Plastic Surgery Center Research Articles

Electric hair straightener burns an epidemiological and thermodynamic study

Hair straighteners are a popular beauty product in the UK. An alarming rise in admissions to the Welsh Centre for Burns and Plastic Surgery, for burns caused by hair straighteners has led to this study. A thermodynamic study was also performed to look at temperature range and cooling profiles of these devices. Thirty-one cases were identified over a 32-month period, January 2003 to August 2006. Ninety-three percent (29 cases) were children with an average age of 4 years. The majority of burns were partial thickness to hands and feet, but 23% (seven cases) required admission and 10% (three cases) required surgical intervention. The hair straighteners reached a maximum temperature of 145 °C within 2 min of activation and took up to 7 min to cool below a temperature that would burn adult skin with a 1 s contact. Children and crawling babies are at particular risk from preventable burns from hair straighteners. The frequency of burns from hair straighteners is rising and even small burns to the hand can have serious sequelae and need to be treated in specialist centres. Health promotion and discussion with the industry is required to stop this new and increasing problem.

Repair of the Pixie Ear Deformity with Modified V to Y Plasty during Rhytidectomy

Introduction: The “pixie ear,” an attached, tapering, inferiorly displaced ear lobule may be congenital or iatrogenic. As a postrhytidectomy complication, the pixie ear deformity is the hallmark of excessive skin tension and a telltale sign of surgery. It is often the result of excessive skin excision or anchoring of the skin to the ear lobule causing it to become displaced in an anterio-inferior direction with elongation and obliteration of the free-hanging edge. Methods: Described is a method of correction useful in addressing both congenital and iatrogenic pixie ear deformities during rhytidectomy that uses a modified V to Y advancement flap where the advanced “V” portion is excised with the redundant skin and the vertical portion of the “Y” is hidden along the contour of the newly created lobule. Results: This technique, used in every patient presenting for rhytidectomy from July 1, 2003, to June 30, 2007, with iatrogenic or congenital pixie ear deformity (n > 30 at the Lasky Clinic and the Georgia Center for Facial Plastic Surgery) results in restoration of the natural, rounded, free border of the ear lobule, while avoiding any conspicuous skin incisions beyond that of the standard rhytidectomy. Conclusions: This method for correcting the pixie ear deformity is easily incorporated into the rhytidectomy and yields excellent cosmetic results. It is useful in correcting iatrogenic pixie ear during revision rhytidectomy or in correcting congenital pixie ear during primary rhytidectomy.

Prediction of Morbidity and Mortality on Admission to a Burn Unit

Sir: We thank Brusselaers and her colleagues for their enlightening remarks about our article, “Prediction of Morbidity and Mortality on Admission to a Burn Unit” (Plast. Reconstr. Surg. 118: 116, 2006). It seems, however, that our point was somehow missed by our respected colleagues. There is no doubt that a study with a larger population, if it is performed correctly, is better than study with a smaller one. In this line of thinking, a multicenter, 10,000-patient study will give more valid results than the described study, but that was not our point! Brusselaers’ 20-year analysis period is a very long one in terms of the development of intensive care and wound care methods. We think that, given the innovations in intensive care strategies and modern wound care, even our data are outdated compared with our current results. Basing one’s study on the known risk factors in the literature can sometimes direct the study in the “expected” ways and not reveal the real factors in that population of patients. With regard to the patients who represented the subgroup of burn patients who were admitted to our burn unit, we believe we have obtained reasonable predictive results. It is true that our clinical experience tells us that age is a major factor in the morbidity and mortality of burn patients, but an analysis of our results yielded a different conclusion. To summarize, our study is a single-center analysis of burn patient outcome. It does not pretend to apply to other places, and its life span is limited until supportive and/or wound care management is changed. Every major burn care facility should conduct an ongoing analysis of patient outcome and should act according to its results. Dean D. Ad-El, M.D. Sagit Meshulam Derazon, M.D. Department of Plastic Surgery and Burn Unit Rabin Medical Center affiliated with the Tel Aviv University School of Medicine Petah Tikva, Israel

The ???Reverse??? Latissimus Dorsi Myocutaneous Flap for Reconstruction of the Gluteal Region

