Christopher Salgado MD - Academia.edu (original) (raw)

Papers by Christopher Salgado MD

Journal of Surgical Case Reports

The authors report a case series of five patients with Leneva grafted into the nose, hand, genita... more The authors report a case series of five patients with Leneva grafted into the nose, hand, genitalia and below-the-knee stump. Leneva is an allograft adipose matrix derived from aseptically processed human adipose tissue with retained matrix proteins, growth factors, cytokines and collagens. It is manufactured hydrated and is available in pre-loaded syringes. Five patients (3F, 2 M) with a mean age of 50.7 (range 31–77 years) injected with a mean volume of 4.2 cc (range 3–6 cc) of Leneva in various anatomic locations with an average follow up time of 4.25 months (range 0.5–12 months) experienced no allergic reactions, infection, fat necrosis or oil cysts. All patients were pleased with the restoration of fullness to the injected site. The authors believe that Leneva is a promising multi-use filler for restoring soft tissue defects following resection of tumours, to rejuvenate age-related atrophy, aesthetically enhance the genitals and provide padding for transtibial prostheses.

Global Journal of Medical Research, 2021

Background: Our goal in the construction of the transman phalloplasty is not only to decrease the... more Background: Our goal in the construction of the transman phalloplasty is not only to decrease the patient’s level of gender dysphoria, obviate the use of an external prosthesis, give the patient the ability to urinate in the standing position and orgasm but also to decrease urinary complications. Material and Methods: A retrospective review of transmen patients from June 2016 to June 2018 was performed on patients undergoing a two- stage mucosa only prelaminated neourethra radial forearm flap phalloplasty. The surgical technique is detailed in addition to patient demographics including co-morbidities, flap complications, and urinary sequelae.

Operative Procedures in Plastic, Aesthetic and Reconstructive Surgery, 2016

Journal of the American College of Surgeons, 2019

INTRODUCTION: Hepatitis C virus (HCV) is a blood-borne viral infection that has considerable morb... more INTRODUCTION: Hepatitis C virus (HCV) is a blood-borne viral infection that has considerable morbidity. As the opioid epidemic escalates, rates of HCV diagnoses have similarly risen. Surgeons exposed intraoperatively due to sharp-sticks are affected both socioeconomically and physically. Current treatment strategies involve antiretroviral agents that are not universally available. This study evaluates the current risk of plastic surgeon exposure to HCV. METHODS: CDC data regarding state-by-state HCV diagnosis reporting was combined with plastic surgery workforce data from the American Society of Plastic Surgery. Proxy variables for exposure risk to HCV were generated for each state and compared. RESULTS: West Virginia plastic surgeons were found to have a significantly elevated risk of exposure (60.0 vs 18.7, p < 0.0001). Their exposure risk is a major outlier compared to the rest of the country (risk > 3 x interquartile range þ 75 th percentile). States within the Ohio Valley were found to be at increased risk (34.8 vs 16.0, p ¼ 0.05). States most heavily burdened by the opioid crisis were found to be at an increased risk for HCV exposure (40.8 vs 13.6, p ¼ 0.0003). CONCLUSION: Plastic surgeons who work in states within the Ohio Valley region were found to be at an increased risk of exposure to HCV. Plastic surgeons operating in states severely impacted by the opioid crisis were also found to be at increased risk of exposure. These findings underscore the importance of reducing the risk in the operating room and the need for better data collection to better understand this association and mitigate risk to the operating surgeon.

