Plastic and reconstructive surgery最新文献

{"title":"Discussion: Remote Incisions as an Alternative to Mastectomy Scars for Breast Tissue Expander-to-Implant Exchange: A Propensity Score-Matched Analysis.","authors":"Christin A Harless, Minh-Doan T Nguyen","doi":"10.1097/PRS.0000000000012024","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012024","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 1","pages":"16-17"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction of Microtia with Constricted Ear Features Using Helix Costal Cartilage Scaffold and Postauricular Flap Advancement.","authors":"Chenglong Wang, Dejin Gao, Pan Luo, Yue Wang, Qingguo Zhang","doi":"10.1097/PRS.0000000000011853","DOIUrl":"10.1097/PRS.0000000000011853","url":null,"abstract":"<p><strong>Background: </strong>Microtia with constricted ear features represents a challenging congenital deformity characterized by the variable shape and large volume of the remnant cartilage and skin involved. This study aimed to evaluate the efficacy and safety of a method using helix costal cartilage scaffold and postauricular flap advancement for the correction.</p><p><strong>Methods: </strong>This prospective study analyzed the clinical and postoperative data of 121 patients diagnosed with microtia and constricted ear features, treated at the authors' institution between January of 2020 and January of 2023. All patients underwent helix reconstruction using the eighth or ninth costal cartilage combined with postauricular flap advancement. Outcomes were assessed based on the incidence of postoperative complications and auricular aesthetic scores. The aesthetic evaluation of the reshaped auricle was based on a 4-point Likert scale (ie, 1 = poor, 2 = fair, 3 = good, and 4 = excellent).</p><p><strong>Results: </strong>The postoperative follow-up period ranged from 12 months to 3 years (mean, 18.5 months). All patients achieved successful helix expansion, with reconstructed ears showing improved symmetry and shape comparable to the contralateral normal ears. The average aesthetic score was 3.4 of 4. Complications included suture exposure in 8.3% of cases and cartilage protrusion in 4.1%, both managed without significant issues. There were no instances of skin necrosis, costal cartilage exposure, or infection.</p><p><strong>Conclusion: </strong>The combination of helix costal cartilage scaffold and postauricular advancing flap offers a reliable and effective method for correcting microtia with constricted ear features, providing satisfactory aesthetic outcomes with minimal complications.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, IV.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"130-137"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Evolution of Unicoronal Synostosis Correction: Long-Term Aesthetics of Fronto-Orbital Distraction versus Advancement.","authors":"Meagan Wu, Benjamin B Massenburg, Dillan F Villavisanis, Ashley E Chang, Dominic J Romeo, Jinggang J Ng, Joseph A Napoli, Scott P Bartlett, Jordan W Swanson, Jesse A Taylor","doi":"10.1097/PRS.0000000000011844","DOIUrl":"10.1097/PRS.0000000000011844","url":null,"abstract":"<p><strong>Background: </strong>This study compares the long-term aesthetic outcomes of patients with unicoronal synostosis (UCS) who underwent fronto-orbital distraction osteogenesis (FODO) versus traditional fronto-orbital advancement and remodeling (FOAR).</p><p><strong>Methods: </strong>Patients treated for nonsyndromic UCS from 2009 to 2023 were retrospectively reviewed. Perioperative and complication characteristics were compared between all patients who underwent FOAR, open FODO, and endoscope-assisted FODO (endo-FODO). Aesthetic outcomes at greater than 5 years postoperatively were compared between patients who underwent FODO and a contemporaneous cohort of age-matched controls who underwent FOAR. Differences between preoperative and postoperative periorbital symmetry ratios, canthal tilt symmetry, orbital dystopia angle, and frontal bossing angle were calculated, with positive differences representing postoperative improvement.</p><p><strong>Results: </strong>Forty-one patients were treated at a median age of 9.7, 5.4, and 5.4 months in the FOAR, open FODO, and endo-FODO groups, respectively. Among 28 patients photographed at a median of 6.3 years postoperatively, the FODO cohort demonstrated greater margin-to-reflex distance 1 symmetry (6.5 [interquartile range (IQR), -9.3 to 0.0] versus -13.9 [IQR, -22.9 to -11.5]; P = 0.010) and canthal tilt symmetry (0.9 degrees [IQR, 0.2 to 2.9 degrees] versus 3.3 degrees [IQR, 2.3 to 5.3 degrees]; P = 0.004) postoperatively and orbital dystopia angle correction (5.4 degrees [IQR, 4.0 to 7.5 degrees] versus 3.0 degrees [IQR, 2.5 to 4.4 degrees]; P = 0.027) compared with the FOAR cohort. Fewer patients in the FODO cohort exhibited temporal hollowing postoperatively compared with the FOAR cohort (14% versus 71%; P = 0.002).</p><p><strong>Conclusions: </strong>Compared with FOAR, FODO was associated with greater periorbital symmetry, greater orbital dystopia correction, and reduced temporal hollowing in the long term. Follow-up to cranial maturity is needed to adequately compare the 2 techniques.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, III.