35 results on '"Ziyad S"'
Search Results
2. Abstract: Flap Reconstruction of Rectovaginal and Rectourethral Fistulas: A 20-Year Experience at Mayo Clinic
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Jeremie Douglas Oliver, BS, BA, Ziyad S. Hammoudeh, MD, Arya Andre Akhavan, MD, Erik D. Hokenstad, MD, John A. Occhino, MD, and Nho V. Tran, MD
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Surgery ,RD1-811 - Published
- 2017
- Full Text
- View/download PDF
3. Allogeneic and Alloplastic Augmentation Grafts in Nipple–Areola Complex Reconstruction: A Systematic Review and Pooled Outcomes Analysis of Complications and Aesthetic Outcomes
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Ziyad S. Hammoudeh, Sammy Sinno, Michael S. Hu, Chase Beal, and Jeremie D. Oliver
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medicine.medical_specialty ,Artificial bone ,Esthetics ,Mammaplasty ,Breast Neoplasms ,030230 surgery ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Patient satisfaction ,medicine ,Humans ,Retrospective Studies ,business.industry ,Wound dehiscence ,Hematopoietic Stem Cell Transplantation ,medicine.disease ,Surgery ,Plastic surgery ,Treatment Outcome ,Otorhinolaryngology ,Nipples ,Implant ,business ,Breast reconstruction ,Complication - Abstract
With advancements in materials engineering, many plastic surgeons have looked to allogeneic tissue and alloplastic materials as a possible source of structure for long-lasting nipple–areola complex reconstruction. Furthermore, in light of the recent mandate from the Food and Drug Administration restricting the marketing and direct indication of acellular dermal matrices (ADMs) in breast reconstruction, we sought to highlight the overall safety and efficacy demonstrated in the existing literature surrounding all alloplastic materials in nipple–areola complex reconstruction. In this study, the authors conduct a systematic review and pooled outcomes analysis on allogenic and alloplastic implant materials utilized to achieve long-lasting nipple projection stratified by specific material used and respective outcomes. A comprehensive systematic review on allogenic and synthetic materials data utilized in nipple reconstruction was conducted utilizing Medline/PubMed database. Articles were stratified by (1) alloplastic material, as well as (2) objective and patient-reported outcomes. A total of 592 nipple–areola complexes on 482 patients were featured in 15 case series. In all studies, alloplastic or allograft material was utilized to achieve and maintain nipple projection. Subjective measurements revealed a patient satisfaction rate of 93.3% or higher with the majority of patients being very satisfied with their reconstruction. The alloplastic and allograft implants analyzed had an overall complication rate of 5.3% across all materials used. The most common complication reported was flap or graft necrosis with a pooled rate of 2.5%. Overall, the Ceratite implant presented with the highest complication rate (18%) including flap/graft necrosis (13%) and extrusion of the artificial bone (5%). Other rigid implants such as the biodesign nipple reconstruction cylinder reported complications of extrusion (3.6%), projection loss requiring revision (2.5%), wound dehiscence/drainage (1.5%), flap or graft necrosis (1.0%) and excessive bleeding (0.5%). ADM implants had reported complications of both insufficient projection (0.8%) and excessive projection (1.6%), which required surgical revision. Injectable materials had minimal reported complications of pain during injection (0.8%) with Radiesse and a false-positive PET scan result (0.8%) with DermaLive. Allogeneic and alloplastic grafts are a reliable means of achieving satisfactory nipple projection, with a relatively low overall complication profile. The use of Ceratite (artificial bone) led to the highest complication rates. Further clinical studies are necessary to better understand the feasibility and longer-term outcomes of the use of allogeneic and synthetic augmentation grafts to improve nipple projection. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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- 2019
4. Nonsurgical Adjuncts Following Facelift to Achieve Optimal Aesthetic Outcomes
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Ziyad S. Hammoudeh and W. Grant Stevens
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medicine.medical_specialty ,business.industry ,Facial rejuvenation ,medicine.medical_treatment ,Dermabrasion ,Facelift surgery ,Intense pulsed light ,Surgery ,Skin Aging ,Cosmetic Techniques ,Facial aging ,Medicine ,business ,Rejuvenation - Abstract
This article discusses the various nonsurgical treatments that can be performed in combination with facelift surgery to provide patients with a more complete facial rejuvenation. Nonsurgical adjuncts focus on facial volume enhancement, skin resurfacing, intense pulsed light for pigmentary changes, neuromodulators, and skin care in addition to the surgical techniques used to combat facial aging. Several options exist for skin resurfacing, including dermabrasion, chemical peels, and lasers; the advantages and limitations of each are discussed. Photographs demonstrating the effectiveness of nonsurgical treatments to facelift patients are displayed as examples of their powerful adjunctive effect.
- Published
- 2019
5. Interproximal bone in maxillary anterior teeth in subjects with Class III facial deformity: Are there options for segmental maxillary osteotomy in 'surgery first'?
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Ziyad S. Haidar, M. de Moraes, Javier Villa, Pablo Navarro, S. Olate, and Leyze Patrícia Barbosa de Brito
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medicine.medical_specialty ,medicine.medical_treatment ,Orthognathic surgery ,Class iii ,03 medical and health sciences ,Facial deformity ,0302 clinical medicine ,Segmental osteotomy ,Alveolar Process ,Maxilla ,medicine ,Humans ,Osteotomy, Le Fort ,Maxillary central incisor ,Maxillary Osteotomy ,Anterior teeth ,business.industry ,030206 dentistry ,Cone-Beam Computed Tomography ,Surgery ,stomatognathic diseases ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Upper left canine ,Oral Surgery ,business - Abstract
Our aim was to give a morphometric description of the interproximal bone between the anterior maxillary teeth of subjects with class III facial deformity, who were candidates for segmented Le Fort I osteotomy. We measured the width of the interproximal bone from the upper right canine to the upper left canine in cone-beam computed tomographic images of 35 subjects, and identified five interproximal areas of measurement. The lower and upper measurements were established 5mm and 10mm from the cervical crest of the interproximal bone. A paired samples t test and Pearson's correlation coefficient were applied and probabilities of less than 0.05 were accepted as significant. In all the scans of interproximal bone, the apical zone was significantly wider than the inferior zone (p
- Published
- 2019
6. Prevalence of preoperative anxiety among hospitalized patients in a developing country: a study of associated factors
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Ramzi Shawahna, Mohammad Jaber, Iyad Maqboul, Hatim Hijaz, Marah Tebi, Nada Al-Sayed Ahmed, and Ziyad Shabello
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Preoperative anxiety ,Anxiety ,Fear of anesthesia ,Preoperative care ,Surgical procedures ,Surveys and questionnaires ,Surgery ,RD1-811 - Abstract
Abstract Background Preoperative anxiety is a health concern among patients scheduled for surgical interventions. Little is known about the prevalence of preoperative anxiety among patients in different healthcare systems of developing countries. This study was conducted to determine the prevalence of preoperative anxiety among patients undergoing surgery in Palestine. Another objective was to identify the factors associated with preoperative anxiety. Methods This study was conducted in a cross-sectional descriptive design. Patients scheduled for surgical interventions were interviewed using an interviewer-administered questionnaire. The questionnaire collected the demographic, clinical, and surgical variables of the patients. The questionnaire also contained the Amsterdam preoperative anxiety and information scale (APAIS), and a short version of the Spielberger state-trait anxiety inventory (STAIS-5/STAIT-5). Result A total of 280 patients were included. The mean APAIS total score was 13.6 ± 5.9, the mean APAIS anxiety domain score was 8.3 ± 4.3, and the mean APAIS need for information domain was 1.6 ± 0.50. Of the patients, 76 (27.1%) had high anxiety and 160 (57.1%) expressed a high need for information. The higher APAIS anxiety scores were predicted by being female, having chronic diseases, being scheduled to be operated on within 24 h, and having experienced surgical complications. The mean STAIS-5 score was 10.0 ± 4.2 and the mean STAIT-5 was 10.3 ± 3.8. Of the patients, 140 (50.0%) had high state anxiety and 56 (20.0%) had high trait anxiety. Higher STAIS-5 scores were predicted by being female, younger than 42 years, and scheduled to be operated on within 24 h. Higher STAIT-5 scores were predicted by being female. A positive correlation was identified between APAIS total, APAIS anxiety, APAIS need for information, STAIS-5, and STAIT-5 scores. Conclusion Preoperative anxiety was prevalent among patients scheduled for surgical operations in Palestinian hospitals. Anesthesiologists and other providers of perioperative care should screen preoperative patients who are female, have chronic diseases, are scheduled to be operated on within 24 h, and having had experienced surgical complications for preoperative anxiety. More studies are still needed to investigate the effects of the implemented measures on the prevalence of preoperative anxiety.
