F. A. Khalid, Omar A Ahmed, Almeotan P Khurshid, A. Mujahid, Junaid Ahmad, Muhammad Saleem, M. A. Yousaf, M. Tarar, Farooq Shahzad
Anterior mandible defects result in loss of support for the tongue, floor of the mouth and lower lip, resulting in impairment of airway, feeding and speech. We treated 4 patients with these ”Andy Gump” deformities. Reconstruction was performed with two free flaps: a fibula osteocutaneous flap for the anterior mandible and floor of the mouth, and a soft tissue free flap for the lip, chin, and anterior neck. The lower lip was suspended cranially with fascia or tendon grafts +/- mini-temporalis turndown flaps. All flaps survived completely. All patients were tube feed dependent before surgery; they all resumed an oral diet. All tracheostomies were decannulated. Lip competence was restored as evidenced by cessation of drooling. Speech improved from unintelligible to intelligible with frequent repetitions. Objectively assessment was performed with the functional intraoral Glasgow scale (FIGS); the mean FIGS score improved from 3.25 (range 3 to 4) to 11 (range 9 to 13). We conclude that composite anterior mandible and tongue defects have large tissue requirements that require multiple free flaps. Reconstruction leads to significant improvement in function.
{"title":"Salvage reconstruction of composite defects of the anterior mandible, floor of mouth and lip","authors":"F. A. Khalid, Omar A Ahmed, Almeotan P Khurshid, A. Mujahid, Junaid Ahmad, Muhammad Saleem, M. A. Yousaf, M. Tarar, Farooq Shahzad","doi":"10.1055/a-2263-8046","DOIUrl":"https://doi.org/10.1055/a-2263-8046","url":null,"abstract":"Anterior mandible defects result in loss of support for the tongue, floor of the mouth and lower lip, resulting in impairment of airway, feeding and speech. We treated 4 patients with these ”Andy Gump” deformities. Reconstruction was performed with two free flaps: a fibula osteocutaneous flap for the anterior mandible and floor of the mouth, and a soft tissue free flap for the lip, chin, and anterior neck. The lower lip was suspended cranially with fascia or tendon grafts +/- mini-temporalis turndown flaps. All flaps survived completely. All patients were tube feed dependent before surgery; they all resumed an oral diet. All tracheostomies were decannulated. Lip competence was restored as evidenced by cessation of drooling. Speech improved from unintelligible to intelligible with frequent repetitions. Objectively assessment was performed with the functional intraoral Glasgow scale (FIGS); the mean FIGS score improved from 3.25 (range 3 to 4) to 11 (range 9 to 13). We conclude that composite anterior mandible and tongue defects have large tissue requirements that require multiple free flaps. Reconstruction leads to significant improvement in function.","PeriodicalId":505284,"journal":{"name":"Archives of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139856066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Innovation and Collaboration in Plastic Surgery","authors":"Peter C. Neligan","doi":"10.1055/s-0043-1778669","DOIUrl":"https://doi.org/10.1055/s-0043-1778669","url":null,"abstract":"","PeriodicalId":505284,"journal":{"name":"Archives of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140486630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Gaxiola-García, Joseph M. Escandón, O. Manrique, Kristin A. Skinner, Beatriz Hatsue Kushida Contreras
Objective: Retrospective review of surgical management for primary lymphedema. Methods: Data were extracted from 55 articles from PubMed MEDLINE, Web of Science, SCOPUS, and Cochrane CENTRAL between the data base inception and December 2022 to evaluate the outcomes of lympho-venous anastomosis (LVA) and vascularized lymph node transfer (VLNT), and outcomes of soft tissue extirpative procedures such as suction-assisted lipectomy (SAL) and extensive soft tissue excision. Results: Data from 485 patients were compiled; these were treated with LVA (n=177), VLNT (n=82), SAL (102), and excisional procedures (n=124). Improvement of the lower extremity lymphedema (LEL) index, the quality of life, and lymphedema symptoms were reported in most studies. LVA and VLNT led to symptomatic relief and improved quality of life, reaching up to 90% and 61% average circumference reduction, respectively. Cellulitis reduction was reported in 25% and 40% of LVA and VLNT papers, respectively. The extirpative procedures, used mainly in patients with advanced disease, also led to clinical improvement from the volume reduction, as well as reduced incidence of cellulitis, although with poor cosmetic results; 87.5% of these reports recommended postoperative compression garments. The overall complication rates were: 1% for LVA, 13% for VLNT, 11% for SAL, and 46% for extirpative procedures. Altogether, only one paper lacked some kind of improvement. Conclusions: Primary lymphedema is amenable to surgical treatment; the currently performed procedures have effectively improved symptoms and quality of life in this population. Complication rates are related to the invasiveness of the chosen procedure.
