Ki-Jae Kim, Sun-Hyeok Kim, Seung-Pil Jung, Eul-Sik Yoon, Jae-Ho Chung
{"title":"The efficacy of immediate lymphatic reconstruction in preventing breast cancer-related lymphedema: long-term follow-up study.","authors":"Ki-Jae Kim, Sun-Hyeok Kim, Seung-Pil Jung, Eul-Sik Yoon, Jae-Ho Chung","doi":"10.2340/jphs.v60.43738","DOIUrl":"https://doi.org/10.2340/jphs.v60.43738","url":null,"abstract":"<p><strong>Background: </strong>Immediate lymphatic reconstruction (ILR) has emerged as an effective intervention to reduce breast cancer-related lymphedema, which affects 2-30% of patients who undergo axillary lymph node dissection (ALND). Our previous research validated ILR's effectiveness over 14 months, but the duration was short and warranted further study. This study provides long-term evidence of its benefits in a well-defined patient cohort.</p><p><strong>Method: </strong>This retrospective cohort study included unilateral breast cancer patients who underwent ALND between November 2019 and February 2021 with ≥ 24 months of follow-up. Patients were grouped by whether ILR was attempted intraoperatively. Exclusion criteria were recurrence, prophylactic mastectomy, and pre-existing lymphedema. The primary outcome was lymphedema incidence at ≥ 24 months; the secondary was lymphedema-free survival. Outcomes were evaluated using Cox regression models.</p><p><strong>Results: </strong>Among 73 patients, we analyzed ALND patients divided into a control group (n = 57, defined as no-try or failure) and an ILR group (n = 16). The pooled median follow-up was 37 months. (range, 26~47 months). Among the ILR group, 13 underwent end-to-end anastomosis and 3 end-to-side. Postoperative lymphedema was higher in the control group (24.6%) compared to the ILR group (6.3%). Multivariate Cox regression analysis showed a significantly lower hazard ratio for the ILR group (HR: 0.117, 95% CI: 0.014-0.965), emphasizing ILR's effectiveness in reducing lymphedema risk post-ALND. Additionally, survival plots illustrating lymphedema-free survival showed a significant difference.</p><p><strong>Conclusion: </strong>Our study emphasizes ILR's efficacy over extended follow-up. The ILR group exhibited a lower rate of postoperative lymphedema, supporting ILR as an effective preventive measure against Breast Cancer-Related Lymphedema (BCRL) following ALND.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"60 ","pages":"138-143"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Torsten Schulz, Johanna Grünewald, Stefania Sima, Yasmin Molter, Kristin Lidzba, Günce Ciklatekerlio, Stefan Langer, Rima Nuwayhid
{"title":"Top surgery enhances body satisfaction and quality of life in transgender men: results from a cross-sectional study using a transgender-specific questionnaire.","authors":"Torsten Schulz, Johanna Grünewald, Stefania Sima, Yasmin Molter, Kristin Lidzba, Günce Ciklatekerlio, Stefan Langer, Rima Nuwayhid","doi":"10.2340/jphs.v60.43490","DOIUrl":"https://doi.org/10.2340/jphs.v60.43490","url":null,"abstract":"<p><strong>Background: </strong>This is the first exploratory investigation of the Essen Transidentity Quality of Life Inventory (ETLI) questionnaire administered to transgender men before and after mastectomy.</p><p><strong>Methods: </strong>Eighty-two transgender men were enrolled in a cross-sectional study. Depending on whether a mastectomy had been performed, 42 patients were assigned to the preoperative and 40 to the postoperative group. Data collection included epidemiologic data, screening questions for comorbidities or mental disorders and three questionnaires (Short-Form Health Survey [SF-36], BODY-Q Chest Module and ETLI). The trial was registered at the German Clinical Trial Register under the number: DRKS00035156. Qualitative data were compared using the chi-squared test, and quantitative scores were analysed using the t-test. Effect sizes were determined using ANOVA. A p-value < 0.05 was considered significant.</p><p><strong>Results: </strong>The average age of the participants was 26.9 years, with an average duration of hormone intake of 31.4 months and a BMI of 23.8 kg/m². The subscales mental quality of life (QoL) (p < 0.001), physical QoL (p < 0.001), social QoL (p < 0.001) and the global sum score (p < 0.001) of the ETLI showed significantly different scores in the postoperative group compared to the preoperative group. Similarly, the mental component scale of the SF-36 (<0.001) and the Body-Q Chest Module 'chest' (< 0.001) and 'nipples' (< 0.001) were significantly increased in the group after mastectomy.</p><p><strong>Conclusion: </strong>The ETLI questionnaire is a viable tool to measure effects on the QoL and satisfaction with body image in transgender men, correlating with well-established scores.