Plastic Surgery Commons^™

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

Plastic Surgery Faculty Publications

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 …

Evaluation Of Boomerang Pattern With J-Torsoplasty For Correction Of Gynecomastia After Massive Weight Loss, Ahmed Nabil Mohamed Emam, Abdel Moneam Hussien Hota, Ahmed Taha Sayed Hassan

Al-Azhar International Medical Journal

Background: Various degree of gynaecomastia with excessive ptosis, nipple malposition, overstretched skin, poorly defined infra-mammary fold, and prominent axillary and lat chest rolls, male chest deformity following significant weight loss is complicated and difficult to treat, so correction methods should allow for the technically correct removal of extra tissue without jeopardizing the blood and nerve supply to the nipple-areola complex. Aim of the work: To ascertain whether J torsoplasty with boomerang excision pattern correction of gynecomastia will result in well-hidden scars and adequate male chest contouring. Patients and methods: The study included 15 patients of bilateral gynecomastia with lateral chest …

Evaluation Of Aesthetic And Oncological Outcomes Of Immediate Versus Delayed Reconstruction In Patients Of Breast Cancer: A Meta-Analysis, Abd-Elrahman Awadeen Abd-Elrahman, Ahmed Mohammed El Mahdy Salem, Hesham Mahmoud Ahmed Emam

Al-Azhar International Medical Journal

Background; with a lifetime probability of up to 10%, breast cancer is considered the utmost prevalent type of cancer among women. One of the key elements for an achieving successful reconstruction is the optimal timing. It is still debated to take a decision choosing between the immediate and the delayed reconstruction.

Aim and objectives: The goal of the present research was the evaluation of both the aesthetic and oncological results of reconstruction: the immediate vs. the delayed, in patients having breast cancer.

Methods: a search in literature was conducted in publications of PUBMED, SienceDirect, EMBASE, Google Scholar and the Cochran …

Skin Graft For Treatment Of Crippled Hypospadias, Ahmed Salem, Khaled Abd Elhaleem Hefny, Mohammad El Sayed Daboos, Amr Mohamed Elsayed

Al-Azhar International Medical Journal

Background: Hypospadias is one of the most frequent birth defects, with an incidence of 1 in every 300 births. After several attempts at hypospadias surgery, the term "crippled hypospadias" has been used to describe patients with unresolved functional problems. Aim of the work: To evaluate the outcome of a two-stage skin graft for treatment of crippled hypospadias regarding graft uptake, penile reconstruction Patients and Method: This clinical study was done in Al-Azhar University Hospital on 15 cases presenting with crippled hypospadias from May 2021 to Oct 2022. After preoperative preparation, all patients were submitted for two-stage skin graft urethroplasty. Results: …

Breast Implant-Associated Anaplastic Large Cell Lymphoma: A Case Report, Jennie Tan, Jamie Johnson-Eddy, Wesley Tang, Yanchun Li

Cooper Rowan Medical Journal

This report aims to review a case of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) by comparing the patient's course with the current literature.

BIA-ALCL is a specific type of T-cell lymphoma that can develop after breast implantation, but has only recently been recognized within the last decade. Although overall rare, certain types of breast implants have increased association with developing subsequent lymphoma. This case occurred after mastectomy with breast reconstruction for unilateral invasive ductal carcinoma with a textured, saline Allergan breast implant. BIA-ALCL manifested and was symptomatic nine years after implantation.

Warren B. Davis And The Birth Of Plastic Surgery In Philadelphia: A Historical Vignette, Sarah F. Wagoner, Charles J. Yeo, Renee M. Tholey, James W. Fox, Steven E. Copit

Department of Surgery Faculty Papers

The field of plastic surgery, formally organized in 1931 with the founding of the American Society of Plastic and Reconstructive Surgery, was shaped in many ways by a small practice of Philadelphia physicians. At the center of the practice was Warren B. Davis, a Philadelphia otolaryngologist and plastics pioneer whose innovations in cleft palate surgery would lead to significant improvements in functional and cosmetic outcomes in his time. In addition to his own innovations, Davis was responsible for the training of John Reese, the inventor of the Reese dermatome that changed the face of burn medicine during World War II. …

Development Of An On-Call Assessment Tool For Competency-Based Surgical Training, Eric C. Mitchell

Electronic Thesis and Dissertation Repository

Introduction: A central tenet of competency-based medical education is formative assessment of trainees. There are no assessments examining resident competence on-call, despite this being a significant component of resident training and characterized by less supervision compared to daytime.

