• Title/Summary/Keyword: Plastic Surgery

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Evolving the Cybersecurity of Clinical Photography in Plastic Surgery

  • Daisy L. Spoer;Alexandra Junn;John D. Bovill;Zoe K. Haffner;Andrew I. Abadeer;Stephen B. Baker
    • Archives of Plastic Surgery
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    • v.50 no.4
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    • pp.443-444
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    • 2023
  • Point-of-care photography and photo sharing optimize patient outcomes and facilitate remote consultation imperative for resident surgeons. This literature review and external pilot survey study highlight the risks associated with current practices concerning patient privacy and biometric security. In a survey of 30 plastic surgeon residents and attendings, we found that the majority took photos of patients with their iPhones and shared them with colleagues via Apple iMessage. These findings corroborate previous reports and highlight a lack of physician user acceptance of secure photo-sharing platforms. Finally, we frame a successful example from the literature in the context of a postulated framework for institutional change. Prioritizing the privacy and safety of patients requires a strategic approach that preserves the ease and frequency of use of current practices.

Gastroepiploic Artery Preservation with Glycerol as a Training Model for Microvascular Anastomosis (미세혈관문합술의 연습 모델로서 글리세롤 처리된 위대망동맥의 활용)

  • Park, Chan Young;Chang, Hak;Chung, Jin Haeng;Heo, Eun Ju;Minn, Kyung Won;Yoo, Moon Won;Yang, Han Kwang
    • Archives of Plastic Surgery
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    • v.35 no.5
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    • pp.626-629
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    • 2008
  • Purpose: We investigate the possibility of vessel preservation with glycerol and evaluate the potential of preserved gastroepiploic artery as a tool for the microsurgical practice. Methods: In 5 early gastric cancer patients, IRB(No. C-0603-040-170), we gained gastroepiploic artery specimens(5 segments, about 10 cm) after gastrectomy. Each segment was rinsed in a normal saline and subsequently placed in a bottle, containing 50 mL anhydrous glycerol (87%). The bottles were refrigerated at $4^{\circ}C$, the longest preservation time being 5 months. Results: At first glance, no fragmentation was detected and the surface of vessel seemed mild sclerotic. In histological examination, vascular structures remained intact though preservation with glycerol led to a mild atrophy of the smooth muscle in the tunica media. Especially, we found out the elastic fibers and endothelial lining of the intima were preserved until 5 months. Adequate status for using microsurgical practice was also maintained and leakage test was performed successfully with gentian violet ink. Conclusion: Based on the results obtained in this study, the gastroepiploic artery preservation with glycerol as a training model for microvascular anastomosis is a technically very simple procedure and useful for the novice microsurgeon.

A multi-institutional analysis of sternoclavicular joint coverage following osteomyelitis

  • Othman, Sammy;Elfanagely, Omar;Azoury, Said C.;Kozak, Geoffrey M.;Cunning, Jessica;Rios-Diaz, Arturo J.;Palvannan, Prashanth;Greaney, Patrick;Jenkins, Matthew P.;Jarrar, Doraid;Kovach, Stephen J.;Fischer, John P.
    • Archives of Plastic Surgery
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    • v.47 no.5
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    • pp.460-466
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    • 2020
  • Background Sternoclavicular joint (SCJ) osteomyelitis is a rare pathology requiring urgent intervention. Several operative approaches have been described with conflicting reports. Here, we present a multi-institutional study utilizing multiple surgical pathways for SCJ reconstruction. Methods A multi-institutional retrospective cohort study was conducted to identify patients who underwent surgical repair for sternoclavicular osteomyelitis between 2008 and 2019. Patients were stratified according to reconstruction approach: single-stage reconstruction with advancement flap and delayed-reconstruction with flap following initial debridement. Demographics, operative approach, type of reconstruction, and postoperative outcomes were analyzed. Results Thirty-two patients were identified. Mean patient age was 56.2±13.8 years and 68.8% were male. The average body mass index (BMI) was 30.0±8.8 kg/㎡. The most common infection etiologies were intravenous drug use and bacteremia (both 25%). Fourteen patients (43.8%) underwent one-stage reconstruction and 18 (56.2%) underwent delayed two-staged reconstruction. Both single and delayed-stage groups had comparable rates of reinfection (7.1% vs. 11.1%, respectively), surgical site complications (21.4% vs. 27.8%), readmissions (7.1% vs. 16.6%), and reoperations (7.1% vs. 5.6%; all P>0.05). The single-stage reconstruction group had a significantly lower BMI (26.2±5.7 kg/㎡ vs. 32.9±9.1 kg/㎡; P<0.05) and trended towards shorter hospital length of stay (11.3 days vs. 17.9 days; P=0.01). Conclusions Both single and delayed-stage approaches are appropriate methods with comparable outcomes for reconstruction for SCJ osteomyelitis. When clinically indicated, a single-stage reconstruction approach may be preferable in order to avoid a second operation as associated with the delayed phase, and possibly shortening total hospital length of stay.

Mechanical irritation by protruding bone: A possible cause of breast implant rupture

  • Aitzetmuller, Matthias Michael;Haslhofer, David Johannes;Wenny, Raphael;Schmidt, Manfred;Duscher, Dominik;Huemer, Georg Michael
    • Archives of Plastic Surgery
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    • v.45 no.5
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    • pp.470-473
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    • 2018
  • Although breast implants have been in clinical use for almost 6 decades and have undergone considerable development during this time, implant rupture is still a dreaded long-term complication. Some obvious external factors, such as trauma, can lead to implant rupture, but many studies have reported a high rate of "spontaneous" implant rupture. Herein, we present two cases with the aim of raising awareness of a new possible cause of "spontaneous" implant rupture: mechanical irritation by bony protrusions.