Paravertebral Blocks for Mastectomy and Breast Reconstruction
Post-mastectomy pain syndrome could occur in approximately 20% of women receiving mastectomy and can last for many years. As there is no effective therapy to treat this syndrome, prevention is key. In a randomized trial, we sought to evaluate whether paravertebral injections of topical anesthetic (ropivacaine) could decrease of both long term and short term post-surgical pain.
Acellular Dermal Matrix Study
To date, little is known regarding the effectiveness of total-Acellular Dermal Matrix (ADM) covered devices using a two stage reconstructive approach in front (subcutaneous plane) and not under the pectoralis muscle (subpectoral plane). Our anecdotal experience suggests that pre-pectoral reconstruction result in less pain. We are conducting the study to evaluate postoperative level of pain between patients undergoing complete human ADM coverage in two-stage pre-pectoral tissue expander breast reconstruction and those undergoing partial sub-pectoral/inferolateral human ADM sling breast reconstruction.
Finger Replantation and Amputation-Challenges in Assessing Impairment, Satisfaction, and Effectiveness (FRANCHISE) Study
The purpose of this study is to compare the outcomes of treatment for thumb or finger amputation patients. The study will include those who have had either a revision amputation surgery (re-operating the patient to improve function and aesthetics) or replantation (re-attachment) surgery. It will assess whether current standardized methods of measuring levels of impairment accurately reflect levels of impairment in patients treated with revision amputation. The findings will help us better understand factors affecting the decision-making process between choosing revision amputation versus replantation. This is a Plastic Surgery Foundation-funded, multi-center study headed by Kevin Chung, M.D., based out of the University of Michigan.
Craniosynstosis Network Study
Craniosynostosis, the premature closure of sutures, is a common and diverse malformation caused by genetic and environmental factors. To better understand the cause of this condition, we are studying the phenotype, genome, and transcriptome of patients compared to controls. Of those patients who are eligible and provide informed consent, we will perform analysis of the clinical features and the medical and surgical course of cases by reviewing medical records and craniofacial CT scan images and using questionnaires, as well as obtaining tissue samples.
Acellular Adipose Tissue Study (closed to enrollment)
Surgeons us adipose tissue (body fat) is used by surgeons for a variety of applications, including soft tissue reconstruction and wound healing. However, harvesting adipose tissue from patients presents challenges such as donor-site morbidity, outcome variability, and difficulty in obtaining adequate volumes to correct large defects. To address this clinical challenge, Jennifer Elisseeff, M.D., and her research team, in coordination with the Department of Plastic and Reconstructive Surgery, have aimed to create an "off-the-shelf" adipose material in an injectable form preferred by patients and physicians. Presently, a Phase I clinical trial funded by the Department of Defense is underway to assess the safety of acellular adipose tissue (AAT) in healthy human volunteers. We hope our novel soft tissue reconstruction agent will have numerous applications in years to come.
Thumb Carpometacarpal Joint Denervation Versus Trapeziectomy
Arthritis of the basal (carpometacarpal or CMC) joint of the thumb is the second most common location where adults get hand arthritis and affects thousands of Americans each year. Traditional surgeries remove bone on one side of the joint with or without inserting an implant or piece of tendon to rebuild the joint. Surgeons in our department have been using a different technique that involves disconnecting the nerve branches that transmit the pain signal from the joint. Initial outcomes have shown similar relief of pain to traditional surgeries with shorter surgical times and more rapid recovery after surgery. We are now doing a study that will track the outcomes of patients undergoing this operation along with outcomes of patients undergoing traditional thumb arthritis surgery.