Levin LS

[BACKGROUND] Xylazine is a veterinary sedative that is added to illicit fentanyl to prolong its euphoric effects. When injected subcutaneously, xylazine causes large, necrotic wounds. In 2023, the White House designated fentanyl adulterated…

[BACKGROUND] Xylazine is a veterinary sedative that is added to illicit fentanyl to enhance its effects. Xylazine-associated wounds differ from those found in patients who inject other drugs. They are larger and frequently involve deeper st…

Mangled extremities are complex injuries of the soft tissues, neurovascular structures, and bone that have devastating functional and psychological consequences for affected individuals. Successful management of mangling injuries to the upp…

G. Ian Taylor and Rollin Daniel described the first fasciocutaneous vascularized free tissue transfer in 1973 using the groin flap. Over the last 50 years, the field of microsurgery has advanced significantly, with the advent of improved su…

[BACKGROUND]  The timing of free flap reconstruction after lower extremity trauma has been a controversial debate since Marko Godina's original 72-hour recommendation. Recent advances in microsurgery warrant an evaluation of the optimal tim…

[BACKGROUND] Lymphovenous anastomosis (LVA) is an established microsurgical treatment for lymphedema. Robotic assistance in LVA procedures (RoboLVA) has emerged as a promising advancement, yet its effectiveness and clinical outcomes have ye…

Anatomy has long served as the foundation of surgical education and innovation. From the anatomical plates of the Renaissance to dissection theaters of the 18th century and currently modern cadaveric simulation labs and courses, the underst…

[BACKGROUND] The Plastic Surgery In-service Training Examination (PSITE) provides residents and faculty with an objective evaluation of hand surgery knowledge during plastic surgery residency training. The purpose of this study was to under…

[BACKGROUND] The elbow is a complex joint that is vital for proper function of the upper extremity. Reconstruction of soft tissue defects over the joint space remains challenging, and outcomes following free tissue transfer remain underrepo…

[PURPOSE] Despite advances in extremity trauma care and reconstructive microsurgery, management of the traumatic amputations remains a challenge. The majority of patients will forever experience some level of disability even with replantati…

The American Society for Reconstructive Microsurgery (ASRM) sponsors the Godina Fellowship to expand the careers of talented early career microsurgeons. This study characterizes the scholarly impact and academic career outcomes of Godina Fe…

[BACKGROUND] Despite advanced wound care techniques, open fractures in the setting of lower extremity trauma remain a challenging pathology, particularly when free tissue transfer is required for coverage. We aimed to evaluate factors assoc…

[UNLABELLED] The medial femoral condyle free flap serves as an attractive reconstructive option for small- to intermediate-sized bony defects. It is commonly applied in the extremities with limited reports in the head and neck. [METHODS] A…

For more than six decades, the use of the operating microscope for extremity surgery has led to remarkable advances in the management of orthopedic trauma, tumors, infections, and congenital differences. The microsurgical reconstructive lad…

Free flap surgery for limb salvage has become the surgical standard for reconstruction of bone and soft tissue with success rates and flap survivals of 94%-95%. The soft tissue defect dictates the technique of coverage. In many cases, multi…

[BACKGROUND] Recalcitrant or persistent nonunions of the metatarsophalangeal (MTP) joint occur following failed MTP surgery for MTP fusion, failed MTP prosthesis, for hallux rigidus or due to infection and erosion. A deficient soft tissue e…

[LEARNING OBJECTIVES] After studying this article, the participant should be able to: 1. Have an in-depth understanding of the functional and aesthetic requirements of lower extremity reconstruction. 2. Describe the considerations for achie…

Historically, the traditional pathways into plastic surgery required board eligibility in a surgical specialty such as general surgery, orthopedics, urology, neurosurgery, otolaryngology, or ophthalmology. This requirement resulted in plast…

[BACKGROUND]  In 2017, our institution initiated a cadaver laboratory-based course dedicated to teaching reconstructive microsurgery indications, preoperative planning, and flap dissection. The goals of this study are to describe the demogr…

[BACKGROUND] Management of traumatic lower extremity injuries requires a skill set of orthopedic surgery and plastic surgery to optimize the return of form and function. A systematic review and meta-analysis was performed comparing demograp…

In order to address complex extremity injuries, the orthoplastic approach uses plastic, orthopedic, and microsurgical techniques and includes other disciplines to optimize limb salvage. This collaboration, if created early in treatment, all…

[BACKGROUND] The use of free flaps from the medial femoral condyle has grown in popularity and is now a workhorse in the reconstruction of skeletal defects. The utility of this technique has not yet been described for the pediatric patient …

[BACKGROUND] Previous studies have demonstrated that nonwhite race and disadvantaged socioeconomic status negatively impact outcomes following lower extremity reconstruction. The authors sought to characterize differences in outcomes betwee…

Reconstructive microsurgery has been an essential aspect of orthopaedic surgery and extremity reconstruction since the introduction of the operating microscope in the mid-20 century. The reconstructive ladder ranges from simple healing by s…

[BACKGROUND] Various surgical techniques exist for lower extremity reconstruction, but limited high-quality data exist to inform treatment strategies. Using multi-institutional data and rigorous matching, the authors evaluated the effective…