@article{ author = {Dhua, Subha and Manashree, Sankhe and Tilak, Bal Gangadhar}, title = {The Clinical Outcome of Perforator Based Sural Artery and Propeller Flaps in Reconstruction of Soft Tissue of Extremities}, abstract ={BACKGROUND The reconstructive options for the soft tissues in extremities present serious challenges due to thin non-expendable soft tissues and predisposition to massive edema formation, thus frequently requiring flap cover. This study was undertaken to assess the outcome of a modified version of the sural artery flap with that of propeller perforator flaps for the reconstruction of lower extremities, particularly the heel defects.  METHODS This prospective study was conducted on 40 consecutive patients, of which 20 treated with sural artery flap and another 20 with perforator based propeller flap cover for soft tissue reconstruction in extremities based on predefined inclusion criteria. The clinical outcome of the flap was assessed after three months. RESULTS Inclusion of the posterior tibial perforators (along with the sural artery and the peroneal artery) was shown to enhance the flap territory. The raising of the flap was quick with minimal blood loss and the modified flap had a wide arc of rotation for reconstruction of the heel defects. The younger patients regained sensation on the flap earlier, while the durability of the fasciocutaneous flap was excellent in the heel weight bearing areas. The success rate was 95% flap take.  CONCLUSION Careful selection of the perforator and optimal designing of the flap result in favorable outcomes with the use of local perforator flaps for reconstruction in extremities. It provides predictable clinical outcomes with minimal donor site morbidity, is cost-effective, relatively easy technique and requires no special microsurgical setup or instruments. }, Keywords = {Propeller flap, Subcutaneous pedicled propeller flap, Perforator pedicled propeller flap}, volume = {8}, Number = {1}, pages = {3-11}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.1.3}, url = {http://wjps.ir/article-1-446-en.html}, eprint = {http://wjps.ir/article-1-446-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Goyal, Lata and Gupta, Narender Dev and Gupta, Namita and Chawla, Kirti}, title = {Free Gingival Graft as a Single Step Procedure for Treatment of Mandibular Miller Class I and II Recession Defects}, abstract ={BACKGROUND Gingival recession is a frequent issue encountered by both the clinician and the patient. This study was aimed to assess the predictability of the free gingival graft as a single step procedure in terms of root coverage and aesthetics in Miller Class I and II mandibular gingival recession.  METHODS Ten patients (4 males, 6 females) aged 25-30 years with a total of 12 mandibular sites having Miller class I and II recession were selected. All recession sites were treated with single step free gingival graft procedure. Clinical parameters like recession depth, recession width, width of attached gingiva, probing depth and clinical attachment level were recorded at baseline, 6 and 9 months. Visual analog score at 1, 6 and 9 months postoperatively was provided.  RESULTS There was a reduction in mean recession depth from 3.66±1.20 to 0.91±0.99 mm suggesting coverage of 82% over a period of 9 months. There was statistically significant gain in clinical attachment level and width of attached gingiva. Aesthetically, it was acceptable by patients as measured by visual analog scores.  CONCLUSION Free gingival graft as a single step procedure is acceptable in terms of root coverage and aesthetics.}, Keywords = {Perioplastic surgery, Aethetics, Gingival recession}, volume = {8}, Number = {1}, pages = {12-17}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.1.12}, url = {http://wjps.ir/article-1-349-en.html}, eprint = {http://wjps.ir/article-1-349-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Jachec, Sebastian and Perbix, Walter and Fuchs, Paul-Christian and Lefering, Rolf and Weinand, Christi}, title = {Candida Antigen Titer Elevation and Mortality in Burn Patients}, abstract ={BACKGROUND Mortality in burn patients has several contributing factors as sex, age, degree of burns, or inhalation injuries. Usefulness of Candida antigen (CAG) titer is still being under debate to predict mortality. This study assessed correlation between CAG titer and mortality in burn patients. METHODS From 1988 to 2011, 877 burn intensive care patients were evaluated for age, sex, total burn surface area (TBSA), multi organ failure (MOF), burn depth, escharotomy, fasciotomy, antibiotic use, co-morbidities, CAG titer and intubation.  RESULTS From 870 admitted patients, 190 patients were not enrolled. Increasing age was correlated with a higher mortality. The ABSI score of the deceased was 4 points and the TBSA was 20% higher than the survivors. The correlation for age, intubation, TBSA, inhalation injury, MOF, CAG titer, antibiotic use and escharotomy was significant. An increasing mortality was noted with antibiotic use and a CAG titer of 1:8 and higher. CAG titer of 1:8 and higher had a sensitivity of 51.1% and specificity of 86.3% for mortality. Multivariate analysis confirmed high influence of older age, MOF, comorbidities, antibiotic use and CAG titer of 1:8 and higher on mortality. There was a significant correlation for sex, younger age and CAG titer. CONCLUSION CAG titers of 1:8 and higher might warrant beginning of antimycotic treatment in elderly patients with high TBSA to avoid increase in mortality.}, Keywords = {Candida, Burn, Mortality, CAG titer }, volume = {8}, Number = {1}, pages = {18-24}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.1.18}, url = {http://wjps.ir/article-1-427-en.html}, eprint = {http://wjps.ir/article-1-427-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Mamashli, Leila and MohaddesArdebili, Fatemeh and Bozorgnejad, Mehri and NajafiGhezeljeh, Tahereh and Manafi, Farz}, title = {The Effect of Self-Care Compact Disk-Based Instruction Program on Physical Performance and Quality of Life of Patients with Burn At-Dismissal}, abstract ={BACKGROUND Burn injuries still negatively influence the various aspects of life like physical performance and quality of life. This study was conducted to investigate at-dismissal self-care compact disk-based instruction program on the physical performance life quality of the patients with burns. METHODS  One-hundred burn patients in Shahid Motahhari Burn Center, Tehran, Iran were randomly assigned to two equal groups of intervention (n=50) and control (n=50). The latter received only routine dismissal self-care program and the former an instruction compact disc plus the routine self-care program at dismissal. The demographic information and burn patients’ quality of life questionnaires were completed before and at months three and six after the intervention self-report program.  RESULTS The physical performance of the intervention and control groups before intervention was 1.61±0.71 and 1.45±0.47, respectively (p=0.41). The physical performance of the intervention group was higher than the control group at three and six months after the intervention (p<0.001).  CONCLUSION At-dismissal self-care compact disk-based instruction program can increase physical performance and quality of life in patients with burns. Therefore, the burn patients can be instructed based on self-care compact disk-based instruction program as an easy, available and less-costly method to take part in more satisfied treatment.}, Keywords = {Self-care, Burn, Physical performance, Quality of life, Iran }, volume = {8}, Number = {1}, pages = {25-32}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.1.25}, url = {http://wjps.ir/article-1-459-en.html}, eprint = {http://wjps.ir/article-1-459-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Kazemzadeh, Jafar and Rabiepoor, Soheila and Alizadeh, Saeedeh}, title = {The Quality of Life in Women with Burns in Iran}, abstract ={BACKGROUND Severe and extensive burns and the consequent burn scars have a profound impact on various aspects of the patients’, especially women’s quality of life (QOL). Although burn is considered as a common phenomenon in Iran, few studies are conducted to investigate the QOL in women with burn scars. Thus, the present study aimed at investigating the quality of life of married women with severe burns.  METHODS The present study was a descriptive-analytic study conducted on 101 patients with severe burns who referred in 2016 to Imam Khomeini Hospital, Tehran, Iran. The Burn Specific Health Scale (BSHS) and a demographic questionnaire were used to collect and analyze the data.  RESULTS Burns had a significant negative impact on the life quality of women with burns. The average score of quality of life in women was obtained as 51.47±10.44. The most difficult in the quality of life of the patients were in skin sensitivity to heat and treatment regimens and the least difficulty was in simple abilities and hand function.  CONCLUSION The interventions to improve the quality of life is of high importance in the patients with burns. The findings of this study can help us in designing care plans for women with burns. }, Keywords = {Burn, Quality of life, Women, Iran }, volume = {8}, Number = {1}, pages = {33-42}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.1.33}, url = {http://wjps.ir/article-1-412-en.html}, eprint = {http://wjps.ir/article-1-412-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Vaghardoost, Reza and Ghavami, Yaser and Sobouti, Behnam}, title = {The Effect of Mentha Pulegium on Healing of Burn Wound Injuries in Rat}, abstract ={BACKGROUND  Burn is one of the most common injuries and the 4th common cause of trauma globally. This study was designed to evaluate the effect of the Mentha pulegium extract on second degree burn injuries in rats assessing histopathologic and macroscopic. METHODS  M. Pulegium extract dressings was used as a treatment to deep dermal contact burns in rats, compared with two control groups of vaseline dressing and simple dressing by normal saline. After creating second-degree burn on the dorsum of rats, the treatments were applied for 15 min in three groups. Wound dressings were performed on days 1, 3, 7, 14 and 21st and at the same time macroscopic assessment was performed using a digital camera and software processing of photos. Pathologic evaluation of skin specimens was undertaken on days 1, 3,7, 14 and 21st. Wound healing parameters such as epithelialization, angiogenesis, granulation tissue formation, inflammatory cells were compared between these 3 groups. RESULTS Application of M. Pulegium extract on second degree burn wounds significantly decreased burn surface area and increased fibroblasts in comparison to simple dressing. There was not any statistically significant relationship between M. Pulegium extract treated group and vaseline treated or simple dressing groups on other wound healing parameters.   CONCLUSION This study delineated that M. Pulegium extract had a positive effect on healing process of second degree burns. }, Keywords = {Mentha pulegium, Burn, Wound, Healing, Rat}, volume = {8}, Number = {1}, pages = {43-50}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.1.43}, url = {http://wjps.ir/article-1-400-en.html}, eprint = {http://wjps.ir/article-1-400-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Ashkani-Esfahani, Soheil and Khoshneviszadeh, Mahsima and Noorafshan, Ali and Miri, Ramin and Rafiee, Shima and Hemyari, Kimia and Kardeh, Sina and KoohiHosseinabadi, Omid and Fani, Dorna and Faridi, Elnaz}, title = {The Healing Effect of Plantago Major and Aloe Vera Mixture in Excisional Full Thickness Skin Wounds: Stereological Study}, abstract ={BACKGROUND Previous studies indicated that both Plantago major and Aloe vera have anti-inflammatory, tissue regeneration, antioxidant, and immune-stimulatory effects. It is assumed that a mixture of these two herbal medicines may provide a potent material in treatment of skin wound injuries. Therefore, in this study we investigated the effects of Plantago major and Aloe vera mixture in the process of wound healing in rat models according to stereological parameters. METHODS In an experiential study, 36 male Sprague-Dawley rats (200±20 g) were randomly assigned into three groups (n=12): The control group which received no treatment, gel base treated group, and the 5% Plantago major and 5% Aloe vera mixture gel treated group (PA group). Treatments were done every 24 hrs for 15 days. Wound closure rate, volume densities of the collagen bundles and the vessels, vessel’s length density and mean diameter, and fibroblast populations were estimated using stereological methods. RESULTS PA treated group showed faster wound closure rate in comparison with control and gel-base groups (p<0.05). Numerical density of fibroblasts, volume density of collagen bundles, mean diameter, and volume densities of the vessels in PA group were significantly higher than the control and the gel-base treated groups (p<0.05). CONCLUSION We showed that Plantago major and Aloe vera mixture has the ability to improve wound healing by enhancing fibroblast proliferation, collagen bundle synthesis and re-vascularization in skin injuries.