Methods: A national survey was conducted to evaluate the state of assessment in Canadian Plastic and Reconstructive Surgery programs. An on-call assessment tool was developed based on a consensus group and was piloted over six months. Validity of the tool was examined through qualitative and quantitative methods.

Results: There were 63 tools completed across ten residents and seven staff physicians. Tool reliability …

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 …

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 …

Modern Therapeutic Options In Diabetic Foot Ulcer, Denisa Tanasescu, Andrei Moisin, Radu Fleaca, Carmen Popa, Ciprian Bacila, Cosmin Mohor, Claudia Diana Gherman, Bogdan Gaspar, Ciprian Tanasescu

Journal of Mind and Medical Sciences

Diabetic foot is a severe complication of diabetes that occurs as a result of poor glycemic control, being associated with significant morbidity and mortality. Mortality associated with this disease is estimated at 5% in the first 12 months, and about 42% in the next 5 years. On average, it affects about 15% of people with diabetes during their lifetime, including as possible manifestations neuropathy, peripheral vascular disease, and subsequent ulceration which, if treated incorrectly, can lead to amputation.

This paper presents a retrospective and descriptive study of patients diagnosed and treated for diabetic foot ulcers in the Proctoven Clinic. The …

Limb Amputations; Etiopathogenesis, Diagnosis And The Multidisciplinary Therapeutic Approach, Vlad Denis Constantin, Bogdan Socea, Bogdan Severus Gaspar, Dragos Epistatu, Ioana Paunica, Anca Silvia Dumitriu, Stana Paunica, Adrian Silaghi

Journal of Mind and Medical Sciences

Despite remarkable advances in medicine, limb amputations remain a therapeutic measure that saves the lives of many patients. Given the varied etiopathogenesis, such operations are performed both as an emergency and as an elective procedure. Such interventions address either only the distal segments of a limb, or even the entire limb, having a great psychological, functional and social impact on the patient. Due to these multiple implications, limb amputations must be performed by specialized teams, in order to achieve the best possible functional and aesthetic results to be compatible with the correction of the remaining deficit with a prosthesis. The …

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

Medical Research Day

Background: When women are poor candidates for abdomen-based free flap reconstruction, the muscle-sparing thoracodorsal artery perforator (TDAP) flap may be considered for total autologous breast reconstruction due to its reliable perforator anatomy and function as a pedicled flap, requiring no vascular anastomosis. However, the TDAP flap is not as popular as other autologous breast reconstruction methods since it is often limited by flap size and distal tip necrosis. Objective: We aim to demonstrate a novel use of the delay phenomenon in TDAP flaps for total autologous breast reconstruction. Methods: This prospective IRB-approved study recruited patients between April 2021 and August …

The Impact Of Facial Feminization On Qol In Transgender Patients, Odette Rosales, Zane Sejdiu, Justin Michael Camacho, Ali Yasback, Caroline E. Quindlen, Sanjeev Herr, Amir Behnam Md

Tower Health Research Day

No abstract provided.

An Update And Report Failure Of Surgical Syndactyly Repair In Harlequin Ichthyosis., Elias H Kahan, Brian Temple, Logan Carr, Elizabeth Zellner

Plastic Surgery Resident Research

Harlequin ichthyosis (HI) is a rare congenital skin disorder caused by irregular epidermal differentiation. Syndactyly in HI is associated with thick hyperkeratotic skin flexion and angulation deformity of the hand and fingers resulting in limited function of the upper extremity. Traditional syndactyly release is limited as full-thickness skin grafts typically used in reconstruction are composed of diseased skin and require donor sites in a patient predisposed for adverse wound healing. This case report is a follow-up to a previous viewpoint written about digital escharotomies in a newborn with HI and outlines a second and fourth webspace syndactyly release with a …

