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Microsurgery 2021 Jun 4. Epub 2021 Jun 4.

Department of Plastic Surgery, Norfolk and Norwich University Hospital, Norwich, United Kingdom.

When performing breast reconstruction, reduction of the contralateral breast is often required to achieve symmetry. The tissue that would otherwise be discarded from the reduced breast has been utilized as a free flap. This has the benefit of minimizing donor site morbidity, and combining the principles of "spare-part-surgery" and replacing "like-with-like. Read More

J Pers Med 2021 May 12;11(5). Epub 2021 May 12.

Division of Plastic and Reconstructive Surgery, Department of Medical and Surgical Sciences, Modena Policlinico Hospital, University of Modena and Reggio Emilia, 41124 Modena, Italy.

Breast cancer-related lymphedema (BCRL) represents a global healthcare issue affecting the emotional and life quality of breast cancer survivors significantly. The clinical presentation is characterized by swelling of the affected upper limb, that may be accompanied by atrophic skin findings, pain and recurrent cellulitis. Cardinal principles of lymphedema management are the use of complex decongestive therapy and patient education. Read More

J Hand Surg Asian Pac Vol 2021 Jun;26(2):152-157

Department of Hand and Reconstructive Microsurgery, National University Health System, Singapore.

Upper extremity trauma is one of the most common types of injuries, accounting for 20 to 40 percent of injured patients presenting to the emergency department. In severe upper extremity injury, the likelihood of secondary procedures to improve function and resolve outstanding clinical problems is high. Secondary procedures are performed later than initial primary surgery, usually after wound healing and with a discernible time gap of days, weeks or occasionally longer. Read More

Clin Oral Investig 2021 Apr 29. Epub 2021 Apr 29.

Department of Periodontics and Oral Medicine, University of Michigan - School of Dentistry, 1011 North University Avenue, Ann Arbor, MI, USA.

Objectives: Microsurgical principles, techniques, and armamentarium have made significant contributions to the periodontal plastic surgery. The present meta-analysis aimed to investigate the overall efficacy of microsurgery on root coverage, and its clinical outcomes when compared to traditional macrosurgery.

Material And Methods: Electronic searches on PubMed, Embase, and CINAHL were used to retrieve prospective clinical trials. Read More

Injury 2021 Apr 7. Epub 2021 Apr 7.

Department of Orthopaedic Surgery, Faculty of Medicine, University of Thessaly, 3 Panepistimiou St, Biopolis41500Larissa, Greece; Hand, Upper Extremity and Microsurgery Department, IASO Thessalias, Nikaia41500Larissa, Greece. Electronic address:

Introduction: Among various patterns of complex injuries of the wrist and forearm, "spaghetti wrist" refers to an extensive volar forearm laceration, in which several of the 12 tendons, 2 major nerves and 2 major arteries are transected, leading to lifelong disability and psychological, social and economic consequences. The aim of the study is to emphasize the keynote principles for the management of these injuries through retrospective review of a large group of patients treated by a team of experienced hand surgeons.

Material-methods: Data were retrospectively obtained for 61 patients (49 males and 12 females with average age of 34. Read More

Clin Plast Surg 2021 Apr 10;48(2):331-340. Epub 2021 Feb 10.

Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Spitalstrasse 21, Basel CH-4031, Switzerland; Centre for Musculoskeletal Infections, University Hospital Basel, Spitalstrasse 21, Basel CH-4031, Switzerland. Electronic address:

Demand has increased for complex lower-extremity reconstruction in the steadily growing elderly patient group in many highly developed countries. Microsurgery is indispensable for soft tissue reconstruction and osseous consolidation salvaging leg function and preventing amputation, with its devastating consequences. Microvascular reconstruction can be performed successfully in specialized centers with low donor-site morbidity, minimal operative time, and comparably low complication rates. Read More

J Neurosurg 2021 Feb 5:1-10. Epub 2021 Feb 5.

1The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona; and.

