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  • 1.
    Berggren, Anders
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Abdiu, Avni
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Marcusson, Agneta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Dental Clinic. Östergötlands Läns Landsting, Reconstruction Centre, Department of Oral Surgery UHL.
    Paulin, Gunnar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Dental Clinic. Östergötlands Läns Landsting, Reconstruction Centre, Department of Oral Surgery UHL.
    Letter: The nasal alar elevator: An effective tool in the presurgical treatment of infants born with cleft lip2005In: Plastic and reconstructive surgery (1963), ISSN 0032-1052, E-ISSN 1529-4242, Vol. 115, no 6, p. 1785-1787Article in journal (Other academic)
    Abstract [en]

    [No abstract available]

  • 2.
    Fagrell, D
    et al.
    Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Berggren, Anders
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Tarpila, Erkki
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Capsular contracture around saline-filled fine textured and smooth mammary implants: A prospective 7.5-year follow-up2001In: Plastic and reconstructive surgery (1963), ISSN 0032-1052, E-ISSN 1529-4242, Vol. 108, no 7, p. 2108-2112p. 2108-2112Article in journal (Other academic)
    Abstract [en]

    In a previous prospective randomized clinical study comparing in the same patient textured and smooth saline-filled mammary implants (Biocell) with large pore size (300 to 600 mum), we saw no difference in capsular contracture. This study was undertaken in a similar way to compare capsular contracture around smooth and textured saline-filled prostheses with pores of small size. During a period of 7.5 years, the breast hardness was followed tip, and at the end of the study patient satisfaction was evaluated. Twenty healthy women with a mean age of 30 years were operated on for breast augmentation. Two surgeons performed all operations in a standardized way. Each patient received subglandularly a Siltex textured saline-filled prosthesis with a pore size of 30 to 70 mum in one breast, and a smooth saline-filled prosthesis in the other. The hardness of the breasts was evaluated after 0.5, 1, and 7.5 years using Baker grading and applanation tonometry. Eighteen patients completed 1-year and 7.5-year follow-up. Two breasts With smooth prostheses were contracted after 6 months (Baker III or IV). After I year, four patients with smooth prostheses and one with a textured prosthesis had capsular contracture (p = 0.34). Seven and one-half years after surgery, six patents with smooth and four with textured implants had contracture (p = 0.66). On two patients with smooth prostheses and one patient with a textured prosthesis, the capsule around the implant hardened between 6 and 12 months. Between 1 year and 7.5 years, three breasts with smooth and textured implants contracted and one with a textured implant softened. The patients reported on a Visual Analogue Scale (I to 10) the impact of the augmentation oil their (quality of life to be 9 +/- 1. Four patients preferred the breast with file smooth prosthesis, three preferred the breast with the textured prosthesis, and the others found both breasts equal. This study showed no significant difference of contracture with smooth versus fine textured implants. The majority of the patients preferred the smooth implants. The patients reported that the breast augmentation had had an extremely high impact on their quality of life.

  • 3.
    Lutz, Barbara S.
    et al.
    Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine and Chang Gung University, Taiwan and Department of Plastic Surgery, Medical Center Örebro., Örebro, Sweden.
    Ma, S.-F.
    Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine and Chang Gung University, Taiwan.
    Chuang, D. C. C.
    Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine and Chang Gung University, Taiwan.
    Chan, K.-H.
    Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine and Chang Gung University, Taiwan.
    Wei, F. -C.
    Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine and Chang Gung University, Taiwan.
    Interposition of a pedicle fat flap significantly improves specificity of reinnervation and motor recovery after repair of transected nerves in adjacency in rats2001In: Plastic and reconstructive surgery (1963), ISSN 0032-1052, E-ISSN 1529-4242, Vol. 107, no 1, p. 116-123Article in journal (Refereed)
    Abstract [en]

    Despite highest standards in nerve repair, functional recovery following nerve transection still remains unsatisfactory. Nonspecific reinnervation of target organs caused by misdirected axonal growth at the repair site is regarded as one reason for a poor functional outcome. This study was conducted to establish a method for preventing aberrant reinnervation between transected and repaired nerves in adjacency.

    Rat sciatic nerve was transected and repaired as follows: epineural sutures of the sciatic nerve (group A, n = 6), fascicular repair of tibial and peroneal nerves respectively (group B, n = 8), and, as in group B, separating both nerves using a pedicle fat flap as barrier (group C, n = 8). As control only, the tibial nerve was transected and repaired (group D, n = 5).

    Muscle contraction force of the gastrocnemius muscle was significantly higher in group C as compared with groups A and B after 4 months. Muscle weight showed significantly lower values in group A as compared with groups B, C, and D. Histologic examination in group C revealed little growth of axons from the tibial to the peroneal nerve and vice versa. This axon crossing was observed only when gaps between the fat cells were available. These findings were confirmed by a significantly lower rate of misdirected axonal growth as compared with groups A and B using sequential retrograde double labeling technique of the soleus motoneuron pool.

