Lower limb prosthesis abandonment is a significant challenge, leading to reliance on walking aids, such as wheelchairs, which frequently do not match the patient’s needs and lead to increased morbidity. Prosthesis abandonment is driven by a lack of embodiment, the latter defined as the integration of a prosthetic device into one’s body schema. This review evaluates interventions enhancing embodiment through three dimensions: ownership, agency, and co-location. The aim of this narrative review is to ask what interventions are available to improve embodiment, and what dimensions of embodiment should be included in the standard of care for lower-limb amputation surgery and componentry development. This narrative is constructed through a thorough literature search on how the aforementioned dimensions of embodiment can be optimized. In the studies reviewed, standardization of embodiment metrics and longitudinal data are lacking, hindering clinical translation. Future work must prioritize patient-centered design, integrate multidimensional assessments, and address practical issues to expand eligibility for advanced interventions.
The deep inferior epigastric perforator (DIEP) flap in breast reconstruction has been an evolution in providing an ideal autologous reconstruction while minimizing donor site morbidity. Innovations have continued to optimize the DIEP flap in multiple facets. Alternative flap designs, vasculature modifications, and conjoined and stacked flaps have improved the ability to increase flap volume and perfusion. Advancements in anatomic understanding of the abdomen have resulted in decreases in donor site morbidity and improved abdominal outcomes. Patient satisfaction regarding aesthetics has been enhanced through careful consideration of mastectomy techniques and recipient site modifications in addition to improved quality of life outcomes through sensory innervation. The study reviews the evolution and current state of abdominally-based breast reconstruction in its goal of optimizing aesthetic, patient-reported and quality-of-life outcomes while minimizing complications.
The deep inferior epigastric perforator (DIEP) flap in breast reconstruction has been an evolution in providing an ideal autologous reconstruction while minimizing donor site morbidity. Innovations have continued to optimize the DIEP flap in multiple facets. Alternative flap designs, vasculature modifications, and conjoined and stacked flaps have improved the ability to increase flap volume and perfusion. Advancements in anatomic understanding of the abdomen have resulted in decreases in donor site morbidity and improved abdominal outcomes. Patient satisfaction regarding aesthetics has been enhanced through careful consideration of mastectomy techniques and recipient site modifications in addition to improved quality of life outcomes through sensory innervation. The study reviews the evolution and current state of abdominally-based breast reconstruction in its goal of optimizing aesthetic, patient-reported and quality-of-life outcomes while minimizing complications.
Joan Viteri Memorial Clinic (JVMC) is a student run clinic in Sacramento, California that serves marginalized and often stigmatized patient populations. The reproductive clinic within JVMC set out to provide medication abortion services to provide more equitable reproductive health care to its patients during a time in which these rights are being threatened across the United States. This descriptive report outlines the hurdles and victories in implementing protocols to offer no-cost medication abortions in a low resource setting.