Journal of Plastic Surgery and Hand Surgery最新文献_第2页

Optimizing localization accuracy in peroneal artery perforator sequential flap transplantation with digital subtraction angiography and high-frequency ultrasound. 数字式减影血管造影和高频超声在腓动脉穿支序贯皮瓣移植中的定位精度优化。

IF 1 4区医学

Journal of Plastic Surgery and Hand Surgery Pub Date : 2025-02-20 DOI: 10.2340/jphs.v60.42954

Yong-Pei Chen, Hai-Yan Zhong, Rui Yang, Ming-Li Zou, Qian Wang, Yong Chen, Min Wang, Si-Ming Yuan

{"title":"Optimizing localization accuracy in peroneal artery perforator sequential flap transplantation with digital subtraction angiography and high-frequency ultrasound.","authors":"Yong-Pei Chen, Hai-Yan Zhong, Rui Yang, Ming-Li Zou, Qian Wang, Yong Chen, Min Wang, Si-Ming Yuan","doi":"10.2340/jphs.v60.42954","DOIUrl":"10.2340/jphs.v60.42954","url":null,"abstract":"The peroneal artery perforator flap is widely used to repair deep defects in the distal lower leg and ankle. However, the success of flap transplantation depends on the accurate location of the peroneal artery perforators, which can be a challenge due to potential vascular damage and anatomical variations. This study utilizes digital subtraction angiography and high-frequency ultrasound to clarify the anatomical features of the peroneal artery and its perforators and accurately locate these perforators, thereby improving preoperative design and clinical outcomes. Peroneal artery perforator sequential flaps were employed to repair the wounds and donor sites, with the second donor site sutured directly. A total of 36 peroneal artery perforators were identified in seven patients, with an average of 5.14 perforators per patient. The majority of these perforators (47.22%) were concentrated in the middle segment of the lower leg. All flaps underwent tension-free primary closure and survived successfully, presenting a smooth appearance, a fine texture, and a color similar to that of the surrounding skin. Only a linear scar was left in the secondary donor site, which did not affect the overall appearance of the limb. This technique can accurately localize peroneal artery perforators, optimize the design of peroneal artery perforator sequential flaps, and facilitate the success of the surgery and postoperative esthetic recovery.","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"60 ","pages":"46-50"},"PeriodicalIF":1.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458414","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}

引用次数: 0

Anatomical study of vulnerable sensory and expendable motor nerves for targeted muscle reinnervation in the upper extremity. 上肢肌肉再神经植入术中易损感觉神经和消耗性运动神经的解剖学研究。

IF 1 4区医学

Journal of Plastic Surgery and Hand Surgery Pub Date : 2025-02-13 DOI: 10.2340/jphs.v60.42655

Kawamura Kenji, Hideo Hasegawa, Shohei Omokawa, Pasuk Mahakkanukrauh, Yasuhito Tanaka

{"title":"Anatomical study of vulnerable sensory and expendable motor nerves for targeted muscle reinnervation in the upper extremity.","authors":"Kawamura Kenji, Hideo Hasegawa, Shohei Omokawa, Pasuk Mahakkanukrauh, Yasuhito Tanaka","doi":"10.2340/jphs.v60.42655","DOIUrl":"10.2340/jphs.v60.42655","url":null,"abstract":"Purpose: Targeted muscle reinnervation (TMR) is a new technique for treating symptomatic neuroma, in which a sensory nerve after resection of a painful neuroma is coapted to an expendable motor nerve. There has been little information about optimal motor nerves for TMR of the vulnerable sensory nerves in the upper extremity.Methods: Fourteen upper extremities of fresh-frozen cadavers were dissected to describe the anatomical course of the vulnerable sensory nerves, which included the superficial radial nerve, the dorsal branch of the ulnar nerve, and the medial and lateral antebrachial cutaneous nerves. The bifurcation, diameter, and entry points in muscles of expendable motor nerves suitable for TMR of the sensory nerves were investigated.Results: The distal anterior interosseus nerve was available as a donor for TMR of the superficial radial nerve and the dorsal branch of the ulnar nerve in the distal third of the forearm. The motor branch to the pronator teres muscle was suitable for TMR of the medial antebrachial cutaneous nerve. It was possible to transfer the lateral antebrachial cutaneous nerve to the motor branch of the brachioradialis or extensor carpi radialis longus muscles.Conclusions: The results of this anatomical study provide useful information when TMR is applied for neuromas of the sensory nerves in the upper extremity.","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"60 ","pages":"35-39"},"PeriodicalIF":1.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408642","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}