Artion Plastic Surgery Center, Athens, Greece Correspondence to Dr. Zambacos, 27 Skoufa Street, Athens 10673, Greece, [email protected]

P700 Comparison of antibiotics susceptibility of different vancomycin-resistant Enterococcus faecium clones

This study analyses staphylococcal septicaemia in a series of 1516 burn patients who were admitted to the burn unit of the Al-Babtain Centre for Burns and Plastic Surgery, Ibn Sina Hospital, Kuwait over a period of 6.5 years (1 June 1992–31 December 1998). One hundred and nine patients (7.2%) developed clinically and microbiologically proven septicaemia, of which 80 (73.4%) showed one or the other type of Staphylococcus in their blood. Fifty (62.5%) of them were males and 30 (37.5%) females, with a mean age of 26 years and the mean total body surface area of burns (TBSA) of 45% (range 1–93%). Preschool age children comprised 27.5% of the patients. Flame was the dominant (80%) cause of burn. Of the 80 patients who had 91 episodes of septicaemia, 52 (65%) had MRSA, 8 (10%) MSSA, 11 (13.8%) MRSE and 5 (6.2%) MSSE and 4 (5%) others had mixed organisms. Only the patients with MRSA had multiple episodes. Eight patients (10%) showed septicaemic episodes within only 48 h of admission; however, the majority of the patients (77.5%) had a septicaemic attack within 2 weeks postburn. Of the 52 MRSA septicaemic cases, 39 (75%) survived and 13 (25%) died. Four patients with septicaemia due to mixed infections died. A total of 19 patients were intubated, 14 due to inhalation injury and 5 because of septicaemia; all in the former group died. Glycopeptide therapy (vancomycin/teicoplanin) was instituted immediately following the detection of staphylococci in the blood. No significant difference was noted in relation to mortality amongst the septicaemic patients, whether or not on prophylactic antibiotic. Fifty-six (70%) of the 80 patients had 139 sessions of skin grafting and survived. Of the 52 MRSA patients, 40 had 101 sessions of skin grafting and 33 of them survived. The apparent low mortality was probably due to early detection of the organism, appropriate antibiotic therapy, care for nutrition and early wound cover. This study indicates a high incidence of staphylococcal septicaemia (especially due to MRSA) in the burn unit. A surface wound is the likely source of entry to the blood stream in these immunocompromised patients. The organism could be detected in blood as early as 48 h postburn and in as little TBSA burn as 1% in this MRSA endemic unit. Inhalation injury with major burns and added staphylococcal septicaemia invariably proved to be fatal.

Dr Robert Malcolm Mcfarlane: May 28, 1927 – February 27, 2006

Dr Robert Malcolm Mcfarlane: May 28, 1927 – February 27, 2006

The Incidence of Tuberous Breast Deformity in Asymmetric and Symmetric Mammaplasty Patients

Artion Plastic Surgery Center; Athens, Greece Correspondence to Dr. Zambacos; 27 Skoufa Street; Athens 10673, Greece; [email protected]

Economic Performance of a Center for Microsurgery and Complex Reconstruction at an Academic Medical Center

Economic pressures have strongly influenced the development of reconstructive surgery, with a long trend of decreasing numbers of reconstructive surgery practices and procedures associated with decreasing reimbursements. Previously, these authors have reported an analysis model to evaluate the financial impact of reconstructive cases on hospital revenues, with the added premise, that if profits existed, they could be partially used to support and further develop reconstructive practice. They have applied this model to assess the performance of an operational reconstructive surgery center.

Complication Rates in Inferior Pedicle Reduction Mammaplasty

Artion Plastic Surgery Center, Athens, Greece Correspondence to Dr. Zambacos, Artion Plastic Surgery Center, 11 D. Vasiliou Street, N. Psychiko, Athens 15451, Greece, [email protected]

1376: Reliability and Agreement on Interpretation of Urodynamic Studies among Physicians in a Multi-Specialty Female Pelvic Medicine & Reconstructive Surgery Center

1376: Reliability and Agreement on Interpretation of Urodynamic Studies among Physicians in a Multi-Specialty Female Pelvic Medicine & Reconstructive Surgery Center

