Seminars in Plastic Surgery最新文献

Vascular anomalies consist of a wide range of diagnoses relating to abnormal vasculature. These lesions can affect a variety of anatomical structures, requiring the expertise of numerous specialists. Over the past few decades, the formation of multidisciplinary vascular anomalies clinics has allowed patients to meet multiple providers within the same clinic visit, leading to improved communication between patients and providers. Furthermore, diagnostic and treatment plans are discussed in multidisciplinary conferences allowing for enhanced diagnostic accuracy and more comprehensive management plans. The purpose of this article is to provide an overview of the multidisciplinary management of vascular anomalies, including descriptions of key team members, multidisciplinary clinics, and benefits and challenges of providing multidisciplinary care.

Breast carcinoma is the second leading cause of cancer-associated death nationwide in women and is also one of the most common in the world. Originally, the diagnosis of breast malignancy left patients with poor prognoses; however, improvements in screening, treatments, and genetic testing in combination with multidisciplinary care have enhanced survival. Multidisciplinary breast cancer clinics (MDBCC) are comprised of surgeons, oncologists, pathologists, and various other specialties who work in tandem to deliver comprehensive treatment. Despite models of MDBCCs being variable throughout the world, tumor board conferences remain a cornerstone for multimodal treatment planning. This article will review common specialists and additional health care workers who are essential to MDBCCs, while describing the experience at a cancer center in Houston, Texas.

Multidisciplinary clinics (MDC) are a mainstay in medical and surgical management of complex diseases in the adult and pediatric populations. Due to increasingly complicated multimodal treatment plans and difficulties coordinating care, MDCs emerged to simplify care administration for patients and providers while optimizing outcomes. Multidisciplinary care is delivered in a variety of ways; however, the most common setups are concurrent and sequential clinics. With proper personnel and infrastructure organization, MDCs are beneficial to patients, providers, and institutions both clinically and financially. This introductory article will describe a brief history of MDCs, different models of operation, and known clinical and financial gains.

Poland syndrome, tuberous breast deformity, gynecomastia, and macromastia are among the most common breast disorders affecting adolescents. While the etiology and physical manifestations may differ between each condition, they all may impose psychosocial stress necessitating evaluation and treatment. A multidisciplinary team is essential to providing comprehensive care specific to an adolescent population. The purpose of this chapter is to discuss common adolescent breast deformities necessitating plastic surgeon involvement, and the components of a successful multidisciplinary adolescent breast care team.

Cleft and craniofacial anomalies impact the functional, psychological, and social well-being of patients and their families. To properly address the manifestations of these conditions, coordinating a team comprised of a variety of specialists is the gold standard. In this chapter, we will discuss the structure of the multidisciplinary team and our experience caring for patients with cleft and craniofacial differences at a large academic pediatric hospital.

Self-inflicted gunshot wounds (SI-GSW) to the head and face are associated with significant morbidity and mortality. Patients who do survive their injuries often face life-altering disfigurement and disability. To effectively care for these patients, providers must not only detect and address the immediate life-threatening injuries, but also plan for long-term definitive reconstruction. This review provides an overview of presentation and management of SI-GSW to the face, including initial stabilization and workup, assembly of a multidisciplinary care team, surgical reconstruction of soft tissue and bony defects, and long-term management to address aesthetic and functional goals. Emphasis is placed on the role of plastic and reconstructive surgeons in SI-GSW reconstruction; however, a better understanding of these complex injuries and their management can help all health care providers better optimize care for this high-risk population.

Combat ballistic injuries to the face present complex challenges for military medical personnel, often involving multiple traumas that require immediate intervention to preserve life and function. This review explores the mechanisms of ballistic trauma, highlighting the unique injury patterns seen in modern conflicts like those in Iraq, Afghanistan, Syria, and Ukraine. Advances in protective gear have altered injury profiles, increasing the incidence of head, neck, and facial injuries. Early evacuation and definitive care are critical, though prolonged field care settings may require adapted surgical techniques due to resource constraints. The goals of surgical management focus on restoring form and function, with treatment strategies influenced by the severity of injuries and available medical resources. This article also discusses the long-term complications, such as infections, nerve injuries, and posttraumatic stress disorder, emphasizing the need for a multidisciplinary approach. The evolving nature of combat injuries underscores the importance of continuous surgical innovation and timely intervention to improve outcomes for soldiers suffering from ballistic facial trauma.

Ballistic facial injuries often cause widespread damage, distorting the native anatomy. Apart from initial resuscitative measures, these injuries require extensive employment of reconstructive techniques to restore the patient's form and function. As such, thoughtful data acquisition from both physical exam and radiographic studies optimizes surgical planning to achieve optimal patient outcomes. Specifically, virtual surgical planning has been shown to decrease intraoperative times and achieve enhanced functional and aesthetic outcomes when compared to traditional methods. The purpose of this chapter is to review surgical planning in the context of ballistic facial injuries, with a specific focus on virtual surgical planning.