Plastic and Reconstructive Surgery Global Open最新文献

{"title":"Addressing Earlobe Elongation: A Systematic Review of Surgical Reduction Techniques in the Aging Population.","authors":"Aref Nassar, Carla Nassar, Elia Kassouf, Marc Aoude, Charbel El Feghaly, Marwan Nasr","doi":"10.1097/GOX.0000000000006547","DOIUrl":"10.1097/GOX.0000000000006547","url":null,"abstract":"<p><strong>Background: </strong>Aging affects all the components of the face, and the earlobe stands among them. Elongation of the earlobes necessitates surgical correction to restore the youthful ear shape.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across the PubMed, Google Scholar, and Cochrane databases. The quality of the included studies was systematically assessed, and data pertaining to surgical earlobe reduction was extracted.</p><p><strong>Results: </strong>Thirteen articles that closely matched the study objectives were included in this systematic review. We regrouped these techniques into 3 categories: those involving inferior margin excision of the earlobe, those involving anterior earlobe resection, and the third group comprising other methods. To aid in clinical decision-making, we created an algorithm to guide the choice of the procedure.</p><p><strong>Conclusions: </strong>Proper management of earlobe ptosis and pseudoptosis enhances facial harmony. By outlining the available techniques and providing a treatment algorithm, we emphasize the importance of incorporating earlobe reduction into comprehensive facial rejuvenation strategies.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 2","pages":"e6547"},"PeriodicalIF":1.5,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449762","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":"Reply: Intraoperative Near-infrared Spectroscopy Can Predict Skin Flap Necrosis.","authors":"Claire Temple-Oberle","doi":"10.1097/GOX.0000000000006480","DOIUrl":"10.1097/GOX.0000000000006480","url":null,"abstract":"","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 2","pages":"e6480"},"PeriodicalIF":1.5,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449764","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":"Outcomes of 32,019 Deep Inferior Epigastric Perforator Flap Reconstructions: Insights from the Largest National Readmission Data.","authors":"Sthefano Araya, Heather Peluso, Nathan Doremus, Jaina Lane, Heli Patel, Lindsay Talemal, Daniel Najafali, Alexander H Chang, Sameer A Patel","doi":"10.1097/GOX.0000000000006536","DOIUrl":"10.1097/GOX.0000000000006536","url":null,"abstract":"<p><strong>Background: </strong>We analyzed patient outcomes after deep inferior epigastric perforator (DIEP) flap reconstruction using a national database to assess readmission, mortality, morbidity, and length of stay (LOS).</p><p><strong>Methods: </strong>This retrospective cohort study utilized the 2017-2020 Nationwide Readmissions Database. Patients had an International Classification of Diseases, Tenth Revision procedure code for DIEP flap reconstruction from January to November each year. The primary outcome was the 30-day readmission rate, with secondary outcomes including in-hospital and 30-day mortality, reasons for admission and readmission, and complication rates. Multivariate regression adjusted for confounders.</p><p><strong>Results: </strong>A total of 32,019 DIEP flap reconstructions were identified, with a median patient age of 51 years. The most common indication was breast reconstruction after mastectomy. In-hospital, 30-day, and calendar-year mortality rates were all under 1% (95% confidence interval [CI]: 1.29-3.99). The 30-day readmission rate was 5.8% (95% CI: 5.4%-6.3%), with infection being the leading cause of readmission (2.0%), a previously unreported finding. Other causes included wound dehiscence (0.19%), pulmonary embolism (0.19%), sepsis (0.18%), and hematoma (0.18%). Reoperation rates were 7% during the index hospitalization and 11% during readmission. The average LOS was 3.7 days (95% CI: 3.65-3.82), consistent with current literature.</p><p><strong>Conclusions: </strong>This study provides valuable insights into DIEP flap reconstruction outcomes, revealing a 2.0% infection readmission rate. It shows a higher overall readmission rate (7% versus 5.6%) and a lower dehiscence rate (0.2% versus 2.8%) compared with previous data. These findings, derived from the largest nationally representative readmission database in the United States, also demonstrate comparable reoperation rates and LOS.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 2","pages":"e6536"},"PeriodicalIF":1.5,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449763","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":"Reply: Comparative Rheology of Hyaluronic Acid Fillers, Poly-l-lactic Acid, and Varying Dilutions of Calcium Hydroxylapatite.","authors":"Danny J Soares, Alec D McCarthy, Akash Chandawarkar, Radia El-Banna, Nadine Hagedorn","doi":"10.1097/GOX.0000000000006504","DOIUrl":"10.1097/GOX.0000000000006504","url":null,"abstract":"","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 2","pages":"e6504"},"PeriodicalIF":1.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441674","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":"Comparative Rheology of Hyaluronic Acid Fillers, Poly-l-lactic Acid, and Varying Dilutions of Calcium Hydroxylapatite.","authors":"Jessica A Hicks, Åke Öhrlund","doi":"10.1097/GOX.0000000000006561","DOIUrl":"10.1097/GOX.0000000000006561","url":null,"abstract":"","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 2","pages":"e6561"},"PeriodicalIF":1.