Plastic Surgery Commons^™

Women, Power, And Cancer: A Lancet Commission, Ophira Ginsburg, Verna Vanderpuye, Ann Marie Beddoe, Nirmala Bhoo-Pathy, Freddie Bray, Carlo Caduf, Narjust Florez, Ibtihal Fadhil, Nazik Hammad, Miriam Mutebi

General Surgery, East Africa

Women interact with cancer in complex ways, as healthy individuals participating in cancer prevention and screening activities, as individuals living with and beyond a cancer diagnosis, as caregivers for family members and friends, as patient advocates, as health workers and healthcare professionals, and as cancer researchers and policy makers. The topic of women and cancer spans broad terrain, beyond women’s cancers and the biomedical aspects of any type of cancer that women in all their diversities might experience. It is inclusive of the ways in which sex and gender influence exposures to cancer risk factors, interactions with the cancer health …

Surgical Delay Of Thoracodorsal Artery Perforator Flaps For Bilateral Autologous Breast Reconstruction, Ryan D. Hoffman, Mark A. Maier, Hugo St. Hilaire, Robert J. Allen

School of Medicine Faculty Publications

Summary; Autologous reconstruction accounts for nearly one-quarter of all breast reconstruction cases in the United States, with the abdomen functioning as the most popular donor site. This case describes a 62-year-old woman who presented to our clinic with a remote history of estrogen receptor+/progesterone+ breast cancer and bilateral implant-based reconstruction. After grade IV capsular contracture of her left breast, she presented for autologous reconstruction. Due to her body habitus and prior belt lipectomy, deep inferior epigastric perforator flap reconstruction was contra-indicated. The thoracodorsal artery perforator (TDAP) flap is well described in the literature, and was chosen as an alternative salvage …

Oropharyngeal Teratoma: Five-Month-Old Presenting With Failure To Thrive And Severe Obstructive Sleep Apnea., Anna Lawrence, Melissa Gener, Shao Jiang, Jill M. Arganbright

Manuscripts, Articles, Book Chapters and Other Papers

Oropharyngeal teratomas are an extremely rare congenital tumor. They are often diagnosed prenatally and can cause significant airway obstruction and feeding difficulties at birth. We present a five-month-old female that was diagnosed with a palatal teratoma that presented with failure to thrive, difficulty feeding, and eventually with severe obstructive sleep apnea. We present a five-month-old term, otherwise healthy female who became stridulous after an episode of the respiratory syncytial virus at one month old. At three months old, an otolaryngologist diagnosed mild laryngomalacia with no mass identified, and no surgical intervention was recommended. Due to continued poor weight gain, at …

Successful Latissimus Dorsi Free Flap Salvage Using Intraoperative Vasopressors: A Case Report, Aubree Ford, Hugo Palacios Vazquez, Sean Figy

Graduate Medical Education Research Journal

Arterial thrombosis is a rare, but dreadful complication in microvascular surgery. Here we report on a case of recurrent arterial thrombosis in a latissimus dorsi (LD) free flap used for scalp reconstruction in an 18-year-old woman who sustained a gunshot wound (GSW) to the head. In the immediate postoperative period, internal and external doppler signals to the flap were lost. Emergent surgical exploration revealed arterial thrombosis, which was emergently explored and successfully repaired. Doppler signals were again lost and the flap was emergently explored for a second time. Following revision of the arterial anastomosis, flap perfusion decreased and appeared to …

Red Breast Syndrome And Acellular Dermal Matrix, Allison Podsednik Gardner, Aidee Nunez, Mauricio De La Garza

School of Medicine Publications

Increasingly popular for use in breast reconstruction, acellular dermal matrix (ADM) can provide support and protection to implants. However, use of ADM may be associated with infection and complications, including red breast syndrome (RBS). RBS is an inflammatory event that typically presents with cutaneous erythema over the domain where the ADM is surgically implanted. As ADM use increases, presumably, more cases of RBS will occur. Thus, techniques and tools to mitigate or manage RBS are needed to improve patient outcomes. Here, we describe a case where RBS was diagnosed and interestingly resolved after exchange for a different brand of dermal …

Analysis Of Graft Types Used With Internal Brace Augmentation For Acl Reconstruction: A Systematic Review, Connor Maginnis, Cooper Root, Julie H. Schiavo, Bryan Vopat, Mary K. Mulcahey