}, Keywords = {Wound healing, Fibroblast, Collagen, Vascularization, Plantago major, Aloevera, Stereology, Rat }, volume = {8}, Number = {1}, pages = {51-57}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.1.51}, url = {http://wjps.ir/article-1-185-en.html}, eprint = {http://wjps.ir/article-1-185-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Hassanpour, Seyed Esmail and Rostami, Khalil and Azargashb, Eznollah and Saberi, Kourosh and Hamraz, Seyyed Hosein and FarajzadehVajari, Fatemeh and Molaei, Hojjat}, title = {The Effect of Topical Vitamin A and E on Ischemic Random Skin Flap Survival}, abstract ={BACKGROUND Ischemia of skin flaps is an important complication in reconstructive surgery. This study evaluated the efficacy of topical vitamins A and E on improving flap survival.  METHODS Twenty-four white-albino male rats were randomly divided into two groups of treatment and control. Standard rectangular, distally based dorsal random pattern skin flap was elevated. Intra-peritoneal cephazoline was administered to prevent any unexpected infection. No pharmaceutical agent was administered for the control group, but pure vaseline ointment. In treatment group, vaseline plus vitamins A and E were administrated daily after surgery for 10 days. The rats were evaluated on the 10th day after surgery for viable and necrotic portions of the flaps.  RESULTS The mean values of necrosis in the flaps were 625±189.56 and 920.00±247.31 in the treatment and control groups, respectively. Vaseline plus vitamins increased flap survival significantly. CONCLUSION Topical vitamins A and E may be effective pharmaceutical agents to increase viability of random skin flaps in rats. They can be added to vasoactive topical agents to reach better results.}, Keywords = {Vitamin A, Vitamin E, Ischemia, Skin flap, Survival, Rat }, volume = {8}, Number = {1}, pages = {58-61}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.1.58}, url = {http://wjps.ir/article-1-408-en.html}, eprint = {http://wjps.ir/article-1-408-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Kalantar-Hormozi, Abdoljalil and Shahrokh, Soraya and Abbaszadeh-kasbi, Ali and RitaDavai, Nazani}, title = {Prefabricated Skin Excision in Face Lift: A Simplified Technique}, abstract ={BACKGROUND The demand for facial plastic surgery has dramatically been increased in recent years. Over the last decade, numerous methods have been improved for facelift surgery. Despite these modifications, skin excision technique has not changed significantly. In this study, authors have tried to introduce a new technique regarding skin excision at the initial step of facelift surgery. METHODS A prospective study from 2012 to 2017 on 52 patients was carried out to apply a new technique for facelift ‘’Prefabricated skin excision method’’ for all eligible patients undergoing facelift surgery. The skin calling for excision was marked by the surgeon, and then, an analgesic drug was administered. Then, excision of the marked part of the skin was performed and afterward the dissection of the superficial musculoaponeurotic system (SMAS) was performed with the direct exposure.  RESULTS All patients were female, and 50 (96.1%) cases were primary face lift and 2 (3.9%) cases were secondary. There were no complications among the patients.  CONCLUSION Facilitating the manipulation of deep layer, using this technique led to the further exposure of the surgical site, and more preferable hemostasis was achieved as well.}, Keywords = {Face lift, Rhytidectomy, Facial cosmetic surgery }, volume = {8}, Number = {1}, pages = {62-68}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.1.62}, url = {http://wjps.ir/article-1-414-en.html}, eprint = {http://wjps.ir/article-1-414-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {MozaffariNiya, Nahid and Kazemi, Majid and Abazari, Farrokh and Ahmadi, Fazlollah}, title = {Iranians’ Perspective to Cosmetic Surgery: A Thematic Content Analysis for the Reasons}, abstract ={BACKGROUND Currently, becoming beautiful is a value among Iranian society, although experts have suggested several complications of cosmetic surgery, but decision to have these surgeries has been dramatically increased in recent years. This increase has imposed high workload and costs on the health care system of the country. This study was conducted to explore the reasons why people perform cosmetic surgery in an Iranian context. METHODS Twenty-one subjects from both sexes who were 22-52 year-old and had undergone face plastic surgery between 1-5 years ago were enrolled and semi-structured data was collected via open interviews, while qualitative content were analyzed utilizing conventional analysis methods. Data analysis considered the theme “my face, my destiny” which contained 2 subcategories of “obtaining a chance for a better life “and” obtaining acceptance in society”. RESULTS  The participants considered cosmetic surgery as a blessing from God that played a major role in their future, so they accepted the risks of the surgery. CONCLUSION Understanding experiences of these individuals may help health care team particularly nurses to consult them and other individuals who might think about doing cosmetic surgery through education to help them make a better decision for to do cosmetic surgery.}, Keywords = {Face, Destiny, Content analysis, Decision, Cosmetic surgery, Iran}, volume = {8}, Number = {1}, pages = {69-77}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.1.69}, url = {http://wjps.ir/article-1-272-en.html}, eprint = {http://wjps.ir/article-1-272-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Shahbazi, Zhaleh and Ardalan, Hossein and Maleki, Mahs}, title = {Aesthetics of Numerical Proportions in Human Cosmetic Surgery}, abstract ={BACKGROUND Beauty is a universal phenomenon and debate over what constitutes beauty particularly beauty to human body, has raged since philosophy began. The beauty of individual features depends on “ideal” proportions, and it is suggested that expressing beauty in terms of geometry is possible. Assessment of some used parameters in facial surgeries and harmony of various facial features are essential to surgeon, who requires facial analysis. One of these parameters, is nasolabial angle, in patients undergoing rhinoplasty. This study based on theoretical definitions of beauty and proportions performed the search for the application of this numerical proportions in modern cosmetic surgery.  METHODS Twenty-three samples [16 (69.5%) female and 7 (30.5%)] male] were enrolled from patients who underwent rhinoplasty, by a single surgeon. The nasolabial angle was measured in these patients from their lateral profile photographs with adobe Photoshop, before and after surgery.  RESULTS Ideal post-operative angle was 111.54±26.5 degrees from this study and 18.8◦ increase in male and 14.68◦ increase in female were seen. There was no significant difference between men and women. CONCLUSION Our results showed that an ideal proportion can be very useful and practical to assess patient’s preoperative expectations and to evaluate the results after surgery and satisfaction of cosmetic surgery process.}, Keywords = {Aesthetic, Numerical proportions, Rhinoplasty, Nasolabial angle }, volume = {8}, Number = {1}, pages = {78-84}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.1.78}, url = {http://wjps.ir/article-1-364-en.html}, eprint = {http://wjps.ir/article-1-364-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Sobhani, Zahra and Amini, Masoud and Zarnaghash, Maryam and Hosseini, Seyed Vahid and Foroutan, Rez}, title = {Self-Management Behaviors in Obese Patients Undergoing Surgery Based on General and Specific Adherence Scales}, abstract ={BACKGROUND Adherence has been defined as the degree to which a patient’s voluntary behavior corresponds with the clinical recommendations of health care providers. The aim of this study was to predict self-management behaviors in obese patients undergoing surgery based on general and specific adherence scales. METHODS  All obese patients who underwent bariatric surgery in Ghadir Mother and Child Hospital, Shiraz, Iran from April 2017 to September 2017 were enrolled. By using available sampling method, 201 patients with BMI above 35 (36.43±35.11) and in the age range of18-65 years (13.38±80/5) were selected. A questionnaire containing general adherence scale (GAS), specific adherence scale (SAS) and post-surgery self-management behaviors questionnaire (BSSQ) was completed by all patients.  RESULTS The general and specific adherence scales were significant predictors for self-management behaviors after surgery, and positive relation was found for general and specific adherence scales with self-management behaviors.  CONCLUSION Self-management behaviors regarding eating behaviors, supplements, fruits, vegetables, grains, protein and fluid intake, physical activity, dumping syndrome management have significant relationship with general and specific adherence scales. So increasing knowledge, skills, motivation, self-confidence, self-efficacy and self-monitoring of obese patients after surgery seem necessary.}, Keywords = {General adherence, Specific adherence, Self-management behaviors, Surgery, Obesity}, volume = {8}, Number = {1}, pages = {85-92}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.1.85}, url = {http://wjps.ir/article-1-376-en.html}, eprint = {http://wjps.ir/article-1-376-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Ahmad, Muhammad and Mohmand, Muhammad Humayun and Ahmad, Taokeer}, title = {A Survey among Plastic Surgeons Wearing a Mask in Operating Room}, abstract ={BACKGROUND Face mask is considered to be an integral part of a surgeon’s dress in operating room. The following study was carried out among the plastic surgeons to know their views about the wearing the face masks in operating room (OR). METHODS A questionnaire was developed and was sent to the 2 groups of plastic surgeons which included 8 questions. Group A consisted of 100 plastic surgeons from the subcontinent. Group B consisted of 100 plastic surgeons of USA and European origins. The questionnaires were sent by emails and the data was analyzed. The questionnaire was consisted of 8 questions. RESULTS About 93% of the plastic surgeons in group A wore the mask and 86% in group B. About 96% of plastic surgeon in group A and 99% in group B used disposable masks and only 4% in group A and 1% in group B used re-usable/washable face masks. About 59% in group A and 63% in group B covered the nose. Botox and filler injections were the commonest procedures in which the surgeons opted to perform without face mask (74% in group A and 68% in group B), followed by liposuction (41% in group A and 34% in group B). The majority in both groups believed that face mask decreases the surgical site infection. CONCLUSION Most of the plastic surgeons wore the face masks in the OR. Care must be taken to ensure that properly designed studies that determine if surgical masks prevent post-operative wound infection.}, Keywords = {Plastic surgeon, Wear, Mask, Operating room}, volume = {8}, Number = {1}, pages = {93-96}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.1.93}, url = {http://wjps.ir/article-1-360-en.html}, eprint = {http://wjps.ir/article-1-360-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Ricci, Joseph and Desai, Nam}, title = {Reconstruction of A Type IIIB Hypoplastic Thumb with A Huber Opposition Transfer in A Five-Year-Old Girl: Redefining Surgical Treatment}, abstract ={Thumb hypoplasia, a congenital deficiency of bony and soft tissue of thumb, is often associated with systemic syndromes like Holt-Oram syndrome, and is the second most common thumb anomaly after duplicated thumb. It has traditionally been classified into six categories, which help guide treatment including reconstruction versus pollicization (transfer of the index finger to thumb). Amputation of the thumb and pollicization is the traditional treatment for a IIIB hypoplastic thumb. A five-year-old girl presented with a classic type IIIB hypoplastic thumb in which she has absent motor function, aplasia of the metacarpal, shortened first web space, and an unstable but present carpometacarpal (CMC) joint. Instead of amputation, the thumb was reconstructed by capsulodesis to stabilize the CMC joint, Huber Transfer Opponensplasty and abductor pollicis longus transfer to restore motor function, W-plasty to deepen the first web space, and distraction to lengthen the metacarpal. The patient tolerated the multi-stage reconstruction and bony distraction well. She was followed for one year postoperatively and has demonstrated a functional thumb. This case questions the surgical algorithm for hypoplastic thumbs and suggests a revised classification system for hypoplastic thumbs which would further divide class III based on not only the stability of the CMC joint but the presence or absence of the joint as well. We propose that amputation be reserved for type III hypoplastic thumbs in which the CMC joint is absent, (revised class IIIC) and reconstruction be attempted when the joint is present irrespective of stability (revised classes IIIA and IIIB).}, Keywords = {Congenital hand deformity, Hypoplastic thumb, Huber opposition transfer}, volume = {8}, Number = {1}, pages = {97-102}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.1.97}, url = {http://wjps.ir/article-1-344-en.html}, eprint = {http://wjps.ir/article-1-344-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Weinand, Christian and Dittes, Carste}, title = {Soft Tissue Mandibula and Tongue Reconstruction Using A Suprafascial, Folded, Deepithelialized Antero-Lateral Thigh Perforator Free Flap}, abstract ={Head and neck squamous cell carcinoma (HNSCC) is the most frequent carcinoma of the head and neck region.  