{"title":"Surgical Treatment for Primary Lymphedema: A Systematic Review of the Literature.","authors":"M. Gaxiola-García, Joseph M. Escandón, O. Manrique, Kristin A. Skinner, Beatriz Hatsue Kushida Contreras","doi":"10.1055/a-2253-9859","DOIUrl":"https://doi.org/10.1055/a-2253-9859","url":null,"abstract":"Objective: Retrospective review of surgical management for primary lymphedema.\u0000Methods: Data were extracted from 55 articles from PubMed MEDLINE, Web of Science, SCOPUS, and Cochrane CENTRAL between the data base inception and December 2022 to evaluate the outcomes of lympho-venous anastomosis (LVA) and vascularized lymph node transfer (VLNT), and outcomes of soft tissue extirpative procedures such as suction-assisted lipectomy (SAL) and extensive soft tissue excision.\u0000Results: \u0000Data from 485 patients were compiled; these were treated with LVA (n=177), VLNT (n=82), SAL (102), and excisional procedures (n=124). Improvement of the lower extremity lymphedema (LEL) index, the quality of life, and lymphedema symptoms were reported in most studies. LVA and VLNT led to symptomatic relief and improved quality of life, reaching up to 90% and 61% average circumference reduction, respectively. Cellulitis reduction was reported in 25% and 40% of LVA and VLNT papers, respectively. The extirpative procedures, used mainly in patients with advanced disease, also led to clinical improvement from the volume reduction, as well as reduced incidence of cellulitis, although with poor cosmetic results; 87.5% of these reports recommended postoperative compression garments. The overall complication rates were: 1% for LVA, 13% for VLNT, 11% for SAL, and 46% for extirpative procedures. Altogether, only one paper lacked some kind of improvement.\u0000Conclusions: \u0000Primary lymphedema is amenable to surgical treatment; the currently performed procedures have effectively improved symptoms and quality of life in this population. Complication rates are related to the invasiveness of the chosen procedure.\u0000","PeriodicalId":505284,"journal":{"name":"Archives of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139596746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Hyaluronic acid fillers can be manufactured using various processes. They have multiple properties, including their concentration, degree of modification, and rheological data. Cohesion is one such property to evaluate gel integrity; however, there is no standardized method for calculating this parameter. This study aimed to evaluate different tests for calculating hyaluronic acid cohesion and discuss the importance of hyaluronic acid cohesion as a consideration when selecting fillers. Methods: The cohesion levels of five different hyaluronic acid fillers with different rheological properties were evaluated and compared using the drop weight, compression, tack, and dispersion time tests. Results: The cohesion tests yielded different results in the samples. Samples 2 and 4 showed approximately two times the number of droplets when compared to Sample 5 in drop test. Samples 1, 2, 3, and 4 were superior to Sample 5 in tack test. Samples 1, 2, 3 showed cohesive appearances at 95 sec in most cases in dispersion test. Rheological test results did not reflect the measures of cohesion. Conclusions: Although there are no definite standardized tests to evaluate the cohesion of hyaluronic acid fillers, our proposed tests showed similar results for different hyaluronic acid filler products. Further studies are needed to evaluate the cohesion of hyaluronic acid fillers and determine the clinical use of this distinguishing characteristic for clinicians selecting the product of choice.
