Copy of Copy of March 2025 Edition
- thestitchprs
- Mar 9
- 3 min read
Welcome to the March edition of The Stitch! We appreciate your continued support and readership. Don't miss our Breast Cancer Education Quiz!!
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Best,
The Stitch Editorial Board
Upper Extremity Anatomy Quiz
Which tendons pass deep to the flexor retinaculum through the carpal tunnel?
The flexor digitorum superficialis (FDS) is the primary flexor of the [1] joint, and the flexor digitorum profundus (FDP) is the primary flexor of the [2] joint.
Injury to which trunk of the brachial plexus will result in an upper extremity hanging limply by the side in medial rotation with the forearm pronated?
Which nerve is most likely to be injured in a midshaft humerus fracture?
What is one of the most common congenital limb disorders where the fingers are fused or webbed?
Updated Treatment Algorithms for Hypertrophic Scars and Keloids
Article Review by Chandler Hinson
The Most Current Algorithms for the Treatment and Prevention of Hypertrophic Scars and Keloids: A 2020 Update of the Algorithms Published 10 Years Ago
Published in Plastic and Reconstructive Surgery, 2022
ARTICLE SUMMARY:
A decade after the publication of his original review, Dr. Rei Ogawa revisits and refines treatment algorithms for hypertrophic scars and keloids in light of new research. The article consolidates findings from numerous randomized controlled trials, emphasizing advancements in prevention, diagnosis, and management strategies.
Methods included a review of high-quality studies, with a focus on clinical trials, systematic reviews, and meta-analyses. The author categorizes risk factors for hypertrophic scars and keloids into local (wound tension), systemic (hypertension, pregnancy), genetic, and lifestyle factors.
Results highlight the evolving treatment strategies: hypertrophic scars are managed based on contracture severity, favoring surgical release for severe cases and multimodal conservative therapy for mild ones. Keloid treatment hinges on size and number, with surgical excision plus adjuvant therapy recommended for small, single keloids, and volume-reducing surgery for larger, multiple lesions. The updated treatment paradigm emphasizes long-term patient follow-up and multimodal conservative therapies, including silicone sheets, steroid injections, radiation, and novel interventions such as botulinum toxin injections and laser therapy.
AUTHOR’S TAKEAWAY:
This update underscores the shift toward evidence-based, individualized treatment approaches. With ongoing research, future therapeutic refinements will likely further improve outcomes. For plastic surgeons, this article serves as a critical roadmap to optimizing hypertrophic scar and keloid management in clinical practice.
Evaluating the Strength of 3D-printed Septorhinoplasty Implants
Article Review by Matthew Henn, University of Oregon
Evaluating the Mechanical Strength of 3-Dimensionally Printed Implants in Septorhinoplasty through Finite Element Analysis
Published in Plastic and Reconstructive Surgery, 2025
3D-printing technology as a promising alternative to autologous cartilage after multiple revision rhinoplasties.
Autologous cartilage grafts are commonly used in rhinoplasty to correct nasal asymmetry, but patients with prior surgeries may have limited graft availability. One new study used finite element analysis (FEA) to compare the mechanical strength of 3D-printed implants to native cartilage, simulating daily mechanical stress at the “keystone” region.
Interestingly, 3D-printed models resulted in lower deformations compared to cartilage, with the highest stress applied well below the model maximum, indicating that daily stress is unlikely to cause permanent damage. Additionally, silk fibroin-gelatin implants showed dependable balance and strength. This research is a large stride forward for patients with minimal autologous graft left from prior surgeries, ensuring a path to treatment for those with a needed or desired correction.
The next steps for this study are to determine safety amongst native tissue integration and other associated risks, with application of the technology to human patients soon to follow. We won’t know the long-term human outcomes for some time, but it is exciting for the world of facial plastics when advances like this come out. As medical students, this is one example of a potential treatment we might use in the future, and being knowledgeable about new technological advances is an important tool for our arsenal.
Breast Cancer Education Quiz Answers
ANSWERS:
The digital flexor tendons
1- PIP, 2-DIP
Upper Trunk (C5-C7), this is Erb’s palsy or “waiter’s tip”
Radial nerve
Syndactyly
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