Lisa R David

Fasciotomy wounds can be a major contributor to length of stay for patients as well as a difficult reconstructive challenge. Once the compartment pressure has been relieved and stabilized, the wound should be closed as quickly and early as possible to avoid later complications. Skin grafting can lead to morbidity and scarring at both the donor and fasciotomy site. Primary closure results in a more functional and esthetic outcome with less morbidity for the patient, but can often be ...

INTRODUCTION: Tissue expander and implant-based breast reconstruction after mastectomy is the most common method of breast reconstruction. Modifications of the traditional total submuscular reconstruction (TSR) have been made using acellular dermal matrix (ADM) to create an inferolateral sling and a more natural implant pocket for superior aesthetic results. The objective of this study was to assess aesthetic outcomes when using ADM in breast reconstruction.

METHODS: A retrospective ...

BACKGROUND: Blood loss is the leading cause of mortality after major craniofacial surgery. Autologous blood donation, short-term normovolemic hemodilution, and intraoperative blood salvage have shown low efficacy in decreasing transfusions. Tranexamic acid (TXA) is a synthetic antifibrinolytic drug that competitively decreases the conversion of plasminogen to plasmin, thereby suppressing fibrinolysis. The purpose of this study was to investigate the impact that TXA administration has on ...

Matching into an integrated plastic surgery program has become highly competitive. As a result it has become more difficult for both the applicants and the residency programs to determine which attributes are most important to match in plastic surgery and, more importantly, to make a surgeon who will contribute to the future of our specialty. This study was conducted to analyze potential associations between a successful match into plastic surgery and the number of interviews offered and ...

Lower-extremity wounds with exposed tendon, bone, or orthopedic hardware present a difficult treatment challenge. In this series of patients, subatmospheric pressure therapy was applied to such lower-extremity wounds. Seventy-five patients with lower-extremity wounds, most of which were the result of trauma, were selected for this study. Dressings made of sterile open-cell foam with embedded fenestrated tubing were contoured to the wound size and placed into the wound. The site was ...

Deformational plagiocephaly, cranial asymmetry secondary to positioning, continues to be a leading cause of head shape abnormalities in infants. Treatment recommendations include nonintervention, positioning therapies, and helmet therapy. Although most agree that surgical intervention is rarely indicated, the ideal therapy is not agreed on. Some even debate the necessity of treatment, especially third-party payers. The purpose of this prospective study is to use an objective outcome ...

INTRODUCTION: Head and neck wounds can present a reconstructive challenge for the plastic surgeon. Whether from skin cancer, trauma, or burns, there are many different treatment modalities used to dress and manage complex head and neck wounds. Vacuum-assisted closure (VAC) therapy has been used on wounds of nearly every aspect of the body but not routinely in the head and neck area. This study was conducted to demonstrate our results using the VAC in the treatment of complex head and ...

Plastic surgery continues to be a very competitive program to match into out of medical school. To analyze the match process, all applicants to our plastic surgery residency program in 2012 were surveyed. Our results showed that with matching into plastic surgery as the primary outcome measure, those who matched applied to more plastic surgery programs, received and accepted more interview invitations, were younger, were less likely to be foreign medical graduates, reported higher costs, ...

BACKGROUND: Spring-assisted surgery (SAS) has demonstrated promising results for the treatment of sagittal craniosynostosis. The purpose of this study was to assess the outcomes of the first 75 cases compared with a prospectively collected group of patients treated with cranial expansion (cranial vault remodeling [CVR]).

METHODS: Seventy-five children with scaphocephaly have completed this institutional review board-approved study. Patients underwent cranial surgery with removal of a ...

BACKGROUND: Haemangiomas are common vascular lesions occurring in up to 10-12% of infants by 1 year of age. Typically, these lesions are treated expectantly unless complicated by haemorrhage, ulceration, infection, or compromise of adjacent vital structures. Ulceration is a particularly difficult problem because of associated pain, infection, haemorrhage, and subsequent scarring.

MATERIALS AND METHODS: Seventy-eight children (54 girls, 24 boys) with ulcerated haemangiomas, from our ...

The gold standard for closing small cranial defects is autogenous bone: iliac crest, rib, or split calvarial grafts. Autogenous grafts result in donor site morbidity, increased operative time, blood loss, and additional cost, and they are limited in quantity. Hydroxyapatite cements are alternative bone substitutes that eliminate these restrictions. Although the use of hydroxyapatite is well accepted in completely developed crania, its use in the growing pediatric skull is limited. The ...

Cosmetic patients have many options when seeking out their surgeons. In midsize and larger cities, these options span not only different specialties but also different levels of experience. Because surgical experience can best be gained first hand, there exists a special and symbiotic relationship between a surgeon-in-training and his or her patient. Benefits stem from the opportunity for a surgeon to gain independent experience while offering cost effective benefits to patients who may ...

The ability to more definitively plan breast reconstruction after obtaining final histologic analysis of the sentinel lymph node biopsy (SLNB) has led several groups to advocate a staged approach to SLNB and mastectomy. Certain disadvantages are inherent in that approach, including increased patient morbidity, financial expense, and inconvenience. A retrospective review was conducted 195 procedures in which mastectomy and SLNB were performed in a single stage with immediate breast ...

BACKGROUND: Aplasia cutis congenita (ACC) is a rare congenital disorder characterized by absence of skin and adjacent tissue that usually affects the scalp, but any part of the body may be affected. Although ACC is more often superficial and small, it can be large and involve the underlying structures such as skull and dura, thus increasing the risk of hemorrhage, infection, and mortality. Controversy exists regarding nonsurgical versus surgical intervention for this condition. This ...