Journal of Plastic Surgery and Hand Surgery最新文献

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The impact of regional anesthesia on opioid demand in distal radius fracture surgery. 区域麻醉对桡骨远端骨折手术中阿片类药物需求的影响。
IF 1.2 4区 医学
Journal of Plastic Surgery and Hand Surgery Pub Date : 2023-02-01 DOI: 10.1080/2000656X.2022.2070178
Daniel Cunningham, Micaela LaRose, Tori Kinamon, Elle MacAlpine, Sandra Au, Ariana Paniagua, Christopher Klifto, Mark J Gage
{"title":"The impact of regional anesthesia on opioid demand in distal radius fracture surgery.","authors":"Daniel Cunningham,&nbsp;Micaela LaRose,&nbsp;Tori Kinamon,&nbsp;Elle MacAlpine,&nbsp;Sandra Au,&nbsp;Ariana Paniagua,&nbsp;Christopher Klifto,&nbsp;Mark J Gage","doi":"10.1080/2000656X.2022.2070178","DOIUrl":"https://doi.org/10.1080/2000656X.2022.2070178","url":null,"abstract":"<p><strong>Purpose: </strong>Regional anesthesia (RA) is commonly used in distal radius fracture surgery to reduce pain and opioid consumption. The purpose of this study was to evaluate the real-world impact of RA on inpatient and outpatient opioid consumption and demand in patients undergoing distal radius fracture surgery.</p><p><strong>Methods: </strong>All patients ages 18 and older undergoing distal radius fracture surgery between 7/2013 and 7/2018 at a single institution (<i>n</i> = 969) were identified. Inpatient opioid consumption and outpatient opioid prescribing in oxycodone 5-mg equivalents (OE's) up to 90-d post-operative were recorded for patients with and without RA. Adjusted models were used to evaluate the impact of RA on opioid outcomes.</p><p><strong>Results: </strong>Adjusted models demonstrated decreases in inpatient opioid consumption in patients with RA (10.7 estimated OE's without RA <i>vs.</i> 7.6 OE's with RA from 0 to 24 h post-op, 10.2 <i>vs.</i> 5.3 from 24 to 48 h post-op and 7.5 <i>vs.</i> 5.0 from 48 to 72 h post-op, <i>p</i><.05). Estimated cumulative outpatient opioid demand was significantly higher in patients with RA (65.3 OE's without RA <i>vs.</i> 81.0 with RA from 1-month pre-op to 2-week post-discharge, 76.1 <i>vs.</i> 87.7 OE's to 6-weeks, and 80.8 <i>vs.</i> 93.5 OE's to 90-d, all <i>p</i> values for RA <.05) though rates of refill were significantly lower in patients with RA from 2-week to 6-week post-op compared to patients without RA.</p><p><strong>Conclusions: </strong>Patients undergoing RA in distal radius fracture surgery had decreased inpatient opioid consumption but increased outpatient demand after adjustment for patient and operative characteristics.</p><p><strong>Level of evidence: </strong>Level III, retrospective, therapeutic cohort study.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"57 1-6","pages":"299-307"},"PeriodicalIF":1.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10853329","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: 1
Outcomes of perineal wound closure techniques after abdominoperineal resections in rectal cancer: an NSQIP propensity score matched study. 直肠癌腹会阴切除术后会阴伤口闭合技术的结果:一项NSQIP倾向评分匹配研究。
IF 1.2 4区 医学
Journal of Plastic Surgery and Hand Surgery Pub Date : 2023-02-01 DOI: 10.1080/2000656X.2022.2144333
Jose L Cataneo, Sydney A Mathis, Diana D Del Valle, Alejandra M Perez-Tamayo, Anders F Mellgren, Gerald Gantt, Lee W T Alkureishi
{"title":"Outcomes of perineal wound closure techniques after abdominoperineal resections in rectal cancer: an NSQIP propensity score matched study.","authors":"Jose L Cataneo,&nbsp;Sydney A Mathis,&nbsp;Diana D Del Valle,&nbsp;Alejandra M Perez-Tamayo,&nbsp;Anders F Mellgren,&nbsp;Gerald Gantt,&nbsp;Lee W T Alkureishi","doi":"10.1080/2000656X.2022.2144333","DOIUrl":"https://doi.org/10.1080/2000656X.2022.2144333","url":null,"abstract":"<p><p>Perineal defects following abdominoperineal resections (APRs) for rectal cancer may require myocutaneous or omental flaps depending upon anatomic, clinical and oncologic variables. However, studies comparing their efficacy have shown contradictory results. We aim to compare postoperative complication rates of APR closure techniques in rectal cancer using