Plastic Surgery Commons^™

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 Student Research Poster Symposium

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 …

Gender Dysphoria And Its Non-Surgical And Surgical Treatments, Danyon Anderson, Himasa Wijetunge, Peyton Moore, Daniel Provenzano, Nathan Li, Jamal Hasoon, Omar Viswanath, Alan D. Kaye, Ivan Urits

School of Medicine Faculty Publications

Gender dysphoria is defined by severe or persistent distress associated with an incongruence between one’s gender identity and biological sex. It is estimated that 1.4 million Americans and 25 million people worldwide identify as transgender and that 0.6% of Americans experience gender dysphoria. The pathophysiology of gender dysphoria is multifactorial and incompletely understood. Genetics, androgen exposure, neuroanatomy, brain connectivity, history of trauma, parents with psychological disorders, and being raised by less than two parents are associated with gender dysphoria. Gender dysphoria most frequently presents in early teenage years but can present earlier or later. Anxiety and depression are the two …

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

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 …

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 …

Biostimulation With Low-Level Laser Therapy And Its Effects On Soft And Hard Tissue Regeneration. Literature Review, Anida Maria Babtan, Aranka Ilea, Claudia Nicoleta Feurdean, Sabino Ceci, Berate Pula, Sebastian Candrea, Daniela Azzollini, Fabio Piras, Luigi Curatoli, Alberto Corriero, Assunta Patano, Francesco Valente, Maria Elena Maggiore, Antonio Mancini, Delia Giovanniello, Ludovica Nucci, Rossella Elia, Adina Sirbu, Nausica Bianca Petrescu, Codruta Mirica, Andrea Galderisi, Filippo Cardarelli

Journal of Mind and Medical Sciences

Objective. Low-Level Laser Therapy encourages the healing process, reduces inflammation and pain. The aim of this study is to identify the impact of Low-Level Laser Therapy on tissue regeneration with special attention to hard tissues and to compare the effect of several wave lengths in the proliferation and differentiation of cells. Methods. The keywords used were “bone regeneration”, “laser therapy”, “photobiomodulation” OR “bio-stimulation”, “Low-Level Laser therapy” OR “LLLT”, “osteoblast proliferation” AND “differentiation”. Results. The bio-stimulation with Low-Level Laser Therapy also seems to interfere with the osseous integration of implants, by increasing its adherence on the bone-implant surfaces. Evidence has shown …

Anatomic Considerations Of Perinasal Musculature For Improved Dental Show During Smile In Facial Synkinesis, Laura T. Hetzler, Marcus Hershey, Todd Lambert, Jason Mussell, Lee Mcdaniel, Sara Macdowell

School of Medicine Faculty Publications

Introduction: There is an anatomic explanation for upper lip and midfacial tethering resulting in lack of motion in facial synkinesis. Objective: To measure the effect of perinasal chemodenervation on dental show in the synkinetic population and clarify the anatomic relationship of perinasal musculature. Methods: Literature search was performed on anatomy of the perinasal modiolus, and anatomic evaluation was performed through human anatomic specimen dissection. Photographic outcomes were observed in synkinetic patients receiving chemodenervation to smile antagonists with and without perinasal muscle injections and assessed through naive observer survey. Retrospective outcomes for all patients receiving perinasal chemodenervation was collected utilizing Facial …

Current Perspectives Of Oncoplastic Breast Surgery In Pakistan, Lubna Mushtaque Vohra, Dua Jabeen, Danish Ali, Syeda Sakina Abidi, Sana Zeeshan, Abida Khalil Sattar

Section of General Surgery

Oncoplastic breast surgery is based on the concept of tumour-specific immediate reconstruction. It combines both local and distant techniques to maintain breast texture, symmetry and cosmesis without compromising oncological outcome. The current narrative review was planned to highlight the current state and future of oncoplastic breast surgery in low- and middle-income countries where its utilisation in surgical practice remains insubstantial because majority of the surgeons who are treating breast cancer are either general surgeons or breast surgeons who do not have expertise in oncoplastic breast surgery or reconstructive surgery. Moreover, scarcity of financial resources, ignorance about oncoplastic breast surgery techniques, …

The Use Of Two Types Of Suture And Stainless-Steel Wire Tension Banding For The Fixation Of Olecranon Fractures: A Biomechanical Comparison, Stuart Drew, Samer Al-Humadi, David Komatsu, Ann M. Meo

Stony Brook Orthopaedic and Musculoskeletal Journal

Purpose: Tension band constructs are commonly used for olecranon fracture fixation. The purpose of this study was to determine if a tension band constructed of No. 2 Dynacord suture, a silicone and salt-filled core within a UHMWPE sheath that expands radially and shortens axially when exposed to saline aqueous environment will provide constant initial static ompression forces compared to No. 2 FiberWire and stainless 18-gauge metal wire tension band.

Methods: A transverse osteotomy was placed in two sawbones models. Two 1.6 K-wires were placed across the osteotomy site and a Tekscan pressure sensor placed into the osteotomy site. The figure …

Relation Of Neurovascular Structures Of The Elbow To An Accessory Anterolateral Approach To The Capitellum: A Cadaveric Study, Michael Okoli, Ryan Tantone, Chidi Okolo, Samantha Muhlrad, Edward D. Wang

Stony Brook Orthopaedic and Musculoskeletal Journal

Purpose: The purpose of this study is to describe an anterolateral portal technique to the capitellum and to investigate its anatomic relationship nearby neurovascular structures in the elbow.

