Eplasty

Publications in this journal

• Article: CASE REPORT Spontaneous Forearm Compartment Syndrome in a Boy With Hemophilia A: A Therapeutic Dilemma.

  Jennifer Kim, Jonathan Zelken, Justin Michael Sacks
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  ABSTRACT: Objective: We present the case of a 14-year-old Factor VIII-deficient patient with no history of trauma, who developed acute spontaneous compartment syndrome of the volar forearm. We also suggest a treatment strategy. Methods: Fasciotomy with hematoma evacuation and ipsilateral carpal tunnel release was performed, and the wound was closed with vascular loops in "Jacob's ladder" fashion. Factor infusions were continued overnight. Results: The volar forearm compartment was successfully decompressed, and the patient's coagulopathy was managed with appropriate clotting factors. Conclusions: Hemophilic patients warrant special consideration and multispecialty care; with replenished coagulation factors and timely surgical decompression, they can expect satisfactory recovery of muscular and neurological function.
  Eplasty 01/2013; 13:e16.
• Article: CASE REPORT Acute Compartment Syndrome of the Forearm Following Blood Gas Analysis Postthrombolysis for Pulmonary Embolism.

  Kamal Bisarya, Samuel George, Sam El Sallakh
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  ABSTRACT: Objectives: Acute compartment syndrome is an important condition with potentially serious consequences if not diagnosed and treated promptly. This report highlights a case of acute compartment syndrome of the forearm after radial artery blood gas analysis in a patient who had been thrombolyzed for a pulmonary embolus. Methods/Case Report: We present a case of a 54-year-old lady, admitted and treated for a pulmonary embolism with tenecteplase for thrombolysis. As per routine management, she had taken an arterial blood gas sample, which caused hematoma in the wrist and a few hours later developed pain and a tense right forearm being diagnosed with compartment syndrome. Results: She underwent fasciotomies and subsequent split skin grafting. We discuss the different etiologies of compartment syndrome, clinical signs, and available investigations as well as immediate and definitive management options including fasciotomy techniques. We present the latest literature on the subject and extract valuable learning points from this case. Conclusions: With the common use of thrombolysis for the management of a myocardial infarction or pulmonary embolus, compartment syndrome is an uncommon but potentially associated problem. Furthermore, with blood gas sampling being part of daily clinical practice and a potential cause of this condition, the compartment syndrome becomes iatrogenic and potentiates serious litigation. As many junior doctors are performing blood gas analysis postthrombolysis, they need to assess patients adequately and realize the risk of possible sequelae such as compartment syndrome in this group and inform patients of such complications.
  Eplasty 01/2013; 13:e15.
• Article: CASE REPORT Temporomandibular Joint Arthroplasty With Human Amniotic Membrane: A Case Report.

  Florian Bauer, Lukas M Hingsammer, Klaus-Dietrich Wolff, Marco R Kesting
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  ABSTRACT: This case reports the usage of human amniotic membrane combined with a costochondral graft as an interpositional material in temporomandibular joint reconstruction for the first time in humans. Because of the favorable outcome 20 months postoperatively, it has to be considered as an approach bringing to light the antiadhesive potential of amniotic membrane. This case report must be regarded as initial spadework and should motivate other institutions to intensify their clinical research in this field. Because of the fact that currently used interpositional materials do not prevent the recurrence of temporomandibular joint ankylosis sufficiently, it is of great interest to establish a proper therapeutic intervention fulfilling these demands. Furthermore, the demonstrated antiadhesive properties of amniotic membrane highlight its multifaceted field of application. Nevertheless, further studies have to prove the findings reported in our case.
  Eplasty 01/2013; 13:e17.
• Article: Internal mammary recipient site breast cancer recurrence following delayed microvascular breast reconstruction.

