Plastic and Reconstructive Surgery Global Open最新文献

{"title":"Managing Complicated Nontuberculous Mycobacteria Infections in Plastic Surgery.","authors":"Miriam García-Ruza, Juan Blanco, Katherine Campusano, Douglas Silva, Franklin Claro, Jacobus H de Waard","doi":"10.1097/GOX.0000000000006254","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006254","url":null,"abstract":"<p><p>Nontuberculous mycobacteria (NTM) infections after cosmetic surgery have become an increasing concern. These infections are often initially misdiagnosed and treated with standard antibiotic regimens, which fail to resolve the underlying infection, leading to prolonged patient suffering. In this case study, we describe a chronic wound infection caused by <i>Mycobacterium abscessus</i> subsp. <i>bolletii</i> after a muscle-repair abdominoplasty. This case illustrates the diagnostic and therapeutic challenges plastic surgeons face in successfully treating such infections. Initial obstacles included the isolation of co-contaminating bacteria that masked the NTM infection, the use of antibiotics ineffective against the specific NTM species, and the failure to identify the infection source. In this instance, contaminated skin marker ink used to mark the rectus muscle, combined with a nonabsorbable (permanent) suture for muscle repair, led to the development of a biofilm that acted as a persistent reservoir for the infection, resistant to antibiotic treatments. Complete resolution was achieved only after evaluation by a plastic surgeon experienced in treating NTM infections and the subsequent removal of the permanent suture. The delayed suture removal contributed to a 15-month recovery period. This case underscores the importance of early recognition of NTM infections after cosmetic procedures. By sharing this case, we aim to raise awareness of NTM infections and help prevent future cases of misdiagnosis and prolonged antibiotic treatments. Key points regarding the diagnosis, sources of infection, and treatment options for NTM infections are highlighted in this article using \"text boxes\" to emphasize the most important information and provide concise summaries of critical insights.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Plastic Surgery Complications at a Tertiary Medical Center after Aesthetic Procedures.","authors":"Caitlyn C Belza, Kelli Lopes, Paige Benyamein, Cyril Harfouche, Riley Dean, Santaria Geter, Clara J Lee, Dan Neubauer, Chris M Reid, Ahmed Suliman, Amanda A Gosman","doi":"10.1097/GOX.0000000000006250","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006250","url":null,"abstract":"<p><strong>Background: </strong>The aesthetic plastic surgery industry has seen tremendous growth, with Americans spending an estimated 20 billion dollars on procedures in 2020. However, the effect of complications from these procedures on the healthcare system is poorly understood. This study aims to create awareness regarding aesthetic procedure complications through the scope of plastic surgeons at a tertiary medical facility.</p><p><strong>Methods: </strong>A retrospective chart review was performed on patients who received care at a single academic tertiary referral center over 5 years for complications from a cash-paid aesthetic procedure at an outside facility. Physician and hospital billing data were analyzed for relevant encounters.</p><p><strong>Results: </strong>Patients in this study (n = 40) presented to the emergency department most frequently with complications secondary to abdominoplasty (35%), breast augmentation (27.5%), and injectable fillers (17.5%). The most common complications were infection (32.5%) and wound dehiscence (22.5%). Of those evaluated, 50% required inpatient admission. Additionally, 42.5% required surgical intervention. The distribution of payors included Medicaid (55%), commercial insurance (30%), and Medicare (7.5%), and 7.5% were uninsured. For physician billing, the total gross collection ratio was 21.3%, whereas the hospital billing total gross collection ratio was 25.16%.</p><p><strong>Conclusions: </strong>Larger referral hospitals are well-suited to support the aesthetic community with complication management; however, the care required to serve this population is resource-intensive. These data advocate for thorough closed-loop patient-surgeon communication regarding risk-benefit analysis and detailed courses of action should complications arise. Likewise, stronger communication between ambulatory surgical centers and tertiary referral centers may also help minimize complications and subsequent healthcare needs.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11498925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction of Extensive Scalp and Skull Defects with Dural Exposure: Report of a Series of Cases and Literature Review.","authors":"Aref Nassar, Samer Abou Zeid, Charbel El Feghaly, Elia Kassouf, Joy Naba, Marwan Nasr, Fadi Sleilati","doi":"10.1097/GOX.0000000000006259","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006259","url":null,"abstract":"<p><strong>Background: </strong>Large scalp and calvarial defects pose significant challenges for reconstruction. Successful reconstruction necessitates soft tissue restoration capable of withstanding radiation following tumor resection. Free flaps allow preserving and maintaining the structural and functional status of the reconstructed area. This article presents our experience with microsurgical free tissue transfer for scalp and calvarial defects as well as a literature review on the subject.</p><p><strong>Methods: </strong>A retrospective study was conducted to retrieve the files of all the extensive scalp/forehead defects with dural exposure treated in the plastic surgery department of Hotel Dieu de France University Hospital from September 2006 to December 2023.