School of Medicine Faculty Publications

International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine Congress 2023, June 18 - 21, 2023, Boston, MA

Acute Diplopia After Glabellar Hyaluronic Acid Filler Injection, Caroline W. Chung, Eric J. Shiuey, César A. Briceño, Vivian Lee

SKMC Student Presentations and Publications

Purpose: Blindness is a well-known complication of filler injection in the glabellar region. Acute diplopia from filler injection without vision loss is a rare complication that typically results in clinical ophthalmoplegia which can have permanent sequelae. Here, we describe a patient who presented with acute diplopia with grossly intact full extraocular motility after glabella hyaluronic acid filler injection that resolved after 1 month.

Observations: A previously healthy 43-year-old woman underwent her first hyaluronic acid injection in the glabella and developed immediate binocular double vision with severe pain and skin mottling above her right eyebrow and central forehead. Hyaluronidase injections, nitroglycerin …

The Spectrum Of Severity In 368 Patients With Metopic Craniosynostosis: An Update To The Craniorate™ Machine Learning Algorithm, Annie Glenney, Joseph Mocharnuk, Griffin Bins, Erin Anstadt, Lucas Dvoracek, Wenzheng Tao, Ross Whitaker, Lisa David, David Runyan, Jesse Goldstein

St. Chris Research Day

No abstract provided.

Pediatric Facial Fractures In Patients With Autism Spectrum Disorder, Annie Glenney, Zhazira Irgebay, Meeti Mehta, Joseph Mocharnuk, Janina Kueper, Lucas A. Dvoracek, Justin Schreiber, Joseph Losee, Jesse Goldstein

St. Chris Research Day

No abstract provided.

Risk Factors For Neonatal Brachial Plexus Injury: A Retrospective Review Of A Single-Institution’S Eleven-Year Experience, Annie Glenney, Meeti Mehta, Hilary Liu, Alexander Comerci, Yusuf Surucu, Tarek Arabi, Elizabeth Moroni, Alexander J. Davit Iii

St. Chris Research Day

No abstract provided.

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.

Chronic Wound Management; Surgical Therapy And Complementary Nursing With Manuka Honey, Georgeta Paunică-Panea, Sergiu Teodorescu, Aurelia Preda, Laura Elena Gligor, Adrian Silaghi, Vlad Denis Constantin

Journal of Mind and Medical Sciences

Objectives. This study aims to analyze the evolution of chronic wounds treated both surgically and by complementary nursing using Manuka honey. The parameters monitored were: presence/persistence of bacterial infection, the duration of healing, the recovery period and the patients' quality of life. Materials and Methods. The study group and the control group each consisted of 10 patients, aged between 50-60 years, with chronic wounds of various etiologies but without other significant systemic pathologies. Data collection was carried out through anamnesis, physical examination and analysis of medical documents. Results. In the study group, the depth of the wound was reduced rapidly …

Surgical Management Of Velopharyngeal Dysfunction: Major Techniques And Trends For The 21st Century, Dominic Alessio-Bilowus, Sadaf Hashemian, Kylie Nikolli, Ahmed Hashem Md

Medical Student Research Symposium

INTRODUCTION: Surgical management of velopharyngeal dysfunction (VPD) has become increasingly complex over recent decades with advances in diagnosis, evaluation and technique, and research focus in this area is expected to shift accordingly. This study aims to educate readers on updates in management of VPD and explore changes in surgical methods through the 21st century.

METHODS: A systematic review was conducted of all literature published on surgical treatment of VPD since the year 2000, following PRISMA reporting guidelines. Adult-acquired VPD, any non-surgical management, implants and prosthetic devices, animal or cadaver models, and case series involving less than 10 subjects were excluded. …

Effects Of Marijuana Use In Patients Undergoing Abdominal Free Flap Breast Reconstruction, Tala Al-Saghir, Kinan Sawar, Alexander Vraa, Dunya Atisha

Medical Student Research Symposium

PURPOSE: Marijuana use is associated with incidence of vascular inflammation and clotting, resulting in endothelial damage and arteritis. As marijuana use rises, few studies have evaluated its impact on surgical outcomes, wound healing, and vascular anastomoses in free flap breast reconstruction.