  Anais Rosich-Medina, Susan Wang, Ertan Erel, Charles M Malata
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  ABSTRACT: Objective: The internal mammary vessels are a popular recipient site for microsurgical anastomoses of free flap breast reconstructions. We, however, observed 3 patients undergoing internal mammary vessel delayed free flap breast reconstruction that subsequently developed tumor recurrence at this site. We reviewed their characteristics to determine whether there was a correlation between delayed microsurgical reconstruction and local recurrence. Methods: A retrospective review of a single surgeon's delayed free flap breast reconstructions using the internal mammary vessels was conducted over a 7-year period to identify the time intervals between mastectomy and delayed breast reconstruction and between delayed breast reconstruction and recurrence. Results: Three patients developed local recurrence at the site of the microvascular anastomoses following delayed breast reconstruction. All patients had been disease-free following mastectomy. The median time interval between mastectomy and delayed breast reconstruction was 28 months (range = 20-120 months) while that between delayed breast reconstruction and local recurrence was 7 months (range = 4-10 months). Two patients died from metastatic disease, 36 and 72 months following their local recurrence. One patient remains alive 44 months after reconstruction. Conclusions: Local tumor recurrence at the internal mammary vessel dissection site following delayed breast reconstruction raises the question whether these 2 events may be related. Specifically, could internal mammary vessel dissection undertaken for delayed microsurgical reconstruction predispose to recurrence in the internal mammary lymph nodes? Further research is needed to ascertain whether delayed breast reconstruction increases the risk of local recurrence in this patient group.
  Eplasty 01/2013; 13:e4.
• Article: Comparative Study of Antibacterial Effects and Bacterial Retentivity of Wound Dressings.

  Toshihiro Fujiwara, Ko Hosokawa, Tateki Kubo
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  ABSTRACT: Objectives: We are often confused on selecting a suitable wound dressing for the treatment of infected wounds from huge number of available wound dressings. Then, to help clinicians easily select a wound dressing, we compared the antibacterial effects and bacterial retentivity (ie, potency of keeping absorbed bacteria inside wound dressings and preventing them from leaking out) of wound dressings. Methods: Five wound dressings with antibacterial constituents were compared to research antibacterial effects against nonpathogenic Escherichia coli using an in vitro model. The 5 other wound dressings with no antibacterial constituent were compared to research bacterial retentivity. The relative amount of E coli was determined using cell proliferation reagent WST-1 (11644807001, Roche Applied Science, United States) with time. Results: The results have shown that the antibacterial effects and bacterial retentivity differed among various wound dressings. Silver ions quickly exerted a very strong antibacterial effect, and hydrofibers had a high potency of bacterial retentivity by gelling the absorbed bacteria in wound dressings. Conclusions: The present study indicated the differences of antibacterial strength, time of onset and duration of the antibacterial effect, and bacterial retentivity between each wound dressing. Clinicians should use appropriate wound dressings according the wound condition in consideration of the different characteristics of wound dressings. The present results are helpful for clinicians to select appropriate wound dressing.
  Eplasty 01/2013; 13:e5.
• Article: Liposuction.

  Sachin M Shridharani, Howard D Wang, Navin K Singh
  Eplasty 01/2013; 13:ic4.
• Article: CASE REPORT An Unusual Case of Abdominal Compartment Syndrome Following Resection of Extensive Posttraumatic Mesenteric Ossification.

  William M Nabulyato, Hebah Alsahiem, Nigel R Hall, Charles M Malata
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  ABSTRACT: Introduction: Heterotopic mesenteric ossification is an extremely rare condition, which often follows trauma and is frequently symptomatic. To date, there are no reports in the literature of abdominal compartment syndrome occurring after surgical resection of mesenteric calcification. The present report documents an unusual case of compartment syndrome complicating resection of extensive mesenteric calcification despite abdominal closure with the components-separation technique. Method: A 48-year-old man undergoing components-separation technique for posttraumatic laparostomy hernia repair (ileostomy reversal and sigmoid stricture correction) was found to have extensive heterotopic mesenteric calcification, which needed resection. Results: Resection of the mesenteric calcification was complicated by intraoperative hemorrhage and unplanned small bowel resection. Later the patient developed secondary hemorrhage leading to an abdominal compartment syndrome, which was successfully treated by decompression, hemostasis, and Permacol-assisted laparotomy wound closure. The patient remains symptom-free more than 2 years after surgery. Discussion: The case herein reported gives an account of the rare occurrence of abdominal compartment syndrome following resection of posttraumatic ectopic mesenteric ossifications. It is highly unusual in that it occurred because of "secondary hemorrhage" and despite abdominal closure with the components-separation technique, which had been undertaken precisely to prevent compartment syndrome with direct closure. It therefore highlights the need for continued clinical vigilance in complex posttraumatic cases.
  Eplasty 01/2013; 13:e13.
• Article: Pigmented urine.

