Notes

Evaluation approaches and good quality criteria regarding investigating muscle tissue structure making use of x-ray diffraction.
e cost of residential training, but is insufficient to compensate for resident inefficiency. Hospitals may consider incorporating PAs into the Graduate Medical Education paradigm to alleviate administrative burden, lower operational charges, and enhance resident training curricula.Free flap reconstruction in the head and neck region is a complex field in which patient comorbidities, radiation therapy, tumor recurrence, and variability of clinical scenarios make some cases particularly challenging and prone to devastating complications. Despite low free flap failure rates, the impact of flap failure has enormous consequences for the patients.
Acknowledging and predicting high risk intra- and postoperative situations and having planned strategies on how to deal with them can decrease their rate and improve the patient's reconstructive journey.

Herein, the authors present 4 examples of significant complications in complex microvascular head and neck cancer reconstruction, encountered for the last 10 years compression and kinking of the vascular pedicle, lack of planning of external skin coverage in osteoradionecrosis, management of the vessel-depleted neck, and vascular donor site morbidity after fibula harvest.

The authors reflect on the causes and propose preventative strategies in each peri-operative stage.
The authors reflect on the causes and propose preventative strategies in each peri-operative stage.Autologous breast reconstruction is widely regarded as the gold standard approach following mastectomy. However, the lack of sensation continues to present a reconstructive challenge. In this study, clinical outcomes following abdominal flap neurotization with processed human nerve allograft were investigated.
In this prospective analysis, patients who underwent microsurgical breast reconstruction with (Group 1) or without (Group 2) abdominal flap neurotization at a single institution were investigated. Processed human nerve allograft (Avance, AxoGen, Alachua, Fla.) was used in all cases of flap neurotization. Only patients with a follow-up of ≥12 months were included. Cutaneous pressure threshold was tested using Semmes-Weinstein monofilaments (SWMF) at 9 pre-defined locations.

A total of 59 patients (96 breasts) were enrolled into the registry. Of these, 22 patients (Group 1 N = 15, 22 breasts; Group 2 N = 7, 14 breasts) had a complete data set with ≥12 months follow-up. Measuring cutaneous pressure thresholds, we observed a greater likelihood for return of protective sensation (SWMF ≤ 4.31) in neurotized breasts in 8 of the 9 examined zones. Additionally, flap neurotization was associated with a greater likelihood for return of protective sensation in the majority of the reconstructed breast-that is, ≥5 zones (55% versus 7%;
< 0.01).

Flap neurotization using processed nerve allograft resulted in a greater degree of return of protective sensation to the reconstructed breast than reconstructions without neurotization at ≥12 months.
Flap neurotization using processed nerve allograft resulted in a greater degree of return of protective sensation to the reconstructed breast than reconstructions without neurotization at ≥12 months.Venous congestion is a frequent problem in flap surgery. Other than surgical revision, there are a multitude of procedures in the literature to tackle this problem, but their effectiveness is not clear. Through a systematic review, we aimed to identify and evaluate the different interventions available for managing flap venous congestion.
The MEDLINE, PubMed central, Embase, and Cochrane databases were searched. The study selection process was adapted from the PRISMA statement. All English and French original articles describing or comparing a method for managing flap venous congestion were included. For each article, a level of evidence was assigned, as defined by the Oxford Centre for Evidence-based Medicine. Lastly, we specifically analyzed the effectiveness of postoperative non-surgical methods. Brr2InhibitorC9 No formal analysis was performed.

Through literature searches carried out in various databases, we identified 224 articles. Finally, 72 articles were included. The majority of these studies had a low-level evidssociated with studies of other methods of venous congestion management does not allow us to draw a scientifically valid conclusion about their effectiveness.Preservation rhinoplasty is a new philosophy in the field of rhinoplasty, focusing on preserving and reshaping nasal structures. However, the authors suggest some patients are not good candidates for preservation rhinoplasty. Patients with underprojected noses and thick skin need a septal extension graft for tip support and to achieve maximum tip definition. In this article, we describe a new technique to combine septal extension graft with the preservation of tip ligaments, called interdomal hanger. It allows the surgeon to benefit from increased tip support in rotation and projection. The technique consists of the preservation of the interdomal ligament, which is then stabilized above the septal extension graft working as a suspensory sling. With this technique, the surgeon can mix important steps of preservation rhinoplasty and benefit from the support of the septal extension grafts.Integrated plastic surgery remains one of the most competitive specialties within the National Resident Matching Program. Although the burden of applying to surgical residencies has been studied, the literature lacks data specific to integrated plastic surgery applicants. This study reports the current total cost, along with the outcomes of applying to and interviewing for integrated plastic surgery residency.
A survey was sent to applicants in the 2018-2020 integrated plastic surgery application cycles. Survey questions focused on applicant demographics and home medical school characteristics, application processes, interview attendance, interview cost, and applicant financing. Comparative and regression analyses were performed on survey responses.

The survey was distributed to 493 applicants. An estimated 245 (49.7%) applicants responded. On average, applicants applied to 68.3 ± 16.4 (mean ± SD) programs, received 17.6 ± 11.4 interview invites, and attended 12.6 ± 5.7 of the interviews they received. On average, each applicant spent a total of $6690 ± $4045 during the interview season, with individual interviews costing $531.
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