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Chemical Peels: Role of Chemical Peels in Facial Rejuvenation Today

Pathak, Abraham; Mohan, Raja; Rohrich, Rod J
The practice of chemical peeling remains an important aspect of the nonsurgical techniques available to the aesthetic surgeon when approaching skin rejuvenation. Despite past predictions of their disappearance in favor of lasers, the overall use of chemical peels by plastic surgeons continues to grow. In the past two decades, the techniques available to the clinician have evolved in safety and efficacy based on the dermatologic investigations of various individuals, including Obagi, Hetter, and Stone. The versatility, clinical endpoint-directed predictability, and favorable risk profile of chemical peels proffered by these latest advancements affirm that this modality is essential to the practice of the plastic surgeon treating patients with rhytides and dyschromias. This review presents the current role of chemical peels in skin rejuvenation, emphasizing the significant clinical advancements and their modern day applications and practice.
PMID: 31881607
ISSN: 1529-4242
CID: 5037062

Prevalence and Patient-Level Risk Factors for 30-Day Readmissions Following Free Tissue Transfer for Head and Neck Cancer

Offodile, Anaeze C; Pathak, Abraham; Wenger, Julia; Orgill, Dennis P; Guo, Lifei
IMPORTANCE/OBJECTIVE:Hospital readmissions are a marker of surgical care delivery and quality that are progressively more scrutinized. OBJECTIVE:To provide a comprehensive analysis of 30-day readmissions for patients with head and neck cancer who underwent free flap reconstruction to highlight the rate, causes, and associated patient risk factors. DESIGN, SETTING, AND PARTICIPANTS/METHODS:Retrospective cohort study at a single tertiary care academic institution. The study consisted of 249 patients who underwent microvascular reconstruction of a presumed head and neck oncologic defect from January 1, 2000, through June 30, 2014. Follow-up continued through July 30, 2014. INTERVENTIONS/METHODS:Microvascular reconstruction of an oncologic head and neck defect. MAIN OUTCOMES AND MEASURES/METHODS:Incidence of 30-day all-cause readmissions, patient risk factors, and readmission indications. Regression analyses were conducted to discern patient-level risk factors related to 30-day readmissions. RESULTS:Among the 249 patients, the 30-day all-cause readmission rate was 14.5%, while the unplanned readmission rate was 11.6%. The most common reason for readmission was neck wound complications. Predictors of readmission following multivariable analysis were T4 pathologic stage (odds ratio [OR], 11.68; 95% CI, 1.37-99.81; P = .02) and having a tumor located in the oropharynx (OR, 4.64; 95% CI, 1.89-11.38; P = .001), hypopharynx (OR, 8.30; 95% CI, 1.52-45.24; P = .01), or larynx (OR, 10.97; 95% CI, 2.27-52.98; P = .003). Patients who were readmitted were more likely to experience neck wound complications (OR, 5.07; 95% CI, 1.31-19.57; P = .02) and undergo reoperation (OR, 47.20; 95% CI, 8.33-267.33; P < .001). CONCLUSIONS AND RELEVANCE/CONCLUSIONS:In this study, advanced pathologic tumor staging and tumor location were associated with 30-day readmissions in patients with head and neck cancer who receive free flaps. Our results provide a benchmark for risk stratification that can be used in system-based practice improvements, health care cost savings, and postoperative patient counseling.
PMID: 26204558
ISSN: 2168-619x
CID: 5037052

The abbe flap for upper lip reconstruction [Case Report]

Nyame, Theodore T; Pathak, Abraham; Talbot, Simon G
PMCID:4153100
PMID: 25328575
ISSN: 1937-5719
CID: 5037042