  Rebecca Nunn, Nicholas Chang, Stephen M Milner, Leigh Ann Price
  Eplasty 01/2013; 13:ic16.
• Article: Lower lip reconstruction: karapandzic flap.

  Aditya Sood, Angie Paik, Edward Lee
  Eplasty 01/2013; 13:ic17.
• Article: Zone II Flexor Tendon Injury.

  Brenon Abernathie, Ramazi Datiashvili
  Eplasty 01/2013; 13:ic20.
• Article: Subungual melanoma of the thumb.

  Nadia F Nocera, Michael I Baruch, Minbae Kim
  Eplasty 01/2013; 13:ic26.
• Article: The rheumatoid hand.

  Edward Hahn, Earl Fleegler
  Eplasty 01/2013; 13:ic27.
• Article: Rheumatoid arthritis.

  Keith E Follmar, Justin M Broyles, Jaimie T Shores
  Eplasty 01/2013; 13:ic29.
• Article: Cuterebral ophthalmomyiasis externa presenting as preseptal cellulitis.

  Yula A Taormina, Caitlin Gannon, Josephine Nguyen, Jennifer Rhodes, Michael Foxworth, William Koch, Kelley Dodson
  Eplasty 01/2013; 13:ic40.
• Article: CASE REPORT Reconstruction and Characterization of Composite Mandibular Defects Requiring Double Skin Paddle Fibular Free Flaps.

  Austin M Badeau, Frederic W-B Deleyiannis
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  ABSTRACT: Objective: Fibular free flaps are the preferred method for reconstruction of composite lateral mandibular defects. This reconstructive technique is limited by the skin paddle's inability to freely rotate when attempting to fill 2 poorly aligned defects. Reconstructive surgeons have been exploring multiple methods of creating 2 independent skin paddles based on the same peroneal blood supply. We present a variation of these techniques. Method: Our patient with a history of squamous cell carcinoma presented with a left retromolar recurrence and osteoradionecrosis of the mandible with a draining anterior sinus tract. The combination of these defects warranted further composite resection with fibular free flap reconstruction. Results: A subperiosteal dissection was performed to create 2 separate septocutaneous skin paddles based on the same peroneal blood supply. This dissection and discard of proximal fibula provided the rotational freedom needed for the 2 skin islands to fill both a lateral oral defect and anterior cutaneous defect. Conclusion: Although similar reconstructive methods have been reported in the literature, the characterization of defects benefiting from these techniques is scarce and unclear. We describe clear and concise characteristics of these defects, which should be meaningful to the reconstructive surgeon when considering operative technique.
  Eplasty 01/2013; 13:e21.
• Article: Lymphedema.

  Howard D Wang, Sachin M Shridharani, Anthony P Tufaro
  Eplasty 01/2013; 13:ic24.
• Article: Breast reconstruction.

  Jennifer E Kim, Justin M Broyles, Sachin M Shridharani, Justin M Sacks
  Eplasty 01/2013; 13:ic22.
• Article: Mandible reconstruction.

  Jennifer E Kim, Justin M Broyles, Justin M Sacks
  Eplasty 01/2013; 13:ic19.
• Article: Head and neck reconstruction.

  Adam M Feintisch, Ramazi Datiashvili
  Eplasty 01/2013; 13:ic30.