Plastic and reconstructive surgery最新文献

{"title":"Reinnervated Serratus Free Flap for a Functional Outcome in Tongue Reconstruction: A Surgical Technique Video.","authors":"Bertrand Baujat, Nicolas Broustaut, Etienne Dauzier, Marc Tassart, Isabelle Wagner, Sarah Atallah, Alix Marhic","doi":"10.1097/PRS.0000000000011447","DOIUrl":"10.1097/PRS.0000000000011447","url":null,"abstract":"<p><strong>Summary: </strong>The current benchmark for tongue reconstruction after excision of locally advanced tumors involves the use of free skin or fasciocutaneous flaps, such as the anterolateral thigh flap or forearm free flap. They facilitate the volumetric reconstruction of the tongue, leveraging passive mobility from the remaining native tongue tissue. The challenge in tongue reconstruction surgery remains achieving functional restoration through adequate volume and optimized mobility, using tissue that is both adapted and comparable to native tissue. Although the free serratus muscle flap has been described for various indications, its application in tongue reconstructions remains underexploited. In cases of locally advanced tumors affecting the mobile tongue, typically within the junctional area and without extension to the floor of the mouth or to the tip of the tongue, the serratus free flap has shown positive results. Reinnervation of the flap is achieved connecting the thoracodorsal nerve to the descending branch of the XII nerve. This technique facilitates functional tongue reconstruction, promoting rapid mucosal epithelialization and reinnervation, which, in turn, preserves muscle volume and sustains adequate trophicity without fibrosis. Regarding these considerations, the pure muscle serratus free flap emerges as a valuable and effective alternative in tongue reconstruction. There is a dearth of step-by-step operative technique descriptions for this indication in the literature. The authors present videos demonstrating the surgical technique, showcasing procedures as performed at Tenon Hospital (Paris, France).</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"1318-1321"},"PeriodicalIF":3.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140336552","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: Coverage of Congenital Anomalies: Ensuring Lasting Smiles Act in Legislation.","authors":"Andrew D Linkugel, Michael L Cunningham, Srinivas M Susarla","doi":"10.1097/PRS.0000000000011473","DOIUrl":"10.1097/PRS.0000000000011473","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"154 6","pages":"1359-1360"},"PeriodicalIF":3.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716866","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: Polyethylene Glycol-Mediated Axonal Fusion Promotes Early Sensory Recovery after Digital Nerve Injury: A Randomized Clinical Trial.","authors":"Anna Luan, Kyle R Eberlin","doi":"10.1097/PRS.0000000000011436","DOIUrl":"10.1097/PRS.0000000000011436","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"154 6","pages":"1257-1258"},"PeriodicalIF":3.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716870","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":"Photometric Comparison of Skin Color Match between Abdominal and Thigh-Based Free Flaps for Breast Reconstruction in White Patients.","authors":"Maximilian Mahrhofer, Raphael Reichert, Frederic Fierdel, Xinchen Gu, Johannes Grabenwöger, Elisabeth Russe, Thomas Schoeller, Laurenz Weitgasser","doi":"10.1097/PRS.0000000000011547","DOIUrl":"10.1097/PRS.0000000000011547","url":null,"abstract":"<p><strong>Background: </strong>With the increasing demand for autologous breast reconstruction, different surgical techniques have emerged to provide patients with the best possible result tailored to their individual needs. The upper thigh provides an alternative tissue resource in patients where abdominal based flaps are not feasible. Although surgical outcomes and donor-site morbidity demonstrate favorable results using abdominal and thigh-based free flaps for autologous breast reconstruction, the differences in skin constitution and color between the two flap donor sites have not been investigated.</p><p><strong>Methods: </strong>From the authors' flap database, 60 patients who underwent unilateral secondary breast reconstruction with free deep inferior epigastric perforator (DIEP) or transverse myocutaneous gracilis (TMG) flaps where randomly selected. In both cohorts, postoperative pictures were used for photometric color evaluation of the reconstructed breast using the delta E (ΔE) 2000 score at time A (1.5 to 3 months), time B (6 to 8 months), and time C (12 to 20 months). Standard univariate descriptive statistics and group comparisons were performed.</p><p><strong>Results: </strong>The DIEP flap demonstrated a better skin color match at time A ( P < 0.001), time B ( P = 0.003), and time C ( P = 0.009). Over time, both flaps showed improved ΔE 2000 values, and patient age was only associated with higher ΔE 2000 values in TMG flaps after 1.5 to 3 months ( P = 0.021).