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Clinics in Plastic Surgery Oct 2020As microsurgical expertise has improved, allowing for the safe transfer of smaller and more refined flaps, free tissue transfer has continued to gain popularity for the... (Review)
Review
As microsurgical expertise has improved, allowing for the safe transfer of smaller and more refined flaps, free tissue transfer has continued to gain popularity for the management of pediatric soft tissue and bony defects. For the past 2 decades pediatric microsurgery has been shown to be technically feasible and reliable. The major advantage of free tissue transfer in children is the ability to reconstruct defects in a single stage, avoiding the historic treatments of skin grafting, tissue expansion, and pedicled flaps. This article reviews the present state-of-the-art in pediatric microsurgery.
Topics: Child; Child, Preschool; Female; Free Tissue Flaps; Humans; Male; Microsurgery; Plastic Surgery Procedures; Skin Transplantation; Surgical Flaps; Tissue Expansion
PubMed: 32892801
DOI: 10.1016/j.cps.2020.06.008 -
Otolaryngologic Clinics of North America Feb 2021Microscopic ear surgery (MES) has been used since the 1950s whereas endoscopic ear surgery (EES) was introduced in the mid-1990s. The advantages of MES should not be... (Review)
Review
Microscopic ear surgery (MES) has been used since the 1950s whereas endoscopic ear surgery (EES) was introduced in the mid-1990s. The advantages of MES should not be forgotten as surgeons turn their attention to new technology. These include depth perception, wide angle view, and the ability to operate with 2 hands. EES affords the ability to look around corners but needs a pristine field and is limited to single-handed surgery in a narrow field. Trainees should be taught both, and technique used should reflect the experience and abilities of the surgeon and the nature of the disease in the particular patient.
Topics: Ear, Middle; Endoscopy; Humans; Microsurgery; Otologic Surgical Procedures
PubMed: 33153737
DOI: 10.1016/j.otc.2020.09.025 -
Journal of Pediatric Orthopedics. Part B May 2021
Topics: Child; Humans; Microsurgery
PubMed: 33767126
DOI: 10.1097/BPB.0000000000000843 -
Current Opinion in Ophthalmology Jan 2020To review various techniques of manual small incision cataract surgery (MSICS), updates on training residents and fellows, and cost-effectiveness of the surgery. (Review)
Review
PURPOSE OF REVIEW
To review various techniques of manual small incision cataract surgery (MSICS), updates on training residents and fellows, and cost-effectiveness of the surgery.
RECENT FINDINGS
Recent population studies estimate that there are 53 million people blind worldwide from cataracts, up from previous figures. This is in part because of population growth and increased life expectancy worldwide. MSICS continues to play a significant role in addressing cataract burden and there is an increasing need to train surgeons in the technique. In response to this need, several modules and rubrics have been developed to assist in the training process.
SUMMARY
MSICS has been refined over recent decades with overall outcomes comparable to phacoemulsification (phaco) in certain settings. MSICS cost and efficiency advantages support its ongoing essential role in addressing global cataract blindness.
Topics: Cataract Extraction; Cost-Benefit Analysis; Education, Medical, Graduate; Humans; Internship and Residency; Microsurgery; Surgical Wound
PubMed: 31770166
DOI: 10.1097/ICU.0000000000000624 -
Annals of Plastic Surgery Jul 2023Microsurgery is an advanced set of techniques that require a high level of skill to be performed safely. Surgical skills courses offer safe environments for practice in...
Microsurgery is an advanced set of techniques that require a high level of skill to be performed safely. Surgical skills courses offer safe environments for practice in such skills and form a fundamental part of surgical training. The Yorkshire Microsurgery Course is a 3-day course at Bradford Royal Infirmary, United Kingdom. Delivered via short lectures followed by supervised practical sessions, the course aims to provide delegates with the essential knowledge and skills required for microsurgery.We detail an outline and critical evaluation of the February 2023 iteration of the course, with recommendations for improvement.Overall, we found the course excellent. It provided delegates with a solid grounding in the fundamentals of microsurgery and the opportunity for personalized practice supervised by experts. We would recommend this course to colleagues interested in a career in plastic surgery.