For coverage of an entire resected mandible with floor of the mouth, 3/4 of the tongue and soft tissue of cheeks and neck bony reconstruction of the mandible and soft tissue reconstruction of tongue, cheeks and a neck large flap are needed. A patient with a superinfected T4 HNSCC was presented to our outpatient clinic. Complete resection of the mandible, bilateral neck dissection and 3/4 resection of the tongue were performed. A complex reconstruction using two free flaps was not feasable, so a large, folded, suprafascial Antero Lateral Thigh Perforator (ALTP) flap for immediate soft tissue reconstruction was used. Because of the anatomy, no reconstruction plate was inserted. On postop day 11, an understandable speaking was possible using a speach canula. Swallowing was possible without regurgitation. Eight months postoperatively, the patients mimic and closure of the mouth were satisfactory. The flap was viable throughout the entire time. It was shown that the suprafascial ALTP flap was a versatile part in the armamentarium for complex mandible soft tissue reconstruction.}, Keywords = {Flap, Mandible, Tongue, Reconstruction, Sqamous cell carcinoma, Surgery}, volume = {8}, Number = {1}, pages = {103-107}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.1.103}, url = {http://wjps.ir/article-1-452-en.html}, eprint = {http://wjps.ir/article-1-452-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Manafi, Amir and Hamedi, Zahra Sadat and Manafi, Farz}, title = {Introduction of a Less Invasive Revision Rhinoplasty Using Closed Nasal Chondrotome}, abstract ={Rhinoplasty is the most common aesthetic surgical procedure in Iran.  Dorsal bony and cartilaginous structures of the nose play an important role in nasal esthetics and function. Manipulation of nasal dorsum is one of the cardinal procedures during rhinoplasty operation. Some cases of primary rhinoplasty lead to various post-operative nasal imperfections. One of the most common imperfections is dorsal nasal spur which can cause dorsal irregularities. The accurate rate of imperfections relates to some factors like the surgeon’s experience and his/her precision, and appropriate post-operative patient care. Alomost  15%of revision or secondary surgical manipulations are acceptable for an experienced plastic surgeon. Most of the revision rhinoplasties are due to minor deformities in nasal dorsum like cartilaginous spur or mild focal depression. We have introduced an innovative device “Closed Nasal Chondrotome” that can ease the procedure for treating of minor nasal dorsal deformities. we propose the use of closed nasal chondrotome for mild dorsal spurs and have presented the effectiveness of this device in one patient. This simple but very effective instrument can be an alternative for a revision rhinoplasty procedure in the operating room to an outpatient procedure with local anesthesia. This method has been used in one patient with the satisfactory result, permitting corrections of minor cartilaginous excess deformities, with a less invasive procedure.}, Keywords = {Closed nasal chondrotome, Revision rhinoplasty, Dorsal spur}, volume = {8}, Number = {1}, pages = {108-111}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.1.108}, url = {http://wjps.ir/article-1-139-en.html}, eprint = {http://wjps.ir/article-1-139-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Al-Qattan, Mohammad and Al-Kahtani, F. S.}, title = {Dorsal and Ventral Dimelia in the Same Hand in A Patient with Severe Ulnar Ray Deficiency: A Case Report}, abstract ={Dorsal dimelia (the appearance of dorsal hand structures on the palmar aspect of the hand) and ventral dimelia (the appearance of ventral hand structures on the dorsal aspect of the hand) are rare congenital anomalies of the hand. None of the previously reported cases had combined dorsal and ventral dimelia in the same patient. Here, we report a case of severe ulnar ray deficiency. The hand had two digits: the radial digit had a palmar nail (dorsal dimelia) and the ulnar digit had absence of the normal dorsal nail along with the appearance of an ectopic pulp on the dorsal aspect of the digit (ventral dimelia). Ulnar ray deficiency is an error of sonic hedgehog (SHH) responsible for antero-posterior patterning of the limb in-utero. Ventral and dorsal dimelia are errors of dorso-ventral patterning of the hand. The complex interactions of SHH with the dorso-ventral axis of development may explain the concurrent dimelia in our patient.}, Keywords = {Dorsal dimelia, Palmar nail, Ventral dimelia, Congenital, Hand}, volume = {8}, Number = {1}, pages = {112-115}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.1.112}, url = {http://wjps.ir/article-1-435-en.html}, eprint = {http://wjps.ir/article-1-435-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Rouientan, Abdolreza and AlizadehOtaghvar, Hamidreza and Mahmoudvand, Hossein and Tizmaghz, A}, title = {Rare Complication of Botox Injection: A Case Report}, abstract ={Botulinum toxin (BTX) is also well-known as Botox is produced by a gram-positive anaerobic bacterium called Clostridium botulinum. Generally, clinical manifestations of BTX can be observed after consumption of contaminated food, from colonization of the infant gastrointestinal tract, as well as following the infection of the wound to this bacterium. There are seven types of this neurotoxin labeled as A, B, C (C1, C2), D, E, and F. Human botulinum is caused by types A, B, E and rarely F. The most common clinical symptoms of BTX in cosmetic goals are cervical dystonia, severe primary axillary hyperhidrosis, strabismus, neurogenic detrusor over-activity, chronic migraine, upper limb spasticity and blepharospasm. Botox has a wide range of therapeutic uses and occasionally patients receiving this treatment may experience botulism symptom including local and even distant and autonomic symptoms. Despite the efficacies of Botox in treatment of myriad neurologic and cosmetic conditions, it may carry some risk of sever adverse effects which may be the result of local or systemic spreading of the drug. Our patient was a 22 years old man who received Botox for axillary hyperhidrosis after two weeks, when most of generalized complications of botulinum toxin appeared. This case was introduced for being aware of dangerous complication of Botox. Pyridostigmine could relieve symptoms of the patient.}, Keywords = {Botulinum, Toxin, Botox, Complication, Iran}, volume = {8}, Number = {1}, pages = {116-119}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.1.116}, url = {http://wjps.ir/article-1-413-en.html}, eprint = {http://wjps.ir/article-1-413-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Javed, Muhammad U and Murison, Maxwell}, title = {The ‘Gopher Sign’: A Clinical Sign to Determine the Adequate Depth of CO2 Laser Ablation in Rhinophyma}, abstract ={}, Keywords = {Gopher sign, CO2 laser, Rhinophyma, Sign}, volume = {8}, Number = {1}, pages = {120-121}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.1.120}, url = {http://wjps.ir/article-1-351-en.html}, eprint = {http://wjps.ir/article-1-351-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Rezaei, Ezatollah and Hojjati, Yavar Shams}, title = {Misdiagnosed Extranasal Mass: Report of A 2-Year Old Child with Maltreated Rare Nasal Neuroglial Heterotopia}, abstract ={}, Keywords = {Nasal glioma, Misdiagnosed, Hemangioma, Encephalocele, Outcome}, volume = {8}, Number = {1}, pages = {122-124}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.1.122}, url = {http://wjps.ir/article-1-474-en.html}, eprint = {http://wjps.ir/article-1-474-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {}, title = {Retraction}, abstract ={This retracts the article “Nutritional Status in Patients with Gastrointestinal Cancer in Comparison To Other Cancers In Shiraz, Southern Iran: a Case-Control Study” in volume 7 on page 186. Jamshidi S, Hejazi N, Zimorovat AR. Nutritional Status in Patients with Gastrointestinal Cancer in Comparison To Other Cancers In Shiraz, Southern Iran: a Case-Control Study. World J Plast Surg 2018;7(2):186-192. This article has been retracted by the editorial due wrong inclusion and the mistake by the publisher in World J Plast Surg. Date of Retraction: 01.08.2018}, Keywords = {}, volume = {8}, Number = {1}, pages = {125-125}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.1.125}, url = {http://wjps.ir/article-1-484-en.html}, eprint = {http://wjps.ir/article-1-484-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Kardeh, Sina and Saki, Nasrin and Jowkar, Farideh and Kardeh, Bahareh and Moein, Seyed Arman and Khorraminejad-Shirazi, Mohammad Hossei}, title = {Efficacy of Azithromycin in Treatment of Acne Vulgaris: A Mini Review}, abstract ={BACKGROUND Antibiotics are commonly used in the treatment of acne vulgaris. Considering the rise of antibiotic resistance, alternative medications may be used in the main anti-acne armamentarium. The aim of this study was to investigate the efficacy of oral azithromycin in the treatment of acne vulgaris. METHODS Database searches were performed in PubMed and Scopus using the keywords "azithromycin" and "acne". RESULTS Azithromycin 500 mg once daily for 3 days per week or in cycles of 10 days for 12 weeks are the most commonly used regimens. CONCLUSION Available experimental data suggest that oral azithromycin is an effective and well-tolerated option for treatment of acne vulgaris.}, Keywords = {Azithromycin, Tetracycline, Doxycycline, Acne vulgaris, Treatment}, volume = {8}, Number = {2}, pages = {127-134}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.2.127}, url = {http://wjps.ir/article-1-453-en.html}, eprint = {http://wjps.ir/article-1-453-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Salehahmadi, Fatemeh and Hajialiasgari, F}, title = {Grand Adventure of Augmented Reality in Landscape of Surgery}, abstract ={Computer as an integral part of continual advancements in medicine has experienced tremendous development to minimize the risks and improving the precision of the surgery. Our review included multi-disciplinary publications in English from 2014 to 2017 using Springer, Oxford library, Elsevier, PubMed, Google Scholar, and Springer search engines using terms of “augmented reality (AR), “plastic surgery,” and “surgery “ and “Augmented Reality Ethics and challenges”. It was shown that AR has been successfully effective in different branches of surgery, but with concerns and challenges like acceptance, privacy, different physical, security and behavioral threats. To come over them partially, a methodological approach for cyber threat landscape proactive exploration has been suggested.  }, Keywords = {Augmented reality, Surgery, Rewards, Drawbacks}, volume = {8}, Number = {2}, pages = {135-145}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.2.135}, url = {http://wjps.ir/article-1-457-en.html}, eprint = {http://wjps.ir/article-1-457-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Dennis, Werner and Alawi, Seyed Arash}, title = {Four Extremity Amputation and Bionic Prosthesis Supply after Disseminated Intravascular Coagulation: A Follow-Up on Functionality and Quality of Life after Bionic Prosthesis Supply}, abstract ={BACKGROUND Disseminated intravascular coagulopathy (DIC) is a rare symptom complex that causes embolisms within the microvasculature and extensive necrosis of the skin and the acres. During surgical decision-making, preserving functionally important structures must be weighed against radical debridement. The aim was to analyze functional recovery and quality of life of patients sustaining amputations from disseminated intravascular coagulopathy and supplied with bionic prostheses. METHODS A monocentric, retrospective review of patients with disseminated intravascular coagulopathy after sepsis was conducted from 2016 to 2018. After initial reconstruction and intensive care treatment, patients were provided with bionic prosthetic devices. A follow-up survey measuring function and quality of life was performed. RESULTS Three patients (mean: 45 years; median: 50 years) were analyzed. The first necrectomy and amputation were performed, on average, after >4 weeks post-symptom onset. All patients required re-amputation, averaging two or one re-amputations in the right or left upper extremity, respectively, and one in ​​the lower extremities. On average, 12 operations for reconstruction of skin defects were required (x͂=8). On average, patients tolerated their prostheses for 5.67 h per day. Satisfaction metrics were either sufficient (SF-36, x̅=69) or moderate (TAPES-R, x̅=4.7). Physical skills were rated poor to fair (average TAPES-R=2.67).  CONCLUSION Supplying bionic prostheses after DIC yielded sufficient to moderate results. However, prothesis weight, signal transmission disorders, and repeated functional failures were suboptimal. For extensive stump scarring, implantable signal electrodes may improve signal transmission.