引用次数: 0

Collagenase clostridium histolyticum for Dupuytren's disease: a comprehensive systematic review and comparative analysis against percutaneous needle aponeurotomy and limited fasciectomy. 胶原酶溶组织梭菌治疗Dupuytren病：一项全面的系统综述和经皮针刺肌腱神经切开术和有限筋膜切除术的比较分析。

IF 1 4区医学

Journal of Plastic Surgery and Hand Surgery Pub Date : 2025-02-13 DOI: 10.2340/jphs.v60.42750

Jevan Cevik, Rohan Rajaram, Michaela Pollock, Ishith Seth, Warren M Rozen

{"title":"Collagenase clostridium histolyticum for Dupuytren's disease: a comprehensive systematic review and comparative analysis against percutaneous needle aponeurotomy and limited fasciectomy.","authors":"Jevan Cevik, Rohan Rajaram, Michaela Pollock, Ishith Seth, Warren M Rozen","doi":"10.2340/jphs.v60.42750","DOIUrl":"10.2340/jphs.v60.42750","url":null,"abstract":"This systematic review compared the efficacy of collagenase clostridium histolyticum (CCH) against percutaneous needle aponeurotomy (PNA) and limited fasciectomy (LF) for Dupuytren's contracture. Searches were conducted in PubMed, Embase, and Web of Science databases to March 2024. Randomised controlled trials (RCTs) were included. Primary outcomes included successful contracture correction as defined by included studies. Secondary outcomes included recurrence rates, patient-reported outcomes, and adverse events. A total of 11 studies (969 patients) were included. Meta-analysis showed no difference in efficacy between CCH and PNA (Relative Risk [RR]: 1.01, 95% Confidence Interval [CI]: 0.93-1.09). Recurrence rates were also similar (RR: 1.18, 95% CI: 0.95-1.48). Data suggested higher recurrence risk with CCH versus LF (RR: 6.84, 95% CI: 1.59-29.48). In some studies, CCH was associated with higher rates of haematoma, local pain, and oedema. CCH demonstrates comparable efficacy to PNA; however, it may have a higher risk of local complications and recurrence compared to LF. Treatment decisions should be made on a case-by-case basis.","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"60 ","pages":"27-34"},"PeriodicalIF":1.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408654","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}

引用次数: 0

An evaluation of the scapular osseous free flap in maxillary reconstruction using the FACE-Q Head and Neck Cancer Module for patient-reported outcome measures. 使用 FACE-Q 头颈部癌症模块评估上颌骨重建中的肩胛骨骨性游离皮瓣患者报告结果。

IF 1 4区医学

Journal of Plastic Surgery and Hand Surgery Pub Date : 2025-01-28 DOI: 10.2340/jphs.v60.42699

Henrik Guné, Johanna Sjövall, Magnus Becker, Stina Klasson

{"title":"An evaluation of the scapular osseous free flap in maxillary reconstruction using the FACE-Q Head and Neck Cancer Module for patient-reported outcome measures.","authors":"Henrik Guné, Johanna Sjövall, Magnus Becker, Stina Klasson","doi":"10.2340/jphs.v60.42699","DOIUrl":"10.2340/jphs.v60.42699","url":null,"abstract":"Introduction: Health-related quality of life (HR-QoL) outcomes following maxillary reconstruction with the scapular osseous free flap (SOFF) are lacking. Material and Methods: To determine these outcomes, a study of patients who completed maxillary reconstruction with flap survival of the SOFF between 2016 and 2023 was conducted, using Face-Q Head and Neck Cancer Module (FACE-Q).Results: Eligible patients had at least six months of follow-up. Twenty questionnaires were completed (100% response rate). Median age was 59 years, 80% were male, and 90% were being treated for malignant disease. Overall, best scores were reported in the facial appearance and experience of care domain. Furthermore, the worst scores were reported in the facial function domain. Subgroup analysis focused on the following three specific surgical outcomes; dental rehabilitation, oronasal fistula and eye-related problems. A better score, though non-significant, in facial function was recorded in the dental rehabilitation group, (70±23 vs. 40±34, p = 0.089). A tendency towards worse facial function regarding eating and drinking was noted in the fistula group (49±14 vs. 56±23, p = 0.468). Patients suffering from eye-related problems reported marginally worse facial appearance scores, (79±21 vs. 68±19, p = 0.289).Conclusion: In 20 patients who completed maxillary reconstruction with flap survival of the SOFF, the group reported the best scores in the facial appearance and experience of care domain.","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"60 ","pages":"21-26"},"PeriodicalIF":1.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052862","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}

