MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Seminars in Plastic Surgery' source. Sun, 18 Dec 2011 23:10:13 +0100 http://www.medworm.com/index.php?rid=5335694&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1288921 Seminars in Plastic Surgery 2011; 25: 288-294DOI: 10.1055/s-0031-1288921ABSTRACTThe prominent ear can produce significant social and psychological effects on an individual. Through the last century, many procedures have been described to correct this deformity. In this review, the authors navigate through the history of otoplasty for the protruded ear, and describe some of the breakthroughs in the procedure. Furthermore, they discuss key measurements that must be kept in mind in preoperative and intraoperative settings. They also describe in more detail some of the more common methods for correcting the protruded ear, as well as postoperative management and common complications faced after surgery.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Abstra... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5335694 Thu, 20 Oct 2011 04:00:00 +0100 5335694 http://www.medworm.com/index.php?rid=5335693&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1288916 Seminars in Plastic Surgery 2011; 25: 249-256DOI: 10.1055/s-0031-1288916ABSTRACTThe authors summarize current methods for reconstructing partial auricular defects resulting from trauma, neoplasm, or congenital defects. They also review the anatomy and embryology of the ear as this is critical for proper reconstruction. Defects of the auricle are divided into upper-third, middle-third, and lower-third defects. Methods of total auricular reconstruction are also briefly discussed as these methods can provide more superior reconstruction than partial techniques in select cases.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5335693 Thu, 20 Oct 2011 04:00:00 +0100 5335693 http://www.medworm.com/index.php?rid=5335692&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1288917 Seminars in Plastic Surgery 2011; 25: 257-264DOI: 10.1055/s-0031-1288917ABSTRACTSculpting a tridimensional autologous rib cartilage framework is essential to restore a natural ear shape and becomes routine with preoperative training, but management of the skin is the key to minimizing complications. Here the authors provide a classification scheme to manage auricular skin: Type 1 is a Z-plasty with transposition of the lobule; type 2 is a transfixion incision of the microtic ear; type 3 exposes the cartilage remnants through a cutaneous incision. They also explain how to choose between the three types, depending upon the auricular skin potential. With training and method, results in ear reconstruction using autologous rib cartilage are excellent and reproducible.[...]© Thieme Medical Publ... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5335692 Thu, 20 Oct 2011 04:00:00 +0100 5335692 http://www.medworm.com/index.php?rid=5335691&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1288915 Seminars in Plastic Surgery 2011; 25: 247-248DOI: 10.1055/s-0031-1288915© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5335691 Thu, 20 Oct 2011 04:00:00 +0100 5335691 http://www.medworm.com/index.php?rid=5335690&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1288914 Seminars in Plastic Surgery 2011; 25: 245-246DOI: 10.1055/s-0031-1288914© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5335690 Thu, 20 Oct 2011 04:00:00 +0100 5335690 http://www.medworm.com/index.php?rid=5335689&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1288919 Seminars in Plastic Surgery 2011; 25: 273-278DOI: 10.1055/s-0031-1288919ABSTRACTCongenital abnormalities of the outer ear pose a reconstructive challenge for plastic surgeons and otologists. Many patients with microtia of the auricle have concurrent atresia of the external auditory canal. The hearing loss associated with canal atresia can have long-lasting effects if not treated promptly and appropriately. The diagnosis and workup for canal atresia requires an otologic evaluation. Audiologic and radiologic evaluations direct treatment, which varies depending on unilateral or bilateral presence of atresia. Rehabilitation of hearing loss can be performed via hearing aids, bone-anchored conductive devices or canalplasty. Due to the complexity of treatments, communication between the reconstru... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5335689 Thu, 20 Oct 2011 04:00:00 +0100 5335689 http://www.medworm.com/index.php?rid=5335688&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1288918 Seminars in Plastic Surgery 2011; 25: 265-272DOI: 10.1055/s-0031-1288918ABSTRACTExtensive defects of the ear require satisfactory cosmetic reconstruction to enable the patient to achieve full social integration. Although surgical procedures are the gold standard for reconstruction of the ear, in some cases they cannot be performed because of extended scars, threatening tumor, or congenital tissue abnormalities. Prosthetic reconstruction of the auricle is an established and reliable alternative technique to autologous surgical reconstructions. Since studies performed by BrÃ¥nemark, osseointegrated implants have been widely used to provide a reliable and stable anchorage for a prosthesis (prosthesis anchored to bone). To allow good osseointegration of the titanium screw implants, two stages ... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5335688 Thu, 20 Oct 2011 04:00:00 +0100 5335688 http://www.medworm.com/index.php?rid=5335687&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1288920 Seminars in Plastic Surgery 2011; 25: 279-287DOI: 10.1055/s-0031-1288920ABSTRACTThe external ear is exposed to weathering and trauma; it also has sparse vascularity, making it prone to infection and disease. The external location of the cutaneous ear makes it easily visible for diagnosis and accessible for treatment. In this article, the authors focus on diseases of the ear that are most commonly encountered and may be subject to surgical and medical evaluation and/or treatment. Epidemiology, pathogenesis, clinical course, and treatment for each disease entity are discussed.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5335687 Thu, 20 Oct 2011 04:00:00 +0100 5335687 http://www.medworm.com/index.php?rid=5192582&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1281493 Seminars in Plastic Surgery 2011; 25: 229-244DOI: 10.1055/s-0031-1281493ABSTRACTIn female-to-male transsexuals, the operative procedures are usually performed in different stages: first the subcutaneous mastectomy which is often combined with a hysterectomy-ovarectomy (endoscopically assisted). The next operative procedure consists of the genital transformation and includes a vaginectomy, a reconstruction of the horizontal part of the urethra, a scrotoplasty and a penile reconstruction usually with a radial forearm flap (or an alternative). After about one year, penile (erection) prosthesis and testicular prostheses can be implanted when sensation has returned to the tip of the penis. The authors provide a state-of-the-art overview of the different gender reassignment surgery procedures th... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5192582 Fri, 02 Sep 2011 23:00:00 +0100 5192582 http://www.medworm.com/index.php?rid=5192581&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1281492 Seminars in Plastic Surgery 2011; 25: 221-228DOI: 10.1055/s-0031-1281492ABSTRACTA variety of surgical options exists for penile reconstruction. The key to success of therapy is holistic management of the patient, with attention to the psychological aspects of treatment. In this article, we review reconstructive modalities for various types of penile defects inclusive of partial and total defects as well as the buried penis, and also describe recent basic science advances, which may promise new options for penile reconstruction.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5192581 Fri, 02 Sep 2011 23:00:00 +0100 5192581 http://www.medworm.com/index.php?rid=5192580&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1281491 Seminars in Plastic Surgery 2011; 25: 213-220DOI: 10.1055/s-0031-1281491ABSTRACTThe scrotal and perineal area serves a special function. It is the pelvic outlet for the gastrointestinal tract, urinary system, and sexual function. In the male, the scrotum allows testicular mobility to reduce trauma and allow optimal thermal regulation for spermatogenesis. Trauma, infection, and cancer resection create defects that require reconstruction. The reconstructive goal here is to obtain durable coverage, function, and lastly aesthetic outcome. Pedicled local and regional flaps are the mainstay for this area. Due to the special function and appearance of the scrotum, reconstructive options for total scrotal defect always fall far short of the native scrotum. On the other hand, perineal reconstructio... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5192580 Fri, 02 Sep 2011 23:00:00 +0100 5192580 http://www.medworm.com/index.php?rid=5192579&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1281490 Seminars in Plastic Surgery 2011; 25: 206-212DOI: 10.1055/s-0031-1281490ABSTRACTHypospadias is one of the most common congenital genital anomalies for which surgery early in life is indicated. The surgical treatment is changing progressively, often by repeating treatment strategies that have been used decades ago. Indeed, historically two-stage procedures were replaced by one-stage procedures and nowadays two-stage procedures gain new interest. The same for reconstructions using the urethral plate, which decades ago were based on the Thiersch Duplay principle. In the 1980s, preputial onlay flaps were most often used and today we see a new interest in the use of the urethral plate. The actual surgical approach to hypospadias is described and technical details are given.[...]© Thieme Medica... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5192579 Fri, 02 Sep 2011 23:00:00 +0100 5192579 http://www.medworm.com/index.php?rid=5192578&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1281489 Seminars in Plastic Surgery 2011; 25: 196-205DOI: 10.1055/s-0031-1281489ABSTRACTThe most common indications for phalloplasty in children include aphallia, micropenis/severe penile inadequacy, ambiguous genitalia, phallic inadequacy associated with epispadias/bladder exstrophy and female to male gender reassignment in adolescents. There are many surgical options for phalloplasty; both local pedicled tissue as well as free tissue transfer. The advantages of local tissue include a more concealed donor site, less complex operation and potentially faster recovery. However, pedicled options are generally less sensate, making placement of a penile prosthesis more risky and many children with bladder exstrophy have been previously operated upon making the blood supply for local pedicled flaps less... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5192578 Fri, 02 Sep 2011 23:00:00 +0100 5192578 http://www.medworm.com/index.php?rid=5192577&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1281488 Seminars in Plastic Surgery 2011; 25: 189-195DOI: 10.1055/s-0031-1281488ABSTRACTAppearance of the male genitalia is linked with self-esteem and sexual identity. Aesthetic surgery of the male genitalia serves to correct perceived deficiencies as well as physical deformities, which may cause psychological distress. Attention to patient motivation for surgery and to surgical technique is key to achieving optimal results. In this review, the authors describe aesthetic surgical techniques for treatment of penile and scrotal deficiencies. They also discuss techniques for revision in patients with previous surgery.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5192577 Fri, 02 Sep 2011 23:00:00 +0100 5192577 http://www.medworm.com/index.php?rid=5192576&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1281487 Seminars in Plastic Surgery 2011; 25: 179-188DOI: 10.1055/s-0031-1281487ABSTRACTA broad overview is provided of the normal anatomy of the male genitalia to offer the best surgical outcomes in cases related to congenital abnormalities, trauma, cancer-related extirpation, and aesthetics. Neural and vascular anatomy is discussed in depth due to its critical role in maintaining function and in assuring tissue viability.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5192576 Fri, 02 Sep 2011 23:00:00 +0100 5192576 http://www.medworm.com/index.php?rid=5192575&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1288913 Seminars in Plastic Surgery 2011; 25: 177-178DOI: 10.1055/s-0031-1288913© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5192575 Fri, 02 Sep 2011 23:00:00 +0100 5192575 http://www.medworm.com/index.php?rid=5192574&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1288912 Seminars in Plastic Surgery 2011; 25: 175-176DOI: 10.1055/s-0031-1288912© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5192574 Fri, 02 Sep 2011 23:00:00 +0100 5192574 http://www.medworm.com/index.php?rid=5052735&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1281486 Seminars in Plastic Surgery 2011; 25: 163-174DOI: 10.1055/s-0031-1281486ABSTRACTMale to female transsexuals frequently seek feminizing vaginoplasty for “below the waist” conformation, enhancement of sexual identity, and interactive sexual function. The author shares his experience with his first 250 primary surgical procedures. Included is a brief historical background, the patient selection process, some guidelines from the World Professional Association for Transgender Health (standards of care), preoperative evaluation and instructions, surgical technique, postoperative regimen, risk factors, results, complications and management. The patients all underwent feminizing vaginoplasty at the author's ambulatory surgical facility, which includes an overnight stay. The author's re... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5052735 Wed, 20 Jul 2011 23:00:00 +0100 5052735 http://www.medworm.com/index.php?rid=5052734&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1281485 Seminars in Plastic Surgery 2011; 25: 155-162DOI: 10.1055/s-0031-1281485ABSTRACTSuccessful reconstruction of vaginal and perineal defects requires close communication and cooperation between the extirpative and reconstructive surgeon. A variety of reconstructive options is available, dependent on the nature of the defect and extent of the ablative surgery. In all cases, obliteration of pelvic dead space and separation of intraabdominal contents from the perineum are important considerations to ensure uncomplicated perineal wound healing. The decision for vaginal reconstruction is also contingent upon the age, sexual function, and wishes of the patient. In this article, we review options for vaginal and perineal reconstruction in acquired defects.