Methods: The study included 6 arm-to-fingertip adult cadavers. The demographic information of the cadavers was recorded. We initially dissected the elbows using a lateral approach to the capitellum. Next, a 1.5-cm anterolateral portal to the radiocapitellar joint was made and tagged with heavy suture and passed through the lateral elbow wound, with the elbow and forearm in an extended, supinated position. We then dissected out neurovascular structures around the elbow and measuring …

Non-Weightbearing In Cam Boots After Foot/Ankle Fracture Fixation: Are Patients Compliant?, Amos Z. Dai, Michelle Regan, Megan Paulus

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: The controlled ankle motion (CAM) boot has become an integral part of the management of both operative and nonoperative foot and ankle conditions. Similar to casts, CAM boots are used to immobilize the foot and ankle after injury or surgery. However, unlike casts, CAM boots can be readily removed for showering and range of motion (ROM) exercises. While CAM boots are well-designed for ambulation and are frequently utilized in early weightbearing (WB) and early ROM protocols, their usage in non-weightbearing (NWB) protocols is less clear.

Purpose: The purpose of the current study is to determine the patient compliance rate …

Comparison Of Early Active Range Of Motion In Primary Reverse Shoulder Arthroplasty Based On Indication: A Single Center Retrospective Review, Michael E. Doany, Kenny Ling, Rosen Jeong, Alireza K. Nazemi, David E. Komatsu, Edward D. Wang

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: Reverse shoulder arthroplasty (RSA) is commonly used in the treatment of rotator cuff arthropathy.  Indications for RSA have expanded to include complex proximal humerus fractures. Studies directly comparing outcomes between traumatic and traditional elective indications are limited. The purpose of this study was to compare early active range of motion (aROM) within the first two years postoperatively between traumatic and non-traumatic primary RSA, as well as compare ASES scores, and patient satisfaction at final follow-up.

Methods: A retrospective analysis was conducted of all RSA performed by a single surgeon between January 2000 and December 2018. Patients were grouped by …

Quality Of Life Before And After Cosmetic Surgery: Should Body Dysmorphic Disorder Be Considered An Absolute Or Relative Contraindication For Cosmetic Surgery?, Lindsay Conlisk

Capstone Showcase

Body Dysmorphic Disorder (BDD) has historically been regarded as a strong contraindication for cosmetic plastic surgery. New research now suggests that the contraindications to cosmetic surgery in patients with BDD may not be so absolute. This paper reviews diagnostic criteria, diagnostic challenges, and current standard of treatment of BDD. It then presents the idea of insight analysis in the BDD patient as a significant factor in determining if patients with BDD may or may not benefit from cosmetic surgery or procedures.

Quality Of Life Before And After Cosmetic Surgery: Should Body Dysmorphic Disorder Be Considered An Absolute Or Relative Contraindication For Cosmetic Surgery?, Lindsay Conlisk

Capstone Showcase

Body Dysmorphic Disorder (BDD) has historically been regarded as a strong contraindication for cosmetic plastic surgery. New research now suggests that the contraindications to cosmetic surgery in patients with BDD may not be so absolute. This paper reviews diagnostic criteria, diagnostic challenges, and current standard of treatment of BDD. It then presents the idea of insight analysis in the BDD patient as a significant factor in determining if patients with BDD may or may not benefit from cosmetic surgery or procedures.

Thirty Day Low-Dose Versus Regular-Dose Aspirin For Venous Thromboembolism Prophylaxis In Primary Total Joint Arthroplasty, Alexander Duke, Stephen Bowen, Samir Baig, David E. Komatsu, James Nicholson

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: Aspirin (ASA) is an effective chemical prophylaxis for venous thromboembolism (VTE) after total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, the optimal dosage and duration of therapy remains debatable. The main objective of this study was to compare two ASA regimens with regard to the incidence of symptomatic deep venous thrombosis (DVT), pulmonary embolism (PE), bleeding (based on patient’s dressing), and infection within 90 days after primary THA and TKA.

Methods: We retrospectively identified 625 primary THA and TKA surgeries among 483 patients who received aspirin for four weeks post operatively. A total of 301 patients received …

Current Concepts Review: Postoperative Analgesia After Posterior Spinal Fusion For Adolescent Idiopathic Scoliosis, Aadit Shah, Eduard P. Pey, Stephen Bowen, James Barsi

Stony Brook Orthopaedic and Musculoskeletal Journal

Many post-operative analgesic options exist after a posterior spinal fusion for adolescent idiopathic scoliosis, with newer interventions gaining attention. It is unclear which provide the most benefit. The aim of this current concept review is to document efficacy, safety and quality of evidence of analgesic interventions after posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS). Potent analgesia with IV opioids or epidural anesthesia remains the cornerstone of postoperative analgesia following PSF for AIS. A diverse set of analgesic adjuvants are under investigation with promising results, including GABA-analogues, intrathecal anesthesia, nonsteroidal anti-inflammatory drugs and acetaminophen, ketamine, spinal nerve block, alpha …