{"title":"“Cohesiveness of hyaluronic acid fillers” : Evaluation using multiple cohesion tests","authors":"Kyun Tae Kim, Won Lee, Eun-Jung Yang","doi":"10.1055/a-2234-1019","DOIUrl":"https://doi.org/10.1055/a-2234-1019","url":null,"abstract":"Background: Hyaluronic acid fillers can be manufactured using various processes. They have multiple properties, including their concentration, degree of modification, and rheological data. Cohesion is one such property to evaluate gel integrity; however, there is no standardized method for calculating this parameter. This study aimed to evaluate different tests for calculating hyaluronic acid cohesion and discuss the importance of hyaluronic acid cohesion as a consideration when selecting fillers. Methods: The cohesion levels of five different hyaluronic acid fillers with different rheological properties were evaluated and compared using the drop weight, compression, tack, and dispersion time tests. Results: The cohesion tests yielded different results in the samples. Samples 2 and 4 showed approximately two times the number of droplets when compared to Sample 5 in drop test. Samples 1, 2, 3, and 4 were superior to Sample 5 in tack test. Samples 1, 2, 3 showed cohesive appearances at 95 sec in most cases in dispersion test. Rheological test results did not reflect the measures of cohesion. Conclusions: Although there are no definite standardized tests to evaluate the cohesion of hyaluronic acid fillers, our proposed tests showed similar results for different hyaluronic acid filler products. Further studies are needed to evaluate the cohesion of hyaluronic acid fillers and determine the clinical use of this distinguishing characteristic for clinicians selecting the product of choice.","PeriodicalId":505284,"journal":{"name":"Archives of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139167848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amy Chen, Shannon R. Garvey, Nimish Saxena, Valeria P. Bustos, Emmeline Jia, Monica Morgenstern, Asha D. Nanda, A. S. Dowlatshahi, R. Cauley
Background: The impact of diabetes on complication rates following free flap, pedicled flap, and amputation procedures on the lower extremity (LE) is examined. Methods: Patients who underwent LE pedicle flap (PF), free flap (FF), and amputation (AMP) procedures were identified from the 2010-2020 ACS-NSQIP® database using CPT and ICD-9/10 codes, excluding cases for non-LE pathologies. The cohort was divided into diabetics and non-diabetics. Univariate and adjusted multivariable logistic regression analyses were performed. Results: Among 38,998 patients undergoing LE procedures, 58% were diabetic. Among diabetics, 95% underwent amputation (AMP), 5% underwent pedicled flap (PF), and <1% underwent free flap (FF). Across all procedure types, non-insulin dependent (NIDDM) and insulin-dependent diabetes mellitus (IDDM) were associated with significantly greater all-cause complication rates compared to absence of diabetes, and IDDM was generally higher risk than NIDDM. Among diabetics, complication rates were not significantly different across procedure types (IDDM: p=0.5969; NIDDM: p=0.1902). On adjusted subgroup analysis by diabetic status, flap procedures were not associated with higher odds of complications compared to amputation for IDDM and NIDDM patients. Length of stay>30days (LOS>30) was statistically associated with IDDM, particularly those undergoing FF (AMP:5%, PF:7%, FF:14%, p=0.0004). Conclusion: Our study highlights the importance of preoperative diabetic optimization prior to LE procedures. For diabetic patients, there were few significant differences in complication rates across procedure type, suggesting that diabetic patients are not at higher risk of complications when attempting limb salvage instead of amputation. Key Words: Diabetes, Lower extremity, Flap reconstruction