propensity score-matching. The American College of Surgeons Proctectomy Targeted Data File was queried from 2016 to 2019. The study population was defined using CPT and ICD-10 codes for patients with rectal cancer undergoing APR, stratified by repair technique. Perioperative demographic and oncologic variables were controlled for by propensity-score matching. Multivariate logistic regression analysis was performed for wound and major complications (MCs). Of the 3291 patients included in the study, 85% underwent primary closure (PC), 8.3% rectus abdominis myocutaneous (RAM) flap, 4.9% pedicled omental flap with PC, and 1.9% lower extremity (LE) flap repair. Primary closure rates were significantly higher for patients with stage T1 and T2 tumors (<i>p</i> < 0.001). RAM and LE flaps were most used with multi-organ resections, 24% and 25%, respectively (<i>p</i> < 0.001). Similarly, cases with T4 tumors used these flaps more frequently, 30% and 40%, respectively (<i>p</i> < 0.001). After propensity score matching for comorbidities and oncologic variables, there was no significant difference in 30-day postoperative wound or MC rates between perineal closure techniques. The complication rates of the different closure techniques are comparable when tumor stage is considered. Therefore, tumor staging and concurrent procedures should guide clinical decision making regarding the appropriate use of each technique.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"57 1-6","pages":"399-407"},"PeriodicalIF":1.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10854833","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
Comparison of total anastomosis time between four different combinations of suturing and knot tying techniques in microsurgical anastomosis. 四种不同缝合打结技术在显微外科吻合中的总吻合时间比较。
IF 1.2 4区 医学
Journal of Plastic Surgery and Hand Surgery Pub Date : 2023-02-01 DOI: 10.1080/2000656X.2022.2052083
Gokhan Sert, Dicle Aksoyler, Murat Kara, Alberto Bolletta, Luigi Losco, Sefa Burak Cam, Petek Korkusuz, Hung-Chi Chen
{"title":"Comparison of total anastomosis time between four different combinations of suturing and knot tying techniques in microsurgical anastomosis.","authors":"Gokhan Sert,&nbsp;Dicle Aksoyler,&nbsp;Murat Kara,&nbsp;Alberto Bolletta,&nbsp;Luigi Losco,&nbsp;Sefa Burak Cam,&nbsp;Petek Korkusuz,&nbsp;Hung-Chi Chen","doi":"10.1080/2000656X.2022.2052083","DOIUrl":"https://doi.org/10.1080/2000656X.2022.2052083","url":null,"abstract":"<p><strong>Background: </strong>Various techniques have been described for performing microsurgical anastomosis with providing high patency rates. Although the total anastomotic time may not be an issue when dealing with a single set of anastomoses, using a faster technique may save significant amount of time in cases of transferring flaps with shorter critical ischemia time or where multiple anastomoses are required. This study compares the total anastomosis time between four different combinations of commonly used suturing and knot tying techniques.</p><p><strong>Methods: </strong>Twenty-four rats were divided into 4 groups. Simple interrupted suture with conventional knot tying technique (SIS-CT) was used in group I, continuous suture technique with conventional knot tying (CST) was used in group II, simple interrupted suture with airborne knot tying technique(SIS-AT) was used in group III, and continuous-interrupted suture with airborne knot tying technique(CIS-AT) was used in group IV for microsurgical anastomosis. Total anastomosis time and patency rates with each technique and samples from anastomotic sites were analyzed.</p><p><strong>Results: </strong>The mean time required for microvascular anastomosis of the femoral artery was 1075 s in group I, 799 s in group II, 844 s in group III, and 973 s in group IV. The difference between four groups was statistically significant. The anastomoses in group II and group III were completed in the shortest period of time. Intergroup comparison revealed that the difference between group II and group III was not statistically significant, however, total anastomosis time for completion of the anastomosis was significantly longer for group I, followed by group IV. Thrombosis rates and histological analysis revealed no significant differences among four groups.