Mark McRae - Academia.edu (original) (raw)
Papers by Mark McRae
Plastic Surgery, 2022
Introduction: Multiple tools have been developed for facial feature measurements and analysis usi... more Introduction: Multiple tools have been developed for facial feature measurements and analysis using facial recognition machine learning techniques. However, several challenges remain before these will be useful in the clinical context for reconstructive and aesthetic plastic surgery. Smartphone-based applications utilizing open-access machine learning tools can be rapidly developed, deployed, and tested for use in clinical settings. This research compares a smartphone-based facial recognition algorithm to direct and digital measurement performance for use in facial analysis. Methods: Facekit is a camera application developed for Android that utilizes ML Kit, an open-access computer vision Application Programing Interface developed by Google. Using the facial landmark module, we measured 4 facial proportions in 15 healthy subjects and compared them to direct surface and digital measurements using intraclass correlation (ICC) and Pearson correlation. Results: Measurement of the naso-f...
There is conflicting data on whether fat transplantation in previously irradiated head and neck p... more There is conflicting data on whether fat transplantation in previously irradiated head and neck patients is beneficial in terms of volume depletion and improvement in both functional and aesthetic outcomes. Resorption is an important issue, especially in those exposed to radiotherapy that predisposes them to fibrotic changes, adiponecrosis and vessel depletion. There have been no previous systematic reviews that have looked into the role that fat transplantation can have in these patients long term. As such, our aim is to determine, among patients who have undergone previous head and neck radiation, does autologous facial fat grafting improve aesthetic and functional outcomes when compared to patients baseline facial contour?
BACKGROUND Spin is the misrepresentation of study findings which may positively or negatively inf... more BACKGROUND Spin is the misrepresentation of study findings which may positively or negatively influence the reader’s interpretation of the results. Little is known regarding the prevalence of spin in abstracts of systematic reviews – specifically systematic reviews pertaining to management and treatment for acne vulgaris. OBJECTIVE Our primary objective was to characterize and determine the frequency of the most severe forms of spin in systematic review abstracts, and to evaluate whether various study characteristics were associated with spin. METHODS Using a cross-sectional study design, we searched PubMed and Embase for systematic reviews focusing on the management and treatment of acne vulgaris. Our search returned 316 studies, of which 36 were included in our final sample. To be included, each systematic review must have addressed either pharmacologic or non-pharmacologic treatment of acne vulgaris. These studies were screened and data were extracted in duplicate by two blinded ...
Plastic and Reconstructive Surgery, 2018
The Spine Journal, 2007
The Spine Journal, Volume 7, Issue 5, Pages 99S, September 2007, Authors:James Yue, MD; Matthew S... more The Spine Journal, Volume 7, Issue 5, Pages 99S, September 2007, Authors:James Yue, MD; Matthew Scott-Young, MD; Rudolf Bertganoli, MD, PhD; Jorge Jaramillo; Matthew McRae, MD;Mark McRae, MD. Journal Home, Register or Login: Password: Auto-Login [Reminder]. ...
Plastic and Reconstructive Surgery, 2010
A 73-year-old man with no family history or physical findings of neurofibromatosis presented with... more A 73-year-old man with no family history or physical findings of neurofibromatosis presented with a painless 1-cm mass of the right medial arm. An incisional biopsy indicated a neurofibroma. After biopsy, the mass rapidly grew to 3 cm. The patient then complained of ...
Plastic and Reconstructive Surgery, 2013
Aesthetic Surgery Journal
Breast augmentation is a commonly performed cosmetic procedure. We set out to determine whether... more Breast augmentation is a commonly performed cosmetic procedure. We set out to determine whether there was any effect on breastfeeding in females after breast implants. The aim of this study was to perform a systematic review and meta-analysis of the current evidence on breastfeeding outcome and complications in females with breast augmentation. A systematic review was performed utilizing MEDLINE, EMBASE, and all evidence-based medicine reviews from their respective inception dates to November 7, 2022, to assess outcomes of breastfeeding in females with breast implants (PROSPERO ID: CRD42022357909). This review was in accordance with both the Cochrane Handbook for Systematic Review of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eleven studies (4 prospective and 7 retrospective) in total were included in the review. A total of 8197 out of 9965 (82.25%) patients were successfully able to breastfeed after breast implants. Of 5 s...