}, Keywords = {Disseminated intravascular coagulopathy, Amputation, Reconstruction, Bionic, Myoelectric, Prosthesis, Rehabilitation }, volume = {8}, Number = {2}, pages = {146-162}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.2.146}, url = {http://wjps.ir/article-1-503-en.html}, eprint = {http://wjps.ir/article-1-503-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Kim, Sung-Hwan and Seo, Bommie Florence and Choi, Young and Oh, Yong-Seog and Kim, Ju You}, title = {Subpectoral Implantation of Cardiovascular Implantable Electronic Device: A Reasonable Alternative for the Conventional Prepectoral Approach}, abstract ={BACKGROUND The prepectoral implantation technique has been the standard procedure for cardiovascular implantable electronic device (CIED). However, it cannot be performed in such patients with thin skin or patients with cosmetic concerns. This study was designed to demonstrate the feasibility and safety of the subpectoral compared to the prepectoral approach. METHODS We conducted a retrospective, nonrandomized comparison of the prepectoral (234 cases) and subpectoral approach (32 cases) in patients who received CIED implantation at a tertiary center between July 2012 and May 2015. We compared lead characteristics, procedure time and complications between the subpectoral and prepectoral approach. RESULTS In the subpectoral group, two complications were observed, whereas six complications were found in the prepectoral group (2/32 vs. 6/234, respectively, p=0.25). In the subpectoral group, one patient developed wound infection and the others were safely conducted without any complications. In the prepectoral group, two patients developed hemopericardium, three developed pocket hematoma requiring surgical revision, and one developed a pneumothorax. Procedure time in the subpectoral group took longer than that in the prepectoral group (150±50 min versus 91±49 min, p=0.06). In lead characteristics, there were no significant differences between the two groups. CONCLUSION The subpectoral approach is technically feasible and non-inferior to the prepectoral approach, in the aspect of complication and lead characteristics, but seemed to take more procedure time. The subpectoral approach is a more reasonable choice for selected patients in whom the prepectoral approach is not feasible or in individuals who have cosmetic concerns.}, Keywords = {Cardiovascular, Subpectoral, Prepectoral, Implantation, Cosmetic}, volume = {8}, Number = {2}, pages = {163-170}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.2.163}, url = {http://wjps.ir/article-1-461-en.html}, eprint = {http://wjps.ir/article-1-461-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {DiPietro, Verdiana and ColicchiaGianfranco, Marcello and Cervelli, Valerio and Gentile, Pietro}, title = {Medial Thigh Contouring in Massive Weight Loss: A Liposuction-Assisted Medial Thigh Lift}, abstract ={BACKGROUND Thigh’s lifting can be associated with significant complications, if the medial thigh excess is removed en bloc. In this study, the liposuction-assisted medial thigh’s lift (LAMeT) procedure, outcomes and complications were assessed. METHODS Twenty four females between 25 and 61 years with grade 2 or 3 on Pittsburgh Rating Scale (PRS) treated with medial thigh’s reduction were enrolled. Medial thigh’s reduction was performed in three different procedures of vertical, horizontal and LAMeT. Vertical thigh’s lift with fascia suspension was conducted in 13 patients with grade 3 of ptosis on PRS; horizontal thigh’s lift with fascia suspension was undertaken in 3 patients with grade 2 on PRS; vertical and horizontal thigh’s lift considered as control group was described as excision-only group; and LAMeT was performed in 8 patients with grade 2 and 3 on PRS. RESULTS Complications were observed in 62.5% of patients who underwent vertical or horizontal thigh’s lift with fascia suspension and in 16.7% who experienced the LAMeT without fascia suspension. The most frequent complication was seroma. Hospital stay was significantly lower in the LAMeT. CONCLUSION Medial thigh’s lift is a safe and satisfying procedure because it provides aesthetic improvement in massive weight loss patients. The complication rate is higher when skin excess and laxity are removed en bloc, as the resection of excess tissue is poorly selective. The LAMeT preserves lymphatic and blood vessels and allows a more anatomical resection of the excess skin. Thus postoperative complications incidence is lower and the patient heals faster.  }, Keywords = {Medial thigh contouring, Weight loss, Liposuction-Assisted Medial Thigh Lift}, volume = {8}, Number = {2}, pages = {171-180}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.2.171}, url = {http://wjps.ir/article-1-483-en.html}, eprint = {http://wjps.ir/article-1-483-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {AhmadShah, Ajaz and Raina, Ashiq Hussain and Ganie, Mudasir Ahmad and Kumar, Irshad Ahm}, title = {Comparison of Aspiration Followed by Intra-Lesional Steroid Injection and Surgical Excision in Management of Dorsal Wrist Ganglion}, abstract ={BACKGROUND About 60-70% of ganglion cysts are found in dorsal part of the wrist. This study compared aspiration followed by intra-lesional steroid (triamcinolone acetate) injection and surgical excision in the management of dorsal wrist ganglion. METHODS                    From Aug 2016 to Aug 2018 in Department of General Surgery, Government Medical College Srinagar, India, 86 Patients with dorsal wrist ganglions were enrolled. The patients were divided to two groups undergoing two different treatment modalities including 68 patients of aspiration with intralesional triamcinolone acetonide injected into the cyst (group A) and 18 patients with surgical excision (group B). Follow up time was 1, 3, 6 and 12 months.  RESULTS Successful treatment was noticed in 59 patients of group A (86.8%), and in 15 patients of group B (83.3%). CONCLUSION Aspiration followed by intra-lesional steroid injection was better managed in comparison to surgical excision.}, Keywords = {Aspiration, Intra-lesional, Steroid, Surgery, Excision, Dorsal wrist ganglion}, volume = {8}, Number = {2}, pages = {181-184}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.2.181}, url = {http://wjps.ir/article-1-502-en.html}, eprint = {http://wjps.ir/article-1-502-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Dhua, Subha and T.R., Suhas and Tilak, Balagangadhar}, title = {The Effectiveness of Autologous Platelet Rich Plasma Application in the Wound Bed Prior to Resurfacing with Split Thickness Skin Graft vs. Conventional Mechanical Fixation Using Sutures and Staples}, abstract ={BACKGROUND Autologous platelet rich plasma (PRP) has significant benefits facilitating improved graft take on wound beds due to hemostasis, adhesive and healing properties. This study aimed at effective use of PRP in wound beds on graft take irrespective of etiology as compared to conventional methods of mechanical fixation using sutures and staples. METHODS Forty cases including 20 in control and 20 in PRP groups admitted to the Department of Plastic Surgery at Vydehi Institute of Medical Sciences and Research Centre, Bangalore were enrolled between October 2015 and September 2017. Freshly prepared autologous PRP was applied on wound beds in the treated group, while conventional mechanical fixation methods like staples and sutures were used in the control group for the fixation of the skin grafts. RESULTS Most significant result was the instant graft take to the wound bed irrespective of the etiology besides hemostasis and healing properties in the PRP treated group which resulted in considerable reduction of surgeon’s time required for the removal of sutures and staples at the final stages. Also, only 10% with graft edema were noted in the PRP treated patients as compared to 68% in the control group. The inner dressings and skin graft were dry in the PRP group and the post-operative etching, weeping and pain at the graft site reduced. CONCLUSION The cosmetic appearance of this scar was better in the PRP group besides post-operative edema and graft loss. The study recommends use of PRP at the recipient site of split thickness skin graft.}, Keywords = {Platelet rich plasma, Autologous, Wound, Split thickness skin graft, Graft}, volume = {8}, Number = {2}, pages = {185-194}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.2.185}, url = {http://wjps.ir/article-1-402-en.html}, eprint = {http://wjps.ir/article-1-402-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Elmelegy, Nader and Elghamry, Sameh and Shoukr, Tarek}, title = {Free Style Perforator Flaps for Aesthetic Facial Reconstruction}, abstract ={BACKGROUND Functional and cosmetic outcomes affect reconstruction of the face more than any region of the body. To use a predetermined perforator flap freely designed allowing a wide range of movement and manipulation can give us an optimum outcome. We present our clinical experience with free style facial perforator flaps, surgical technique, and complications.  METHODS  Thirty patients with post-tumor resection of the face were reconstructed with free style local perforator flaps between January 2014 and November 2016. Doppler was used to identify the perforator vessels preoperatively.  RESULTS Twenty-two clinical cases had no complications. Four had venous congestion that resolved spontaneously, three had a distal 1/3 superficial necrosis, and one suffered from hematoma.  CONCLUSION Freestyle perforator flaps were applied to get better cosmetic facial reconstruction, allowing one stage procedure and decreasing donor site morbidity. Modern anatomical understanding, good planning, and meticulous surgical technique can affect clinical results.}, Keywords = {Perforator, Flap, Aesthetic, Facial, Reconstruction }, volume = {8}, Number = {2}, pages = {195-199}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.2.195}, url = {http://wjps.ir/article-1-468-en.html}, eprint = {http://wjps.ir/article-1-468-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Masoomi, Hossein and Fairchild, Berry and Marques, Erik S.}, title = {Frequency and Predictors of 30-Day Surgical Site Complications in Autologous Breast Reconstruction Surgery}, abstract ={BACKGROUND Surgical site complication (SSC) is one of the known complications following autologous breast reconstruction. The aim of this study was to evaluate the frequency and predictors of 30-day surgical site complications in autologous breast reconstruction. METHODS American College of Surgeons National Surgery Quality Improvement Project (ACS-NSQIP) database was used to identify patients who underwent autologous breast reconstruction during  2011-2015. Multivariate regression analysis was performed to identify independent perioperative risk factors of SSC. RESULTS Totally, 7,257 patients who underwent autologous breast reconstruction surgery were identified. The majority of the procedures were free flap (60%) versus pedicled flap (40%). The mean age was 51 years and the majority of patients were classified as American Society of Anesthesiologists (ASA)-II (60%) and 15% of patients had BMI>35. The overall 30-day SSC rate was 6.3%. The overall frequency of different types of SSC were superficial incisional infection (3.2%), wound dehiscence (1.8%), deep incisional infection (1.4%) and organ space infection (0.6%). BMI>35 (adjusted odds ratio [AOR]=2.38), smoking (AOR=2.0), diabetes mellitus (AOR=1.67) and hypertension (AOR=1.38) were significant risk factors of SSC. There was no association with age, ASA classification, steroid use, or reconstruction type. CONCLUSION The rate of 30-day SSC in autologous breast reconstruction was noticeable. The strongest independent risk factor for SSC in autologous breast reconstruction was BMI>35. The type of autologous breast reconstruction was not a predictive risk factor for SSC. Plastic surgeons should inform patients about their risk for SSC and optimizing these risk factors to minimize the rate of surgical site complications.}, Keywords = {Frequency, Predictor, Surgical site, Complication, Autologous, Breast, Reconstruction }, volume = {8}, Number = {2}, pages = {200-207}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.2.200}, url = {http://wjps.ir/article-1-505-en.html}, eprint = {http://wjps.ir/article-1-505-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Abbasi, Rohollah and Dowlati, Ali and SeifRebiei, Mohamad Reza and Hashemian, Farnaz}, title = {Correction of Severe Deviated Nose by Intermediate Short Osteotomy}, abstract ={BACKGROUND The deviated nose is a common deformity encountered in rhinoplasty, and yet it is the most challenging pathology to treat, because multiple internal and external structures have deformity, so there is a need to be corrected.  METHODES The intermediate short osteotomy has been applied as a technique to correct severe nasal bony deviations. Eleven patients with severe deviated nose who had been operated by the senior author from 2013 through 2016 were included in the study (follow-up period of 6-24 month). Intermediate short osteotomy was performed after medial and before lateral osteotomy. Surgical outcomes were assessed by another otolaryngologist based on review of pre- and post-operative (6 to 24 months after surgery) photographs. The post-operative outcome in terms of deviation correction was classified as excellent, good, fair, or no change. RESULTS Of all 11 cases, 6 (54.5%) were accepted as excellent, 4 (36.4%) as good, and 1 (9%) as no change. CONCLUSION Intermediate short osteotomy can be considered as a modification of intermediate osteotomy that eliminates nasal dorsal deviation more completely. This osteotomy is very simple and need only 1 to 2 minutes and use of this method is recommended for correction of severe deviated bony noses.