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- 2023
- Full Text
- View/download PDF
7. Desmoid tumor following abdominally-based free flap breast reconstruction
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Brian T. Carlsen, Ziyad S. Hammoudeh, and Christine Oh
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0301 basic medicine ,medicine.medical_specialty ,business.industry ,Fibromatosis ,Free flap breast reconstruction ,Connective tissue ,Case Report ,Fibrous capsule ,medicine.disease ,Surgery ,law.invention ,body regions ,Abdominal wall ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,medicine.anatomical_structure ,law ,030220 oncology & carcinogenesis ,Breast implant ,Medicine ,business ,Breast reconstruction - Abstract
Desmoid tumors are fibroblastic connective tissue tumors that most commonly develop within the anterior abdominal wall. The etiology of desmoid tumors has not been well defined; however, hereditary, hormonal, traumatic, and surgery-related causes have been implicated. Desmoid tumors are believed to arise from musculoaponeurotic structures. Development in the breast is very rare. Several reports of desmoid tumors arising in the vicinity of the fibrous capsule of a breast implant have been described, but to date, the authors are not aware of any published cases following autologous breast reconstruction. This report describes a desmoid tumor developing after a muscle-sparing free transverse rectus abdominis musculocutaneous (TRAM) flap for breast reconstruction and subsequent surgical management.
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- 2017
8. Flap Reconstruction of Gastrointestinal-to-Genitourinary Fistulas: A 20-Year Experience
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Ziyad S. Hammoudeh, Nho V. Tran, Jeremie D. Oliver, and Arya A. Akhavan
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Fistula ,Population ,030230 surgery ,Dehiscence ,Surgical Flaps ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,medicine ,Humans ,education ,Aged ,Retrospective Studies ,education.field_of_study ,Vesicovaginal Fistula ,business.industry ,Urinary Bladder Fistula ,Retrospective cohort study ,Digestive System Fistula ,Middle Aged ,Plastic Surgery Procedures ,medicine.disease ,Surgery ,Radiation therapy ,030220 oncology & carcinogenesis ,Cohort ,Etiology ,Female ,Complication ,business - Abstract
Background Gastrointestinal-to-genitourinary fistulas may occur secondary to obstetric complications, radiation therapy, cancer without radiation, inflammatory bowel disease, or previous surgery. Flap reconstruction is useful for complex cases refractory to standard techniques, separating the fistula tracts to aid healing. The purpose of this study was to investigate outcomes and risk factors for complications in flap reconstruction of fistulas from several different etiologies performed over a 20-year period. Methods All patients who underwent flap reconstruction between January 1995 and December 2014 were reviewed. Patient demographics, prior treatment failures, surgical indications, and comorbidities were obtained. Operative and postoperative data were collected, including flap type, length of stay, early and late complications, recurrences, and follow-up time. Operative success was defined as definitive treatment of the fistula without recurrence within 6 months. Results There were 59 patients who underwent 66 reconstructions. The overall complication rate was 59.1%. Complications included infection (21%), dehiscence (17%), and partial flap loss (1.5%). Operative success rate was 51.5%. Smoking history (p = 0.021) and body mass index (BMI) > 35 (p = 0.003) were significantly associated with increased likelihood of postoperative complications following flap reconstruction in these patients. Additionally, fistulas due to cancer resections had a higher likelihood of postoperative complications compared with fistulas due to bowel disease or obstetric complications (p = 0.04). Conclusion Flap reconstruction can be successfully used for complex or refractory gastrointestinal-to-genitourinary fistulas. However, considerable complication and recurrence rates were found in this population. Patients with a BMI > 35 and a history of smoking were at greatest risk in this cohort of experiencing postoperative complications.
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- 2019
9. Engineering Solutions for Cranio-Maxillo-Facial Rehabilitation and Oro-Dental Healthcare
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Frédéric Cuisinier, Ziad Noujeim, Ziyad S. Haidar, John E. Davies, Avijit Banerjee, and Lucy DiSilvio
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lcsh:R5-920 ,Rehabilitation ,lcsh:Medical technology ,Article Subject ,business.industry ,medicine.medical_treatment ,Biomedical Engineering ,MEDLINE ,Oral Health ,Health Informatics ,Oral health ,medicine.disease ,Surgery, Oral ,Editorial ,lcsh:R855-855.5 ,Health care ,Humans ,Medicine ,Surgery ,Medical emergency ,business ,lcsh:Medicine (General) ,Biotechnology - Published
- 2019
10. Nonmotile Single-Cell Migration as a Random Walk in Nonuniformity: The 'Extreme Dumping Limit' for Cell-to-Cell Communications
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Sebastian Aguayo, Ziyad S. Haidar, and Grigorios P. Panotopoulos
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0301 basic medicine ,Work (thermodynamics) ,lcsh:Medical technology ,Article Subject ,Biomedical Engineering ,Osteoclasts ,Health Informatics ,Cell Communication ,Models, Biological ,Displacement (vector) ,Bacterial Adhesion ,Diffusion ,03 medical and health sciences ,Cell Movement ,Oscillometry ,Animals ,Humans ,Statistical physics ,Limit (mathematics) ,Brownian motion ,Physics ,lcsh:R5-920 ,Stochastic Processes ,Stochastic process ,Dynamics (mechanics) ,Equations of motion ,Random walk ,030104 developmental biology ,lcsh:R855-855.5 ,Surgery ,lcsh:Medicine (General) ,Algorithms ,Blood Flow Velocity ,Biotechnology ,Signal Transduction ,Research Article - Abstract
In the present work, we model single-cell movement as a random walk in an external potential observed within the extreme dumping limit, which we define herein as the extreme nonuniform behavior observed for cell responses and cell-to-cell communications. Starting from the Newton–Langevin equation of motion, we solve the corresponding Fokker–Planck equation to compute higher moments of the displacement of the cell, and then we build certain quantities that can be measurable experimentally. We show that, each time, the dynamics depend on the external force applied, leading to predictions distinct from the standard results of a free Brownian particle. Our findings demonstrate that cell migration viewed as a stochastic process is still compatible with biological and experimental observations without the need to rely on more complicated or sophisticated models proposed previously in the literature.
