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In total, 154 (76%) prescribe PT to less than 50% of their patients, and those who do most commonly prescribe it more than 3 weeks postoperatively. There was no difference in perceived rate of complications by respondents who prescribe early versus late exercise (



(5) = 8.815,

= 0.117).

Based on our survey results, only a small percentage of plastic and reconstructive surgeons support early initiation of exercise, and PT is being prescribed to a minority of patients. Surgeons and physical therapists must work together to devise a recovery program that maximizes functional outcomes for patients while also limiting complications.

Based on our survey results, only a small percentage of plastic and reconstructive surgeons support early initiation of exercise, and PT is being prescribed to a minority of patients. Surgeons and physical therapists must work together to devise a recovery program that maximizes functional outcomes for patients while also limiting complications.Reconstruction of the posterior trunk and torso defects presents unique challenges to the reconstructive surgeon, particularly in the setting of oncologic resection and adjuvant multimodality therapy such as chemotherapy and radiation. The operation can be more complicated in the setting of hardware exposure. Although local flaps represent the primary workhorse option, reconstruction using a microvascular free tissue transfer should be considered when local flap options have been exhausted. Here, we present a unique case reconstructing a complex, radiated back wound with exposed hardware that failed prior bilateral paraspinous, latissimus dorsi, and trapezius muscle flaps. A unilateral free TRAM flap was used and revascularized through an arteriovenous loop to provide stable coverage of the 15 × 25 cm defect. The patient also had preexisting upper extremity ischemia, which limited flap perfusion and positioning options. The usage of arteriovenous loops and free musculocutaneous flaps can provide another potential adequate option for the treatment of these complex defects.Pan-facial fracture repair is considered one of the most challenging complex reconstructive procedures to perform. It is always better to treat facial fractures as soon as possible. A delay of several days or weeks makes an ideal anatomic reduction difficult, if not impossible.

Patients presenting late with noncompound pan-facial fractures and interrupting maxillary and mandibular arches who were candidates for ORIF were included. Patients had been divided randomly into two groups group A was managed by the ordinary sequence of repair, and group B was managed with the aid of occlusal dental splint.

In total, 20 patients presented late (3-9 weeks post insult) due to serious injuries that required previous intervention. The time until obtaining optimal occlusion ranged between 80 and 120 minutes in the study group, whereas in the control group, the time ranged between 120 and 180 minutes (

< 0.0001). Postoperative malocclusion was noticed to be less frequent in the splint group than in the control group only one patient with residual malocclusion in the study group versus two patients in the control group.

Occlusal splints could be a good modality for restoring the pre-morbid occlusion in patients with delayed pan-facial fractures. It is a simple, reliable technique that could be easily integrated into our daily practice, and could help decrease the intraoperative time needed for restoration of optimal occlusion and decrease the postoperative malocclusions.

Occlusal splints could be a good modality for restoring the pre-morbid occlusion in patients with delayed pan-facial fractures. It is a simple, reliable technique that could be easily integrated into our daily practice, and could help decrease the intraoperative time needed for restoration of optimal occlusion and decrease the postoperative malocclusions.Spirituality is an important, yet often overlooked, component of personal well-being. The purpose of this study was to assess whether spirituality plays an important role in the well-being of US plastic surgeons and residents, and whether spirituality is viewed as an important component of patient care.

An anonymous and voluntary email survey was distributed to 3375 members of ASPS during the months of April through June of 2020. The survey distribution included 2230 active members of ASPS and 1149 resident members, all who practice or train within the United States. The survey consisted of 18 multiple-choice questions with answer choices based on a descriptive five-point Likert scale and ranking by priority. Statistical analysis of the results was performed using StataCorp 2019 software.

A total of 431 completed surveys were received for a response rate of 12.7%. The majority of participants (70%) reported that personal spiritual beliefs and faith contribute positively to emotional well-being. In total, 65% agreed or strongly agreed that their spiritual beliefs provide a healthy framework for handling conflict, suffering, and loss. More than half (51%) reported that as a result of the COVID-19 global pandemic, their spiritual beliefs and practices have provided increased support and guidance.

Spirituality is an important component of maintaining wellness for plastic surgeons, and spirituality is recognized by plastic surgeons as an important aspect of the healing process for patients. Efforts should be made to promote spiritual health among the surgical community both during training and in practice.

