Plastic and reconstructive surgery最新文献

{"title":"Spinal Accessory Nerve Injury in Patients with Brachial Plexus Injury: Prevalence, Predisposing Factors, and Spontaneous Recovery.","authors":"Yasunori Hattori, Kazuteru Doi, Sayantani Misra, Sotetsu Sakamoto, Jun Sasaki, Ayumi Suzuki, Kota Hayashi","doi":"10.1097/PRS.0000000000012199","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012199","url":null,"abstract":"<p><strong>Background: </strong>Spinal accessory nerve is occasionally injured during brachial plexus injuries, potentially limiting its use as a donor motor nerve for reconstructive surgery. Assessing spinal accessory nerve function pre-operatively is essential to optimize outcomes in brachial plexus reconstruction. We examined the demographics of spinal accessory nerve injury, focusing on its prevalence, predisposing factors, and potential for spontaneous recovery in patients with brachial plexus injuries.</p><p><strong>Methods: </strong>A total of 170 patients were included in this study. At the first visit, the spinal accessory nerve function was assessed by measuring the compound muscle action potential of the upper trapezius muscle. The function of the nerve was classified as follows: \"no injury\" (amplitude of the potential ≥ 50% compared to the unaffected side), \"partial injury\" (amplitude < 50%), and \"severe injury\" (absence of the potential). For the evaluation of spontaneous recovery, patients with partial and severe injuries underwent further assessment at 1 year after the injury and at the final follow-up.\"</p><p><strong>Results: </strong>We found the associated spinal accessory nerve injury in 30 patients (17.6%) (17: partial, 13: severe). Spinal accessory injury occurred in 13 of 39 patients with phrenic nerve palsy (33.3%). Phrenic nerve palsy may serve as a predisposing factor for this injury. In 18 patients followed for more than 1 year, 15 (83.3%) showed good spontaneous recovery.</p><p><strong>Conclusion: </strong>Spinal accessory nerve injury occurred in approximately 18% of patients with brachial plexus injuries. Most of the spinal accessory nerve injury associated with brachial plexus injury have a potential for good spontaneous recovery.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040474","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":"Incidence of Post Operative VTE following Panniculectomy in Patients with History of COVID-19.","authors":"Mary Newland, Charles C Lee, Cindy Li, Ashley Sun, John Potochny","doi":"10.1097/PRS.0000000000012202","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012202","url":null,"abstract":"<p><strong>Purpose: </strong>Venous thromboembolism (VTE) is a well-documented post operative complication with potentially life-threatening sequela. While the risk of VTE in plastic surgery patients is low, these devastating consequences pose a critical need for assessment of risk factors in elective operations. Recent research has elucidated that a history of COVID-19 infection may be an additional predisposing risk factor to VTE formation. Therefore, our study aims to assess the risk of VTE in panniculectomy patients with the history of COVID-19.</p><p><strong>Methods: </strong>The TriNetX LLC. National Health Research database, which collects data from hospitals within the United States, was queried to identify patients who underwent panniculectomy in the years 2017-2020 (pre-pandemic) and 2020-2023 (post-pandemic). Mandatory testing and reporting offered a unique opportunity to capture the ICD-10 COVID diagnosis during the study period. Post-pandemic patients were studied by querying the data to look for those with a history of COVID versus those without. These cohorts were analyzed to calculate the incidence rate of VTE in the 30 day post operative period.</p><p><strong>Results: </strong>A total cohort of 7,114 patients who underwent panniculectomy on prophylactic anticoagulation - a treatment for VTE - were identified. There were 3,015 patients in the pre-pandemic category and 4,099 patients in the post-pandemic group. Within the post-pandemic classification, there were 790 patients with a prior history of COVID and 3,309 patients without. The rate of VTE was not significantly different in the pre (3.2%) versus post (3.0%) pandemic cohorts (p=0.64). However, in the post-pandemic cohort, there was a significant difference in VTE rates between patients with (4.9%) and without (2.5%) prior history of COVID (p= 0.0002).</p><p><strong>Conclusion: </strong>Our study showed there was no significant increase in VTE incidence after panniculectomy during the pandemic. However, in the subpopulation of patients identified with a COVID diagnosis, we observed a significantly higher rate of VTE compared to panniculectomy patients without a diagnosis of COVID. Therefore, patients with a history of COVID may be more susceptible to postoperative VTEs. Seeing as its true long-term morbidity effects are yet to be fully understood, a history of COVID should be carefully considered when determining a patient's VTE risk. This data thereby warrants further study for optimal perioperative and postoperative anticoagulation strategies.