</p><p><strong>Results: </strong>Twelve free tissue transfers were performed in 11 patients between 2006 and 2023. In 3 cases, a 2-stage procedure was performed with the transfer of the free flap in the first stage and the ablative surgery in the second stage 1 week later. A muscular latissimus dorsi flap was used in 9 cases. In 3 patients, the defect involved the forehead and required cutaneous flaps: 2 radial forearm flaps and 1 parascapular flap. Complications included 1 flap venous thrombosis, 2 hematomas, 1 subdural hematoma, and 2 cases of distal flap necrosis.</p><p><strong>Conclusions: </strong>Free tissue transfer is indispensable for addressing large defects of the scalp and calvaria. A 2-stage operation is warranted for debilitated patients with a high risk of complications. The latissimus dorsi muscle flap is the flap of choice to cover extensive defects. Delayed cranioplasty is preferable in contaminated wounds.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11498929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot Study: Use of Stem Cell Therapy and Diced Cartilage in Secondary Rhinoplasty Cases Clinical Outcomes: The Golden Turkish Delight.","authors":"Ramazan Erkin Unlu, Ozer Ozmut, Hasan Murat Ergani, Burak Yasar, Furkan Yildirim","doi":"10.1097/GOX.0000000000006243","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006243","url":null,"abstract":"<p><strong>Background: </strong>Although many techniques in the secondary rhinoplasty field have been developed in recent years, there are debates regarding achieving results with a high satisfaction rate. We aimed to share the surgical use technique in secondary rhinoplasty patients by enriching the Turkish delight technique with mesenchymal stem cells, which we described as the golden Turkish delight (GTD) technique, and the long-term patient satisfaction results.</p><p><strong>Methods: </strong>The study was planned as prospective research, and 30 secondary rhinoplasty patients who presented to our service for rhinoplasty were included. The GTD technique was applied to these patients. The patient's satisfaction with the surgical procedure was evaluated at least 9-12 months after the surgery, and the Global Aesthetic Improvement Scale (GAIS) was used as a measurement tool.</p><p><strong>Results: </strong>Of the participants, the satisfaction levels of 30 patients were evaluated with a 1-year follow-up on average, and the rate of those who improved was found to be 80% using the GAIS score. The rate of those with high GAIS scores and those with high satisfaction levels was approximately 56%. Twenty percent of the patients were not satisfied with the result.</p><p><strong>Conclusions: </strong>When we evaluate the postoperative 1-year results of our patients in terms of satisfaction and complications, we may state that the absorption that may occur in the Turkish delight technique over time could give better results with the GTD technique. In addition to GTD and fat graft support, regenerative medicine products such as stromal vascular fraction are very effective in obtaining favorable results.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11498922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nasal Light Reflex: A Useful Intraoperative Tool in Correction of Cleft Lip Nasal Deformity.","authors":"Anil Madaree","doi":"10.1097/GOX.0000000000006187","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006187","url":null,"abstract":"<p><strong>Background: </strong>The correction of a unilateral cleft lip nasal deformity remains a challenge to cleft surgeons. It is difficult to obtain a routinely predictable outcome. This is in part due to there being no objective intraoperative method to assess the correction.</p><p><strong>Methods: </strong>We have come up with a simple objective intraoperative method to plan and assess the correction of the nasal deformity. This is done by assessing the nasal light reflex using a mobile phone camera to define the deformity. The points of the desired correction of the lower lateral cartilage are transposed onto the patient. Once the lip and nose repair is completed, another photograph is taken to assess the nasal light reflex and assess the extent of correction. If this is inadequate, further nasal correction is performed. We have used this procedure in 122 cleft lip patients with 93 complete and 29 incomplete.</p><p><strong>Results: </strong>We have found this to be a useful objective intraoperative method to assist in obtaining improved nasal correction in cleft lip patients. As is well known, relapse of the nose is common in cleft lip repairs, but this method allows one to better gauge the correction at the primary surgery.</p><p><strong>Conclusion: </strong>Nasal light reflex should be added to the armamentarium of cleft surgeons to assist in superior correction of the nose, which is an item that continues to vex these surgeons.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11498926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Control versus Choice in Deciding Career Pathway in Plastic Surgery: The Perfect Ratio.","authors":"Steven P Davison, Gregory Evans, Eleanor Ball, Ashley Newman, Wayne Sotile","doi":"10.1097/GOX.0000000000006240","DOIUrl":"10.1097/GOX.0000000000006240","url":null,"abstract":"<p><strong>Background: </strong>The decisions and components of a career in medicine have changed. Historically, a career selection was often a decision between joining an institution or academic center versus the fiscal risks associated with private practice. This created a relatively simple risk versus reward equation: those in private practice made more money if it went well. The medical landscape has changed immensely, and priorities and remuneration have morphed, including concerns about promoting and sustaining well-being.</p><p><strong>Methods: </strong>The authors performed a systematic review of scholarly databases to identify relevant resources to the topic of study. Additionally, the authors relied on their own cumulative experience in the field, including the work of Dr. Wayne Sotile of the Sotile Center for Physician Resilience.