The Journal of Sexual Medicine, 2019

Introduction Some transgender men express the wish to undergo genital gender-affirming surgery. M... more Introduction Some transgender men express the wish to undergo genital gender-affirming surgery. Metoidioplasty and phalloplasty are procedures that are performed to construct a neophallus. Genital gender-affirming surgery contributes to physical well-being, but dissatisfaction with the surgical results may occur. Disadvantages of metoidioplasty are the relatively small neophallus, the inability to have penetrative sex, and often difficulty with voiding while standing. Therefore, some transgender men opt to undergo a secondary phalloplasty after metoidioplasty. Literature on secondary phalloplasty is scarce. Aim Explore the reasons for secondary phalloplasty, describe the surgical techniques, and report on the clinical outcomes. Methods Transgender men who underwent secondary phalloplasty after metoidioplasty were retrospectively identified in 8 gender surgery clinics (Amsterdam, Belgrade, Bordeaux, Austin, Ghent, Helsinki, Miami, and Montreal). Preoperative consultation, patient mot...

The Journal of Hand Surgery, 2019

Purpose Nerve transfers for peripheral nerve injuries can result in variable outcomes. We investi... more Purpose Nerve transfers for peripheral nerve injuries can result in variable outcomes. We investigated the neuroprotective effect of epineurial lidocaine injection in the donor nerve prior to transection, with the hypothesis that proximal axon loss would be decreased with consequent increased neuroregeneration and functional recovery. Methods A rat sciatic nerve model was used with 4 intervention groups: (1) lidocaine; (2) lidocaine/ calcium gluconate (CG); (3) CG; or (4) saline (control). Behavioral testing and qualitative and quantitative histological evaluation was performed at 8 and 12 weeks. Histological assays included transmission electron microscopy, retrograde fluorogold labeling, and whole mount immunostaining. Results Functional assessments through the sciatic functional index and Basso, Beattie, and Bresnahan scale showed a statistically significant increase in recovery at 8 and 12 weeks with lidocaine treatment. Significantly higher axonal counts were obtained in the lidocaine-treated groups. Fragmentation and increased myelin damage was present in the CG and saline groups. Retrograde fluorogold labeling showed a statistically significant increase in the number of L4-6 dorsal root ganglion neurons in the lidocaine-treated groups. Whole mount immunostaining identified extension of the axonal growth cone past the nerve coaptation site in lidocainetreated groups, but not in CG and saline groups. Conclusions Our results suggest that epineurial lidocaine injection prior to donor nerve transection for nerve transfer has a neuroprotective effect, resulting in increased proximal axon counts and improved functional recovery. Clinical relevance These findings may have direct clinical application because epineurial lidocaine can be used in surgery as a simple and inexpensive intervention for promoting improved clinical outcomes after nerve transfer.

Journal of Surgical Oncology, 2019

BackgroundTreatment of advanced lymphedema requires not only restoration of physiological lymph d... more BackgroundTreatment of advanced lymphedema requires not only restoration of physiological lymph drainage, but also excision of fibrotic tissue and excess skin. The aim of this study is to show how the combination of double vascularized lymph node transfers (VLNTs) and a modified radical reduction with preservation of perforators (RRPP) can accomplish both of these treatment goals.MethodsBetween 2010 and 2016, 16 patients (15 female and one male) with extremity lymphedema underwent a combined double gastroepiploic VLNTs and modified RRPP. Demographics, outcomes including circumference reduction rates, preoperative and postoperative lymphoscintigraphy, complications, and responses to the Lymphedema Quality of Life (LYMQOL) questionnaire were analyzed.ResultsAll flaps survived. The mean follow‐up period was 14.2 months (range, 12‐19). The mean circumference reduction rate was 74.5% ± 6.9% for the upper limb and 68.0% ± 4.2% for the lower limb. There were no major complications. Minor c...

Clinics in Plastic Surgery, 2018

Facial stigmata associated with one's assigned gender can be very distressing for the gender ... more Facial stigmata associated with one's assigned gender can be very distressing for the gender dysphoric patient. The lower face and neck contain several structures that play a significant role in their ability to "pass" as their desired gender. Clinical recognition and modification of these structures will allow the patient to have facial and neck features that are consistent with their desired gender. This article reviews the techniques of mandibular angle contouring, genioplasty, chondrolaryngoplasty, facelift, and neck lift as they pertain to the feminization and masculinization of the face and neck of the patient with gender dysphoria.

