Plastic Surgery Commons^™

Burn Injury Characteristics: Findings From Pakistan National Emergency Department Surveillance Study, Emaduddin Siddiqui, Nukhba Zia, Asher Feroze, Safia Awan, Arifa Liaquat Ali, Junaid Razzak, Adnan Hyder, Asad Latif

Department of Emergency Medicine

Background: Burn injury is an important yet under-researched area in Pakistan. The objective of this study was to determine the characteristics and associated outcomes of burn injury patients presenting to major emergency departments in Pakistan.
Methods: Pakistan National Emergency Department Surveillance (Pak-NEDS) was a pilot active surveillance conducted between November 2010 and March 2011. Information related to patient demographics, mode of arrival, cause of burn injury, and outcomes was analyzed for this paper. Data were entered using Epi Info and analyzed using SPSS v.20. Ethical approval was obtained from all participating sites.
Results: There were 403 burn injury patients in …

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.

Plastic Surgical Techniques For The Foot And Ankle, John Stapleton, Crystal Ramanujam

John J Stapleton DPM, FACFAS

No abstract provided.

Dyspnea Associated With Silicone Breast Implant Rupture, Katherine Rider, Hatice Kaya, Guillermo Gutierrez

Medicine Faculty Publications

We present a case of a 48-year-old woman with a significant history of atopy. She presented with a 1-month history of dyspnea on exertion. Pulmonary function testing was normal, with no obstruction or reversibility post-bronchodilation. Bilateral breast implant rupture was detected on further investigation for a left upper lobe nodule, and the patient underwent bilateral implant removal. There was an improvement in her respiratory symptoms. Systemic symptoms, labeled as “Autoimmune/Inflammatory Syndrome Induced by Adjuvants,” are known to be associated with breast implants, with 14% of women in a cohort developing autoimmune disease secondary to their implants. An improvement in symptoms …

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 …

Mass Production Of Nanofibrous Extracellular Matrix With Controlled 3d Morphology For Large-Scale Soft-Tissue Regeneration, Mohammad Alamein, Sebastien Stephens, Qin Liu, Stuart Skabo, Patrick Warnke

Qin Liu

Aim: Biomaterials that mimic the nanofibrous architecture of the natural extracellular matrix (ECM) are in the focus for stem cell hosting or delivery in tissue engineering of multilayered soft tissues such as skin, mucosa, or retina. Synthetic nanofibers for such ECM are usually produced by single-syringe electrospinning with only one needle-jet at very low production rates of 0.005–0.008 g·min−1. The aim of this study was to utilize a novel industrial needle-free multijet electrospinning device with the potential for mass production of nanofibrous ECM (NF-ECM) exhibiting a controlled three-dimensional (3D) morphology for large-scale applications such as large area skin regeneration in …

Oral Clefts: A Review Of The Cases And Our Experience At A Single Institution, Mohammad Raheel Nawaz Jajja, Alina Gilani, Zain Feroze Cawasji, Sehyr Imran, Muhammad Shahjahan Khan, Salila Shoaib Hashmi, Tahir Shafi Khan

Section of Dental-Oral Maxillofacial Surgery

Objective: To identify the frequency of different types of oral clefts and presence of known risk factors among patients.Methods: The retrospective review of 292 patients, presenting with oral clefts between 1992 and 2011, was conducted at the Aga Khan University Hospital, Karachi. A pre-designed questionnaire was used to collect details, including demographics, type of cleft, presence of known risk factors, surgical details, and follow-up visits. SPSS 16 was used for data analysis. Chi-square test and analysis of variance was used: whenever applicable.Results: Of the total, 168 (57-53%) patients had cleft lip with or without cleft palate, and 124 (42.5%) had …

Tensional Forces Influence Gene Expression And Sutural State Of Rat Calvariae In Vitro, S. Tholpady, T. Freyman, Debbie Chachra, R. Ogle

Debbie Chachra

BACKGROUND:

Theories regarding the cause of craniosynostosis that are more than 15 years old cite the role that tensional forces play in the normal and abnormal development of the cranial suture. These theories highlight the effect of stress bands originating from the skull base to the vertex, guiding sutural development.

