Barry Press

All Publications

• Immunological Effect of Skin Allograft in Burn Treatment: Impact on Future Vascularized Composite Allotransplantation JOURNAL OF BURN CARE & RESEARCH Garza, R. M., Press, B. H., Tyan, D. B., Karanas, Y. L., Lee, G. K. 2017; 38 (3): 169-173

  Abstract

  Skin allografts are the benchmark in temporary burn wound coverage, but allografts are hypothesized to place a high antigenic load on recipients. This project aims to determine the degree of human leukocyte antigen sensitization in burn patients treated with allografts. Serum was obtained from nine adult, nontransfused, and nontransplanted burn patients treated with allografts. Group 1 included patients tested in the acute burn period, while group 2 included different patients tested months to years after injury. A calculated panel reactive antibody (cPRA) percent was assessed for each patient, and data for a control group of 92 adult nontransplanted males were used for comparison. Each patient received allografts from an average 3.55 ± 1.24 different donors. cPRA in group 1 was lower than in group 2 (6 ± 12% vs 42 ± 33%, P = .08). cPRA in the study group was significantly higher than in the control group (26 ± 31% vs 8 ± 17%, P = .0075). Burn patients who receive skin allograft demonstrate increased immunological sensitization compared with unsensitized controls. Detection of human leukocyte antigen antibody is lower in the acute burn period than months to years after injury. Increased sensitization may ultimately limit burn patients' candidacy for vascularized composite allotransplantation or decrease success of these procedures.

  View details for DOI 10.1097/BCR.0000000000000458

  View details for Web of Science ID 000399817800007

• The unusual presentation of a burn from methyl bromide exposure: A case report and review of the literature. Burns Sue, G. R., Karanas, Y. L., Davis, D. J., Press, B. 2017

  Abstract

  Methyl bromide chemical burns are rare. Only two cases have been reported to date. The presentation of methyl bromide chemical burns is unusual. Patients with an acute exposure should be observed closely as the initial presentation can appear deceptively benign. The latency period lasts several hours prior to the development of chemical burn wounds. In this article, we review the literature on methyl bromide chemical burns and present our experience managing a patient with an extensive methyl bromide burn.

  View details for DOI 10.1016/j.burns.2016.12.001

  View details for PubMedID 28069343

• Optimizing functional upper extremity reconstructionSimultaneous free anterolateral thigh flap and tendon transfersA case report MICROSURGERY Sorice, S. C., Press, B., Momeni, A. 2017; 37 (1): 71-74

  Abstract

  Composite upper extremity defects involving muscle-tendon units are amongst the most formidable reconstructive challenges and mandate functional restoration in addition to stable soft-tissue coverage. Here, the authors present a case of a composite defect involving the extensor muscle-tendon units of the forearm resulting from surgical resection of a recurrent Merkel cell cancer. Functional restoration was achieved via multiple tendon transfers followed by soft tissue coverage with a free anterolateral thigh (ALT) flap. No donor- or recipient-site complications were encountered and complete flap survival was noted. Following a 6-week period of immobilization, physical therapy and range of motion exercises were initiated. Excellent functional outcome and high patient satisfaction were noted at 8 weeks postoperatively. In summary, simultaneous tendon transfers and microsurgical tissue transfer may provide a potentially superior approach for upper extremity reconstruction in complex composite defects.

  View details for DOI 10.1002/micr.30096

  View details for Web of Science ID 000393458400012

  View details for PubMedID 27580418

• Immunological Effect of Skin Allograft in Burn Treatment: Impact on Future Vascularized Composite Allotransplantation. Journal of burn care & research Garza, R. M., Press, B. H., Tyan, D. B., Karanas, Y. L., Lee, G. K. 2016: -?