}, Keywords = {Deviated nose, Crooked nose, Rhinoplasty, Osteotomy}, volume = {8}, Number = {2}, pages = {208-212}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.2.208}, url = {http://wjps.ir/article-1-428-en.html}, eprint = {http://wjps.ir/article-1-428-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Hoghoughi, Mohammad Ali and Habibagahi, Rah}, title = {Novel Technique to Repair Unilateral Cleft Lip: Separated Multiple Y-to-V-Plasty under Magnification}, abstract ={BACKGROUND Various techniques have been used for cleft repair such as the straight-line closure, the rotation advancement technique and the anatomic subunit approach which are famous new approaches gained popularity. However, these methods have several advantages and disadvantages and sometimes are difficult to adopt. In this study, we described our novel technique, known as separated multiple Y-to-V-plasty, in treatment of several cases of unilateral cleft lip. METHODS Plastic surgeons usually try to avoid straight closure of the wound, especially in areas where they need to stretch, move and enhance the length of the wound in some stages of the procedure. Since the lip is a dynamic and active structure and is constantly moving, the use of straight-line incision and closure in that area is in conflict with this basic concept. RESULTS In our newly introduced technique, we avoided a straight-line closure along the skin and mucosa for the repair of the unilateral cleft lip. This issue is of utmost importance in cases with severe loss of lip height and discrepancy. CONCLUSION To acquire a natural and balanced shape in unilateral cleft lip repair, we recommended the novel Y-to-V-plasty technique as an effective method for severe unilateral cleft lip with enormous discrepancy.  }, Keywords = {Cleft lip, Y-to-V-plasty, Repair, Aesthetic}, volume = {8}, Number = {2}, pages = {213-218}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.2.213}, url = {http://wjps.ir/article-1-481-en.html}, eprint = {http://wjps.ir/article-1-481-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Motamed, Sadrollah and MohammadiTorbati, Peyman and ZaferaniArani, Hamid and Motabar, Amir Reza and Zabolian, Amirhossein and Madadi, Zahr}, title = {Effects of the Human Amniotic Membrane on the Cartilage Graft: Prognosis and Absorption in White Rabbits}, abstract ={BACKGROUND Cartilage grafts are generally accepted for the restoration and reconstruction of nasal contours. The main concern that plastic surgeons may need to address after surgery pertains to the resorption and disfigurement of the grafted cartilage, especially in allogenic and heterogenic grafts. METHODS A total of 12 white rabbits were divided into three groups according to the types of graft including autograft, allograft, and heterograft. We used three shapes of grafts, including block, crushed, and diced cartilage in the upper, middle, and lower rows. However, in each rabbit, these grafts were divided into two columns of wrapped and unwrapped grafts, with human amniotic membrane (HAM) grafted on each side of the rabbit’s back. RESULTS In total, 60 specimens underwent histopathological examination. No inflammation was observed in about 50% of the block-shaped conchal cartilages with HAM, and in 50%, less than 25 inflammatory cells per unit were seen. The prognosis and absorption of autograft specimens in block-shaped cartilages with HAM were significantly better compared with other shapes of cartilages with HAM and without HAM. The proliferation rate of fibroblasts in autograft and allograft specimens was more than that in heterograft specimens with HAM. CONCLUSION Our findings have demonstrated the new role of HAM in clinical applications, indicating that HAM may be used as a low-cost, easily accessible alternative for wrapping in cartilage grafts instead of fascia or surgicel in early future. It is useful for improving the long-term outcomes and decreasing the resorption rate.}, Keywords = {Graft, Cartilage, Amniotic membrane, Rabbit}, volume = {8}, Number = {2}, pages = {219-228}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.2.219}, url = {http://wjps.ir/article-1-494-en.html}, eprint = {http://wjps.ir/article-1-494-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Gholami, Mahdi and Hedjazi, Arya and Milani, Amir Kiamarz}, title = {Evaluation of Anatomic Variations of Fibula Free Flap in Human Fresh Cadavers}, abstract ={BACKGROUND Reconstruction of the head and neck defects is still one of the most challenging surgeries for the surgeons. This study investigated on anatomic variations of fibula free flap in human fresh cadavers. METHODS Twenty fibula free flaps harvested from 10 fresh human corpses were enrolled. The number and type of skin perforators and their origin were recorded during the flap harvesting. After the completion of flap harvesting, the length of vascular pedicle and diameter of the artery and vein at the origin, the fibula length, the distance of the head of fibula to the site of peroneal artery bifurcation and harvesting time were also recorded.  RESULTS The fibula free flaps were performed on 2 women and 8 men with the mean age of 35.6 years. The average number of perforators per flap was 1.7, most of which were musculocutaneous (35.29%) from soleus muscle. The mean fibula length was 33.1 (range: 31-35) cm. The mean distance of the head of fibula to the site of peroneal artery bifurcation from the tibialis posterior trunk was 5.76 (range: 4.5-6.5) cm. The mean length of the pedicle flap was 11.15 (range: 10-13) cm. The mean diameters of the peroneal artery and vein at the origin were 2.83 and 51.5 mm, respectively.  CONCLUSION Although the fibula osteocutaneous flap is a reliable choice for maxillofacial reconstruction, flap harvesting is fairly difficult. Accordingly, surgeons must be aware of anatomical variations of the flap and have a suitable case selection to minimize the risk of surgical complications}, Keywords = {Fibula, Free flap, Fresh cadaver, Skin perforators}, volume = {8}, Number = {2}, pages = {229-236}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.2.229}, url = {http://wjps.ir/article-1-499-en.html}, eprint = {http://wjps.ir/article-1-499-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Loghmani, Shahriar and Loghmani, Alireza and Maraki, Fatemeh}, title = {Oblique Split Rib Graft Surgery in Primary and Secondary Septorhinoplasty}, abstract ={BACKGROUND Rib cartilage is an outstanding material in reconstructive septorhinoplasty, especially in revision surgery with a low rate of complications compared to other materials. In this study, the results of oblique splitting of rib grafts were evaluated in 25 patients operated for primary and secondary septorhinoplasty. METHODS The prospective case series were undertaken on 25 patients of saddle or crooked nose that referred to the senior author’s private office between January 2015 and November 2017. They had primary and secondary septorhinoplasty using autologous costal cartilage carved by the oblique split method (OSM). The postoperative follow-up period ranged from 3 to 36 months (Mean follow up of 19 months). RESULTS The problems seen in patients were saddle-nose deformity in 16 cases, crooked-nose deformity in 3, crooked nose and saddle nose in 3 and implant infection, inverted V-pinch, destruction of septum in 3 more cases. After oblique split rib grafts surgery and 3-36 month follow-up (an average of 19 months), the operative outcomes were successful and no severe resorption, infection, warping or displacement were observed related to graft and patients were also satisfied, and there was no complication of the donor-site. The patients did not have any post-operative complications and no complain of nasal distortion during follow up period. CONCLUSION OSM allowed obtaining large quantities of graft material without the risk of warping due to inclusion of both peripheral and central portions of the rib cartilage.  }, Keywords = {Oblique split method, Rib, Graft, Septorhinoplasty, Cartilage}, volume = {8}, Number = {2}, pages = {237-244}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.2.237}, url = {http://wjps.ir/article-1-464-en.html}, eprint = {http://wjps.ir/article-1-464-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Nasiri, Mojtaba and Kardar, Mohammad Hosei}, title = {Nasojugal Flap with Dermal Pennant for Reconstructive of Lower Lid Defect}, abstract ={BACKGROUND Basal cell carcinomas (BCCs) are locally invasive periocular skin cancers affecting lower eyelids more than upper eyelids. The purpose of this study was to describe techniques used for lower eyelid reconstruction after extended excision of BCC.  METHODS Eight referred patients with BCC who underwent lower eyelid reconstruction were enrolled. The tumor was surgically excised with sufficient margins by one surgeon. Defects were repaired by subdermal tunnel between lateral border of defect and insertion site of lateral cantus.  RESULTS Eight patients aged 45 to 75 years were followed up for 6 months. After follow up, adequate viability of the grafts, satisfactory functional and good cosmetic results was noticed in all patients. One patient complained of irritation at the site of surgery. No total or partial necrosis, hematoma, or infection were observed in flaps, and no additional surgery was needed.  CONCLUSION The present novel surgical procedure was useful to close full thickness defects in the lower lid to preserve the function of the lower eyelid and a good aesthetic outcome. }, Keywords = {Nasojugal flap, Dermal pennant, Lower lid}, volume = {8}, Number = {2}, pages = {245-248}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.2.245}, url = {http://wjps.ir/article-1-431-en.html}, eprint = {http://wjps.ir/article-1-431-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Nasiri, Mojtaba and Kardar, Mohammad Hossei}, title = {Effect of Ethanol on Micro-Vessels Diameter and Prevention of Thrombosis}, abstract ={BACKGROUND Microvascular surgery is one of the most important parts of reconstructive surgery. In the present study, the effect of ethanol on microvascular diameter and prevention of thrombosis was evaluated. METHODS Totally, 80 vessels including 40 arteries and 40 veins in right and left ears of 20 adult rabbits were enrolled. Seven days after injection of ethanol to rabbit ear vessel, vessel diameter and thrombosis rate post-iced saline challenge were documented and compared to normal saline injection in contralateral ear as a control group. RESULTS Vessel diameter in both arteries and veins in ethanol group was significantly larger than normal saline control group, and patency rates due to preventive effect of ethanol were also significantly higher in the ethanol group after iced saline challenge. CONCLUSION Pretreatment with ethanol can enlarge vessel diameter and play a preventive role on thrombosis after iced saline challenge.}, Keywords = {Ethanol, Vessel, Diameter, Thrombosis, Rabbit }, volume = {8}, Number = {2}, pages = {249-253}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.2.249}, url = {http://wjps.ir/article-1-377-en.html}, eprint = {http://wjps.ir/article-1-377-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {GhoddusiJohari, Masoumeh and Mohamadi, Ali Akbar and Dastgerdi, Vahi}, title = {Burn: A Predictable but Preventable Tragedy in Epileptic Patients}, abstract ={BACKGROUND Epilepsy, the world’s most common neurological brain dysfunction, affects more than 50 million people worldwide. Burn injuries can be the leading cause of morbidity and mortality in the patients. This study assessed the predictable but preventable tragedy in epileptic burn patients. METHODS From January 2001 to January 2011, data included patient’s demographic, burn cause, Total Body Surface Area (TBSA) of the burn injury, patient’s risk awareness, the type of treatment required as well as the treatment outcome were collected from burn admissions. Totally, 39 patients who sustained burn injuries due to epileptic seizures w were enrolled. RESULTS Totally, 39 (1.7%) were epileptic with mean age of 30±11 years, 51.3% were female, 41.2% were single and 53.84% were rural residents and 12.8% had academic education. The majority of the thermal injuries occurred at home (82.1%). Flame was the most common cause of burn (66.7%). The mean Total Body Surface Area was 19.69±18.25. Finally, 38 patients were discharged with mortality rate of 2.6%. Thirty patients underwent split or full thickness graft as the most common surgery. Only 5 patients were aware of the burn injury risk during seizure attack. CONCLUSION Despite reduction in burn injuries secondary to seizure, still such injuries lead to significant morbidity and mortality. Since these patients should adhere to specific medication, controlling it remains to be difficult. So preparation for preventive strategies is consisted of life style modification along with patients’ education that is further warranted.  }, Keywords = {Burn, Injury, Patient, Prevent, Epilepsy, Iran}, volume = {8}, Number = {2}, pages = {254-258}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.2.254}, url = {http://wjps.ir/article-1-478-en.html}, eprint = {http://wjps.ir/article-1-478-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Maheshwari, Kavish and Hindocha, Sandip and Yousif, Ali}, title = {Rare Presentation of Pilar Cyst of the Thumb}, abstract ={Pilar cysts are common cysts on the scalp and hair bearing area of the body. We found one such cyst on the dorsum of the thumb. There have been previous reports of them in the finger tips as a very rare occurrence. The site of this lesion supports the theory of a possible origin from the nail matrix. These lesions, even when found at unusual sites should have pilar cyst as a differential diagnosis. They must always be excised and subjected to careful histopathology to rule out proliferating trichilemmal cysts, which carry a rare risk of malignancy.