METHODS: A retrospective cohort study of patients undergoing abdominal free flap breast reconstruction between 2016 and 2022 at a large metropolitan healthcare system was performed. Patient demographics, comorbidities, procedural details, and complications were analyzed. Minor complications were defined as skin necrosis, any wound requiring management in the clinic, hematoma, seroma, or fat necrosis that did not require intervention. Major …

Radiated Immediate Prepectoral Direct To Implant Reconstruction: A Retrospective Cohort Study, Kinan Sawar, Tala Al-Saghir, Jamie Hall, Michael Diffley, Madeleine Gonte, Donna Tepper, Vigen Darian, Maristella Evangelista, Amy Tang, Dunya Atisha

Medical Student Research Symposium

Purpose: Increasing use of prepectoral plane in post mastectomy implant-based reconstruction has made immediate direct to implant (DTI) reconstruction more achievable. There has been increased incidence of post mastectomy radiation therapy (PMRT) making it important to understand the complication profile of immediate DTI reconstruction in patients who may require adjuvant radiation therapy.

Methods: A retrospective cohort study of consecutive patients undergoing prepectoral DTI reconstruction with and without PMRT was performed. Patient and treatment level factors, operative, and post-operative outcomes were extracted on both the patient and breast level for the prepectoral radiated and nonradiated patients. The presence of at least …

A Nationwide Analysis Of Gunshot Wounds Of The Head And Neck: Morbidity, Mortality, And Cost, John M. Menezes, Kavita Batra, Vladislav Pavlovich Zhitny

Department of Plastic Surgery Faculty Research

Background:

Gun violence in the United States rose continuously from 2010 to 2022, spiking during the pandemic, and peaking in 2021 at 48,830 deaths (14.8 per 100,000). Previous reports investigated health and financial burden associated with gunshot wounds (GSWs) during 2004 to 2013; however estimates related specifically to head and neck (H&N) injuries have been lacking. This population-based study aims to examine incidence, morbidity, mortality, and health resource utilization of H&N injuries utilizing the Nationwide Inpatient Sample database.

Methods:

A population-based study was undertaken using the National (Nationwide) Inpatient Sample (NIS) database (2015Q4–2017Q4). The International Classification of Diseases, Tenth Revision …

Review Of Orthoplastic Techniques For Lower Extremity Reconstruction: Part One, Benjamin Heddy, Brady Webb

Advances in Clinical Medical Research and Healthcare Delivery

Orthoplastic techniques are effective tools for limb salvage in the lower extremity. In order to apply proper techniques successfully, a surgeon must be aware of all the different types of flaps available. Proper pre-operative evaluation and patient selection are also important factors. The following review covers six papers that give surgeons a strong foundation in the anatomical basis and surgical technique of intrinsic muscle flaps and other fasciocutaneous or adipofascial flaps of the foot. These flaps, along with split thickness skin grafts, external fixation, and dermal regenerative templates, quickly close soft tissue deficits in the foot and ankle that often …

Small Finger Reverse Ulnar Digital Artery Hypothenar Perforator Flap For Small Finger Proximal Interphalangeal Joint Reconstruction, Nicholas Kunda, Alexander Dagum

Stony Brook Orthopaedic and Musculoskeletal Journal

Purpose: Local flaps are commonly used for digital reconstruction for soft tissue defects. There remains a paucity of options available for small finger volar proximal interphalangeal joint coverage. The purpose of this study was to analyze perforators along the hypothenar eminence arising from the artery of the ulnar side of the small finger as it comes off the superficial palmer arch for consistency and potential to be used for perforator-based flap reconstruction of the small finger proximal interphalangeal joint.

Methods: Four cadaveric upper extremities were injected with Microfil® silicone injection compound. Dissection was performed from the superficial palmer arch to …

Clinical And Radiographic Outcomes For Femoral Neck Fracture Fixation With Femoral Neck System Versus Multiple Cannulated Screws, Samer M. Al-Humadi, D’Arcy Marsh, Michael Doany, David Swanson, David E. Komatsu, Stephen A. Kottmeier, Nicholas Divaris

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: The There are few studies in the orthopaedic surgery literature that examine clinical outcomes for femoral neck system (FNS) fixation of femoral neck fractures. The purpose of this study was to compare primary outcome of non-union for femoral neck fracture fixation using FNS versus multiple cannulated screws (MCS).