    We conclude that a pedicle fat flap significantly prevents aberrant reinnervation between repaired adjacent nerves resulting in significantly improved motor recovery in rats. Clinically, this is of importance for brachial plexus, sciatic nerve, and facial nerve repair.

  • 4. Niemela, Birgitta Johansson
    et al.
    Hedlund, Anders
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Wahlsten, Viveka Sundelin
    Prominent Ears: The Effect of Reconstructive Surgery on Self-Esteem and Social Interaction in Children with a Minor Defect Compared to Children with a Major Orthopedic Defect2008In: Plastic and reconstructive surgery (1963), ISSN 0032-1052, E-ISSN 1529-4242, Vol. 122, no 5, p. 1390-1398Article in journal (Refereed)
    Abstract [en]

    Background: In a prospective study of patients with prominent ears, the effect of reconstructive surgery on self-esteem and social interaction was examined 1 year after surgery. Methods: Of 42 patients with prominent ears aged 7 to 15 years, 21 were matched with a comparison group of orthopedic patients (leg lengthening) and a control group of schoolchildren. Psychological measures evaluated self-esteem, depression, anxiety, cognition, parents' ratings of child behavior and symptoms, and parent anxiety. Semistructured interviews with the child and parents were also conducted. Results: The motivation to be operated on was pain, teasing, and feelings of being different. The satisfaction rate with the result of reconstructive surgery was high. The psychological measures of the prominent ears group had results close to those of the control group, although the leg lengthening group had lower self-esteem and higher depression and anxiety scores. With few exceptions, all patients had scores within the normal range on self-rating scales. Parents reported less activity at leisure time in both patient groups than in the control group. After surgery, parents reported improved behavior on the Child Behavior Checklist total problem score. Conclusions: Patients with minor defects had fewer self-reported psychological and behavior problems than the major defect group. Interestingly, prominent ears patients also had low activity levels. Reconstructive surgery had no adverse effect on the prominent ears patients in this interim study but rather resulted in improved well-being. It is important to investigate further the effect of reconstructive surgery on children's self-esteem and social interaction. (Plast. Reconstr. Surg. 122: 1390, 2008.)

  • 5.
    Nordenskjöld, Jesper
    et al.
    Hassleholm Kristianstad Hospital, Sweden.
    Waldén, Markus
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Kjellin, Anders
    Lund University, Sweden.
    Franzen, Herbert
    Ängelholm Hospital. Sweden.
    Atroshi, Isam
    Lund University, Lund, Sweden.
    Benefit of Local Anesthesia in Reducing Pain during Collagenase Injection for Dupuytrens Contracture2017In: Plastic and reconstructive surgery (1963), ISSN 0032-1052, E-ISSN 1529-4242, Vol. 140, no 3, p. 565-569Article in journal (Refereed)
    Abstract [en]

    Collagenase injection for Dupuytrens contracture is commonly administered without anesthesia. The authors studied the benefit of injecting local anesthesia before collagenase in reducing treatment-related pain. This prospective cohort study included 187 patients (mean age, 69 years; 80 percent men) at two orthopedic departments in Sweden. At one center, 161 consecutive patients scheduled for collagenase injection were assigned to two groups by alternating outpatient clinics; 78 received collagenase without local anesthesia using a modified method (injecting 0.80 mg in multiple spots in the cord) and 83 received local anesthesia injected in the proximal palm before collagenase. At the other center, 26 consecutive patients received collagenase using the standard method (0.58 mg injected in one spot) without local anesthesia. Immediately after the first injection (collagenase or local anesthesia), the patients rated the severity of injection-related pain on a visual analogue scale from 0 (no pain) to 10 (worst pain). Before finger manipulation 1 or 2 days after injection, the patients rated the pain experienced since injection. Mean score +/- SD for pain experienced during modified collagenase injection was 4.3 +/- 2.5 without local anesthesia and 2.3 +/- 1.7 during injection of local anesthesia (before collagenase) (age-and sex-adjusted mean difference, 2.1; 95 percent CI, 1.5 to 2.7; p amp;lt; 0.001). Mean pain score +/- SD during standard collagenase injection without local anesthesia was 4.8 +/- 1.8. Mean pain score +/- SD during the injection-manipulation interval was 2.9 +/- 1.9 in the group without local anesthesia and 2.9 +/- 2.3 in the local anesthesia group (p = 0.79). This study shows that local anesthesia significantly reduces the patients overall pain experience during collagenase treatment for Dupuytrens contracture.