</p><p><strong>Conclusion: </strong>CST and SIS-AT techniques can significantly reduce microsurgical anastomosis time and provide high patency rates. Also, the time needed to complete an anastomosis was significantly shorter for CIS-AT when compared to SIS-CT.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"57 1-6","pages":"240-246"},"PeriodicalIF":1.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10795816","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: 1
Anatomic study of septocutaneous system of the human fetuses' lower leg: peroneal artery. 人胎儿小腿隔皮系统:腓动脉的解剖学研究。
IF 1.2 4区 医学
Journal of Plastic Surgery and Hand Surgery Pub Date : 2023-02-01 DOI: 10.1080/2000656X.2022.2142598
Goran Stevanović, Stefan Momčilović
{"title":"Anatomic study of septocutaneous system of the human fetuses' lower leg: peroneal artery.","authors":"Goran Stevanović,&nbsp;Stefan Momčilović","doi":"10.1080/2000656X.2022.2142598","DOIUrl":"https://doi.org/10.1080/2000656X.2022.2142598","url":null,"abstract":"<p><p>The septocutaneous system of the lower leg perforating blood vessels consists of a vascular basis of fasciocutaneous flaps. This system is of particular importance when designing distally based fasciocutaneous flaps that are the 'workhorse' in reconstructing the distal third of the lower leg and foot. The aim of this study was to provide a comprehensive, clear and conclusive overview of the lower-leg septocutaneous system of skin blood supply in fetal age. Dissection was conducted on 20 fetuses of both sexes and gestational age from 20 to 28 weeks. The focus was on the vascular anatomy of peroneal artery and its septocutaneous (fasciocutaneous) perforating arterial vessels. Cluster analysis was applied to the obtained data. A total of 212 perforating arterial vessels were identified for peroneal artery. The average number of perforating arterial vessels was 5.32 (ranging from 4 to 7). Based on cluster analysis, perforating blood vessels were more likely to be found at certain lower-leg levels ('safe levels of finding perforators'). The presence of septocutaneous system of perforating blood vessels and reliability of their localization even in the fetal period allows for the application of these findings in the lower leg reconstructions in children of early age.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"57 1-6","pages":"383-387"},"PeriodicalIF":1.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9344890","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
Surgical flap delay to allow primary transabdominal transplantation of extended rectus abdominis myocutaneous flaps in increasingly complex pelvic wound reconstructions. 在日益复杂的盆腔伤口重建中,外科皮瓣延迟允许扩展腹直肌肌皮瓣的经腹移植。
IF 1.2 4区 医学
Journal of Plastic Surgery and Hand Surgery Pub Date : 2023-02-01 DOI: 10.1080/2000656X.2022.2142600
Maurits Lange, J Joris Hage, Arend Aalbers, Esther M K Wit, Frédéric Amant, Marije J Hoornweg
{"title":"Surgical flap delay to allow primary transabdominal transplantation of extended rectus abdominis myocutaneous flaps in increasingly complex pelvic wound reconstructions.","authors":"Maurits Lange,&nbsp;J Joris Hage,&nbsp;Arend Aalbers,&nbsp;Esther M K Wit,&nbsp;Frédéric Amant,&nbsp;Marije J Hoornweg","doi":"10.1080/2000656X.2022.2142600","DOIUrl":"https://doi.org/10.1080/2000656X.2022.2142600","url":null,"abstract":"<p><p>Primary intra- or transabdominal transplantation of an extended rectus abdominis myocutaneous (ERAM) flap may help prevent surgical complications of pelvic resections. Surgical delay of the ERAM flap may help prevent intra-abdominal (partial) flap loss after transplantation in highly complex situations including previous irradiation. We report on the outcome of this approach and the risk-factors associated with an eventful outcome. From 2012 to 2020, 105 delayed ERAM flaps were consecutively applied immediately following extended pelvic resections