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049112","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 Cost of Policy: Tariffs and Their Potential Ripple Effects in Plastic Surgery.","authors":"Francis D Graziano, Danielle H Rochlin, Babak J Mehrara, Jonas A Nelson","doi":"10.1097/PRS.0000000000012207","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012207","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049111","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":"Whose Procedure Is It Anyway? Navigating Specialty Creep in Plastic Surgery.","authors":"Abbas M Hassan, Gregory H Borschel, Timothy W King","doi":"10.1097/PRS.0000000000012206","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012206","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050051","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":"Subfascial Mini-Muscle Release Dual-Plane Technique: A Modified Procedure for Breast Augmentation.","authors":"Alexandre Mendonça Munhoz","doi":"10.1097/PRS.0000000000012204","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012204","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974956","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":"Barcelona Consensus Paper on Reconstructive Lymphedema Surgery: A Delphi Study.","authors":"Jaume Masià, Ali M Al Sakkaf, Joon Pio Hong, Peter Neligan, Gemma Pons, Alexandra Rovnaya, Patricia Martínez-Jaimez","doi":"10.1097/PRS.0000000000012201","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012201","url":null,"abstract":"<p><strong>Background: </strong>Lymphedema, a chronic condition characterized by accumulation of lymph fluid due to malfunction of the lymphatic system, remains a significant clinical challenge despite advances in diagnosis and treatment. Given that lymphatic surgery is an important therapeutic option, the aim of the present study was to establish an expert consensus on recommendations for improving the surgical management of lymphedema.</p><p><strong>Methods: </strong>This was an international consensus study involving a modified nominal group and Delphi process. During the World Symposium for Lymphedema Surgery in 2023, the steering group invited five experts to participate in a nominal group with the aim of drawing up a set of seven preliminary recommendations. These recommendations were then evaluated and revised by a panel of 31 international experts in a two-round Delphi process. The threshold for consensus was set at a minimum of 70% agreement among panelists.</p><p><strong>Results: </strong>Consensus regarding the content of the seven recommendations was high (mean overall agreement of 79.6%). Agreement was highest for the recommendations concerning specific techniques of reconstructive surgery, measures for preventing lymphedema and its clinical assessment, and post-intervention follow-up protocols.</p><p><strong>Conclusions: </strong>The consensus recommendations on the surgical management of lymphedema highlight the importance of preoperative preparation of patients and careful clinical assessment. Also recommended is the use of preventive surgical procedures, including the combination of reconstructive and reductive techniques, along with multidisciplinary monitoring and follow up. Although these guidelines hold promise, further studies are required to evaluate their implementation and explore their impact on patient health outcomes.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019896","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":"\"Introducing Preservation Rhinoplasty Principles to Cleft Nasal Surgery: Unveiling the Role of Nasal Ligaments in Infant Anatomy\".","authors":"Daniela Tanikawa, Álvaro Sá, Álvaro Figueroa, David Chong, Luiz Carlos Ishida","doi":"10.1097/PRS.0000000000012197","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012197","url":null,"abstract":"<p><p>Preservation rhinoplasty emphasizes maintaining ligament integrity for stable and natural surgical outcomes. However, its principles have not yet been applied to primary or secondary cleft nasal deformities. In our experience using a modified Tajima (reverse U) incision for cleft nasal reconstruction, we have previously reported unique kinking distortions in the cleft-side lower lateral cartilage (LLC) and distinct soft tissue attachments in abnormal relationship with the dome and crural regions. This raises questions about the role of the Pitanguy ligament-a key structure for nasal stability-in these deformities. During primary lip and nose repair on six infants with cleft lip and palate (three unilateral, three bilateral), we adapted preservation rhinoplasty principles by releasing and repositioning the Pitanguy ligament. This approach alleviated tension on the nasal tip, expanded the skin envelope, and facilitated precise midline alignment of the LLCs through controlled reconstruction of the intercrural and interdomal ligaments. Our findings suggest that preservation rhinoplasty principles, particularly ligament release and reconstruction, may offer functional and aesthetic improvements in cleft nasal surgery. This approach could represent a promising direction for primary and secondary cleft rhinoplasty, focusing on ligament management to achieve balanced and lasting outcomes. Further studies are needed to validate these findings and establish normative references for cleft anatomy.