Journal of Hand Surgery (European Volume), 2016

in treating a benign tumour. At the final follow-up after 1 year, shoulder abduction power was st... more in treating a benign tumour. At the final follow-up after 1 year, shoulder abduction power was still M4+; no other problems were found. Neuromuscular choristoma is a very rare benign peripheral nerve tumour comprising mature skeletal myofibres of variable sizes in an intimate relationship with nerve fibres. The natural history of this tumour is not fully characterized. Its benign chronic evolution typically results in limb length and girth discrepancy. It presents typically as a solitary lesion in childhood involving cranial nerves and other large peripheral nerves, most commonly the sciatic nerve. HébertBlouin et al. (2012) identified ten patients with a diagnosis of neuromuscular choristoma treated at the Mayo Clinic between 1992 and 2010. They noted that the diagnosis of this tumour might be underreported. MRI findings are described as pathognomonic and should be enough to make the diagnosis and preclude the need of a biopsy (Niederhauser et al., 2013). Up to 30% of excised or biopsied neuromuscular choristoma developed an aggressive fibromatosis (Hébert-Blouin et al., 2012; Oeppen et al., 2003). Despite its rarity, neuromuscular choristoma has characteristic clinical manifestations (i.e. child age, limb length discrepancy) and MRI features that can lead to diagnosis. The present report may alert the surgeon and radiologist to look for clinical presentations and the MRI findings of neuromuscular choristoma to establish the diagnosis and to avoid a biopsy (Marom and Helms, 1999).

Aesthetic Plastic Surgery, 2017

Mycobacterium chelonae is a nontuberculous mycobacterium, classified as a Runyon type IV mycobact... more Mycobacterium chelonae is a nontuberculous mycobacterium, classified as a Runyon type IV mycobacterium. In relation to humans, it is most commonly associated with tissue trauma or pulmonary infections. The majority of medical reports describe finding M. chelonae in the surgical setting, attributing infection to inadequate sterilization of surgical equipment. Symptoms are often nonspecific and include pain, erythema, and draining subcutaneous nodules and skin lesions. Therefore, the diagnosis of M. chelonae is often difficult to establish without prior suspicion of the disease, but can be confirmed with culture. We will describe the case of a 40-year-old female who contracted M. chelonae infection of the buttocks after abdominal liposuction and gluteal fat injection. We will describe her symptomatology, diagnosis, and successful treatment with surgical excision and antibiotics.

Operative Dictations in Plastic and Reconstructive Surgery, 2016

Pressure sores (ulcers) develop in an area of unrelieved pressure that ultimately leads to tissue... more Pressure sores (ulcers) develop in an area of unrelieved pressure that ultimately leads to tissue ischemia, cell death, and necrosis. Various modalities to include topical therapies, pressure reduction and distribution products, and nutritional support all play a role in treatment; however, surgical debridement and flap coverage provides the most definitive intervention. The posterior thigh fasciocutaneous advancement flap may be used in treatment of ischial and trochanteric pressure sores. Benefits of this flap are that it offers versatility in design and the option of future re-advancement.

Operative Dictations in Plastic and Reconstructive Surgery, 2016

Anal incontinence is distressing for many affected patients. Various etiologies including trauma,... more Anal incontinence is distressing for many affected patients. Various etiologies including trauma, neurologic disorders, and iatrogenic events lead to poor function of the anal sphincter. The gracilis muscle is ideally located and provides an option for treatment of incontinence due to anal sphincter defect, pudendal neuropathy, or after other standard treatment options have failed.