after chemoradiation or hyperthermic intraperitoneal chemotherapy. We addressed the increased reconstructive demands by designing the flap in line with the 10<sup>th</sup> rib and delaying the flap's skin island. All post-operative complications were assessed in light of patient-related or procedure-related potential risk-factors. Major complications occurred in 39 patients. These were correlated with surgery for residual or recurrent malignancy (<i>p</i> < 0.01), with tip necrosis after flap delay (<i>p</i> = 0.02), and with the use of a mesh to close the abdominal donor site (<i>p</i> < 0.01). (Partial) flap loss occurred in 4 cases. We observed a comparably high rate of major complications after ERAM transplantations for increasingly extending indications of perineal-pelvic resections. We consider this to be attributable to poorer patients' conditions and disease processes, rather than to flap viability. Delay of the flap allowed for the use of large and voluminous flaps with comparably little (partial) flap loss.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"57 1-6","pages":"393-398"},"PeriodicalIF":1.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10797363","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 modified arthroscopic ulnar tunnel technique for foveal triangular fibrocartilage complex injury. 改良的关节镜尺骨隧道技术治疗中央凹三角形纤维软骨复合体损伤。
IF 1.2 4区 医学
Journal of Plastic Surgery and Hand Surgery Pub Date : 2023-02-01 DOI: 10.1080/2000656X.2022.2070179
Robert Gvozdenovic, Sabine Hessler Simonsen
{"title":"A modified arthroscopic ulnar tunnel technique for foveal triangular fibrocartilage complex injury.","authors":"Robert Gvozdenovic,&nbsp;Sabine Hessler Simonsen","doi":"10.1080/2000656X.2022.2070179","DOIUrl":"https://doi.org/10.1080/2000656X.2022.2070179","url":null,"abstract":"<p><p>Arthroscopically assisted techniques for the treatment of foveal triangular fibrocartilage complex (TFCC) injuries offer a less invasive option. Reports of the ulnar tunnel technique on a larger patient population are needed. This prospective cohort study of 44 patients aimed to evaluate the clinical and patient-reported outcome after arthroscopic foveal re-attachment using a novel, modified ulnar tunnel technique. Furthermore, preoperative magnetic resonance imaging findings were compared with the findings from the arthroscopic evaluation. History of ulnar sided wrist pain, positive fovea-sign at the clinical examination and positive hook test at the surgery were the main inclusion criteria for the study. Pain, grip strength, wrist motion and patient-reported outcomes were assessed pre-and postoperatively. The follow-up of this study was 31 months (range 18-48). No complications occurred during the surgery. All outcomes improved besides the range of motion, which remained unchanged. Pain on a visual analogue scale was 63 before, and 14 after the surgery (<i>p</i> = .0004). Pre- and postoperative values of Disability of Arm, Shoulder and Hand Questionnaire were 41/6, respectively (<i>p</i> = .007). Grip strength, measured in Kilogram-force were 29 and 36, pre-and postoperatively (<i>p</i> = .0004). Conspicuously, all patients achieved stability. Six patients needed re-operation, three for renewed injury. Thirty-nine of 44 patients scored excellent or good on the satisfaction score. We found the devised method to be with fewer complications and with favourable results compared with other techniques for the treatment of TFCC injuries. Level of evidence: III.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"57 1-6","pages":"308-314"},"PeriodicalIF":1.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10853323","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: 1
Validation and reliability testing of the BREAST-Q expectations questionnaire in Swedish. 瑞典语BREAST-Q期望问卷的效度与信度检验。
IF 1.2 4区 医学
Journal of Plastic Surgery and Hand Surgery Pub Date : 2023-02-01 DOI: 10.1080/2000656X.2022.2070180
Linn Weick, Anna Grimby-Ekman, Carolina Lunde, Emma Hansson