</p><p><strong>Conclusions: </strong>The study provides the first objective analysis of skin color match in secondary autologous breast reconstruction. The DIEP flap reconstruction shows a preferable color match compared with the TMG flap. Both free flaps demonstrate an improved skin color match 12 to 20 months after secondary breast reconstruction.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, III.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"1076e-1083e"},"PeriodicalIF":3.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082101","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":"Characterization and Risk Factors of Folliculitis after Hair Transplantation: A Multicenter Retrospective Study.","authors":"Yi Zhou, Jiaxian Zhang, Yanhua Yi, Xiang Xie, Rui Lei, Zhexiang Fan, Pingping Sun, Zhiqi Hu, Qian Qu, Yong Miao","doi":"10.1097/PRS.0000000000011175","DOIUrl":"10.1097/PRS.0000000000011175","url":null,"abstract":"<p><strong>Background: </strong>Postoperative folliculitis is a common complication of hair transplantation (HT) requiring effective preventive interventions. This study characterized postoperative folliculitis and determined risk factors in patients undergoing HT.</p><p><strong>Methods: </strong>The authors retrospectively reviewed 1317 patients who underwent HT and completed 9-month follow-up between January of 2018 and June of 2021 at 4 medical centers. The incidence of postoperative folliculitis and demographic characteristics were assessed. Logistic regression analysis was used to identify risk factors, and the characteristics of different types of folliculitis were compared.</p><p><strong>Results: </strong>The overall incidence of postoperative folliculitis was 12.11%, and clinical characteristics varied among the different types of folliculitis. Surgery in summer (OR, 1.772 [95% CI, 1.05 to 2.992]), number of transplant grafts 4000 or greater (OR, 4.818 [95% CI, 1.45 to 16.014]), transplant density greater than 45 grafts/cm 2 (OR, 2.152 [95% CI, 1.376 to 3.367]), and first nursing time greater than 3 days (OR, 1.555 [95% CI, 1.088 to 2.223]) were the main risk factors for postoperative folliculitis.</p><p><strong>Conclusions: </strong>Postoperative folliculitis after HT presents different characteristics. Surgical factors and postoperative nursing care were demonstrated to be related to folliculitis. The authors propose a preventive folliculitis model based on preoperative, intraoperative, and postoperative factors.</p><p><strong>Clinical question/level of evidence: </strong>Risk, III.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"1115e-1122e"},"PeriodicalIF":3.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71413525","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":"Clinical Applications of Tranexamic Acid in Plastic and Reconstructive Surgery.","authors":"Stav Brown, Tal Brown, Rod J Rohrich","doi":"10.1097/PRS.0000000000011288","DOIUrl":"10.1097/PRS.0000000000011288","url":null,"abstract":"<p><strong>Background: </strong>Tranexamic acid (TXA) has gained increasing recognition as a valuable pharmacologic agent within plastic surgery. This study reviews the scientific evidence regarding the use of TXA in the full range of plastic and reconstructive surgery to provide clinical recommendations for safe and effective use in various plastic surgical procedures.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. An established appraisal process was used to rate the quality of articles (Grading of Recommendations Assessment, Development, and Evaluation methodology).</p><p><strong>Results: </strong>Forty-five studies describing the use of TXA in plastic surgery were included. There is moderate-certainty evidence to support the use of intravenous administration of TXA in craniofacial surgery procedures to reduce blood loss and transfusion requirements. There is high-certainty evidence to support the use of TXA in cosmetic surgery and intravenous administration in rhinoplasty procedures to reduce blood loss. Further high-level studies are needed to determine TXA's effects on hematoma rates in face-lift surgery and breast-related procedures. There is moderate-certainty evidence to support the use of TXA in burn care. Further studies are required to provide quantitative conclusions on the effects of TXA administration in microsurgery.</p><p><strong>Conclusions: </strong>This is the largest study to date on the use of TXA in plastic surgery and the first to provide clinical recommendations. The literature highlights TXA's promising role in the fields of craniofacial surgery, cosmetic surgery, and burn care. Standardized, objective measurements are required to provide quantitative conclusions regarding TXA's effects on ecchymoses and edema in cosmetic surgery procedures.