Plastic Surgery Commons^™

Maximizing Patient Benefit In Interfacility Transfer For The Management Of Pediatric Hand Trauma, Annie Glenney, Zainab Balogun, Meeti Mehta, Shirley Liu, Vivian Wang, Lucille Cheng, Darya Fadavi, Alexander Davit Iii

St. Chris Research Day

No abstract provided.

Severe Lower Extremity Trauma In Ontario: A Linked Population-Based Analysis, Stephanie M. Kim

Electronic Thesis and Dissertation Repository

Open tibia fractures (OTF) are a management challenge. Admission to a trauma center (TC) and a coordinated approach to bony fixation and soft-tissue reconstruction (STR) have been shown to improve outcomes. The objective of this study was to describe patients who had OTF in Ontario and analyze their outcomes. Linked population data pertaining to patients who had OTF between the years 2009-2020 were examined. Demographic information, admission location, and management course were collected. 4240 patients were found. The mean age was 47, and majority were males. Patients admitted to TC had greater proportion of having Injury Severity Score >15, and …

4dct Analysis Of In-Vivo Carpal Kinematics During Fem, Manisha R. Mistry

Electronic Thesis and Dissertation Repository

A consensus, detailed understanding of carpal kinematics remains elusive. 4-dimensional CT (4DCT) is a validated modality capable of accurately studying in-vivokinematic motion. The objective of this work is to quantify normal, in-vivo kinematic motion of the carpus through a flexion-extension arc of motion using 4DCT. Ten healthy, un-injured volunteers underwent a 4DCT scanning protocol through a complete arc of flexion-extension motion. Kinematic changes in motion were quantified using helical axis motion data for each carpal bone. Helical axes were compared between bones and statistical analysis performed using repeated-measures ANOVA to identify difference in kinematic motion between bones (p<0.05). The carpus can be divided into four main kinematic blocks: the distal carpal block, the proximal carpal block and individual scaphoid and trapezial blocks. This work supports an additional segmentation of the trapezium from the distal carpal row, which suggests some modulation between the scaphoid and distal carpal row.

Reconstructionof Congenital Arhinia With Stereolithography, Kelly Spiller, Kaitlynne Pak, Lucas M. Harrison, Spencer Anderson, Steven Schmidt, Salim Mancho

Medical Student Research Symposium Abstracts and Posters

Complete congenital arhinia is a rare defect of embryogenesis leading to the absence of the external nose and nasopharyngeal airway. In this study, we report our novel multi-staged reconstructive approach of congenital arhinia in addition to literature review. Reconstruction was achieved via several spaced operations. A nasal methyl methacrylate prosthesis was first created from a stereolithographic model for use as a temporary prosthesis and tissue expander. Lefort 1 osteotomy with cannulization was then utilized for midface advancement and nasopharyngeal airway formation. External nasal framework was constructed with bilateral conchal bowl cartilage and rib osteocartilagenous grafts. The patient was overall pleased …

Inadvertent Radial Head Inversion During Closed Reduction Of A Pediatric Radial Neck Fracture, Zachary J. Sirois, Sarah Kreul, Craig F. Shank

Orthopaedic Surgery Faculty Publications

Management of displaced pediatric radial neck fractures can be fraught with challenges. This unique case presents an 11-year-old female with a Salter-Harris type II radial neck fracture and how her radial head overturned 180° with the articular surface facing the radial shaft rather than the capitellum during closed manipulation under anesthesia. The malreduction subsequently required open reduction and highlights the importance of a careful stepwise approach to managing markedly displaced radial neck fractures. After closed reduction, meticulous assessment of intraoperative imaging when determining proper alignment is of the utmost importance as a result of the transverse nature of Salter-Harris type …

Reconstruction Of Heel Soft Tissue Defects Using Sensate Medial Plantar Flap, Mihaela Pertea, Natalia Velenciuc, Oxana Grosu, Bogdan Veliceasa, Vladimir Poroch, Sorinel Lunca

Journal of Mind and Medical Sciences

Introduction. Reconstruction of heel soft tissue defects represents a true challenge for any surgeon due to the particularities of this anatomical region. The tissue used to reconstruct the heel area must be resistant, innervated, and adapted to take over the body weight. Innervated medial plantar fasciocutaneous flap is one of the best solutions to cover defects at the heel level.

Materials and Methods. We studied 5 patients, 4 males and one female, aged 42 to 67 years, who presented heel soft tissue defects of various etiologies. In all cases, the used reconstructive method was an insular innervated medial plantar fasciocutaneous …

The Effects Of Emerging Technology On Healthcare And The Difficulties Of Integration, Skyler J. Pavlish-Carpenter

Honors Undergraduate Theses

Background: Disruptive technology describes technology that is significantly more advanced than previous iterations, such as: 3D printing, genetic manipulation, stem cell research, innovative surgical procedures, and computer-based charting software. These technologies often require extensive overhauls to implement into older systems and must overcome many difficult financial and societal complications before they can be widely used. In a field like healthcare that makes frequent advancements, these difficulties can mean that the technology will not be utilized to its full potential or implemented at all.

