REVIEW_ARTICLE Efficacy of Azithromycin in Treatment of Acne Vulgaris: A Mini Review 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. http://wjps.ir/article-1-453-en.pdf 2019-06-18 127 134 10.29252/wjps.8.2.127 Azithromycin Tetracycline Doxycycline Acne vulgaris Treatment Sina Kardeh Sinakardeh@gmail.com 1 Cellular and Molecular Medicine Student Research Group, School of Medicine, Shiraz University of Medical Science, Shiraz, Iran AUTHOR Nasrin Saki 2 Molecular Dermatology Research Center, Department of Dermatology, Shiraz University of Medical Sciences, Shiraz, Iran AUTHOR Farideh Jowkar 3 Molecular Dermatology Research Center, Department of Dermatology, Shiraz University of Medical Sciences, Shiraz, Iran AUTHOR Bahareh Kardeh 4 Bone and Joint Diseases Research Center, Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran AUTHOR Seyed Arman Moein 5 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran AUTHOR Mohammad Hossein Khorraminejad-Shirazi 6 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran AUTHOR
REVIEW_ARTICLE Grand Adventure of Augmented Reality in Landscape of Surgery 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.   http://wjps.ir/article-1-457-en.pdf 2019-06-18 135 145 10.29252/wjps.8.2.135 Augmented reality Surgery Rewards Drawbacks Fatemeh Salehahmadi fatemehsalehahmadi24@gmail.com 1 Computer Engineering Department, Islamic Azad University, Bushehr Branch, Dashtestan Campus, Borazjan Motaghin Research Center, Bushehr, Iran AUTHOR F Hajialiasgari 2 Information Technology Department, Electronic Health Group, Tehran University of Medical Sciences, Tehran, Iran AUTHOR
ORIGINAL_ARTICLE Four Extremity Amputation and Bionic Prosthesis Supply after Disseminated Intravascular Coagulation: A Follow-Up on Functionality and Quality of Life after Bionic Prosthesis Supply 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. http://wjps.ir/article-1-503-en.pdf 2019-06-18 146 162 10.29252/wjps.8.2.146 Disseminated intravascular coagulopathy Amputation Reconstruction Bionic Myoelectric Prosthesis Rehabilitation Werner Dennis Dennis.Werner@stud.mh-hannover.de 1 Department of Plastic, Aesthetic, Hand and Reconstructive Surgery Hannover Medical School AUTHOR Seyed Arash Alawi s.a.alawi88@gmail.com 2 Department of Plastic, Aesthetic, Hand and Reconstructive Surgery Hannover Medical School AUTHOR
ORIGINAL_ARTICLE Subpectoral Implantation of Cardiovascular Implantable Electronic Device: A Reasonable Alternative for the Conventional Prepectoral Approach 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. http://wjps.ir/article-1-461-en.pdf 2019-06-18 163 170 10.29252/wjps.8.2.163 Cardiovascular Subpectoral Prepectoral Implantation Cosmetic Sung-Hwan Kim sunghwan@catholic.ac.kr 1 Division of Cardiology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; AUTHOR Bommie Florence Seo bommiefseo@catholic.ac.kr 2 Department of Plastic Surgery, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea AUTHOR Young Choi superstar@catholic.ac.kr 3 Division of Cardiology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; AUTHOR Yong-Seog Oh oys@catholic.ac.kr 4 Division of Cardiology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; AUTHOR Ju Youn Kim kzzoo921@gmail.com 5 Division of Cardiology, Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea AUTHOR