Journal of Plastic, Reconstructive & Aesthetic Surgery, 2016

Esthetic augmentation of the gluteal region can lead to complications including debilitating pain... more Esthetic augmentation of the gluteal region can lead to complications including debilitating pain, infections, wounds, and scars. To our knowledge, a general consensus of staging and treatment guidelines for managing gluteal foreign body reaction to injectables has not yet been established. The objective of this study was to develop a reliable staging system that can be used to implement a treatment algorithm for gluteal foreign body reactions. A retrospective review of 40 patients treated for complications of gluteal injections between September 2010 and May 2014 was performed. Patient symptoms, imaging, and photographs were used to develop a staging system of disease. Institutional review board approval was obtained from the University of Miami Miller School of Medicine. Five independent observers reviewed the patients&amp;amp;amp;amp;#39; documented symptoms and photographs. Using our staging system, the independent observers reviewed the patient cases at two separate time intervals. Intra- and interclass correlation coefficients (ICCs) were computed to assess the reliability for each of the observers. Seven patients were classified as Stage I, fifteen as Stage IIa, nine as Stage IIb, and nine as Stage III. The mean patient age was 34 years (21-50). Analysis of the independent reviewer results revealed ICC for each rater to range from 0.96 to 0.98, demonstrating high indexes of intra-rater reliability. Based on our statistical analysis, we found an excellent inter- and intra-observer reliability, indicating that the staging system is reproducible and reliable. A treatment strategy dependent on the stage can be implemented as a guideline to optimize functional and esthetic outcomes.

Journal of plastic, reconstructive & aesthetic surgery : JPRAS, Jan 14, 2015

Anaplastology, 2013

A wide variety of surgical options exist for abdominal wall reconstruction. Part of the key to su... more A wide variety of surgical options exist for abdominal wall reconstruction. Part of the key to success, however, consist on choosing the operation that will give the most functional and aesthetic result while focusing on measures to decrease the incidence of catastrophic complications and need for reoperation. In this article, we review reconstructive modalities for abdominal wall defects, with special attention to complex ventral hernias and components separation techniques. Our description of recent scientific advances and the emphasis on a multidisciplinary approach to patient care reflects current trend and going forward to the use of bioprosthetic materials. Anaplastology A n ap lastol o g y

Archives of Facial Plastic Surgery, 2002

Journal of Surgical Case Reports

The authors report a case series of five patients with Leneva grafted into the nose, hand, genita... more The authors report a case series of five patients with Leneva grafted into the nose, hand, genitalia and below-the-knee stump. Leneva is an allograft adipose matrix derived from aseptically processed human adipose tissue with retained matrix proteins, growth factors, cytokines and collagens. It is manufactured hydrated and is available in pre-loaded syringes. Five patients (3F, 2 M) with a mean age of 50.7 (range 31–77 years) injected with a mean volume of 4.2 cc (range 3–6 cc) of Leneva in various anatomic locations with an average follow up time of 4.25 months (range 0.5–12 months) experienced no allergic reactions, infection, fat necrosis or oil cysts. All patients were pleased with the restoration of fullness to the injected site. The authors believe that Leneva is a promising multi-use filler for restoring soft tissue defects following resection of tumours, to rejuvenate age-related atrophy, aesthetically enhance the genitals and provide padding for transtibial prostheses.

Global Journal of Medical Research, 2021

Background: Our goal in the construction of the transman phalloplasty is not only to decrease the... more Background: Our goal in the construction of the transman phalloplasty is not only to decrease the patient’s level of gender dysphoria, obviate the use of an external prosthesis, give the patient the ability to urinate in the standing position and orgasm but also to decrease urinary complications. Material and Methods: A retrospective review of transmen patients from June 2016 to June 2018 was performed on patients undergoing a two- stage mucosa only prelaminated neourethra radial forearm flap phalloplasty. The surgical technique is detailed in addition to patient demographics including co-morbidities, flap complications, and urinary sequelae.