Methods: Retrospective electronic medical record search for patients 18 years or older who underwent surgery between March 01, 2018 and September 01, 2021 for femoral neck fracture fixation. Two reviewers examined radiographic and clinical data reaching consensus. Patients were called via telephone to complete Short Form 12-item (SF-12) surveys with consent. …

Alcohol And Opiate Abuse Are Risk Factors For Dislocation After Primary Reverse Shoulder Arthroplasty, Ryan P. Tantone, Kenny Ling, Michael E. Doany, Rosen Jeong, Emma Smolev, Edward D. Wang

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: As indications for reverse total shoulder arthroplasty (RTSA) expand and patients present with increasing comorbidities, complications have become more frequent. Dislocation and instability are devastating complications and have become one of the leading causes of revision surgery. Current literature suggests multifactorial causes for dislocation, but studies are limited to physiologic and mechanical risk factors. The purpose of this study was to investigate social risk factors, including alcohol and drug abuse, and their association with dislocation after RTSA.

Methods: A retrospective cohort of all RTSA performed at a single center by the senior author between January 2012 and March 2021 …

Core Muscle Injuries: Functional Outcomes And Return To Sport In A Consecutive Series Of Twenty Athletes, Nicholas Tsouris, Jack Tesoriero, James A. Vosswinkel, James Penna

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: Core muscle injury can cause significant dysfunction in athletes. A variety of surgical procedures have been described. This study examines an orthopaedic and general surgeon’s technique and patient reported outcomes of adductor tenotomy and rectus abdominus imbrication with ilioinguinal nerve neurolysis.

Hypothesis: Surgical treatment of core muscle injuries with adductor tenotomy and rectus abdominus imbrication with ilioinguinal nerve neurolysis will result in decreased symptoms and high rates of return to play.

Study Design: Operative technique; retrospective case series.

Methods: Our electronic medical record system was searched for patients who underwent core muscle injury surgery by the treating surgeons. The …

The Utility Of The Axillary Shoulder Radiograph In The Management Of Clavicle Fractures, Stephen Bowen, Ryan Tantoe, Daniel Botros, Samer Al-Humadi, Nicholas Tsouris, Nicholas Divaris

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: Prior literature is mixed on the necessity of an axillary shoulder radiograph in the setting of presumably isolated clavicle fractures, with some authors endorsing its need for any shoulder girdle trauma and others stating it is unnecessary. However, no studies to date have specifically evaluated this.

Hypothesis: We hypothesize that an axillary shoulder radiograph will offer no management changing information in the setting of clavicle fractures.

Methods: Ninety-five patients presented for follow-up for management of a clavicle fracture. Analysis was performed to determine if the axillary view was useful based on the discovery of a glenohumeral dislocation or a …

Outcomes In Early Versus Delayed Management Of Pediatric Femoral Shaft Fractures, Daniel Botros, Sofia Hidalgo Perea, Rachel Loyst, James Barsi

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: There is a paucity of literature regarding the timing of treatment for pediatric femur fractures.

Purpose: The purpose of this study was to analyze whether early versus delayed management of pediatric femoral shaft fractures would impact outcomes regarding time to union and return to baseline function.

Methods: Pediatric patients presenting with femoral shaft fractures from 01/01/2010-01/01/2021 were identified using the Database at a single level one Trauma Center and retrospectively reviewed. Demographic information, surgical details, associated injuries, length of follow-up, time to union, and return to baseline function was collected. Patients were then divided into two groups; the early …

Suture Tape Stabilization Of The Distal Ulna Following Darrach Procedure. A Biomechanical Study, Miles S. Parsons, Evan C. Olsen, David E. Komatsu, Samantha Muhlrad

Stony Brook Orthopaedic and Musculoskeletal Journal

Introduction: The Darrach procedure (complete resection of distal ulna) is commonly used for definitive treatment of end- stage distal radioulnar joint (DRUJ) arthritis. This resection alone often results in treatment failure due to ulnar stump instability in a dorsal-palmar direction and ulnar convergence. Modified Darrach procedures with tenodesis have improved outcomes, but none have completely resolved these issues. Thus, we propose a novel technique of fixation via an internal brace.

Purpose: To evaluate stability and degree of dorsal-palmar displacement with an internal brace fixation (IBF) versus a modified extensor carpi ulnaris tenodesis (ECUT) following a Darrach procedure.

Methods: We tested …