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- 2018
11. The 3 R’s for Platelet-Rich Fibrin: A 'Super' Tri-Dimensional Biomaterial for Contemporary Naturally-Guided Oro-Maxillo-Facial Soft and Hard Tissue Repair, Reconstruction and Regeneration
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Marcelo Parra, Francisco T Muñoz, S. Olate, Ziyad S. Haidar, Eduardo G Fernández, and Consuelo C Zumarán
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0106 biological sciences ,periodontology ,medicine.medical_specialty ,Oral surgery ,Review ,01 natural sciences ,lcsh:Technology ,Fibrin ,osteogenesis ,03 medical and health sciences ,0302 clinical medicine ,Tissue engineering ,010608 biotechnology ,growth factors ,grafts ,Medicine ,General Materials Science ,fibrin ,lcsh:Microscopy ,lcsh:QC120-168.85 ,platelet ,biology ,dentistry ,lcsh:QH201-278.5 ,business.industry ,lcsh:T ,Regeneration (biology) ,Biomaterial ,030206 dentistry ,Platelet-rich fibrin ,Surgery ,Clinical trial ,lcsh:TA1-2040 ,tissue engineering ,regeneration ,biology.protein ,Oral and maxillofacial surgery ,lcsh:Descriptive and experimental mechanics ,lcsh:Electrical engineering. Electronics. Nuclear engineering ,business ,lcsh:Engineering (General). Civil engineering (General) ,leukocyte ,lcsh:TK1-9971 ,oral surgery - Abstract
Platelet-Rich fibrin (PRF) is a three-dimensional (3-D) autogenous biomaterial obtained via simple and rapid centrifugation from the patient’s whole blood samples, without including anti-coagulants, bovine thrombin, additives, or any gelifying agents. At the moment, it is safe to say that in oral and maxillofacial surgery, PRFs (particularly, the pure platelet-rich fibrin or P-PRF and leukocyte and platelet-rich fibrin or L-PRF sub-families) are receiving the most attention, essentially because of their simplicity, cost-effectiveness, and user-friendliness/malleability; they are a fairly new “revolutionary” step in second-generation therapies based on platelet concentration, indeed. Yet, the clinical effectiveness of such surgical adjuvants or regenerative platelet concentrate-based preparations continues to be highly debatable, primarily as a result of preparation protocol variability, limited evidence-based clinical literature, and/or poor understanding of bio-components and clinico-mechanical properties. To provide a practical update on the application of PRFs during oral surgery procedures, this critical review focuses on evidence obtained from human randomized and controlled clinical trials only. The aim is to serve the reader with current information on the clinical potential, limitations, challenges, and prospects of PRFs. Accordingly, reports often associate autologous PRFs with early bone formation and maturation; accelerated soft-tissue healing; and reduced post-surgical edema, pain, and discomfort. An advanced and original tool in regenerative dentistry, PRFs present a strong alternative and presumably cost-effective biomaterial for oro-maxillo-facial tissue (soft and hard) repair and regeneration. Yet, preparation protocols continue to be a source of confusion, thereby requiring revision and standardization. Moreover, to increase the validity, comprehension, and therapeutic potential of the reported findings or observations, a decent analysis of the mechanico-rheological properties, bio-components, and their bioactive function is eagerly needed and awaited; afterwards, the field can progress toward a brand-new era of “super” oro-dental biomaterials and bioscaffolds for use in oral and maxillofacial tissue repair and regeneration, and beyond.
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- 2018
12. The Ideal Thigh: A Crowdsourcing-Based Assessment of Ideal Thigh Aesthetic and Implications for Gluteal Fat Grafting
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W. Grant Stevens, Beina Azadgoli, Luis H. Macias, Ziyad S. Hammoudeh, Daniel J. Gould, and Emma Vartanian
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Adult ,Male ,Esthetics ,Population ,030230 surgery ,Thigh ,Crowdsourcing ,03 medical and health sciences ,Horizontal projection ,Young Adult ,0302 clinical medicine ,Age groups ,Lipectomy ,Surveys and Questionnaires ,medicine ,Fat grafting ,Humans ,Buttocks ,education ,Aged ,Orthodontics ,education.field_of_study ,Ideal (set theory) ,business.industry ,General Medicine ,Middle Aged ,Body Contouring ,medicine.anatomical_structure ,Adipose Tissue ,Patient Satisfaction ,030220 oncology & carcinogenesis ,Surgery ,Female ,business - Abstract
Background As the popularity of aesthetic gluteoplasty continues to grow, there is renewed focus on defining the ideal buttocks. However, the literature lacks studies characterizing an ideal thigh, despite the impact of thigh contour on overall gluteal aesthetic. Objectives The authors performed the first population analysis of the characteristics of perception of attractive thighs, to identify a role for fat grafting of the thigh in gluteoplasty. Methods Survey images were digitally modified to create thighs of varying widths and angles relative to fixed buttocks. Thigh-to-buttock ratios and the buttock-thigh junction were studied. Data were stratified and analyzed according to age, gender, and ethnicity of the respondents. Amazon Mechanical Turk was used as a novel crowdsourcing platform for surveying aesthetic preferences. Results A total of 1034 responses were included of whom 54.4% were male, and 45.6% were female. All age groups and ethnicities were represented. Overall, 43.8% of respondents preferred the widest buttock-thick junction angle on posterior view. There was no clear preference between larger or smaller thigh-to-hip ratios on lateral view. Conclusions Characteristics of the ideal thigh include wider thighs with greater horizontal projection, creating a more natural contour from the augmented buttock. These findings represent a paradigm shift from the traditionally assumed preference for slender thighs. Plastic surgeons should carefully consider thigh anatomy in their gluteal augmentation patients, as simultaneous thigh augmentation may lead to a more aesthetically pleasing outcome. Further research is needed into best practices and techniques to attain ideal thigh proportions.