Operative Procedures in Plastic, Aesthetic and Reconstructive Surgery, 2016

Journal of the American College of Surgeons, 2019

INTRODUCTION: Hepatitis C virus (HCV) is a blood-borne viral infection that has considerable morb... more INTRODUCTION: Hepatitis C virus (HCV) is a blood-borne viral infection that has considerable morbidity. As the opioid epidemic escalates, rates of HCV diagnoses have similarly risen. Surgeons exposed intraoperatively due to sharp-sticks are affected both socioeconomically and physically. Current treatment strategies involve antiretroviral agents that are not universally available. This study evaluates the current risk of plastic surgeon exposure to HCV. METHODS: CDC data regarding state-by-state HCV diagnosis reporting was combined with plastic surgery workforce data from the American Society of Plastic Surgery. Proxy variables for exposure risk to HCV were generated for each state and compared. RESULTS: West Virginia plastic surgeons were found to have a significantly elevated risk of exposure (60.0 vs 18.7, p < 0.0001). Their exposure risk is a major outlier compared to the rest of the country (risk > 3 x interquartile range þ 75 th percentile). States within the Ohio Valley were found to be at increased risk (34.8 vs 16.0, p ¼ 0.05). States most heavily burdened by the opioid crisis were found to be at an increased risk for HCV exposure (40.8 vs 13.6, p ¼ 0.0003). CONCLUSION: Plastic surgeons who work in states within the Ohio Valley region were found to be at an increased risk of exposure to HCV. Plastic surgeons operating in states severely impacted by the opioid crisis were also found to be at increased risk of exposure. These findings underscore the importance of reducing the risk in the operating room and the need for better data collection to better understand this association and mitigate risk to the operating surgeon.

The Journal of Sexual Medicine, 2019

Introduction Some transgender men express the wish to undergo genital gender-affirming surgery. M... more Introduction Some transgender men express the wish to undergo genital gender-affirming surgery. Metoidioplasty and phalloplasty are procedures that are performed to construct a neophallus. Genital gender-affirming surgery contributes to physical well-being, but dissatisfaction with the surgical results may occur. Disadvantages of metoidioplasty are the relatively small neophallus, the inability to have penetrative sex, and often difficulty with voiding while standing. Therefore, some transgender men opt to undergo a secondary phalloplasty after metoidioplasty. Literature on secondary phalloplasty is scarce. Aim Explore the reasons for secondary phalloplasty, describe the surgical techniques, and report on the clinical outcomes. Methods Transgender men who underwent secondary phalloplasty after metoidioplasty were retrospectively identified in 8 gender surgery clinics (Amsterdam, Belgrade, Bordeaux, Austin, Ghent, Helsinki, Miami, and Montreal). Preoperative consultation, patient mot...

The Journal of Hand Surgery, 2019

Purpose Nerve transfers for peripheral nerve injuries can result in variable outcomes. We investi... more Purpose Nerve transfers for peripheral nerve injuries can result in variable outcomes. We investigated the neuroprotective effect of epineurial lidocaine injection in the donor nerve prior to transection, with the hypothesis that proximal axon loss would be decreased with consequent increased neuroregeneration and functional recovery. Methods A rat sciatic nerve model was used with 4 intervention groups: (1) lidocaine; (2) lidocaine/ calcium gluconate (CG); (3) CG; or (4) saline (control). Behavioral testing and qualitative and quantitative histological evaluation was performed at 8 and 12 weeks. Histological assays included transmission electron microscopy, retrograde fluorogold labeling, and whole mount immunostaining. Results Functional assessments through the sciatic functional index and Basso, Beattie, and Bresnahan scale showed a statistically significant increase in recovery at 8 and 12 weeks with lidocaine treatment. Significantly higher axonal counts were obtained in the lidocaine-treated groups. Fragmentation and increased myelin damage was present in the CG and saline groups. Retrograde fluorogold labeling showed a statistically significant increase in the number of L4-6 dorsal root ganglion neurons in the lidocaine-treated groups. Whole mount immunostaining identified extension of the axonal growth cone past the nerve coaptation site in lidocainetreated groups, but not in CG and saline groups. Conclusions Our results suggest that epineurial lidocaine injection prior to donor nerve transection for nerve transfer has a neuroprotective effect, resulting in increased proximal axon counts and improved functional recovery. Clinical relevance These findings may have direct clinical application because epineurial lidocaine can be used in surgery as a simple and inexpensive intervention for promoting improved clinical outcomes after nerve transfer.

