No abstract

Craniosynostosis, or the premature closure of the sutures of the skull, has historically been repaired in an open manner and included extensive cranial reconstruction. In recent years, technological advancements have given surgeons the ability to perform repairs with minimal surgical invasion. With the advent of endoscopy and bioresorbable plates, recent reports [J Craniofac Surg 2002;13(4):578-82] have emphasized attempts at decreased morbidity. Recently, researchers have been able to compare the results of traditional open and minimally invasive techniques in 45 craniosynostosis cases, demonstrating decreased operating room time, blood loss, transfusions, complications, and hospital stay in minimally invasive patients [Clin Plast Surg 2004;31(3):429-42]. Many of the parameters comparing the 2 types of procedures are easily quantified and comparable, but a variety of other considerations, such as the parent's reaction to the stress of surgery, arise. The purpose of this study was to compare the effects of these surgical procedures on the parent's level of stress at the time of operation. To accomplish this, we measured stress postoperatively using the Parenting Stress Index-Short Form. Subjects undergoing surgical treatment of craniosynostosis were placed into 2 groups: open versus minimally invasive. To test for confounding factors, subjects were subcategorized for sex, parent's sex, ethnicity, and parent's marital status. Analysis of our data reveals a statistically significant decrease in total stress in the households of minimally invasive patients.

The ideal soft-tissue filler for wrinkles and skin defects should be safe, biocompatible, resistant to phagocytosis, persist and maintain its volume without being resorbed or degraded. ArteFill, an improved, next-generation derivative of Artecoll, is expected to become the first and only FDA-approved permanent filler for use in the USA in 2006 and will be available worldwide. ArteFill consists of polymethylmethacrylate microspheres suspended in a 3.5% solution of bovine collagen containing 0.3% lidocaine. In this article, the pathophysiology, efficacy and safety of ArteFill are discussed and details of its injection technique are provided. Insight into the pharmacoeconomic value of ArteFill over nonpermanent fillers and ArteFill's unique role in the growing world market of dermal fillers is provided.

This study reports the largest experience to date with the clinical use of the Fraxel SR laser and is the first report of patient satisfaction after fractional photothermolysis. Patients reported high satisfaction rates for improvements in texture, dyschromia, and scarring.

Gram-positive organisms are emerging as possibly the most important nosocomial pathogens during the past decade. Methicillin-resistant Staphylococcus aureus (MRSA) is a frequent cause of infection in the postoperative patient. Burn victims are at high risk for developing vancomycin-resistant Enterococcus (VRE) and other multidrug-resistant microbial infections as a result of the immunocompromising effects of burn injury, prolonged intensive care unit stays, and broad-spectrum antibiotic therapy. To prevent serious and dreaded complications such as skin graft breakdown, delayed wound healing, loss of a limb, and even death, these infections require a combination of extensive antibiotic therapy and plastic surgical intervention. The objectives of this study were to report clinical experience with linezolid in addition to wound care, debridement, and wound coverage techniques for the treatment of S. aureus (including MRSA) and VRE infections. Forty patients received linezolid for infections of wound coverage such as an infected graft or flap, or received linezolid in conjunction with wound coverage techniques for a S. aureus or VRE infection. The median patient age was 53 years (range, 14-85 years), 55% were female, 28% of patients received intravenous (i.v.) linezolid only, 45% received i.v. with a switch to the oral formulation, and 28% received the oral formulation only. The clinical success rate of linezolid with adjuvant wound coverage techniques was 90.0% for osteomyelitis and was 100% for skin and soft-tissue infections. For infections of wound coverage, the clinical success rate was 83.3%. In conclusion, linezolid was an effective antibiotic for the treatment of S. aureus (including MRSA) and VRE infections in conjunction with wound coverage techniques. In addition, linezolid offers the option of treating these infections with an oral agent that is 100% bioavailable.