgery, Queen Alexandra Hospital, Portsmouth, NHS, UK
-
Duplicate extensor pollicus longus muscle and tendon—a rare anomaly
Abstract The authors present an extremely rare finding of a duplicated extensor pollicus longus (EPL) muscle belly and tendon of the
thumb, in a patient undergoing extensor synovectomy for rheumatoid disease. The previous reported cases are briefly reviewed,
and the specific anatomical findings are presented. The case history of duplicated EPL muscle and tendon is reported alongwith
the interoperative findings. Intraoperative photographs are used to display the anomaly clearly. A literature review was conducted
to determine the reported frequency of such an apparently rare anatomical anomaly.
- Content Type Journal Article
- Category Case Report
- Pages 1-2
- DOI 10.1007/s00238-012-0699-x
- Authors
- Heather Leaver, Department of Plastic Surgery, Ninewells Hospital & Medical School, Dundee, Scotland, UK
- Justin S. Chatterjee, Canniesburn Plastic Surgery Unit, Glasgow, Scotland, UK
-
Surgical approach for treatment of pedunculated ulnar polydactyly: our experience
Abstract
Background Pedunculated ulnar polydactyly type II(A) variety has been treated with ligature of pedicle, but surgical excision of the
accessory digit with high transection and retraction of the accompanying accessory digital nerve may prevent the complications
associated with suture ligation. In order to assess the efficacy of surgical excision of pedunculated ulnar type II(A) polydactyly,
the current study was undertaken.
Methods From June 2007 to May 2008, all patients with bilateral pedunculated type II(A) ulnar polydactyly attending the surgery department
were treated with excision of the accessory digit and high transection and retraction of supernumerary digital nerve. Patients
were regularly followed up postoperatively up to 2 years to assess any complication.
Results Ten patients were included in the study. The age ranged from 6 months to 3 years. There was one case of wound infection successfully
managed with antibiotics. No other complications like painful neuroma and postoperative bumps or nubbins were detected during
the follow-up.
Conclusion The surgical approach seems to be the treatment of choice for pedunculated ulnar polydactyly and can be performed effectively
and safely with negligible rate of complications.
- Content Type Journal Article
- Category Original Paper
- Pages 1-3
- DOI 10.1007/s00238-012-0717-z
- Authors
- Parwez Sajad Khan, Department of Health and Medical Education, Kashmir, Jammu and Kashmir, India
- Humera Hayat, Department of Community Medicine, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
-
The use of the Internet and social software by plastic surgeons
Abstract Social software allows users to communicate and share data through online social interaction using Web 2.0 technology. Three
hundred and fifty-six members of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) within
the UK and Ireland were invited by e-mail to complete an online survey (e-survey) anonymously on their knowledge and use of
Web 2.0 technology and whether they would like this to be used in BAPRAS’s e-Learning for Plastic, Reconstructive and Aesthetic
Surgery (e-LPRAS). Fifty-eight members completed the e-survey (response rate of 58 out of 356 or 16.3%). The respondents comprised
52 males (89.7%) and 6 females (10.3%) with a mean age (range) of 44.1 years (24–61). Forty one (70.7%) were consultants and
17 (29.3%) were non-consultants with a mean time (range) at this level of 10.1 years (1–30) and 3.4 years (1–6), respectively.
The mean (range) ages of consultants and non-consultants were 48.7 years (35–61) and 32.8 years (24–38), respectively. Fifty-eight
(100%) plastic surgeons used the Internet and e-mail, 48 (82.8%) owned a handheld device and 48 (82.8%) owned a digital media
player. Sixteen plastic surgeons (27.6%) used instant messaging, 29 (50.0%) used Internet telephone, 12 (20.7%) used videoconferencing,
23 (39.7%) used media sharing, 2 (3.4%) used social bookmarking, 21 (36.2%) used social networking, 24 (41.4%) used forums,
29 (50.0%) used podcasts, 1 (1.7%) contributed to a wiki, 6 (10.3%) wrote a blog and 18 (31.0%) read a blog. Non-consultants
were more likely to use social networking and forums than consultants. Forty-one (70.7%) plastic surgeons used e-learning,
and 31 (53.4%) would like Web 2.0 technology to be used in e-LPRAS, whilst 5 (8.6%) would not and 22 (37.9%) do not know what
Web 2.0 technology is. Most respondents either used Web 2.0 technology or were aware of it. Over half of respondents would
like Web 2.0 technology to be used in e-LPRAS. We recommend that BAPRAS adopts Web 2.0 technology in their development of
e-LPRAS.
- Content Type Journal Article
- Category Original Paper
- Pages 1-9
- DOI 10.1007/s00238-011-0681-z
- Authors
- Roger J. G. Stevens, Department of Plastic and Reconstructive Surgery, Aberdeen Royal Infirmary, Foresterhill, AB25 2ZN Aberdeen, Scotland, UK
- Neil M. Hamilton, Medi-CAL Unit, College of Life Sciences and Medicine, University of Aberdeen, Aberdeen, Scotland, UK
- Joseph M. O’Donoghue, Department of Plastic and Reconstructive Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, England, UK
- Michaela P. Davies, Department of Plastic and Reconstructive Surgery, Aberdeen Royal Infirmary, Foresterhill, AB25 2ZN Aberdeen, Scotland, UK
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