Transorbital surgery has gained recent notoriety because of its incorporation into endoscopic skull base surgery. The use of this surgical corridor has been pervasive throughout the 20th century. It has been utilized by multiple disciplines for both clinical and experimental purposes, although its historical origin is medically and ethically controversial. Read More

J Orthop Trauma 2021 07;35(7):e234-e240

Department of Orthopaedic Surgery, University Orthopaedic, Hand and Reconstructive Microsurgery Cluster, National University Health System (NUHS), Singapore.

Objectives: We hypothesize that in adequately resuscitated borderline polytrauma patients with long bone fractures (femur and tibia) or pelvic fractures, early (within 4 days) definitive stabilization (EDS) can be performed without an increase in postoperative ventilation and postoperative complications.

Design: Retrospective cohort study.

Setting: Level 1 trauma center. Read More

Clin Plast Surg 2020 Oct;47(4):547-559

Division of Plastic and Reconstructive Surgery, Mayo Clinic, 200 First Street, Rochester, MN 55905, USA. Electronic address:

Reconstruction of soft tissue defects following tumor ablation procedures in the trunk and extremities can challenge the microsurgeon. The goal is not just to provide adequate soft tissue coverage but also to restore form and function and minimize donor site morbidity. Although the principles of the reconstructive ladder still apply in the trunk and extremities, free tissue transfer is used in many cases to optimally restore form and function. Read More

Indian J Plast Surg 2020 Aug 30;53(2):254-259. Epub 2020 Aug 30.

Department of Orthopaedic, Hand and Microsurgery, Assiut University, Assiut, Egypt.

 There is consensus on the need for early microsurgical reconstruction in birth palsies involving three or more roots, that is, extensive partial palsies and total palsies. The fundamental principles of these operations are complete exploration and judicious use of the ruptured stumps by nerve grafting to suitable distal targets. The frequent observation of root avulsions in such cases makes it imperative to look for extraplexual nerve donors for some functions. Read More

J Reconstr Microsurg 2021 Feb 1;37(2):161-166. Epub 2020 Sep 1.

Department of Plastic and Reconstructive Surgery, NYU Langone Health, New York, New York.

Background:  Collaboration has been shown to be beneficial when we have complex problems and highly specialized groups, such as in head and neck reconstruction. Otolaryngology, plastic surgery, and oral maxillofacial surgeons perform head and neck reconstruction research. While the specialties represent unique backgrounds, the degree of interdisciplinary collaboration and subtopic focus is unknown. Read More

J Reconstr Microsurg 2021 Feb 1;37(2):154-160. Epub 2020 Sep 1.

Division of Plastic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.

Background:  In 2017, our institution initiated a cadaver laboratory-based course dedicated to teaching reconstructive microsurgery indications, preoperative planning, and flap dissection. The goals of this study are to describe the demographics and experience of participants/instructors and to evaluate the learning objectives and effectiveness of the course.

Methods:  Penn Flap Course (PFC) participants were sent an anonymous survey at the inaugural PFC 2017. Read More

Injury 2020 Nov 24;51(11):2601-2611. Epub 2020 Aug 24.

Istanbul Hand Surgery and Microsurgery Group, Yeni Yüzyıl University, Hand and Upper Extremity Surgery Unit, Gaziosmanpaşa Private Hospital, Nisantasi University Vocational High School, Istanbul, Turkey.

Objective: In this study, we aimed to describe the relationship between the localization of rarely seen upper extremity war injuries and their complications in the subacute period, and define our preferences for surgery and antibiotic use.

Methods: Patients with an upper extremity war injury who presented to our institution between 2015 and 2018 were retrospectively evaluated. Data regarding demographics, time between injury and presentation, location of injury, type of damage, complications, treatment methods, infection rates and antibiotic use were recorded. Read More

Acta Neurochir (Wien) 2020 12 9;162(12):3031-3035. Epub 2020 Aug 9.

Tata Memorial Centre, Mumbai, 400012, India.

Background: Maximizing resection is an oft-sought-after albeit challenging goal in diffuse gliomas. Microsurgical technique remains the mainstay.

