Matthew J. Concannon

University of Missouri, Columbia, Missouri, United States

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Publications (42)94.87 Total impact

  • Steven L Henry · Bradley A Hubbard · Matthew J Concannon
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    ABSTRACT: Postoperative splinting is common after carpal tunnel release, despite a lack of scientific evidence supporting its value. The purpose of this study was to characterize postoperative splinting regimens among hand surgeons and to identify trends in splint use after this procedure. Questionnaires were mailed to members of the American Society for Surgery of the Hand. Recipients were asked to record whether and for how long they use splints after carpal tunnel release. They were also asked to indicate their training (i.e., orthopedic, plastic, or general surgery). Results were compared with those of previously conducted surveys. One thousand ninety-one questionnaires were returned, for a response rate of 48 percent. Fifty-three percent of respondents use splinting postoperatively. Duration of splinting varied tremendously, from 1 to 42 days. Splinting patterns were similar across all training backgrounds. In comparison with related surveys conducted in 1987 and 1997, a trend is evident toward less use of splinting after carpal tunnel release. The use and duration of splinting after carpal tunnel release vary widely among hand surgeons. This divergence of practice implies that there is little therapeutic benefit to splinting after this procedure, a concept supported by substantial scientific evidence and by a trend away from splinting over the past 20 years.
    No preview · Article · Nov 2008 · Plastic and Reconstructive Surgery
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    Steven L Henry · Matthew J Concannon · Gloria J Yee
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    ABSTRACT: Objective: Magnets are purported to aid wound healing despite a paucity of scientific evidence. The purpose of this study was to evaluate the effect of static magnetic fields on cutaneous wound healing in an animal model. The literature was reviewed to explore the historical and scientific basis of magnet therapy and to define its current role in the evidence-based practice of plastic surgery. Methods: Standardized wounds were created on the backs of 33 Sprague-Dawley rats, which were divided into 3 groups with either a 23 gauss magnet (group 1), a sham magnet (group 2), or nothing (group 3) positioned over the wound. The rate of wound closure by secondary intention was compared between the groups. Literature review was conducted through searches of PubMed and Ovid databases for articles pertinent to magnets and wound healing. Results: Wounds in the magnet group healed in an average of 15.3 days, significantly faster than those in either the sham group (20.9 days, P = .006) or control group (20.3 days, P < .0001). There was no statistically significant difference between the sham and control groups (P = .45). Conclusions: An externally applied, low-power, static magnetic field increases the rate of secondary healing. Review of the literature reveals conflicting evidence regarding the use of magnetic energy to aid the healing of bone, tendon, and skin. Level I studies are lacking and difficult to execute but are needed to define conclusively the role of magnets in clinical practice.
    Preview · Article · Jul 2008 · Eplasty
  • Steven L. Henry · Matthew J. Concannon