Objective: To determine the inhibiting factors that prevent disruptive technology from being implemented in conventional healthcare.

Methods: …

Advanced Plastic Surgery Techniques For Soft Tissue Coverage Of The Diabetic Foot., Thomas Zgonis, John Stapleton, Thomas S Roukis

John J Stapleton DPM, FACFAS

Obtaining stable, durable, and functional wound closure of a diabetic foot wound or open pedal amputation through plastic surgical techniques is essential to limit the potential for repeated ulceration, infection, and "supra-pedal" amputation. Myriad conservative and surgical techniques can be used to obtain wound closure. The authors discuss their approach and present operative pearls for their most commonly employed plastic surgical techniques to provide adequate soft tissue coverage of diabetic foot wounds. Emphasis is placed on the techniques necessary to perform these procedures and the surgical thought process involved in closing diabetic foot wounds.

A Case Report Of A Double Advancement Flap Closure Combined With An Ilizarov Technique For The Chronic Plantar Forefoot Ulceration., Ronald Belczyk, John Stapleton, Thomas Zgonis

John J Stapleton DPM, FACFAS

Soft tissue closure of defects on the plantar surface of the foot continues to be a challenge for the reconstructive surgeon secondarily to the limited number of surgical options and often difficulty of replacing durable and similar soft tissue coverage. Primary closure and skin grafting may not be suitable for the weight-bearing surfaces of the plantar forefoot area, and closure may then be obtained by other means of plastic surgery techniques.

Evaluation Of Tissue-Engineered Tendon Enthesis Polymer Constructs, Joshua A. Bundy Bs, Mary Beth Wade Phd, Hitomi Nakao Md, Phillip Mcclellan Phd, Qing Yu Phd, Robin Jacquet-Childs Ms, William J. Landis Phd

Williams Honors College, Honors Research Projects

Both scientists and clinicians have proposed tissue engineering as the future of medicine. The possibilities for tissue engineering, that is, fabrication of tissues and organs in the laboratory and their translation to patients, appear to be endless, and many believe that this new approach in medicine will result in abolishing many common ailments, injuries, and congenital defects. Injuries to a tendon enthesis, the normal tissue connection between tendon and bone, are of particular concern to clinicians because of their frequency and failure to repair as a result of surgery. While these injuries may not be life threatening, they can certainly …

Nanospiderwebs: Artificial 3d Extracellular Matrix From Nanofibers By Novel Clinical Grade Electrospinning For Stem Cell Delivery, Mohammad Alamein, Qin Liu, Sebastien Stephens, Stuart Skabo, Frauke Warnke, Robert Bourke, Peter Heiner, Patrick Warnke

Qin Liu

Novel clinical grade electrospinning methods could provide three-dimensional (3D) nanostructured biomaterials comprising of synthetic or natural biopolymer nanofibers. Such advanced materials could potentially mimic the natural extracellular matrix (ECM) accurately and may provide superior niche-like spaces on the subcellular scale for optimal stem-cell attachment and individual cell homing in regenerative therapies. The goal of this study was to design several novel “nanofibrous extracellular matrices” (NF-ECMs) with a natural mesh-like 3D architecture through a unique needle-free multi-jet electrospinning method in highly controlled manner to comply with good manufacturing practices (GMP) for the production of advanced healthcare materials for regenerative medicine, and …

A Clinically-Feasible Protocol For Using Human Platelet Lysate And Mesenchymal Stem Cells In Regenerative Therapies, Patrick Warnke, Andreas Humpe, Dirk Strunk, Sebastien Stephens, Frauke Warnke, Jorge Wiltfang, Katharina Schallmoser, Mohammad Alamein, Robert Bourke, Peter Heiner, Qin Liu

Qin Liu

The transplantation of human stem cells seeded on biomaterials holds promise for many clinical applications in cranio-maxillo-facial tissue engineering and regenerative medicine. However, stem cell propagation necessary to produce sufficient cell numbers currently utilizes fetal calf serum (FCS) as a growth supplement which may subsequently transmit animal pathogens. Human platelet lysate (HPL) could potentially be utilized to produce clinical-grade stem cell-loaded biomaterials as an appropriate FCS substitute that is in line with clinically-applicable practice. The goal of this study was to investigate whether HPL can be successfully used to propagate human mesenchymal stem cells (HMSCs) seeded on clinically-approved collagen materials …