Plastic Surgery Commons^™

Craniofacial Differences And Safe Sleep Practices: Findings From A Caregiver Survey At A Children’S Hospital, Cait Vuturo-Brady, Aracelia S. Aldrete, Jesus Gil Inciong, Miccah Seaman, Rianna Leazer

Knowledge and Creativity Expo

Purpose

Many infants with cleft lip and/or palate (CL/P) have airway issues that make supine, flat-surface sleep challenging.¹ Prior studies indicate that alternative positioning may reduce obstructive events,² and early sleep-disordered breathing can affect later development.³  Despite this, caregivers of infants with craniofacial differences rarely receive tailored sleep guidance, and no evidence-based, condition-specific recommendations currently exist.^4,5

Methods

This single-site, cross-sectional study evaluated sleep practices, caregiver education, and barriers to adherence among parents of children (< 3 years) with CL/P treated at CHKD’s Craniofacial Program. Eligible caregivers (n=117) were identified via query of the electronic medical record by CHKD Data Governance and invited to complete an anonymous REDCap survey assessing demographics, sleep environment, counseling, and understanding of safe-sleep recommendations.

Results & Conclusions

Of the 11 caregivers who completed the survey, 91% reported crib sleep, though several also used beds, couches, …

Review Of Outcomes: Quality Improvement Of Upper-Extremity Necrotizing Soft Tissue Infections, Cailey A. England Bs, Ryan A. Reinhart Bs, Tien Do Do, Maame A. Effirim Bs, Dylan Bezzini Md

Summer Research Program Abstracts

No abstract provided.

Expansion Of Hand Trauma Transfers At A Level 1 Trauma Center Following Integration With The Assh Hand Trauma Center Network, William Delahoussaye, Madeline Gautreaux, Patrick A. Palines, Ramin Shekouhi, Kelly L. Babineaux

School of Medicine Faculty Publications

Purpose: This study sought to evaluate how joining the National Hand Trauma Center Network (NHTCN) affected the volume, demographics, and severity of hand trauma transfers to our institution. Methods: Data for this study were collected retrospectively over a 6-year period from 2016 to 2021 from our institutional trauma registry. Patients were selected based on the criterion of being transferred to our facility because of isolated hand trauma. Analyses of transfer rates, transfer distance, sending facilities, injury patterns, insurance type, path of care, and hospital charges prior to and after joining the NHTCN were performed. Results: There was a total of …

Synthetic Electrospun Fiber Matrix In The Management Of Acute Wounds Following Excision Of Hidradenitis Suppurativa Lesions: A Prospective Pilot Study, Michael Madueke, Frank Lau

School of Medicine Faculty Publications

Hurley Stage II or III hidradenitis suppurativa (HS) may necessitate surgical excision of diseased skin and subcutaneous fat for symptom control and disease management. These excisions result in open wounds in topographically challenging regions and typically cannot be primarily closed. This study evaluates the use of a synthetic electrospun fiber matrix (SEFM) as a post-resection regeneration template to accelerate re-granulation and improve subsequent skin graft incorporation. This prospective pilot study enrolled Hurley Stage II or III patients undergoing surgical resection of HS lesions. SEFM was applied to the resulting wounds in conjunction with negative pressure wound therapy (NPWT). Patients were …

Breast Reconstruction In Becker Nevus Syndrome, Alexis K. Schlosser, Mohammed S. Rais, Ruston J. Sanchez

School of Medicine Faculty Publications

Becker nevus syndrome is a rare cutaneous disorder characterized by the presence of a hyperpigmented patch of skin typically occurring on the upper trunk, often associated with hypertrichosis, and sometimes associated with musculoskeletal abnormalities ipsilateral to the nevus. Becker nevus syndrome can lead to breast hypoplasia. Unlike other forms of breast hypoplasia, treatment should begin before the completion of breast development. Due to the rarity of the disease, breast reconstruction in these patients has no gold-standard approach, and treatment is often delayed. Therefore, our case report highlighted the need for early treatment and provided options for reconstruction in this population. …

Mapping Fat Embolism As A Complication Of Liposuction And Fat Grafting: A Systematic Review Of Anatomical And Technical Risk Factors, Jared Garfinkle, Jack Hennen, Wen Luo

Rowan-Virtua Research Day

Fat grafting (FG) and liposuction are widely performed aesthetic procedures with associated fat embolism risks. However, no comprehensive review has specifically mapped the anatomical distribution and technical causes of fat embolism events across these procedures. This review aims to characterize regional and procedural frequencies of fat embolism to inform safer surgical practices. A review was conducted using PubMed, Embase, Scopus, and Cochrane. Included studies were English-language case reports/series, retrospective reviews, and systematic analyses reporting fat embolism following liposuction or FG. Among 227 FG cases, the most frequent regions were the face (n=120), gluteal region (n=91), genitalia (n=9), and chest (n=7). …

Incidence Of Orbital Mucocele Following Orbital Floor Fracture Repair, Adeem M. Nachabe, Genevieve E. Messa, Jonathan C. Boraski

School of Medicine Faculty Publications

Mucoceles can often present as a complication after prior sinus surgery or maxillofacial trauma when mucosal drainage is obstructed. Their presence in the orbit following orbital wall fracture and subsequent repair represent an exceedingly rare complication whose occurrence is limited to a few reported cases in the literature. In these patients, continuous cyst expansion and subsequent mass effect may lead to ophthalmic symptoms, including orbital pain, proptosis, diplopia, and globe dystopia. We report the discovery of an orbital mucocele after orbital floor fracture repair and its possible association with the nonporous reconstruction plate utilized for fixation. When a patient with …