}, Keywords = {Pilar cyst, Trichilemmal cyst, Benign hand cyst}, volume = {8}, Number = {2}, pages = {259-261}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.2.259}, url = {http://wjps.ir/article-1-482-en.html}, eprint = {http://wjps.ir/article-1-482-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Patel, Ritul and Patel, Prutha and Kalariya, Viral and Patel, Het and Chavada, Chet}, title = {Closure of Oro-Antral Communication Using Buccal Advancement Flap}, abstract ={Improper and inadequate treatment can lead to oro-antral communication and fistula. Certain surgical procedure during operation in posterior maxilla can lead to communication between oral cavity and sinus. In children and adolescents, the risk of oro-antral communication is less, due to smaller volume of the maxillary sinus defect smaller than 2 mm that would adequately heal without any intervention, but larger communications more than 2 mm would require immediate attention from surgeon and treatment should be done as soon possible in order to avoid further complications, infection and patient’s discomfort.}, Keywords = {Oro-antral, Closure, Flap, Fistula}, volume = {8}, Number = {2}, pages = {262-264}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.2.262}, url = {http://wjps.ir/article-1-487-en.html}, eprint = {http://wjps.ir/article-1-487-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Ince, Bilsev and Yildirim, Mehmet Emin Cem and Dadaci, Mehmet}, title = {A Low-Cost, Easily Accessible Simulation Model for Microsurgery Training}, abstract ={}, Keywords = {Microsurgery training, simulation model, anastomosis}, volume = {8}, Number = {2}, pages = {265-266}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, doi = {10.29252/wjps.8.2.265}, url = {http://wjps.ir/article-1-500-en.html}, eprint = {http://wjps.ir/article-1-500-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Ploumis, Avraam and Mpourazanis, George and Martzivanou, Christina and Mpourazanis, Pantelis and Theodorou, Areti}, title = {The Role of Vacuum Assisted Closure in Patients with Pressure Ulcer and Spinal Cord Injury: A Systematic Review}, abstract ={BACKGROUND Patients with spinal cord injury (SCI) tend to develop pressure ulcers (PrUs) because of prolonged immobility. This study assessed the efficacy of vacuum assisted closure for healing of PrUs in individuals with SCI. METHODS In a systematic review, CINAHL, PubMed, Cochrane Clinical Trials, DARE, MEDLINE, Scopus, Embase, Science Direct, PsycInfo and Spinal Cord Journal were searched in March 2019. The search combined related terms for pressure ulcer, spinal cord injury, and vacuum assisted closure. Each database was searched from its inception with no restrictions on year of publication.  RESULTS The search yielded 7 studies for inclusion in a qualitative analysis. The studies included a variety of methodologies, specifically 2 randomized controlled trials, 2 assessor-blinded crossover and retrospective cohort study, 1 prospective non-randomized trial, 1 randomized case study and 1 case report. The meta-analysis was unsuccessful. Only descriptive results mean±SD were reported as well as time to heal and time to discharge after admission.  CONCLUSION The studies that we included in our qualitative synthesis showed that vacuum assisted closure promoted the healing of PrUs in individuals with SCI.}, Keywords = {Pressure ulcer, Spinal cord injury, Vacuum assisted closure, Intermittent negative pressure }, volume = {8}, Number = {3}, pages = {279-284}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://wjps.ir/article-1-541-en.html}, eprint = {http://wjps.ir/article-1-541-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Masoomi, Hossein and Greives, Matthew R. and Cantor, Andrew D. and Marques, Erik S.}, title = {Effect of Anemia in Postoperative Outcomes of Autologous Breast Reconstruction Surgery}, abstract ={BACKGROUND The true effects of anemia on postoperative surgical outcomes in autologous breast reconstruction surgery are unknown. We intended to evaluate the effect of chronic anemia on surgical outcomes in autologous breast reconstruction surgeries using a large national database. METHODS Using the Nationwide Inpatient Sample database, we examined the clinical data of patients who underwent immediate or delayed autologous breast reconstruction surgery from 2012 to 2014. Univariate and multivariate regression analyses were performed to independently evaluate the effect of chronic anemia on postoperative outcomes. RESULTS Totally, 55,839 patients underwent autologous breast reconstruction surgery (immediate: 40% vs. delayed: 60%) during this period. Overall, 6.0% of patients had chronic anemia at the time of surgery. Compared with patients without chronic anemia, patients with chronic anemia had a significantly higher complication rate (19.8% vs. 9.4%) and a longer mean length of hospital stay (5.4 vs. 3.7 days). Postoperative complications were significantly higher in patients with chronic anemia compared with patients without chronic anemia except for venous thromboembolism (VTE) and fat necrosis. Multivariate regression analyses demonstrated that chronic anemia was independently associated with an increased overall complication rate (adjusted odds ratio: 2.20). Also, multivariate regression analyses showed that chronic anemia was an independent risk factor of all the evaluated postoperative complications except VTE, stroke and fat necrosis. CONCLUSION This study demonstrated that chronic anemia was a significant predictor factor of morbidity in autologous breast reconstruction including flap failure. Correction of anemia prior to breast reconstruction may help reduce poor surgical outcomes related to chronic anemia.}, Keywords = {Anemia, Postoperative, Autologous, Breast, Reconstruction}, volume = {8}, Number = {3}, pages = {285-292}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://wjps.ir/article-1-543-en.html}, eprint = {http://wjps.ir/article-1-543-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {ThiitamaranahalliMuguregowda, Honnegow}, title = {An Observational Study on Clothing Characteristics Involved as Major Contributors in Sustaining Domestic Burns Injuries}, abstract ={BACKGROUND Fire and burn-related injuries are a leading cause of morbidity and mortality worldwide, and is a serious public health problem in developing countries. Several studies showed causes such as low socioeconomic status, poor living conditions, illiteracy, and floor level cooking, however, very few studies stated severity of the burn injuries to be dependent on ignition of type clothing garment and fabric wore at the time of incident.  METHODS A cross sectional observational study done on burn injury patients admitted from February 2014 to August 2016. Data were collected from the patients or their relatives and analysed.  RESULTS Among 224 burn injury patients, majority were females (59.3%) sustained burn injuries in the study population (p=0.005). Victims wearing long loose flowing garments such as sarees (41.1%), salwar (22.3%), and dupatta (9.8%) were caught fire easily and sustained more burn injuries, compared to clothes reaching down to the knee and short fitting dresses (p=0.004). Percentage of burn was higher among wearers of synthetic fabrics (50.89%) than that of cottons (20.53%, p=0.028].  CONCLUSION Every year, thousands of people are injured when their clothing catches fire. The findings reported herein documented that public knowledge about clothing related fire risks was lacking. This can be reduced by bringing about stronger regulations by government and to educate about the magnitude of the problems inflicted by burn injuries and to oversight and to promote less inflammable fabrics to be worn at home, especially in kitchen.}, Keywords = {Burn, Injury, Garment, Clothing, India }, volume = {8}, Number = {3}, pages = {293-297}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://wjps.ir/article-1-531-en.html}, eprint = {http://wjps.ir/article-1-531-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Okochi, Masayuki and Komuro, Yuzo and Ueda, Kazuki}, title = {Selective and Continuous Transarterial Heparin Infusion: Postmicrosurgical Therapy of Lower Leg Reconstruction for Cases with Recipient Artery Damage}, abstract ={BACKGROUND Microsurgical lower extremity reconstruction is challenging because of high incidence of vascular thrombosis compared to microsurgical head and neck reconstruction. The risk of vascular pedicle thrombosis increases, if patients have arterial sclerosis or intimal dissection at the recipient artery. We performed selective and continuous transarterial heparin infusion for postoperative anticoagulant therapy.  METHODS Fifteen patients (10 men and 5 women; mean age of 55.1 years; range of 16–86 years) received lower leg reconstruction using free flap. Postoperatively, a catheter was inserted into the femoral artery during surgery. Heparin infusion was performed through the catheter as a postoperative therapy for patients who had a risk factor of vascular pedicle thrombosis. Until two days post-operation, heparin was started between 5,000 and 10,000 IU per day. In postoperative days 3 and 4, half of the initial dose of heparin was administered. In postoperative days 5 and 6, 25% of the initial dose of heparin was administered.  RESULTS Recipient arteries were the posterior tibial (n=11), anterior tibial (n=2), lateral circumflex femoral (n=1), and medial sural (n=1) arteries. Thirteen of the 15 cases showed arterial sclerosis or intimal dissection at the recipient artery. There was no case of vascular thrombosis. Hematoma formation at flap recipient was observed in four cases. Their initial heparin dose was than 8.5±1.7 U/kg/h.  CONCLUSION Continuous transarterial heparin infusion was an effective anticoagulant therapy for the patients who had received free tissue transfer to a lower extremity. The initial dose of heparin should not exceed 6.5 U/kg/h. }, Keywords = {Microsurgery, Postoperative therapy, Anticoagulant therapy, Free flap}, volume = {8}, Number = {3}, pages = {298-304}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://wjps.ir/article-1-515-en.html}, eprint = {http://wjps.ir/article-1-515-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Loonen, Martain and Tahir, A}, title = {Modification of the Superomedial Pedicle in Wise-Pattern Breast Reduction: New Sling Suspension Technique to Prevent (Pseudo) Ptosis}, abstract ={BACKGROUND The combination of the superomedial pedicle with the traditional Wise-pattern skin resection has gained increasing popularity for its versatility and ability to achieve significant reduction of breast parenchyma and skin envelope.  METHODS The author describes a reproducible new dermal suspension technique for cranial stabilization and fixation of the superomedial pedicle in Wise inverted T breast reductions to prevent pseudoptosis. RESULTS One patient had a small dermal skin abscess caudal from the right areola as a tissue reaction on the remaining suture. The other peri- and post-operative cases were uncomplicated. Two patients experienced a two-week postoperative pain in the areas treated by liposuction. There was no reduced or increased sensibility of the nipple-areola complex. No signs of (pseudo) ptosis were seen. There was a 100% patient satisfaction rate.  CONCLUSION Our technique denoted to a direct support of the pedicle using a non-interrupted dermal suspension flap continued with the pedicle to be a medial, caudal and lateral support for the pedicle. The dermal sling reduced the anterior force generated by the pedicle. The pedicle enfolded by the dermal flap formed a vital basis for ingrowth in the surrounding tissue.}, Keywords = {Superomedial pedicle, Wise-pattern, Breast reduction, Ptosis}, volume = {8}, Number = {3}, pages = {305-310}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://wjps.ir/article-1-512-en.html}, eprint = {http://wjps.ir/article-1-512-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Vidya, Raghavan and Iqbal, Fahad Mujtaba and Becker, Hilton and Zhadan, Olg}, title = {Rippling Associated with Pre-Pectoral Implant Based Breast Reconstruction: A New Grading System}, abstract ={BACKGROUND The incidence of breast cancer and immediate breast reconstruction is on the rise particularly in the US and Western Europe. Over the last decade, implant based breast reconstructions have gained popularity. The prepectoral breast reconstruction has emerged as a novel technique, minimally invasive, preserves the chest wall anatomy while restoring body image. However, implant rippling appears to be an adverse effect associated with this technique.  METHODS We have described a new grading system for rippling following prepectoral implant breast reconstruction and discussed its management. We then evaluated the new grading system in our practice.  RESULTS We looked at the first 50 consecutive patients who underwent prepectoral implant based breast reconstruction. In our experience, 45 patients (90%) had grade 1, 3 patients (6%) had grade 2, 1 patient (2%) had grade 3 and 1 patient (2%) had grade 4 rippling. The observed rippling was seen more often in patients with low BMI<20 and in those who had poor subcutaneous fat preoperatively (pinch test<2 cm).  CONCLUSION Prepectoral implant based breast reconstruction adds a whole new dimension to breast reconstruction. However rippling can be an undesired adverse effect associated with this technique and patients need to be informed.