  • 6.
    Thorfinn, Johan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Surgery . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Saber, Sepideh
    Stanford University Medical Center.
    Angelidis, Ioannis
    Stanford University Medical Center.
    Ki, Sae
    Stanford University Medical Center.
    Zhang, Andrew
    Stanford University Medical Center.
    Chong, Alphonsus
    Stanford University Medical Center.
    Pham, Hung
    Stanford University Medical Center.
    Lee, Gordon
    Stanford University Medical Center.
    Chang, James
    Stanford University Medical Center.
    Flexor Tendon Tissue Engineering: Temporal Distribution of Donor Tenocytes versus Recipient Cells2009In: Plastic and reconstructive surgery (1963), ISSN 0032-1052, E-ISSN 1529-4242, Vol. 124, no 6, p. 2019-2026Article in journal (Refereed)
    Abstract [en]

    Background: Tissue-engineered tendon material may address tendon shortages in mutilating hand injuries. Tenocytes from rabbit flexor tendon can be successfully seeded onto acellularized tendons that are used as tendon constructs. These constructs in vivo exhibit a population of tenocyte-like cells; however, it is not known to what extent these cells are of donor or recipient origin. Furthermore, the temporal distribution is also not known. Methods: Tenocytes from New Zealand male rabbits were cultured and seeded onto acellularized rabbit forepaw flexor tendons (n = 48). These tendon constructs were transplanted into female recipients. Tendons were examined after 3, 6, 12, and 30 weeks using fluorescent in situ hybridization to detect the Y chromosome in the male donor cells. One unseeded, acellularized allograft in each animal was used as a control. Results: The donor male tenocytes populate the epitenon and endotenon of the grafts at greater numbers than the recipient female tenocytes at 3 and 6 weeks. The donor and recipient tenocytes are present jointly in the grafts until 12 weeks. At 30 weeks, nearly all cells are recipient tenocyte-like cells. Conclusions: Donor male cells survive in decreasing numbers over time until 30 weeks. The presence of cells in tissue-engineered tendon grafts has been shown in prior studies to add to the strength of the constructs in vitro. This study shows that recipient cells can migrate into and repopulate the tendon construct. Cell seeding onto tendon material may create stronger constructs that will allow the initiation of motion earlier. (Plast. Reconstr. Surg. 124: 2019, 2009.)

  • 7.
    Yafi, Amr
    et al.
    Beckman Laser Institute and Medical Clinic, University of California, Irvine, 1002 Health Sciences Rd. East, Irvine, CA 92617, USA.
    Vetter, Thomas S.
    Aesthetic and Plastic Surgery Institute, University of California, Irvine 200 S. Manchester Ave., Suite 650, Orange, CA 92868, USA.
    Scholz, Thomas
    Aesthetic and Plastic Surgery Institute, University of California, Irvine 200 S. Manchester Ave., Suite 650, Orange, CA 92868, USA.
    Patel, Sarin
    Beckman Laser Institute and Medical Clinic, University of California, Irvine, 1002 Health Sciences Rd. East, Irvine, CA 92617, USA.
    Saager, Rolf B.
    Beckman Laser Institute and Medical Clinic, University of California, Irvine, 1002 Health Sciences Rd. East, Irvine, CA 92617, USA.
    Cuccia, David J.
    Modulated Imaging Inc., Beckman Laser Institute Photonic Incubator 1002 Health Sciences Rd. East, Irvine, CA 92617, USA.
    Evans, Gregory R.
    Aesthetic and Plastic Surgery Institute, University of California, Irvine 200 S. Manchester Ave., Suite 650, Orange, CA 92868, USA.
    Durkin, Anthony J.
    Beckman Laser Institute and Medical Clinic, University of California, Irvine, 1002 Health Sciences Rd. East, Irvine, CA 92617, USA.
    Postoperative Quantitative Assessment of Reconstructive Tissue Status in a Cutaneous Flap Model Using Spatial Frequency Domain Imaging2011In: Plastic and reconstructive surgery (1963), ISSN 0032-1052, E-ISSN 1529-4242, Vol. 127, no 1, p. 117-130Article in journal (Refereed)
    Abstract [en]

    Background:

    The purpose of this study was to investigate the capabilities of a novel optical wide-field imaging technology known as spatial frequency domain imaging to quantitatively assess reconstructive tissue status.

    Methods:

    Twenty-two cutaneous pedicle flaps were created on 11 rats based on the inferior epigastric vessels. After baseline measurement, all flaps underwent vascular ischemia, induced by clamping the supporting vessels for 2 hours (either arteriovenous or selective venous occlusions); normal saline was injected into the control flap and hypertonic-hyperoncotic saline solution was injected into the experimental flap. Flaps were monitored for 2 hours after reperfusion. The spatial frequency domain imaging system was used for quantitative assessment of flap status over the duration of the experiment.

    Results:

    All flaps demonstrated a significant decline in oxyhemoglobin and tissue oxygen saturation in response to occlusion. Total hemoglobin and deoxyhemoglobin were increased markedly in the selective venous occlusion group. After reperfusion and the administration of solutions, oxyhemoglobin and tissue oxygen saturation in those flaps that survived gradually returned to baseline levels. However, flaps for which oxyhemoglobin and tissue oxygen saturation did not show any signs of recovery appeared to be compromised and eventually became necrotic within 24 to 48 hours in both occlusion groups.

    Conclusions:

    Spatial frequency domain imaging technology provides a quantitative, objective method of assessing tissue status. This study demonstrates the potential of this optical technology to assess tissue perfusion in a very precise and quantitative way, enabling wide-field visualization of physiologic parameters. The results of this study suggest that spatial frequency domain imaging may provide a means for prospectively identifying dysfunctional flaps well in advance of failure.

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