Plastic and reconstructive surgery最新文献

{"title":"Modified McKissock Technique for Secondary Breast Reduction: A Prospective Study on Safety and Surgical and Aesthetic Outcomes.","authors":"Sandra Feldler, Maximilian Zaussinger, Gudrun Ehebruster, Kathrin Bachleitner, Theresia Steinkellner, Manfred Schmidt","doi":"10.1097/PRS.0000000000011785","DOIUrl":"10.1097/PRS.0000000000011785","url":null,"abstract":"<p><strong>Summary: </strong>Secondary breast reductions are increasingly being performed, but they are potentially associated with higher complication rates than primary mammaplasty. Necrosis of the nipple-areola complex (NAC) is a devastating complication that can occur after repeated NAC transposition, particularly when the initially used pedicle is unknown. Thus, the authors established a modification of the McKissock technique for secondary breast reductions including 3 pedicle components to ensure safe vascular supply of the NAC. The presented technique incorporates a superior and inferior dermoglandular pedicle, according to the McKissock technique, and an additional central pedicle. The technique was applied for secondary breast reduction in a series of 25 breasts (14 patients: 11 bilateral, 3 unilateral). Complication rates, preoperative and postoperative BREAST-Q scores, and aesthetic outcomes were evaluated. Mean resection weight was 299 g (range, 40 to 646 g), and the NAC was transposed by 4.2 cm on average (range, 1 to 10 cm). No case of NAC necrosis was observed, and comparison of preoperative and postoperative BREAST-Q values indicated substantial improvement in all domains. After surgery, 84.6% of patients reported excellent satisfaction with breast appearance. According to these results, the modified McKissock technique is safe for patients requiring secondary breast reduction, even if the primarily used pedicle is unknown. The established technique is associated with improved postoperative patient-reported outcomes and yields aesthetically favorable results.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, IV.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"670e-675e"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352035","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":"Outcome of Patients with Complete Cleft Lip and Alveolus: 20-Year Follow-Up.","authors":"Yoshitsugu Hattori, Betty Chien-Jung Pai, Takafumi Saito, Pang-Yun Chou, Ting-Chen Lu, Chun-Shin Chang, Yu-Ray Chen, Lun-Jou Lo","doi":"10.1097/PRS.0000000000011622","DOIUrl":"10.1097/PRS.0000000000011622","url":null,"abstract":"<p><strong>Background: </strong>Patients with cleft have functional and aesthetic impairment, and typically require several interventions as they grow. Long-term evaluation following a treatment protocol is essential, but such reports on patients with complete cleft lip and alveolus (CLA) are sparse in the literature.</p><p><strong>Methods: </strong>A retrospective review was conducted of all patients with complete CLA born between January of 1995 and August of 2002 and treated at our center. Patients who received continuous multidisciplinary team care until 20 years of age were included, and patients with cleft palate and syndromic abnormalities were excluded. Facial bone growth was evaluated using cephalometric analysis.</p><p><strong>Results: </strong>Eighty-seven and 11 patients with unilateral and bilateral CLA, respectively, were included. All patients underwent one-stage cheiloplasty with primary rhinoplasty. Revision lip/nose surgery was performed in 21.8% and 27.3% during growing age, and in 51.7% and 72.7% after skeletal maturity, respectively. Orthognathic surgery was performed in 20.7% and 27.3%, respectively. Compared with unilateral CLA patients, bilateral CLA patients had more operations (3.0 versus 3.7; P = 0.03) and a higher chance of undergoing alveolar bone grafting twice (1.1% versus 36.4%; P < 0.01). Patients with complete CLA had less hypoplastic maxilla, and underwent fewer operations than those with complete cleft lip and palate.</p><p><strong>Conclusions: </strong>Complete CLA is a less severe form of cleft, but the patients still require multiple interventions. This review revealed certain suboptimal results, and modifications have been made in the treatment protocol. Longitudinal follow-up and periodic assessment help to establish an ideal therapeutic strategy and improve overall cleft care.