- Published
- 2018
13. Seroma Rates Are Not Increased When Combining Liposuction With Progressive Tension Suture Abdominoplasty: A Retrospective Cohort Study of 619 Patients
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Phillip Dauwe, Ziyad S. Hammoudeh, W. Grant Stevens, Fouad Saeg, Luis H. Macias, and Daniel J. Gould
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Adult ,Male ,medicine.medical_specialty ,Demographics ,medicine.medical_treatment ,Wound seroma ,macromolecular substances ,030230 surgery ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Postoperative Complications ,Suture (anatomy) ,otorhinolaryngologic diseases ,medicine ,Humans ,Aged ,Retrospective Studies ,Abdominoplasty ,business.industry ,Suture Techniques ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Body Contouring ,Surgery ,carbohydrates (lipids) ,body regions ,stomatognathic diseases ,Seroma ,Treatment Outcome ,Liposuction ,Concomitant ,Lipoabdominoplasty ,Female ,business - Abstract
Background Several studies have demonstrated that progressive tension sutures (PTS) reduce seroma. Many fear that adding liposuction to abdominoplasty will increase seroma rates and avoid drainless abdominoplasty when performing concomitant liposuction. Objectives We sought to identify whether liposuction increases seroma in PTS and non-PTS abdominoplasty. Methods In this retrospective study, 619 patients underwent abdominoplasty between 2009 and 2017, of which 299 patients had drainless abdominoplasty with PTS and 320 had drain-based abdominoplasty. We compared complications among PTS patients with and without liposuction and among drain-based abdominoplasty patients with and without liposuction. Results Demographics were similar between PTS and drain patients and between liposuction and nonliposuction PTS. Mean liposuction volume with PTS was 1592 ± 1048 mL. Seroma in the PTS group was found to be 2.6%, which is consistent with previous data. PTS without liposuction had a rate of seroma of 6.67% compared to a rate of 2.2% with liposuction; these rates were not significantly different (P = 0.20). A total of 207 patients had drain-based abdominoplasty with liposuction, and 113 had it without liposuction. Seroma with liposuction was 9.17% and without liposuction was 6.19%, although these differences were not significant (P = 0.52). PTS lipoabdominoplasty had less seroma compared with drain-based lipoabdominoplasty (P = 0.01). Conclusions Liposuction was performed in 80% of the patients, and patients with lipoabdominoplasty were not at a higher risk of seroma, in the drain group or the PTS group. More patients may allow validation that liposuction may actually be protective with PTS. Regardless, there is no increase in seroma with the addition of liposuction to PTS drainless abdominoplasty. Level of Evidence 3
- Published
- 2018
14. Split Latissimus Dorsi Muscle Flap Repair of Acquired, Nonmalignant, Intrathoracic Tracheoesophageal and Bronchoesophageal Fistulas
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Eti Gursel, Frank A. Baciewicz, and Ziyad S. Hammoudeh
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Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Fistula ,Muscle flap ,Risk Assessment ,Surgical Flaps ,Esophageal Fistula ,medicine ,Humans ,Latissimus dorsi muscle flap ,Esophagus ,business.industry ,Middle Aged ,Plastic Surgery Procedures ,medicine.disease ,Surgery ,body regions ,Treatment Outcome ,medicine.anatomical_structure ,Thoracotomy ,Superficial Back Muscles ,Blood supply ,Bronchial Fistula ,Patient Safety ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
The development of a fistula between the tracheobronchial tree and oesophagus due to nonmalignant causes is uncommon. Division of the fistula with muscle flap interposition eliminates contact between the tracheobronchial segment and the oesophagus, theoretically decreasing the chance of recurrence as well as providing a robust blood supply to aid in healing. The split latissimus dorsi muscle flap is a well-suited flap for such repairs because of the ability to simultaneously cover two separate apertures (tracheobronchial and oesophageal). The authors describe the split latissimus dorsi muscle flap with step-by-step technique for repair of intrathoracic aerodigestive fistulas.
- Published
- 2015
15. Maximizing aesthetic outcome in autologous breast reconstruction with implants and lipofilling
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Chrisovalantis Lakhiani, Angela Cheng, Yvonne Rasko, Michael R. Lee, Johnathon M. Aho, Ziyad S. Hammoudeh, and Michel Saint-Cyr
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medicine.medical_specialty ,business.industry ,Free flap breast reconstruction ,Level iv ,Autologous tissue ,medicine.disease ,Surgery ,Plastic surgery ,medicine ,Fat grafting ,Fat necrosis ,Implant ,Breast reconstruction ,business - Abstract
Free flap breast reconstruction is an option widely sought in postmastectomy breast reconstruction. However, the volume of autologous tissue from the patient is often not sufficient for symmetrical reconstruction. In these cases, flaps can be used in combination with implants or autologous fat injections to augment volume and achieve shape, symmetry, and contour. A retrospective chart review was performed on patients who underwent postmastectomy free flap reconstruction with secondary augmentation using autologous fat grafting or implant from 2008 to 2011. Twenty-four patients (39 breasts) received further augmentation of autologous tissue reconstruction during this period. Sixteen patients (26 breasts) had fat graft augmentation only, four patients (eight breasts) had implant augmentation only, and three patients (five breasts) had both procedures. Among patients who had fat grafting, operative intervention was required twice for fat necrosis. Contrastingly, of patients who received implants, one patient required operative intervention for implant malpositioning. These differences were not significant (P = 0.57). The group with both fat grafting and implant augmentation had significantly higher aesthetic scores regarding overall appearance, contour, and volume, but not projection, than the group with fat grafting only and the group with implant only. Autologous fat grafting offers several contouring aesthetic advantages, including selectively augmenting areas of hollowness to improve contour and maximize symmetry. However, implant augmentation generally allows for a larger increase in projection in a single procedure, with similar rates of postaugmentation complications. Use of both autologous fat grafting and implant augmentation may allow for superior aesthetic results. Level of Evidence: Level IV, therapeutic study.
