Plastic and reconstructive surgery最新文献_第3页

Should Breast Reconstruction Be Considered a Clean-Contaminated Procedure? Challenging the Standard of Care. 乳房重建应该被认为是一种清洁污染的手术吗？挑战护理标准。

IF 3.4 2区医学

Plastic and reconstructive surgery Pub Date : 2026-05-01 Epub Date: 2026-04-29 DOI: 10.1097/PRS.0000000000012663

Amy S Colwell

引用次数: 0

What Happens to Weight following Abdominoplasty: An Analysis of 188 Consecutive Cases. Glp-1诱导的减肥和整形手术：是时候进行多学科对话了。

IF 3.4 2区医学

Plastic and reconstructive surgery Pub Date : 2026-05-01 Epub Date: 2025-09-30 DOI: 10.1097/PRS.0000000000012485

Roberta Albanese, Federica Tomaselli, Damiano Tambasco

引用次数: 0

Randomized Controlled Trials of Carpal Tunnel Release: Robustness and Fragility Index of Published Literature. 腕管释放的随机对照试验：已发表文献的稳健性和脆弱性指数。

IF 3.4 2区医学

Plastic and reconstructive surgery Pub Date : 2026-05-01 Epub Date: 2025-09-30 DOI: 10.1097/PRS.0000000000012481

Constance M Sullivan, Thomas J McQuillan, Kevin R Cuneo, Hayden L Cooke, Krishna N Chopra, Eric R Wagner, Michael B Gottschalk

{"title":"Randomized Controlled Trials of Carpal Tunnel Release: Robustness and Fragility Index of Published Literature.","authors":"Constance M Sullivan, Thomas J McQuillan, Kevin R Cuneo, Hayden L Cooke, Krishna N Chopra, Eric R Wagner, Michael B Gottschalk","doi":"10.1097/PRS.0000000000012481","DOIUrl":"10.1097/PRS.0000000000012481","url":null,"abstract":"Background: Many randomized controlled trials (RCTs) have studied outcomes after carpal tunnel surgery, but they have not been scrutinized collectively for their risk of bias or robustness of statistically significant findings. This study applies the fragility index (FI) and bias risk assessments on RCTs for carpal tunnel surgery.Methods: A PubMed search was designed to extract English-language carpal tunnel RCTs published between 2003 and 2023. RCTs with dichotomous outcomes, statistically significant results, and a 1:1 parallel treatment arm were included. The FI, fragility quotient, and risk of bias for these trials were calculated, and results were collectively analyzed.Results: Seven RCTs investigating 11 dichotomous variables were included in this study. The average FI was 1.36 ± 1.12 SD, the average fragility quotient was 0.03 ± 0.03 SD, and the average Jadad score was 3 ± 0.00 SD. The risk of bias determined by means of the Cochrane risk-of-bias tool was moderate in most studies, typically from nonblinding of the treating surgeon.Conclusions: Dichotomous variables that are reported in carpal tunnel literature have FIs that are overall lower than the suggested threshold of 2, demonstrating poor overall robustness. The overall risk of bias in these trials was moderate and acceptable. This study indicates that more multicenter trials with larger sample sizes are required to ensure robustness of carpal tunnel RCTs.","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"723e-728e"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192320","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}

引用次数: 0

Single versus Multiple Perforator Flaps in Autologous Breast Reconstruction: A Regression Analysis of Clinical Outcomes and Financial Metrics. 自体乳房重建中单个与多个穿支皮瓣：临床结果和财务指标的回归分析。

IF 3.4 2区医学

Plastic and reconstructive surgery Pub Date : 2026-05-01 Epub Date: 2025-10-09 DOI: 10.1097/PRS.0000000000012512

Robert G DeVito, Benjamin G Ke, Eileen Wen, Jesse Chou, Kristen L Stephens, Scott T Hollenbeck, Chris A Campbell, John T Stranix