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"1253e-1263e"},"PeriodicalIF":3.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404056","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":"Parallel Osteotome Technique: New Approach to Reduce Neurosensory Disturbances following Bilateral Sagittal Split Osteotomy.","authors":"Anantanarayanan Parameswaran, Elavenil Panneerselvam","doi":"10.1097/PRS.0000000000011291","DOIUrl":"10.1097/PRS.0000000000011291","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to determine clinically whether the parallel osteotome technique (POST) reduces the incidence of neurosensory disturbances (NSDs) following bilateral sagittal split osteotomy (BSSO), and to corroborate the findings with finite element analysis.</p><p><strong>Methods: </strong>The authors conducted a quasiexperimental study of 30 patients requiring BSSO. The sample was divided into two groups: a control group who underwent the conventional osteotomy technique and an experimental group who underwent POST osteotomy. A finite element analysis simulation of the two techniques was also generated for computational analysis. The primary outcome was clinical comparison of subjective and objective measures for NSDs; the secondary outcome was a comparison of stress, strain, and deformation. The osteotomy technique was the exposure studied. Data were analyzed for differences in proportions and means.</p><p><strong>Results: </strong>Thirty patients (12 female and 18 male patients; age range, 18 to 28 years; mean age, 21.6 years) were recruited for the study, providing 60 sides as a sample. The experimental group had significantly lower subjective scores for NSD at the 3-month ( P = 0.03) and 6-month follow-ups ( P = 0.025). Objective testing revealed a lower incidence of NSDs for the experimental group during postoperative months 3 ( P = 0.07), 6 ( P = 0.007), and 12 ( P = 0.17). The computational analysis also revealed significantly lower stress ( P = 0.007), strain ( P = 0.009), and deformation ( P = 0.04) on the inferior alveolar nerve with the POST osteotomy.</p><p><strong>Conclusions: </strong>The incidence of NSDs following BSSO is lower with the POST osteotomy. This technique also induced significantly lower deformational forces on the inferior alveolar nerve when compared with the conventional osteotomy.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"1181e-1190e"},"PeriodicalIF":3.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404059","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":"Upper Extremity Surgery in Cervical Spinal Cord Injury: A Prospective Comparative Mixed-Methods Study.","authors":"Rachel Skladman, Caitlin A Francoisse, Allison J L'Hotta, Christine B Novak, Catherine M Curtin, Doug Ota, Katherine C Stenson, Katharine Tam, Carie R Kennedy, Aimee James, Ida K Fox","doi":"10.1097/PRS.0000000000011352","DOIUrl":"10.1097/PRS.0000000000011352","url":null,"abstract":"<p><strong>Background: </strong>Cervical spinal cord injury (SCI) has a devastating effect on health and independence. Restoring upper extremity function is a top priority and can be accomplished by tendon transfer (TT) and nerve transfer (NT) surgery. The purpose of this prospective comparative study was to assess long-term changes in upper extremity function between surgical (TT or NT) and nonsurgical groups through a comprehensive mixed-methods approach.</p><p><strong>Methods: </strong>This multicenter cohort study compared data among 3 groups: those undergoing no surgery, TT surgery, or NT surgery. Quantitative data from the Spinal Cord Independence Measure (SCIM) and 36-item Short Form Health Survey were collected at baseline and long-term follow-up (6 to 24 months). Qualitative semistructured interview data were also obtained from these participants and their identified caregivers at baseline, early follow-up (1 month), and long-term follow-up (6 to 24 months).</p><p><strong>Results: </strong>Thirty-one participants had quantitative data across all time points: no surgery ( n = 14), TT ( n = 7), and NT ( n = 10). SCIM scores improved in TT and NT groups compared with the no-surgery group ( P < 0.05). The 36-Item Short Form Health Survey scores did not differ among groups. Qualitative data analysis ( n = 168 interviews) corroborated SCIM findings: surgical participants and their caregivers reported improvement in transfers and ability to perform activities of daily living, including grooming and self-catheterization. Improved use of electronics and ability to operate a motor vehicle were also reported. Postoperative therapy was identified as a critical component of achieving gains.</p><p><strong>Conclusions: </strong>TT and NT surgery lead to quantitative and qualitative functional gains when compared to no surgery. This comparative information should be used to help surgeons discuss treatment options.