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"746e-757e"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591034","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 Use of Grayscale Muscle Ultrasound to Indicate Muscle Recovery after Peripheral Nerve Reconstruction.","authors":"Sara Saffari, Andrea J Boon, Alexander Y Shin","doi":"10.1097/PRS.0000000000011811","DOIUrl":"10.1097/PRS.0000000000011811","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to validate the use of grayscale muscle ultrasound by measuring echo intensity to longitudinally evaluate functional muscle reinnervation in a rabbit peroneal nerve defect model.</p><p><strong>Methods: </strong>Eighteen New Zealand white rabbits underwent a 30-mm peroneal nerve reconstruction with autografts or decellularized allografts. Ultrasound measurements of tibialis anterior muscles were performed before surgery and at 4, 8, 12, 16, 20, and 24 weeks postoperatively and included cross-sectional muscle area, mean gray value (MGV), and mean gray value normalized for area (MGVA). At 24 weeks, functional motor recovery was evaluated with isometric tetanic force (ITF) and compound muscle action potential (CMAP). MGVA data were compared with ITF and CMAP measurements by calculating the Spearman correlation coefficient.</p><p><strong>Results: </strong>Muscle area (left/right [L/R] ratio) of autografts was superior to allografts at 4, 12, 16, 20, and 24 weeks ( P < 0.03 for all comparisons). MGVs of the operated side were significantly higher for autografts at 4, 8, and 12 weeks and at 12, 16, 20, and 24 weeks for allografts ( P < 0.01 for all comparisons), compared with their unoperated sides. Similar patterns were seen in both groups for MGVA (operated versus control side). MGVA (L/R) demonstrated a strong correlation with ITF (L/R) for autografts (ρ = -0.7) and allografts (ρ = -0.87), but inconsistent with CMAPs (L/R).</p><p><strong>Conclusions: </strong>Quantitative muscle ultrasound demonstrated a reliable, noninvasive tool for evaluating motor recovery in a rabbit peroneal nerve reconstruction model. Clinical translation could provide valuable insights into muscle health and structural changes following nerve reconstruction.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"709-719"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11945609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472444","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":"Does Surgical Sequencing Influence the Accuracy of Maxillary Positioning in Bimaxillary Cleft Orthognathic Surgery?","authors":"Ryan K Badiee, Russell E Ettinger, Hitesh Kapadia, Barbara Sheller, Srinivas M Susarla","doi":"10.1097/PRS.0000000000011634","DOIUrl":"10.1097/PRS.0000000000011634","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to evaluate whether the sequence of osteotomies influences the accuracy of maxillary positioning in patients with cleft palate with or without cleft lip undergoing bimaxillary orthognathic surgery (OGS).</p><p><strong>Methods: </strong>This was a prospective study of patients with Veau II through IV clefts who underwent bimaxillary OGS at a tertiary-care children's hospital over a 3-year period. The primary predictor variable was the sequence of osteotomies (maxilla first versus mandible first). The primary outcome of interest was the concordance between the planned and achieved maxillary position, as assessed using linear and angular measurements. Secondary study predictors were demographic and surgical variables. Differences between groups were compared using nonparametric independent samples tests for continuous measures (data reported as median and interquartile range) and chi-square tests for categorical measures. For all analyses, P ≤ 0.05 was considered significant.</p><p><strong>Results: </strong>Participants who underwent maxilla-first ( n = 15) and mandible-first ( n = 16) operations were comparable with regard to age, sex, cleft type, skeletal classification, segmental maxillary osteotomy, and magnitude of maxillary movement ( P ≥ 0.09). The planned sagittal and vertical positions of the maxilla were similarly accurate between the 2 groups ( P ≥ 0.68). Angular accuracy was also comparable ( P ≥ 0.56) between the study groups.</p><p><strong>Conclusion: </strong>In patients with cleft palate with or without cleft lip undergoing bimaxillary OGS, use of mandible-first sequencing, when compared with maxilla-first sequencing, does not affect the accuracy of maxillary positioning in the immediate postoperative period in well-selected patients.