Penile Resurfacing With Vascularized Fascia Lata

No AccessJournal of UrologyAdult urology1 Feb 2006Penile Resurfacing With Vascularized Fascia Lata A.I. Gravvanis, D.A. Tsoutsos, T.G. Iconomou, and S.G. Papadopoulos A.I. GravvanisA.I. Gravvanis More articles by this author , D.A. TsoutsosD.A. Tsoutsos More articles by this author , T.G. IconomouT.G. Iconomou More articles by this author , and S.G. PapadopoulosS.G. Papadopoulos More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)00420-9AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Penile Resurfacing With Vascularized Fascia Lata." The Journal of Urology, 175(2), p. 594 Department of Plastic Surgery, Microsurgery and Burn Center, General State Hospital of Athens “G. Gennimatas,” Athens, Greece© 2006 by American Urological AssociationFiguresReferencesRelatedDetails Volume 175Issue 2February 2006Page: 594 Advertisement Copyright & Permissions© 2006 by American Urological AssociationMetricsAuthor Information A.I. Gravvanis More articles by this author D.A. Tsoutsos More articles by this author T.G. Iconomou More articles by this author S.G. Papadopoulos More articles by this author Expand All Advertisement PDF DownloadLoading ...

Surgical Treatment of an Unusual Patient With Proteus Syndrome

From the *Al-Babtain Center for Plastic and Craniofacial Surgery, Iben Sina Hospital; and the †Department of Surgery, Division of Plastic Surgery, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait. Kuwait City, Kuwait Address correspondence and reprint requests to Dr. Anwar A. Ali, Ibn Sina & Babtain Hospital, Kuwait City, Kuwait 44000; E-mail: [email protected]. The authors thank Dr. Rameshwar Bang for his guidance and support in plastic surgery and the care of this patient.

Dennis J. Hurwitz, M.D., F.A.C.S.

I want to thank Dr. Dennis J. Hurwitz for serving as guest editor of this issue of Seminars in Plastic Surgery on the topic of “Post-Bariatric Body Contouring” and the group of outstanding authors who contributed to this issue. Dr. Dennis J. Hurwitz is a Clinical Professor of Surgery (Plastic) at the University of Pittsburgh School of Medicine. He is also Director of the Hurwitz Center for Plastic Surgery in Pittsburgh. He has treated thousands of individuals with cosmetic concerns, structural defects, and congenital deformities. Dr. Hurwitz has innovated new techniques in obesity surgery and is well known for the “total body lift” procedure that he pioneered. He is a diplomat of the American Board of Plastic Surgery and a member of numerous plastic surgery societies. Dr. Hurwitz lectures internationally and throughout the nation and has published more than 100 articles on plastic surgery and most recently published a book on total body lift surgery.

Maxillo-facial laboratory technique and facial prostheses. By Stanley Brasier, Chief Technician, Prosthetic Laboratory, Plastic Surgery, Burns and Jaw Injury Centre, St. Lawrence Hospital, Chepstow, Mon. With a Foreword by Sir William Kelsey Fry, C.B.E., M.C., F.R.C.S., M.D.S., F.D.S.R.C.S. 9½ × 6 in. Pp. 232 + xi, with 291 illustrations. 1954. London: Henry Kimpton. 31s. 6d

Maxillo-facial laboratory technique and facial prostheses. By Stanley Brasier, Chief Technician, Prosthetic Laboratory, Plastic Surgery, Burns and Jaw Injury Centre, St. Lawrence Hospital, Chepstow, Mon. With a Foreword by Sir William Kelsey Fry, C.B.E., M.C., F.R.C.S., M.D.S., F.D.S.R.C.S. 9½ × 6 in. Pp. 232 + xi, with 291 illustrations. 1954. London: Henry Kimpton. 31s. 6d Get access Maxillo-facial Laboratory Technique and Facial Prostheses. By StanleyBrasier, Chief Technician, Prosthetic Laboratory, Plastic Surgery, Burns and Jaw Injury Centre, St. Lawrence Hospital, Chepstow, Mon. With a Foreword by William KelseyFrySir, C.B.E., M.C., F.R.C.S., M.D.S., F.D.S.R.C.S. 9½ × 6 in. Pp. 232 + xi, with 291 illustrations. 1954. London: Henry Kimpton. 31s. 6d. British Journal of Surgery, Volume 42, Issue 173, November 1954, Page 333, https://doi.org/10.1002/bjs.18004217323 Published: 06 December 2005

Adamantinoma; a brief review of the condition, with a description of a case treated by immediate replacement with a tantalum and acrylic prosthesis following resection of the affected area of the mandible.