Supplemental material, sj-docx-1-psg-10.1177_22925503211073840 for Closed Incision Negative Press... more Supplemental material, sj-docx-1-psg-10.1177_22925503211073840 for Closed Incision Negative Pressure Therapy Versus Traditional Dressings for Low Transverse Abdominal Incisions Healing by Primary Closure: A Systematic Review and Meta-Analysis by Lucas Gallo, Matteo Gallo, Brian Chin, Andrea Copeland, Ronen Avram, Mark McRae, Matthew McRae, Achilleas Thoma, Christopher J. Coroneos and Sophocles H. Voineskos in Plastic Surgery
Plastic Surgery
Background: Plastic surgeons treat a large volume of patients with upper limb morbidity resulting... more Background: Plastic surgeons treat a large volume of patients with upper limb morbidity resulting from intravenous drug use. The use of motivational interviewing by health care providers has demonstrated effectiveness in eliciting behavioral change, leading to improved health outcomes. This paper aims to explore the concept and process of motivational interviewing and its role in facilitating behavior change in the plastic surgery setting. Methods: The authors reviewed the literature on motivational interviewing in various health care settings. Results: Motivational interviewing, first developed in the field of psychology, has demonstrated effectiveness in facilitating behavior change in various clinical contexts, including brief clinical encounters. Using motivational interviewing guides the patient as they move through the stages of readiness for change in dealing with unhealthy behaviors. The authors demonstrate these techniques in a supplemental instructional video. Conclusions:...
Connecticut medicine, 2008
The purpose of this retrospective study is to document the incidence and etiology of frontal sinu... more The purpose of this retrospective study is to document the incidence and etiology of frontal sinus fracture at a level 1 traumacenterin Connecticut, assess the variability of management within our institution, and assess the effect on outcome over a seven-year period (January 1995-March 2002). Sixty-three cases were identified. Mean age was 31 years (92% male). The most common mechanism of injury was motor vehicle accident, followed by falls. The rates of associated facial fracture and intracranial injury were 83%, and 54% respectively. Diagnostic imaging missed two fractures. This study documents significant intrainstitutional variation in surgical management across contemporaneous primary treatment teams. There was no significant difference in outcome noted based on the treating specialty of the primary team for a given fracture type. The material used for sinus obliteration had no affect on outcome. Notable complications ofcerebrospinal fluid leak and mucocele are discussed as th...
The Yale Journal of Biology and Medicine, 2007
A multi-center retrospective review of major prosthetic graft infection outcomes was undertaken t... more A multi-center retrospective review of major prosthetic graft infection outcomes was undertaken to determine graft preservation and limb salvage rates. The management of infected prosthetic vascular grafts continues to be controversial. The purpose of this study was to review the surgical management of major extracavitary prosthetic vascular graft infections and to correlate the outcomes on the basis of bacteriology and grade. The change in patient population seen by vascular surgeons and the recent emergence of more virulent bacterial strains should influence surgical management. Bacteriology and severity of infection based on grade must play a greater role in the selection criteria for graft salvage. Despite advancement in the understanding of these interactions and the emergence of new management algorithms, we are continuing to operate without a uniform standard in managing this difficult and rapidly evolving clinical problem.
Supplemental Digital Content is available in the text Abstract Autologous fat grafting has been u... more Supplemental Digital Content is available in the text Abstract Autologous fat grafting has been used as a reconstructive modality following the treatment of head and neck malignancy. However, it has been criticized for poor graft retention and unpredictable results, which may be further compromised by prior radiation therapy. This systematic review will consolidate the literature on autologous fat grafting in the previously irradiated craniofacial region and report its effects on aesthetic and functional outcomes, volume resorption, and postoperative complications. A computerized search of Medline, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and Web of Science was performed. Screening and data extraction were performed in duplicate. Data were extracted from the included articles, and outcomes were analyzed categorically. Sixty patients from six studies were included. Mean age was 46.06 years (range 13–73) and 37.5...