ORIGINAL_ARTICLE Medial Thigh Contouring in Massive Weight Loss: A Liposuction-Assisted Medial Thigh Lift 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.   http://wjps.ir/article-1-483-en.pdf 2019-06-18 171 180 10.29252/wjps.8.2.171 Medial thigh contouring Weight loss Liposuction-Assisted Medial Thigh Lift Verdiana Di Pietro verdiana.di.pietro@gmail.com 1 Department of Plastic and Reconstructive Surgery, University of Rome “Tor Vergata”, Rome, Italy AUTHOR Marcello Colicchia Gianfranco gianfrancocolicchia@libero.it 2 Department of Plastic and Reconstructive Surgery, University of Rome “Tor Vergata”, Rome, Italy AUTHOR Valerio Cervelli valeriocervelli@virgilio.it 3 Department of Plastic and Reconstructive Surgery, University of Rome “Tor Vergata”, Rome, Italy AUTHOR Pietro Gentile pietrogentile2004@libero.it 4 Department of Plastic and Reconstructive Surgery, University of Rome “Tor Vergata”, Rome, Italy AUTHOR
ORIGINAL_ARTICLE Comparison of Aspiration Followed by Intra-Lesional Steroid Injection and Surgical Excision in Management of Dorsal Wrist Ganglion 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. http://wjps.ir/article-1-502-en.pdf 2019-06-18 181 184 10.29252/wjps.8.2.181 Aspiration Intra-lesional Steroid Surgery Excision Dorsal wrist ganglion Ajaz Ahmad Shah ajazshah17@gmail.com 1 Department of General Surgery, GMC Srinagar, Jammu and Kashmir, 190010, India AUTHOR Ashiq Hussain Raina 2 Department of General Surgery, GMC Srinagar, Jammu and Kashmir, 190010, India AUTHOR Mudasir Ahmad Ganie 3 Department of General Surgery, GMC Srinagar, Jammu and Kashmir, 190010, India AUTHOR Irshad Ahmad Kumar 4 Department of General Surgery, GMC Srinagar, Jammu and Kashmir, 190010, India AUTHOR
ORIGINAL_ARTICLE 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 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. http://wjps.ir/article-1-402-en.pdf 2019-06-18 185 194 10.29252/wjps.8.2.185 Platelet rich plasma Autologous Wound Split thickness skin graft Graft Subha Dhua subhadhua@yahoo.com 1 The study was fully funded by the Vydehi Institute of Medical Sciences and REsearch Centre AUTHOR Suhas T.R. -do- 2 -do- AUTHOR Balagangadhar Tilak -do- 3 -do- AUTHOR
ORIGINAL_ARTICLE Free Style Perforator Flaps for Aesthetic Facial Reconstruction 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. http://wjps.ir/article-1-468-en.pdf 2019-06-18 195 199 10.29252/wjps.8.2.195 Perforator Flap Aesthetic Facial Reconstruction Nader Elmelegy naderelmelegy@gmail.com 1 Department of Plastic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt AUTHOR Sameh Elghamry samehalghamry1979@gmail.com 2 Department of Plastic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt AUTHOR Tarek Shoukr tarekshoukr@yahoo.com 3 Department of Plastic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt AUTHOR
ORIGINAL_ARTICLE Frequency and Predictors of 30-Day Surgical Site Complications in Autologous Breast Reconstruction Surgery 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. http://wjps.ir/article-1-505-en.pdf 2019-06-18 200 207 10.29252/wjps.8.2.200 Frequency Predictor Surgical site Complication Autologous Breast Reconstruction Hossein Masoomi masoomi.hosein@yahoo.com 1 University of Texas Health Science Center at Houston- Division of Plastic and Reconstructive Surgery AUTHOR Berry Fairchild Berry.Fairchild@uth.tmc.edu 2 University of Texas Health Science Center at Houston- Division of Plastic and Reconstructive Surgery AUTHOR Erik S. Marques Erik.S.Marques@uth.tmc.edu 3 University of Texas Health Science Center at Houston- Division of Plastic and Reconstructive Surgery AUTHOR