Method: By virtue of their pattern of growth and spread, gliomas respect anatomical boundaries like the pia. Read More

J Hand Surg Asian Pac Vol 2020 Sep;25(3):257-266

Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore.

The proximal interphalangeal joint (PIPJ) is a complex anatomical structure. In managing fracture dislocations about the PIPJ, the aim is to restore a congruent joint that allows for smooth gliding motion. Detailed knowledge of the anatomy and biomechanics of the PIPJ is necessary in managing these injuries with predictable success. Read More

J Clin Orthop Trauma 2020 Jul-Aug;11(4):562-569. Epub 2020 Jun 9.

Dept. of Plastic, Hand, Burns and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamilnadu, India.

Objective: Fracture dislocations of the multiple carpometacarpal joints [CMCJ] of the fingers are uncommon injuries that can significantly compromise hand function and durability if managed sub-optimally. These injuries are at risk of being missed as they are commonly a part of major high energy trauma with associated more obvious and immediately threatening injuries getting all the attention. The clinical and radiological parameters which could help a surgeon to detect and analyse these injuries well are discussed. Read More

J Clin Orthop Trauma 2020 Jul-Aug;11(4):517-522. Epub 2020 Apr 11.

Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore.

Crush injuries of the hand involve damage to multiple structures within the hand, loss of tissue, devascularisation and possibly amputation of digits. They are complex and difficult to classify. Each injury has a unique pattern and requires a unique plan of management. Read More

J Plast Reconstr Aesthet Surg 2020 Oct 26;73(10):1825-1833. Epub 2020 May 26.

University of Pittsburgh, Department of Plastic Surgery, Pittsburgh, PA.

Surgeons have preferential ways of performing venous anastomosis in head and neck microsurgery. However, controversies exist regarding the superiority of each method. This study aims to determine the effects of these variables on the rates of thrombosis and flap failure, and propose an algorithm to be used as a facilitator in the decision-making process. Read More

Int J Colorectal Dis 2020 Jul 24;35(7):1173-1182. Epub 2020 May 24.

Department of Surgery, University Hospital of Larissa, Mezourlo, 41110, Larissa, Greece.

Background: In order to assess the various surgical modalities for local resection of rectal tumors, a systematic review of the current literature and a network meta-analysis (NMA) was designed and conducted.

Methods: The present study adhered to the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions principles. Scholar databases (Medline, Scopus, Web of Science) were systematically screened up to 23/12/2019. Read More

Nat Protoc 2020 06 13;15(6):1992-2023. Epub 2020 May 13.

Department of Biomedical Engineering, University of Minnesota Twin Cities, Minneapolis, MN, USA.

Cranial microsurgery is an essential procedure for accessing the brain through the skull that can be used to introduce neural probes that measure and manipulate neural activity. Neuroscientists have typically used tools such as high-speed drills adapted from dentistry to perform these procedures. As the number of technologies available for neuroscientists has increased, the corresponding cranial microsurgery procedures to deploy them have become more complex. Read More

Orthop Traumatol Surg Res 2020 Jun 28;106(4):725-729. Epub 2020 Apr 28.

CHU Angers-Neurochirurgie, 4, rue Larrey, 49033 Angers cedex 3; Faculté de Médecine, Laboratoire d'Anatomie, Université Angers, rue Haute de Reculée, 49045 Angers, France.

Introduction: In France, microsurgery is taught in University diploma courses, for a mean 100hours (range, 45-120hours) extending over several months. This training, spread over the year, encounters problems of maintaining high-quality supervision and enduring acquisition of skills. These difficulties risk leading to withdrawal of certain courses, already suffering from funding issues and administrative requirements for animal welfare. Read More

Surg Technol Int 2020 May;36:444-452

UOC Traumatology-Reconstructive Microsurgery, Department of Orthopedics and Traumatology, CTO Hospital, Torino, Italy.