{"title":"Validation and reliability testing of the BREAST-Q expectations questionnaire in Swedish.","authors":"Linn Weick,&nbsp;Anna Grimby-Ekman,&nbsp;Carolina Lunde,&nbsp;Emma Hansson","doi":"10.1080/2000656X.2022.2070180","DOIUrl":"https://doi.org/10.1080/2000656X.2022.2070180","url":null,"abstract":"<p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier NCT04714463, 19 January 2021 <b>Patient and public contribution:</b> All the data were generated directly from patients.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"57 1-6","pages":"315-323"},"PeriodicalIF":1.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9085482","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
Lateral supramalleolar flap for soft-tissue coverage of ankle and foot defects. 踝上外侧皮瓣修复踝足缺损。
IF 1.2 4区 医学
Journal of Plastic Surgery and Hand Surgery Pub Date : 2023-02-01 DOI: 10.1080/2000656X.2022.2152826
Thach Ngoc Nguyen, Tuong Trong Mai, Thi Cao, Truc Thanh Thai
{"title":"Lateral supramalleolar flap for soft-tissue coverage of ankle and foot defects.","authors":"Thach Ngoc Nguyen,&nbsp;Tuong Trong Mai,&nbsp;Thi Cao,&nbsp;Truc Thanh Thai","doi":"10.1080/2000656X.2022.2152826","DOIUrl":"https://doi.org/10.1080/2000656X.2022.2152826","url":null,"abstract":"<p><p>The reconstruction of soft tissue defects in the foot and ankle remains a big challenge due to the anatomical characteristics of this area. This study evaluated the long-term effectiveness of covering by lateral supramalleolar flap in patients with soft tissue defects around the ankle and foot. We conducted a retrospective study from January 2017 to December 2020 at the Hospital for Traumatology and Orthopedics, Ho Chi Minh City, Vietnam. Data about patients' characteristics, detailed injuries, perioperative information, intraprocedural dossier, and complications of this method were recorded and analyzed. There were 31 male and 17 female patients, with an average age of 39.8 (ranging from 11 to 77) years. The skin defects ranged from 8 cm<sup>2</sup> to 120 cm<sup>2</sup>. The blood supply for the flap included a mixed-flow pattern (<i>n</i> = 30) and retrograde flow (<i>n</i> = 18). The success rate was 94%. Forty-two patients had been successfully covered, five patients had partial flap necrosis (in which two cases needed skin graft afterwards and three cases got spontaneous healing), only one patient had total flap necrosis. In conclusion, the lateral supramalleolar flap can cover the soft tissue of ankle and foot defects in both mixed-blood supply pattern or retrograde pattern with high success rates. However, the risk of venous congestion should be considered, particularly when using the retrograde pattern flap.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"57 1-6","pages":"459-465"},"PeriodicalIF":1.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10786487","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
Immediate tendon transfer for functional reconstruction of a dorsal forearm defect after sarcoma resection. 前臂背侧缺损肉瘤切除后立即肌腱转移功能重建。
IF 1.2 4区 医学
Journal of Plastic Surgery and Hand Surgery Pub Date : 2023-02-01 DOI: 10.1080/2000656X.2021.2024556
Ryo Karakawa, Hidehiko Yoshimatsu, Yuma Fuse, Kenta Tanakura, Tomohiro Imai, Masayuki Sawaizumi, Tomoyuki Yano
{"title":"Immediate tendon transfer for functional reconstruction of a dorsal forearm defect after sarcoma resection.","authors":"Ryo Karakawa,&nbsp;Hidehiko Yoshimatsu,&nbsp;Yuma Fuse,&nbsp;Kenta Tanakura,&nbsp;Tomohiro Imai,&nbsp;Masayuki Sawaizumi,&nbsp;Tomoyuki Yano","doi":"10.1080/2000656X.2021.2024556","DOIUrl":"https://doi.org/10.1080/2000656X.2021.2024556","url":null,"abstract":"<p><p>In the treatment of sarcoma, the reconstructive surgeon must consider not only limb salvage but also functional reconstruction. The aim of this study was to evaluate a functional reconstruction of a dorsal forearm defect after sarcoma resection using immediate tendon transfer. Patients who underwent reconstruction of a dorsal forearm defect after sarcoma resection with an immediate tendon transfer between 1997 and 2019 at our hospital were included in this retrospective study. Patient demographics, tumor characteristics, surgical