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"60 ","pages":"127-133"},"PeriodicalIF":1.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Corrigendum.","authors":"Paolo Marchica","doi":"10.2340/jphs.v60.41400","DOIUrl":"https://doi.org/10.2340/jphs.v60.41400","url":null,"abstract":"","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"60 ","pages":"134-137"},"PeriodicalIF":1.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Translation and evaluation of the Infant Characteristics Questionnaire in a sample of Swedish patients with craniosynostosis.","authors":"Johanna Kling, Lars Kölby, Marizela Kljajić","doi":"10.2340/jphs.v60.43488","DOIUrl":"https://doi.org/10.2340/jphs.v60.43488","url":null,"abstract":"<p><strong>Background: </strong>Research on the psychological development of infants with craniosynostosis would benefit from further properly validated tailored measures.</p><p><strong>Aim: </strong>Our study aimed to translate and evaluate the Infant Characteristics Questionnaire (ICQ; Bates et al., 1979) for use with parents of infants with craniosynostosis in Sweden.</p><p><strong>Methods: </strong>Participants included parents of 83 infants (67.5% boys) with isolated craniosynostosis (sagittal: n = 51, metopic: n = 32), and an average age of 184.7 days (SD = 67.1). Parents completed the ICQ and interviews were conducted with 22 of the families. The interviews were analyzed using conventional qualitative content analysis.</p><p><strong>Results: </strong>Reliability in terms of internal consistencies were sufficient for the overall scale (α = .85), the Fussy/Difficult (α = .80) and Unadaptable (α = .76) subscales, close to acceptable for the Unpredictable subscale (α = .66), and low for the Sociable subscale (α = .45). Parents found the ICQ relevant for capturing important aspects of their infants' temperament, and the instructions and questions easy to understand. However, many parents noted that the question regarding their child's first reaction to solid food was not applicable and some suggested adding more questions about sleeping difficulties.</p><p><strong>Conclusion: </strong>Overall, the ICQ seems to be acceptable to parents of children with craniosynostosis in Sweden - a prerequisite for continued use and development. Future studies should investigate additional psychometric properties, including factorial validity, to further establish its usefulness in Swedish populations, both with and without craniosynostosis.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"60 ","pages":"114-119"},"PeriodicalIF":1.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Måns Cornefjord, Karin Källén, Kristina Klintö, Mia Stiernman, Anna-Paulina Wiedel, Magnus Becker
{"title":"Birth prevalence of cleft lip and/or palate - a register study of all children born in Sweden years 2000-2020.","authors":"Måns Cornefjord, Karin Källén, Kristina Klintö, Mia Stiernman, Anna-Paulina Wiedel, Magnus Becker","doi":"10.2340/jphs.v60.43739","DOIUrl":"https://doi.org/10.2340/jphs.v60.43739","url":null,"abstract":"<p><p>This study investigated the birth prevalence of cleft lip and/or palate (CL/P) in Sweden between 2000 and 2020 using data from the Swedish National Medical Birth Register, which includes over 97% of children born in the country, and its subregister the National Register of Congenital Anomalies. The dataset included 2,230,771 anonymized children, with the variables year of birth, sex and diagnoses according to ICD-10. Computed variables were any CL/P diagnosis, cleft palate without cleft lip (CP), cleft lip with or without cleft palate (CL ± P), bilateral cleft lip with or without cleft palate (BCL ± P), unilateral cleft lip and palate (UCLP), bilateral cleft lip and palate (BCLP), and maternal smoking. Overall cleft birth prevalence was 1.52 / 1,000 births, with a yearly risk ratio of 0.989. Trends in the birth prevalences of different cleft types showed a decrease in CL ± P, BCL ± P, UCLP, and BCLP, while CP birth prevalence remained stable. CL/P, CL ± P, BCL ± P, UCLP, and BCLP were significantly more common in boys than girls, but the opposite was shown for CP. The overall birth prevalence was relatively coherent with previous findings, and the decreasing trend seemed to be attributable to the decreasing occurrence of visible clefts (CL ± P, BCL ± P, UCLP, and BCLP). Possible explanations for this are yet to be examined but could include better management of risk factors, demographic changes, or shifts in attitudes toward cleft pregnancy termination. The study provides reliable epidemiological data on CL/P, suggesting a decreasing birth prevalence and changing distribution of cleft types that may require future adjustments of cleft care protocols.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"60 ","pages":"120-126"},"PeriodicalIF":1.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rana Kapukaya, Gazi Kutalmış Yaprak, Asena Ayça Özdemir, Ahmet Kapukaya