The purpose of the study was to evaluate the consequences of athletic activity on the clinical an... more The purpose of the study was to evaluate the consequences of athletic activity on the clinical and radiographic outcomes of lumbar spine total disc replacement (TDR) patients. The data for this study is drawn secondarily from a prospective randomized study evaluating the Prodisc prosthesis at Yale New Haven Hospital. Athletic activities prior to the onset of spinal injury, after the onset of spinal injury, and post lumbar spine total disc replacement (TDR) surgery were assessed. Athletic activity was classified into three groups. These were contact/vigorous, moderate, and light, based on effect on the involved spinal segments. Outcomes were assessed both clinically and radiographically. Out of 195 patients enrolled in the Prodisc study at Yale, 82 qualified for inclusion and fulfilled all follow-up criteria. In these 82 patients 120 disc replacements were performed. The average reduction from pre-operative visual analog pain scale was 44 (std dev 30.1) at a minimum of 2 years follow...
1 From the *Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada; †D... more 1 From the *Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada; †Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; and ‡Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada. Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Plast Reconstr Surg Glob Open 2020;8:e2908; doi: 10.1097/ GOX.0000000000002908; Published online 15 June 2020. Comment on: “Negative Pressure Wound Therapy Reduces Wound Breakdown and Implant Loss in Prepectoral Breast Reconstruction”
Evidence‐Based Orthopedics
Annals of Plastic Surgery
PURPOSE The aim of this study was to present a case series emphasizing low medial maxillary (pyri... more PURPOSE The aim of this study was to present a case series emphasizing low medial maxillary (pyriform) buttress displacement in naso-orbito-ethmoid (NOE) fractures as an operative indication, in the absence of the typical NOE surgical indications (medial canthus displacement, midface bony comminution, nasal bone collapse, and orbital indications), to prevent nasal airway obstruction. METHODS Five cases of minor NOE fractures are reviewed, where only the low medial maxillary buttress was displaced. The typical surgical indications for NOE repair were absent. RESULTS In each case, the pyriform buttress was medially and posteriorly displaced, creating nasal airway obstruction in each patient. The medial canthal tendons were all nondisplaced, there was no diplopia, and the other 2 cardinal buttresses (infraorbital rim and nasofrontal junction) were minimally displaced or greensticked. In the acute setting, patients were treated with open reduction and internal fixation. With delayed presentation, septorhinoplasty or osteotomy and fixation were used. Among the patients who had adequate follow-up, nasal airway obstruction was resolved. CONCLUSIONS This series suggests that, in NOE fractures with isolated displacement at the medial maxillary buttress, nasal airway obstruction should be considered an operative indication (independent of the classical indications) in order to prevent or resolve nasal airway obstruction.
Cureus
Rectus diastasis plication performed during abdominoplasty aims to narrow the widened linea alba ... more Rectus diastasis plication performed during abdominoplasty aims to narrow the widened linea alba and return the rectus muscle bellies to their anatomic position. It is unclear whether plication improves abdominal strength and function. This systematic review summarizes the effect of rectus plication on abdominal strength, function, and postoperative complications. A comprehensive search of CINAHL, Embase, Medline and Web of Science was performed. Screening and data extraction were performed in duplicate. Data were extracted from the included articles, and outcomes were analyzed categorically. A total of 497 patients from seven articles were included. Mean age was 44.5 years (range 20.5-72) and 94.4% were female. Three articles reported abdominal strength measurements, with two showing significant improvement. Four articles used the SF-36 survey, all demonstrating improvement in physical function subscale postoperatively. An additional six instruments were used to assess functional outcomes, of which four demonstrated significant improvement. The overall complication rate was 17.0%. Rectus plication is commonly performed during abdominoplasty to improve abdominal form and function. While the literature to date is encouraging with respect to functional outcomes, improvements in abdominal strength are less consistent. Heterogeneity in patient population, outcome measures, and comparison groups limit the strength of our conclusions. Future research should include a large comparative study as well as a protocol for standardizing outcomes in this population.