引用次数: 0

A reliable and objective method of measuring soft tissue changes in 2D photographs after distraction osteogenesis in individuals with CL/P. 一种可靠、客观的测量CL/P患者牵张成骨后二维照片软组织变化的方法。

IF 1 4区医学

Journal of Plastic Surgery and Hand Surgery Pub Date : 2025-01-28 DOI: 10.2340/jphs.v60.40580

Annika Bergendal Sterner, Henry Svensson, Magnus Becker, Farokh Collander Farzaneh, Anna-Paulina Wiedel

{"title":"A reliable and objective method of measuring soft tissue changes in 2D photographs after distraction osteogenesis in individuals with CL/P.","authors":"Annika Bergendal Sterner, Henry Svensson, Magnus Becker, Farokh Collander Farzaneh, Anna-Paulina Wiedel","doi":"10.2340/jphs.v60.40580","DOIUrl":"10.2340/jphs.v60.40580","url":null,"abstract":"Pre- and postoperative photos to assess results are widely used in plastic and reconstructive surgery, for instance, in patients with cleft lip and palate (CL/P). Evaluations are often performed by assessment panels by viewing the photos. However, these are prone to be subjective. Measurements of soft tissues in photos could be an alternative method but have not been widely used so far. Some patients with CL/P develop a retrognathic maxilla in adolescence, with ensuing Class III malocclusion. In severe cases, distraction osteogenesis (DO) of the maxilla may be indicated. The effect of DO on the facial soft tissues is sparsely reported, perhaps due to the rare procedure. The primary aim of the present study is to provide a reliable and objective method of measuring soft tissue profiles in two-dimensional digital photos. Furthermore, the study aims at assessing changes in soft tissues following DO. Fourteen patients who had undergone DO at our unit were recruited. Preoperative and postoperative photos were identified, and long-term follow-up photos were taken. Three raters performed measurements of four angles and two distances. Inter- and intra-rater reliability and soft tissue changes were analyzed statistically. Inter- and intra-rater reliability was high overall for most variables. Two angles related to facial convexity changed significantly. So did the upper lip height. Soft tissues can be measured with a high degree of accuracy, but further evaluation of the method is necessary. DO causes a favorable increase in facial convexity, and an increased upper lip height.","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"60 ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052936","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}

引用次数: 0

Arthroscopic-assisted total wrist arthrodesis: surgical design and clinical outcomes. 关节镜辅助全腕关节融合术：手术设计和临床结果。

IF 1 4区医学

Journal of Plastic Surgery and Hand Surgery Pub Date : 2025-01-28 DOI: 10.2340/jphs.v60.42751

Fengchi Sun, Yuchen Liu, Shuai Zhu, Xiangmeng Su, Siwei Xu, Huawei Yin, Wendong Xu, Yundong Shen

{"title":"Arthroscopic-assisted total wrist arthrodesis: surgical design and clinical outcomes.","authors":"Fengchi Sun, Yuchen Liu, Shuai Zhu, Xiangmeng Su, Siwei Xu, Huawei Yin, Wendong Xu, Yundong Shen","doi":"10.2340/jphs.v60.42751","DOIUrl":"10.2340/jphs.v60.42751","url":null,"abstract":"Introduction: This study presents an innovative arthroscopy-assisted total wrist arthrodesis technique utilising three hollow screws, aimed at improving clinical outcomes for patients with severe wrist arthritis.Materials and methods: The technique involved the placement of three hollow screws to facilitate wrist bone fusion. Between August 2019 and August 2023, four patients diagnosed with severe wrist arthritis underwent the arthroscopy-assisted procedure. Each patient was followed postoperatively for at least 1 year. Clinical evaluations included the Visual Analogue Scale (VAS), the Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) questionnaire, and the Patient-Rated Wrist Evaluation (PRWE). Radiographic imaging was performed to confirm successful bone fusion. Postoperative complications and scar length were also recorded.Results: At the final follow-up, all patients exhibited decreased scores on the VAS, Quick DASH, and PRWE assessments, indicating reduced pain and improved wrist function. Radiographic imaging confirmed successful wrist bone fusion. No major complications arose, with an average scar length of 2.8 cm.Conclusion: The novel arthroscopy-assisted total wrist arthrodesis technique offers a simple and minimally invasive method that effectively improves joint function and alleviates pain in patients with severe wrist arthritis, while reducing the risk of complications.","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"60 ","pages":"13-20"},"PeriodicalIF":1.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052863","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}

引用次数: 0

Clinical presentation of hemifacial microsomia in a South African population. 南非人群中面肌短小症的临床表现。