{"title":"Is diabetes a contraindication to lower extremity flap reconstruction? An analysis of threatened lower extremities in the NSQIP database (2010-2020)","authors":"Amy Chen, Shannon R. Garvey, Nimish Saxena, Valeria P. Bustos, Emmeline Jia, Monica Morgenstern, Asha D. Nanda, A. S. Dowlatshahi, R. Cauley","doi":"10.1055/a-2233-2617","DOIUrl":"https://doi.org/10.1055/a-2233-2617","url":null,"abstract":"Background: The impact of diabetes on complication rates following free flap, pedicled flap, and amputation procedures on the lower extremity (LE) is examined. Methods: Patients who underwent LE pedicle flap (PF), free flap (FF), and amputation (AMP) procedures were identified from the 2010-2020 ACS-NSQIP® database using CPT and ICD-9/10 codes, excluding cases for non-LE pathologies. The cohort was divided into diabetics and non-diabetics. Univariate and adjusted multivariable logistic regression analyses were performed. Results: Among 38,998 patients undergoing LE procedures, 58% were diabetic. Among diabetics, 95% underwent amputation (AMP), 5% underwent pedicled flap (PF), and <1% underwent free flap (FF). Across all procedure types, non-insulin dependent (NIDDM) and insulin-dependent diabetes mellitus (IDDM) were associated with significantly greater all-cause complication rates compared to absence of diabetes, and IDDM was generally higher risk than NIDDM. Among diabetics, complication rates were not significantly different across procedure types (IDDM: p=0.5969; NIDDM: p=0.1902). On adjusted subgroup analysis by diabetic status, flap procedures were not associated with higher odds of complications compared to amputation for IDDM and NIDDM patients. Length of stay>30days (LOS>30) was statistically associated with IDDM, particularly those undergoing FF (AMP:5%, PF:7%, FF:14%, p=0.0004). Conclusion: Our study highlights the importance of preoperative diabetic optimization prior to LE procedures. For diabetic patients, there were few significant differences in complication rates across procedure type, suggesting that diabetic patients are not at higher risk of complications when attempting limb salvage instead of amputation. Key Words: Diabetes, Lower extremity, Flap reconstruction","PeriodicalId":505284,"journal":{"name":"Archives of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139169188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joachim N. Meuli, Jung-Ju Huang, Susana Heredero, Wei F. Chen, Tommy Chang
Career building can be challenging for young surgeons, especially when topics such as lifestyle, work-life balance and subspecialisation arise. Suggestions and advices from senior colleagues is very valuable but many young surgeons do not have such opportunities or are limited to a few senior surgeons. The international Microsurgery Club (IMC), in collaboration with the World Society of Reconstructive Microsurgery, organized a combined webinar for this topic and invited world renowned microsurgery masters polled by the IMC members to join, including Prof. Peter Neligan (Emeritus from University of Washington, U.S.A.), Prof. Raja Sabapathy (Ganga Hospital, India), Dr. Gregory Buncke (The Buncke Clinic, U.S.A.), Prof. Isao Koshima (Hiroshima University Hospital, Japan), Prof. David Chwei-Chin Chuang (Chang Gung Memorial Hospital, Taiwan) and Prof. Eric Santamaria (Hospital General Dr. Manuel Gea Gonzalez, Mexico) on May 1, 2022. Prof. Joon-Pio Hong (Asan Medical Center, South Korea) and Prof. Fu-Chan Wei (Chang Gung Memorial Hospital, Taiwan) were also selected but unfortunately could not make it and were therefore invited to another event in April 2023. There is ample literature reporting on different aspects of developing a microsurgical career1–3 but the goal of this session was to offer an opportunity for direct exchange with experienced mentors. Moreover, insights from experienced microsurgeons from different part of the world were more likely to offer different perspectives on aspects such as career building, failure management and team culture. This webinar event was moderated by Dr. Jung-Ju Huang (Taiwan), Dr. Susana Heredero (Spain), and Dr. Wei F. Chen (U.S.A.).
对于年轻的外科医生来说，职业生涯的建立可能具有挑战性，尤其是当生活方式、工作与生活的平衡以及亚专业化等话题出现时。资深同行的建议和意见非常宝贵，但许多年轻外科医生没有这样的机会，或者只能向少数资深外科医生请教。国际显微外科俱乐部（IMC）与世界修复显微外科学会（World Society of Reconstructive Microsurgery）合作，针对这一主题组织了一次联合网络研讨会，并邀请了由国际显微外科俱乐部成员投票选出的世界知名显微外科大师参加，其中包括 Peter Neligan 教授（美国华盛顿大学荣誉退休教授）、Raja Raja 教授（美国华盛顿大学荣誉退休教授）、Peter Neligan 教授（美国华盛顿大学荣誉退休教授）、Raja Raja 教授（美国华盛顿大学荣誉退休教授拉贾-萨巴帕蒂教授（印度甘加医院）、格雷戈里-邦克博士（美国邦克诊所）、小岛勇夫教授（日本广岛大学附属医院）、庄伟钦教授（台湾长庚纪念医院）和埃里克-桑塔玛利亚教授（墨西哥曼努埃尔-盖亚-冈萨雷斯总医院）将于 2022 年 5 月 1 日参加研讨会。此外，Joon-Pio Hong教授（韩国牙山医疗中心）和Fu-Chan Wei教授（台湾长庚纪念医院）也被选中，但遗憾的是他们未能出席，因此被邀请参加2023年4月的另一场活动。 有大量文献报道了显微外科事业发展的各个方面1-3，但本次会议的目的是提供一个与经验丰富的导师直接交流的机会。此外，来自世界不同地区的经验丰富的显微外科医生的见解更有可能在职业发展、失败管理和团队文化等方面提供不同的视角。本次网络研讨会由 Jung-Ju Huang 博士（台湾）、Susana Heredero 博士（西班牙）和 Wei F. Chen 博士（美国）主持。Chen 博士（美国）主持。