Journal Article Adamantinoma. A brief review of the condition, with a description of a case treated by immediate replacement with a tantalum and acrylic prosthesis following resection of the affected area of the mandible Get access W G Holdsworth, W G Holdsworth Consultant Plastic Surgeon The Plastic and Oral Surgery Centre, Rooksdown House, Basingstoke, Hants Search for other works by this author on: Oxford Academic Google Scholar N L Rowe N L Rowe Consultant Oral Surgeon The Plastic and Oral Surgery Centre, Rooksdown House, Basingstoke, Hants Search for other works by this author on: Oxford Academic Google Scholar British Journal of Surgery, Volume 43, Issue 179, November 1955, Pages 255–260, https://doi.org/10.1002/bjs.18004317904 Published: 06 December 2005

Burns and their Treatment. By I. F. K. Muir, M.B.E., M.B., M.S. (Lond.), F.R.C.S. (Eng.), Consultant Surgeon, Mount Vernon Centre for Plastic Surgery, Northwood, and T. L. Barclay, M.B., Ch.B. (Edin.), Consultant Plastic Surgeon, Pinderfields General Hospital, Wakefield. 8½ × 5½ in. Pp. 148 +viii. Illustrated. 1962. London: Lloyd-Luke Ltd. 27s. 6d

Burns and their Treatment. By I. F. K. Muir, M.B.E., M.B., M.S. (Lond.), F.R.C.S. (Eng.), Consultant Surgeon, Mount Vernon Centre for Plastic Surgery, Northwood, and T. L. Barclay, M.B., Ch.B. (Edin.), Consultant Plastic Surgeon, Pinderfields General Hospital, Wakefield. 8½ × 5½ in. Pp. 148 +viii. Illustrated. 1962. London: Lloyd-Luke Ltd. 27s. 6d Get access Burns and their Treatment. By I F K Muir, M.B.E., M.B., M.S. (Lond.), F.R.C.S. (Eng.), Consultant Surgeon, Mount Vernon Centre for Plastic Surgery, Northwood, and T L Barclay, M.B., Ch.B. (Edin.), Consultant Plastic Surgeon, Pinderfields General Hospital, Wakefield. 8½ × 5½ in. Pp. 148 + viii. Illustrated. 1962. London: Lloyd-Luke Ltd. 27s. 6d. British Journal of Surgery, Volume 50, Issue 222, January 1963, Page 454, https://doi.org/10.1002/bjs.18005022230 Published: 06 December 2005

Hospital Transfer and Death Resulting From In-Office Surgical Procedures

Archives of Facial Plastic SurgeryVol. 7, No. 6 Abstracts: CommentaryHospital Transfer and Death Resulting From In-Office Surgical ProceduresVigilance Still RequiredRonald E. IversonRonald E. IversonCorrespondence: Dr Iverson, The Plastic Surgery Center, 1387 Santa Rita Rd, Pleasanton, CA 94566 E-mail Address: REIversonMD@sbcglobal.netSearch for more papers by this authorPublished Online:1 Nov 2005https://doi.org/10.1001/archfaci.7.6.422AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View article"Hospital Transfer and Death Resulting From In-Office Surgical Procedures." Archives of Facial Plastic Surgery, 7(6), p. 422FiguresReferencesRelatedDetails Volume 7Issue 6Nov 2005 InformationCopyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.To cite this article:Ronald E. Iverson.Hospital Transfer and Death Resulting From In-Office Surgical Procedures.Archives of Facial Plastic Surgery.Nov 2005.422-422.http://doi.org/10.1001/archfaci.7.6.422Published in Volume: 7 Issue 6: November 1, 2005PDF download