- Published
- 2014
16. Cost-Effectiveness of Simvastatin Plus Ezetimibe for Cardiovascular Prevention in Patients With a History of Acute Coronary Syndrome: Analysis of Results of the IMPROVE-IT Trial
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A. Alahmari, Jeff J. Guo, Hilal Thaibah, Nawaf M. Alotaibi, and Ziyad S. Almalki
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Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Acute coronary syndrome ,Simvastatin ,Combination therapy ,Cost effectiveness ,Cost-Benefit Analysis ,Myocardial Infarction ,Saudi Arabia ,030204 cardiovascular system & hematology ,Brain Ischemia ,03 medical and health sciences ,0302 clinical medicine ,Cardiovascular prevention ,Ezetimibe ,Internal medicine ,Medicine ,Humans ,In patient ,030212 general & internal medicine ,Prospective Studies ,Acute Coronary Syndrome ,health care economics and organizations ,Dose-Response Relationship, Drug ,business.industry ,Anticholesteremic Agents ,Cost-effectiveness analysis ,Middle Aged ,medicine.disease ,Surgery ,Treatment Outcome ,Drug Therapy, Combination ,Female ,Quality-Adjusted Life Years ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug ,Follow-Up Studies ,Forecasting - Abstract
Background Simvastatin plus ezetimibe reduced the risk of cardiovascular events in the IMProved Reduction of Outcomes: Vytorin Efficacy International (IMPROVE-IT) study. The aim of this study is to investigate the cost-effectiveness of adding ezetimibe to simvastatin treatment for patients with ACS based on the recently completed IMPROVE-IT trial. Methods We constructed a Markov state-transition model to evaluate the costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness (ICER) associated with co-therapy compared with simvastatin alone from a health care perspective. We ran separate base-case analyses assuming a trial-length and longer term follow-up. One-way sensitivity analyses were used to explore uncertainty in model parameters. Results In the trial-length model, the ICERs compared with simvastatin alone were $114,400 per QALY for the combination therapy. In 5- and 10-year time horizons, the ICERs remained above the cost-effectiveness threshold of $50,000 per QALY. In the lifetime horizon model, The ICER was $45,046 per QALY for combination treatment compared with simvastatin alone. The combination therapy is cost-effective at an 80% decrease in the current branded simvastatin and ezetimibe cost. Probabilistic sensitivity analysis suggested simvastatin and ezetimibe co-therapy would be a cost-effective alternative to simvastatin monotherapy 60.7% of the time. Conclusions In our trial-length, 5-year, and 10-year models, the co-therapy was not a cost-effective alternative; however, as follow-up was extended to lifetime, the co-therapy became a cost-effective treatment compared with the simvastatin monotherapy in patients with histories of ACS.
- Published
- 2016
17. Endobronchial-Guided Vascularized Tissue Flaps for a Bronchopleural Fistula
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Basel Sharaf, Sarah M. Elswick, Eric S. Edell, David E. Midthun, Ali Saeed, Shanda H. Blackmon, and Ziyad S. Hammoudeh
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Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Fistula ,Bronchopleural fistula ,Surgical Flaps ,Endosonography ,03 medical and health sciences ,Bilobectomy ,0302 clinical medicine ,Positron Emission Tomography Computed Tomography ,Bronchoscopy ,medicine ,Initial treatment ,Humans ,030212 general & internal medicine ,Aged ,Squamous-cell carcinoma of the lung ,business.industry ,Pedicled Flap ,Pleural Diseases ,medicine.disease ,Empyema ,Surgery ,Treatment Outcome ,030228 respiratory system ,Bronchial Fistula ,Stage IIIa ,Cardiology and Cardiovascular Medicine ,business - Abstract
The management of bronchopleural fistulas can be challenging. The initial treatment is usually conservative, but operative intervention with transposition of vascularized pedicled flaps may be required in refractory cases. We present the case of a 67-year-old man with stage IIIa squamous cell carcinoma of the lung who underwent a lower and middle bilobectomy after receiving neoadjuvant chemoradiation. His postoperative course was complicated by empyema and a bronchopleural fistula. Because of difficulty accessing the fistula, endobronchial-guided vascularized tissue flaps were successfully used to close the fistula.
- Published
- 2016
18. Management of temporomandibular joint Coccidioidomycosis
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Ziyad S. Hammoudeh and Salvatore C. Lettieri
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Condyle ,03 medical and health sciences ,0302 clinical medicine ,Amphotericin B ,medicine ,Humans ,Coccidioides ,030223 otorhinolaryngology ,Abscess ,Infusions, Intravenous ,General Dentistry ,Fluconazole ,Debridement ,Coccidioidomycosis ,biology ,business.industry ,Mandible ,Osteomyelitis ,030108 mycology & parasitology ,Temporomandibular Joint Disorders ,medicine.disease ,biology.organism_classification ,Long-Term Care ,Temporomandibular joint ,Surgical access ,Surgery ,medicine.anatomical_structure ,Otorhinolaryngology ,Drug Therapy, Combination ,business ,Tomography, X-Ray Computed ,Bony destruction - Abstract
The aim of this report was to present the first known case of coccidioidomycosis involving the temporomandibular joint, review the literature regarding dissemination to the mandible, and to provide treatment recommendations for this challenging condition.Coccidioidomycosis of the mandibular condyle was identified in a 30-year-old Somali male residing in Arizona. Due to the difficulty of surgical access and the anticipated temporomandibular joint morbidity of radical condylar debridement, primary medical management was performed.Marked symptomatic improvement was observed after 10 days of IV antifungal therapy. Resolution of the abscess with residual bony destruction was observed on CT scan. Based on the results of this patient and review of the literature, an algorithm is presented to help guide management of coccidioidomycosis dissemination to the mandible.Prolonged antifungal therapy should be attempted for initial management of a Coccidioides abscess involving the condyle with early surgical intervention reserved for the more easily accessible and less functionally compromising portions of the mandible.
- Published
- 2016
19. The 'Independent' Plastic Surgery Match: Analysis of Changes in Recent Years and Applicant Preferences
- Author
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Michel Saint-Cyr, Gamal Mostafa, Samir Mardini, Ziyad S. Hammoudeh, and Karim Bakri
- Subjects
Adult ,Male ,Demographics ,Decision Making ,030230 surgery ,Subspecialty ,Education ,Interviews as Topic ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Medicine ,Humans ,Surgery, Plastic ,Location ,Personnel Selection ,Medical education ,Training quality ,Career Choice ,business.industry ,Incidence ,Internship and Residency ,Future career ,Research opportunities ,Preference ,United States ,Match analysis ,Cross-Sectional Studies ,Education, Medical, Graduate ,030220 oncology & carcinogenesis ,Surgery ,Female ,business ,Social psychology - Abstract
Background The number of surgical applicants to "independent" plastic surgery programs has drastically decreased. However, the competitiveness of recent applicants relative to previous years has not been assessed. The purpose of this study was to analyze the characteristics of recent "independent" applicants and to obtain their preferences regarding the match. Methods A 25-question survey was distributed to 97 applicants of the 2012 "independent" match. The survey consisted of questions regarding demographics, academic qualifications, interview results, match results, program characteristic preferences, interview preferences, and future career plans. Results A total of 62 applicants responded; 71% male, 82% US medical graduates, 94% general surgery residents, and 76% in university programs. Three-quarters had ≥2 publications and 29% in plastic surgery journals. Applicants most commonly attended 11 to 13 interviews, and 31% got their top choice. Mean rank list position matched was 2.7. Out of 10 program selection criteria, overall training quality and geographic location were most important to applicants. Difficulty of on-call responsibilities and research opportunities were least important. Applicants interested in university-based practice had a significantly higher interest in research (p = 0.003). Most prefer one-on-one interviews with 5 sessions being ideal. Two-thirds would prefer regional coordination of interviews. Half were undecided about fellowship, and most were undecided about subspecialty of greatest interest. University-affiliated (39%) and university-based (33%) were the most commonly envisioned future practices. Conclusion The profile of "independent" plastic surgery applicants has not changed much in recent years. When selecting a program, applicants are looking for the best overall operative training above all else with little regard for difficulty of on-call responsibilities or ability to do research. Applicants are still very moldable in their preference of future career plans with the majority possessing an early interest in academic-related practices.