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441698","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":"Effectiveness of Intraoperative Ketorolac in Outpatient Breast Surgery: A Double-blinded Prospective Randomized Controlled Trial.","authors":"Joowon M Choi, Jose D Rodriguez, Michael A Saccocci, Robert P Shafer, Mark E Feldmann, Kurtis E Moyer, James T Thompson","doi":"10.1097/GOX.0000000000006540","DOIUrl":"10.1097/GOX.0000000000006540","url":null,"abstract":"<p><strong>Background: </strong>The use of nonnarcotic analgesics, such as ketorolac, has been shown to reduce postoperative pain and opioid consumption. This double-blinded randomized trial is designed to assess the efficacy of intraoperative ketorolac in reducing postoperative narcotic use in outpatient breast reconstruction and reduction procedures.</p><p><strong>Methods: </strong>This study is a prospective double-blinded randomized controlled trial. Adult patients, 18-64 years of age, undergoing breast surgery were randomized to receive 15 mg of ketorolac, 30 mg of ketorolac, or a placebo dose of saline. Patients' opioid requirements in the postoperative anesthesia care unit and postoperative opioid utilization and pain scores were collected through a daily survey. Postoperative hematomas were assessed before discharge and at subsequent follow-up visits for a period of 14 days.</p><p><strong>Results: </strong>Of the 63 patients included in the study, 31 patients underwent delayed reconstruction following mastectomy and 35 patients underwent breast reduction surgery. Patients who received 30 mg of ketorolac had the fastest pain resolution (<i>P</i> < 0.05). The rate of opioid discontinuance was the fastest overall in patients who received 15 mg of ketorolac (rate = -0.072) when compared with the 30-mg ketorolac group (rate = -0.071) and the placebo group (rate = -0.065). Total opioid usage in the postoperative anesthesia care unit was not statistically different across the 3 groups. Only 1 patient developed a hematoma in the 15-mg ketorolac group.</p><p><strong>Conclusions: </strong>This study demonstrates that a single dose of intraoperative ketorolac was associated with reduced opioid usage and postoperative pain. However, due to the study size, the difference in hematoma rate was not statistically significant.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 2","pages":"e6540"},"PeriodicalIF":1.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441664","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":"Mastering the Art of Independent Surgery: 10 Tips for Solo Surgeons in Reconstructive Microsurgery.","authors":"Chad Chang, Juan Enrique Berner, Martina Astolfi, Filippo Di Meglio, Alex Sorkin, Hung-Chi Chen, Marco Marcasciano","doi":"10.1097/GOX.0000000000006535","DOIUrl":"10.1097/GOX.0000000000006535","url":null,"abstract":"<p><p>The increasing necessity for solo surgery in plastic and reconstructive microsurgery is driven by contemporary challenges such as a growing and aging population, a shortage of qualified assistants, and the ongoing recovery efforts from COVID-19. Historically limited to remote or exceptional circumstances, solo surgery is now more frequently performed due to these evolving factors. Technological advancements, including robotics, play a crucial role in facilitating this transition and supporting the trend toward self-sufficiency in surgical practice. This article presents practical strategies for executing solo surgery based on our team's experience and a review of current literature. Key considerations discussed include patient positioning and optimizing surgical workflows. By presenting these recommendations and techniques, derived from both practical experience and literature, we highlight that plastic surgeons and microsurgeons can maintain consistently high standards of surgical care, even when operating independently.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 2","pages":"e6535"},"PeriodicalIF":1.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441667","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":"Readability of Patient Education Materials in Plastic Surgery: Assessing 14 Years of Progress.","authors":"Peter J Wirth, Aleah M Warden, Steven P Moura, Pradeep K Attaluri, Jeffrey D Larson","doi":"10.1097/GOX.0000000000006541","DOIUrl":"10.1097/GOX.0000000000006541","url":null,"abstract":"<p><strong>Background: </strong>Current recommendations suggest that patient education materials (PEMs) be written at or below the sixth-grade reading level. In a 2010 study, the average readability of PEMs on the American Society of Plastic Surgeons (ASPS) and The Aesthetic Society (AS) websites was found to be at the 11th-grade level or higher. We sought to assess progress made toward providing accessible PEMs.</p><p><strong>Methods: </strong>PEMs were obtained from the ASPS and AS websites. The PEMs were entered into an online scoring tool. PEMs were scored on 3 common readability indices: Flesch-Kincaid, Simple Measure of Gobbledygook, and Flesch Reading Ease (FRE).