Topics: Humans; Microsurgery; Plastic Surgery Procedures; Surgery, Plastic; Curriculum; Clinical Competence
PubMed: 37450857
DOI: 10.1097/SAP.0000000000003580 -
Microsurgery Jul 2021
Topics: Humans; Microsurgery
PubMed: 33844352
DOI: 10.1002/micr.30742 -
Journal of Biological Regulators and... 2021The purpose of this review was twofold. The first aim was to show predictable protocols of guided endodontic microsurgery (EMS) and to describe its clinical outcomes.... (Review)
Review
The purpose of this review was twofold. The first aim was to show predictable protocols of guided endodontic microsurgery (EMS) and to describe its clinical outcomes. The second aim was to verify the accuracy of this technique compared to the traditional pathway. An electronic search of publications was established from two electronic databases, Cochrane and PubMed, by two independent researchers. The search strategy used a combination of controlled vocabulary and free-text words. Inclusion and exclusion criteria were defined by the authors before the start of the study. Inclusion criteria were: all studies published in English language; studies in vivo on humans; human cadaver studies; studies analyzing guided surgery in apicoectomy. The initial search yielded 67 citations, of which 10 were included. The studies included in this review analysis have shown two different technique both for digitization of dental arch and for surgical procedures too. Guided endodontic micro-surgery is a more predictable technique with less intra-operative and post-operative complications compared to the "freehand" technique and this procedure has shown a greater accuracy.
Topics: Apicoectomy; Humans; Microsurgery
PubMed: 34289664
DOI: 10.23812/21-3supp1-7 -
Hand Surgery & Rehabilitation Apr 2024Very often, post-traumatic defects involve multiple tissues. Microsurgical techniques can reconstruct them with tissues taken from a toe: from the nail complex alone to... (Review)
Review
Very often, post-traumatic defects involve multiple tissues. Microsurgical techniques can reconstruct them with tissues taken from a toe: from the nail complex alone to compound osteo-onychocutaneous flaps. Several techniques have been reported since the 1980s. This paper describes techniques and indications for microsurgical nail reconstruction. Technique differs according to the deficit, and first and foremost whether only the nail complex is involved or whether other components of the fingertip important for the normal growth of the nail, such as the phalanx bone or the finger pad, are also missing (toenail flaps and the custom-made osteo-onychocutaneous flaps). For most patients the absence of a fingernail is an esthetic rather than functional concern, and the outcomes of microsurgical reconstruction are far from ideal in this regard. We prefer to reserve reconstruction for symptomatic patients with functional impairment.
Topics: Humans; Microsurgery; Nails; Finger Injuries; Surgical Flaps; Plastic Surgery Procedures; Amputation, Traumatic
PubMed: 38447746
DOI: 10.1016/j.hansur.2024.101676 -
Otolaryngologic Clinics of North America Feb 2021Herein we provide a broad overview of the literature as it applies to endoscopic myringoplasty and type I tympanoplasty. Advantages and disadvantages of the endoscopic... (Review)
Review
Herein we provide a broad overview of the literature as it applies to endoscopic myringoplasty and type I tympanoplasty. Advantages and disadvantages of the endoscopic approach are reviewed for both the adult and pediatric populations and are compared with conventional microscopic techniques.
Topics: Adult; Child; Endoscopy; Humans; Microsurgery; Myringoplasty; Treatment Outcome; Tympanic Membrane Perforation; Tympanoplasty
PubMed: 33153741
DOI: 10.1016/j.otc.2020.09.010 -
Advances in Wound Care Aug 2022Excisional procedures for lymphedema have been used for over a century, and many surgeons have abandoned the old techniques as improvements in nonsurgical management...
Excisional procedures for lymphedema have been used for over a century, and many surgeons have abandoned the old techniques as improvements in nonsurgical management and microsurgery have limited their clinical utility. Nonetheless, excisional procedures remain relevant as an important tool in the comprehensive surgical management of lymphedema. Modifications to the Charles procedure and other direct excisional procedures have improved the complication profile and patient outcomes. Moreover, the use of liposuction techniques for minimally invasive tissue excision has expanded the scope of excisional surgery to benefit patients with less severe lymphedema. Recent operations combining excisional and physiologic procedures may prove to have superior results to stand-alone procedures. No standard protocol exists for the comprehensive surgical management of lymphedema. Proper patient selection for any procedure requires robust outpatient assessment, cooperation with physiotherapy treatment teams, careful patient stratification, and a clear understanding of the procedure's goal. Larger, prospective trials will be needed to elucidate the ideal timing and combinations of techniques to optimize outcomes for patients with late-stage lymphedema.
Topics: Anastomosis, Surgical; Humans; Lipectomy; Lymphedema; Microsurgery; Prospective Studies
PubMed: 34128393
DOI: 10.1089/wound.2021.0005