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"105-116"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Out-of-Pocket Expenses and Postoperative Therapy after Open Reduction and Internal Fixation of a Distal Radius Fracture.","authors":"Mark Spencer, Pui Man Pamela Chan, Jialiang Liu, Donghan M Yang, Eric D Peterson, Jessica I Billig","doi":"10.1097/PRS.0000000000011930","DOIUrl":"10.1097/PRS.0000000000011930","url":null,"abstract":"<p><strong>Background: </strong>Hand therapy after surgery for distal radius fractures is associated with improved functional outcomes. However, financial impediments can be a potential barrier to adherence to postoperative care requirements. The aim of this study was to evaluate the relationship between surgical and therapy out-of-pocket (OOP) expenses and therapy visits after operative treatment of a distal radius fracture.</p><p><strong>Methods: </strong>The authors performed a retrospective cohort study of surgically treated patients with a distal radius fracture using Merative MarketScan Research Databases (2019 through 2021). Multivariable logistic regression and multivariable negative binomial regression were used to assess the association of patient-level variables, OOP expenses, and postoperative hand therapy visits.</p><p><strong>Results: </strong>In the cohort of 17,405 patients, 1158 (6.7%) had inpatient surgery and 16,247 (93.4%) had outpatient surgery. A total of 27% had no therapy visits in the 6-month postoperative period. Surgical OOP costs were not associated with a minimum of 1 therapy visit postoperatively. However, the highest quartile of surgical OOP expenses was associated with fewer therapy visits (incidence rate ratio [IRR], 0.92 [95% CI, 0.88 to 0.96]), and the highest average therapy OOP expenses were associated with fewer therapy visits in the inpatient (IRR, 0.79 [95% CI, 0.65 to 0.96]) and outpatient (IRR, 0.86 [95% CI, 0.82 to 0.89]) cohorts.</p><p><strong>Conclusions: </strong>One in 4 patients undergoing open reduction and internal fixation of a distal radius fracture did not receive therapy. Increasing surgical and therapy OOP expenses were associated with fewer therapy visits. Given the importance of therapy for functional outcomes, policy changes, such as bundling therapy visits into the global period, are needed to promote postinjury therapy.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"85e-90e"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142838746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk and Mortality of Cardiovascular Diseases in Patients with Dupuytren Disease: A Nationwide Population-Based Cohort Study.","authors":"Jeong Yeop Ryu, Tae Hwan Park, Joon Seok Lee, Kang Young Choi, Jung Dug Yang, Ho Yun Chung","doi":"10.1097/PRS.0000000000011944","DOIUrl":"10.1097/PRS.0000000000011944","url":null,"abstract":"<p><strong>Background: </strong>Dupuytren disease (DD) is a type of fibroproliferative disease that involves the palmar aspect of the hand. Although many benign fibroproliferative diseases have been shown to increase the risk of cardiovascular disease, the relationship between DD and myocardial infarction (MI) or stroke has not been fully elucidated.</p><p><strong>Methods: </strong>A total of 35,909 patients with DD and a control cohort with 1,077,270 age- and sex-matched participants from the Korean National Health Insurance database were included. The incidences of MI, stroke, and survival after cardiovascular events, were compared between participants with DD and the control cohort.</p><p><strong>Results: </strong>Compared with the control cohort, the incidence rate ratios for cardiovascular diseases in DD were as follows: 1.51 (95% CI, 1.44 to 1.58) for MI; 2.01 (95% CI, 1.94 to 2.09) for ischemic stroke (IS); and 1.49 (95% CI, 1.36 to 1.63) for hemorrhagic stroke . After adjusting for other cardiovascular disease risk factors, DD was associated with an increased risk of IS. Based on the age-, sex-, and body mass index-stratified analyses, an increased risk of MI was identified in the younger age group (<50 years) and thin subjects (body mass index < 18.5 kg/m 2 ). Adjusted hazard ratios for mortality in subjects with DD who developed cardiovascular diseases were 0.51 (95% CI, 0.43 to 0.60), 0.56 (95% CI, 0.50 to 0.62), and 1.08 (95% CI, 0.86 to 1.36), respectively.</p><p><strong>Conclusions: </strong>DD is associated with an increased risk of IS, independent of cardiovascular risk factors. DD is also associated with an increased risk of MI in individuals younger than 50 years. DD did not significantly aggravate mortality secondary to cardiovascular events.</p><p><strong>Clinical question/level of evidence: </strong>Risk, II.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"93-101"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Dangling the Lower Extremity after Free Flap Reconstruction Reduce Partial Flap Loss? A Multicenter Randomized Controlled Trial.","authors":"David D Krijgh, Emile B List, Shan S Qiu, Rutger M Schols, Marc A M Mureau, Antonius J M Luijsterburg, T M T Tempelman, E S J van der Beek, J Henk Coert, Teun Teunis, Wiesje Maarse","doi":"10.1097/PRS.0000000000011906","DOIUrl":"10.1097/PRS.0000000000011906","url":null,"abstract":"<p><strong>Background: </strong>Controlled, gradually increased venous pressure exposure of lower extremity free flaps (dangling) is common, based on the assumption that this reduces (partial) flap loss. Dangling protocols potentially increase length of hospital stay and resource use. The authors investigated whether (1) the proportion of partial flap loss 6 weeks after lower extremity free flap reconstruction is noninferior after uncontrolled exposure compared with gradually increased venous pressure exposure; (2) there is a difference in length of hospital stay and major or minor adverse events 3 months after surgery.