    No preview · Article · Mar 2008 · Plastic & Reconstructive Surgery
  • Source
    Steven L Henry · Matthew J Concannon · Gloria J Yee
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    ABSTRACT: Magnets are purported to aid wound healing despite a paucity of scientific evidence. The purpose of this study was to evaluate the effect of static magnetic fields on cutaneous wound healing in an animal model. The literature was reviewed to explore the historical and scientific basis of magnet therapy and to define its current role in the evidence-based practice of plastic surgery. Standardized wounds were created on the backs of 33 Sprague-Dawley rats, which were divided into 3 groups with either a 23 gauss magnet (group 1), a sham magnet (group 2), or nothing (group 3) positioned over the wound. The rate of wound closure by secondary intention was compared between the groups. Literature review was conducted through searches of PubMed and Ovid databases for articles pertinent to magnets and wound healing. Wounds in the magnet group healed in an average of 15.3 days, significantly faster than those in either the sham group (20.9 days, P = .006) or control group (20.3 days, P < .0001). There was no statistically significant difference between the sham and control groups (P = .45). An externally applied, low-power, static magnetic field increases the rate of secondary healing. Review of the literature reveals conflicting evidence regarding the use of magnetic energy to aid the healing of bone, tendon, and skin. Level I studies are lacking and difficult to execute but are needed to define conclusively the role of magnets in clinical practice.
    Preview · Article · Feb 2008 · Eplasty
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    ABSTRACT: Herbal medicines are used by a considerable number of surgical patients. An increased risk of bleeding, substantiated by anecdotal reports, has been attributed to the use of certain herbs, and numerous in vitro experiments have identified some herbal extracts as platelet inhibitors. The purpose of this investigation was to determine whether standard commercial preparations of commonly used herbal medicines have an effect on platelet function in vivo and, by extension, to provide clinical scientific evidence of the safety of their use in the perioperative period. Five commercially available herbal agents were investigated, including Ginkgo biloba, garlic, Asian ginseng, St. John's wort, and saw palmetto. In a blinded fashion, one of the agents was administered to 10 adult volunteers at the manufacturer's recommended dose for 2 weeks. At the end of the 2-week period, in vivo platelet function was quantified using the PFA-100 assay. After a 2-week "washout" period, the protocol was repeated using a different agent. This 4-week cycle was repeated for each of the five herbal agents, as well as the control agent aspirin. In vivo platelet function was not affected by the administration of any herbal agent and was markedly inhibited with the administration of aspirin. The herbal medicines investigated in this study do not affect platelet function in vivo. Neither this experiment nor a review of the literature supports the concern of perioperative bleeding in users of these herbal medicines.
    No preview · Article · Jan 2008 · Plastic and Reconstructive Surgery
  • Steven L Henry · Matthew J Concannon · Paul A Kaplan · Alberto A Diaz-Arias
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    ABSTRACT: Matrix metalloproteinases are enzymes that serve to degrade the extracellular matrix, giving them a central role in the inflammatory and wound-healing processes; they have been implicated in the pathophysiology of hypertrophic scarring. The purpose of this study was to examine the effect of minocycline, a matrix metalloproteinase inhibitor, on hypertrophic scarring. Standardized wounds were created on the ears of eight New Zealand White rabbits. Half of the rabbits received daily injections of minocycline, whereas the other half received daily injections of saline (control). After 4 weeks, the resulting ear scars were harvested. Histologic slides were prepared from the thickest cross-sections of the scars, and from these slides the cross-sectional area of each scar was measured. A hypertrophic index was calculated by comparing the area of the scar to the baseline value of unwounded skin. Statistical analysis was performed using the SAS/STAT NESTED Procedure for hierarchical data. Among the rabbits treated with minocycline, the mean hypertrophic index was 1.08 +/- 0.01, compared with 1.54 +/- 0.03 in the control group (p = 0.03), representing an 85 percent reduction in hypertrophic area. Systemically administered minocycline significantly reduces the severity of hypertrophic scarring in a rabbit model. Although not directly examined in this study, matrix metalloproteinase inhibition is hypothesized to be responsible for this effect.
    No preview · Article · Aug 2007 · Plastic and Reconstructive Surgery
  • Steven L Henry · Matthew J Concannon · Charles L Puckett

    No preview · Article · Feb 2007 · Plastic and Reconstructive Surgery
  • Matthew J Concannon · Steven L Henry

    No preview · Article · Nov 2005 · Plastic and Reconstructive Surgery
  • Faeza R. Kazmier · Matthew J. Concannon · C Lin Puckett

    No preview · Article · Sep 2005 · Plastic & Reconstructive Surgery
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    ABSTRACT: Microvascular anastomotic thrombosis is a significant clinical problem, particularly in crush and avulsion injuries. Platelet deposition plays a particularly important role in the initiation and propagation of microvascular thrombosis, whereas thrombin has little effect in the acute phase of thrombus formation. Nevertheless, heparin (a specific thrombin inhibitor) remains the most widely used microvascular irrigant. The purpose of this study was to evaluate tirofiban HCl (Aggrastat), a glycoprotein IIb/IIIa inhibitor, and its role in preventing postoperative thrombosis in a crush anastomosis model. A crush injury model using the rat femoral artery was used. End-to-end microvascular repairs were performed. One milliliter of irrigant was used within the vessel lumen before placement of the last suture. The irrigant used was randomized into one of four groups: lactated Ringer's as a control, tirofiban (50 microg/ml), heparin (100 U/ml), and a combination of heparin (100 U/ml) and tirofiban (50 microg/ml). The vessels were reexamined 24 hours postoperatively and patency was assessed. A total of 62 vessels were used for the study. The patency rate was two of 20 (10 percent) for the control group, 13 of 22 (59 percent) for the tirofiban group, one of 10 (20 percent) for the heparin group, and eight of 10 (80 percent) for the heparin plus tirofiban group. This study demonstrates a statistically significant improvement in patency with tirofiban irrigation in a crush anastomosis rat model when compared with saline or heparin alone. Clinically, tirofiban may have utility as a potent anticoagulant and is potentially useful in microvascular injuries that have a significant crush/avulsion component.
    No preview · Article · Aug 2005 · Plastic and Reconstructive Surgery
  • Benjamin W Beckert · Charles L Puckett · Matthew J Concannon
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    ABSTRACT: Fresh water injuries are often contaminated with bacteria that are not typically encountered in other wounds. Their treatment should include empiric administration of appropriate antibiotics. This study identifies the most common pathogens found in the Lake of the Ozarks and their antibiotic sensitivity. Eleven of the twelve lake water samples (92%) had a positive culture result. Sixty-seven percent of lake water samples contained at least two strains of bacteria. Five different bacterial species of gram negative rods were isolated. All isolates were sensitive to Cefotetan, Ceftazidime, Ceftriaxone, Imipenem, Levofloxacin, Tobramycin, and Trimetheprim/sulfa. Antibiotic coverage after traumatic wounds required gram positive coverage. Our study suggests the addition of gram negative coverage for penetrating trauma contaminated by fresh water.
    No preview · Article · May 2004 · Missouri medicine