Postoperative Management of Nasal Vestibular Stenosis

To evaluate the effect of a custom-made postoperative vestibular device on the occurrence and severity of restenosis. This was a retrospective study conducted at the Department of Otorhinolaryngology/Head and Neck Surgery, Center for Facial Plastic and Reconstructive Surgery of the Academic Medical Center. In this tertiary care center between January 1994 and December 2000, 52 patients treated for nasal vestibular stenosis received a vestibular device directly postoperatively, with the intention to decrease the risk of restenosis. The vestibular device was composed of thermoplastic acrylic material and had a lumen to facilitate breathing. The shape of the device was custom-made within 1 week after surgery and was subsequently worn by the patient for 12 weeks (6 weeks continuously and 6 weeks only during the night). After this period, the occurrence and severity of restenosis of the nasal vestibule were evaluated and the necessity for a potential adjuvant operation was assessed. Preoperatively, of the 52 patients, 38 (73%) had severe stenosis, 13 (25%) had moderate stenosis, and 1 (2%) had mild stenosis. Postoperatively, 15 (29%) of the patients had mild restenosis, 1 had a case of moderate stenosis, and 1 had a case of severe stenosis. Only the latter patient required a subsequent revision. Functional improvement was noticed in 51 (98%) of the patients, whereas 49 (94%) of the patients showed aesthetic improvement after the initial procedure. In case of surgical treatment of vestibular stenosis, the use of a custom-made vestibular device may help prevent restenosis. In addition to functional improvement, the device may also improve the aesthetic result. The device does not seem to have any negative adverse effects, was easy to make, and was comfortable for the patient to wear.

170: Laparoscopic Mesh-Sacrovaginopexy for Pelvic Organ Prolapse

To evaluate the efficacy of our technique of laparoscopic mesh-sacrovaginopexy (LMSVP) for pelvic organ prolapse (POP). Retrospective analysis of 122 patients with POP operated on in our clinic between 2003 and 2004. Gynecology Department of the Cosmetology and Plastic Surgery Center. One hundred twenty two patients (ages 35-55 yrs) with POP including 46 operated on using our technique and 76 by other approaches; 22% of patients had history of hysterectomy. Our technique of laparoscopic sacrovaginopexy with Prolene mesh implied anchoring the mesh to anterior vaginal vault (after bladder shift downwards), cervix, and posterior vaginal wall in extraperitoneal tunnel under the promontory in one block, followed by reperitonealization. LMSVP achieved resolution of preexistent vaginoperineal symptoms in 42 (91%) patients; 3 patients reported pelvic pain at rest and under physical load; 1 patient had POP recurrence due to mesh rejection, which required revision using a different approach. No mesh erosion was observed. LMSVP is an effective treatment for POP, providing support between sacro-uteral ligaments, rectovaginal septum, vaginal vault and presacral ligament; fast recovery after simultaneous repair of cystocele and rectocele in one block with one mesh, minimizing operative time and complications.

Extracorporeal Septoplasty for the Markedly Deviated Septum

To describe a technique of extracorporeal septal reconstruction to correct the markedly deviated nasal septum. Retrospective medical chart review of 2119 patients undergoing extracorporeal septoplasty from January 1, 1981, through July 31, 2004, by the author in a tertiary care facial plastic surgery center. The main outcomes measured included surgical complications, revision rate, and the surgeon's subjective determination of functional and aesthetic outcomes. Of the 2119 patients, 2 cohorts were available for review. From January 1, 1981, to July 31, 1987, the author performed the operation on 459 patients. Fifty-seven complications (12%) occurred, with irregular contour of the dorsum or saddling noted in 38 (8%). Twenty patients (4%) elected to have revision septoplasty. From January 1, 1996, to December 31, 1996, the author supervised residents performing extracorporeal septoplasty in 108 patients. Fourteen postoperative complications (13%) occurred, with dorsal irregularity noted in 12 (11%). Eight patients (7%) elected to have revision septoplasty. Extracorporeal septal reconstruction is an important surgical option for the correction of the markedly deviated nasal septum. Fixation of the straightened and replanted septum at the nasal spine and dorsal septum border with the upper lateral cartilages is essential. Spreader grafts for stabilization of the internal nasal valve and dorsal onlay grafts to prevent dorsal irregularity are strongly encouraged.