{"title":"International Microsurgery Club & World Society for Reconstructive Microsurgery Webinar - Career Building in Microsurgery","authors":"Joachim N. Meuli, Jung-Ju Huang, Susana Heredero, Wei F. Chen, Tommy Chang","doi":"10.1055/a-2229-3420","DOIUrl":"https://doi.org/10.1055/a-2229-3420","url":null,"abstract":"Career building can be challenging for young surgeons, especially when topics such as lifestyle, work-life balance and subspecialisation arise. Suggestions and advices from senior colleagues is very valuable but many young surgeons do not have such opportunities or are limited to a few senior surgeons. The international Microsurgery Club (IMC), in collaboration with the World Society of Reconstructive Microsurgery, organized a combined webinar for this topic and invited world renowned microsurgery masters polled by the IMC members to join, including Prof. Peter Neligan (Emeritus from University of Washington, U.S.A.), Prof. Raja Sabapathy (Ganga Hospital, India), Dr. Gregory Buncke (The Buncke Clinic, U.S.A.), Prof. Isao Koshima (Hiroshima University Hospital, Japan), Prof. David Chwei-Chin Chuang (Chang Gung Memorial Hospital, Taiwan) and Prof. Eric Santamaria (Hospital General Dr. Manuel Gea Gonzalez, Mexico) on May 1, 2022. Prof. Joon-Pio Hong (Asan Medical Center, South Korea) and Prof. Fu-Chan Wei (Chang Gung Memorial Hospital, Taiwan) were also selected but unfortunately could not make it and were therefore invited to another event in April 2023. There is ample literature reporting on different aspects of developing a microsurgical career1–3 but the goal of this session was to offer an opportunity for direct exchange with experienced mentors. Moreover, insights from experienced microsurgeons from different part of the world were more likely to offer different perspectives on aspects such as career building, failure management and team culture. This webinar event was moderated by Dr. Jung-Ju Huang (Taiwan), Dr. Susana Heredero (Spain), and Dr. Wei F. Chen (U.S.A.).","PeriodicalId":505284,"journal":{"name":"Archives of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139179726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad KH B Abdulaziz, Mohammad Al-Jamali, Sundus Al-Mazidi, Sarah Albuloushi, Ahamd B. Al-Ali
Background: Plastic surgery has developed to benefit in a variety of challenging areas formerly handled by other disciplines. Society lack a basic understanding of plastic surgery as a clinical area of expertise, including general practitioners, nursing staff, medical trainees, and the general public. Methodology: pre-clinical l and clinical year students of Kuwait University were rolled into the study.The purpose of the study was not declared, which was to assess student perception of plastic surgery, and rather disclosed that it was to assess general knowledge of various medical scenarios, preceded with questions on background information. The survey was generated by using Survey Monkey Software. Results: 244 students participated in the study including 121 males and 123 females, with a mean age of 21 (±2). Number of students who participated in the survey from 2nd, 3rd, 4th, 5th, 6th and 7th academic year were 37 (15.2%), 42 (17.2%), 39 (16%), 42 (17.2%), 42 (17.2%) and 42 (17.2%) respectively. 126 (51.6%) were pre-clinical students, while 118 (48.4%) were clinical students. 79.8% of the students believed that plastic surgery plays an essential role in trauma management, whereas 9.2% did not consider plastic surgery significant for trauma management. Conclusion: The teaching of medical students regarding the spectrum of plastic surgery needs improvement. This can be achieved through systematic education of students who cycle on the plastic surgery service and by providing students with a succinct but thorough overview of the spectrum of plastic surgery early on during medical school.