{"title":"Single versus Multiple Perforator Flaps in Autologous Breast Reconstruction: A Regression Analysis of Clinical Outcomes and Financial Metrics.","authors":"Robert G DeVito, Benjamin G Ke, Eileen Wen, Jesse Chou, Kristen L Stephens, Scott T Hollenbeck, Chris A Campbell, John T Stranix","doi":"10.1097/PRS.0000000000012512","DOIUrl":"10.1097/PRS.0000000000012512","url":null,"abstract":"Background: Perforator selection in free flap breast reconstruction is complex, often involving both preoperative imaging and clinical examination. The number of perforators selected for flap design has classically been analyzed as a tradeoff between donor-site morbidity, flap perfusion, and operative time.Methods: A retrospective review was performed of 258 consecutive abdominal autologous breast reconstruction patients, stratified by laterality and single- versus multiple-perforator flaps. Primary outcomes were operating time, length of stay, daily/total opioid use, flap loss, fat necrosis, and hernia/bulge. Financial metrics analyzed included charges, total cost, and estimated margin.Results: While controlling for bilateral and unilateral reconstruction, each additional perforator added an average of 27.6 minutes of operating time ( P > 0.001), 0.22 days length of stay ( P = 0.011), and 16.2 morphine milligram equivalents of total opioid use ( P = 0.021). The likelihood of flap thrombosis, flap loss, fat necrosis, or hernia/bulge was similar between single- and multiple-perforator cohorts. Each additional perforator added $4591 in charges ( P = 0.033) and $1425 in total cost ( P = 0.013), and decreased estimated margin by $2717 ( P = 0.010).Conclusions: These results demonstrate equivalent donor- and recipient-site clinical outcomes between single- versus multiple-perforator flaps. This likely reflects the surgeons' approach to balanced flap designs that prioritize adequate flap perfusion and attempt to limit excess abdominal dissection. When multiple perforators are indicated, operating time, length of stay, and morphine milligram equivalent use increase accordingly. The financial impact of this is not insignificant and warrants consideration.","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"657e-667e"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275471","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}

引用次数: 0

Ergonomix versus Round Implants: A Comprehensive Evaluation of Aesthetic Outcomes and Long-Term Follow-Up in Breast Surgery. “人体工程学与圆形植入物：乳房手术美学效果的综合评估和长期随访”。

IF 3.4 2区医学

Plastic and reconstructive surgery Pub Date : 2026-05-01 Epub Date: 2025-10-14 DOI: 10.1097/PRS.0000000000012519

Ruth M Graf, Maria C C Ono, Dayane R de Paula, Renato S Freitas, Ovídio L Ferreira

{"title":"Ergonomix versus Round Implants: A Comprehensive Evaluation of Aesthetic Outcomes and Long-Term Follow-Up in Breast Surgery.","authors":"Ruth M Graf, Maria C C Ono, Dayane R de Paula, Renato S Freitas, Ovídio L Ferreira","doi":"10.1097/PRS.0000000000012519","DOIUrl":"10.1097/PRS.0000000000012519","url":null,"abstract":"Background: Breast implant shape influences final aesthetic outcomes, but direct comparisons remain limited. Anatomical implants offer natural results but have associated risks. Round implants provide fullness with fewer complications. This study assesses whether experienced surgeons can distinguish between Motiva round and Ergonomix implants postoperatively.Methods: Twenty patients undergoing primary subfascial breast augmentation were randomly assigned to receive either Motiva round or Ergonomix implants. Standardized surgical techniques were applied, and postoperative evaluations occurred at 6 and 18 months, conducted by blinded independent assessors analyzing shape, contour, and symmetry. Statistical tests included Mann-Whitney, Wilcoxon, and interrater reliability, with significance set at P < 0.05.Results: Patients had a mean age of 24.5 years, with similar preoperative breast volumes and implant sizes. A total of 662 evaluations showed that round implants were identified correctly at a rate of 68.3%. Ergonomix implants were identified correctly in 51.9% of cases. In the standing position, recognition of Ergonomix implants improved significantly from 47.8% to 70.8% ( P = 0.041). The nipple-to-inframammary fold distance increased slightly more in the Ergonomix group, without statistical significance.Conclusions: Ergonomix implants effectively combine the advantages of traditional round and anatomical designs, delivering a dynamic, gravity-responsive behavior that results in a more natural breast appearance, particularly in the upright position over time. The increased recognition accuracy suggests that their long-term performance may be underestimated, emphasizing the importance of extended follow-up to fully assess implant outcomes.","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"826-834"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293122","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}

引用次数: 0

Blocking the Holes: A Systems-Based Approach to Error Prevention in the Operating Room Using the Swiss Cheese Model. 堵塞漏洞：使用瑞士奶酪模型在手术室中预防错误的基于系统的方法。

