The current treatment of craniosynostosis is open surgical excision of the prematurely fused suture and cranial vault remodeling. Due to the change in skull morphology and the increase in volume, some tension on the skin flaps is noted with closure. Although complete wound breakdown is rare, it can be a devastating complication. We present our experience with the use of the SPY imaging system (Lifecell Corporation, Branchburg, NJ, USA) to visualize and record blood flow within the flaps of a 1-year-old patient with anterior plagiocephaly. Intraoperative indocyanine green angiography has the potential to be a significant advantage in such cases, providing a safe and objective method to assess intraoperative scalp perfusion, allowing the surgeon to take additional measures to ameliorate any ischemic problems.
Supplement 40 to 36 (10%), and 63 to 57 (9.5%), respectively. The number of applicants increased from 90 in 2019 to 124 in 2022 (37.8%), and match rate decreased from 82% to 56%. Osteopathic and international medical graduates increased from 9 to 21 (133%), and 20 to 28 (40%) respectively. A successful match was associated with US medical school graduates, prerequisite training at a university-affiliated general surgery program, greater number of interviews (13 ± 6 vs. 3 ± 3), higher USMLE step 1/2 scores, and AOA status (p<0.05). By multivariate regression, number of interviews completed (odd ratio [OR] 1.40 95% confidence interval [CI] 1.23-1.59 p <0.001) and allopathic medical school background (OR 3.65 95% CI 1.1 -12 p = 0.003) were predictive of a successful match.CONCLUSION: Despite residency review committee's ongoing support of the independent plastic surgery track, program participation during the period examined has decreased while applicant interest increased, likely contributing to a decreased match rate. Although more interviews and allopathic medical school background correlate with a successful match, continued support for the independent plastic surgery track is encouraged.
Background Microsurgical anastomosis is a delicate, highly nuanced procedure that can be done in several different ways; the most basic approach to performing microsurgical anastomoses is by using simple interrupted sutures, but even within that approach, there are different sequences by which the sutures can be placed. To date, there is no review of these sequences and the advantages and disadvantages of each.
Methods A PubMed search was performed in October 2019 that sought all published descriptions of simple interrupted microsurgery techniques. Keywords included were “microvascular anastomosis,” “microvascular anastomosis technique,” “simple interrupted,” and “microsurgery.”
Results Four simple interrupted microsurgery techniques were identified: triangulation, 12 o'clock to 6 o'clock, posterior-wall-first, and 3 o'clock to 9 o'clock-side-side. Additionally, there is no uniform nomenclature that describes the techniques for simple interrupted microvascular anastomoses.
Conclusion This study identified four distinct sequences for the placement of simple interrupted sutures for microsurgical anastomosis and the advantages and disadvantages of each, and for the first time described them utilizing standardized nomenclature.
The expansion of robotic surgery has led to developments in robotic-assisted breast reconstruction techniques. Specifically, robotic flap harvest is being evaluated to help maximize operative reliability and reduce donor site morbidity without compromising flap success. Many publications are feasibility studies or technical descriptions; few cohort analyses exist. This systematic review aims to characterize trends in robotic autologous breast reconstruction and provide a summative analysis of their results. A systematic review was conducted using PubMed, Medline, Scopus, and Web of Science to evaluate robot use in breast reconstruction. Studies dated from 2006 to 2022 were identified and analyzed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Full-text, peer-reviewed, English-language, and human subject studies were included. Non-breast reconstruction articles, commentary, expert opinion, editor’s letter, and duplicate studies were excluded. A total of 17 full-text articles were analyzed. The two robotic breast procedures identified were the deep inferior epigastric perforator (DIEP) and the latissimus dorsi (LD) flap. Results showed comparable complication rates and increased operative times compared to NSQIP data on their corresponding open techniques. Additional findings reported in studies included patient reported outcomes, incision lengths, and downward trends in operative time with consecutive procedures. The available data in the literature confirms that robotic surgery is a promising alternative to traditional open methods of breast reconstruction following mastectomy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.