{"title":"Medical Students Perception of the Scope of Plastic Surgery","authors":"Mohammad KH B Abdulaziz, Mohammad Al-Jamali, Sundus Al-Mazidi, Sarah Albuloushi, Ahamd B. Al-Ali","doi":"10.1055/a-2219-2411","DOIUrl":"https://doi.org/10.1055/a-2219-2411","url":null,"abstract":"Background: Plastic surgery has developed to benefit in a variety of challenging areas formerly handled by other disciplines. Society lack a basic understanding of plastic surgery as a clinical area of expertise, including general practitioners, nursing staff, medical trainees, and the general public. Methodology: pre-clinical l and clinical year students of Kuwait University were rolled into the study.The purpose of the study was not declared, which was to assess student perception of plastic surgery, and rather disclosed that it was to assess general knowledge of various medical scenarios, preceded with questions on background information. The survey was generated by using Survey Monkey Software. Results: 244 students participated in the study including 121 males and 123 females, with a mean age of 21 (±2). Number of students who participated in the survey from 2nd, 3rd, 4th, 5th, 6th and 7th academic year were 37 (15.2%), 42 (17.2%), 39 (16%), 42 (17.2%), 42 (17.2%) and 42 (17.2%) respectively. 126 (51.6%) were pre-clinical students, while 118 (48.4%) were clinical students. 79.8% of the students believed that plastic surgery plays an essential role in trauma management, whereas 9.2% did not consider plastic surgery significant for trauma management. Conclusion: The teaching of medical students regarding the spectrum of plastic surgery needs improvement. This can be achieved through systematic education of students who cycle on the plastic surgery service and by providing students with a succinct but thorough overview of the spectrum of plastic surgery early on during medical school.","PeriodicalId":505284,"journal":{"name":"Archives of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139212103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Kang, Il Young Ahn, Han Koo Kim, W. Kim, Soo Hyun Woo, Seung-Hyun Kang, Soon Auck Hong, T. Bae
Intraneural hematoma is a rare disease that results in an impaired nerve function because of bleeding around the peripheral nerve with only 20 cases reported. Trauma, neoplasm, and bleeding disorders are known factors for intraneural hematoma. However, here we report atypical features of asymptomatic and spontaneous intraneural hematoma which difficult to make diagnosis. A 60-year-old woman visited our clinic with the complaint of a palpable mass on the right calf. She reported no medical history or trauma to the right calf and laboratory findings showed normal coagulopathy. Ultrasonography was performed, which indicate hematoma near saphenous vein and sural nerve or neurogenic tumor. We performed surgical exploration and intraneural hematoma was confirmed on sural nerve. Meticulous paraneuriotomy and evacuation was performed without nerve injury. Histological examination revealed intraneural hematoma with a vascular wall. No neurologic symptoms were observed. In literature review, we acknowledge that understanding anatomy of nerve, using ultrasonography as a diagnostic tool and surgical decompression is key for intraneural hematoma. Our case report may help establish the implications of diagnosis and treatment. Also, we suggested surgical treatment is necessary even in cases that do not present symptoms because neurological symptoms and associated symptoms may occur later.
{"title":"A Rare Atypical Case of Asyptomatic and Spontaneous Intraneural Hematoma of Sural Nerve: A Case Report and Literature Review","authors":"S. Kang, Il Young Ahn, Han Koo Kim, W. Kim, Soo Hyun Woo, Seung-Hyun Kang, Soon Auck Hong, T. Bae","doi":"10.1055/a-2218-8461","DOIUrl":"https://doi.org/10.1055/a-2218-8461","url":null,"abstract":"Intraneural hematoma is a rare disease that results in an impaired nerve function because of bleeding around the peripheral nerve with only 20 cases reported. Trauma, neoplasm, and bleeding disorders are known factors for intraneural hematoma. However, here we report atypical features of asymptomatic and spontaneous intraneural hematoma which difficult to make diagnosis. A 60-year-old woman visited our clinic with the complaint of a palpable mass on the right calf. She reported no medical history or trauma to the right calf and laboratory findings showed normal coagulopathy. Ultrasonography was performed, which indicate hematoma near saphenous vein and sural nerve or neurogenic tumor. We performed surgical exploration