Cortical plasticity is a finely regulated process that allows the central nervous system (CNS) to change in response to internal and external stimuli. While these modifications occur throughout normal brain development, interestingly, they are also elicited after peripheral nerve injury and surgery. This article provides an overview of the principle mechanisms of synaptic, neuronal, cortical and subcortical neuroplasticity, with special attention to cortical and subcortical modifications-as suggested by modern neuroimaging techniques-after peripheral nerve surgery. Read More

Chin Med J (Engl) 2020 May;133(9):1096-1098

Emergency Center of Trauma, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, China.

J Endod 2020 Jun 10;46(6):863-871. Epub 2020 Apr 10.

Air Force Postgraduate Dental School, Lackland Air Force Base, Texas; Uniformed Services University, Bethesda, Maryland.

Targeted endodontic microsurgery (TEMS) combines a precisely designed 3-dimensional (3D)-printed surgical guide with a trephine bur for safe and efficient osteotomy and root-end resection. The TEMS digital workflow converts the patient's anatomy into digital data in 4 steps. First, bone, teeth, and neurovascular spaces are rendered with cone-beam computed tomographic imaging. Read More

J Cutan Med Surg 2020 Mar/Apr;24(2):154-160. Epub 2020 Feb 27.

8166 Department of Dermatology and Skin Science, University of British Columbia, Vancouver, Canada.

Background: Island pedicle flaps (IPFs) are widely used in reconstructive surgery due to their versatility, tissue efficiency, and excellent clinical outcomes. While IPF rotations and 'pincer flap' modifications have previously been sparsely described, they are not often discussed in the literature.

Objective: We demonstrate the use of both rotating IPFs and pincer techniques for defects traditionally considered too large for classic IPF design on the nasal ala. Read More

J Biol Regul Homeost Agents 2020 Jan-Feb;34(1 Suppl. 1):161-164

Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy.

Introduction: CBCT combined to intra-oral scansion are the means to build an endodontic surgical guide to perform an easier and safer access to the apex in endodontic micro-surgery. .

Methods: A 38-year-old woman presented chronic apical periodontitis, which involved the three roots of 16 that was treated by endodontic therapy several years ago elsewhere. Read More

Int J Pediatr Otorhinolaryngol 2020 Apr 9;131:109872. Epub 2020 Jan 9.

Department of Otolaryngology Head and Neck Surgery, Ningbo Medical Center (Ningbo Lihuili Hospital), The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang, China; School of Medicine, Ningbo University, Ningbo, Zhejiang, China. Electronic address:

Acquired cholesteatoma leads to significant morbidities while current surgical options remain a challenge. The principles of surgery include complete removal of disease, prevention of recurrence, and restoration of hearing function when possible. Traditionally, this has been performed using microscopes; however, a novel technique using endoscopes offers a new perspective on our understanding of anatomy, pathogenesis and surgical approaches. Read More

J Neurosurg 2019 Nov 29:1-12. Epub 2019 Nov 29.

5Department of Neurosurgery, Uludag University School of Medicine, Bursa, Turkey.

Objective: Transorbital approaches for neurosurgery have recently attracted attention and several anatomical studies have aimed to improve these techniques, but significant deficiencies in clinical practice remain, especially for aneurysm surgery. The authors present an alternative microsurgical route and the results of an analysis of patients with intracranial aneurysms who underwent a lateral transorbital approach (LTOA) using lateral orbito-zygoma-sphenotomy (LOZYGS).

Methods: The clinical and surgical results of a series of 54 consecutive patients with 1 or more aneurysms who underwent surgery via LTOA are reported. Read More

Plast Reconstr Surg 2019 12;144(6):1351-1357

From the Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center; the Section of Plastic Surgery, Dartmouth-Hitchcock Medical Center; and the Orlando Plastic Surgery Institute.

Background: Treating ring avulsion injuries continues to challenge the reconstructive hand surgeon. The complex operation draws from plastic surgery and orthopedic surgery principles to provide soft-tissue coverage, skeletal fixation, tendon repair, and neurovascular reconstruction. Furthermore, the application of microsurgical techniques has enabled the revascularization and replantation of completely avulsed fingers. Read More