Halloween Special Edition: Firework Injuries, Pumpkin Carving, & Replants.
Also: New podcast episode, the Sunday quiz, & calculating burn depth.
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Plastic Surgery
A curated suite of educational tools designed specifically for the evidence-based Plastic Surgeon.
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Osteomyelitis - Clinical Scenario
A patient with a prior tibial fracture plating presents with suspected post-traumatic osteomyelitis. Management includes imaging, bone biopsy, and the orthoplastic approach — early debridement, soft tissue coverage, and antibiotics.
28 Days in Gaza, Journal Partnership & Technique Tips.
Also: Reverse anterolateral thigh flap illustration, bilobed flap design technique, & evidence on the scalp rotation flap.
Apert's Hand - Clinical Scenario
Apert syndrome presents with craniosynostosis, midface hypoplasia, and complex syndactyly affecting the upper limbs. The Upton classification helps guide surgery for hand anomalies, with staged interventions to improve function and appearance.
Wound Dressings - Clinical Scenario
A 97-year-old diabetic woman with a 3-month-old foot wound. History includes wound duration, diabetes control, and treatments. Exam focuses on wound depth, vascular status, and sensation. Chemical debridement, NPWT, and silver-impregnated foam dressing promote healing and infection control.
CRPS - Clinical Scenario
A 51-year-old woman has persistent pain and sweating asymmetry one year after ORIF for a distal radius fracture, suggesting CRPS. The Budapest criteria support the diagnosis. Treatment includes physical therapy, medications, and interventions like sympathetic blocks.
Plastic Surgery in Gaza, Burns, & New Podcast Episode
Also: Sunday quiz winner, inhalation injury illustration, & chemical burns feature.
De Quervians: Presentation, Diagnosis, & Treatment
De Quervain's disease (stenosing tenosynovitis) involves thickening of the APL and EPB tendon sheaths in the first dorsal wrist compartment, causing pain with thumb movements. Diagnosis is clinical, with provocative tests. Treatment begins conservatively, with surgery as a last resort.
Soft Tissue Sarcoma - Clinical Scenario
A patient with a growing sternal mass, initially thought to be a lipoma, is diagnosed with undifferentiated pleomorphic sarcoma. Management includes staging, wide local excision, and possible radiotherapy. Reconstruction options involve pectoralis major or free ALT flap for the sternal defect.
Infantile Haemangioma - Clinical Scenario
An infant presents with a large erythematous lesion on the face. Diagnosis of infantile hemangioma is confirmed with GLUT-1 positive immunohistochemistry. First-line treatment is propranolol (2mg/kg/day). Surgery may be indicated for visual obstruction, airway issues, or ulceration.
Trigger Finger - Clinical Scenario
A patient presents with trigger finger in the right middle finger. Initial treatment includes activity modification, splinting, NSAIDs, and a corticosteroid injection. Due to persistent symptoms, A1 pulley release surgery is planned, ensuring the A2 pulley is preserved to prevent bowstringing.
Mallet Finger - Clinical Scenario
A patient with a mallet finger injury is unable to extend his fingertip. X-rays show a small bony avulsion fragment. This is a closed, bony mallet injury classified as Doyle Type I. Management includes continuous splinting of the DIP joint in extension for 6–8 weeks.
De Quervians - Clinical Scenario
A postpartum woman presents with radial wrist pain. Diagnosis of De Quervain's is confirmed with a positive Finkelstein test. Initial treatment includes rest, splinting, NSAIDs, and corticosteroid injections. Surgery is considered if symptoms persist after conservative management.
You Now Operate 10% Less Than 4 Years Ago, Z-Plasty Technique, & Student Textbook Updates
Also: The Sunday quiz, evidence on LA use, & tissue expansion article.
Lymphoedema - Clinical Scenario
A patient with a history of mastectomy and axillary lymph node dissection presents with progressive swelling in her left arm. Lymphoedema is suspected, classified as Stage II. Treatment includes complete decongestive therapy, and surgical options like Vascularized Lymph Node Transfer (VLNT).
Lymphoedema: Anatomy, Diagnosis, & Management
Lymphedema is a chronic condition caused by impaired lymphatic drainage, leading to swelling, typically in the limbs. It can be primary (congenital) or secondary (from surgery, radiation, or infection). Treatment focuses on complete decongestive therapy, with surgery reserved for severe cases.
The 20% Dilemma: Why Med Students Are Leaving Plastic Surgery (+ Hand Tumour Updates, Illustrations & More)
Also: The Sunday quiz, operating on Enchondromas, & glomus tumours - clinical scenario.
3 New Plastic Surgery Trends, Burn Resuscitation & New Podcast Episode
Also: Macrodactyly, Sunday Quiz and 3 recommended reads.
Meet Threads: The Invite-Only Community for Plastic Surgery Trainees.
Also: The Sunday quiz, cervical lymph nodes of the neck illustration, & mandibular defects feature.
Special 100th Edition: The Best of ThePlasticsPaper (& What You Might Have Missed)
In this week's edition 1. ✍️ Letter from P'Fella How We Hit 100: The Journey of ThePlasticsPaper
4 Tips for the FRCS Plastic Surgery Part 2 (Oral/Viva) Exam
This guide provides four key tips, along with practical examples, to help you approach the FRCS Plastic Surgery Oral Exam with confidence and clarity.
4 Tips for the FRCS Vivas, New Oral Exams, & All Things Paediatric Plastic Surgery.
Also: Anatomy illustration of the week, macrodactyly feature, & 3 recommended articles.
Soft Tissue Sarcoma: Classification, Diagnosis, & Management
Soft tissue sarcomas are rare, malignant tumors of mesenchymal origin. They are classified into over 70 subtypes, with risk factors including environmental exposures and genetic predispositions. Management involves surgery, radiotherapy, and sometimes chemotherapy, tailored to the sarcoma type.
Median Nerve Tendon Transfers: Anatomy, Principles, & Procedure
Median nerve tendon transfers restore thumb opposition, flexion of the index and middle fingers, and thumb flexion. The procedure involves relocating functional tendons to compensate for lost function due to nerve injury.
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View allST3 Plastic Surgery Interview: Structure, Guides & Tools.
A guide to Plastic Surgery courses, companions, and questions for your upcoming ST3 plastic surgery interview.
6 min read
Key Notes on Plastic Surgery - Book Review
"Key Notes on Plastic Surgery" is a comprehensive guide to the field of plastic surgery, authored by Adrian Richards and Hywel Dafydd.
3 min read
4 Best Resources for Plastic Surgery Residency Interviews.
Online Plastic Surgery interviews resources are the best way to prepare for your residency interview. This article details the best methods and resources to prepare for your ST3 or residency interview.
4 min read