and intraneural hematoma was confirmed on sural nerve. Meticulous paraneuriotomy and evacuation was performed without nerve injury. Histological examination revealed intraneural hematoma with a vascular wall. No neurologic symptoms were observed. In literature review, we acknowledge that understanding anatomy of nerve, using ultrasonography as a diagnostic tool and surgical decompression is key for intraneural hematoma. Our case report may help establish the implications of diagnosis and treatment. Also, we suggested surgical treatment is necessary even in cases that do not present symptoms because neurological symptoms and associated symptoms may occur later.","PeriodicalId":505284,"journal":{"name":"Archives of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139225639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Chalwade, Armaan Khosa, Kishor Ballary, Raghav Mago
Primary Tuberculous osteomyelitis involving the mandible represents less than 2% of skeletal locations. In this paper, we report a case of mandibular tuberculosis detected after histopathological analysis of the surgically resected specimen during surgical management of a suspected case of ameloblastoma. A 14 -year-old male patient presented to us with history of right sided chin swelling. The clinical examination revealed a swelling, involving right body and parasymphysis of mandible, measuring approximately 6cm in length and 2cm in width, extending from right lateral incisor till the first molar. Radiological scans revealed a large multiloculated osteolytic expansive lesion measuring 52 x 20 x18 mm. Excision of the lesion was performed and reconstruction was done with iliac bone grafting. The histopathological findings revealed a granulomatous lesion, suggestive of tuberculous osteomyelitis. The patient was successfully treated with standard multidrug therapy. One year after completion of therapy, there were no signs of recurrence. Primary mandibular tuberculosis is an extremely rare entity. Its clinical presentation is not specific. Radiologically, tuberculosis has no characteristic appearance. The positive diagnosis is based on histology. Primary mandibular tuberculosis is rare and should be kept amongst differential diagnoses in susceptible population and in endemic areas.
累及下颌骨的原发性结核性骨髓炎在骨骼部位的发病率不到 2%。在本文中，我们报告了一例在对一例疑似颌骨母细胞瘤病例进行手术治疗时，对手术切除标本进行组织病理学分析后发现的下颌骨结核病例。一名14岁的男性患者因右侧下巴肿胀前来就诊。临床检查发现，肿物累及右侧下颌骨体和骨骺旁，长约6厘米，宽约2厘米，从右侧切牙一直延伸到第一磨牙。放射学扫描显示，这是一个巨大的多灶性溶骨膨胀性病变，大小为 52 x 20 x 18 毫米。对病灶进行了切除，并用髂骨移植进行了重建。组织病理结果显示为肉芽肿性病变，提示为结核性骨髓炎。患者接受了标准的多种药物治疗，并取得了成功。治疗结束一年后，没有出现复发迹象。原发性下颌骨结核是一种极为罕见的疾病。其临床表现没有特异性。在放射学上，结核病没有特征性的表现。组织学诊断是确诊的依据。原发性下颌骨结核非常罕见，在易感人群和流行地区应将其作为鉴别诊断之一。
{"title":"Primary mandibular tuberculous osteomyelitis mimicking ameloblastoma: A case report and literature review of mandibular tuberculous osteomyelitis","authors":"C. Chalwade, Armaan Khosa, Kishor Ballary, Raghav Mago","doi":"10.1055/a-2217-8784","DOIUrl":"https://doi.org/10.1055/a-2217-8784","url":null,"abstract":"Primary Tuberculous osteomyelitis involving the mandible represents less than 2% of skeletal locations. In this paper, we report a case of mandibular tuberculosis detected after histopathological analysis of the surgically resected specimen during surgical management of a suspected case of ameloblastoma. A 14 -year-old male patient presented to us with history of right sided chin swelling. The clinical examination revealed a swelling, involving right body and parasymphysis of mandible, measuring approximately 6cm in length and 2cm in width, extending from right lateral incisor till the first molar. Radiological scans revealed a large multiloculated osteolytic expansive lesion measuring 52 x 20 x18 mm. Excision of the lesion was performed and reconstruction was done with iliac bone grafting. The histopathological findings revealed a granulomatous lesion, suggestive of tuberculous osteomyelitis. The patient was successfully treated with standard multidrug therapy. One year after completion of therapy, there were no signs of recurrence. Primary mandibular tuberculosis is an extremely rare entity. Its clinical presentation is not specific. Radiologically, tuberculosis has no characteristic appearance. The positive diagnosis is based on histology. Primary mandibular tuberculosis is rare and should be kept amongst differential diagnoses in susceptible population and in endemic areas.","PeriodicalId":505284,"journal":{"name":"Archives of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139236284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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