ORIGINAL_ARTICLE Correction of Severe Deviated Nose by Intermediate Short Osteotomy 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. http://wjps.ir/article-1-428-en.pdf 2019-06-18 208 212 10.29252/wjps.8.2.208 Deviated nose Crooked nose Rhinoplasty Osteotomy Rohollah Abbasi r.abbasi@umsha.ac.ir 1 Department of Ear-Nose-Throat Surgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. AUTHOR Ali Dowlati alidolati607@gmail.com 2 Department of Ear-Nose-Throat Surgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. AUTHOR Mohamad Reza Seif Rebiei seifrabiei@yahoo.com 3 Department of Community Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. AUTHOR Farnaz Hashemian hashemian@umsha.ac.ir 4 Department of Ear-Nose-Throat Surgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. AUTHOR
REVIEW_ARTICLE Novel Technique to Repair Unilateral Cleft Lip: Separated Multiple Y-to-V-Plasty under Magnification 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.   http://wjps.ir/article-1-481-en.pdf 2019-06-18 213 218 10.29252/wjps.8.2.213 Cleft lip Y-to-V-plasty Repair Aesthetic Mohammad Ali Hoghoughi hoghoughima@yahoo.com 1 MD, Assistant professor of burn and wound healing research center, plastic and reconstructive surgery ward, Shiraz University of medical science, Shiraz, Iran. AUTHOR Raha Habibagahi raha2979@yahoo.com 2 DDS, PhD of Biomaterials, Orthodontic Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. AUTHOR
ORIGINAL_ARTICLE Effects of the Human Amniotic Membrane on the Cartilage Graft: Prognosis and Absorption in White Rabbits 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. http://wjps.ir/article-1-494-en.pdf 2019-06-18 219 228 10.29252/wjps.8.2.219 Graft Cartilage Amniotic membrane Rabbit Sadrollah Motamed SadrollahMotamed@gmail.com 1 Department of Plastic Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran; AUTHOR Peyman Mohammadi Torbati PeymanMohammadiTorbati@gmail.com 2 Department of Pathology, Shahid Beheshti University of Medical Sciences, Tehran, Iran; AUTHOR Hamid Zaferani Arani Hamid_zaferani73@yahoo.com 3 Young Researchers and Elite Club, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran; AUTHOR Amir Reza Motabar amotabar@yahoo.com 4 Department of Plastic Surgery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran AUTHOR Amirhossein Zabolian Fzr2000_0007@yahoo.com 5 Young Researchers and Elite Club, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran; AUTHOR Zahra Madadi zahramadadi1394@gmail.com 6 Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran Unive AUTHOR
ORIGINAL_ARTICLE Evaluation of Anatomic Variations of Fibula Free Flap in Human Fresh Cadavers 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 http://wjps.ir/article-1-499-en.pdf 2019-06-18 229 236 10.29252/wjps.8.2.229 Fibula Free flap Fresh cadaver Skin perforators Mahdi Gholami gholamimh@mums.ac.ir 1 Mashhad University of Medical Sciences, Mashhad, Iran. AUTHOR Arya Hedjazi arya_hedjazi@yahoo.com 2 Iranian Legal Medicine Organization and Research center for Legal Medicine, Tehran, Iran AUTHOR Amir Kiamarz Milani amir.kiamarz.milani@gmail.com 3 Mashhad University of Medical Sciences, Mashhad, Iran. AUTHOR
ORIGINAL_ARTICLE Oblique Split Rib Graft Surgery in Primary and Secondary Septorhinoplasty 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.   http://wjps.ir/article-1-464-en.pdf 2019-06-18 237 244 10.29252/wjps.8.2.237 Oblique split method Rib Graft Septorhinoplasty Cartilage Shahriar Loghmani Fmaraki1373@gmail.com 1 Department of Plastic Surgery, Ordibehesht Surgical Center, Isfahan University of Medical Sciences, Isfahan, Iran AUTHOR Alireza Loghmani asimaghami@yahoo.com 2 Department of Dentistry, Ordibehesht Surgical Center, Isfahan University of Medical Sciences, Isfahan, Iran AUTHOR Fatemeh Maraki Fmaraki1373@gmail.com 3 Department of Operating Rroom, Isfahan university of Medical Sciences, Isfahan, Iran AUTHOR