Cureus
Scalp defects with exposed calvaria that have previously been irradiated present a unique reconst... more Scalp defects with exposed calvaria that have previously been irradiated present a unique reconstructive challenge. Patients with previously radiated scalp defects often have few reconstructive options due to poor health or personal choice. The aim of this study was to evaluate the results of non-operative management for patients with prior radiotherapy to the scalp who developed exposed calvaria. The outcomes of interest were major and minor complications related to exposed calvaria with a time frame of follow-up of greater than one year or death from any cause. A retrospective chart review was performed to identify patients with prior radiotherapy and surgery for skin cancer to the scalp who subsequently developed exposed calvaria. Data from four surgeons from 2008 to 2019 was collected. Next, a systematic review of PubMed, EMBASE, Cochrane Library, and CINAHL was conducted to identify articles in which non-operative management was utilized for exposed calvaria postradiotherapy. Nineteen patients were identified who received radiotherapy either before developing recurrent malignancy requiring operation or requiring radiation postoperatively because of close or involved margins and who subsequently developed exposed calvaria. Six of these patients had an additional attempt at local flap or skin grafting that failed. All patients had an American Society of Anesthesiologists score of three or four. All were managed with local wound care. Ten patients had near-complete healing with wound care alone. Eight patients are still alive from one to six years after the presentation. One patient, who remains alive, developed an intracranial abscess requiring long-term antibiotics but was medically compromised by concomitant myelodysplastic syndrome, mantle cell lymphoma on chemotherapy, atrial fibrillation on anticoagulation, and heart failure. Three patients developed new malignancies requiring re-operation with watchful waiting. Two of the three cases resulted in failure to control disease, but control of malignancy occurred in one case with resection of recurrent cancer and exposed bone. The systematic review of the literature yielded three studies that met the inclusion criteria. None of the studies encountered cases of meningitis, encephalitis, or death due to the non-operative treatment of exposed calvaria post radiation. Coverage of the calvaria with well-vascularized tissue is the reconstructive goal in the majority of circumstances. This case series and systematic review found that non-operative management of exposed calvaria post-radiotherapy can be an option for patients who are either not candidates for aggressive surgical treatment or who refuse surgery.
Plastic Surgery Case Studies
We report the case of a 66-year-old female who underwent autologous breast reconstruction and sus... more We report the case of a 66-year-old female who underwent autologous breast reconstruction and sustained a massive upper gastrointestinal bleed secondary to a duodenal ulcer after using nonsteroidal anti-inflammatory drugs (NSAIDs) consistently for 2 weeks. She required resuscitation with a massive blood transfusion protocol and definitive hemorrhage control with interventional coiling of the gastroduodenal artery. We discuss the importance of thinking beyond surgical site bleeding with NSAIDs as well as risk stratification and prevention of NSAID-induced complications.
Plastic Surgery, 2022
Introduction: Multiple tools have been developed for facial feature measurements and analysis usi... more Introduction: Multiple tools have been developed for facial feature measurements and analysis using facial recognition machine learning techniques. However, several challenges remain before these will be useful in the clinical context for reconstructive and aesthetic plastic surgery. Smartphone-based applications utilizing open-access machine learning tools can be rapidly developed, deployed, and tested for use in clinical settings. This research compares a smartphone-based facial recognition algorithm to direct and digital measurement performance for use in facial analysis. Methods: Facekit is a camera application developed for Android that utilizes ML Kit, an open-access computer vision Application Programing Interface developed by Google. Using the facial landmark module, we measured 4 facial proportions in 15 healthy subjects and compared them to direct surface and digital measurements using intraclass correlation (ICC) and Pearson correlation. Results: Measurement of the naso-f...
There is conflicting data on whether fat transplantation in previously irradiated head and neck p... more There is conflicting data on whether fat transplantation in previously irradiated head and neck patients is beneficial in terms of volume depletion and improvement in both functional and aesthetic outcomes. Resorption is an important issue, especially in those exposed to radiotherapy that predisposes them to fibrotic changes, adiponecrosis and vessel depletion. There have been no previous systematic reviews that have looked into the role that fat transplantation can have in these patients long term. As such, our aim is to determine, among patients who have undergone previous head and neck radiation, does autologous facial fat grafting improve aesthetic and functional outcomes when compared to patients baseline facial contour?
BACKGROUND Spin is the misrepresentation of study findings which may positively or negatively inf... more BACKGROUND Spin is the misrepresentation of study findings which may positively or negatively influence the reader’s interpretation of the results. Little is known regarding the prevalence of spin in abstracts of systematic reviews – specifically systematic reviews pertaining to management and treatment for acne vulgaris. OBJECTIVE Our primary objective was to characterize and determine the frequency of the most severe forms of spin in systematic review abstracts, and to evaluate whether various study characteristics were associated with spin. METHODS Using a cross-sectional study design, we searched PubMed and Embase for systematic reviews focusing on the management and treatment of acne vulgaris. Our search returned 316 studies, of which 36 were included in our final sample. To be included, each systematic review must have addressed either pharmacologic or non-pharmacologic treatment of acne vulgaris. These studies were screened and data were extracted in duplicate by two blinded ...