characteristics and functional outcomes were examined. Nine patients were included in this study. Tendon transfer of the flexor carpi radialis (FCR) or the flexor carpi ulnaris (FCU) to the extensor digitorum communis (EDC), the brachioradialis (BR) to the EDC, and the palmaris longus (PL) tendon to the extensor pollicis longus (EPL) was performed in seven, two and five patients, respectively. Seven patients underwent reconstruction using a free flap. Neither anastomosis complications nor infections were encountered. Partial flap necrosis and donor site dehiscence were seen in one case each. The mean distal interphalangeal (DIP), proximal interphalangeal (PIP) and metacarpophalangeal (MP) joint active extension were 4.4°, 6.1° and 11.1° postoperatively. The mean Musculoskeletal Tumor Society (MSTS) score was 26. Immediate tendon transfers of the FCR or the FCU to the EDC and the PL tendon to the EPL can be considered an optimal functional reconstruction of a dorsal forearm defect after sarcoma resection.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"57 1-6","pages":"157-162"},"PeriodicalIF":1.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10792267","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: 2
Could hyperbaric oxygen be an effective therapy option for pathological scars? A systematic review and meta-analysis. 高压氧是治疗病理性疤痕的有效方法吗?系统回顾和荟萃分析。
IF 1.2 4区 医学
Journal of Plastic Surgery and Hand Surgery Pub Date : 2023-02-01 DOI: 10.1080/2000656X.2022.2075371
Ruxin Xie, Ai Zhong, Junliang Wu, Ying Cen, Junjie Chen
{"title":"Could hyperbaric oxygen be an effective therapy option for pathological scars? A systematic review and meta-analysis.","authors":"Ruxin Xie,&nbsp;Ai Zhong,&nbsp;Junliang Wu,&nbsp;Ying Cen,&nbsp;Junjie Chen","doi":"10.1080/2000656X.2022.2075371","DOIUrl":"https://doi.org/10.1080/2000656X.2022.2075371","url":null,"abstract":"<p><strong>Background: </strong>Hyperbaric oxygen (HBO) therapy involves breathing pure oxygen or a high oxygen concentration above atmospheric (ATM) pressure in an enclosed chamber. Studies on pathological scars have demonstrated that HBO can inhibit the formation of pathological scars.</p><p><strong>Objective: </strong>To evaluate the efficacy of HBO in the treatment of pathological scars <i>via</i> meta-analysis.</p><p><strong>Methods: </strong>Searches were run on various databases, including the Cochrane, Embase, PubMed, Web of Science, and CNKI databases. A comparative study was conducted on patients with pathological scars treated with or without HBO. We used RevMan 5.4 software to determine the recurrence rate, treatment satisfaction, and Vancouver Scar Scale(VSS) score in the pathological scar.</p><p><strong>Results: </strong>A total of 543 publications were identified; after screening, four were selected for review, including one randomized controlled trial (RCT), one controlled clinical trial (CCT), and two retrospective cohort studies. Meta-analysis results showed that HBO treatment reduced the pathological scar recurrence rate after surgery and radiotherapy (OR = 0.26, 95% CI: 0.13-0.52, <i>p</i> = 0.0001). Patients had higher satisfaction after HBO therapy (OR = 4.45, 95% CI: 1.49-13.30, <i>p</i> = 0.007). The Vancouver scar scale (VSS) score of patients with pathological scars was significantly improved in the HBO group (SMD: -3.82, 95% CI: -6.07to -0.49, <i>p</i> = 0.02).</p><p><strong>Conclusions: </strong>HBO treatment decreased the recurrence rate of pathological scars after surgery and radiotherapy, increased patient satisfaction, and reduced the VSS score, thus providing a new way to treat pathological scar hyperplasia. However, evaluation of the longer-term effects of HBO treatment requires further comprehensive studies, including more RCTs.</p>","PeriodicalId":16847,"journal":{"name":"Journal of Plastic Surgery and Hand Surgery","volume":"57 1-6","pages":"330-335"},"PeriodicalIF":1.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10792759","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
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