Plastic surgery最新文献_第10页

Bilateral Gastrocnemius Muscle Flap for Bilateral Defects of Knee Joint in Schatzker Type V & VI Proximal Tibial Condyle Fractures. 双侧腓肠肌瓣修复胫骨髁近端Schatzker V、VI型骨折双侧膝关节缺损

IF 0.7 4区医学

Plastic surgery Pub Date : 2024-02-01 Epub Date: 2022-03-30 DOI: 10.1177/22925503221085371

Raj Kumar Manas, Kavya Chinta

{"title":"Bilateral Gastrocnemius Muscle Flap for Bilateral Defects of Knee Joint in Schatzker Type V & VI Proximal Tibial Condyle Fractures.","authors":"Raj Kumar Manas, Kavya Chinta","doi":"10.1177/22925503221085371","DOIUrl":"10.1177/22925503221085371","url":null,"abstract":"Bilateral defects around the knee joint following fracture of the proximal tibia (Schatzker type V & VI) are difficult to reconstruct because of the unavailability of local tissue. A bicondylar proximal tibial fracture requires a bilateral approach and dual plates for fracture fixation. Because of extensive dissection during plating and extended zone of trauma, the suture lines occasionally dehisce resulting in soft tissue defects on both sides of the proximal tibia. Because of its bilateral nature, the defect requires 2 flaps. We are reporting 2 cases of suture dehiscence after fixation of bicondylar fracture of the proximal tibia which required reconstruction with bilateral gastrocnemius flaps. This reconstruction is a simple option that helps in providing stable coverage. The first case was followed up for a period of 5 years and the second case was followed up for a minimum period of 6 months. Both cases demonstrated well-healed flaps, united bone and no donor side morbidity. Bilateral gastrocnemius muscle flaps can be used simultaneously for 2 separate defects on both sides of the knee without significant donor site morbidly. This reconstructive option provides stable coverage, reduces the infection and promotes bony union thus helping in early ambulation.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10902481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43543147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Procedure and Complication-Specific Assessment of Smoking in Aesthetic Surgery: A Systematic Review and Meta-Analysis. 美容手术中吸烟的程序和并发症评估:系统回顾和荟萃分析

IF 0.7 4区医学

Plastic surgery Pub Date : 2024-02-01 Epub Date: 2022-03-18 DOI: 10.1177/22925503221085083

Gabriel Bouhadana, Hassan ElHawary, Peter Alam, Mirko S Gilardino

{"title":"A Procedure and Complication-Specific Assessment of Smoking in Aesthetic Surgery: A Systematic Review and Meta-Analysis.","authors":"Gabriel Bouhadana, Hassan ElHawary, Peter Alam, Mirko S Gilardino","doi":"10.1177/22925503221085083","DOIUrl":"10.1177/22925503221085083","url":null,"abstract":"Background: The popularity of aesthetic surgery is on the rise, as is patients' expectations towards excellent surgical results. In order to meet these expectations, risk factors that hinder desired outcomes, such as smoking, need to be identified and addressed. To that end, the present study summarizes an updated systematic review focused on the effects of smoking on cosmetic surgical procedures and outcomes. Methods: A systematic review of studies comparing aesthetic surgical outcomes by procedure, between tobacco smokers and non-smokers was carried out, querying PubMed, Embase and the Cochrane databases. Data regarding surgical outcomes were extracted and meta-analyzed by a random effects model in conjunction with the Mantel-Haenszel statistical method. Results: Eighty-two studies were included in the final synthesis. Abdominoplasty/panniculectomy (n = 19 cohorts) and breast reduction (n = 27 cohorts) were the most common types of procedures included in this review. Other than mastopexy and rhinoplasty, smoking conferred a statistically significant increased risk of overall complications for all studied aesthetic procedures. Conclusions: The data demonstrates that smoking is a clear risk factor for the vast majority of aesthetic plastic surgeries studied. Although our meta-analysis suggests that smoking is not a risk factor for complications in mastopexies and rhinoplasties, these two specific analyses may have been biased, and should therefore be re-evaluated with future additional evidence. The results of this systematic review confirm the importance of smoking cessation and education relative to the outcomes of common cosmetic surgical procedures.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10902487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46077225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Cost of Ambulatory Breast Reduction: Hospital Reimbursement Versus Surgeon Payments. 门诊缩胸手术的费用:医院报销与外科医生付款

IF 0.7 4区医学

Plastic surgery Pub Date : 2024-02-01 Epub Date: 2022-02-15 DOI: 10.1177/22925503221078716

Peyton H Terry, Christopher A Campbell, Jonathan S Black, John T Stranix, Grace L Forster, Brent R DeGeorge