</p><p><strong>Results: </strong>The average grade level of ASPS PEMs calculated using the Flesch-Kincaid, Simple Measure of Gobbledygook, and FRE readability models were 9.7 ± 1.1, 12.6 ± 0.7, and 47.6 ± 6.2, respectively. This FRE score corresponds to approximately grade 13-16 reading levels. The average of AS PEMs were 9.3 ± 0.5, 12.3 ± 0.3, and 51.3 ± 3.9, respectively; this FRE corresponds to grade 10-12 reading levels. There were no PEMs written at or below the recommended sixth-grade reading level found on ASPS and AS websites.</p><p><strong>Conclusions: </strong>Despite increasing awareness of the need for equitable access to healthcare, PEMs continue to be written at a reading level well above the recommendation. Over the past 14 years, we have seen only modest improvement in readability indices. In addition to advocating for more accessible PEMs, we must gather a deeper understanding of how patients seek information about plastic surgery.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 2","pages":"e6541"},"PeriodicalIF":1.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441671","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":"Impact of Surgery Timing on Outcomes After Nerve Transfer to Restore Elbow Flexion.","authors":"Katie Hicks, Justin Haas, Moaath Saggaf, Christine B Novak, Jana Dengler","doi":"10.1097/GOX.0000000000006460","DOIUrl":"10.1097/GOX.0000000000006460","url":null,"abstract":"<p><strong>Background: </strong>Nerve reconstruction following brachial plexus injury (BPI) is a time-sensitive procedure, and surgical delay may negatively impact muscle reinnervation and outcomes. This study investigated the impact of surgical timing on elbow flexion strength in patients with BPI undergoing nerve transfer to restore elbow flexion.</p><p><strong>Methods: </strong>Following PRISMA guidelines, MEDLINE, Embase, and the Cochrane Library databases were systematically searched. English-language studies investigating the single fascicular transfer (SFT) or double fascicular transfer (DFT) to restore elbow flexion in BPI were included. Data were analyzed to identify the predictors of elbow flexion strength: surgery timing, age, injury level, and SFT versus DFT.</p><p><strong>Results: </strong>The literature search identified 1051 articles. Studies (n = 31) reporting data of individual patients who underwent SFT (n = 341) or DFT (n = 67) were included; the mean age was 29.6 ± 11.2 years, time from injury to surgery was 6.5 ± 5.0 months, and follow-up was 27.1 ± 24.3 months. Good elbow flexion strength was found: Medical Research Council grade greater than or equal to 3 in 352 (86.3%) and Medical Research Council grade greater than or equal to 4 in 288 (70.6%). In the adjusted analysis, poorer motor recovery was associated with increased age (<i>P</i> = 0.02), surgical delay (<i>P</i> < 0.0001), C5-7 injuries (<i>P</i> < 0.01), and pan-plexus injuries (<i>P</i> < 0.0001). A 32% reduction in the odds of favorable motor recovery was observed with a 3-month delay to surgery. Patients who had a nerve transfer 6 months or earlier from injury had 2.4 times the odds of favorable motor recovery (<i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>SFT and DFT provide excellent elbow flexion strength in the majority of patients. Following nerve transfers in individuals with BPI, poorer motor recovery was observed with each 3-month delay to surgery.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 2","pages":"e6460"},"PeriodicalIF":1.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433432","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":"Predictive Evaluation of Septal Cartilage-bone Complex for Rhinoplasty Using Cone Beam Computed Tomography.","authors":"Min-Gi Seo, Dong-Woo Jung","doi":"10.1097/GOX.0000000000006473","DOIUrl":"10.1097/GOX.0000000000006473","url":null,"abstract":"<p><strong>Background: </strong>Septal extension grafting (SEG) is commonly used for correcting Asian short noses. When septal cartilage is limited, septal bone can be included. This study evaluates the outcomes of SEG using a septal cartilage-septal bone complex (SCBC) and assesses preoperative cone beam computed tomography (CBCT) for predicting septal bone suitability.</p><p><strong>Methods: </strong>A retrospective review was conducted of Korean women planned for SEG with SCBC from July 2021 to June 2022. Preoperative CBCT scans measured Hounsfield Unit (HU) values for septal cartilage, perpendicular plate of the ethmoid (PPE), and vomer. Of 27 patients, 19 underwent SEG with SCBC, whereas 8 did not due to unsuitable septal bone. Clinical outcomes and satisfaction were assessed through surveys and photographs.</p><p><strong>Results: </strong>For the 19 patients using SCBC, the average HU for PPE was 286.5 ± 126.6 (ratio 6.8 ± 2.1), and for vomer, HU was 230.3 ± 95.2 (ratio 5.7 ± 1.8). SEG significantly improved nasal length and tip projection, although tip softness was less favorable. Among the 8 patients not using SCBC, 5 had bones that were too thick and stiff (PPE: 667.8 ± 102.2, ratio 15.5 ± 2.7; vomer: 342.8 ± 55.1, ratio 8.1 ± 2.3), and 3 had fragile bones (PPE: 148.7 ± 45.4, ratio 3.1 ± 0.7; vomer: 199.0 ± 68.6, ratio 4.1 ± 0.9).</p><p><strong>Conclusions: </strong>SEG using SCBC effectively corrects short noses in Asian patients. Preoperative HU ratios from CBCT can help predict septal bone quality and guide surgical planning. Further research with larger cohorts is needed to confirm these findings.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 2","pages":"e6473"},"PeriodicalIF":1.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433588","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}