}, Keywords = {Breast, Implant, Reconstruction, Complication, Rippling, Lipomodelling}, volume = {8}, Number = {3}, pages = {311-315}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://wjps.ir/article-1-466-en.html}, eprint = {http://wjps.ir/article-1-466-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Saaiq, Muhammad and Zimri, Farid Ullah Kh}, title = {Reverse Flow Superficial Sural Artery Fasciocutaneous Flap: A Comparison of Outcome between Interpolated Flap Design versus Islanded Flap Design}, abstract ={BACKGROUND Complex soft-tissue defects of the distal third of the leg, proximal third of foot and similar wounds around the ankle represent formidable foes for plastic surgeons. This study compared the outcome of 2-staged interpolated flap design versus single stage islanded flap design of reverse flow superficial sural artery flap. METHODS Thirty-four patients were enrolled, while half randomly underwent interpolated flap design (group A) and for half, islanded flap design (group B). The outcome measures were frequency of epidermolysis, flap-tip necrosis, partial flap loss, total flap loss and number of secondary procedures required for addressing these complications. RESULTS Among patients, 79.41% were male and 20.58% were females. The age range was 12-51 years (mean: 28.82±10.76 years). The wound locations were hind foot (50%), ankles (17.64%), heel (14.70%), distal third of leg (11.76%) and dorsum of proximal third of foot (5.88%). In group B, epidermolysis was noted in 35.29% of flaps, and flap tip necrosis and partial flap necrosis in 17.64%. In group A, 5.88% were tip necrosis with no other problems. In group B, 76.47% of secondary procedures were done to address various flap related complications, whereas in group A, 5.88% additional procedures were required to address the flap tip necrosis. CONCLUSION The reverse flow superficial sural artery flap constituted a practical solution to address complex defects of the distal leg, ankle, heel and proximal foot. The 2-staged interpolated flap design considerably enhanced the flap reliability and reduced the frequency of venous congestion and resultant flap necrosis of variable proportions}, Keywords = {Reverse flow, Superficial sural artery, Flap, Interpolated, Islanded, Necrosis }, volume = {8}, Number = {3}, pages = {316-323}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://wjps.ir/article-1-458-en.html}, eprint = {http://wjps.ir/article-1-458-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Tripathee, Sanjib and Xiong, Meng and Zhang, Jue}, title = {Microtia Ear Reconstruction Using Tissue Expander and Autologous Costal Cartilage: Our Experience and Comparing Two Age Groups}, abstract ={BACKGROUND Ear reconstruction is one of the most challenging surgeries faced by reconstructive surgeons because of its complex three-dimensional structure. Various surgical methods and materials have been used over the years. The process of microtia reconstruction using tissue expander is performed in three stages of first that is implantation of tissue expander, second stage involves framework fabrication using autologous costal cartilage and implantation in the pocket and third stage involves tragus and concha reconstruction. METHODS Totally 180 cases of microtia reconstruction using tissue expander and autologous costal cartilage over 2 years were enrolled, while two age groups were compared regarding operative time, tissue expansion, number of autologous costal cartilage harvested and complications during and after reconstruction. RESULTS The overall complication in microtia reconstruction was 25%. No major difference was found between complication rates among the 2 age groups. Similarly, no significant difference was found between two groups in term of surgical time and tissue expansion. The major difference was found in number of costal cartilage harvested for the framework fabrication among the two groups.  CONCLUSION Microtia reconstruction using tissue expander and autologous costal cartilage is a standard method of ear reconstruction with good satisfaction rate for surgeons and patients. Although the complication rate was high in our study, most of the cases were managed with acceptable results. Therefore, a standard protocol should be developed regarding the timing of the surgery for microtia reconstruction, considering pre-operative radiological analysis of the costal cartilage development along with age and weight of the patient.}, Keywords = {Microtia, Ear, Reconstruction, Tissue expander, Costal cartilage}, volume = {8}, Number = {3}, pages = {324-330}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://wjps.ir/article-1-498-en.html}, eprint = {http://wjps.ir/article-1-498-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Hilton, Carolina Maria Helena and Hölmich, Lisbet Rosenkrantz}, title = {Full- or Split-Thickness Skin Grafting in Scalp Surgery? Retrospective Case Series}, abstract ={BACKGROUND Closure of skin defects after scalp surgery may be accomplished by grafting; either split- or full-thickness. Both methods are used in Denmark, and the optimal approach on scalp defects without exposed bone is not known. This study aimed to investigate if the two methods were equal regarding graft take as primary outcome and as secondary outcomes complications and number of outpatient visits/ number of days from surgery until the last outpatient visit for the recipient site (as a proxy for time to healing), hypothesizing that they were. METHODS The present retrospective single-center case series reported our experience using the two types of skin grafts after scalp surgery in the inclusion period from 1.1.2014 to 30.09.2015. Data were analyzed according to graft type with a full-thickness skin graft (FTSG-group) or a split-thickness skin graft (STSG-group). RESULTS In the inclusion period, 106 patients had surgery (28 with a FTSG and 78 with a STSG). Irrespectively of which skin graft that was used, we found no statistically significant difference regarding percentage of adherence, complications or number of outpatient visits and time from operation until last outpatient visit regarding the recipient site (p>0.05). CONCLUSION Our findings supported that use of either FTSG or STSG in scalp lesions were equal choices.}, Keywords = {Full thickness, Split thickness, Scalp surgery, Skin, graft, Transplant}, volume = {8}, Number = {3}, pages = {331-337}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://wjps.ir/article-1-536-en.html}, eprint = {http://wjps.ir/article-1-536-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Mohammadi, Aliakbar and Kardeh, Sina and Motazedian, Gholam Reza and Mohammadi, Soheil}, title = {Management of Ear Keloids Using Surgical Excision Combined with Postoperative Steroid Injections}, abstract ={BACKGROUND Ear keloids are a challenging problem that affect people of different races with substantial aesthetic consequences. Various types of adjuvant therapies, including intralesional corticosteroid injection are advocated to lower recurrence following excision. We investigated the efficacy of a protocol combined of excision and postoperative intralesional triamcinolone acetonide (TA) injection for treating earlobe keloids in a group of Iranian female patients. METHODS A retrospective analysis of 21 patients representing 31 ear keloids treated by a single physician between 2013 and 2017 was conducted. All keloids occurred after ear piercing in female cases. Postoperative intralesional TA injection was administered once monthly and continued for several months based on the patients’ clinical progress. Results were assessed according to Kyoto scar scale. RESULTS The patients’ mean age was 24.29 years and ranged from 16 to 40 years. After the surgery, the follow-up period ranged from 10 to 29 months (mean: 15.93 months) and patients were given TA intralesional injections 3 to 6 times (mean: 4.22 times) with no complication or adverse effect. Of the treated keloids, success was achieved in all of 31 keloids (100%) and final evaluation revealed that the mean Kyoto scar scale was significantly decreased. No recurrence occurred.  CONCLUSION Surgical excision followed by postoperative intralesional TA injection can be suggested as the primary protocol for the treatment of ear keloids considering its durable results and economic advantage.}, Keywords = {Ear, Keloid, Piercing, Excision, Steroid, Triamcinolone acetonide}, volume = {8}, Number = {3}, pages = {338-344}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://wjps.ir/article-1-448-en.html}, eprint = {http://wjps.ir/article-1-448-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Gholami, Mahdi and Vaezi, Assil}, title = {Comparison of the Effects of External and Internal Lateral Nasal Osteotomies on Ecchymosis, Periorbital Edema, and Step off Deformity After Rhinoplasty}, abstract ={BACKGROUND Periorbital edema and ecchymosis are considered as the main complications of rhinoplasty. The current study was conducted to compare the effects of internal and external lateral osteotomies on ecchymosis, periorbital edema, and step off deformity after rhinoplasty.  METHODS This double-blind randomized clinical trial was conducted on 69 patients (including 37 and 32 cases undergoing external and internal lateral osteotomies, respectively), between the fall of 2016 and 2018. The participants were randomly divided into two groups and matched by gender and age for rhinoplasty. In addition, all surgeries were performed by the same surgeon to control the confounding variables. Edema, ecchymosis, and step off deformity were evaluated by a researcher blind to the methods of rhinoplasty 2, 7, and 21 days after the surgery.  RESULTS There was no significant difference between the two groups regarding postoperative edema on days 2, 7, and 21 post-operation. Similarly, the postoperative ecchymosis demonstrated no significant difference between the two groups on the 2nd, 7th, and 21st days post-surgery. No significant difference was noted between the two groups in terms of step off deformity on day 21st.  CONCLUSION The obtained results demonstrated no significant difference between the internal and external lateral osteotomy techniques. Based on our findings, surgeons should apply a procedure with the lowest side effects according to their experiences}, Keywords = {Rhinoplasty, Nasal osteotomy, Ecchymosis, Edema, Deformity}, volume = {8}, Number = {3}, pages = {345-351}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://wjps.ir/article-1-522-en.html}, eprint = {http://wjps.ir/article-1-522-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Karami, Ali and Tebyanian, Hamid and Soufdoost, Reza Sayyad and Motavallian, Ebrahim and Barkhordari, Aref and Nourani, Mohammad Rez}, title = {Extraction and Characterization of Collagen with Cost-Effective Method from Human Placenta for Biomedical Applications}, abstract ={BACKGROUND Collagen is the main product in pharmaceutics and food industry with a high demand. Collagen can be extracted from several tissues such as skin, bone and tendon, etc. Collagen can be used in tissue engineering researches as a substrate of wound healing and nerve regeneration. Extraction methods of collagen are various with different purities. In this research, we aimed to extract collagen from human placenta with a modified method.  METHODS This modified approach was used for extracting of collagen from human placenta with acetic acid and NaCl treatment using different concentrations.  RESULTS SDS page showed three different bands that reflected two alpha-chains and one beta-chain with molecular weights of 102, 118 and 220 kDa, respectively. There was no significant difference between extracted collagen from human placenta and standard collagen in western blot analysis.  CONCLUSION It was concluded that human placenta can be an alternative source of collagen with high purity for biomedical applications such as tissue engineering, stem cell therapy and research.}, Keywords = {Collagen, Huma, Placenta, Extraction, Characterization}, volume = {8}, Number = {3}, pages = {352-358}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://wjps.ir/article-1-480-en.html}, eprint = {http://wjps.ir/article-1-480-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Seyedoshohadaee, Mahnaz and Khachian, Alice and Seyedfatemi, Naimeh and Mahmoudi, Mokhtar}, title = {The Effect of Short-Term Training Course by Nurses on Body Image in Patients with Burn Injuries}, abstract ={BACKGROUND Burn is the fourth most common cause of trauma worldwide and is the fourth among the injuries and surgeries requiring medical care. This study was designed to determine the effect of a short-term training course by nurses on body image in patients with burn injuries. METHODS This study was a semi-experimental single-group survey assessing before and after interventions. Totally, 130 subjects (65 women and 65 men) were enrolled. The training course was held in 3 sessions of two hours. The contents of the group training course (a group of 5 people) were in relation to the body image and the factors affecting it, and the ways to improve the body image. The data collection instrument was the satisfaction with appearance scale (SWAP). RESULTS The mean scores of the body image of patients before and after the intervention were 49.44±11.39 and 41.63±11.89, respectively. There was a significant difference between the mean scores of body image before and after educational interventions (T=6.013, P≤0.001). The mean score of body image in women before and after intervention was 49.2±10.9 and 41.2±11.65, respectively (T=4.51, P≤0.000). The mean score of body image in men before and after intervention was 49.6±11.89 and 42.07±12.19, respectively (T=4.51, P≤0.000). CONCLUSION Short-term courses held by nurses were shown to have a significant role in improving the body image of burn patients.