{"title":"The Cost of Ambulatory Breast Reduction: Hospital Reimbursement Versus Surgeon Payments.","authors":"Peyton H Terry, Christopher A Campbell, Jonathan S Black, John T Stranix, Grace L Forster, Brent R DeGeorge","doi":"10.1177/22925503221078716","DOIUrl":"10.1177/22925503221078716","url":null,"abstract":"Introduction: Reduction mammoplasty (RM) is one of the most common operations performed in plastic surgery. While US national surgical expenditures have risen in recent years, studies have reported decreasing reimbursement rates for plastic surgeons. The purpose of this study is to characterize the trends in charges and payments for a common plastic surgery operation, ambulatory RM, for facilities and physicians. Methods: A Medicare patient records database was used to capture hospital, surgeon, and anesthesiologist charges and payments for ambulatory RM from 2005 to 2014. Values were adjusted for inflation. A ratio of hospital to surgeon charges and payments were calculated: charge multiplier (CM) and payment multiplier (PM), respectively. Charges, payments, Charlson comorbidity index, CM, and PM values were analyzed for trends. Results: This study included 1001 patients. During the study period, the facility charge for RM per patient increased from $8477 to $11,102 (31% increase; p < .0005), and the surgeon charge increased from $7088 to $7199 (2% increase; p = .0009). Facility payments increased from $3661 to $3930 (7% increase; p < .0005), and surgeon payments decreased from $1178 to $1002 (15% decrease; p < .0005). CM increased from 1.2 to 1.54, and PM increased from 3.11 to 3.92. Conclusions: Charges and payments to facilities for ambulatory RM increased disproportionately to that of surgeons, likely due in part to rising administrative costs in health care delivery. This may disincentivize plastic surgeons from offering RM at hospital-based surgical centers, limiting patient access to this operation.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10902483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46561071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pediatric Hand Fracture Outcomes: How Often Do We Need to Operate? 儿童手部骨折的结果：我们需要多久做一次手术？

IF 0.7 4区医学

Plastic surgery Pub Date : 2024-02-01 Epub Date: 2022-03-24 DOI: 10.1177/22925503221085076

Sabrina Wei, Diana Forbes, Rebecca L Hartley, Saoussen Salhi, Frankie O G Fraulin, A Robertson Harrop, Jugpal S Arneja

{"title":"Pediatric Hand Fracture Outcomes: How Often Do We Need to Operate?","authors":"Sabrina Wei, Diana Forbes, Rebecca L Hartley, Saoussen Salhi, Frankie O G Fraulin, A Robertson Harrop, Jugpal S Arneja","doi":"10.1177/22925503221085076","DOIUrl":"10.1177/22925503221085076","url":null,"abstract":"Purpose: Pediatric hand fractures are frequent presentations to the emergency department. This study set out to evaluate the epidemiology, management, and outcomes, where care was imparted and by whom, and offer resource utilization suggestions regarding pediatric fractures presenting to a Canadian pediatric hospital. Methods: Records of patients from 0 to 18 years of age who presented to the British Columbia Children's Hospital Emergency Department between November 1, 2016, and January 31, 2021, with metacarpal or phalangeal fractures were analyzed. Results: A total of 524 hand fractures were identified in 499 patients. Over 60% of fractures occurred in boys. The number of fractures peaked at the age of 11 years for girls and 12 years for boys. Open fractures accounted for only 4.0% of all fractures. Approximately 40% of fractures were epiphyseal growth plate fractures, with Salter-Harris II fractures being the most common diagnosis overall. Management was primarily nonsurgical, with 75% of fractures managed with immobilization alone and 23% of fractures managed with bedside closed reduction and immobilization. Of the fractures requiring closed reduction, the majority were performed by the emergency physician with a success rate of 82%. Only 2.3% of all fractures required surgery. Conclusions: Hand fractures are common pediatric injuries and make up a large proportion of emergency room visits. The majority of fractures do not require formal surgery and are well managed with immobilization alone or closed reduction by an emergency room physician and immobilization. Nonsurgical treatment offers very encouraging outcomes. A certain percentage of these simple fractures would likely benefit from primary care management alone and not require specialist intervention.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10902479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41840140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

State of the art: The Unilateral Cleft lip and Nose Deformity and Anatomic Subunit Approximation. 单侧唇裂和鼻畸形及解剖亚基近似

IF 0.7 4区医学

Plastic surgery Pub Date : 2024-02-01 Epub Date: 2022-06-30 DOI: 10.1177/22925503221109069