IF 1 4区医学

Journal of Plastic Surgery and Hand Surgery Pub Date : 2025-01-21 DOI: 10.2340/jphs.v60.42402

Peterson M Atiba, Anil Madaree, Lelika Lazarus

{"title":"Clinical presentation of hemifacial microsomia in a South African population.","authors":"Peterson M Atiba, Anil Madaree, Lelika Lazarus","doi":"10.2340/jphs.v60.42402","DOIUrl":"10.2340/jphs.v60.42402","url":null,"abstract":"Background: Hemifacial microsomia (HFM) presentation includes gross distorted ramus, malposition temporomandibular joint, small glenoid fossa, distorted condyle and notch, malformed orbit, cupping ear or absent external ear, and facial nerve palsy. HFM is the second most prevalent congenital deformity of the face, with little literature from the South African population. This retrospective study elucidated the demographic characteristics and clinical presentations of HFM patients in a select South African population and compared it to the literature. Methods: A retrospective study of HFM patients diagnosed through clinical presentation and confirmed by plain radiograph or computed tomography was conducted. The patient's charts were reviewed for age, sex, laterality, side, the severity of the deformity, and associated craniofacial and extra-craniofacial anomalies. The clinical presentation of malformations was categorised according to the OMENS classification, using five major craniofacial manifestations of HFM.Results: Twenty-five patients were included, with a male-to-female ratio of 1:1.78. The population distribution is 60% Black, 32% Indian, 4% White and 4% Coloured. A right-to-left laterality ratio of 1.4:1 and 4% bilateral affectation. This study showed 100% mandibular hypoplasia, 84% ear deformity, 40% orbital deformity, 60% facial nerve defect and 100% soft tissue defect affectation with noticeable facial asymmetry. Other craniofacial anomalies were recorded in 84%, while extracraniofacial anomalies were recorded in 40% of this HFM population.Conclusion: There is a high degree of variability in the deformities in HFM in the South African population, distinguishing it from the international population. A multidisciplinary approach is required for its treatment and management.","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"60 ","pages":"1-6"},"PeriodicalIF":1.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007121","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}

引用次数: 0

Variations in orbital morphology, globe:orbit volume relation, and ophthalmological outcome in unicoronal synostosis. 单冠状结膜闭锁的眼眶形态、球体：眼眶体积关系和眼科结果的变化。

IF 1 4区医学

Journal of Plastic Surgery and Hand Surgery Pub Date : 2024-12-12 DOI: 10.2340/jphs.v59.42322

Hanna M Lif, Evangelia Ntoula, Eva Larsson, Daniel J Nowinski

{"title":"Variations in orbital morphology, globe:orbit volume relation, and ophthalmological outcome in unicoronal synostosis.","authors":"Hanna M Lif, Evangelia Ntoula, Eva Larsson, Daniel J Nowinski","doi":"10.2340/jphs.v59.42322","DOIUrl":"https://doi.org/10.2340/jphs.v59.42322","url":null,"abstract":"Nonsyndromic unicoronal synostosis is associated with variability of severity in orbital morphology and ophthalmological manifestations. The relation between the two is not fully understood, nor how surgical treatment with fronto-orbital advancement and remodelling (FOAR) changes the relation. The aim of this study was to elucidate associations between ophthalmological manifestations and variations in orbital morphology and globe:orbit volume ratios preoperatively and at long-term follow-up after surgery. Twelve children referred to Uppsala Craniofacial Center who underwent computed tomography and standardized ophthalmological examinations regarding strabismus, spherical equivalent, astigmatism, anisometropia, and subnormal vision preoperatively and at 3 years of age were included. Orbits and globes were segmented. Principal component analysis elucidated morphological variation, and symmetry between orbital pairs was measured as the Dice similarity coefficient and globe:orbit volume ratios were calculated. The defined orbital shape variations were correlated with strabismus, refractive error, and subnormal vision. Different shape variations were associated with strabismus pre- and postoperatively and ipsi- and contralateral astigmatism. Greater improvement in orbital symmetry after surgery was associated with improvement in astigmatic anisometropia and new onset strabismus at follow-up. A small globe:orbit volume ratio was associated with preoperative strabismus, while the opposite was seen at follow-up. Different mechanisms seem to cause strabismus pre- and postoperatively, and FOAR might not sufficiently correct orbital morphology.","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"59 ","pages":"162-170"},"PeriodicalIF":1.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813533","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}

引用次数: 0

Translation and validation of the Swedish version of the Appearance Schemas Inventory-Revised and investigation of the modified three subscale structure in patients undergoing breast reconstruction. 翻译和验证瑞典语版的 "外貌模式清单-修订版"，并对接受乳房再造的患者进行经修改的三分量表结构调查。