</p><p><strong>Results: </strong>The first installment of this article proposes a new model in opposition to the current standard of \"risk versus reward\" where the tradeoff is instead \"control versus choice,\" where autonomy is the new risk.</p><p><strong>Conclusions: </strong>The five components that make up the majority of the ingredients in a plastic surgery career are clinical practice model, administrative duty, corporate support, academic involvement, and per diem or retainers. Much of finding or developing a practice model that suits the individual is figuring out an acceptable ratio of these ingredients. Inherent to this process is how much authority one has versus instituted control of any form, from hospital to university to insurance company.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Change in Facial Appearance, Function, and Quality of Life after Cleft Surgery: A Nigerian Multicenter Longitudinal Pilot Study-Erratum.","authors":"","doi":"10.1097/GOX.0000000000006318","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006318","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1097/GOX.0000000000006201.].</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraneural Topography and Branching Patterns of the Common Peroneal Nerve: Studying the Feasibility of Distal Nerve Transfers.","authors":"Elliot L H Le, Taylor H Allenby, Marlie Fisher, Ryan S Constantine, Colin T McNamara, Caleb Barnhill, Anne Engemann, Orlando Merced-O'Neill, Matthew L Iorio","doi":"10.1097/GOX.0000000000006258","DOIUrl":"10.1097/GOX.0000000000006258","url":null,"abstract":"<p><strong>Background: </strong>Common peroneal nerve (CPN) disruption is the most common lower extremity nerve injury and results in gait disturbances and sensory paresthesias. The goal of this study is to describe branching patterns and the intraneural topography of the CPN to facilitate operative planning in CPN reconstruction.</p><p><strong>Methods: </strong>The CPN and its distal motor and sensory branches were dissected in 6 lower leg cadavers. Branching patterns and distances were recorded with the fibular head as the landmark. Histological review of the nerve cross sections helped characterize the intraneural topography within the fibular tunnel.</p><p><strong>Results: </strong>The CPN distal branching patterns were highly variable. The tibialis anterior motor branch was found on average 9.6 cm distal to the fibular head. Despite the variable branching patterns, the fascicular topography of the CPN within the fibular tunnel was consistent. Proximal to the tunnel, the nerve has 3 major fascicles, which include the superficial peroneal motor, common sensory, and deep peroneal motor (DPN) fascicles from lateral to medial. Within the tunnel, the topography consolidates into the superficial peroneal motor and DPN major divisions-motor axons anteriorly and sensory axons posteriorly.</p><p><strong>Conclusions: </strong>The data presented provide clinically relevant information for the peripheral nerve surgeon where fascicular reconstruction of the nerve and neurolysis should focus on the anterior half of the nerve to restore ankle dorsiflexion. The nerve proximally is divided into 3 major fascicles compared with 2 distally. Surgeons may consider distal nerve transfers from the tibial nerve motor branches to the DPN or tibialis anterior motor branch.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrence and Risk Factors of Giant Cell Tumors in Hand Bones: A Systematic Review.","authors":"Ori Berger, Mor Mendelson, David Goren, Andrey Andrakhanov, Ran Talisman","doi":"10.1097/GOX.0000000000006253","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006253","url":null,"abstract":"<p><strong>Background: </strong>Giant cell tumor of bone (GCTB) is a locally aggressive tumor that may affect the bones of the hand and rarely causes pulmonary metastasis. It exhibits a variable recurrence rate after surgical interventions, which presents challenges in its management. This systematic review aims to delineate recurrence rates and identify risk factors for GCTB in the hand.</p><p><strong>Methods: </strong>We conducted a systematic literature search in April 2024, following PRISMA guidelines, on PubMed and TDNet for studies reporting postsurgical recurrence of GCTB in the hand. Cohort and case-control studies provided recurrence rates, whereas case reports and series were utilized to identify risk factors, compensating for the sparse data in the primary studies. We used descriptive statistics, χ² tests, and logistic regression to analyze demographics, lesion characteristics, treatments, and outcomes.</p><p><strong>Results: </strong>We reviewed 13 cohort and case-control studies involving 244 patients, finding an overall recurrence rate of 19.57%. Curettage was associated with higher recurrence rates compared with other surgical methods. After additional review of case reports, a limited range of motion in patients emerged as a significant protective factor against recurrence, suggesting potential benefits in surgical management and outcome prediction.</p><p><strong>Conclusions: </strong>The significant recurrence rate associated with curettage highlights the need for alternative surgical strategies in GCTB management of the hand. The protective role of limited ROM underscores the importance of thorough preoperative assessments to optimize surgical approaches and enhance patient outcomes.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First Clinical Microvascular Anastomosis Reported and the Importance of Updating Historical Records.","authors":"Alberto Franchi, Jakob R Schnegg, Florian J Jung, Abdul R Jandali","doi":"10.1097/GOX.0000000000006262","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006262","url":null,"abstract":"","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}