[...]© Thieme Medical PublishersArticle in ... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5052734 Wed, 20 Jul 2011 23:00:00 +0100 5052734 http://www.medworm.com/index.php?rid=5052733&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1281484 Seminars in Plastic Surgery 2011; 25: 148-154DOI: 10.1055/s-0031-1281484ABSTRACTAcquired perineovulvar defects are usually the result of excision of vulvar intraepithelial neoplasia (VIN) or invasive squamous cell carcinoma. Because both VIN and vulvar carcinoma have a tendency toward local recurrence, future reconstructive options should be reckoned with during treatment of the primary and all subsequent (pre-) malignant perineovulvar lesions. Hence, a proposal of sequence of reconstructive options for these defects is called for. In cases where local skin flaps suffice, these are preferably designed in such a fashion as not to sever the branches of the internal pudendal vascular system. In cases where either a pudendal thigh flap or an infragluteal flap may be used to close the perineovu... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5052733 Wed, 20 Jul 2011 23:00:00 +0100 5052733 http://www.medworm.com/index.php?rid=5052732&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1281483 Seminars in Plastic Surgery 2011; 25: 142-147DOI: 10.1055/s-0031-1281483ABSTRACTCongenital absence of the vagina is a relatively rare condition most commonly associated with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. Historically, several reconstructive techniques have been described to provide for functional vaginal reconstruction on these patients, both operative and nonoperative. Although there are many advantages and disadvantages of the various procedures, one experience with the use of split thickness skin grafts to reconstruct the vagina has produced acceptable functional results with limited donor site morbidity. Careful planning and timing of this form of reconstruction can produce predictable results in patients who are nearing sexual maturity.[...]© Thieme Medical Publishe... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5052732 Wed, 20 Jul 2011 23:00:00 +0100 5052732 http://www.medworm.com/index.php?rid=5052731&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1281482 Seminars in Plastic Surgery 2011; 25: 130-141DOI: 10.1055/s-0031-1281482ABSTRACTAesthetic genital surgery seems to have become a fashionable issue nowadays. Many procedures and techniques have been described these last years, but very few long-term results or follow up studies are available. The novelty of this aspect of plastic surgery and the lack of evidence-based interventions, have led to a comparison with female genital mutilation. In this article, the authors provide an overview of the possible surgical procedures as well as the general principles of aesthetic surgery of the female genitalia.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5052731 Wed, 20 Jul 2011 23:00:00 +0100 5052731 http://www.medworm.com/index.php?rid=5052730&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1281481 Seminars in Plastic Surgery 2011; 25: 121-129DOI: 10.1055/s-0031-1281481ABSTRACTA thorough insight into the female genital anatomy is crucial for understanding and performing pelvic reconstructive procedures. The intimate relationship between the genitalia and the muscles, ligaments, and fascia that provide support is complex, but critical to restore during surgery for correction of prolapse or aesthetic reasons. The external female genitalia include the mons pubis, labia majora and minora, clitoris, vestibule with glands, perineal body, and the muscles and fascia surrounding these structures. Through the perineal membrane and the perineal body, these superficial vulvar structures are structurally related to the deep pelvic muscle levator ani with its fascia. The levator ani forms the pelv... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5052730 Wed, 20 Jul 2011 23:00:00 +0100 5052730 http://www.medworm.com/index.php?rid=5052729&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1281480 Seminars in Plastic Surgery 2011; 25: 119-120DOI: 10.1055/s-0031-1281480© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5052729 Wed, 20 Jul 2011 23:00:00 +0100 5052729 http://www.medworm.com/index.php?rid=5052728&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1281479 Seminars in Plastic Surgery 2011; 25: 117-118DOI: 10.1055/s-0031-1281479© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=5052728 Wed, 20 Jul 2011 23:00:00 +0100 5052728 http://www.medworm.com/index.php?rid=4686390&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1275177 This article will review chest wall deformities and the current management strategies of these interesting anomalies.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4686390 Mon, 04 Apr 2011 23:00:00 +0100 4686390 http://www.medworm.com/index.php?rid=4686389&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1275176 Seminars in Plastic Surgery 2011; 25: 098-108DOI: 10.1055/s-0031-1275176ABSTRACTAlthough rare, sternal nonunion after median sternotomy or traumatic injury is associated with a high rate of morbidity. Pain and sternal clicking are two of the most common complaints and reasons these patients seek evaluation and treatment. Diagnosis of sternal nonunion is based on a thorough history and physical examination and can be confirmed with subsequent radiographic imaging. The treatment for symptomatic sternal nonunion requires stable fixation of the bony fragments and chest wall after the debridement of all nonviable bony and soft tissue by the cardiothoracic or reconstructive surgery team. Multiple fixation techniques have been described and incorporate a wide variety of materials including combin... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4686389 Mon, 04 Apr 2011 23:00:00 +0100 4686389 http://www.medworm.com/index.php?rid=4686388&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1275175 Seminars in Plastic Surgery 2011; 25: 086-097DOI: 10.1055/s-0031-1275175ABSTRACTChest wall and mediastinal wounds may be life-threatening. Although modern reconstruction methods with various muscle flaps have reduced morbidity and mortality, chest wall reconstruction presents unique challenges. Major categories of adverse outcomes include (1) persistent infection; (2) interference with respiratory mechanics; (3) functional deficits of the shoulder; and (4) hernias. Persistent infection may be resolved by providing coverage via muscle or omental flap, performing thorough debridement, filling the “dead space” with adequate volume, buttressing repair of visceral fistulae, and covering exposed prosthetic material with vascularized flaps. Potential deficits in respiratory mechanics ... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4686388 Mon, 04 Apr 2011 23:00:00 +0100 4686388 http://www.medworm.com/index.php?rid=4686387&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1275174 Seminars in Plastic Surgery 2011; 25: 078-085DOI: 10.1055/s-0031-1275174ABSTRACTThe posterior trunk roughly encompasses the upper back from the shoulders to the lumbar area above the iliac crests. Long-term outcomes in the treatment of defects of the spine and bony thorax have been proved superior if flaps were used. Many local muscle and fasciocutaneous flaps are available alternatives. A guideline, patterned according to arbitrary anatomic territories of the back, is suggested as a starting point for the selection of appropriate primary and secondary flap options. Depending on flap availability, the latissimus dorsi and trapezius muscles are the workhorse flaps for the upper back, whereas perforator flaps have become a useful alternative for the lumbar region in lieu of free flaps.[...]Â... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4686387 Mon, 04 Apr 2011 23:00:00 +0100 4686387 http://www.medworm.com/index.php?rid=4686386&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1275173 Seminars in Plastic Surgery 2011; 25: 070-077DOI: 10.1055/s-0031-1275173ABSTRACTIntrathoracic defects continue to provide one of the most challenging problems faced by the reconstructive surgeon, particularly in the presence of bronchopleural fistula. We review the principles of management of bronchopleural fistulae and empyema, with an emphasis on the Clagett principle, pedicled and free muscle flaps, and the concept of a “designed air fistula” in bronchopleural fistula management. Although the importance of muscle flap closure in intrathoracic defects is undisputed, the timing and relative superiority of muscle flap closure versus conventional thoracic-surgical techniques remains an unanswered question.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of cont... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4686386 Mon, 04 Apr 2011 23:00:00 +0100 4686386 http://www.medworm.com/index.php?rid=4686385&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1275172 Seminars in Plastic Surgery 2011; 25: 060-069DOI: 10.1055/s-0031-1275172ABSTRACTDefect reconstruction after radical oncologic resection of malignant chest wall tumors requires adequate soft tissue reconstruction with function, stability, integrity, and an aesthetically acceptable result of the chest wall. The purpose of this article is to describe possible reconstructive microsurgical pathways after full-thickness oncologic resections of the chest wall. Several reliable free flaps are described, and morbidity and mortality rates of patients are discussed.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4686385 Mon, 04 Apr 2011 23:00:00 +0100 4686385 http://www.medworm.com/index.php?rid=4686384&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1275171 Seminars in Plastic Surgery 2011; 25: 055-059DOI: 10.1055/s-0031-1275171ABSTRACTThe omentum, external oblique musculocutaneous, and thoracoepigastric flaps are uncommonly used for chest wall reconstruction. Nevertheless, awareness and knowledge of these flaps is essential for reconstructive surgeons because they fill specific niche indications or serve as lifeboats when workhorse flaps are unavailable. The current report describes the anatomic basis, technical aspects of flap elevation, and indications for these unusual flaps.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4686384 Mon, 04 Apr 2011 23:00:00 +0100 4686384 http://www.medworm.com/index.php?rid=4686383&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1275170 Seminars in Plastic Surgery 2011; 25: 043-054DOI: 10.1055/s-0031-1275170ABSTRACTLarge and life-threatening thoracic cage defects can result from the treatment of traumatic injuries, tumors, infection, congenital anomalies, and radiation injury and require prompt reconstruction to restore respiratory function and soft tissue closure. Important factors for consideration are coverage with healthy tissue to heal a wound, the potential alteration in respiratory mechanics created by large extirpations or nonhealing thoracic wounds, and the need for immediate coverage for vital structures. The choice of technique depends on the size and extent of the defect, its location, and donor site availability with consideration to previous thoracic or abdominal operations. The focus of this article is spec... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4686383 Mon, 04 Apr 2011 23:00:00 +0100 4686383 http://www.medworm.com/index.php?rid=4686382&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1275169 Seminars in Plastic Surgery 2011; 25: 034-042DOI: 10.1055/s-0031-1275169ABSTRACTThe goals of chest wall stabilization include maintenance of a rigid airtight cavity, protection of the thoracic and abdominal contents, optimization of respiration, and, whenever possible, an aesthetic reconstruction. Evidence suggests that bony fixation results in reduced ventilator dependence, a shorter overall hospital stay, and improved upper extremity function. We prefer to accomplish this with autologous tissue alone (such as the pectoralis major, latissimus dorsi, or rectus abdominus muscle flaps) for small to moderate defects. En bloc resection of defects larger than 5 cm or containing four or more ribs will likely benefit from chest wall stabilization. For patients previously treated with radiation, e... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4686382 Mon, 04 Apr 2011 23:00:00 +0100 4686382 http://www.medworm.com/index.php?rid=4686381&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1275168 Seminars in Plastic Surgery 2011; 25: 025-033DOI: 10.1055/s-0031-1275168ABSTRACTSternal wound infection is a life-threatening complication after cardiac surgery associated with high morbidity and mortality. Past treatment options have included closed suction and continuous irrigation. Current paradigms in the management of sternal wound infection include surgical debridement, vacuum-assisted closure therapy, flap coverage, and sternal plating. We provide a general overview of sternal wound infection and treatment options for the plastic surgeon.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4686381 Mon, 04 Apr 2011 23:00:00 +0100 4686381 http://www.medworm.com/index.php?rid=4686380&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1275167 Seminars in Plastic Surgery 2011; 25: 016-024DOI: 10.1055/s-0031-1275167ABSTRACTChest wall tumors are a heterogeneous group of lesions that provide an interesting diagnostic and therapeutic challenge for surgeons. They make up less than 5% of thoracic malignancies and vary widely in pathology as they arise from all anatomic structures of the chest wall. In general, treatment is wide local excision, the margins for malignant disease are necessarily wider, and adjuvant radiation is typically given for those with positive margins. Chemotherapy is rarely effective. Local control is the most important prognostic factor. Disease-free survival for malignant disease is limited by positive margins; therefore full oncologic resection with 4-cm margins should be attempted. For small lesions, the rese... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4686380 Mon, 04 Apr 2011 23:00:00 +0100 4686380 http://www.medworm.com/index.php?rid=4686379&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1275166 This article will provide an overview of key principles and evidence-based approaches to chest wall reconstruction.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4686379 Mon, 04 Apr 2011 23:00:00 +0100 4686379 http://www.medworm.com/index.php?rid=4686378&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1275165 Seminars in Plastic Surgery 2011; 25: 003-004DOI: 10.1055/s-0031-1275165© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4686378 Mon, 04 Apr 2011 23:00:00 +0100 4686378 http://www.medworm.com/index.php?rid=4686377&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0031-1275164 Seminars in Plastic Surgery 2011; 25: 001-002DOI: 10.1055/s-0031-1275164© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4686377 Mon, 04 Apr 2011 23:00:00 +0100 4686377 http://www.medworm.com/index.php?rid=4299043&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0030-1269769 Seminars in Plastic Surgery 2010; 24: 398-410DOI: 10.1055/s-0030-1269769ABSTRACTOrbital fractures account for a significant portion of traumatic facial injuries. Although plastic surgery literature is helpful, additional pearls and insights are provided in this article from the experience of an oculoplastic surgeon. The fundamentals remain the same, but the perceptions differ and provide a healthy perspective on a long-standing issue. The most important thing to remember is that the optimal management plan is often variable, and the proper choice regarding which plan to choose rests upon the clinical scenario and the surgeon having an honest perception of his or her level of expertise and comfort level.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  A... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4299043 Wed, 29 Dec 2010 00:00:00 +0100 4299043 http://www.medworm.com/index.php?rid=4299042&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0030-1269768 Seminars in Plastic Surgery 2010; 24: 389-397DOI: 10.1055/s-0030-1269768ABSTRACTZygomaticomaxillary complex (ZMC) fractures are a group of fractures that can significantly alter the structure, function, and appearance of the midface, including the globe. Like other facial fractures, the optimal management of operative ZMC fractures requires anatomic reduction of all fractures followed by rigid internal fixation. However, surgical treatment of these fractures can be quite challenging with the potential for high rates of complications. The goal of this article is to provide an overview of ZMC fractures and discuss treatment options, with an emphasis on providing surgical pearls to optimize outcomes.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Abstrac... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4299042 Wed, 29 Dec 2010 00:00:00 +0100 4299042 http://www.medworm.com/index.php?rid=4299041&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0030-1269767 Seminars in Plastic Surgery 2010; 24: 383-388DOI: 10.1055/s-0030-1269767ABSTRACTNasoorbitoethmoid fractures account for ∼5% of adult and 15% of pediatric facial fractures. The appropriate management of these injuries requires an understanding of the anatomic features of the region, the classification of injury severity, assessment, and treatment methods. The purpose of this article is to provide a general overview of the topic, with a more specific focus on the pearls of managing these fractures. Prompt and proper management of these injuries can achieve both adequate functional and aesthetic outcomes.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4299041 Wed, 29 Dec 2010 00:00:00 +0100 4299041 http://www.medworm.com/index.php?rid=4299040&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0030-1269766 Seminars in Plastic Surgery 2010; 24: 375-382DOI: 10.1055/s-0030-1269766ABSTRACTThe management of frontal sinus fractures has changed over the past 20 years. Whereas the indications for an invasive procedure had been much broader in the past, it has become more common to treat these fractures conservatively, due to improved imaging modalities, the advent of endoscopic surgical treatment of the nasofrontal outflow tracts, and the improved understanding of frontal sinus physiology. A variety of algorithms have been proposed for the management of frontal sinus fractures; however, we present a simplified treatment algorithm, which uses cranialization, obliteration, reconstruction, observation, and endoscopic sinus surgery.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of co... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4299040 Wed, 29 Dec 2010 00:00:00 +0100 4299040 http://www.medworm.com/index.php?rid=4299039&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0030-1269765 Seminars in Plastic Surgery 2010; 24: 357-374DOI: 10.1055/s-0030-1269765ABSTRACTMandibular trauma is a common problem seen by plastic surgeons. When fractures occur, they have the ability to affect the patient's occlusion significantly, cause infection, and lead to considerable pain. Interventions to prevent these sequelae require either closed or open forms of reduction and fixation. Physicians determining how to manage these injuries should take into consideration the nature of the injury, background information regarding the patient's health, and the patient's comorbidities. Whereas general principles guide the management of the majority of injuries, special consideration must be paid to the edentulous patient, complex and comminuted fractures, and pediatric patients. These topics are d... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4299039 Wed, 29 Dec 2010 00:00:00 +0100 4299039 http://www.medworm.com/index.php?rid=4299038&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0030-1269764 This article provides a review of the relevant literature related to this topic and describes the authors' approach to the evaluation and management of the patient with facial soft tissue injuries.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4299038 Wed, 29 Dec 2010 00:00:00 +0100 4299038 http://www.medworm.com/index.php?rid=4299037&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0030-1269763 Seminars in Plastic Surgery 2010; 24: 339-347DOI: 10.1055/s-0030-1269763ABSTRACTNasal trauma plays a large and important role in the field of craniofacial trauma. The resulting aesthetic, structural, and functional sequelae associated with these injuries necessitate a thorough understanding of the topic. This includes an appreciation for the unique anatomic features of the region, the important aspects of the initial history and examination, nasal injury classification, and subsequent treatment timing and options. While a large body of literature has accumulated on the topic, the purpose of this article is to focus on both clinically relevant information and pearls of management. Additionally, age-specific concerns, secondary procedures, and nasal fracture grafting, will be addressed as we... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4299037 Wed, 29 Dec 2010 00:00:00 +0100 4299037 http://www.medworm.com/index.php?rid=4299036&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0030-1269762 Seminars in Plastic Surgery 2010; 24: 337-338DOI: 10.1055/s-0030-1269762© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4299036 Wed, 29 Dec 2010 00:00:00 +0100 4299036 http://www.medworm.com/index.php?rid=4299035&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0030-1269761 Seminars in Plastic Surgery 2010; 24: 335-336DOI: 10.1055/s-0030-1269761© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4299035 Wed, 29 Dec 2010 00:00:00 +0100 4299035 http://www.medworm.com/index.php?rid=3886713&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1263075 Seminars in Plastic Surgery 2010; 24: 331-334DOI: 10.1055/s-0030-1263075ABSTRACTHead and neck cancer remains a significant cause of morbidity worldwide. Multimodality treatment is often the only way to achieve improved function, quality of life, and survival, calling for a multidisciplinary team approach, particularly in view of the rapid advances being made in various fields. The roles of the head and neck surgeon and reconstructive surgeon are discussed, together with the input afforded by specialists in areas such as diagnostic imaging, radiation therapy, medical oncology, and gene therapy. Telemedicine is of importance in centers where multidisciplinary expertise is not available.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3886713 Sat, 21 Aug 2010 05:33:25 +0100 3886713 http://www.medworm.com/index.php?rid=3886712&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1263074 Seminars in Plastic Surgery 2010; 24: 325-330DOI: 10.1055/s-0030-1263074ABSTRACTAnorexia and cachexia frequently complicate the late stages of malignancy and can be a prominent feature of early disease. The resulting weight loss significantly affects the morbidity and mortality of the cancer patient. A fundamental understanding of nutrition and the pathophysiology of cancer cachexia will aid in diligent treatment decisions to achieve optimal results. The pathophysiology of cancer cachexia is discussed, together with methods of nutritional assessment, nutritional requirements, and postoperative nutritional support. The advantages and disadvantages of the various modes of parenteral and enteral feeding are presented, together with information about enteral feeding in the home.[...]© Thieme ... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3886712 Sat, 21 Aug 2010 05:33:25 +0100 3886712 http://www.medworm.com/index.php?rid=3886711&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1263073 Seminars in Plastic Surgery 2010; 24: 319-324DOI: 10.1055/s-0030-1263073ABSTRACTHead and neck reconstruction is often mandatory in elderly and ill patients, especially after tumor ablation. Even complex reconstructive procedures can be done in the elderly population after careful evaluation. The morbidity and mortality rates increase with age, thus the risks and benefits of surgical intervention must be weighed precisely. The functional capacities of the vital organs and the limitations should be assessed. The only significant preoperative guide for the risk of the operation is the American Society of Anesthesiologists (ASA) score. According to this scoring system, ASA 3 and 4 patients are more prone to complications. For a successful reconstructive procedure in old and ill patients, detai... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3886711 Sat, 21 Aug 2010 05:33:25 +0100 3886711 http://www.medworm.com/index.php?rid=3886710&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1263072 The objective of this article is to provide insight into how to prevent undesirable functional and aesthetic outcome after the initial procedure and also to provide solutions for enhancement of functional and aesthetic outcome with secondary procedures. Functional and aesthetic outcome enhancement is discussed in relation to the individual structures within the oral cavity, for the mandible, and for facial reconstruction. Normal prerequisites for all individual structures are described, and key points for restoration of these functional and aesthetic issues are proposed. In addition, further suggestions to improve suboptimal results after initial reconstructive surgery are presented. Understanding the function and aesthetics of the area to be reconstructed will allow appropriate planning a... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3886710 Sat, 21 Aug 2010 05:33:25 +0100 3886710 http://www.medworm.com/index.php?rid=3886709&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1263071 Seminars in Plastic Surgery 2010; 24: 299-308DOI: 10.1055/s-0030-1263071ABSTRACTPatients afflicted with head and neck cancer, traumatic injuries to the head and neck, or those with congenital or developmental defects benefit from multidisciplinary team management. The head and neck region participates in complex physiologic processes that can often be impeded by these circumstances. Evaluation of the patient by the maxillofacial prosthodontist can assist the other members of the team in providing treatment planning options for the patients. Intraoral defects arising from these circumstances can be treated with prosthodontics that serve to assist with speech, swallowing, and to some degree mastication. If chemotherapeutic or radiation modalities are also used to treat the head and neck, ass... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3886709 Sat, 21 Aug 2010 05:33:25 +0100 3886709 http://www.medworm.com/index.php?rid=3886708&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1263070 This article explores the general complications, including free flap failure, carotid artery blowout, hardware exposure, and ectropion, as well as regional complications relating to operations of the scalp, cranium, base of skull, midface, mandible, and pharyngoesophagus.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3886708 Sat, 21 Aug 2010 05:33:25 +0100 3886708 http://www.medworm.com/index.php?rid=3886707&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1263069 Seminars in Plastic Surgery 2010; 24: 281-287DOI: 10.1055/s-0030-1263069ABSTRACTReconstruction of head and neck patients using free tissue transfer is perhaps the most challenging of areas in the human body. Although complications are inevitable in a percentage of patients, it is good postoperative care and monitoring that determines the success or failure of the reconstruction and also permits early salvage of a failing free flap. Teamwork and cooperation among members of the reconstructive team are critical. Here we review the significance of clinical care and monitoring of reconstructed head and neck patients in the intraoperative and postoperative periods. We also review different techniques and strategies for flap monitoring and anticoagulation used for free tissue transfers.[...]© T... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3886707 Sat, 21 Aug 2010 05:33:25 +0100 3886707 http://www.medworm.com/index.php?rid=3886706&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1263068 Seminars in Plastic Surgery 2010; 24: 262-280DOI: 10.1055/s-0030-1263068ABSTRACTBurns can cause extensive and devastating injuries of the head and neck. Prevention of the initial injury must always be a priority, but once an injury has occurred, then prevention of progression of the damage together with survival of the patient must be the immediate goals. The acute care will have a major influence on the subsequent scarring, reconstructive need, and long-term outcome. In the majority of cases, the reconstruction will involve restoration of form and function to the soft tissues, and the methods used will depend very much on the extent of scarring locally and elsewhere in the body. In nearly all cases, a significant improvement in functional and aesthetic outcomes can be achieved, which, in ... