Canadian society of Plastics urgeons société canadienne des chirurgiens Plasticiens

Learning Objectives: 1. Participants will recognize advantages and disadvantages of flap reconstruction of pelvic and perineal defects following abdominal perineal resection or pelvic exenteration.2. Participants will identify strategies to reconstruct the pelvic, perineal and vaginal structures using flaps from various donor sites.3. Participants will understand the advantages and disadvantages of thigh-based and abdominal-based flaps for pelvic/perineal reconstruction. 01aUtologoUs Bone cranioPlastY safetY and efficacY: a review of 128 cases over 39 Years n nathan, ir Macarthur, r Burke, sa wolfe Miami, florida, Usa PURPOSE: Many cranioplasties in North America are performed with alloplastic implants because of ease of the procedure and a lack of experience related to bone harvest.Published series of alloplastic repairs have reported infection rates of 9 to 23%.The senior author has used autogenous bone of various sources for 128 calvarial defects over a 39-year period and this report will present that experience.METHODS: A total of 134 cases met inclusion criteria (several patients had staged reconstructions).Data regarding patient demographics, underlying pathology, complications, and length of follow-up were collected.RESULTS: Average patient age was 22, with a range of 12 months to 76 years.Causes of the cranial defects included trauma, malignancy, infection, craniosynostosis, and surgically created defects resulting from full-thickness calvarial harvest.Donor sites included calvarium (72%), rib (22%) and ilium (10 %).Eleven patients had had prior failures with alloplastic materials.Notably, there were no cases of infection, no cases requiring bone graft removal, and no significant graft resorption on follow-up.Furthermore, no complications were seen related to harvesting of the autogenous grafts.CONCLUSIONS: This retrospective study demonstrates that autogenous bone is the ideal graft replacement for full-thickness, cranial vault defects.Absolute indications for the use of autogenous bone include defects near the paranasal sinuses, defects in growing children, previous alloplastic failures, and complex orbito-cranial defects requiring staged procedures.More emphasis should be placed on teaching plastic surgery residents how to harvest and work with bone so that alloplastic materials will not be their only recourse. Learning Objectives:Participants will learn the advantages of using autologous bone in cranioplasty surgery. fUnctional oUtcoMes of enoPHtHalMos correctionM Mcrae, a Budning, c lynham, o antonyshyn toronto, on PURPOSE: Determine functional outcomes of late post-traumatic enophthalmos repair, specifically, ocular motility, diplopia, and strabismus.METHODS: The study series comprises 81 consecutive patients with late post-traumatic enophthalmos with functional impairment, that underwent enophthalmos repair by a single surgeon (OA) between May 2002 and April 2014.Of those, 39 patients fulfilled study inclusion and exclusion criteria.Outcomes (diplopia, limitations of ocular motility, and strabismus) were assessed independently by a single ophthalmologist who specializes in strabismus surgery (AB), and were performed preop and postop for each patient.RESULTS: Average age was 43.1 (range 15-79) with 26 males, and 13 females.After enopthalmos correction 20 patients decreased by 1 or more grades of diplopia, while 7 patients had complete resolution.Re-operation was required in 6 patients to address inadequate correction or post-operative complication.Two patients worsened by 1 or more grades of diplopia after enophthalmos repair.Residual diplopia was treated with strabismus surgery in 10 patients.4 patients were managed with prism glasses without further surgery.Of the 10 patients that received strabismus surgery, 6 patients improved by 1 or more grades of diplopia, 2 worsened.34 of 39 patients presented with vertical restriction μ=-1.95(σ=1.13) was improved to μ=-1.21 (σ=0.98) with enopthalmos repair and to μ=-1.06 (σ=0.98) after all interventions.18 patients presented with horizontal restriction μ=-0.88 (σ=0.62).This improved to μ=-0.56 (σ=0.6) after enopthalmos repair and μ=0.59 (σ=0.6) after all interventions.CONCLUSIONS: Late enopthalmos repair post orbital fracture resulted in functional improvement of diplopia, ocular restriction and strabismus in this retrospective case series.Learning Objectives: 1. Understand the functional sequelae of post-traumatic enopthalmos 2. Appreciate of the benefits and limitations of enopthalmos repair to address functional outcomes of diplopia, ocular motility, and strabismus 03 airwaY ManageMent in Pierre roBin seqUence: tHe vancoUver classification sYsteM wY li, a Poon, d courtemanche, c verchere, c Malic, J arneja vancouver, Bc PURPOSE: Neonates with Pierre Robin Sequence (PRS) present with airway obstruction and feeding difficulties.No current practical classification of PRS patients exists.We hereby propose a clinical classification and treatment algorithm.METHOD: A 10-year retrospective study of all neonates diagnosed with PRS was performed.Patients with glossoptosis, retrognathia, airway obstruction ± cleft palate were included.We collected data on demographics, treatment and outcomes during the first year of life.

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