</p><p><strong>Clinical qusetion/level of evidence: </strong>Therapeutic, II.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"1149e-1159e"},"PeriodicalIF":3.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723662","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":"Alar Base Lining Graft: A New Technique to Prevent and Correct Alar Retraction in Primary and Secondary Rhinoplasty.","authors":"Mirco Pozzi, Pietro Susini, Andrea Murante, Alberto Bolletta, Roberto Cuomo, Carlos Weck Roxo","doi":"10.1097/PRS.0000000000011353","DOIUrl":"10.1097/PRS.0000000000011353","url":null,"abstract":"<p><strong>Background: </strong>Rhinoplasty traditionally presents a challenge for plastic surgeons. The aim of this article is to describe a new alar base lining graft (ABLG) in augmentation rhinoplasty to prevent and treat alar retraction.</p><p><strong>Methods: </strong>In this study, the authors retrospectively reviewed patients treated with ABLG at their institution between July of 2019 and April of 2022. The authors describe their technique and graft. At a minimum follow-up time of 1 year, postoperative photographs were taken, and patients were reassessed, evaluating aspects such as global symmetry, shape, and contour of the nose. Patient satisfaction was investigated according to the rhinoplasty outcomes evaluation questionnaire.</p><p><strong>Results: </strong>A total of 42 patients were included in the study. They reported significant satisfaction with the aesthetic results, as demonstrated by the mean postoperative rhinoplasty outcomes evaluation score. Alar contracture in secondary rhinoplasty was treated successfully. None of the grafts was extruded or collapsed. Wounds healed without reported major infection.</p><p><strong>Conclusion: </strong>This study demonstrates that ABLG is safe, contributes to improved functional and aesthetic outcomes, results in a high patient satisfaction rate, and has a low rate of postoperative complications.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, IV.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"1211-1216"},"PeriodicalIF":3.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723659","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":"Perioperative Estrogen Hormonal Therapy Does Not Increase Venous Thromboembolism Risk in Facial Feminization Surgery.","authors":"Alexander Y Li, Matthew J Park, Jennifer Fick, Douglas K Ousterhout, Jordan C Deschamps-Braly","doi":"10.1097/PRS.0000000000011437","DOIUrl":"10.1097/PRS.0000000000011437","url":null,"abstract":"<p><strong>Background: </strong>Conflicting data exist regarding increased perioperative venous thromboembolism (VTE) risk with feminizing hormone therapy. The effect has been poorly studied within the transgender population. Acute perioperative cessation of feminizing hormone therapy often leads to unpleasant side effects and exacerbates gender dysphoria in the perioperative period. The authors sought to identify VTE incidence in patients undergoing facial feminization surgery while continuing hormone replacement therapy throughout the time of surgery.</p><p><strong>Methods: </strong>A 38-year retrospective cohort study within a 2-surgeon practice (D.K.O. and J.C.D.-B.) was designed to evaluate postoperative VTE in patients continuing hormone therapy. The primary outcome variable was postoperative VTE.</p><p><strong>Results: </strong>A total of 1715 patients underwent facial feminization surgery within our search window. A total of 953 patients met final inclusion criteria. One patient (0.10%) was diagnosed with a VTE postoperatively, comparable to reported literature rates for similar cosmetic and orthognathic procedures. The average Caprini score of all patients was 3.1 ± 1.0 and the average case length was 491.9 ± 111.0 minutes. Subgroup analysis of patients before and after internal practice changes identified 714 patients (77.7%) continuing full-dose hormonal therapy perioperatively, 197 (20.7%) undergoing hormonal dose reduction to 25% to 50% perioperatively, and 8 who were either not taking hormonal therapy or stopped in the perioperative period. There was no significant difference in VTE incidence among the 3 subgroups ( P > 0.99).</p><p><strong>Conclusions: </strong>Perioperative use of feminizing hormonal therapy does not increase risk for perioperative VTE in patients undergoing facial feminization surgery. Therefore, it is reasonable to continue these medications through the time of surgery.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, III.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"1309-1315"},"PeriodicalIF":3.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11584186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140336511","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}