Plastic and Reconstructive Surgery, 2018
The Spine Journal, 2007
The Spine Journal, Volume 7, Issue 5, Pages 99S, September 2007, Authors:James Yue, MD; Matthew S... more The Spine Journal, Volume 7, Issue 5, Pages 99S, September 2007, Authors:James Yue, MD; Matthew Scott-Young, MD; Rudolf Bertganoli, MD, PhD; Jorge Jaramillo; Matthew McRae, MD;Mark McRae, MD. Journal Home, Register or Login: Password: Auto-Login [Reminder]. ...
Plastic and Reconstructive Surgery, 2010
A 73-year-old man with no family history or physical findings of neurofibromatosis presented with... more A 73-year-old man with no family history or physical findings of neurofibromatosis presented with a painless 1-cm mass of the right medial arm. An incisional biopsy indicated a neurofibroma. After biopsy, the mass rapidly grew to 3 cm. The patient then complained of ...
Plastic and Reconstructive Surgery, 2013
Aesthetic Surgery Journal
Breast augmentation is a commonly performed cosmetic procedure. We set out to determine whether... more Breast augmentation is a commonly performed cosmetic procedure. We set out to determine whether there was any effect on breastfeeding in females after breast implants. The aim of this study was to perform a systematic review and meta-analysis of the current evidence on breastfeeding outcome and complications in females with breast augmentation. A systematic review was performed utilizing MEDLINE, EMBASE, and all evidence-based medicine reviews from their respective inception dates to November 7, 2022, to assess outcomes of breastfeeding in females with breast implants (PROSPERO ID: CRD42022357909). This review was in accordance with both the Cochrane Handbook for Systematic Review of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eleven studies (4 prospective and 7 retrospective) in total were included in the review. A total of 8197 out of 9965 (82.25%) patients were successfully able to breastfeed after breast implants. Of 5 s...
Supplemental material, sj-docx-1-psg-10.1177_22925503211073840 for Closed Incision Negative Press... more Supplemental material, sj-docx-1-psg-10.1177_22925503211073840 for Closed Incision Negative Pressure Therapy Versus Traditional Dressings for Low Transverse Abdominal Incisions Healing by Primary Closure: A Systematic Review and Meta-Analysis by Lucas Gallo, Matteo Gallo, Brian Chin, Andrea Copeland, Ronen Avram, Mark McRae, Matthew McRae, Achilleas Thoma, Christopher J. Coroneos and Sophocles H. Voineskos in Plastic Surgery
Plastic Surgery
Background: Plastic surgeons treat a large volume of patients with upper limb morbidity resulting... more Background: Plastic surgeons treat a large volume of patients with upper limb morbidity resulting from intravenous drug use. The use of motivational interviewing by health care providers has demonstrated effectiveness in eliciting behavioral change, leading to improved health outcomes. This paper aims to explore the concept and process of motivational interviewing and its role in facilitating behavior change in the plastic surgery setting. Methods: The authors reviewed the literature on motivational interviewing in various health care settings. Results: Motivational interviewing, first developed in the field of psychology, has demonstrated effectiveness in facilitating behavior change in various clinical contexts, including brief clinical encounters. Using motivational interviewing guides the patient as they move through the stages of readiness for change in dealing with unhealthy behaviors. The authors demonstrate these techniques in a supplemental instructional video. Conclusions:...
Connecticut medicine, 2008
The purpose of this retrospective study is to document the incidence and etiology of frontal sinu... more The purpose of this retrospective study is to document the incidence and etiology of frontal sinus fracture at a level 1 traumacenterin Connecticut, assess the variability of management within our institution, and assess the effect on outcome over a seven-year period (January 1995-March 2002). Sixty-three cases were identified. Mean age was 31 years (92% male). The most common mechanism of injury was motor vehicle accident, followed by falls. The rates of associated facial fracture and intracranial injury were 83%, and 54% respectively. Diagnostic imaging missed two fractures. This study documents significant intrainstitutional variation in surgical management across contemporaneous primary treatment teams. There was no significant difference in outcome noted based on the treating specialty of the primary team for a given fracture type. The material used for sinus obliteration had no affect on outcome. Notable complications ofcerebrospinal fluid leak and mucocele are discussed as th...
