Free flaps: the hemophilia factor.
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Arthritis, Infectious↗
Biomedical subjects
W Jason Martin
Publications and source records attributed to W Jason Martin.
The model graft: reconstruction of the maxilla using a fibular bone graft template.
The reconstruction of the partial maxillectomy decfect with a free graft depends on a team approach in a coordinated manner. However, this is not always possible due to physical limitations or, unfortunately, pragmatic factors in the era of managed care. A surgical template oftentimes is the critical measure of success in these cases, but may not be available or easily created for the previously mentioned reasons. In this article, we describe the use of redundant fibular bone as a template for reconstruction of the partial maxillectomy defect. This is a satisfactory alternative to a dental template in many cases, and, we believe, in some cases, may even be superior because it is the graft itself. As a result insetting can be hastened and precious ischemic time can be lessened-all favoring a successful, functional result.
Anastomosis, Surgical↗
The pubic bone graft.
We introduce a new technique for harvesting cancellous bone, the pubic bone graft. The pubic bone graft is a predictable and efficient technique that yields an ample harvest of rich cancellous bone. With experience gained from multiple fresh cadaver dissections, we present this technique in detail, including our most recent clinical application to graft alveolar clefts and its advantages over the traditional technique of bone graft harvesting.
Bone Transplantation↗
Sentinel lymph node biopsy lowers the rate of lymphedema when compared with standard axillary lymph node dissection.
Arm edema occurs in 20 to 30 per cent of patients who undergo axillary lymph node dissection (ALND) for carcinoma of the breast. Sentinel lymph node biopsy (SLNB) in lieu of ALND for staging of breast cancer significantly lowers this morbidity. We hypothesized that SLNB would have a lower lymphedema rate than conventional axillary dissection. Patients who underwent SLNB were compared with those who underwent level I and II axillary node dissection. A total of 125 patients were evaluated with 77 patients who underwent SLNB and 48 patients who underwent ALND. The arm circumference 10 cm above and 10 cm below the olecranon process was measured on both arms. In this series a difference in arm circumference greater than 3 cm between the operated and nonoperated side was defined as significant for lymphedema. Lymphedema was seen in two of 77 (2.6%) patients in the SLNB group as compared with 13 of 48 (27%) ALND patients. Given the above data patients who underwent sentinel lymph node biopsy show a significantly lower rate of lymphedema than those who had axillary lymph node dissection. This has an important impact on long-term postoperative management of patients with breast cancer.
Breast Neoplasms↗
Abdominal wall endometrioma found during abdominoplasty.
Extrauterine manifestations of endometriosis are well-recognized and frequently encountered by gynecologists, but are not necessarily familiar to the plastic surgery community. With the current increase in gastric bypass procedures performed and the subsequent increase in abdominal wall reconstructions secondary to massive weight loss, the plastic surgeon should have some familiarity with the diverse presentations of this common disease. To help with this, the authors present the case of an abdominal wall endometrioma diagnosed during abdominoplasty.
Abdominal Wall↗