ORIGINAL_ARTICLE Nasojugal Flap with Dermal Pennant for Reconstructive of Lower Lid Defect 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.  http://wjps.ir/article-1-431-en.pdf 2019-06-18 245 248 10.29252/wjps.8.2.245 Nasojugal flap Dermal pennant Lower lid Mojtaba Nasiri nasirimed@yahoo.com 1 School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran AUTHOR Mohammad Hosein Kardar mhkardar@yahoo.com 2 School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran AUTHOR
ORIGINAL_ARTICLE Effect of Ethanol on Micro-Vessels Diameter and Prevention of Thrombosis 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. http://wjps.ir/article-1-377-en.pdf 2019-06-18 249 253 10.29252/wjps.8.2.249 Ethanol Vessel Diameter Thrombosis Rabbit Mojtaba Nasiri nasirimed@yahoo.com 1 Medical Doctor, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran AUTHOR Mohammad Hossein Kardar mhkardar@yahoo.com 2 Assistant Professor of Plastic Surgery, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran AUTHOR
ORIGINAL_ARTICLE Burn: A Predictable but Preventable Tragedy in Epileptic Patients 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.   http://wjps.ir/article-1-478-en.pdf 2019-06-18 254 258 10.29252/wjps.8.2.254 Burn Injury Patient Prevent Epilepsy Iran Masoumeh Ghoddusi Johari m.ghoddusi94@yahoo.com 1 Breast Diseases Research Center,Shiraz University of Medical Sciences, Shiraz, Iran AUTHOR Ali Akbar Mohamadi mohamadiaa1347@gmail.com 2 Burn and Wound Healing Research Center, Plastic and Reconstructive Surgery Ward, Shiraz University of Medical Science, Shiraz, Iran AUTHOR Vahid Dastgerdi vahid.dastgerdi@yahoo.com 3 Burn and Wound Healing Research Center, Plastic and Reconstructive Surgery Ward, Shiraz University of Medical Science, Shiraz, Iran AUTHOR
CASE_STUDY Rare Presentation of Pilar Cyst of the Thumb 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. http://wjps.ir/article-1-482-en.pdf 2019-06-18 259 261 10.29252/wjps.8.2.259 Pilar cyst Trichilemmal cyst Benign hand cyst Kavish Maheshwari dr.kavish@gmail.com 1 Senior clinical research fellow AUTHOR Sandip Hindocha sandip.hindocha@bedfordhospital.nhs.uk 2 Professor and clinical lead AUTHOR Ali Yousif aliyousif15@yahoo.co.uk 3 Consultant AUTHOR
CASE_STUDY Closure of Oro-Antral Communication Using Buccal Advancement Flap 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. http://wjps.ir/article-1-487-en.pdf 2019-06-18 262 264 10.29252/wjps.8.2.262 Oro-antral Closure Flap Fistula Ritul Patel drritulpatel17@gmail.com 1 405 Edward Street North, Apt-21. Thunder Bay AUTHOR Prutha Patel pruthapatel9393@gmail.com 2 Thunder Bay Regional Health Sciences Centre, Thunder Bay, Canada AUTHOR Viral Kalariya viralkalariya112@gmail.com 3 Thunder Bay Regional Health Sciences Centre, Thunder Bay, Canada AUTHOR Het Patel sunhet@gmail.com 4 Thunder Bay Regional Health Sciences Centre, Thunder Bay, Canada AUTHOR Chetan Chavada ritsfire177@yahoo.com 5 Thunder Bay Regional Health Sciences Centre, Thunder Bay, Canada AUTHOR
OTHERS_CITABLE A Low-Cost, Easily Accessible Simulation Model for Microsurgery Training http://wjps.ir/article-1-500-en.pdf 2019-06-18 265 266 10.29252/wjps.8.2.265 Microsurgery training simulation model anastomosis Bilsev Ince bilsevince@yahoo.com 1 Necmettin Erbakan University, Meram Faculty of Medicine, Department of Plastic Surgery AUTHOR Mehmet Emin Cem Yildirim dr.cem_yildirim@hotmail.com 2 Necmettin Erbakan University, Meram Faculty of Medicine, Department of Plastic Surgery AUTHOR Mehmet Dadaci mdadaci@gmail.com 3 Necmettin Erbakan University, Meram Faculty of Medicine, Department of Plastic Surgery AUTHOR