Journal of Plastic Surgery and Hand Surgery最新文献

{"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}

{"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}

{"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}

{"title":"Autologous and implant based immediate breast reconstructive trends following unilateral modified radical and radical mastectomy: a SEER database analysis.","authors":"Jian H Li, Stephen A Stearns, Angelica Hernandez Alvarez, Samuel J Lin","doi":"10.2340/jphs.v60.43198","DOIUrl":"10.2340/jphs.v60.43198","url":null,"abstract":"<p><p>Longitudinal trends in breast reconstruction after modified radical mastectomy remain under described. This study aims to assess procedural trends in autologous reconstruction (AR) and implant-based reconstruction (IBR), to analyse demographic shifts in these patients, and to examine differences in oncologic management. This retrospective study utilizes the Surveillance, Epidemiology, and End Results (SEER) database to investigate trends in immediate breast reconstruction from 2000 to 2020 following unilateral modified radical and radical mastectomy. Demographic and oncologic variables were collected, and reconstruction types were categorised as IBR, AR, or a combination. Subgroup analyses compared IBR and AR patients, and demographic changes between the 2000-2010 and 2010-2020 cohorts were examined. Chi-square tests in R studio were used for statistical analysis. Of the 25,649 patients, 51.8% underwent IBR and 48.2% AR. AR patients were typically younger, more frequently Black, had higher incomes, and were less likely to live in rural areas compared to IBR patients. A shift from AR to IBR was observed, with AR decreasing from 41.8% in 2000 to 24.5% in 2020. Significant demographic changes in AR patients included increased age, higher proportions of Black and Asian patients, reduced income, and increased non-marital status. Oncologic management differed, as AR patients were less likely to have received chemotherapy and radiation prior to their reconstruction, and experienced longer reconstruction times compared to IBR patients. This study highlights a decline in AR and rising IBR popularity, and reveals evolving patient characteristics. Understanding these trends is crucial for equitable access and informed decision-making in breast cancer reconstructive care.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"60 ","pages":"78-83"},"PeriodicalIF":1.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764212","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":"Nationwide rates of limited fasciectomy for Dupuytren's contracture: data from the Finnish National Registry.","authors":"Mikko Räisänen, Teemu Valtteri Karjalainen, Tuomas Tapani Huttunen, Ville Matti Mattila, Aleksi Rafael Reito, Olli Ville Leppänen, Janne Johannes Soikkeli, Jarkko Juhani Jokihaara","doi":"10.2340/jphs.v60.40569","DOIUrl":"https://doi.org/10.2340/jphs.v60.40569","url":null,"abstract":"<p><p>Dupuytren's contracture (DC) is often treated with limited fasciectomy (LF), while percutaneous treatment options are gaining popularity. The recent trends in the incidence rates of LF are not well known. Our study aimed to investigate the incidence rates of LF over time, and we collected nationwide data on all LF performed between January 1, 1997 and December 31, 2018. The main outcome variables were the incidence rates of first and subsequent LF for each patient per 100,000 person-years, calculated for each study year, gender, and age group. Data were obtained from the Finnish National Hospital Discharge Registry, which covers the entire population of Finland. Reporting to the registry is mandatory for all public and private hospitals, and the validity has been found to be excellent. All adult patients with a diagnosis code of M72.0 for DC and a surgical procedure code of NDM10 for LF were included in this study. The incidence rate of the first LF declined from 36.5 to 11.7, while the rate of subsequent LF increased from 2.3 to 14.0 from 1997 to 2011 and then declined to 9.3 in 2018. LF was performed significantly more often in men than in women (ratio 4:1). Additionally, it was performed significantly more often in patients between 60 and 79 years than in other age groups. Despite the estimated increase in the prevalence of DC, our data show that the incidence rate of first LF has declined, and there was no discernible consistent trend in the incidence of subsequent LF during the same period.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"60 ","pages":"71-77"},"PeriodicalIF":1.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142835","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":"The effect of muscle defect size on donor site hernia and bulge after transverse rectus abdominis flap.","authors":"Yumin Kim, Ji-Young Kim, Hak Chang","doi":"10.2340/jphs.v60.42961","DOIUrl":"10.2340/jphs.v60.42961","url":null,"abstract":"<p><strong>Background: </strong>Muscle sparing-transverse rectus abdominis flap has been widely used for breast reconstruction and the abdominal hernia or bulging at the donor site is relatively common complication. Previous studies have emphasized the fascial defects and the defect of muscle has been neglected. This study aims to investigate the relationship between the size of the rectus abdominis muscle defect and its impact on hernia or bulge formation after muscle sparing-transverse rectus abdominis flap.</p><p><strong>Materials and methods: </strong>A retrospective study of patients undergoing unilateral or bilateral breast reconstruction with muscle sparing-transverse rectus abdominis myocutaneous flap was performed. We compared the patient group with postoperative abdominal hernia or bulging requiring surgery with the patient group without hernia. The surgical specific data of the size of rectus abdominis muscle defect, muscle sparing type and flap weight are analyzed.  