- Published
- 2016
20. Ear Lobule Rejuvenation in Face-Lifting: The Role of Fat Augmentation
- Author
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Rod J. Rohrich, Jacob G. Unger, Kevin Small, Ziyad S. Hammoudeh, and Ran Y. Stark
- Subjects
medicine.medical_specialty ,Ear lobule ,business.industry ,medicine.medical_treatment ,Cartilage ,Face lifting ,Anatomy ,030230 surgery ,Autologous Fat Transfer ,Surgery ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Ptosis ,Facial aging ,medicine ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,Original Article ,medicine.symptom ,business ,Rejuvenation ,Rhytidectomy - Abstract
Supplemental Digital Content is available in the text., Background: Ear lobule ptosis and deflation are characteristics of facial aging. A rhytidectomy without rejuvenation of a deflated ear lobule may fail to address all aspects of facial aging. Fillers have been used to treat ear lobule deflation; however, autologous fat transfer has never been utilized for ear lobule rejuvenation. This investigation studies the success of autologous fat transfer to the ear lobule as part of volume augmentation rhytidectomy. Methods: A retrospective review of patients who underwent rhytidectomy between 2000 and 2014 by a single surgeon was performed. Patients between 2000 and 2004 who did not receive autologous fat transfer served as controls (group A). Patients between 2010 and 2014 who received autologous fat transfer to the ear lobule formed the treatment group (group B). Three independent observers reviewed preoperative and postoperative photographs for both groups at 1 year postoperatively. The following ear lobule volume grading scale was applied to numerically assess the patients: concave = 0, flat = 1, convex = 2, and round = 3. Results: Groups A and B each consisted of 65 consecutive patients (130 ears). In group A, the mean preoperative ear lobule grading score was 1.20, and the mean postoperative score was 1.22 (mean difference, 0.02; P = 0.42). In group B, the mean preoperative ear lobule grading score was 0.98, and the mean postoperative score was 2.00 (mean difference, 1.02; P < 0.0001). Conclusion: In patients receiving autologous fat transfer to the ear lobule during rhytidectomy, there was a significant change from a deflated ear lobule preoperatively to a more voluminous lobule at 1 year postoperatively.
- Published
- 2016
21. Use of leukocyte and platelet-rich fibrin (L-PRF) in periodontally accelerated osteogenic orthodontics (PAOO): clinical effects on edema and pain
- Author
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Francisco T Muñoz, Daniela Espinoza, Alain Vervelle, Jacques Beugnet, Constanza Jiménez, and Ziyad S. Haidar
- Subjects
medicine.medical_specialty ,Dentistry ,Inflammation ,Odontología ,Fibrin ,03 medical and health sciences ,0302 clinical medicine ,Edema ,Biomaterials and Bioengineering in Dentistry ,medicine ,General Dentistry ,Dental alveolus ,Orthodontics ,biology ,business.industry ,Research ,030206 dentistry ,CIENCIAS MÉDICAS [UNESCO] ,Complete resolution ,Ciencias de la salud ,Platelet-rich fibrin ,Surgery ,030220 oncology & carcinogenesis ,UNESCO::CIENCIAS MÉDICAS ,biology.protein ,medicine.symptom ,business ,Wound healing ,Corticotomy - Abstract
Background Demand for shorter treatment time is common in orthodontic patients. Periodontally Accelerated Osteogenic Orthodontics (PAOO) is a somewhat new surgical procedure which allows faster tooth movement via combining orthodontic forces with corticotomy and grafting of alveolar bone plates. Leukocyte and Platelet-Rich Fibrin (L-PRF) possess hard- and soft-tissue healing properties. Further, evidence of pain-inhibitory and anti-inflammatory potential is growing. Therefore, this study explores the feasibility, intra- and post-operative effects of using L-PRF in PAOO in terms of post-operative pain, inflammation, infection and post-orthodontic stability. Material and methods A pilot prospective observational study involving a cohort of 11 patients was carried out. A Wilcko's modified PAOO technique with L-PRF (incorporated into the graft and as covering membrane) was performed with informed consent. Post-surgical pain, inflammation and infection were recorded for 10 days post-operatively, while the overall orthodontic treatment and post-treatment stability were followed up to 2 years. Results Accelerated wound healing with no signs of infection or adverse reactions was evident. Post-surgical pain was either "mild" (45.5%) or "moderate" (54.5%). Immediate post-surgical inflammation was either "mild" (89.9%) or "moderate" (9.1%). Resolution began on day 4 where most patients experienced either "mild" or no inflammation (72.7% and 9.1%, respectively). Complete resolution was achieved in all patients by day 8. The average orthodontic treatment time was 9.3 months. All cases were deemed stable for 2 years. Conclusions L-PRF is simple and safe to use in PAOO. Combination with traditional bone grafts potentially accelerates wound healing and reduces post-surgical pain, inflammation, infection without interfering with tooth movement and/or post-orthodontic stability, over a 2 years period; thus alleviating the need for analgesics and anti-inflammatory medications. Key words Periodontally accelerated osteogenic orthodontics, leukocyte and platelet-rich fibrin, corticotomy, osteogenesis, grafts.
- Published
- 2016
22. Autonomous Robotics: A fresh Era of Implant Dentistry… is a reality!
- Author
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Ziyad S. Haidar
- Subjects
medicine.medical_specialty ,business.industry ,Implant dentistry ,Robotics ,030206 dentistry ,030218 nuclear medicine & medical imaging ,Surgery ,lcsh:RK1-715 ,03 medical and health sciences ,0302 clinical medicine ,lcsh:Dentistry ,Medicine ,Medical physics ,Artificial intelligence ,business ,General Dentistry - Published
- 2017
23. Collagenase Clostridium histolyticum Injection for Plantar Fibromatosis (Ledderhose Disease)
- Author
-
Ziyad S. Hammoudeh
- Subjects
Male ,Biological Products ,medicine.medical_specialty ,business.industry ,Collagenase Clostridium histolyticum Injection ,Fibroma ,Disease ,medicine.disease ,Dermatology ,Injections ,Dupuytren Contracture ,Foot Diseases ,Microbial Collagenase ,Humans ,Medicine ,Surgery ,business ,Aged ,Plantar fibromatosis - Published
- 2014
24. Seromuscular Colonic Flap for Intrapelvic Soft-Tissue Coverage: A Reconstructive Option for Plastic Surgeons When Traditionally Used Flaps Are Not Available
- Author
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Sebastian Winocour, Ziyad S. Hammoudeh, Johnathon M. Aho, Heidi Nelson, Peter S. Rose, and Nho V. Tran
- Subjects
Alternative methods ,medicine.medical_specialty ,Skin incision ,business.industry ,lcsh:Surgery ,Muscle flap ,Soft tissue ,Case Report ,lcsh:RD1-811 ,Surgery ,medicine.anatomical_structure ,Medicine ,Pharmacology (medical) ,In patient ,business ,Mesentery ,Pelvis ,Recurrent Rectal Cancer - Abstract
Background. Reconstruction of intrapelvic defects can be a challenging problem in patients with limited regional muscle flap options and previously resected omentum. In such situations, alternative methods of mobilizing vascularized tissue may be required.Methods. A case of a patient that underwent pelvic extirpation for recurrent rectal cancer who had limited donor sites for flap reconstruction is presented. The mucosa was removed from a blind loop of colon, and a pedicled seromuscular flap based on the colonic mesentery was placed into the pelvis for vascularized soft-tissue coverage and elimination of dead space.Results. The postoperative course was only complicated by a small subcutaneous fluid collection beneath the sacrectomy skin incision, which was drained with radiological assistance. The patient recovered without any major postoperative complications.Conclusion. Seromuscular colonic flap is a useful option for soft-tissue coverage after pelvic extirpation and should be considered by plastic surgeons when other reconstruction options are not available.
