Erin Brown

University of British Columbia

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Aziz Ghahary

University of British Columbia

Michael Berger

International Collaboration On Repair Discoveries

Christopher Doherty

University of British Columbia

Joon Pio Hong

University of Ulsan

Hyunsuk Peter Suh

University of Ulsan

Ruhangiz T. Kilani

University of British Columbia

Neil F. Jones

University of California, Los Angeles

H.C. Fibiger

University of British Columbia

Harvey Wu

International Collaboration On Repair Discoveries

Amy K. Hanlan

University of British Columbia

Cooperative Institutions

University of British Columbia

Johns Hopkins University

University of Alberta

National Institutes of Health

International Collaboration On Repair Discoveries

Johns Hopkins Medicine

National Institute of Allergy and Infectious Diseases

University of Southern California

Asan Medical Center

University of Ulsan

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Maximizing the Flap Inflow in a Foot Reconstruction: Ultrasonographic Evaluation of Artery Flow in Accordance with the Angle of the Ankle

Plastic & Reconstructive Surgery (2021)

Young Chul Suh Hyung Bae Kim Erin Brown Joon Pio Hong Hyunsuk Peter Suh

Summary: Adequate arterial inflow is mandatory for a successful free tissue transfer. Maximizing this inflow appears to be especially important during distal lower extremity reconstruction, where perfusion pressures can be significantly lower than in the trunk or head and neck. In the current study, the authors used color and pulsed-wave Doppler ultrasonography to analyze blood flow volumes in the foot in accordance with the ankle position. Twenty feet of 10 healthy subjects were included in the analyses. All subjects were examined by Doppler ultrasonography at three different ankle angles (dorsiflexion at 90 degrees, relaxed position, and complete plantar flexion). The average flow volumes of the dorsalis pedis artery varied dramatically at the different ankle positions, as follows: dorsiflexion, 19.81 ± 3.88 ml/minute; relaxed position, 11.71 ± 4.72 ml/minute; and plantar flexion, 3.47 ± 1.41 ml/minute. The average flow volume of the posterior tibial artery also varied dramatically at these different ankle positions: dorsiflexion, 9.08 ± 8.25 ml/minute; relaxed position, 14.78 ± 2.45 ml/minute; and plantar flexion, 19.03 ± 5.03 ml/minute. The ankle position dramatically affects the flow velocity in the anterior and posterior tibial vessels, which is an important consideration when performing free tissue transfer reconstruction of the foot. Ankle dorsiflexion would be recommended when using the anterior tibial artery as a recipient vessel, whereas plantar flexion of the ankle would be advised when the posterior tibial artery is used as a recipient vessel.

Posterior tibial artery

Dorsalis pedis artery

Anterior tibial artery

Plantar flexion

Popliteal artery

10.1097/prs.0000000000008176

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Citations (4)

Healing of a Scaphoid Nonunion Using Human Bone Morphogenetic Protein

The Journal Of Hand Surgery (2005)

Neil F. Jones Erin Brown Amir Mostofi Esther Vögelin Marshall R. Urist

Curettage

Bone grafting

Avascular Necrosis

Human bone

10.1016/j.jhsa.2004.12.005

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Citations (28)

Planes for Perforator/Skin Flap Elevation—Definition, Classification, and Techniques

Journal of Reconstructive Microsurgery (2022)

Jin Geun Kwon Erin Brown Hyunsuk Peter Suh Changsik John Pak Joon Pio Hong

Abstract Background Elevation in different layers achieving thin flaps are becoming relatively common practice for perforator flaps. Although postreconstruction debulking achieves pleasing aesthetic results and is widely practiced, customized approach during elevation to achieve the ideal thickness will increase efficiency while achieving the best possible aesthetic outcome. Multiple planes for elevation have been reported along with different techniques but it is quite confusing and may lack correspondence to the innate anatomy of the skin and subcutaneous tissue. Methods This article reviews the different planes of elevation and aims to clarify the definition and classification in accordance to anatomy and present the pros and cons of elevation based on the different layers and provide technical tips for elevation. Results Five different planes of elevation for perforator flaps are identified: subfascial, suprafacial, superthin, ultrathin, and subdermal (pure skin) layers based on experience, literature, and anatomy. Conclusion These planes all have their unique properties and challenges. Understanding the benefits and limits along with the technical aspect will allow the surgeon to better apply the perforator flaps.

Elevation (ballistics)

Perforator flaps

Debulking

10.1055/s-0042-1750127

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Citations (13)

Prevalence of Sexually Transmitted Infections Among Transgender Women With and Without HIV in the Eastern and Southern United States

The Journal of Infectious Diseases (2024)

Erin Brown Eshan U. Patel Tonia Poteat Kenneth H. Mayer Andrew J. Wawrzyniak

Abstract Background Data on the epidemiology of sexually transmitted infections (STIs) among transgender women (TGW) with and without human immunodeficiency virus (HIV) are limited. Methods We analyzed baseline data collected from a cohort of adult TGW across 6 eastern and southern US cities between March 2018 and August 2020 (n = 1018). Participants completed oral HIV screening, provided self-collected rectal and urogenital specimens for chlamydia and gonorrhea testing, and provided sera specimens for syphilis testing. We assessed associations with ≥1 prevalent bacterial STI using modified Poisson regression. Results Bacterial STI prevalence was high and differed by HIV status: 32% among TGW with HIV and 11% among those without HIV (demographic-adjusted prevalence ratio = 1.91; 95% confidence interval = 1.39–2.62). Among TGW without HIV, bacterial STI prevalence differed by geographic region, race and ethnicity, and gender identity, and was positively associated with reporting >1 sexual partner, hazardous alcohol use, homelessness, having safety concerns regarding transit to health care, and no prior receipt of gender-affirming health services. Among TGW with HIV, older age was inversely associated with bacterial STI. Conclusions TGW had a high prevalence of bacterial STIs. The prevalence and correlates of bacterial STI differed by HIV status, highlighting the unique needs and risks of TGW with and without HIV. Tailored interventions may reduce sexual health-related inequities.