The Yale Journal of Biology and Medicine, 2007
A multi-center retrospective review of major prosthetic graft infection outcomes was undertaken t... more A multi-center retrospective review of major prosthetic graft infection outcomes was undertaken to determine graft preservation and limb salvage rates. The management of infected prosthetic vascular grafts continues to be controversial. The purpose of this study was to review the surgical management of major extracavitary prosthetic vascular graft infections and to correlate the outcomes on the basis of bacteriology and grade. The change in patient population seen by vascular surgeons and the recent emergence of more virulent bacterial strains should influence surgical management. Bacteriology and severity of infection based on grade must play a greater role in the selection criteria for graft salvage. Despite advancement in the understanding of these interactions and the emergence of new management algorithms, we are continuing to operate without a uniform standard in managing this difficult and rapidly evolving clinical problem.
Supplemental Digital Content is available in the text Abstract Autologous fat grafting has been u... more Supplemental Digital Content is available in the text Abstract Autologous fat grafting has been used as a reconstructive modality following the treatment of head and neck malignancy. However, it has been criticized for poor graft retention and unpredictable results, which may be further compromised by prior radiation therapy. This systematic review will consolidate the literature on autologous fat grafting in the previously irradiated craniofacial region and report its effects on aesthetic and functional outcomes, volume resorption, and postoperative complications. A computerized search of Medline, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and Web of Science was performed. Screening and data extraction were performed in duplicate. Data were extracted from the included articles, and outcomes were analyzed categorically. Sixty patients from six studies were included. Mean age was 46.06 years (range 13–73) and 37.5...
The purpose of the study was to evaluate the consequences of athletic activity on the clinical an... more The purpose of the study was to evaluate the consequences of athletic activity on the clinical and radiographic outcomes of lumbar spine total disc replacement (TDR) patients. The data for this study is drawn secondarily from a prospective randomized study evaluating the Prodisc prosthesis at Yale New Haven Hospital. Athletic activities prior to the onset of spinal injury, after the onset of spinal injury, and post lumbar spine total disc replacement (TDR) surgery were assessed. Athletic activity was classified into three groups. These were contact/vigorous, moderate, and light, based on effect on the involved spinal segments. Outcomes were assessed both clinically and radiographically. Out of 195 patients enrolled in the Prodisc study at Yale, 82 qualified for inclusion and fulfilled all follow-up criteria. In these 82 patients 120 disc replacements were performed. The average reduction from pre-operative visual analog pain scale was 44 (std dev 30.1) at a minimum of 2 years follow...
1 From the *Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada; †D... more 1 From the *Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada; †Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; and ‡Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada. Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Plast Reconstr Surg Glob Open 2020;8:e2908; doi: 10.1097/ GOX.0000000000002908; Published online 15 June 2020. Comment on: “Negative Pressure Wound Therapy Reduces Wound Breakdown and Implant Loss in Prepectoral Breast Reconstruction”
Evidence‐Based Orthopedics
Annals of Plastic Surgery
PURPOSE The aim of this study was to present a case series emphasizing low medial maxillary (pyri... more PURPOSE The aim of this study was to present a case series emphasizing low medial maxillary (pyriform) buttress displacement in naso-orbito-ethmoid (NOE) fractures as an operative indication, in the absence of the typical NOE surgical indications (medial canthus displacement, midface bony comminution, nasal bone collapse, and orbital indications), to prevent nasal airway obstruction. METHODS Five cases of minor NOE fractures are reviewed, where only the low medial maxillary buttress was displaced. The typical surgical indications for NOE repair were absent. RESULTS In each case, the pyriform buttress was medially and posteriorly displaced, creating nasal airway obstruction in each patient. The medial canthal tendons were all nondisplaced, there was no diplopia, and the other 2 cardinal buttresses (infraorbital rim and nasofrontal junction) were minimally displaced or greensticked. In the acute setting, patients were treated with open reduction and internal fixation. With delayed presentation, septorhinoplasty or osteotomy and fixation were used. Among the patients who had adequate follow-up, nasal airway obstruction was resolved. CONCLUSIONS This series suggests that, in NOE fractures with isolated displacement at the medial maxillary buttress, nasal airway obstruction should be considered an operative indication (independent of the classical indications) in order to prevent or resolve nasal airway obstruction.