IF 1 4区医学

Journal of Plastic Surgery and Hand Surgery Pub Date : 2024-11-27 DOI: 10.2340/jphs.v59.42324

Linn Weick, Carolina Lunde, Emma Hansson

{"title":"Translation and validation of the Swedish version of the Appearance Schemas Inventory-Revised and investigation of the modified three subscale structure in patients undergoing breast reconstruction.","authors":"Linn Weick, Carolina Lunde, Emma Hansson","doi":"10.2340/jphs.v59.42324","DOIUrl":"https://doi.org/10.2340/jphs.v59.42324","url":null,"abstract":"Breast cancer can lead to changes in appearance and subsequent concerns about body image. This study aimed to translate the body investment instrument, Appearance Schemas Inventory-Revised (ASI-R), to Swedish, and perform a validation in women who underwent mastectomy and were awaiting breast reconstruction. The instrument was translated, and its psychometric properties were investigated according to current guidelines. Three hundred and ninety-seven women were eligible for the study, and 215 (54%) participants responded. An exploratory factor analysis (EFA) revealed that a three-factor structure was the most adequate solution. Three new subscales were suggested: body image investment cognition; breast and body image investment emotions; breast reflecting dysfunctional cognitive and emotional patterns of appearance investment and body image investment behaviors; breast reflecting positive ways of investing in body image. Consistent with previous findings, control over appearance is a central theme in women with breast cancer undergoing mastectomy and reconstruction. The obtained factor structure was considered similar to the original structure and three-factor solutions obtained from an American cohort of patients with breast cancer. The ASI-R has shown good psychometric properties in Swedish women undergoing mastectomy and reconstruction. Further studies on convergent validity and confirmatory factor analysis are required.","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"59 ","pages":"153-161"},"PeriodicalIF":1.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729415","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}

引用次数: 0

Staged dissection reduces blood loss in surgery for metopic synostosis. 分阶段剥离可减少偏头合骨术的失血量。

IF 1 4区医学

Journal of Plastic Surgery and Hand Surgery Pub Date : 2024-11-12 DOI: 10.2340/jphs.v59.42160

Anna Sundelin, Madiha Bhatti-Søfteland, Ingrid Stubelius, Tobias Hallén, Robert Olsson, Giovanni Maltese, Peter Tarnow, Karin Säljö, Lars Kölby

{"title":"Staged dissection reduces blood loss in surgery for metopic synostosis.","authors":"Anna Sundelin, Madiha Bhatti-Søfteland, Ingrid Stubelius, Tobias Hallén, Robert Olsson, Giovanni Maltese, Peter Tarnow, Karin Säljö, Lars Kölby","doi":"10.2340/jphs.v59.42160","DOIUrl":"https://doi.org/10.2340/jphs.v59.42160","url":null,"abstract":"Introduction: Fronto-orbital remodelling for metopic synostosis is an extensive operation with substantial blood loss, particularly from emissary veins in the glabellar region. One possibility to reduce blood loss may be to stage dissection and cauterise anomalous emissary veins before dissecting in the subperiostal plane. OBJECTIVE: The aim of the present study was to compare perioperative bleeding using a staged dissection in the glabellar region with the traditional subperiostal dissection technique during surgery for metopic synostosis.Methods: All consecutive patients operated for metopic synostosis with the new staged dissection technique (T2) were included. For comparison, the most recent equal number of cases operated with the traditional dissection technique (T1) were included. Age, sex, weight, surgical technique (spring or bone graft), perioperative blood loss, perioperative blood pressure, per- and postoperative blood transfusion, operation time and length of hospital stay were registered. RESULTS: A total of 80 patients were included; 40 T1 and 40 T2, respectively. Perioperative blood loss was significantly reduced with the new staged dissection technique. Blood loss in absolute numbers was reduced from 160.0 (120-240) (median and (interquartile range)) ml to 150 (102.5-170.0) ml, p=0.028. Blood loss in relation to patient weight was reduced from 24.2 ml/kg (15.3-33.3) to 18.7 (16.6-23.1) ml/kg, p=0.024. As percentage of total blood volume, blood loss was reduced from 32.3 (20.3-32.3) % to 29.9 (18.4-30.8) %, p=0.024. No other variables differed significantly between the techniques. CONCLUSION: In summary, staged dissection technique in the glabellar region, allowing control of the emissary veins, reduces perioperative blood loss during surgery for metopic synostosis.","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"59 ","pages":"146-152"},"PeriodicalIF":1.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622675","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}

引用次数: 0