- Published
- 2015
25. Abstract
- Author
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Ziyad S. Hammoudeh, Arya A. Akhavan, John A. Occhino, Nho V. Tran, Jeremie D. Oliver, and Erik D. Hokenstad
- Subjects
medicine.medical_specialty ,business.industry ,medicine ,Surgery ,business - Published
- 2017
26. The diagnostic and surgical challenges of massive localized lymphedema
- Author
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Anna M. Ledgerwood, Rebecca C. Bachusz, Ziyad S. Hammoudeh, Charles E. Lucas, and Furrukh Jabbar
- Subjects
Adult ,medicine.medical_specialty ,Liposarcoma ,Thigh ,Severity of Illness Index ,Edema ,Abdomen ,medicine ,Humans ,Angiosarcoma ,Lymphedema ,neoplasms ,Leg ,business.industry ,Lymph Leakage ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Obesity, Morbid ,Lymphatic system ,medicine.anatomical_structure ,Surgical Procedures, Operative ,Female ,medicine.symptom ,business ,Follow-Up Studies - Abstract
BACKGROUND: Massive localized lymphedema (MLL) is a rare entity first described in 1998 in patients with morbid obesity; the incidence is rising with the increased prevalence of morbid obesity. This report defines the clinical presentation and surgical challenges in 6 patients with MLL. METHODS: The MLL in 6 patients with morbid obesity (weight range 270 to 585 lbs) involved the thigh in 3 patients, the calf in 1 patient, and the abdomen in 2 patients. The time from onset to presentation averaged 3 years (range 1 to 8 years). Two thigh lesions precluded ambulation because both legs could not be on the ground simultaneously; the 2 abdominal lesions were too heavy to permit ambulation. RESULTS: The surgical excision required the use of pulleys to elevate the MLL tissues, which, on excision, weighed between 24 and 78 lbs. A long oval horizontal incision and a long transverse incision were used for the 2 abdominal lesions. Long horizontal oval limb incisions with multiple perpendicular cross incisions had to be used to excise MLL in the 4 limb lesions. In 2 cases, the vessel-sealing device was employed successfully for dissecting subcutaneous edematous tissue. Loose wound closure permitted postoperative lymph leakage, which continued for 3 to 8 weeks. The histology demonstrated fibrotic lymphatic tissue with vascular and lymphatic proliferation and edema; all patients did well. CONCLUSIONS: MLL is rare and is best treated by surgical excision facilitated by pulleys and imaginative incisions to obtain primary closure. Long-term follow-up is necessary to assess for subsequent liposarcoma or angiosarcoma.
- Published
- 2014
27. Abstract 69
- Author
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Amelia C. Van Handel, Akhavan A. Arya, Steven L. Moran, Ziyad S. Hammoudeh, Brian T. Carlsen, and Francis C. Nichols
- Subjects
medicine.medical_specialty ,business.industry ,Medicine ,Surgery ,business - Published
- 2015
28. Rectovaginal Fistula Repair using a Gracilis Muscle Flap
- Author
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John A. Occhino, Nho V. Tran, Erik D. Hokenstad, Heidi K. Chua, and Ziyad S. Hammoudeh
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,Fistula ,Rectovaginal Fistula ,Obstetrics and Gynecology ,Middle Aged ,medicine.disease ,Surgical Flaps ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Gracilis muscle flap ,Rectovaginal fistula ,Gracilis Muscle ,030220 oncology & carcinogenesis ,medicine ,Humans ,Female ,030211 gastroenterology & hepatology ,business - Abstract
This video demonstrates a technique for using a pedicled gracilis muscle flap to repair rectovaginal fistula.We present the case of a 48-year-old woman diagnosed with rectal cancer 2 years earlier. She underwent neoadjuvant chemoradiation followed by ultralow anterior resection. Six weeks after surgery, a fistula was identified at the anastomotic site. Preoperative planning with urogynecology, plastic surgery, and colon and rectal surgery teams deemed a pedicled gracilis muscle flap to be the best approach for this patient due to the rich blood supply and the patient's prior history of pelvic irradiation. The gracilis muscle is suitable due to the proximity of its vascular pedicle to the perineum, length, and minimal functional donor-site morbidity. We discuss techniques used to interpose a gracilis muscle flap between the rectum and vagina to repair a rectovaginal fistula.Using the gracilis muscle is a viable option for repairing rectovaginal fistulas, especially in the setting of prior pelvic radiation. A multispecialty approach may be beneficial in complex cases to determine the optimal approach for repair.
- Published
- 2015
29. The independent plastic surgery match: a survey of applicants analyzing recent changes and preferences for the future
- Author
-
Samir Mardini, Ziyad S. Hammoudeh, Gamal Mostafa, and Michel Saint-Cyr
- Subjects
medicine.medical_specialty ,Plastic surgery ,business.industry ,medicine ,Surgery ,Medical physics ,business - Published
- 2013
30. An Objective Scoring System and Simple Mathematical Algorithm for the Plastic Surgery Applicant to Rank Residency Programs Based on Personalized Preferences
- Author
-
Ziyad S. Hammoudeh
- Subjects
medicine.medical_specialty ,Scoring system ,Career Choice ,business.industry ,Rank (computer programming) ,Internship and Residency ,Machine learning ,computer.software_genre ,Surgery.plastic ,Surgery ,Plastic surgery ,Simple (abstract algebra) ,Job Application ,medicine ,Artificial intelligence ,Surgery, Plastic ,business ,computer ,Algorithms ,Mathematics ,Career choice - Published
- 2013
31. Mandibular Gunshot Wound With Bullet Aspiration
- Author
-
Ziyad S. Hammoudeh
- Subjects
Adult ,Male ,medicine.medical_specialty ,Poison control ,Bronchoscopy ,medicine ,Humans ,Craniofacial ,medicine.diagnostic_test ,business.industry ,Major trauma ,Respiratory Aspiration ,Mandible ,General Medicine ,Foreign Bodies ,medicine.disease ,Mandibular Injuries ,humanities ,Surgery ,Otorhinolaryngology ,Wounds, Gunshot ,Gunshot wound ,Tomography, X-Ray Computed ,business ,Airway - Abstract
Urban violence continues to be an important source of penetrating craniofacial injuries in major trauma centers. Gunshot wounds to the mandible are a commonly treated condition by craniofacial surgeons. Some gunshot wounds are through-and-through injuries, but in many patients, the bullet enters with no visible exit wound. In such situations, the bullet's trajectory and final destination are certainly important to the craniofacial surgeon in the extent of bony damage but may also be of unforeseen consequence to the patient's airway and respiratory condition. We present a case of a patient who had a gunshot wound to the face with comminuted mandibular ramus fracture in which the bullet was unexpectedly found to be aspirated down the right mainstem bronchus. This is the first reported case of a completely intact bullet being aspirated after gunshot wound to the face in an adult patient. We present this case to illustrate a rare possible complication after penetrating mandibular injury and offer a strategy for management of such an occurrence.