{"title":"Medial gastrocnemius flap: infection control in megaprostheses.","authors":"Rana Kapukaya, Gazi Kutalmış Yaprak, Asena Ayça Özdemir, Ahmet Kapukaya","doi":"10.2340/jphs.v60.43537","DOIUrl":"https://doi.org/10.2340/jphs.v60.43537","url":null,"abstract":"<p><strong>Introduction: </strong>Medial gastrocnemius flaps are commonly employed in conjunction with endoprosthesis implantations for the management of malignant tumors affecting the proximal segment of the tibia. This study aimed to evaluate the effect of the routine transfer of the muscle on the incidence of infections within the surgical field.</p><p><strong>Methods: </strong>Forty-three patients presenting with a suspected malignant tumor in the proximal segment of the cruris underwent evaluation at our hospital. The enrolled patients were stratified into two cohorts. Patients in Group 1 (n = 16) underwent a combined procedure involving a medial gastrocnemius flap and a megaprosthesis, whereas patients in Group 2 (n = 17) did not undergo flap surgery.</p><p><strong>Results: </strong>In Group 1, osteosarcoma (OS) was diagnosed in seven patients (43%). Subsequently, oncologic resection with a wide margin was performed on the affected bone region, resulting in an average defect length of mean 12.81 ± 5.05 cm. The patients in this group were followed-up for an average duration of 34.06 ± 13.21 months. Similarly, in Group 2, OS was present in seven patients (41.17%), and they underwent identical oncologic resection procedures. The mean defect length in Group 2 was measured at mean 14.12 ± 4.54 cm. The average follow-up period for patients in Group 2 was 30.41 ± 12.06 months.</p><p><strong>Conclusion: </strong>Within Group 1, four patients (25%) experienced infections within the surgical site, while within Group 2, five patients (29.4%) exhibited such infections (p > 0.05). The utilization of megaprostheses in osseous defect repair, either alone or in combination with gastrocnemius flaps, did not yield statistically significant differences in infection rates.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"60 ","pages":"109-113"},"PeriodicalIF":1.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Péter Sallai, Barbara Sebők, Luca Hergár, Judit Réka Hetthéssy
{"title":"Trigger finger and carpal tunnel syndrome: a meta-analysis of co-occurrence and risk.","authors":"Péter Sallai, Barbara Sebők, Luca Hergár, Judit Réka Hetthéssy","doi":"10.2340/jphs.v60.43199","DOIUrl":"https://doi.org/10.2340/jphs.v60.43199","url":null,"abstract":"<p><p>Carpal tunnel syndrome (CTS) and trigger finger (TF) are two of the most common conditions of the hand. Co-occurrence is mentioned by a number of publications, but there are few high-level evidence studies that summarise the results of large databases to quantify the chances of concurrency in detail making it difficult to gauge clinical significance. We aimed to quantify the impact of CTS, TF and surgery for these conditions on the prevalence of the other condition. Systematic review based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, with registration in the PROSPERO database. TF is clearly more common with CTS and after CTS surgery, so it is important to seek out symptoms of TF, even the initial ones, at every examination performed for CTS. Thus, conservative treatment of TF maybe started in time and TF surgery may be performed in conjunction with CTS surgery. Level of Evidence: IV. Prospero registration number: CRD42022382672.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"60 ","pages":"102-108"},"PeriodicalIF":1.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peter Tarnow, Giovanni Maltese, Madiha Bhatti-Søfteland, Karin Säljö, Björn Holmström, Robert Olsson, Tobias Hallén, Lars Kölby
{"title":"Dynamic osteodistraction with springs - the Gothenburg experience of spring-assisted cranioplasty.","authors":"Peter Tarnow, Giovanni Maltese, Madiha Bhatti-Søfteland, Karin Säljö, Björn Holmström, Robert Olsson, Tobias Hallén, Lars Kölby","doi":"10.2340/jphs.v60.43315","DOIUrl":"https://doi.org/10.2340/jphs.v60.43315","url":null,"abstract":"<p><p>Surgical treatment of craniosynostosis includes a wide range of techniques. Although a variety of more extensive cranioplasties have been employed to enhance outcomes, efforts to identify less invasive surgical approaches with better results continue. Since the introduction of springs as a tool for craniosynostosis surgery in 1997 at Sahlgrenska University Hospital in Gothenburg, Sweden, several studies have established their utility as an efficient surgical method. Because springs are currently used in the majority of our surgeries addressing craniosynostosis in children, this review summarizes our extensive experience with this method in more than 750 surgeries.