Journal of Surgical Oncology, 2019

BackgroundTreatment of advanced lymphedema requires not only restoration of physiological lymph d... more BackgroundTreatment of advanced lymphedema requires not only restoration of physiological lymph drainage, but also excision of fibrotic tissue and excess skin. The aim of this study is to show how the combination of double vascularized lymph node transfers (VLNTs) and a modified radical reduction with preservation of perforators (RRPP) can accomplish both of these treatment goals.MethodsBetween 2010 and 2016, 16 patients (15 female and one male) with extremity lymphedema underwent a combined double gastroepiploic VLNTs and modified RRPP. Demographics, outcomes including circumference reduction rates, preoperative and postoperative lymphoscintigraphy, complications, and responses to the Lymphedema Quality of Life (LYMQOL) questionnaire were analyzed.ResultsAll flaps survived. The mean follow‐up period was 14.2 months (range, 12‐19). The mean circumference reduction rate was 74.5% ± 6.9% for the upper limb and 68.0% ± 4.2% for the lower limb. There were no major complications. Minor c...

Clinics in Plastic Surgery, 2018

Facial stigmata associated with one's assigned gender can be very distressing for the gender ... more Facial stigmata associated with one's assigned gender can be very distressing for the gender dysphoric patient. The lower face and neck contain several structures that play a significant role in their ability to "pass" as their desired gender. Clinical recognition and modification of these structures will allow the patient to have facial and neck features that are consistent with their desired gender. This article reviews the techniques of mandibular angle contouring, genioplasty, chondrolaryngoplasty, facelift, and neck lift as they pertain to the feminization and masculinization of the face and neck of the patient with gender dysphoria.

Journal of Hand Surgery (European Volume), 2016

in treating a benign tumour. At the final follow-up after 1 year, shoulder abduction power was st... more in treating a benign tumour. At the final follow-up after 1 year, shoulder abduction power was still M4+; no other problems were found. Neuromuscular choristoma is a very rare benign peripheral nerve tumour comprising mature skeletal myofibres of variable sizes in an intimate relationship with nerve fibres. The natural history of this tumour is not fully characterized. Its benign chronic evolution typically results in limb length and girth discrepancy. It presents typically as a solitary lesion in childhood involving cranial nerves and other large peripheral nerves, most commonly the sciatic nerve. HébertBlouin et al. (2012) identified ten patients with a diagnosis of neuromuscular choristoma treated at the Mayo Clinic between 1992 and 2010. They noted that the diagnosis of this tumour might be underreported. MRI findings are described as pathognomonic and should be enough to make the diagnosis and preclude the need of a biopsy (Niederhauser et al., 2013). Up to 30% of excised or biopsied neuromuscular choristoma developed an aggressive fibromatosis (Hébert-Blouin et al., 2012; Oeppen et al., 2003). Despite its rarity, neuromuscular choristoma has characteristic clinical manifestations (i.e. child age, limb length discrepancy) and MRI features that can lead to diagnosis. The present report may alert the surgeon and radiologist to look for clinical presentations and the MRI findings of neuromuscular choristoma to establish the diagnosis and to avoid a biopsy (Marom and Helms, 1999).