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, II.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"758e-766e"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760297","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":"Single-Stage Reconstruction of Congenital Multifinger Syndactyly with Contiguous Cross-Shaped Advancement Flaps.","authors":"Guang Yang, Fei Yin, Chunhua Yin, Wei Liu, Wentao Yu, Qinyuan Yu, Xiaofang Shen","doi":"10.1097/PRS.0000000000011741","DOIUrl":"10.1097/PRS.0000000000011741","url":null,"abstract":"<p><strong>Background: </strong>The authors report the techniques and results of contiguous dorsal cross-shaped advancement flaps for reconstruction of 3- or 4-finger syndactyly in a single-stage operation for congenital syndactyly.</p><p><strong>Methods: </strong>Thirty-five patients with multiple-finger syndactyly who received webspace reconstruction using the contiguous dorsal cross-shaped advancement flaps in a single operation were retrospectively studied. The patients ranged in age from 5 to 96 months (average age, 29.6 months). The contiguous dorsal cross-shaped flaps were advanced to reconstruct both webspace and lateral walls of the bases of the conjoined fingers. Withey grading was used for postoperative evaluation of web creep. Scar hyperplasia was assessed using the Vancouver Scar Scale. A visual analog scale of 0 to 10 was applied to evaluate the subjective satisfaction of the parents.</p><p><strong>Results: </strong>In all cases, the syndactyly was successfully released in a single operation. There were no perioperative complications in this group. During a 12- to 58-month follow-up period, all reconstructed webspaces exhibited satisfactory appearance, and there was no obvious web creep. The dorsal hand scars were acceptable. Revision surgery was not needed in any patient. The average web creep was 0.45, and the average Vancouver Scar Scale score was 1.6. The average visual analog scale score for appearance was 1.2, and that for function was 2.5.</p><p><strong>Conclusions: </strong>Multiple syndactyly release in 1 stage is feasible and safe. The contiguous cross-shaped flaps can be used to reconstruct 2 or more webspaces simultaneously after releasing.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, IV.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"661-670"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189435","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":"Genetic Correlations between Migraine and Carpal Tunnel Syndrome.","authors":"Nienke A Krijnen, Teun Teunis","doi":"10.1097/PRS.0000000000011772","DOIUrl":"10.1097/PRS.0000000000011772","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"843e-844e"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352031","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":"Effects of Nanofat in Plastic and Reconstructive Surgery: A Systematic Review.","authors":"Alexandre Mendonça Munhoz","doi":"10.1097/PRS.0000000000011773","DOIUrl":"10.1097/PRS.0000000000011773","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"842e-843e"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352033","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":"Predisposing Factors for Postoperative Complications in the Year following Frontoorbital Advancement and Remodeling: A Single-Institution Study of 267 Patients.","authors":"Larissa E Wietlisbach, Carlos E Barrero, Dillan F Villavisanis, Jordan W Swanson, Scott P Bartlett, Jesse A Taylor","doi":"10.1097/PRS.0000000000011364","DOIUrl":"10.1097/PRS.0000000000011364","url":null,"abstract":"<p><strong>Background: </strong>Frontoorbital advancement and remodeling (FOAR) is a common surgical approach used for craniosynostosis, conferring functional and aesthetic benefit. There are few reports examining predisposing factors for postoperative complications within the first year after surgery. This study aimed to establish complication rates and identify risk factors for inferior outcomes in a large population of patients undergoing FOAR.</p><p><strong>Methods: </strong>All patients who underwent FOAR from 2013 through 2022 at the authors' institution were retrospectively studied. Perioperative and postoperative data were collected to yield outcomes analyses. Multivariable logistic regression with backward selection was performed to identify predictors of postoperative complications.