  • No preview · Article · Nov 2003 · Southern Medical Journal
  • York J Yates · Matthew J Concannon
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    ABSTRACT: There are two types of fungi (yeasts and molds) both of which can cause superficial infections of the perionychium. Yeasts (such as Candida albicans) grow as single cells and reproduce by asexual budding. In contrast, molds grow in long filaments, called hyphae. There are approximately 100,000 species of fungi that have been characterized. Most of these are ubiquitous. Fortunately only about 200 are human pathogens, and only a handful are commonly found to be associated with human disease. This article discusses causes, symptoms, diagnosis, and treatment of the most common fungal infections of the perionychium, including superficial dermatophytosis, onychomycosis, and chronic paronychia.
    No preview · Article · Dec 2002 · Hand Clinics
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    ABSTRACT: Free fat grafts from liposuction aspirate can be used as donor material for soft-tissue augmentation. The purpose of this study was to attempt to identify a subpopulation of adipose cells within liposuction aspirate with the greatest viability and, it is hoped, a greater chance for increased survival after transplantation. Liposuction samples were obtained from 20 individuals (16 women, four men; age range, 27 to 49 years). These samples were then centrifuged at 50 g. At 2-minute intervals, specimens from three different areas (superficial, middle, deep) were obtained from each specimen. After collagenase degradation, the specimens were stained with trypan blue, and the number of viable cells were counted. The bottom (deepest) layer consistently contained the highest number of viable cells after centrifugation: 250 percent more viable cells when compared with the top layer (p < 0.0001) and 140 percent more viable cells when compared with the middle layer (p < 0.0002). Centrifugation beyond 2 minutes did not increase the number or proportion of viable adipocytes. When using aspirated fat from liposuction for soft-tissue augmentation, centrifugation for 2 minutes at 50 g will stratify the adipocytes, with more viable cells being found at the deepest layer. Using only this bottom portion of the fat layer for transplantation will yield a fat graft with a greater number of viable adipocytes, potentially improving fat graft survival and decreased fat graft resorption.
    No preview · Article · Feb 2002 · Plastic & Reconstructive Surgery
  • Gregory M Bazell · Mark T Boschert · Matthew J Concannon · Charles L Puckett