Results: We conducted a survey on a total of 160 patients, of which six patients experienced abdominal hernia or bulging requiring surgery. Comparing patient group requiring surgical treatment for hernia or bulging with patient group without hernia, there was a significant difference of the width of rectus abdominis muscle defect. The cut-off value of the width was 4.5 cm.  Conclusion: When performing MS-TRAM, minimizing the resection of rectus abdominis muscle remains crucial, especially the horizontal width.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"60 ","pages":"67-70"},"PeriodicalIF":1.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663757","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":"Moving beyond surgical excellence: a qualitative systematic review into the perspectives and experiences of children, adolescents, and adults living with a rare congenital craniofacial condition and their parents.","authors":"Mariët Faasse, Hester M van de Bovenkamp, Karolijn Dulfer, Virginie Kauffman, Ivana Marinac, Veronica Leonardi, Gareth Davies, Philippe Pakter, Jana Angelova, Karen Wilkinson-Bell, Lars Kölby, Marizela Kljajić","doi":"10.2340/jphs.v60.42953","DOIUrl":"10.2340/jphs.v60.42953","url":null,"abstract":"<p><p>This qualitative systematic review aims to get a better understanding of what it means to live with a rare congenital craniofacial condition according to patients and their parents. Eight patient representatives provided input to this study. After a systematic search, 1,291 studies were screened and 32 qualitative and mixed methods articles (> 691 participants) were included. ENhancing Transparency in REporting the synthesis of Qualitative research (ENTREQ), Cochrane, and COnsolidated criteria for REporting Qualitative research (COREQ) checklists were used for reporting qualitative evidence synthesis and assessment of reporting of included studies. Studies predominantly included parents' perspectives and used mixed samples of diagnosis and sometimes combined the parent and patient perspectives. The results sections of the articles were analyzed inductively using Thematic Synthesis (i.e. line-by-line coding, generating descriptive and analytical themes). Five analytical themes were identified that describe experiences and perspectives: (1) Healthcare experiences, (2) Raising and Growing up, (3) Development of character, (4) Physical impact of the condition, and (5) Social experiences. Underlying themes illustrate that the different aspects throughout life are intertwined, that relationships in all different domains play an important role in shaping perspectives, and that experiences may change over time. Furthermore, it demonstrates that living with a craniofacial condition and undergoing treatment is multifaceted and that the perspectives of patients and parents may differ. In conclusion, well-being and quality of life of patients and their parents are dependent on many different aspects, and surgeons and other healthcare professionals should tailor their skills, expertise, and support to individual-specific needs besides medical indications and move beyond surgical excellence.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"60 ","pages":"51-66"},"PeriodicalIF":1.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492514","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":"Prevalence and treatment outcomes of hydrocephalus among children with craniofacial syndromes.","authors":"Saga Jönsson, Daniel Nilsson, Peter Tarnow, Giovanni Maltese, Madiha Bhatti-Søfteland, Lars Kölby, Tobias Hallén","doi":"10.2340/jphs.v60.42957","DOIUrl":"10.2340/jphs.v60.42957","url":null,"abstract":"<p><strong>Introduction: </strong>Hydrocephalus is more common in patients with craniofacial syndromes (CS) relative to non-syndromic craniosynostosis, and the optimal management is challenging. This study examined the prevalence and treatment outcomes of hydrocephalus among children with CS.</p><p><strong>Materials and methods: </strong>We performed a retrospective review of medical records for all children with established CS and registered in the Gothenburg Craniofacial Registry between 1975 and 2022. This review included analyses of data regarding patient demographics, radiological imaging, hydrocephalus treatment modalities, and shunt revisions.</p><p><strong>Results: </strong>Eligible patients (n = 193) included those with CS, including Pfeiffer (n = 13), Crouzon (n = 57), Apert (n = 49), Muenke (n = 25), and Saethre-Chotzen (n = 49) syndromes. A total of 22 patients (11.4%) presented hydrocephalus requiring treatment [Pfeiffer, n = 8 (61.5%); Crouzon, n = 13 (22.8%); and Apert, n = 1 (2.0%)]. Nineteen (9.8%) patients underwent ventricular shunt insertion, and three (1.6%) underwent endoscopic third ventriculostomy as a first procedure. None of the Muenke or Saethre-Chotzen patients required hydrocephalus treatment. Seventeen (85%) patients with shunts required revision mainly due to shunt obstruction. Pfeiffer patients had the highest risk of both developing hydrocephalus requiring treatment and needing shunt revision (p < 0.001 and p = 0.004, respectively). Approximately 40% of patients with Pfeiffer, Crouzon, or Apert presented ventriculomegaly not requiring treatment.</p><p><strong>Conclusions: </strong>Hydrocephalus requiring treatment is common in Pfeiffer and Crouzon patients but rare in Apert, Muenke, or Saethre-Chotzen syndrome. Shunt treatment is often associated with complications that require revisions, emphasizing the importance of distinguishing non-progressive ventriculomegaly from hydrocephalus requiring treatment.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"60 ","pages":"40-45"},"PeriodicalIF":1.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458415","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}