</p><p><strong>Results: </strong>A total of 267 patients underwent FOAR. The overall complication rate was 14.2%, most commonly delayed wound healing (7.4%), postoperative blood transfusion (5.8%), and infection requiring readmission (1.9%). Tense closure independently predicted delayed wound healing ( P < 0.001) and infection requiring readmission ( P = 0.03). Syndromic patients were more likely than nonsyndromic patients to have undergone previous craniofacial surgery (45.3% versus 23.8%; P = 0.003). Syndromic status and previous craniofacial surgery were associated with increased risk of developing infection requiring readmission ( P = 0.012 and P = 0.004, respectively). A greater proportion of malnourished patients experienced postoperative complications compared with patients without malnourishment (24.4% versus 12.1%; P = 0.031), although there were no significant differences in individual postoperative outcomes.</p><p><strong>Conclusions: </strong>Identified risk factors for complications included syndromic status, tense closure, and previous craniofacial surgery. Most complications were managed nonoperatively. These factors may be considered in preoperative planning and when counseling families.</p><p><strong>Clinical question/level of evidence: </strong>Risk, III.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"673-681"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139906330","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":"Spotlight in Plastic Surgery: April 2025.","authors":"Brett T Phillips, Antonio Baez, Christine S W Best, Sahar Borna, Valeria P Bustos, Jesse Chou, Daniel De Luna Gallardo, Bianca Di Chiaro, Mayank Mandavgane, Kalinne F S Martins, Tina Moon, Dillan Villavisanis, Pooja S Yesantharao","doi":"10.1097/PRS.0000000000011910","DOIUrl":"10.1097/PRS.0000000000011910","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 4","pages":"737-740"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710963","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":"\"Assessing the Quality of Breast Reconstruction Outcomes Reporting: A Five-Year Scoping Review\".","authors":"Sonali Biswas, Alexandria M Mullikin, Steven L Zeng, William M Tian, Brett T Phillips","doi":"10.1097/PRS.0000000000012133","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012133","url":null,"abstract":"<p><strong>Background: </strong>Outcomes reporting is essential to advancing healthcare quality in plastic surgery and aligns closely with patient satisfaction. At present, there is no widely used set of standards for breast reconstruction reporting in the literature. This study aims to define how breast reconstruction outcomes are characterized in the literature and identify opportunities to improve consistency across studies.</p><p><strong>Methods: </strong>All articles published between 2015 and 2021 in Plastic and Reconstructive Surgery and Annals of Plastic Surgery were screened for original articles that pertain to breast reconstruction. Included articles were evaluated using existing outcomes reporting criteria for breast reconstruction that were adapted from general surgery literature.</p><p><strong>Results: </strong>Of 833 breast reconstruction articles reviewed, 192 met inclusion criteria. Approximately one-half of the articles (n = 87, 45.38%) pertained to autologous breast reconstruction, 66% (n = 127) pertained to prosthetic breast reconstruction, and 16.15% (n = 31) included both procedures. Less than 1/5 of studies (n = 53, 27.42%) defined at least half of the complications in their study. Less than 1/3 included at least half of the suggested procedure-specific complications (n = 53, 27.42%), utilized severity grades (n = 46, 24.19%), or considered risk factors in analyses (n = 64, 33.33%). Infection was the most reported complication (n=120, 62.71%), and 18 distinct definitions were used. Outcomes reporting criteria assessment revealed the average number of criteria met was 3.3 out of a possible 10.</p><p><strong>Conclusions: </strong>This study demonstrates significant gaps in outcomes reporting with regards to study design, complications included, and definitions used. There was little improvement in outcomes reporting from 2015 - 2021 compared to 2000-2014. This study supports the need for outcomes reporting standards in breast reconstruction to improve study generalizability and quality.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773038","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}