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027533","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":"Forward Strides in Academic Plastic and Reconstructive Surgery Gender Representation: 2025 Update.","authors":"Holly Cordray, Adina Singer, Helen Molteni, Saïd C Azoury","doi":"10.1097/PRS.0000000000012196","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012196","url":null,"abstract":"<p><strong>Background: </strong>Although academic plastic and reconstructive surgery has trended toward dismantling gender disparities over the last decade, gaps remain within program leadership. This study mapped gender distributions of plastic surgery chiefs and program directors (PDs) in context of faculty and trainees to characterize how current leadership reflects and shapes the broader gender landscape.</p><p><strong>Methods: </strong>In a national cross-sectional study, data on academic plastic surgery leaders, faculty, and trainees were extracted from program websites and/or social/professional media, determining gender using documented pronouns. Career metrics were collected for all leaders. Differences by gender were evaluated using Chi-square/Fisher's exact tests, independent-samples t-tests, and analyses of covariance. Associations among female representation in program leadership, faculty, and trainees were examined.</p><p><strong>Results: </strong>As of 2025, women comprise 26.4% of faculty and 50.9% of residents; 0.1% are nonbinary. In comparison, 13.5% of department/division chiefs, 22.5% of primary PDs, and 43.1% of associate PDs are female. Associate PDs are significantly more likely than chiefs or primary PDs to be female (P < .001), indicating expansion of women entering leadership positions. Analyses of qualifications and professional attainment supported gender parity in selection and advancement of program leaders. PDs may shape trainee gender distributions: significant associations suggested greater inclusion of female residents at programs with female primary and/or associate PDs (P ≤ .03). Female vs male leaders were associated with significantly greater female faculty representation within their programs (approximately 150% relative magnitudes, P ≤ .005).</p><p><strong>Conclusions: </strong>Gender inclusion has progressed throughout academic plastic surgery; parity among trainees anticipates further shifts.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027536","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":"Ashramas of Hinduism: A Guide to the Journey of Life and Career of a Plastic Surgeon.","authors":"Sakar Gupta, Pradeep K Attaluri, Arun K Gosain, Venkat K Rao","doi":"10.1097/PRS.0000000000012193","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012193","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994138","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":"Dorsal Preservation versus Open Structural Rhinoplasty: Can We Tell the Difference Between Aesthetic and Functional Outcomes?","authors":"Sean McCleary, Awais Khan, Sumun Khetpal, Catherine Cascavita, Yasmine Ibrahim, Erin M Wolfe, Alexandra Klomhaus, Jason Roostaeian","doi":"10.1097/PRS.0000000000012050","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012050","url":null,"abstract":"<p><strong>Purpose: </strong>Preservation - with respect to the dorsum, nasal cartilages, and soft tissue envelope - has re-emerged as a guiding philosophy in rhinoplasty. Dorsal preservation (DP) is attractive to its advantages of maintaining the osseocartilaginous construct and avoiding an open roof deformity. While several studies have suggested comparable outcomes of DP relative to structural rhinoplasty, it remains unclear how aesthetic, functional, and patient-reported outcome measures may compare, and also whether surgeons can discern differences between cohorts.</p><p><strong>Methods: </strong>A retrospective review of patients undergoing dorsal preservation and structural rhinoplasty were included. Pre- and post-operative photographs at one year were included. Patients were classified into two cohorts - DP versus non-dorsal preservation (NDP). There were three types of raters - the general population (GP), plastic surgeons (PS), and rhinoplasty surgeons (RS). Patients were also asked to fill out questionnaires, including Rhinoplasty Outcomes Evaluation (ROE) and Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS).</p><p><strong>Results: </strong>78 subjects were included within the analysis. Overall, the evaluators correctly identified the surgical approach 52.9% of the time. Rhinoplasty surgeons demonstrated the least inter-rater variability, when compared to the general population and plastic surgeons. From the ROE and SCHNOS questionnaire, the overall mean (SD) obstruction composite scores was comparable between DP and NDP cohorts.</p><p><strong>Conclusion: </strong>Across evaluators, there were comparable functional, aesthetic, and patient-reported outcomes between DP and NDP cohorts. Given its key advantage of ensuring the stability of the osseocartilaginous framework, DP should be performed for appropriate patients given its favorable aesthetic and functional outcomes.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009810","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}