Transgender women

10.1093/infdis/jiad605

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Citations (1)

Evidence-based obstetric guidance in the setting of a global intravenous fluid shortage

American Journal of Obstetrics & Gynecology MFM (2024)

Sarah Heerboth Pauline Devlin Savvy Benipal Trawick Emma Nandini Raghuraman

Economic shortage

Intravenous fluid

10.1016/j.ajogmf.2024.101556

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Citations (0)

A new method for skin grafting in murine model

Wound Repair and Regeneration (2016)

Mohammadreza Pakyari Ali Farokhi Mohsen Khosravi‐Maharlooei Ruhangiz T. Kilani Aziz Ghahary

Skin transplantation provides an excellent potential model to investigate the immunology of allograft rejection and tolerance induction. Despite the theoretical ease of performing skin transplantation, as well as the potential of directly observing the reaction to the transplanted tissue, the poor reliability of skin transplantation in the mouse has largely precluded the use of this model. Furthermore, there is controversy regarding the most appropriate skin graft donor site due to poor success of back skin transplantation, as compared with the thinner ear or tail skin. This study demonstrates a reliable method to successfully perform skin grafts in a mouse model, as well as the clinical and histologic outcome of syngeneic grafts. A total of 287 grafts were performed (in 126 mice) utilizing donor skin from the ear, tail or back. No graft failure or postoperative mortality was observed. Comparison of this technique with two previously established protocols of skin transplantation (5.0 absorbable Suture + tissue glue technique and no-suture technique) demonstrates the significant improvement in the engraftment success of the new technique. In summary, a new technique for murine skin grafting demonstrates improved reliability across donor site locations and strains, increasing the potential for investigating interventions to alter the rejection process.

Skin grafting

10.1111/wrr.12445

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Citations (24)

Transdifferentiation of Peripheral Blood Mononuclear Cells into Epithelial-Like Cells

American Journal Of Pathology (2007)

Abelardo Medina Ruhangiz T. Kilani Nicholas Carr Erin Brown Aziz Ghahary

Transdifferentiation

Matrix (chemical analysis)

10.2353/ajpath.2007.070051

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Citations (29)

ECS-induced dopamine release: Effects of electrode placement, anticonvulsant treatment, and stimulus intensity

Biological Psychiatry (1993)

Kathleen McGarvey Athanasios P. Zis Erin Brown George G. Nomikos H.C. Fibiger

Stimulus (psychology)

Cortical Spreading Depression

10.1016/0006-3223(93)90385-q

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Citations (40)

Contemporary Approaches to Peripheral Nerve Surgery

Plastic Surgery (2022)

Christopher Doherty Erin Brown Michael Berger Alexander Seal David Tang

This manuscript serves to provide the reader with a general overview of the contemporary approaches to peripheral nerve reconstruction as the field has undergone considerable advancement over the last 3 decades. The learning objectives are as follows: To provide the reader with a brief history of peripheral nerve surgery and some of the landmark developments that allow for current peripheral nerve care practices.To outline the considerations and management options for the care of patients with brachial plexopathy, spinal cord injury, and lower extremity peripheral nerve injury.Highlight contemporary surgical techniques to address terminal neuroma and phantom limb pain.Review progressive and future procedures in peripheral nerve care, such as supercharge end-to-side nerve transfers.Discuss rehabilitation techniques for peripheral nerve care.

10.1177/22925503221120571

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Citations (2)

Free Tissue Transfer after Open Transmetatarsal Amputation in Diabetic Patients

Journal of Reconstructive Microsurgery (2021)

Eleanor S. Lumley Jin Geun Kwon Beatriz Hatsue Kushida-Contreras Erin Brown Julian Viste

Transmetatarsal amputation (TMA) preserves functional gait while avoiding the need for prosthesis. However, when primary closure is not possible after amputation, higher level amputation is recommended. We hypothesize that reconstruction of the amputation stump using free tissue transfer when closure is not possible can achieve similar benefits as primarily closed TMAs. Twenty-eight TMAs with free flap reconstruction were retrospectively reviewed in 27 diabetic patients with a median age of 61.5 years from 2004 to 2018. The primary outcome was limb salvage rate, with additional evaluation of flap survival, ambulatory status, time until ambulation, and further amputation rate. In addition, subgroup analysis was performed based on the microanastomosis type. Flap survival was 93% (26 of 28 flaps) and limb salvage rate of 93% (25 of 27 limbs) was achieved. One patient underwent a second free flap reconstruction. In the two failed cases, higher level amputation was required. Thirteen flaps had partial loss or other complications which were salvaged with secondary intension or skin grafts. Median time until ambulation was 14 days following reconstruction (range: 9-20 days). Patients were followed-up for a median of 344 days (range: 142-594 days). Also, 88% of patients reported good ambulatory function, with a median ambulation score of 4 out of 5 at follow-up. There was no significant difference between the subgroups based on the microanastomosis type. TMA with free flap reconstruction is an effective method for diabetic limb salvage, yielding good functional outcomes and healing results.

10.1055/s-0041-1726394

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Citations (7)