  Abstract

  Skin allografts are the benchmark in temporary burn wound coverage, but allografts are hypothesized to place a high antigenic load on recipients. This project aims to determine the degree of human leukocyte antigen sensitization in burn patients treated with allografts. Serum was obtained from nine adult, nontransfused, and nontransplanted burn patients treated with allografts. Group 1 included patients tested in the acute burn period, while group 2 included different patients tested months to years after injury. A calculated panel reactive antibody (cPRA) percent was assessed for each patient, and data for a control group of 92 adult nontransplanted males were used for comparison. Each patient received allografts from an average 3.55 ± 1.24 different donors. cPRA in group 1 was lower than in group 2 (6 ± 12% vs 42 ± 33%, P = .08). cPRA in the study group was significantly higher than in the control group (26 ± 31% vs 8 ± 17%, P = .0075). Burn patients who receive skin allograft demonstrate increased immunological sensitization compared with unsensitized controls. Detection of human leukocyte antigen antibody is lower in the acute burn period than months to years after injury. Increased sensitization may ultimately limit burn patients' candidacy for vascularized composite allotransplantation or decrease success of these procedures.

  View details for PubMedID 27801681

• Tarsal ectropion repair and lower blepharoplasty: A case report and review of literature JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY Garza, R. M., Lee, G. K., Press, B. H. 2012; 65 (2): 249-251

  Abstract

  Ectropion is frequently encountered in plastic surgery. A variety of etiologies exist, but tarsal ectropion, defined as complete eversion of the tarsal plate and its overlying conjunctiva, is rarely considered. First described in 1960 by Fox, this variant was initially attributed to pre-septal orbicularis oculi spasm or tarsoligamentous relaxation. However, subsequent investigators determined that the true etiology involved lower lid retractor disinsertion on the tarsal plate. We present a case of chronic right lower lid ectropion in a 66-year-old male. Through understanding of eyelid anatomy, especially that of the lower eyelid retractors, tarsal ectropion was correctly identified in our patient preoperatively. A repair including correction of retractor disinsertion on the tarsus was planned, and given our patient's degree of lower lid delamination and mobilization, we also proceeded with bilateral lower lid blepharoplasty with canthal and lower lid soft tissue support. Ultimately, we were able to achieve an improved aesthetic appearance for our patient, along with resolution of his symptoms.

  View details for DOI 10.1016/j.bjps.2011.06.035

  View details for Web of Science ID 000299111100022

  View details for PubMedID 21764653

• ASSOCIATION OF DOWN-REGULATION OF CYTOKINE ACTIVITY WITH RAT HIND-LIMB ALLOGRAFT SURVIVAL TRANSPLANTATION FEALY, M. J., Most, D., Huie, P., Wolf, M., Sibley, R. K., Morris, R. E., PRESS, B. H. 1995; 59 (10): 1475-1480

  Abstract

  Cytokines are short-acting protein modulators of many physiologic processes including graft rejection. An understanding of the production, action, and interaction of cytokines may lead to better appreciation of the complex mechanism of graft rejection. The potential would then exist for more selective and less-toxic means of modulating the immune response. A rat hind limb allograft model with major immunohistoincompatibility was used to study the local mRNA expression of IL-1 alpha, IL-2, IL-6, gamma interferon (gamma INF), platelet-derived growth factor-alpha (PDGF-alpha), basic fibroblast growth factor (FGF), and transforming growth factor-beta (TGF-beta) during acute allograft rejection. A 14-day postoperative course of immunosuppressive therapy with FK506 or rapamycin was administered. In situ hybridization was performed on serial full-thickness skin punch biopsies of the untreated rejecting limb allograft and compared with tissue from treated allografts, isografts, and to normal limb tissue. A sequential pattern of cytokine mRNA expression was demonstrated which progressed in a time-dependent manner and paralleled observed clinical rejection. Maximal cytokine mRNA expression correlated with peak graft rejection. Cellular expression of IL-1 alpha, IL-2, IL-6, gamma-INF, FGF, and TGF-beta mRNA was suppressed with FK506 to below isograft levels, and clinical rejection was not observed with the doses, routes, and schedules used. Rapamycin was ineffective in suppressing cytokine expression, and allograft rejection was not prevented. Isografts demonstrated no evidence of rejection. The in situ hybridization technique demonstrates a time-dependent, selective expression of cytokines within rejecting allograft tissue, and the modification of this response with immunosuppressive therapy. Down-regulation of cytokine expression is associated with clinical allograft survival.

  View details for Web of Science ID A1995RB42900020

  View details for PubMedID 7539555