Raymond W Tse, David M Fisher

引用次数: 0

Prospective Validation of the Calgary Kids' Hand Rule: A Clinical Prediction Rule for Pediatric Hand Fracture Triage. 卡尔加里儿童手部规则的前瞻性验证:儿童手部骨折分诊的临床预测规则

IF 0.7 4区医学

Plastic surgery Pub Date : 2024-02-01 Epub Date: 2022-05-26 DOI: 10.1177/22925503221101939

Altay Baykan, Rebecca L Hartley, Paul E Ronksley, Alan R Harrop, Frankie O G Fraulin

{"title":"Prospective Validation of the Calgary Kids' Hand Rule: A Clinical Prediction Rule for Pediatric Hand Fracture Triage.","authors":"Altay Baykan, Rebecca L Hartley, Paul E Ronksley, Alan R Harrop, Frankie O G Fraulin","doi":"10.1177/22925503221101939","DOIUrl":"10.1177/22925503221101939","url":null,"abstract":"Introduction: Pediatric hand fractures are common and routinely referred to surgeons, yet most heal well without surgical intervention. This trend inspired the development of the Calgary Kids' Hand Rule (CKHR), a clinical prediction rule designed to predict \"complex\" fractures that require surgical referral. The CKHR was adapted into a checklist whereby the presence of any 1 of 6 clinically or radiologically identifiable fracture characteristics predicts a complex fracture. The aim of this study was to assess the accuracy of the CKHR in a prospective sample of children with hand fractures. Methods: Physicians were asked to complete the CKHR checklist when referring pediatric patients (< 18 years) to hand surgeons at a Canadian pediatric hospital (April 2019-September 2020). Completed checklists represented predicted outcomes and were compared to observed outcomes (determined via chart review). Predictive accuracy (primary outcome) was evaluated based on sensitivity and specificity. Secondary outcomes were interrater reliability between referring physicians and surgeons, and survey assessment of CKHR user satisfaction. Results: In total 365 fractures were included, with only 16 requiring surgical intervention. Overall performance of the CKHR was good with 84% sensitivity and 71% specificity. Percent agreement between referring physicians and surgeons ranged from 84.1% to 96.3% on individual predictors, with 78.1% agreement on the presence of any predictors. Survey results showed general user satisfaction but also identified areas for improvement. Conclusion: This study posits the CKHR as an accurate and clinically useful prediction rule and highlights the importance of education for its effective use and eventual scale and spread.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10902491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49111674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Associations with Discharge to Post-Acute Care Facilities Among Patients Undergoing Open Reduction Internal Fixation of Distal Radius Fractures. 桡骨远端骨折切开复位内固定术患者出院至急诊后护理机构的关系

IF 0.7 4区医学

Plastic surgery Pub Date : 2024-02-01 Epub Date: 2022-03-10 DOI: 10.1177/22925503221085082

Daniel P Donato, Andrew M Simpson, James Willcockson, Jacob Veith, Brody W King, Jayant P Agarwal

{"title":"Associations with Discharge to Post-Acute Care Facilities Among Patients Undergoing Open Reduction Internal Fixation of Distal Radius Fractures.","authors":"Daniel P Donato, Andrew M Simpson, James Willcockson, Jacob Veith, Brody W King, Jayant P Agarwal","doi":"10.1177/22925503221085082","DOIUrl":"10.1177/22925503221085082","url":null,"abstract":"Introduction: Distal radius fractures are a common injury of the hand and wrist that often require intensive rehabilitation. We sought to identify risk factors associated with discharge to a post-acute care facility following distal radius fracture repair. Methods: The 2011 to 2016 National Surgical Quality Improvement Program® (NSQIP) database was queried for all Current Procedural Terminology (CPT) codes that corresponded with open distal radius fracture repair. Patients with concomitant traumatic injuries were excluded. Patient demographics, comorbidities, perioperative factors, laboratory data, and surgical details were collected. Our primary outcome was to determine postoperative discharge destination: home versus a post-acute care facility, and to identify factors that predict discharge to post-acute care facility. Secondary outcomes included unplanned readmission, reoperation, and complications. Results: Between 2011 and 2016, a total of 12,001 patients underwent open distal radius fracture repair and had complete information for their discharge. Of these analyzed patients, 3.24% (n = 389) were discharged to rehabilitation facilities. The following factors were identified on multivariate analysis to have an association with discharge to a post-acute care facility: 65 years or older, White race, underweight, using steroids preoperatively, American Society of Anesthesiologists (ASA) classification > 2, admitted from a nursing home or already hospitalized, anemic, undergoing bilateral surgery, wound classification other than clean, and complications prior to discharge. Conclusion: Factors identified by our study to have associations with discharge to post-acute care facilities following distal radius fracture repair can help in appropriate patient counseling and triage from the hospital to home versus a post-acute care facility.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10902480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42749257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Techniques for Retrieval of Lacerated Flexor Tendons: A Scoping Review. 屈肌腱撕裂伤的恢复技术:范围综述