</p><p><strong>Methods: </strong>For this multicenter randomized controlled trial, patients who underwent lower extremity free flap reconstruction were included. Seven days after surgery, 39 were randomized to dangling and 36 were mobilized without limitations. Partial flap loss was assessed 6 weeks after surgery (primary outcome), and length of stay and major and minor adverse events, 3 months after surgery. An absolute increase of 12% partial flap loss was considered inferior.</p><p><strong>Results: </strong>Uncontrolled exposure was noninferior to controlled, gradually increased venous pressure exposure (absolute risk difference, 2.4%; 95% CI, -10% to 15%; partial flap loss, dangling, 5.1% [ n = 2]; nondangling, 2.8% [ n = 1]). There was no difference in length of stay and major or minor complications.</p><p><strong>Conclusions: </strong>Seven days after surgery, dangling the lower extremity after free flap reconstruction seems unnecessary. Surgeons and patients can consider forgoing a formal dangling protocol at that time. Future research is warranted to assess whether forgoing dangling is also safe earlier after free tissue transfer, possibly reducing length of hospital stay and resource use.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, II.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"162-169"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement in Temple Hollowing with VYC-20L Hyaluronic Acid Filler: A Multicenter Randomized Controlled Trial of Safety and Effectiveness.","authors":"José Raúl Montes, Deirdre Hooper, Derek Jones, Brian Biesman, Leslie Baumann, Kenneth Beer, Steve Yoelin, Kelly Leung, Smita Chawla","doi":"10.1097/PRS.0000000000011957","DOIUrl":"10.1097/PRS.0000000000011957","url":null,"abstract":"<p><strong>Background: </strong>Temple hollowing is characterized by a reduction of volume in the temporal fossa, which can result in a skeletonized look and contribute to an aged appearance. This study aimed to evaluate the safety and effectiveness of VYC-20L injectable gel to improve temple hollowing.</p><p><strong>Methods: </strong>Adults with minimal, moderate, or severe temple hollows were randomized 2:1 to receive VYC-20L or no treatment. Participants were followed up for 13 months for safety and effectiveness assessments. Treatment effectiveness was assessed by blinded evaluating investigators using the validated Allergan Temple Hollowing Scale (ATHS) and the Global Aesthetic Improvement Scale (GAIS), and by participants using GAIS, FACE-Q scales, and patient satisfaction questionnaires. Adverse events and injection-site responses were monitored.</p><p><strong>Results: </strong>At month 3, 80.4% of the treatment group versus 13.5% of the untreated control group achieved a 1-grade improvement or greater in both temples on the ATHS ( P < 0.0001). The ATHS responder rate remained high throughout month 13. The GAIS responder rates at month 3 (responses of improved or much improved) were high in the treatment group, as assessed by the blinded evaluating investigator (83.8%) and participants (92.9%). Furthermore, satisfaction with facial appearance and temples on the FACE-Q questionnaires increased significantly from baseline (both P < 0.0001). Adverse events and injection-site responses were mostly mild and consistent with the known safety profile of fillers.</p><p><strong>Conclusions: </strong>VYC-20L treatment showed favorable safety and effectiveness results in restoring temple volume, with significant aesthetic improvement and high participant satisfaction. Treatment effects lasted for more than a year.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, II.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"25e-36e"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discussion: Does Dangling the Lower Extremity after Free Flap Reconstruction Reduce Partial Flap Loss? A Multicenter Randomized Controlled Trial.","authors":"Eric I Chang","doi":"10.1097/PRS.0000000000011969","DOIUrl":"https://doi.org/10.1097/PRS.0000000000011969","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 1","pages":"170-171"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discussion: Evaluating the Accuracy of Relative Value Unit and Operative Time Changes in Breast Reconstruction.","authors":"Sahil K Kapur","doi":"10.1097/PRS.0000000000012012","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012012","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 1","pages":"185-186"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discussion: The Evolution of Unicoronal Synostosis Correction: Long-Term Aesthetics of Fronto-Orbital Distraction versus Advancement.","authors":"Jeffrey A Fearon","doi":"10.1097/PRS.0000000000011845","DOIUrl":"https://doi.org/10.1097/PRS.0000000000011845","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 1","pages":"117-118"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}