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3886706 Sat, 21 Aug 2010 05:33:25 +0100 3886706 http://www.medworm.com/index.php?rid=3886705&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1263067 Seminars in Plastic Surgery 2010; 24: 255-261DOI: 10.1055/s-0030-1263067ABSTRACTBone grafts are used in a variety of clinical situations and can be divided into two categories: treatment of bone gaps (inlay bone grafting) and bone projection (onlay bone grafting). Cortical grafts are useful in situations requiring immediate mechanical strength. These grafts can survive with or without complete revascularization or resorption and are primarily used by plastic surgeons in the treatment of bone volume deficiency. Cancellous grafts, in contrast, have no mechanical strength and therefore require additional support to bridge bone defects. Thus, they are used primarily for the treatment of bone gaps and in general revascularize quickly, resorb completely, and stimulate significant new bone format... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3886705 Sat, 21 Aug 2010 05:33:25 +0100 3886705 http://www.medworm.com/index.php?rid=3886704&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1263066 This article also describes head and neck reconstruction in a region-specific manner and gives a short-list of suitable flaps based on the location of the defect.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3886704 Sat, 21 Aug 2010 05:33:25 +0100 3886704 http://www.medworm.com/index.php?rid=3886703&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1264963 Seminars in Plastic Surgery 2010; 24: 235-236DOI: 10.1055/s-0030-1264963© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3886703 Sat, 21 Aug 2010 05:33:25 +0100 3886703 http://www.medworm.com/index.php?rid=3886702&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1263065 Seminars in Plastic Surgery 2010; 24: 233-234DOI: 10.1055/s-0030-1263065© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3886702 Sat, 21 Aug 2010 01:14:17 +0100 3886702 http://www.medworm.com/index.php?rid=4299055&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0030-1264963 Seminars in Plastic Surgery 2010; 24: 235-236DOI: 10.1055/s-0030-1264963© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4299055 Fri, 20 Aug 2010 00:00:00 +0100 4299055 http://www.medworm.com/index.php?rid=4299054&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0030-1263075 Seminars in Plastic Surgery 2010; 24: 331-334DOI: 10.1055/s-0030-1263075ABSTRACTHead and neck cancer remains a significant cause of morbidity worldwide. Multimodality treatment is often the only way to achieve improved function, quality of life, and survival, calling for a multidisciplinary team approach, particularly in view of the rapid advances being made in various fields. The roles of the head and neck surgeon and reconstructive surgeon are discussed, together with the input afforded by specialists in areas such as diagnostic imaging, radiation therapy, medical oncology, and gene therapy. Telemedicine is of importance in centers where multidisciplinary expertise is not available.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Abstract  |  Ful... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4299054 Fri, 20 Aug 2010 00:00:00 +0100 4299054 http://www.medworm.com/index.php?rid=4299053&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0030-1263074 Seminars in Plastic Surgery 2010; 24: 325-330DOI: 10.1055/s-0030-1263074ABSTRACTAnorexia and cachexia frequently complicate the late stages of malignancy and can be a prominent feature of early disease. The resulting weight loss significantly affects the morbidity and mortality of the cancer patient. A fundamental understanding of nutrition and the pathophysiology of cancer cachexia will aid in diligent treatment decisions to achieve optimal results. The pathophysiology of cancer cachexia is discussed, together with methods of nutritional assessment, nutritional requirements, and postoperative nutritional support. The advantages and disadvantages of the various modes of parenteral and enteral feeding are presented, together with information about enteral feeding in the home.[...]© Thieme ... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4299053 Fri, 20 Aug 2010 00:00:00 +0100 4299053 http://www.medworm.com/index.php?rid=4299052&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0030-1263073 Seminars in Plastic Surgery 2010; 24: 319-324DOI: 10.1055/s-0030-1263073ABSTRACTHead and neck reconstruction is often mandatory in elderly and ill patients, especially after tumor ablation. Even complex reconstructive procedures can be done in the elderly population after careful evaluation. The morbidity and mortality rates increase with age, thus the risks and benefits of surgical intervention must be weighed precisely. The functional capacities of the vital organs and the limitations should be assessed. The only significant preoperative guide for the risk of the operation is the American Society of Anesthesiologists (ASA) score. According to this scoring system, ASA 3 and 4 patients are more prone to complications. For a successful reconstructive procedure in old and ill patients, detai... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4299052 Fri, 20 Aug 2010 00:00:00 +0100 4299052 http://www.medworm.com/index.php?rid=4299051&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0030-1263072 The objective of this article is to provide insight into how to prevent undesirable functional and aesthetic outcome after the initial procedure and also to provide solutions for enhancement of functional and aesthetic outcome with secondary procedures. Functional and aesthetic outcome enhancement is discussed in relation to the individual structures within the oral cavity, for the mandible, and for facial reconstruction. Normal prerequisites for all individual structures are described, and key points for restoration of these functional and aesthetic issues are proposed. In addition, further suggestions to improve suboptimal results after initial reconstructive surgery are presented. Understanding the function and aesthetics of the area to be reconstructed will allow appropriate planning a... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4299051 Fri, 20 Aug 2010 00:00:00 +0100 4299051 http://www.medworm.com/index.php?rid=4299050&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0030-1263071 Seminars in Plastic Surgery 2010; 24: 299-308DOI: 10.1055/s-0030-1263071ABSTRACTPatients afflicted with head and neck cancer, traumatic injuries to the head and neck, or those with congenital or developmental defects benefit from multidisciplinary team management. The head and neck region participates in complex physiologic processes that can often be impeded by these circumstances. Evaluation of the patient by the maxillofacial prosthodontist can assist the other members of the team in providing treatment planning options for the patients. Intraoral defects arising from these circumstances can be treated with prosthodontics that serve to assist with speech, swallowing, and to some degree mastication. If chemotherapeutic or radiation modalities are also used to treat the head and neck, ass... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4299050 Fri, 20 Aug 2010 00:00:00 +0100 4299050 http://www.medworm.com/index.php?rid=4299049&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0030-1263070 This article explores the general complications, including free flap failure, carotid artery blowout, hardware exposure, and ectropion, as well as regional complications relating to operations of the scalp, cranium, base of skull, midface, mandible, and pharyngoesophagus.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4299049 Fri, 20 Aug 2010 00:00:00 +0100 4299049 http://www.medworm.com/index.php?rid=4299048&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0030-1263069 Seminars in Plastic Surgery 2010; 24: 281-287DOI: 10.1055/s-0030-1263069ABSTRACTReconstruction of head and neck patients using free tissue transfer is perhaps the most challenging of areas in the human body. Although complications are inevitable in a percentage of patients, it is good postoperative care and monitoring that determines the success or failure of the reconstruction and also permits early salvage of a failing free flap. Teamwork and cooperation among members of the reconstructive team are critical. Here we review the significance of clinical care and monitoring of reconstructed head and neck patients in the intraoperative and postoperative periods. We also review different techniques and strategies for flap monitoring and anticoagulation used for free tissue transfers.[...]© T... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4299048 Fri, 20 Aug 2010 00:00:00 +0100 4299048 http://www.medworm.com/index.php?rid=4299047&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0030-1263068 Seminars in Plastic Surgery 2010; 24: 262-280DOI: 10.1055/s-0030-1263068ABSTRACTBurns can cause extensive and devastating injuries of the head and neck. Prevention of the initial injury must always be a priority, but once an injury has occurred, then prevention of progression of the damage together with survival of the patient must be the immediate goals. The acute care will have a major influence on the subsequent scarring, reconstructive need, and long-term outcome. In the majority of cases, the reconstruction will involve restoration of form and function to the soft tissues, and the methods used will depend very much on the extent of scarring locally and elsewhere in the body. In nearly all cases, a significant improvement in functional and aesthetic outcomes can be achieved, which, in ... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4299047 Fri, 20 Aug 2010 00:00:00 +0100 4299047 http://www.medworm.com/index.php?rid=4299046&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0030-1263067 Seminars in Plastic Surgery 2010; 24: 255-261DOI: 10.1055/s-0030-1263067ABSTRACTBone grafts are used in a variety of clinical situations and can be divided into two categories: treatment of bone gaps (inlay bone grafting) and bone projection (onlay bone grafting). Cortical grafts are useful in situations requiring immediate mechanical strength. These grafts can survive with or without complete revascularization or resorption and are primarily used by plastic surgeons in the treatment of bone volume deficiency. Cancellous grafts, in contrast, have no mechanical strength and therefore require additional support to bridge bone defects. Thus, they are used primarily for the treatment of bone gaps and in general revascularize quickly, resorb completely, and stimulate significant new bone format... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4299046 Fri, 20 Aug 2010 00:00:00 +0100 4299046 http://www.medworm.com/index.php?rid=4299045&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0030-1263066 This article also describes head and neck reconstruction in a region-specific manner and gives a short-list of suitable flaps based on the location of the defect.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4299045 Fri, 20 Aug 2010 00:00:00 +0100 4299045 http://www.medworm.com/index.php?rid=4299044&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fdx.doi.org%2F10.1055%2Fs-0030-1263065 Seminars in Plastic Surgery 2010; 24: 233-234DOI: 10.1055/s-0030-1263065© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=4299044 Fri, 20 Aug 2010 00:00:00 +0100 4299044 http://www.medworm.com/index.php?rid=3681079&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1255340 This article reviews methods of voice reconstruction. Nonsurgical methods of voice reconstruction include electrolarynx, pneumatic artificial larynx, and esophageal speech. Surgical methods of voice reconstruction include neoglottis, tracheoesophageal puncture, and prosthesis. Tracheoesophageal puncture can be performed in patients with pedicled flaps such as colon interposition, jejunum, or gastric pull-up or in free flaps such as perforator flaps, jejunum, and colon flaps. Other flaps for voice reconstruction include the ileocolon flap and jejunum. Laryngeal transplantation is also reviewed.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3681079 Tue, 22 Jun 2010 05:21:00 +0100 3681079 http://www.medworm.com/index.php?rid=3681078&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1255339 This article reviews the literature on esophageal reconstruction. The most common methods used are gastric pull-up, pectoralis major flap, colon interposition, fasciocutaneous flaps (radial forearm free flap or anterolateral thigh flap), and free jejunum and colon flaps. The stricture rates, fistula rates, morbidity, and mortality of each flap are reviewed.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3681078 Tue, 22 Jun 2010 05:21:00 +0100 3681078 http://www.medworm.com/index.php?rid=3681077&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1255338 Seminars in Plastic Surgery 2010; 24: 212-218DOI: 10.1055/s-0030-1255338ABSTRACTThe lips are highly visible structures on the face, providing oral competence and expressing emotion. The reconstruction of large full-thickness defects of the lips is a formidable challenge for the plastic surgeon. The most challenging defect of the lower lip is full thickness, larger than two thirds. Such an extensive defect requires either staged reconstruction or a flap of distant tissue. We consider that the gracilis muscle, due to its anatomic and functional features, is the ideal flap for reconstruction of the lips. A functioning gracilis matches all the requisites and allows normal movements that are uniform to all of the lip. The new commissure is symmetric and moves simultaneously with the residual co... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3681077 Tue, 22 Jun 2010 05:21:00 +0100 3681077 http://www.medworm.com/index.php?rid=3681076&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1255337 Seminars in Plastic Surgery 2010; 24: 198-211DOI: 10.1055/s-0030-1255337ABSTRACTChoosing a pedicled flap to reconstruct an intraoral defect depends on the size and the anatomic position of the tissue defect. The goals are to restore form and function and minimize donor site morbidity. Regional pedicled flaps available for intraoral reconstruction are the buccal fat pad flap, facial artery musculomucosal flap, platysma, pectoralis major, temporalis muscle flap, and trapezius flaps. We give a concise illustration of anatomy, our harvesting technique, indications, and eventual pitfalls for each of the six flaps.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3681076 Tue, 22 Jun 2010 05:21:00 +0100 3681076 http://www.medworm.com/index.php?rid=3681075&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1255336 Seminars in Plastic Surgery 2010; 24: 188-197DOI: 10.1055/s-0030-1255336ABSTRACTDefects requiring reconstruction in the mandible are commonly encountered and may result from resection of benign or malignant lesions, trauma, or osteoradionecrosis. Mandibular defects can be classified according to location and extent, as well as involvement of mucosa, skin, and tongue. Vascularized bone flaps, in general, provide the best functional and aesthetic outcome, with the fibula flap remaining the gold standard for mandible reconstruction. In this review, we discuss classification and approach to reconstruction of mandibular defects. We also elaborate upon four commonly used free osteocutaneous flaps, inclusive of fibula, iliac crest, scapula, and radial forearm. Finally, we discuss indications and ... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3681075 Tue, 22 Jun 2010 05:21:00 +0100 3681075 http://www.medworm.com/index.php?rid=3681074&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1255335 Seminars in Plastic Surgery 2010; 24: 181-187DOI: 10.1055/s-0030-1255335ABSTRACTIn the midface, two polyhedron-shaped maxillary units are separated by the central midportion, which includes the nasal area. The midface includes such facial features as the nose, cheek, and upper lip, and posteriorly it extends to the anterior skull base. In the superoinferior direction, the midface includes the soft and bony tissue from the orbital cavity to the oral cavity. Laterally, the midface extends to the temporal bone. Although most superficial skin defects of the midface can be covered by various standard reconstructive modalities, because of the need to evaluate the nature of the tissues involved and because of structural and also functional considerations, the management of large, full-thickness d... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3681074 Tue, 22 Jun 2010 05:21:00 +0100 3681074 http://www.medworm.com/index.php?rid=3681073&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1255334 Seminars in Plastic Surgery 2010; 24: 171-180DOI: 10.1055/s-0030-1255334ABSTRACTThe treatment of scalp and forehead defects is challenging. There are few cases in which an untreated scalp defect can heal by secondary intention. However, lack of adequate treatment can also lead to fatal consequences. Adequate judgment and treatment of a defect on the scalp are therefore mandatory. There are many options to reconstruct a scalp defect. Each option has its role in the reconstruction repertoire. Various factors need to be considered when choosing the method to be used. These factors include etiology and the size of the defect, age and general health of the patient, as well as the situation at the hospital/unit where the treatment is performed. In this article, different reconstruction methods a... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3681073 Tue, 22 Jun 2010 05:21:00 +0100 3681073 http://www.medworm.com/index.php?rid=3681072&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1255333 This article reviews the commonly encountered variations in the recipient vessels in the neck with emphasis on alternatives and techniques to circumvent these variations. Flaps commonly used in head and neck reconstruction are also reviewed in detail. Furthermore, safety, potential pitfalls, and technical pearls are highlighted.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3681072 Tue, 22 Jun 2010 05:21:00 +0100 3681072 http://www.medworm.com/index.php?rid=3681071&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1255332 Seminars in Plastic Surgery 2010; 24: 148-154DOI: 10.1055/s-0030-1255332ABSTRACTAdvances in head and neck reconstruction have resulted in improved outcomes with single-stage repair of defects ranging from intraoral to pharyngoesophageal to skull base defects. Key to success of surgery is choosing an appropriate reconstructive option based on the patient's wishes and fitness for major surgery. Where possible, free tissue transfer provides the best functional and aesthetic outcomes for the vast majority of defects. In this article, we present an algorithm to guide choice of flap selection and review principles of reconstruction and secondary surgery for head and neck defects.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars ... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3681071 Tue, 22 Jun 2010 05:21:00 +0100 3681071 http://www.medworm.com/index.php?rid=3681070&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1255331 Seminars in Plastic Surgery 2010; 24: 137-147DOI: 10.1055/s-0030-1255331ABSTRACTRecent advances in the management of patients with head and neck cancer point to an expanding role of chemotherapy, resulting in an increased involvement of the medical oncologist in the multidisciplinary care of these patients. This review focuses on patients with squamous cell carcinoma of the oral cavity, pharynx, and larynx. A comprehensive review of the clinical trial data that have defined new standards of care and a detailed presentation of widely used chemotherapeutic regimens, including both cytotoxic and molecularly targeted agents, are presented. Information on human papilloma virus–associated squamous cell cancer of the head and neck is presented, and implications in the clinical management of... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3681070 Tue, 22 Jun 2010 05:21:00 +0100 3681070 http://www.medworm.com/index.php?rid=3681069&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1255330 Seminars in Plastic Surgery 2010; 24: 127-136DOI: 10.1055/s-0030-1255330ABSTRACTTreatment for patients with head and neck cancer requires a multidisciplinary approach. Radiotherapy is employed as a primary treatment or as an adjuvant to surgery. Each specific subsite dictates the appropriate radiotherapy techniques, fields, dose, and fractionation scheme. Quality of life is also an important issue in the management of head and neck cancer. The radiation-related complications have a tremendous impact on the quality of life. Modern radiotherapy techniques, such as intensity-modulated radiotherapy and image-guided radiotherapy, can offer precise radiation delivery and reduce the dose to the surrounding normal tissues without compromise of target coverage. In the future, efforts should be made... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3681069 Tue, 22 Jun 2010 05:21:00 +0100 3681069 http://www.medworm.com/index.php?rid=3681068&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1255329 Seminars in Plastic Surgery 2010; 24: 117-126DOI: 10.1055/s-0030-1255329ABSTRACTThe majority of skin cancers of the head and neck are nonmelanoma skin cancers (NMSC). Basal cell carcinoma and squamous cell carcinoma are the most frequent types of NMSC. Malignant melanoma is an aggressive neoplasm of skin, and the ideal adjuvant therapy has not yet been found, although various options for treatment of skin cancer are available to the patient and physician, allowing high cure rate and excellent functional and cosmetic outcomes. Sunscreen protection and early evaluation of suspicious areas remain the first line of defense against skin cancers.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3681068 Tue, 22 Jun 2010 05:21:00 +0100 3681068 http://www.medworm.com/index.php?rid=3681067&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1255328 Seminars in Plastic Surgery 2010; 24: 107-116DOI: 10.1055/s-0030-1255328ABSTRACTAblative surgery for malignancies of the upper aerodigestive tract is the most common reason why the reconstructive surgeon is called upon to reconstruct adult head and neck defects. An understanding of the pathophysiology and treatment of head and neck malignancy is vital to the reconstructive surgeon so that restoration of both form and function can be achieved. It is important to understand the behavior of cancers of each head and neck subsite, as staging and ultimately the treatment of tumors from each subsite is different. Historically, the standard treatment of head and neck cancer was surgery and/or primary radiation therapy with surgical salvage for failure. Beginning in the 1980s, advances in chemother... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3681067 Tue, 22 Jun 2010 05:21:00 +0100 3681067 http://www.medworm.com/index.php?rid=3681066&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1255341 Seminars in Plastic Surgery 2010; 24: 105-106DOI: 10.1055/s-0030-1255341© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3681066 Tue, 22 Jun 2010 05:21:00 +0100 3681066 http://www.medworm.com/index.php?rid=3681065&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1255327 Seminars in Plastic Surgery 2010; 24: 103-104DOI: 10.1055/s-0030-1255327© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3681065 Tue, 22 Jun 2010 05:21:00 +0100 3681065 http://www.medworm.com/index.php?rid=3535430&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1253245 Seminars in Plastic Surgery 2010; 24: 077-102DOI: 10.1055/s-0030-1253245ABSTRACTThe challenging reconstructive treatment of defects in the upper extremity requires a sound working knowledge of a variety of flaps. As the hand surgeon weighs the pros and cons of each possible flap to obtain definitive closure, he or she must also integrate the priorities of function, contour, and stability as well as the anticipation of further reconstructive surgery in choosing the flap of choice. This review describes the various flaps available for closure of soft tissue defects of the upper extremity. The principles of management of wounds of the upper extremity is described to guide hand surgeons in the early treatment of massive wounds that will eventually need free tissue coverage. Currently used flap... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3535430 Thu, 06 May 2010 13:10:44 +0100 3535430 http://www.medworm.com/index.php?rid=3535429&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1253246 Seminars in Plastic Surgery 2010; 24: 067-076DOI: 10.1055/s-0030-1253246ABSTRACTThe treatment of hand and upper-extremity injuries is complex. The treatment goals are to restore maximal hand function and, if possible, preinjury form. Several complications are frequently encountered while treating hand and upper-extremity injuries. Complications such as edema, direct structural destruction, and nerve palsies are the result of the inflicting injury. Skin graft contraction, fascial adhesions causing restricted tendon motion, and diminution of muscle function with time during staged reconstructions are treatment-related complications. The nature of these complications as well as means for their prevention and treatment are reviewed.[...]© Thieme Medical PublishersGet connected:Table of conten... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3535429 Thu, 06 May 2010 13:10:44 +0100 3535429 http://www.medworm.com/index.php?rid=3535428&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1253242 Seminars in Plastic Surgery 2010; 24: 057-066DOI: 10.1055/s-0030-1253242ABSTRACTAdult brachial plexus injury remains a dilemma to a reconstructive microsurgeon, especially when attempting to reconstruct cases of total root avulsion. Different degrees and different levels of injury require different strategies of reconstruction. The purpose of this article is to illustrate the author's reconstructive strategy in correlation with the injury level of classification. Nerve transfer, functioning free muscle transplantation, and other palliative surgery are reconstructive options for level 1 injuries. Neurolysis, nerve repair, nerve grafts (free nerve graft or vascularized ulnar nerve graft), nerve transfer if associated with level 1 lesion in other spinal nerves, and palliative reconstruction a... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3535428 Thu, 06 May 2010 13:10:44 +0100 3535428 http://www.medworm.com/index.php?rid=3535427&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1253239 Seminars in Plastic Surgery 2010; 24: 043-056DOI: 10.1055/s-0030-1253239ABSTRACTThe diabetic triad of neuropathy, vasculopathy, and foot deformity can be surgically challenging to the reconstructive surgeon. Soft tissue deficits must be closed to protect underlying structures from infection and to provide a stable environment for healing. It is critical to have adequate blood flow and to debride the wound to clean healthy tissue before considering reconstruction. Surgical options commonly used include healing by secondary intention, local flap closure, skin grafts, pedicled flaps, and free tissue transfer. Despite a surgeon's best operative efforts, these strategies may fail perioperatively due to postoperative shear forces created by premature joint motion and/or pressure (either weight b... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3535427 Thu, 06 May 2010 13:10:44 +0100 3535427 http://www.medworm.com/index.php?rid=3535426&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1253244 Seminars in Plastic Surgery 2010; 24: 034-042DOI: 10.1055/s-0030-1253244ABSTRACTTrauma is one of the main causes of upper- and lower-limb defects. Limb injuries frequently result in complex defects, hence reconstruction can be demanding. The basic principles of trauma management and methods of reconstruction are analyzed. Then, the evolution of free tissue transfer is reviewed with particular attention to the use of anterolateral thigh flap in reconstruction of upper- and lower-limb trauma cases. The anterolateral thigh flap is the workhorse flap in our department due to its versatility in the reconstruction of complex defects. Finally, the concept of free-style perforator flaps is presented. Microsurgery has supplied the armamentarium of the plastic surgeon with a very powerful tool. Esse... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3535426 Thu, 06 May 2010 13:10:44 +0100 3535426 http://www.medworm.com/index.php?rid=3535425&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1253240 Seminars in Plastic Surgery 2010; 24: 018-033DOI: 10.1055/s-0030-1253240ABSTRACTLimb-sparing resection and reconstruction has become the treatment of choice in extremity malignancies, as amputation does not provide better long-term survival rates or functional advantages. R0 resection, the removal of the tumor in sano, remains the prerequisite and most important oncologic parameter to avoid local recurrence. Successful treatment requires the combination of surgical eradication and the patient's specific functional and aesthetic rehabilitation. Our clinical rationale resulting from more than 2000 cases will be demonstrated. The problematic aspects of different tumor entities and the locoregional clearance of lymphatic pathways will be discussed. Differential diagnosis and multimodality trea... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3535425 Thu, 06 May 2010 13:10:44 +0100 3535425 http://www.medworm.com/index.php?rid=3535424&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1253243 Seminars in Plastic Surgery 2010; 24: 011-017DOI: 10.1055/s-0030-1253243ABSTRACTIn the past decade, more than 100 different composite tissue allotransplantation (CTA) procedures have been performed around the world including more than 50 hand and 8 facial transplants with encouraging graft survival and excellent functional outcomes. Broader clinical application of CTA, however, continues to be hampered by requirement for long-term, high-dose, multidrug maintenance immunosuppression to prevent graft rejection mediated particularly by composite tissue allograft's highly immunogenic skin component. Medication toxicity could result in severe adverse events including metabolic and infectious complications or malignancy. Notably, unlike in solid organs, clinical success is dictated not only by g... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3535424 Thu, 06 May 2010 13:10:44 +0100 3535424 http://www.medworm.com/index.php?rid=3535423&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1253241 This article provides an overview of damage control principles in the management of high-energy traumatic vascular injuries of the lower limb during recent U.S. military combat operations.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3535423 Thu, 06 May 2010 13:10:44 +0100 3535423 http://www.medworm.com/index.php?rid=3535422&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1253238 Seminars in Plastic Surgery 2010; 24: 003-003DOI: 10.1055/s-0030-1253238© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3535422 Thu, 06 May 2010 13:10:44 +0100 3535422 http://www.medworm.com/index.php?rid=3535421&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0030-1253237 Seminars in Plastic Surgery 2010; 24: 001-001DOI: 10.1055/s-0030-1253237© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=3535421 Thu, 06 May 2010 13:10:44 +0100 3535421 http://www.medworm.com/index.php?rid=2996997&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1242180 Seminars in Plastic Surgery 2009; 23: 288-291DOI: 10.1055/s-0029-1242180ABSTRACTThe anatomic understanding of the superficial compartments of the head and neck are evolving. Recently, studies have shown that the superficial fat is sequestered into separate “compartments”; however, the superficial anatomy of the submental region of the neck has yet to be defined, and improved understanding of this area may lead to advances in our ability to rejuvenate the neck. This cadaveric investigation revealed that there is one superficial fat compartment in the submental region. The anterior boundary of this compartment, previously without name, has been labeled the “submental septum.” The posterior boundary of the submental fat compartment is created by a septum that arises fr... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2996997 Tue, 17 Nov 2009 13:55:46 +0100 2996997 http://www.medworm.com/index.php?rid=2996996&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1242181 This report provides a review of the locations and characteristics of the facial fat compartments and provides examples of how this knowledge can be used clinically, specifically with regard to soft tissue fillers.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2996996 Tue, 17 Nov 2009 13:55:46 +0100 2996996 http://www.medworm.com/index.php?rid=2996995&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1242182 Seminars in Plastic Surgery 2009; 23: 274-282DOI: 10.1055/s-0029-1242182ABSTRACTThe endoscopic midface lift procedure has evolved from experience with postreduction soft tissue repair after facial fracture fixation. The procedure elevates and repositions midface soft tissue, which descends with facial aging; as well, it can correct periorbital congenital abnormalities, such as exorbitism and lateral canthal displacement. The procedure has been refined by the senior author to employ a temporal endoscopic approach alleviating the need for a lower eyelid incision. The plane is sub-SMAS (superficial muscular aponeurotic system) within the pre-zygomatic space with release of the zygo-orbicular ligament and the malar retaining ligament. Using an endoscopically placed suture in the malar retainin... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2996995 Tue, 17 Nov 2009 13:55:46 +0100 2996995 http://www.medworm.com/index.php?rid=2996994&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1242178 Seminars in Plastic Surgery 2009; 23: 264-273DOI: 10.1055/s-0029-1242178ABSTRACTThe contour of the neck is a very important determinant of facial aesthetics. Precise knowledge of neck anatomy is essential for adequate planning and execution of this procedure. There are three anatomic and surgical planes involved in the management of the aging neck; the superficial plane (subcutaneous fat), the intermediate plane (platysma muscles and the fat between the two muscles), and the deep plane (subplatysmal fat, the anterior belly of the digastric muscles, and the submandibular glands). These planes need to be thoroughly evaluated in the preoperative assessment and dealt with according to each patient's needs. Even though this article focuses on isolated management of the aging neck, careful evalu... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2996994 Tue, 17 Nov 2009 13:55:46 +0100 2996994 http://www.medworm.com/index.php?rid=2996993&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1242184 This article is intended to bridge that gap and stimulate further discussion about this clinical situation.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2996993 Tue, 17 Nov 2009 13:55:46 +0100 2996993 http://www.medworm.com/index.php?rid=2996992&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1242183 Seminars in Plastic Surgery 2009; 23: 247-256DOI: 10.1055/s-0029-1242183ABSTRACTThe composite face-lift is a well-described, comprehensive facial rejuvenation technique that results in harmonious repositioning of all components of the aging face. It is distinguished by the superior-medial movement of the cheek and the septal reset maneuver. The composite rhytidectomy reverses the unbalanced vectors of the traditional face-lift in patients with the lateral sweep and may reestablish the youthful convexity in patients with hollow eyes.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2996992 Tue, 17 Nov 2009 13:55:46 +0100 2996992 http://www.medworm.com/index.php?rid=2996991&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1242179 Seminars in Plastic Surgery 2009; 23: 245-245DOI: 10.1055/s-0029-1242179© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2996991 Tue, 17 Nov 2009 13:55:46 +0100 2996991 http://www.medworm.com/index.php?rid=2595666&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224803 We present an article reviewing current trends in buttock aesthetic procedures and discuss issues relevant to the ethnic populations.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2595666 Tue, 14 Jul 2009 10:49:15 +0100 2595666 http://www.medworm.com/index.php?rid=2595665&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224802 Seminars in Plastic Surgery 2009; 23: 223-231DOI: 10.1055/s-0029-1224802ABSTRACTOver the past three decades, an increasing number of African American patients have undergone rhinoplasty, and many continue to present to surgeons for rhinoplasty evaluation. The reality is that rhinoplasty is no longer an uncommon procedure in the African American population. Most patients desire nasal refinement while preserving their cultural identity. The African American nose has many unique features that have to be appreciated and understood to provide the desired outcome. In this paper, we present an overview of the unique anatomic features of the African American nose, rhinoplasty techniques tailored to this patient population, and complications encountered postoperatively.[...]© Thieme Medical Publis... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2595665 Tue, 14 Jul 2009 10:49:15 +0100 2595665 http://www.medworm.com/index.php?rid=2595664&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224801 The objective for Asian rhinoplasty is augmentation rather than reduction in which the dorsum is raised and the nasal tip projection and definition are enhanced. The watchword today is ethnic preservation rather than effacement for the Asian patient. An ethnically sensitive standard for aesthetic rhinoplasty for the Asian nose is proposed. Also, a thorough discussion of cultural issues that can be important when working with the Asian patient is undertaken to guide a surgeon through every phase of patient care. Finally, the technical details are elaborated on both rhinoplasty and revision rhinoplasty for the Asian nose with an emphasis on correcting previous silicone augmentation rhinoplasty, the most popular choice for material in the Far East but that has failed the author in achieving c... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2595664 Tue, 14 Jul 2009 10:49:15 +0100 2595664 http://www.medworm.com/index.php?rid=2595663&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224800 Seminars in Plastic Surgery 2009; 23: 207-214DOI: 10.1055/s-0029-1224800ABSTRACTIn the United States, rhinoplasty has traditionally been performed in Caucasian patients. Ethnic rhinoplasty is often thought of as a procedure done to reshape the nose of a black or Asian patient. Little attention has been paid to rhinoplasty in Hispanic patients. There has been a large increase in the Hispanic population of the United States, and plastic surgeons will see a concomitant rise in requests for rhinoplasty among this population. In an effort to increase our understanding of Hispanic rhinoplasty, a retrospective review of a senior surgeon's experience was performed. A retrospective chart review was done examining the senior author's (S.S.) rhinoplasty practice over the past 10 years. Hispanic patie... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2595663 Tue, 14 Jul 2009 10:49:15 +0100 2595663 http://www.medworm.com/index.php?rid=2595662&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224799 Seminars in Plastic Surgery 2009; 23: 198-206DOI: 10.1055/s-0029-1224799ABSTRACTThe rejuvenation of the African American periorbit is rooted in select modifications of traditional techniques. The African American patient presents with dynamic considerations and needs. Whereas this subset is at risk for pigmentation and scar concerns, the natural resistance to actinic damage makes rejuvenation efforts rewarding. We will review the composite that makes up the periorbit, the brow, upper eyelid, lower eyelid/lateral canthus, and the midface unique. Specific indications and presurgical and postsurgical considerations will be presented in addition to technical considerations to manage periorbital aging that spares the skin. Common pitfalls and succinct ways to avoid them without compromising on ... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2595662 Tue, 14 Jul 2009 10:49:15 +0100 2595662 http://www.medworm.com/index.php?rid=2595661&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224798 Seminars in Plastic Surgery 2009; 23: 185-197DOI: 10.1055/s-0029-1224798ABSTRACTOne of the defining features between an individual of Asian descent and someone of Western descent is the presence of an upper eyelid crease. Approximately 50% of Asians do not have an upper eyelid crease. The double eyelid operation, or creation of a supratarsal crease, is the most common cosmetic procedure requested in Asia and the third most common procedure requested by Asian Americans. In this comprehensive article, we explore the art of creating an eyelid crease in the individual who either does not have a crease or has an indistinct crease. We will review the history of the development of Asian blepharoplasty, explain the anatomy of the Asian eyelid and how it differs from the Caucasian eyelid, and clari... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2595661 Tue, 14 Jul 2009 10:49:15 +0100 2595661 http://www.medworm.com/index.php?rid=2595660&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224797 Seminars in Plastic Surgery 2009; 23: 178-184DOI: 10.1055/s-0029-1224797ABSTRACTCutaneous wound healing is a complex response to skin injury. Deregulation of this process can lead to excessive scar formation, as seen in keloids. Keloids are common skin lesions that are difficult to treat and are associated with high recurrence rates despite the large number of available treatment options. With increased knowledge of the disease process and further scientific advancements, future approaches will hopefully improve keloid treatment. In this article, we review the epidemiology, genetic basis, etiology, clinical features, pathogenesis, and management of keloids.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surger... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2595660 Tue, 14 Jul 2009 10:49:15 +0100 2595660 http://www.medworm.com/index.php?rid=2595659&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224796 Seminars in Plastic Surgery 2009; 23: 173-177DOI: 10.1055/s-0029-1224796ABSTRACTToday, laser therapy is standard treatment for a wide variety of dermatologic complaints. From skin rejuvenation to the management of complex vascular malformations, laser treatment has proved to be an effective, innovative solution to once-challenging dilemmas. However, laser application in those with darker complexions remains a topic of great concern. Although contemporary devices may use longer-wavelength lasers and cooling devices to isolate target tissues within patients with high levels of epidermal melanin, significant risk remains. Today's laser surgeon must have a thorough understanding of patient concerns, lesion character and response to treatment, as well as the unique needs of those with darker sk... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2595659 Tue, 14 Jul 2009 10:49:15 +0100 2595659 http://www.medworm.com/index.php?rid=2595658&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224795 Seminars in Plastic Surgery 2009; 23: 168-172DOI: 10.1055/s-0029-1224795ABSTRACTUse of over-the-counter cosmetics, approaches to hygiene, and many basic dermatologic principles differ between individuals with Caucasian skin and ethnic skin. Still, comparatively few publications highlight these variations or discuss appropriate management. Among many ethnic patients, issues related to skin hydration, restoration of even pigmentation, hair removal, and acne care remain problematic yet not fully addressed. As well, there are some dermatologic conditions that may be rare in Caucasian skin but are much more common in the ethnic patient. Here, we discuss various aspects of skin hydration, dyschromia, sunscreen use, and chemical depilatories in the ethnic population.[...]© Thieme Medical Publish... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2595658 Tue, 14 Jul 2009 10:49:15 +0100 2595658 http://www.medworm.com/index.php?rid=2595657&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224794 Seminars in Plastic Surgery 2009; 23: 163-167DOI: 10.1055/s-0029-1224794ABSTRACTAnalysis of the differences in facial morphology and skin structure and tone among ethnic groups within the realm of plastic surgery is relevant due to the increasing number of ethnic individuals seeking cosmetic surgery. Previous classifications of ideal facial morphologic characteristics have been revised and challenged over the years to accurately reflect the differences in facial structure that are aesthetically pleasing to individuals of differing ethnic groups. The traditional neoclassic canons reflected the European Caucasian facial morphology and cannot be used to classify facial characteristics in ethnic groups due to drastic differences in measurement and proportion. In addition, differences in biophy... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2595657 Tue, 14 Jul 2009 10:49:15 +0100 2595657 http://www.medworm.com/index.php?rid=2595656&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224793 Seminars in Plastic Surgery 2009; 23: 159-162DOI: 10.1055/s-0029-1224793ABSTRACTThe popularity of cosmetic surgery has increased around the world, and whereas in the past, the patient base consisted of mainly Caucasian individuals, interest in this field has grown among persons of varying ethnic backgrounds. Growing interest enables ethnic populations to contribute to the economic growth of the cosmetic surgery industry and impact the direction of the field in the future. Minority populations accounted for 22% of the cosmetic procedures performed in 2007, with the most common being liposuction, Botox generic botulinum toxin type A (Allergan, Inc., Irvine, CA), and chemical peels. Ultimately, changes in the population characteristics of the plastic surgery patient will alter the techniques ... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2595656 Tue, 14 Jul 2009 10:49:15 +0100 2595656 http://www.medworm.com/index.php?rid=2595655&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224792 Seminars in Plastic Surgery 2009; 23: 157-157DOI: 10.1055/s-0029-1224792© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2595655 Tue, 14 Jul 2009 10:49:15 +0100 2595655 http://www.medworm.com/index.php?rid=2595654&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1224791 Seminars in Plastic Surgery 2009; 23: 155-155DOI: 10.1055/s-0029-1224791© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2595654 Tue, 14 Jul 2009 00:44:48 +0100 2595654 http://www.medworm.com/index.php?rid=2383541&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1214167 The objective of this review was to provide a literature review of the animal models created to study osteomyelitis. The models were chosen based on historical relevance and clinical applicability. Numerous animal models exist to study both acute and chronic osteomyelitis. Many models have been created that allow investigators to study various aspects in the treatment and diagnosis of osteomyelitis. Based on the needs of investigators, an animal model must be carefully selected for ideal research, as no single model encompasses all aspects of osteomyelitis.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2383541 Sun, 03 May 2009 19:11:02 +0100 2383541 http://www.medworm.com/index.php?rid=2383540&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1214166 Seminars in Plastic Surgery 2009; 23: 141-147DOI: 10.1055/s-0029-1214166ABSTRACTThe current management for chronic osteomyelitis centers on adequate antibiotic coverage and surgical debridement of nonviable tissue. The eradication of osteomyelitis, however, often involves a prolonged and frustrating course of management. Nonsurgical adjunctive modalities have not been widely used, mostly due to a lack of perceived efficacy, and have remained in a state of infancy. In this article, we will outline the rationale, current status, and evidence for several potential adjuncts to osteomyelitis management.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2383540 Sun, 03 May 2009 19:11:02 +0100 2383540 http://www.medworm.com/index.php?rid=2383539&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1214165 Seminars in Plastic Surgery 2009; 23: 132-140DOI: 10.1055/s-0029-1214165ABSTRACTAlthough osteomyelitis is a difficult problem, certain conditions make it even more difficult to address. Diabetes, peripheral vascular disease, and radiation are all comorbidities that interfere with wound healing and therefore make the treatment of osteomyelitis challenging. In this article, we discuss these conditions, their pathophysiology, and highlight the special considerations in treating osteomyelitis in patients with these comorbidities.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2383539 Sun, 03 May 2009 19:11:02 +0100 2383539 http://www.medworm.com/index.php?rid=2383538&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1214164 Seminars in Plastic Surgery 2009; 23: 119-131DOI: 10.1055/s-0029-1214164ABSTRACTOsteomyelitis of the craniofacial skeleton closely resembles osteomyelitis elsewhere in the body in its pathophysiology and medical management; subsequent reconstruction after debridement remains distinctly challenging. The goals of reconstruction must include the restoration of the complex and readily visible morphology of the cranium and face, as well as the adequate return of vital sensory, expressive, and digestive functions. In this article, the various reconstructive modalities will be discussed including pedicled and nonpedicled flaps with or without an osseous component, nonvascularized bone grafts, alloplastic implants, and bone regeneration using protein therapy. Although reconstruction of craniofacia... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2383538 Sun, 03 May 2009 19:11:02 +0100 2383538 http://www.medworm.com/index.php?rid=2383537&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1214163 Seminars in Plastic Surgery 2009; 23: 108-118DOI: 10.1055/s-0029-1214163ABSTRACTReconstruction of large skeletal defects secondary to osteomyelitis remains a challenging problem. Osteomyelitis can result from a variety of etiologies; most often, it is a consequence of trauma to a long bone. Despite advances in antibiotic therapy, treatment of chronic osteomyelitis requires adequate surgical debridement, which can often lead to large soft tissue and bone loss. Free vascularized bone can be used to reconstruct large skeletal defects greater than 6 cm or bone defects of smaller size that failed to heal with nonvascularized bone grafting. The length, cortical strength, and anatomic configuration of the free vascular fibular graft make it an ideal bone graft to bridge extremity defects, and it ... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2383537 Sun, 03 May 2009 19:11:02 +0100 2383537 http://www.medworm.com/index.php?rid=2383536&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1214162 Seminars in Plastic Surgery 2009; 23: 100-107DOI: 10.1055/s-0029-1214162ABSTRACTThe local delivery of antibiotics in the treatment of osteomyelitis has been used safely and effectively for decades. Multiple methods of drug delivery have been developed for the purposes of both infection treatment and prophylaxis. The mainstay of treatment in this application over the past 20 years has been non-biodegradable polymethylmethacrylate, which has the advantages of excellent elution characteristics and structural support properties. Biodegradable materials such as calcium sulfate and bone graft substitutes have been used more recently for this purpose. Other biodegradable implants, including synthetic polymers, are not yet approved for use but have demonstrated potential in laboratory investigatio... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2383536 Sun, 03 May 2009 19:11:02 +0100 2383536 http://www.medworm.com/index.php?rid=2383535&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1214161 Seminars in Plastic Surgery 2009; 23: 090-099DOI: 10.1055/s-0029-1214161ABSTRACTAppropriately designed antibiotic regimens are critical to the management of all stages of osteomyelitis, although goals of therapy may vary in different stages of infection. The most important consideration for antibiotic selection is spectrum of action. Route of administration by intravenous or oral route is less important than drug levels that are achievable at the site of infection. Outpatient parenteral therapy and use of oral agents has simplified delivery of long-term treatment regimens. There are few high-quality studies that compare specific treatment regimens or durations of therapy, and recommendations for drugs and duration of antibiotic therapy are based on expert opinion, case series, and extrapol... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2383535 Sun, 03 May 2009 19:11:02 +0100 2383535 http://www.medworm.com/index.php?rid=2383534&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1214160 Seminars in Plastic Surgery 2009; 23: 080-089DOI: 10.1055/s-0029-1214160ABSTRACTThe diagnostic imaging of osteomyelitis can require the combination of diverse imaging techniques for an accurate diagnosis. Conventional radiography should always be the first imaging modality to start with, as it provides an overview of the anatomy and the pathologic conditions of the bone and soft tissues of the region of interest. Sonography is most useful in the diagnosis of fluid collections, periosteal involvement, and surrounding soft tissue abnormalities and may provide guidance for diagnostic or therapeutic aspiration, drainage, or tissue biopsy. Computed tomography scan can be a useful method to detect early osseous erosion and to document the presence of sequestrum, foreign body, or gas formation bu... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2383534 Sun, 03 May 2009 19:11:02 +0100 2383534 http://www.medworm.com/index.php?rid=2383533&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1214159 Seminars in Plastic Surgery 2009; 23: 073-079DOI: 10.1055/s-0029-1214159ABSTRACTSkull-based osteomyelitis, which is a true bony infection, originates from a chronic, inadequately treated infection. Because of the complex craniofacial skeletal anatomy and associated aesthetic concerns, osteomyelitis of the craniofacial skeleton must be uniquely managed and is more difficult to treat than osteomyelitis of other bones of the body. It is thought that osteomyelitis is decreasing in prevalence due to broad-spectrum antibiotic treatment; however, it still remains a challenging clinical entity in developing countries and lower socioeconomic areas.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2383533 Sun, 03 May 2009 19:11:02 +0100 2383533 http://www.medworm.com/index.php?rid=2383532&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1214158 This article offers a basic review of the classification, etiology, epidemiology, pathogenesis, and treatment of long bone osteomyelitis.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2383532 Sun, 03 May 2009 19:11:02 +0100 2383532 http://www.medworm.com/index.php?rid=2383531&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1214157 Seminars in Plastic Surgery 2009; 23: 057-058DOI: 10.1055/s-0029-1214157© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2383531 Sun, 03 May 2009 19:11:02 +0100 2383531 http://www.medworm.com/index.php?rid=2383530&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0029-1214156 Seminars in Plastic Surgery 2009; 23: 055-055DOI: 10.1055/s-0029-1214156© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2383530 Fri, 01 May 2009 01:03:26 +0100 2383530 http://www.medworm.com/index.php?rid=2173828&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1111101 Seminars in Plastic Surgery 2009; 23: 048-054DOI: 10.1055/s-0028-1111101ABSTRACTWith the rapid economic development of Southeast Asia, the demand for cosmetic surgery has increased rapidly. Breast augmentation is among the most frequently performed cosmetic procedures. However, breast augmentation still has “bad press” in Southeast Asia because of not so distant catastrophes caused by direct liquid silicone injection and “Amazing Gel” augmentations. Asian patients have special characteristics that need to be taken into consideration when performing breast augmentation. The patients are usually thin and small with proportionally smaller breasts. The areola is often small with a large nipple. Because of poor scar healing, incisions need to be hidden. The transaxillary... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2173828 Tue, 10 Feb 2009 23:15:07 +0100 2173828 http://www.medworm.com/index.php?rid=2173827&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1110100 This article therefore attempts to define important differences between Asians and Caucasians in terms of signs of facial aging, perception of beauty, and surgical goals. Our face-lift technique, a modified deep-plane face lift for Asians, is detailed and cases are presented.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2173827 Tue, 10 Feb 2009 23:15:07 +0100 2173827 http://www.medworm.com/index.php?rid=2173826&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1110099 Seminars in Plastic Surgery 2009; 23: 032-039DOI: 10.1055/s-0028-1110099ABSTRACTBimaxillary protrusion is a commonly seen deformity in Asian populations. This condition is characterized by protrusive and proclined upper and lower incisors and an increased procumbency of the lips. It is usually combined with lip incompetence, gummy smile, mentalis strain, and anterior open bite. Facial aesthetics is the primary concern of these patients. Successful treatment depends on a thorough evaluation and understanding of this dentofacial deformity. Typical orthodontic treatment includes retraction and retroclination of maxillary and mandibular incisors after extraction of the four first premolars. Orthognathic surgery is required to correct significant skeletal problems. Anterior subapical osteotomie... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2173826 Tue, 10 Feb 2009 23:15:07 +0100 2173826 http://www.medworm.com/index.php?rid=2173825&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1110098 Seminars in Plastic Surgery 2009; 23: 022-031DOI: 10.1055/s-0028-1110098ABSTRACTAsian people, especially women, prefer a more delicate and feminine facial shape. To achieve a softer and better facial contour, there are several procedures to change the facial skeleton. Reduction malarplasty and mandibular angleplasty are common facial contouring operations in Asia. A lot of techniques have been developed independently by several authors. Various approaches can be chosen, such as intraoral or external skin incisions. There as also different contouring methods that can be chosen depending on the patient's morphology and the surgeon's technical preferences. The different osteotomy techniques used to mobilize the zygomatic complex can be classified according to the specific portion that is bein... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2173825 Tue, 10 Feb 2009 23:15:07 +0100 2173825 http://www.medworm.com/index.php?rid=2173824&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1110097 This article focuses on current rhinoplasty practices and controversies in Asia. It reviews morphologic differences between the Oriental and Western noses, as well as common patient requests. Polytetrafluoroethylene (Gore-Tex) and silicone implant augmentation are discussed. A new augmentation rhinoplasty with diced cartilage is described in more detail.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2173824 Tue, 10 Feb 2009 23:15:07 +0100 2173824 http://www.medworm.com/index.php?rid=2173823&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1110096 This article will discuss Oriental eyelid characteristics, preoperative patient assessment, commonly used corrective techniques for the “double-eyelid” creation, and complications and how to avoid them.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2173823 Tue, 10 Feb 2009 23:15:07 +0100 2173823 http://www.medworm.com/index.php?rid=2173822&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1110095 Seminars in Plastic Surgery 2009; 23: 003-003DOI: 10.1055/s-0028-1110095© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2173822 Tue, 10 Feb 2009 23:15:07 +0100 2173822 http://www.medworm.com/index.php?rid=2173821&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1110094 Seminars in Plastic Surgery 2009; 23: 001-001DOI: 10.1055/s-0028-1110094© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=2173821 Tue, 10 Feb 2009 23:15:07 +0100 2173821 http://www.medworm.com/index.php?rid=1943793&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1095889 Seminars in Plastic Surgery 2008; 22: 306-318DOI: 10.1055/s-0028-1095889ABSTRACTA variety of defects of the upper and lower eyelids can be encountered after Mohs surgery. The goals of eyelid reconstruction are to provide structural and functional restoration with an acceptable aesthetic result. A thorough knowledge of the intricate anatomy of the eyelids combined with familiarity of the wide variety of reconstructive options is required to achieve these goals. In this article, we review the anatomy of the eyelids, and we present commonly used techniques for reconstruction of the upper and lower eyelids and the medial and lateral canthal regions after Mohs surgery.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=1943793 Sat, 08 Nov 2008 14:27:00 +0100 1943793 http://www.medworm.com/index.php?rid=1943792&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1095888 Seminars in Plastic Surgery 2008; 22: 294-305DOI: 10.1055/s-0028-1095888ABSTRACTSignificant defects of the cheek present a reconstructive challenge due to their extremely visible site, as well as limited local tissue supply. In addition, the cheek abuts several structures of expressive function, such as the eye, mouth, and local facial musculature. To achieve satisfactory functional and aesthetic results, reconstruction of such defects requires careful three-dimensional restoration of all missing components, adequate texture matching, as well as functional restoration. Aesthetic reconstruction of facial defects should adhere to the priority goals of first preserving function and second achieving cosmesis. According to the size of the defect, location on the cheek, relationship to adjacent ... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=1943792 Sat, 08 Nov 2008 14:27:00 +0100 1943792 http://www.medworm.com/index.php?rid=1943791&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1095887 This article will review basic anatomy, principles, and pearls of reconstruction for simple to complex scalp defects. Included will be anatomic considerations, indications and contraindications for reconstruction, and an overview of reconstructive options.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=1943791 Sat, 08 Nov 2008 14:27:00 +0100 1943791 http://www.medworm.com/index.php?rid=1943790&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1095886 Seminars in Plastic Surgery 2008; 22: 269-280DOI: 10.1055/s-0028-1095886ABSTRACTLip reconstruction poses a particular challenge to the plastic surgeon in that the lips are the dynamic center of the lower third of the face. Their role in aesthetic balance, facial expression, speech, and deglutination is not replicated by any other tissue substitute. The goals of lip reconstruction are both functional and aesthetic, and the surgical techniques employed are often overlapping. This discussion will focus on lip defects with significant tissue loss that require flap reconstruction. Flaps described include Webster-Bernard cheek advancement flaps, Abbe cross-lip flaps, Karapandzic rotation advancement flaps, and single and dual free-flap lip reconstructions. The principles and techniques described... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=1943790 Sat, 08 Nov 2008 14:27:00 +0100 1943790 http://www.medworm.com/index.php?rid=1943789&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1095885 This article provides an overview of nasal reconstruction with brief descriptions of subtle nuances involving certain techniques that the authors believe help their overall outcomes. The major aspects of nasal reconstruction are included: lining, support, skin coverage, local nasal flaps, nasolabial flap, and paramedian forehead flap. The controversy of the subunit reconstruction versus defect-only reconstruction is briefly discussed. The authors believe that strictly adhering to one principle or another limits one's options, and the patient will benefit more if one is able to apply a variety of options for each individualized defect. A different approach to full-thickness skin grafting is also briefly discussed as the authors propose its utility in lower third reconstruction. In general, ... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=1943789 Sat, 08 Nov 2008 14:27:00 +0100 1943789 http://www.medworm.com/index.php?rid=1943788&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1095884 Seminars in Plastic Surgery 2008; 22: 247-256DOI: 10.1055/s-0028-1095884ABSTRACTSince the inception of Mohs micrographic surgery in the 1930s, this technique has proved its utility in the treatment of cutaneous tumors. This review describes the technique of Mohs micrographic surgery and the various indications for which it is used. We discuss the use of Mohs micrographic surgery for the following cutaneous tumors: basal cell carcinoma, squamous cell carcinoma, melanoma in situ, dermatofibrosarcoma protuberans, Merkel cell carcinoma, microcystic adnexal carcinoma, atypical fibroxanthoma, and sebaceous carcinoma. Mohs micrographic surgery is cost effective in the U.S. health care system because billing for the surgeon-pathologist and laboratory processing is bundled together. However, Mohs m... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=1943788 Sat, 08 Nov 2008 14:27:00 +0100 1943788 http://www.medworm.com/index.php?rid=1943787&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1095883 Seminars in Plastic Surgery 2008; 22: 245-245DOI: 10.1055/s-0028-1095883© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=1943787 Sat, 08 Nov 2008 14:27:00 +0100 1943787 http://www.medworm.com/index.php?rid=1943786&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-0028-1095882 Seminars in Plastic Surgery 2008; 22: 243-243DOI: 10.1055/s-0028-1095882© Thieme Medical PublishersGet connected:Table of contents  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=1943786 Sat, 08 Nov 2008 14:27:00 +0100 1943786 http://www.medworm.com/index.php?rid=1902591&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-2008-1081406 Seminars in Plastic Surgery 2008; 22: 234-241DOI: 10.1055/s-2008-1081406ABSTRACTLimb salvage has now replaced amputation as the standard treatment for primary bone tumors and can usually be offered to more than 85% of patients. Recently, a novel approach to limb salvage has been described by Capanna and colleagues whereby a massive bone allograft and intramedullary vascularized fibula are combined to reconstruct large, segmental bone defects. This produces a structurally competent reconstruction with enhanced vascular and osteogenic capabilities and the potential to achieve lower rates of infection, fracture, and nonunion. The Capanna technique has become a well-established means of long bone reconstruction and limb salvage in cases of large bony resection. The operative technique and repo... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=1902591 Fri, 24 Oct 2008 14:49:27 +0100 1902591 http://www.medworm.com/index.php?rid=1902590&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-2008-1081405 This article provides an overview of the anatomic basis, indications, and operative technique for the use of this flap.[...]© Thieme Medical PublishersGet connected:Table of contents  |  Abstract  |  Full text (Source: Seminars in Plastic Surgery) Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=1902590 Fri, 24 Oct 2008 14:49:27 +0100 1902590 http://www.medworm.com/index.php?rid=1902589&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-2008-1081404 Seminars in Plastic Surgery 2008; 22: 213-227DOI: 10.1055/s-2008-1081404ABSTRACTVascularized bone grafts (VBGs) are techniques in the management of certain types of carpal pathology. VBGs have traditionally been advocated for conditions including delayed and nonunion of fractures and avascular necrosis. The most common indications for VBG have been for scaphoid nonunion, lunatomalacia (Kienböck's disease), and osteonecrosis of the scaphoid (Preiser's disease). Advantages over NVBG have been established. VBGs provide improved blood flow, osteocyte preservation, and accelerated healing rates. Local pedicled VBGs are the most commonly used methods. They are technically less demanding than are free VBGs and are associated with less morbidity. Commonly used donor grafts arise from the dorsal v... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=1902589 Fri, 24 Oct 2008 14:49:27 +0100 1902589 http://www.medworm.com/index.php?rid=1902588&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-2008-1081403 Seminars in Plastic Surgery 2008; 22: 195-212DOI: 10.1055/s-2008-1081403ABSTRACTThe relatively new concept and technique of microvascular joint transplantation for the correction of the congenitally deformed wrist is presented with a series of 24 operated radial club hands. The results from the 19 upper extremities with a mean follow-up of 11 years show that the new technique will not diminish the longitudinal growth of the ulna. The ulna length in the series is now 15.4 cm in mean and will develop further and presumably better than that reported in the previous long-term studies after centralization. The superiority in wrist active mobility compared with those of some previous long-term studies is reported with total active motion of 83 degrees in mean. The radial deviation deformity has ... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=1902588 Fri, 24 Oct 2008 14:49:27 +0100 1902588 http://www.medworm.com/index.php?rid=1902587&cid=s_36602_9_f&fid=36602&url=http%3A%2F%2Fwww.thieme-connect.com%2FDOI%2FDOI10.1055%2Fs-2008-1081402 Seminars in Plastic Surgery 2008; 22: 186-194DOI: 10.1055/s-2008-1081402ABSTRACTDistal radius reconstruction in children should meet two requests: restoration of some joint function and preservation of the physiologic growth of the segment. None of the conventional options is likely to successfully achieve both goals. Conversely, a vascularized transfer of the proximal fibula including the growth plate provides enough bone stock for diaphyseal reconstruction, an articular surface for joint function, and the potential for longitudinal growth. From 1992 to 2006, eight children ranging in age between 2 and 10 years underwent a vascularized transfer of the proximal fibula for distal radius reconstruction after bone sarcoma resection. The follow-up ranges were between 1 year and 15 years. All t... Seminars in Plastic Surgery journals http://www.medworm.com/rss/comments.php?id=1902587 Fri, 24 Oct 2008 14:49:27 +0100 1902587