Use Of Flow-Through Free Flaps In Head And Neck Reconstruction, Mark A. Maier, Patrick A. Palines, Richard F. Guidry, Mark W. Stalder

School of Medicine Faculty Publications

Background: Reconstructive obstacles in composite head and neck defects are compounded in reoperated, traumatized, irradiated, and vessel-depleted surgical fields. In cases that require multiple free flaps, recipient vessel accessibility and inset logistics become challenging. Strategic flow-through flap configurations mitigate these issues by supplying arterial inflow and venous outflow to a second flap in a contiguous fashion. This approach (1) permits the use of a singular native recipient vessel, (2) increases the reach of the vascular pedicle, avoiding the need for arteriovenous grafting, and (3) allows for a greater three-dimensional flexibility in configuring soft tissue and bony flap inset. Methods: To …

Innovative Therapeutic Approach To Chemical Burns Produced By Vesicants; An Experimental Study, Cristina Anca Secara, Otilia Liudmila Cinteza, Diana Popescu, Claudia Valentina Popa, Camelia Andreea Hirjeu, Oana Cristina Voinea, Luiza Georgia Serbanescu, Andreea Marilena Pauna, Mihail Tudosie

Journal of Mind and Medical Sciences

Vesicants are compounds that cause severe toxic effects on various tissues. Such chemical action causes tissue necrosis, with clinical expression of skin lesions with a burning character and characteristic blisters. Clinical toxic effects of cutaneous vesicles are correlated with the absorbed dose and exposure time. The goals of the study are to evaluate in vitro the skin toxicity produced by the vesicant chemical compound 2-chloroethyl-ethyl sulfide (CEES), to develop a complex antidote formula, and to optimize the therapeutic efficacy by inclusion in controlled release systems. The experimental protocol aims at the in vitro evaluation of the cytotoxicity of the vesicant …

Collagen-Based Biomaterials With Possible Therapeutic Effects, Ramona Mihaela Nedelcuţă, Gigi Călin, Mihai Cristian Nedelcuţă, Vlad Dumitru Baleanu, Dragos Virgil Davitoiu, Bogdan Socea, Bogdan-Petre Stănoiu

Journal of Mind and Medical Sciences

Epidermolysis bullosa (EB) is a rare, serious genetic disease, incurable through the current means. Apart from this initial definition, there was later some ease in the definition of the disease, including the manifestations of toxic epidermal necrolysis and Stevens Johnson syndrome in this entity. In medical practice, there are cases that do not overlap with the description in the literature, thus the treatment must be adapted and personalized to the particularities. We present the case of a female new-born, with "de novo" mutation for the early-onset antenatal epidermolysis and our personalized therapeutic management, based on collagen from bovine corneas by …

Spare Parts Surgery For Oncologic Reconstruction To Preserve Local Advancement Flap For Decubitus Ulcer Reconstruction: A Case Report, Emily Zurbuchen, Nathan Foje, Sean Figy

Graduate Medical Education Research Journal

A 58-year-old male presented to our institution with synchronous large left thigh sarcoma and sacral decubitus ulcer requiring oncologic resection and reconstruction. Due to extensive tumor involvement, use of local flap for reconstruction was not feasible. Therefore, a spare parts free fillet flap from the disarticulated lower leg was utilized for reconstruction following oncologic resection. The benefits of this spare parts approach include no donor site morbidity, sufficient tissue padding for later use of prosthesis, and preservation of other flaps for future reconstruction of his sacral decubitus ulcer.

Post-Surgical Pyoderma Gangrenosum After Breast Surgery: A Case Series, Jahan Tajran, Daniella Anderson, Arif Chaudhry, Dennis Hammond

Medical Student Research Symposium

Background:

Pyoderma gangrenosum (PG) is a rare inflammatory cutaneous disorder that is thought to be due to innate immune system dysfunction, specifically of neutrophils. PG has been well documented in patients with autoimmune disorders like Ulcerative Colitis and Rheumatoid Arthritis. PG can also present in surgical patients, imitating a potential wound infection and necrotizing fasciitis. Although PG is a diagnosis of exclusion, prompt recognition is essential to attaining desired aesthetic outcomes, especially with breast involvement. We present a case series of four patients who developed PG following breast surgery. We analyze each patient’s medical history, symptoms, wound progression and management …

Panniculectomy Performed In Conjunction With Gynecologic Surgery In The Morbidly Obese Patient - A Nsqip Analysis And Meta-Analysis Of The Literature, Shayoni Nag, Tirth Patel, Steven C. Bonawitz

Rowan-Virtua Research Day

Purpose: Panniculectomy is a common procedure in plastic surgery, often performed following massive weight loss and in morbidly obese patients. It can be performed in combination with various gynecologic procedures based on the rational that it will reduce complication rates.^{1, 2, 3} These studies fail to provide proof of these claims for reasons including study design and the lack of inclusion of both morbidly obese and non-morbidly obese patients. Recent medical practice has focused increasingly on minimizing patient morbidity and trends in reimbursement are moving towards penalizing practices which increase complications.

Methods/Results:We reviewed the NSQIP database to assess …

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 …