Aesthetic Plastic Surgery, 2017

Mycobacterium chelonae is a nontuberculous mycobacterium, classified as a Runyon type IV mycobact... more Mycobacterium chelonae is a nontuberculous mycobacterium, classified as a Runyon type IV mycobacterium. In relation to humans, it is most commonly associated with tissue trauma or pulmonary infections. The majority of medical reports describe finding M. chelonae in the surgical setting, attributing infection to inadequate sterilization of surgical equipment. Symptoms are often nonspecific and include pain, erythema, and draining subcutaneous nodules and skin lesions. Therefore, the diagnosis of M. chelonae is often difficult to establish without prior suspicion of the disease, but can be confirmed with culture. We will describe the case of a 40-year-old female who contracted M. chelonae infection of the buttocks after abdominal liposuction and gluteal fat injection. We will describe her symptomatology, diagnosis, and successful treatment with surgical excision and antibiotics.

Operative Dictations in Plastic and Reconstructive Surgery, 2016

Pressure sores (ulcers) develop in an area of unrelieved pressure that ultimately leads to tissue... more Pressure sores (ulcers) develop in an area of unrelieved pressure that ultimately leads to tissue ischemia, cell death, and necrosis. Various modalities to include topical therapies, pressure reduction and distribution products, and nutritional support all play a role in treatment; however, surgical debridement and flap coverage provides the most definitive intervention. The posterior thigh fasciocutaneous advancement flap may be used in treatment of ischial and trochanteric pressure sores. Benefits of this flap are that it offers versatility in design and the option of future re-advancement.

Operative Dictations in Plastic and Reconstructive Surgery, 2016

Anal incontinence is distressing for many affected patients. Various etiologies including trauma,... more Anal incontinence is distressing for many affected patients. Various etiologies including trauma, neurologic disorders, and iatrogenic events lead to poor function of the anal sphincter. The gracilis muscle is ideally located and provides an option for treatment of incontinence due to anal sphincter defect, pudendal neuropathy, or after other standard treatment options have failed.

Journal of Plastic, Reconstructive & Aesthetic Surgery, 2016

Esthetic augmentation of the gluteal region can lead to complications including debilitating pain... more Esthetic augmentation of the gluteal region can lead to complications including debilitating pain, infections, wounds, and scars. To our knowledge, a general consensus of staging and treatment guidelines for managing gluteal foreign body reaction to injectables has not yet been established. The objective of this study was to develop a reliable staging system that can be used to implement a treatment algorithm for gluteal foreign body reactions. A retrospective review of 40 patients treated for complications of gluteal injections between September 2010 and May 2014 was performed. Patient symptoms, imaging, and photographs were used to develop a staging system of disease. Institutional review board approval was obtained from the University of Miami Miller School of Medicine. Five independent observers reviewed the patients&amp;amp;amp;amp;#39; documented symptoms and photographs. Using our staging system, the independent observers reviewed the patient cases at two separate time intervals. Intra- and interclass correlation coefficients (ICCs) were computed to assess the reliability for each of the observers. Seven patients were classified as Stage I, fifteen as Stage IIa, nine as Stage IIb, and nine as Stage III. The mean patient age was 34 years (21-50). Analysis of the independent reviewer results revealed ICC for each rater to range from 0.96 to 0.98, demonstrating high indexes of intra-rater reliability. Based on our statistical analysis, we found an excellent inter- and intra-observer reliability, indicating that the staging system is reproducible and reliable. A treatment strategy dependent on the stage can be implemented as a guideline to optimize functional and esthetic outcomes.

Journal of plastic, reconstructive & aesthetic surgery : JPRAS, Jan 14, 2015

Anaplastology, 2013

A wide variety of surgical options exist for abdominal wall reconstruction. Part of the key to su... more A wide variety of surgical options exist for abdominal wall reconstruction. Part of the key to success, however, consist on choosing the operation that will give the most functional and aesthetic result while focusing on measures to decrease the incidence of catastrophic complications and need for reoperation. In this article, we review reconstructive modalities for abdominal wall defects, with special attention to complex ventral hernias and components separation techniques. Our description of recent scientific advances and the emphasis on a multidisciplinary approach to patient care reflects current trend and going forward to the use of bioprosthetic materials. Anaplastology A n ap lastol o g y

Archives of Facial Plastic Surgery, 2002