The Virtual Peripheral Nerve Academy: Education For The Identification And Treatment Of Peripheral Nerve Disorders, Erica B. Lee, Allison Podsednik, Kimberly Khoo, Amal Cheema, Raysa Cabrejo, Chen Shen, Joseph Rosen, A Lee Dellon

School of Medicine Publications and Presentations

Millions of people around the globe suffer peripheral nerve injuries caused by trauma and medical disorders. However, medical school curricula are profoundly deficient in peripheral nerve education. This lack of knowledge within the healthcare profession may cause inadequate patient care. We developed the Virtual Peripheral Nerve Academy (VPNA) as a reusable virtual learning environment to provide medical students with detailed education on the peripheral nervous system (PNS). Students are introduced to the PNS through virtual 3D rendering of the human body, wherein they visualize individual nerves through dissection and observe normal motor and sensory function associated with each nerve. PNS …

Breaking Barriers To Breast Reconstruction Among Socioeconomically Disadvantaged Patients At A Large Safety-Net Hospital, Anna E Meade, Samantha M Cummins, Jordyn T Farewell, Sofia Duque, Sydney K Mulqueen, Ashleigh Chuah, Andrew Y Zhang

Department of Medicine Faculty Papers

Socioeconomic disparities remain prevalent among those who undergo breast reconstruction. At our institution, patients must meet certain criteria to become eligible for breast reconstruction. The purpose of this study was to determine the impact of socioeconomic factors on breast reconstruction eligibility, enrollment, choice, and completion at our large safety-net institution.

Methods: A retrospective chart review of patients who underwent partial or total mastectomy at a large safety-net hospital from 2016 to 2019 was completed. Surgical and demographic data were compared across varying socioeconomic factors.

Results: A total of 645 patients were included in the study. More patients of a racial …

Breast Augmentation: The Current Landscape, Khalifa Sh. Al-Ghanim

Electronic Thesis and Dissertation Repository

Primary breast augmentation is one of the most common surgeries performed by plastic surgeons. Breast augmentation, since its inception in 1895, has become a multimillion-dollar industry. Today, the two most common methods include implant-based and fat graft augmentation. Implant-based augmentation includes the use of silicone or saline prosthesis to enhance breast volume or shape. With fat grafting, a patient’s fat is harvested, processed, and injected into the breast to achieve the desired result. This thesis aims to outline the current literature on both methods of breast augmentation, review patient reported outcomes, as well as a proposed clinical trial to gain …

Development Of A Novel Rodent Model Of Radiation-Induced Implant Capsular Contracture, Tanya Delyzer

Electronic Thesis and Dissertation Repository

Radiation-induced implant capsular contracture is a challenging complication of post-mastectomy breast reconstruction. The objective of this thesis was to establish a novel rodent model that replicates the critical properties of this complication. Retired breeder female Sprague-Dawley rats underwent surgery with custom smooth silicone implants placed under the right 4^th mammary fat pad. Half these rats received 26Gy of ionizing radiation to the implant and fat pad. Radiated implants had both higher Baker grades of capsular contracture and Kumar scores denoting radiation-induced fibrosis. Irradiated capsules showed increased Masson’s trichrome staining and significantly higher hydroxyproline to total protein ratio compared to …

Predictive Factors For Length Of Hospital Stay In Pediatric Dog Bite Patients, Dominic Alessio-Bilowus, Nishant Kumar, Elika Ridelman Ph.D, Christina Shanti Md

Medical Student Research Symposium

Title: Predictive Factors for Length of Hospital Stay in Pediatric Dog Bite Patients

Authors: Alessio-Bilowus D¹, Kumar N², Ridelman E¹, Shanti C^2
1Wayne State University, Detroit, MI; ²Children’s Hospital of Michigan, Detroit, MI

Introduction: Dog bite injuries are a source of significant morbidity in the United States, with children being at increased risk compared to adults, yet there is a lack of published data on factors affecting hospital length of stay (LOS) in pediatric patients.

Methods: A full-text retrospective chart review was conducted of all patients presenting to our urban, academic …