METHODS:

In this study, the normally fusing posterior intrafrontal suture of the rat was subjected to 3 mN of tensional force for 30 minutes per day. The suture was then assessed for patency, proliferation, apoptosis, and transforming growth factor (TGF)-beta signaling components.

RESULTS:

Sutures that were subjected to tensional force …

Gynaecomastia; Management With Liposuction And Glandular Excision, Stanley Ominde Khainga, Ronald Wasike, P. K. Biribwa

General Surgery, East Africa

Gynaecomastia is caused by an increase in ductal tissue, stroma and fat in the male breast. Frequently it occurs at the time of hormonal changes during infancy, adolescence and old age. Galen, introduced the term gynaecomastia in the second century AD and surgical excision was first described by Pauli of Aegina in the seventh AD (1,2). Ultrasound assisted liposuction and surgical excision of glandular tissue through an inferior circumareolar incision is currently the best mode of treatment. In this study seven patients varying from the ages 17-45 years were operated on using this technique at the Aga Khan University teaching …

Can Female Genital Mutilation Victims Benefit From Corrective Surgery: To Regain Sexual Pleasure And Be “Whole” Once Again?, Monique Sulls

Festival of Communities: UG Symposium (Posters)

Female Genital Mutilation (FGM) is defined by the World Health Organization, (WHO), as the removal or cutting of the external female genitalia. WHO estimates between 100 and 140 million girls and women worldwide currently live with the consequences of FGM. The study finds that through corrective surgery, pre/post therapy, counseling, and sexual education victims to FGM can regain sexual pleasure providing them a chance to be “Whole” once again.

Reduction Of Mammoplasty Using Inferior Pedicle In Heavy Breasts (Macromastia)., Stanley Ominde Khainga, Ronald Wasike, P. K. Biribwa

General Surgery, East Africa

Symptoms associated with heavy breasts are pain in the upper part of the body; back pains, poor body posture and headache. These patients also have difficulties in finding suitable clothes and experience poor self-image and problems such as establishing sexual relationships. Reduction mammoplasty procedure provides weight and volume reduction of the breast as well as enhancement of the aesthetic appearance of the breasts. In this study, the inferior pedicle technique was used in reduction of thirty five patients over the last four years with macromastia. In all the patients except three, good results were achieved. One patient suffered nipple necrosis …

Controle De Infecção Em Clínicas De Cirurgia Plástica / Infection's Control In Plastic Surgery Clinics, Everton Fernando Alves

Everton Fernando Alves

A infecção é a mais frequente e grave complicação que acomete pacientes que procuram serviços estéticos e/ou funcionais em clínicas de cirurgia plástica. Uma infecção hospitalar eleva os custos do processo, tanto para o paciente quanto para a empresa. Diante disso, torna-se importante a instalação de uma comissão de controle de infecção hospitalar, tendo como responsável um enfermeiro. A importância deste profissional se dá por meio da organização da Central de Material Estarilizado (CME), bem como do estabelecimento de outras medidas efetivas para a prevenção e controle de infecções nas clínicas apresentadas ao longo desse artigo.

Perfil Dos Atendimentos Ambulatoriais Realizados Em Uma Clínica De Cirurgia Plástica No Sul Do Brasil / Outpatient Service Profile In A Plastic Surgery Clinic In Southern Brazil, Everton Fernando Alves

Everton Fernando Alves

Objetivo: Descrever o perfil dos atendimentos ambulatoriais realizados em uma clínica de cirurgia plástica no sul do Brasil. Materiais e Métodos: Foi realizado um estudo descritivo, exploratório e de caráter quantitativo com o intuito de analisar a totalidade de atendimentos ambulatoriais (consultas e cirurgias) realizadas em uma clínica privada de cirurgia plástica no período de 01 de janeiro a 31 de dezembro de 2010. Resultados: Observou-se que, das 671 (60,5%) consultas novas, apenas 205 (18,5%) cirurgias foram realizadas. Março foi o mês com mais consultas (10%) e cirurgias (11,7%). Do total de consultas novas, as reparadoras foram predominantes em 55,6% …