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"60 ","pages":"91-95"},"PeriodicalIF":1.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Uncovering the carbon cost: Environmental impact of free flap reconstruction procedures in the UK.","authors":"Benjamin Clay, Sandip Hindocha, Kavish Maheshwari","doi":"10.2340/jphs.v60.43375","DOIUrl":"https://doi.org/10.2340/jphs.v60.43375","url":null,"abstract":"<p><strong>Introduction: </strong>Free flap reconstruction procedures are renowned for their duration and the requirement for many staff and large quantities of equipment. This single-centre cross-sectional study aimed to quantify the total emissions related to two such procedures carried out at a district general hospital.</p><p><strong>Methods: </strong>One deep inferior epigastric perforator (DIEP) free flap procedure and one anterolateral thigh (ALT) free flap procedure, both carried out in February 2024, were analysed. Data related to staff transport, anaesthetic duration, mass of disposable equipment, quantity of reusable surgical equipment and consumption of electricity and heating for the relevant theatre areas were collected. Emissions were calculated using UK government conversion factors and classified by scope and contributory element as per the Greenhouse Gas Protocol.</p><p><strong>Results: </strong>Total emissions were estimated at 385.5 kgCO2eq for the DIEP and 369.6 kgCO2eq for the ALT. Scope 1 emissions related to heating, atmospheric release of general anaesthetic and incineration of waste accounted for 33.7% of DIEP emissions and 35.6% of ALT emissions. Scope 2 emissions related to the use of grid electricity accounted for 44.8% of DIEP emissions and 46.7% of ALT emissions. Scope 3 emissions related to staff transport, cleaning of reusable equipment and the supply chain for disposable equipment accounted for 21.5% of DIEP emissions and 17.7% of ALT emissions.</p><p><strong>Conclusion: </strong>Significant reductions in emissions may be achievable without significant infrastructural changes through initiatives to reduce staff transport by single-occupancy car, improving the energy efficiency of the theatre areas and reducing the use of single-use surgical equipment.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"60 ","pages":"96-101"},"PeriodicalIF":1.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Can artificial ıntelligence detect the anti-aging effect of rhinoplasty?","authors":"Muhammed Zeki Yalçın, Yuksel Toplu, Osman Kurt","doi":"10.2340/jphs.v60.43316","DOIUrl":"10.2340/jphs.v60.43316","url":null,"abstract":"<p><strong>Background: </strong>The quest for eternal youth has been a common theme in many cultures for centuries. While we have yet to discover a way to preserve youth eternally, we have made significant progress in understanding the aging process and in developing pharmaceuticals, surgical techniques, and technologies. In addition to rhinoplasty's facial beautification effect, we investigated whether it had a facial anti-aging effect using an artificial intelligence (AI)-based program. We also examined the correlation between patient satisfaction and the anti-aging effect of rhinoplasty.</p><p><strong>Methods: </strong>This study included 244 patients who underwent functional septorhinoplasty (FSRP) between January 2018 and August 2020 at Inonu University, Department of Otorhinolaryngology. Preoperative and postoperative photographs in our archive were evaluated using an AI-based age analysis program. In addition, the participants evaluated preoperative and postoperative nose satisfaction with the FACE-Q survey in the postoperative period.</p><p><strong>Results: </strong>One hundred two males (41.8%) and 142 females (58.2%) were included in the study. The mean preoperative age determined by the program was 25.9 ± 6.1, and the mean postoperative age was 25.7 ± 5.8. Despite the mean follow-up period of the patients was 25.3 ± 8.7 months, our study showed no significant difference between the mean preoperative and postoperative ages. The mean general satisfaction of the patients increased postoperatively. Conclusion: Despite the average follow-up period, the absence of a significant difference between preoperative and postoperative perceived mean age may be interpreted as a possible anti-aging effect of rhinoplasty. This effect was more prominent in older patients and in women.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"60 ","pages":"84-90"},"PeriodicalIF":1.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}