    No preview · Article · Oct 2000 · Journal of the American College of Surgeons
  • Matthew J. Concannon · Mona L. Brownfield · Charles L. Puckett
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    ABSTRACT: Endoscopic carpal tunnel release has been used to decompress the median nerve in carpal tunnel syndrome for over the past decade, with an advantage (over the traditional "open" release) being decreased pain in the postoperative period. The goals of this study were to attempt to define the recurrence rate after endoscopic carpal tunnel release and to determine if it differs from that of open technique. The charts of 191 consecutive carpal tunnel syndrome patients treated operatively at the University of Missouri were reviewed. For this study, recurrent carpal tunnel syndrome was defined as documented cases in which the symptoms had resolved following surgical release but subsequently recurred, requiring surgical rerelease of the carpal tunnel. All endoscopic releases were performed using the Chow two-portal technique. Statistical analysis was performed using Fisher's exact test. A total of 103 patient hands had open carpal tunnel releases; 88 were endoscopically released. Total follow-up time (from the initial release) averaged 29 months for the open group and 22 months for the endoscopic group. There were no recurrences in the open group and six recurrences in the endoscopic group (7 percent, p = 0.008). All six recurrences were in worker's compensation patients. The median time between endoscopic release and rerelease was 8.5 months. There seems to be a statistically higher incidence of recurrence of carpal tunnel syndrome after endoscopic release compared with the traditional "open" release in our cases. Although the pathogenesis of this increased rate of recurrence is not clear, this should be considered when planning surgical release of the volar carpal ligament for carpal tunnel syndrome.
    No preview · Article · May 2000 · Plastic & Reconstructive Surgery
  • Source
    Matthew J. Concannon · Gregory M. Bazell · Charles L. Puckett
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    ABSTRACT: An open injury at the distal dorsal finger with loss of the teminal extensor tendon mechanism is challenging to treat, particularly if there is associated overlying soft tissue loss as well. Current options for this type of injury include joint fusion or revision amputation (in severe cases). We present a case of a patient who had a 1.5-cm loss of the terminal extensor tendon with associated loss of the overlying skin that was successfully reconstructed with a palmaris longus tendon graft and covered with a reversed cross-finger flap in the immediate postinjury setting. This technique has allowed restoration of active flexion and extension of the distal interphalangeal joint.
    Preview · Article · Feb 2000 · Operative Techniques in Plastic and Reconstructive Surgery
  • Jack R. Hurov · Matthew J. Concannon
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    ABSTRACT: Dynamic traction and early motion have been used by hand therapists to treat proximal interphalangeal joint fractures with good results. However, metacarpophalangeal joint fractures have been neglected, perhaps because of their relative infrequency. The purpose of this case study is to report the authors' experience using dynamic traction in conjunction with early motion to treat a construction worker who fell from scaffolding and sustained a complex fracture of the left smallfinger proximal phalanx with involvement of the metacarpophalangeal joint. Range of motion of the patient's left small finger at discharge from therapy, approximately 22 weeks postoperatively, was as follows: metacarpophalangeal joint, hyperextension/65 (85 degrees passive flexion); proximal interphalangeal joint, 20/80 (5/90 passively); and distal interphalangeal joint, 0/50 (65 degrees passive flexion). The patient made a successful return to full-time construction work. The results of this case appear to support consideration of the use of dynamic traction and early motion for management of selected metacarpophalangeal joint fractures.
    No preview · Article · Jul 1999 · Journal of Hand Therapy
  • Allan C. Roth · John C. Reid · Charles L. Puckett · Matthew J. Concannon
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    ABSTRACT: The use of digital wound images could allow remote consultation among patients, physicians, or other care-givers located at quite distant sites by means of the Internet. To evaluate the efficacy and validity of digital images for the evaluation of wounds, the ability and reliability of surgeons to diagnose and make treatment suggestions using digital images of several types of wounds were compared. Twenty-four wound images on 35-mm slides were selected for use in this study. Each slide image was digitized at 24-bit color with a resolution of 640 pixels horizontal by 425 pixels vertical and stored as a JPEG file. These images were then presented as a slide show on a video monitor, with resolution set at 640 x 480. Six physicians examined the images, first in digital format and later in the original slide form. Each observer assessed each wound and possible treatment options by filling out a questionnaire using a series of yes/no questions. For all observers, there was an 87 percent agreement between digital and slide images (p = 0.004). The agreement between the digital and slide images was measured for each individual observer using a kappa coefficient. The agreement level corresponded to the experience of the observer, with the kappa values ranging from greater than 0.8 (almost perfect agreement) for the attending plastic surgeon to just greater than 0.5 (moderate agreement) for the intern. With this study, the feasibility of distance wound consultation using digital images of a quality consistent with consumer-grade digital photography was demonstrated.
    No preview · Article · Mar 1999 · Plastic & Reconstructive Surgery
  • Source
    Matthew J. Concannon

    Preview · Article · Feb 1999 · Plastic & Reconstructive Surgery

Publication Stats

840 Citations
94.87 Total Impact Points

Institutions

  • 1991-2008
    • University of Missouri
      • • Department of Surgery
      • • School of Medicine
      Columbia, Missouri, United States
  • 1987
    • Palm Drive Hospital
      Себастопол, California, United States