IF 0.7 4区医学

Plastic surgery Pub Date : 2024-02-01 Epub Date: 2022-04-05 DOI: 10.1177/22925503221088841

Assaf Kadar, Shanny Gur, Haggai Schermann, Sorin D Iordache

{"title":"Techniques for Retrieval of Lacerated Flexor Tendons: A Scoping Review.","authors":"Assaf Kadar, Shanny Gur, Haggai Schermann, Sorin D Iordache","doi":"10.1177/22925503221088841","DOIUrl":"10.1177/22925503221088841","url":null,"abstract":"Introduction: Flexor tendon laceration is often followed by retraction of the proximal stump. The goals of this review were to describe the myriad of proximal stump retrieval surgical techniques and where available to provide the clinical evidence associated with each. Methods: A Medline and Web of Science search was performed to identify any publication whose primary purpose was to describe a tendon retrieval technique. The techniques were assigned to 8 groups. Clinical outcomes, where reported, and advantages and disadvantages of the technique as reported by the authors of the articles were analyzed. Results: Eight-hundred and forty-one publications complied with the search terms, and 33 articles were included in the current analysis. Only 2 of these articles were randomized controlled trials, and they were of low quality. Conclusion: There is no high-quality evidence to allow quantitative comparison of tendon retrieval techniques. An incremental approach can be recommended based on the qualitative review. After failed atraumatic attempts to retrieve the tendon by milking, retrieval should be done through proximal incision at the A1 pulley level, preferably without pulling the tendon out of the wound. When available, using an endoscope to retrieve the tendon appears to be a promising alternative.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10902468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48407971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cost-effective Solution for Maxillofacial Reconstruction Surgery with Virtual Surgical Planning and 3D Printed Cutting Guides Reduces Operative Time. 具有成本效益的颌面重建手术解决方案，采用虚拟手术规划和 3D 打印切割导板，缩短了手术时间。

IF 0.7 4区医学

Plastic surgery Pub Date : 2024-02-01 Epub Date: 2022-02-15 DOI: 10.1177/22925503221078692

Andrea Nallely Garza-Cisneros, Mauricio Manuel García-Pérez, William Josef Rodriguez-Guajardo, Guillermo Elizondo-Riojas, Adrian A Negreros-Osuna

{"title":"Cost-effective Solution for Maxillofacial Reconstruction Surgery with Virtual Surgical Planning and 3D Printed Cutting Guides Reduces Operative Time.","authors":"Andrea Nallely Garza-Cisneros, Mauricio Manuel García-Pérez, William Josef Rodriguez-Guajardo, Guillermo Elizondo-Riojas, Adrian A Negreros-Osuna","doi":"10.1177/22925503221078692","DOIUrl":"10.1177/22925503221078692","url":null,"abstract":"Background: This study aimed to explore a low-cost solution for virtual surgical planning/3D printed surgical guides in a training hospital, assessing the impact on intraoperative time and bleeding. Material and Methods: We included a total of 13 patients. 8 who underwent maxillofacial reconstruction surgery with fibula-free flap utilizing virtual surgical planning/3D printed guides (VP/SG), and 5 using conventional surgery (CS) from 2017 to 2020. The surgical time, bleeding, length of hospital stay, and comorbidities were collected and compared in two groups. We recorded the average cost for the complete surgical planning and 3D printed guides. We applied a qualitative survey to the surgeons involved in the surgical procedures. Results The mean surgical time in the VP/SG group was 8.16 ± 2.7, compared to the CS group 12.5 ± 3.8, showing a 4.34 hours difference with statistical significance (p = 0.033). Patients from the CS group had a higher bleeding volume of 921 ± 467.6 mL VS 760 ± 633.8 mL in the VP/SG group. The average cost for the complete surgical planning and 3D printed guides was 914.44 ± 46.39 USD. All the surgeons who answered the survey preferred to perform the procedure utilizing the virtual planning/3D printed guides. Conclusions Virtual planning and 3D printed surgical guides have the potential to reduce operation time in maxillofacial reconstruction.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10902495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140022471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Impact of COVID-19 on Reconstructive Surgery for Burns and Complex Wounds. COVID-19对烧伤和复杂创面重建手术的影响

IF 0.7 4区医学

Plastic surgery Pub Date : 2024-02-01 Epub Date: 2022-05-11 DOI: 10.1177/22925503221094104

Alan D Rogers

引用次数: 0