Cureus
Rectus diastasis plication performed during abdominoplasty aims to narrow the widened linea alba ... more Rectus diastasis plication performed during abdominoplasty aims to narrow the widened linea alba and return the rectus muscle bellies to their anatomic position. It is unclear whether plication improves abdominal strength and function. This systematic review summarizes the effect of rectus plication on abdominal strength, function, and postoperative complications. A comprehensive search of CINAHL, Embase, Medline and Web of Science was performed. Screening and data extraction were performed in duplicate. Data were extracted from the included articles, and outcomes were analyzed categorically. A total of 497 patients from seven articles were included. Mean age was 44.5 years (range 20.5-72) and 94.4% were female. Three articles reported abdominal strength measurements, with two showing significant improvement. Four articles used the SF-36 survey, all demonstrating improvement in physical function subscale postoperatively. An additional six instruments were used to assess functional outcomes, of which four demonstrated significant improvement. The overall complication rate was 17.0%. Rectus plication is commonly performed during abdominoplasty to improve abdominal form and function. While the literature to date is encouraging with respect to functional outcomes, improvements in abdominal strength are less consistent. Heterogeneity in patient population, outcome measures, and comparison groups limit the strength of our conclusions. Future research should include a large comparative study as well as a protocol for standardizing outcomes in this population.
Cureus
Scalp defects with exposed calvaria that have previously been irradiated present a unique reconst... more Scalp defects with exposed calvaria that have previously been irradiated present a unique reconstructive challenge. Patients with previously radiated scalp defects often have few reconstructive options due to poor health or personal choice. The aim of this study was to evaluate the results of non-operative management for patients with prior radiotherapy to the scalp who developed exposed calvaria. The outcomes of interest were major and minor complications related to exposed calvaria with a time frame of follow-up of greater than one year or death from any cause. A retrospective chart review was performed to identify patients with prior radiotherapy and surgery for skin cancer to the scalp who subsequently developed exposed calvaria. Data from four surgeons from 2008 to 2019 was collected. Next, a systematic review of PubMed, EMBASE, Cochrane Library, and CINAHL was conducted to identify articles in which non-operative management was utilized for exposed calvaria postradiotherapy. Nineteen patients were identified who received radiotherapy either before developing recurrent malignancy requiring operation or requiring radiation postoperatively because of close or involved margins and who subsequently developed exposed calvaria. Six of these patients had an additional attempt at local flap or skin grafting that failed. All patients had an American Society of Anesthesiologists score of three or four. All were managed with local wound care. Ten patients had near-complete healing with wound care alone. Eight patients are still alive from one to six years after the presentation. One patient, who remains alive, developed an intracranial abscess requiring long-term antibiotics but was medically compromised by concomitant myelodysplastic syndrome, mantle cell lymphoma on chemotherapy, atrial fibrillation on anticoagulation, and heart failure. Three patients developed new malignancies requiring re-operation with watchful waiting. Two of the three cases resulted in failure to control disease, but control of malignancy occurred in one case with resection of recurrent cancer and exposed bone. The systematic review of the literature yielded three studies that met the inclusion criteria. None of the studies encountered cases of meningitis, encephalitis, or death due to the non-operative treatment of exposed calvaria post radiation. Coverage of the calvaria with well-vascularized tissue is the reconstructive goal in the majority of circumstances. This case series and systematic review found that non-operative management of exposed calvaria post-radiotherapy can be an option for patients who are either not candidates for aggressive surgical treatment or who refuse surgery.
Plastic Surgery Case Studies
We report the case of a 66-year-old female who underwent autologous breast reconstruction and sus... more We report the case of a 66-year-old female who underwent autologous breast reconstruction and sustained a massive upper gastrointestinal bleed secondary to a duodenal ulcer after using nonsteroidal anti-inflammatory drugs (NSAIDs) consistently for 2 weeks. She required resuscitation with a massive blood transfusion protocol and definitive hemorrhage control with interventional coiling of the gastroduodenal artery. We discuss the importance of thinking beyond surgical site bleeding with NSAIDs as well as risk stratification and prevention of NSAID-induced complications.