- Published
- 2012
32. Desmoid Tumor (Fibromatosis) of the Breast after Augmentation with Saline Implants
- Author
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Ziyad S. Hammoudeh and Vigen B. Darian
- Subjects
Adult ,medicine.medical_specialty ,business.industry ,Breast Implants ,Mammaplasty ,medicine.medical_treatment ,Fibromatosis ,Breast Neoplasms ,Sodium Chloride ,medicine.disease ,Surgery ,Fibromatosis, Aggressive ,Text mining ,medicine ,Humans ,Female ,business ,Saline - Published
- 2012
33. 4: DEVELOPING A DOSE-RESPONSE CURVE OF EXOGENOUS OP-1 TO ACCELERATE BONE FORMATION DURING DISTRACTION OSTEOGENESIS
- Author
-
Ali Izadpanah, Reggie C. Hamdy, Lucie Lessard, Ziyad S. Haidar, and L Alsalmi
- Subjects
Dose–response relationship ,business.industry ,Anesthesia ,medicine.medical_treatment ,Medicine ,Distraction osteogenesis ,Surgery ,Bone formation ,business - Published
- 2010
34. 199A: WNT SIGNALING IS ENHANCED DURING NEW BONE REGENERATION IN A MOUSE MODEL OF DISTRACTION OSTEOGENESIS
- Author
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L Alsalmi, Ali Izadpanah, M Tabrizian, Lucie Lessard, Ziyad S. Haidar, and Reggie C. Hamdy
- Subjects
business.industry ,medicine.medical_treatment ,Wnt signaling pathway ,Medicine ,Distraction osteogenesis ,Surgery ,Bone regeneration ,business ,Cell biology - Published
- 2010
35. Evidence-Based Clinical Efficacy of Leukocyte and Platelet-Rich Fibrin in Maxillary Sinus Floor Lift, Graft and Surgical Augmentation Procedures
- Author
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Mohamadamin Damsaz, Consuelo Zumarán Castagnoli, Majid Eshghpour, Daryouosh Hamidi Alamdari, Aida Hamidi Alamdari, Ziad Eva Fouad Noujeim, and Ziyad Samir Haidar
- Subjects
maxillary sinus lift ,augmentation ,schneiderian membrane ,platelet concentrates ,bone grafting ,Surgery ,RD1-811 - Abstract
Bone augmentation techniques have increasingly been indicated for re-creating adequate bone height and volume suitable for dental implant sites. This is particularly applicable in the severely atrophic posterior maxilla where sinus perforation (ruptured Schneiderian membrane) is a very common complication and sinus floor elevation or lift is frequently considered a standard procedure. The augmentation of the maxillary sinus can be performed with or without grafting biomaterials. Herein, numerous biomaterials and bone substitutes have been proposed, primarily to sustain the lifted space. In addition, cytokines and growth factors have been used to stimulate angiogenesis, enhance bone formation as well as improve healing and recovery period, either as the sole filling material or in combination with bone substitute materials. Within such, is the family of autologous blood extracts, so-called platelet concentrates, which are simply the “product” resulting from the simple centrifugation of collected whole blood samples of the patient, immediately pre-surgery. Platelet-Rich Fibrin (PRF), a sub-family of platelet concentrates, is a three-dimensional (3-D) autogenous biomaterial obtained, without including anti-coagulants, bovine thrombin, additives, or any gelifying agents during the centrifugation process. Today, it is safe to say that, in implant dentistry and oral and maxillofacial surgery, PRFs (particularly, the pure platelet-rich fibrin or P-PRF and leukocyte and platelet-rich fibrin or L-PRF sub-classes) are receiving the most attention, essentially due to their simplicity, rapidness, user-friendliness/malleability, and cost-effectiveness. Whether used as the sole “bioactive” filling/additive material or combined with bone substitutes, the revolutionary second-generation PRFs have been very often associated with promising clinical results. Hence, this review aims to provide a 10-years update on the clinical effectiveness of L-PRF when applied/used as the “sole” biomaterial in maxillary sinus augmentation procedures. An electronic search using specific keywords for L-PRF and maxillary sinus augmentation was conducted in three main databases (PubMed-MEDLINE database, Google Scholar and Cochrane library) for the period between January 2009–February 2020. The quest yielded a total of 468 articles. Based on the pre-established strict inclusion/exclusion criteria, only seven articles were deemed eligible and included in the analysis. Surprisingly, of the 5 studies which used de-proteinized bovine bone mineral (DBBM) in combination with L-PRF, 60% acclaimed no significant effects and only 40% declared positive effects. Of the two articles which had used allogenous bone graft, 50% declared no significant effects and 50% acclaimed positive effects. Only one study had used L-PRF as the sole grafting material and reported a positive effect. Likewise, positive effects were reported in one other study using L-PRF in combination with a collagen membrane. Due to the heterogeneity of the included studies, this review is limited by the inability to perform a proper systematic meta-analysis. Overall, most of the published studies reported impressive results of L-PRF application as a grafting material (sole or adjuvant) in maxillary sinus augmentation and dental implant restorative procedures. Yet, distinct technical processing for L-PRF preparation was noted. Hence, studies should be approached with caution. Here in, in sinus lift and treatment of Schneider membrane, the formation of mature bone remains inconclusive. More studies are eagerly awaited in order to prove the beneficial or detrimental effects of PRFs, in general and L-PRFs, in specific; especially in their tissue regenerative potential pertaining to the promotion of angiogenesis, enhancing of cell proliferation, stimulation of cell migration and autocrine/paracrine secretion of growth factors, as well as to reach a consensus or a conclusive and distinct determination of the effect of leukocytes (and their inclusion) on inflammation or edema and pain; a call for standardization in PRFs and L-PRFs composition reporting and regimenting the preparation protocols.
- Published
- 2020
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