IF 3.4 2区医学

Plastic and reconstructive surgery Pub Date : 2026-05-01 Epub Date: 2025-10-23 DOI: 10.1097/PRS.0000000000012561

Alisha S Khosla, Emily E Zona, Myiah P Quach, Camille J LaLiberte, Samuel O Poore

引用次数: 0

Reply: Predictors of Facial Synkinesis Severity. 回复：面部综合功能严重程度的预测因子。

IF 3.4 2区医学

Plastic and reconstructive surgery Pub Date : 2026-05-01 Epub Date: 2026-04-29 DOI: 10.1097/PRS.0000000000012614

Shai M Rozen, Benjamin Rail

引用次数: 0

Discussion: Efficacy and Safety of Ultrasound-Guided Carpal Tunnel Release: A Systematic Review and Meta-Analysis. 讨论：超声引导下腕管释放术的有效性和安全性：系统回顾和meta分析。

IF 3.4 2区医学

Plastic and reconstructive surgery Pub Date : 2026-05-01 Epub Date: 2026-04-29 DOI: 10.1097/PRS.0000000000012520

John R Fowler

引用次数: 0

Discussion: Prepectoral versus Subpectoral Implant-Based Breast Reconstruction: Evaluating the Shift. 讨论：胸前与胸下假体乳房重建：评估转移。

IF 3.4 2区医学

Plastic and reconstructive surgery Pub Date : 2026-05-01 Epub Date: 2026-04-29 DOI: 10.1097/PRS.0000000000012573

Debra J Johnson

引用次数: 0

Body Mass Index as a Predictor of Surgical Outcomes in Gender-Affirming Vaginoplasty: A Nationwide Analysis. 体重指数作为性别确认阴道成形术手术结果的预测因子：一项全国性分析。

IF 3.4 2区医学

Plastic and reconstructive surgery Pub Date : 2026-05-01 Epub Date: 2025-10-09 DOI: 10.1097/PRS.0000000000012514

Artur Manasyan, Erin M Wolfe, Jacqueline Stoneburner, Idean Roohani, Eloise W Stanton, Michael I Kim, Roberto Travieso

{"title":"Body Mass Index as a Predictor of Surgical Outcomes in Gender-Affirming Vaginoplasty: A Nationwide Analysis.","authors":"Artur Manasyan, Erin M Wolfe, Jacqueline Stoneburner, Idean Roohani, Eloise W Stanton, Michael I Kim, Roberto Travieso","doi":"10.1097/PRS.0000000000012514","DOIUrl":"10.1097/PRS.0000000000012514","url":null,"abstract":"Background: There is no universally agreed upon body mass index (BMI) cutoff for performing gender-affirming vaginoplasty. This study aimed to identify the relationship between BMI and postoperative outcomes, if any, following vaginoplasty in adult transgender patients.Methods: A retrospective analysis was performed using the National Surgical Quality Improvement Program data sets from 2005 through 2022. Adult patients with an International Classification of Diseases-9 or International Classification of Diseases-10 code diagnosis of gender dysphoria who underwent gender-affirming vaginoplasty were included. Multivariable logistic regressions were performed to assess the impact of BMI on surgical outcomes.Results: Among 11,574,114 patients in the database, 312 patients underwent gender-affirming vaginoplasty. Patients in the higher obesity classes demonstrated higher rates of 30-day readmissions ( P < 0.001), 30-day reoperations ( P < 0.001), operating room takebacks ( P < 0.001), and wound dehiscence ( P < 0.001). Upon multivariable regression analysis, class 2 or 3 obesity diagnoses significantly increased the risk of 30-day readmissions (odds ratio [OR], 33.6 [ P = 0.008]; OR, 69.1 [ P = 0.001], respectively), 30-day reoperations (OR, 25.3 [ P = 0.011]; OR, 61.4 [ P = 0.001], respectively), and operating room takebacks (OR, 25.3 [ P = 0.011]; OR, 61.4 [ P = 0.001], respectively). The risk of wound dehiscence was significantly higher for patients with class 3 obesity (19.5 [ P = 0.004]), but not for those with class 2 obesity (OR, 3.3 [ P = 0.377]).Conclusions: Patients with class 3 obesity have higher rates of dehiscence, reoperation, and readmission. Surgeons should consider these findings when discussing risks and expectations with patients during the informed consent process.","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"922-927"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275489","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}

引用次数: 0