Spirituality is an important component of maintaining wellness for plastic surgeons, and spirituality is recognized by plastic surgeons as an important aspect of the healing process for patients. this website Efforts should be made to promote spiritual health among the surgical community both during training and in practice.Morel-Lavallée lesions have been described in the literature since the mid-19th century, yet contemporary clinical management continues to be challenging and remains variable. These closed degloving injuries are usually seen in the setting of blunt trauma and are due to shearing forces, creating a space for the collection of hemolymphatic fluid. These fluid collections can be persistent despite conservative treatment attempts and can require staged surgical interventions.

A literature search of peer-reviewed articles pertaining to Morel-Lavallée lesions was performed. Articles relating to the pathophysiology, clinical presentation, diagnosis, treatment, and management of complications of Morel-Lavallée lesions were included to formulate recommendations for clinical management.

Fifty-six relevant articles were included in the review. Recognition of these lesions may be delayed and the use of imaging is important in diagnosis. Initial attempts at conservative management may be appropriate for smaller, uncomplicated Morel-Lavallée lesions. Surgical interventions such as open debridement, techniques to close dead space, negative pressure wound therapy, and skin grafts or flaps are critical to managing complex or recurring lesions. An algorithm for the treatment of Morel-Lavallée lesions is proposed based on review of the literature.

Plastic and reconstructive surgeons are frequently involved in more complex Morel-Lavallée lesions such as those exhibiting delayed healing or super-infection. The skillset needed for successful management of patients with Morel-Lavallée lesions is well within the armamentarium of plastic and reconstructive surgeons.

Plastic and reconstructive surgeons are frequently involved in more complex Morel-Lavallée lesions such as those exhibiting delayed healing or super-infection. The skillset needed for successful management of patients with Morel-Lavallée lesions is well within the armamentarium of plastic and reconstructive surgeons.Granuloma faciale is a rare, benign inflammatory skin disease that has multiple medical treatment modalities due to its frequent unresponsiveness to treatment. This skin disease presents as a single, well-demarcated red-brown to violaceous, raised lesion, most commonly on the face, in middle-aged White men. Its etiology is unknown; sun exposure is thought to have some implications in its formation. Treatment modalities for granuloma faciale include topical therapy, intralesional injections, systemic therapies, phototherapy, lasers, cryotherapy, and surgical excision. In this article, we will highlight a rare case of granuloma faciale and its novel and successful treatment with a carbon dioxide emulated ErYAG laser.Although pre- and postoperative three-dimensional (3D) photography are well-established in breast reconstruction, intraoperative 3D photography is not. We demonstrate the process of intraoperative acquisition and visualization of 3D photographs for breast reconstruction and present clinicians' opinions about intraoperative visualization tools.

Mastectomy specimens were scanned with a handheld 3D scanner during breast surgery. The 3D photographs were processed to compute morphological measurements of the specimen. Three visualization modalities (screen-based viewing, augmented reality viewing, and 3D printed models) were created to show different representations of the 3D photographs to plastic surgeons. We interviewed seven surgeons about the usefulness of the visualization methods.

The average time for intraoperative acquisition of 3D photographs of the mastectomy specimen was 4 minutes, 8 seconds ± 44 seconds. The average time for image processing to compute morphological measurements of the specimen wasability of visualization methods and of measurements of the mastectomy specimen, which can be used to guide future surgical practice.

The endocannabinoid system has emerged as a key regulatory signaling pathway in the pathophysiology of alcohol-associated liver disease (ALD). More than 30 years of research have established different roles of endocannabinoids and their receptors in various aspects of liver diseases, such as steatosis, inflammation, and fibrosis. However, pharmacological applications of the endocannabinoid system for the treatment of ALD have not been successful because of psychoactive side effects, despite some beneficial effects. Thus, a more delicate and detailed elucidation of the mechanism linking the endocannabinoid system and ALD may be of paramount significance in efforts to apply the system to the treatment of ALD.

Three electronic databases (PubMed, MEDLINE, and Cochrane Library) were used for literature search from November 1988 to April 2021. Major keywords used for literature searches were "cannabinoid," "cannabinoid receptor," "ALD," "steatosis," and "fibrosis."

According to the inclusion and exclusion criteria, the authors selected 47 eligible full-text articles out of 2,691 searched initially. Studies in the past 3 decades revealed the opposite effects of cannabinoid receptors CB1R and CB2R on steatosis, inflammation, and fibrosis in ALD.

This review summarizes the endocannabinoid signaling in the general physiology of the liver, the pathogenesis of ALD, and some of the potential therapeutic implications of cannabinoid-based treatments for ALD.

This review summarizes the endocannabinoid signaling in the general physiology of the liver, the pathogenesis of ALD, and some of the potential therapeutic implications of cannabinoid-based treatments for ALD.

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