}, Keywords = {Burns, Psychology, Body image, Training course}, volume = {8}, Number = {3}, pages = {359-364}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://wjps.ir/article-1-525-en.html}, eprint = {http://wjps.ir/article-1-525-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Tolouie, Mohammad and Farzan, Ramyar}, title = {A Six-Year Study on Epidemiology of Electrical Burns in Northern Iran: Is It Time to Pay Attention?}, abstract ={BACKGROUND Although electrical burns are less prevalent than other types, they put socioeconomic burden on communities, yielding higher mortalities. Therefore, the frequency and causes of electrical burns in the largest burn center in northern Iran were studied. METHODS All patients with electrical burn injuries admitted to Velayat Hospital, Rasht, Iran participated in this descriptive cross-sectional study. The data collection tool was a checklist including demographic data, damage mechanism, voltage classification (high or low), injured organ, ICU need, length of stay (LOC), electrical burn severity (degree and area of burns based on TBSA), surgical interventions, and return to work. All data were gathered through HIS system and analyzed. RESULTS Most electrical burns occurred in men (99.4%) and most of whom had electricity-related jobs (26%). The majority of victims had third-degree burns (63%), and electrical current-induced burns in entry points occurred in the upper and lower extremities, head and other organs ranked the first to fourth, respectively. Most burns happened due to abrupt contact with electrical current (83.33%) in routine home activities (52.78%). The mean LOC was 8.73 days, suggesting that LOC increased significantly, if the electrical current entered the body through lower extremities, while it decreased significantly, if the electrical current exited through lower extremities.  CONCLUSION The majority of electrical burn victims were men. Most burns occurred in urban communities in summer. Most people were affected by high voltage electricity.}, Keywords = {Epidemiology, Electrical burn, Iran}, volume = {8}, Number = {3}, pages = {365-371}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://wjps.ir/article-1-521-en.html}, eprint = {http://wjps.ir/article-1-521-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Mamashli, Leila and MohaddesArdebili, Fatemeh and NajafiGhezeljeh, Tahereh and Manafi, Farzad and Bozorgnezhad, Mehri}, title = {Investigating the Psychosocial Empowerment Interventions through Multimedia Education in Burn Patients}, abstract ={BACKGROUND Burns patients often encounter lots of psychological problems affecting all parts of life. This study investigated the psychosocial empowerment interventions through multimedia education in burn patients. METHODS  In a randomized clinical trial study undertaken in Shahid Motahari Burn Center in Tehran, Iran in 2016, 50 patients were selected as control and 50 patients as intervention group. The demographic characteristics and the quality of life questionnaires (BSHS-B) were used. Patients in the control group received only routine educational self-care, but the intervention group received routine cares as well as the multimedia trainings. Then, the psychological quality of life was evaluated in both groups before the interventions and after three and six months. RESULTS Before interventions, the mean of mental dimension in intervention and control groups were 2.08±0.59 and 1.64±0.47, respectively (p<0.001). Three and six months after the intervention, they were 3.37±0.93 and 2.24±0.4, 4.11±0.74 and 2.75±0.58, respectively (p<0.001). CONCLUSION The multimedia intervention was shown to be effective in empowering the psychology of burn patients.  }, Keywords = {Burn, Psychological empowerment, Multimedia, Education}, volume = {8}, Number = {3}, pages = {372-381}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://wjps.ir/article-1-463-en.html}, eprint = {http://wjps.ir/article-1-463-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Keshavarzi, Abdolkhalegh and Kardeh, Sina and Dehghankhalili, Maryam and Varahram, Mohammad Hossein and Omidi, Mohsen and Zardosht, Mitra and Mehrabani, Davoo}, title = {Mortality and Body Mass Index in Burn Patients: Experience from a Tertiary Referral Burn Center in Southern Iran}, abstract ={BACKGROUND The role of obesity has been widely studied as a determinant factor of increasing mortality in surgical patients. In this study we aimed to investigate the association of mortality determinants with obesity classification and BMI score in burn patients admitted to a tertiary referral center in Southern Iran.  METHODS In this retrospective cross-sectional study, medical profiles of burn patients admitted from 2016 to 2017 were obtained from Amiralmomenin Burn Hospital, a tertiary referral burn center affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Demographic, and clinical characteristics as well as patient outcomes were recorded to determine prognostic factors in fatal burns based on anthropometric measurements.  RESULTS Among 101 patients who were enrolled in this study including 73 males and 28 females, mean age was 34.85±12.04 years, total burn surface area (TBSA) was 37.37 (10.50%), BMI was 25.46±5.33 kg/m2 and hospital stay was 22.28±13.62 days. Overall mortality rate was 24.7% with 25 expired cases. Logistic regression demonstrated significant association of older age, male gender, and greater TBSA with mortality. However, difference in mortality rate in patients with BMI of 25 kg/m2 (27.4%) in comparison to patients with BMI<25 kg/m2 (18%) did not reach statistical significance. CONCLUSION Although patients with higher BMI had increased mortality rate following burn injury, this finding showed no significant association. Further studies with larger samples may be necessary to conclude a causal association between BMI and mortality in burn patients.}, Keywords = {Body Mass Index, Burn, Mortality, Obesity, Risk factor}, volume = {8}, Number = {3}, pages = {382-387}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://wjps.ir/article-1-433-en.html}, eprint = {http://wjps.ir/article-1-433-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Gupta, Saurabh and Chittoria, Ravi Kumar and Chavan, Vinayak and Aggarwal, Abhinav and Reddy, Chirra Likhitha and Mohan, Padmalakshami Bharathi and Koliath, Shijina and Pathan, Imr}, title = {New 5-D Coding System for Categorization of Plastic Surgery Conditions}, abstract ={BACKGROUND There is need for a coding system for categorizing the plastic surgery conditions to facilitate efficient data exchange, retrieval, research, time-series analysis, clinical audit, insurance and legal purposes. This is a pilot study to assess feasibility of newly proposed 5-D coding system in categorizing the plastic surgery conditions. METHODS Retrospective analysis of records of plastic surgery patients visited in last 15 months was done. Each patient was assigned a code according to the newly proposed 5-D system of coding and recorded in excel sheet. Data analysis was done to categorize various plastic surgery conditions. Results of analysis were shown to 11 plastic surgeons and their feedback was taken. RESULTS Feedback taken from participants showed 5-D coding system was useful and practically easy to categorize the plastic surgery conditions. CONCLUSION Proposed new 5-D coding system is easy and useful in categorization of plastic surgery conditions.}, Keywords = {Coding system, Plastic surgery, Categorization}, volume = {8}, Number = {3}, pages = {388-393}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://wjps.ir/article-1-529-en.html}, eprint = {http://wjps.ir/article-1-529-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Rezaei, Ezzatollah and Pouryousef, Kamrooz and Karimi, Mohammad and HajebiKhaniki, Saeedeh and BaradaranSirjani, Ehs}, title = {Latissimus Dorsi Musculocutaneous Flap Inset Innovation in Breast Reconstruction}, abstract ={BACKGROUND Breast reconstruction is distinct among plastic surgery techniques. This study analysed the results of breast reconstruction with the Latissimus dorsi (LD) myocutaneous flap as a strategy for better coverage and positioning of the implant. METHODS Twenty patients who underwent surgery between September 2013 and September 2016 were enrolled. Fourteen patients underwent reconstruction with LD and tissue expander (TE) exchanged later with implant. Six patients were reconstructed with LD and implant. The complications, problems, and aesthetic improvement associated with the use of implants placed under LD muscle were assessed. RESULTS 0ne case required an expander removal because of deflation of TE, also one case had seroma formation due to recurrence of breast cancer and also one case had seroma in donor site. No asymmetry was detected in the inframammary fold (IMF) position between reconstructed and normal regions. After the procedure, 80% of the patients reported that their expectations were met, 95% reported no functional limitations, and 5% reported mild limitations that ameliorated with physiotherapy. The placement of implants (prostheses or expanders) under the muscle with using the LD muscle flap to cover the implant improved the breast contour by softening the inframammary crease and positioning the implants in the upper and medial quadrants of the new breasts. CONCLUSION Breast reconstruction using silicone implants and the LD muscle flap can have excellent outcomes with low rates of complications. Placing the implant under a layer of muscle improved the harmony of the upper quadrants during breast reconstruction.}, Keywords = {Latissimus dorsi, Breast, Reconstruction, Implant}, volume = {8}, Number = {3}, pages = {394-400}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://wjps.ir/article-1-519-en.html}, eprint = {http://wjps.ir/article-1-519-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Davudov, Mahammad and Rahimov, Chingiz and Fathi, Hamidreza and Mirzajani, Zoheir and Aliyeva, Mirvari and Ghahremani, Arjang}, title = {The Use of Pectoralis Major Musculocutaneus and Deltopectoral Flaps in Oromandibular Defects Reconstruction}, abstract ={The main complication in patients with combined treatment of head, neck, mandibular and maxillary tumors is osteoradionecrosis, which appears after radiation therapy. Radiation therapy is widely used to treat cancer, but growing concern is related to the risk of osteoradionecrosis after treatment. This can occur after radiation therapy. Below, we would like to describe the treatment of osteoradionecrosis, which appeared 5 years after radiation therapy in a 54-year-old male patient. In 2012, a patient in Turkey was diagnosed with adenocystic carcinoma of the tongue base, and surgery was performed to remove the tumor after the patient underwent a course of radiotherapy. In 2016, the patient underwent again a surgery for tumor recurrence. In December 2017, the patient was admitted to our clinic with osteoradionecrosis. We performed segmental resection of the mandible, type I right-sided modified neck dissection, reconstruction of the mandible with a titanium plate and a pectoralis major muscle skin flap. The technique described in this case is the insertion of a well-vascularized tissue into the pre-irradiated and necrotic hypovascular region of the mandible with a skin-muscle flap of the pectoralis major muscle wrapped around the plate for reconstruction. As a result, a pectoralis major flap coverred the mouth floor on internal side and the outside skin defect was covered with a deltopectoral one. The viability of the skin-muscle flap of the pectoralis major muscle was assessed using clinical monitoring, checking the flap every four hours for the first 3 days. This study describes a successful outcome.}, Keywords = {Pectoral major musculocutaneus, Flap, Deltopectoral, Osteoradionecrosis, Mandible, Reconstruction}, volume = {8}, Number = {3}, pages = {401-405}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://wjps.ir/article-1-497-en.html}, eprint = {http://wjps.ir/article-1-497-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} } @article{ author = {Goussous, Naeem and Abdullah, Anas and Milner, Stephen M.}, title = {Fusarium Solani Infection Following Burn Injury: A Case Report}, abstract ={Fungal infections are becoming increasingly recognized among burn patients. Infection with Fusarium, a filamentous mold, is rarely encountered and mainly seen in immunocompromised patients. High mortality and morbidity were reported with these virulent infections. We present a rare case of refractory septic shock from upper extremity fungal infection with Fusarium solani in a burn patient. Multiple operative debridements and below elbow amputation caused resolution of septic shock. Closure was achieved with a split thickness skin graft. Aggressive approach should be adopted in managing burn patients with Fusarium infection. Serial debridements and extremity amputation should be considered in attempts to improve survival.}, Keywords = {Fusarium solani, Fungus, Mold, Infection, Burn}, volume = {8}, Number = {3}, pages = {406-409}, publisher = {}, title_fa = {}, abstract_fa ={}, keywords_fa = {}, url = {http://wjps.ir/article-1-534-en.html}, eprint = {http://wjps.ir/article-1-534-en.pdf}, journal = {World Journal of Plastic Surgery}, issn = {2228-7914}, eissn = {2252-0724}, year = {2019} }