Plastic surgery最新文献_第8页

Commentary: “We Have a Problem…” 评论："我们有一个问题......"

IF 0.7 4区医学

Plastic surgery Pub Date : 2024-03-26 DOI: 10.1177/22925503241241519

Achilles Thoma

引用次数: 0

Short-Term Postoperative Complications in Flexor Tendon Repair: A Subcategory Analysis by Surgical Specialty 屈肌腱修复术的术后短期并发症：按外科专业分类的子类别分析

IF 0.7 4区医学

Plastic surgery Pub Date : 2024-03-22 DOI: 10.1177/22925503241241083

Matthew D. Rich, Rafat H. Solaiman, Christopher Hillard

{"title":"Short-Term Postoperative Complications in Flexor Tendon Repair: A Subcategory Analysis by Surgical Specialty","authors":"Matthew D. Rich, Rafat H. Solaiman, Christopher Hillard","doi":"10.1177/22925503241241083","DOIUrl":"https://doi.org/10.1177/22925503241241083","url":null,"abstract":"Introduction: We aimed to investigate and compare the 30-day postsurgical complication rates and total operative times for hand or wrist flexor tendon injury repair procedures. Methods: We performed a retrospective cohort analysis of the American College of Surgeon National Quality Improvement Program database between 2015 and 2019. Patients were included in our study if they were 18 years or older and underwent surgical repair of a wrist or hand flexor tendon by a plastic surgeon, general surgeon, or orthopedic surgeon. Primary endpoint of the study was 30-day postsurgical complications. Secondary endpoint included subcategory analysis of 30-day postsurgical complications. Another variable of interest included total operative time. Results: There were 2614 surgeries performed for wrist or hand flexor tendon injury repair during the 5-year period. Orthopedic surgeons performed the majority of the operations (1548, 59.2%). Repair or advancement of the flexor tendon zone 2 without grafts (1284, 49.1%) were the most common surgeries performed. Overall surgical site complication rate was 2%, with no significant associations between the complication and the surgical specialty performing the operation. A significant difference in total operative time between surgical specialties was only found in single flexor tendon repairs ( P < .001). Conclusions: Surgical repair for hand and wrist flexor tendon injury is a safe surgical procedure with a low short-term postoperative complication rate. Despite variations in training, complications remain similar between specialties for flexor tendon repairs.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140202692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Breast Implant Reconstruction in the Ptotic Patient: Evaluation of Wise and Vertical Skin Sparing Mastectomy 下垂患者的乳房假体重建：明智和垂直皮肤切除术的评估

IF 0.7 4区医学

Plastic surgery Pub Date : 2024-03-12 DOI: 10.1177/22925503241234940

M. Margaret Holohan, Stephanie M. Diaz, Keeley Newsom, Alex Smith, Betty Fan, Folasade O. Imeokparia, Carla S. Fisher, Kandice K. Ludwig, Mary E. Lester, Aladdin H. Hassanein

{"title":"Breast Implant Reconstruction in the Ptotic Patient: Evaluation of Wise and Vertical Skin Sparing Mastectomy","authors":"M. Margaret Holohan, Stephanie M. Diaz, Keeley Newsom, Alex Smith, Betty Fan, Folasade O. Imeokparia, Carla S. Fisher, Kandice K. Ludwig, Mary E. Lester, Aladdin H. Hassanein","doi":"10.1177/22925503241234940","DOIUrl":"https://doi.org/10.1177/22925503241234940","url":null,"abstract":"Introduction: Post-mastectomy reconstruction in patients with severe breast ptosis can be challenging. Traditionally, a skin sparing mastectomy (SSM) with a circumareolar incision or a horizontal elliptical extension results in a long, horizontally-oriented scar in the central breast. The Wise pattern SSM with an inferiorly-based dermal flap addresses skin redundancy and provides added vascularized implant coverage in ptotic patients with macromastia. The purpose of this study is to compare outcomes in ptotic patients undergoing SSM with Wise pattern and a modified vertical technique which also uses de-epithelialized excess skin under the incision. Methods: A retrospective chart review was performed on patients that underwent SSM using a Wise or vertical skin reducing technique. The Wise pattern was performed using an inferiorly-based dermal flap and the vertical method used a laterally-based dermal flap covering the implant/tissue expander (TE). Results: SSM with the use of autoderm was performed in 42 patients (67 breasts) using either the Wise (n = 49 breasts) or vertical (n = 18 breasts) method. Both groups had similar BMI (35.4). The prepectoral plane was used in 93.5% of Wise pattern patients and all vertical patients. All cases of seroma and hematoma occurred in the Wise pattern group (10.2%). Mastectomy skin necrosis requiring unplanned return to surgery for debridement occurred in 20.4% of those undergoing Wise pattern SSM and 11.1% undergoing the vertical pattern (p = 0.49). Conclusion: Severely ptotic patients undergoing SSM have a high risk of skin necrosis. A dermal flap under the closure has the advantage of vascularized tissue reinforcing the wound in implant based reconstruction. The vertical pattern SSM using a laterally-based dermal flap may be a safe, simple alternative to the Wise pattern in select patients.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140117332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current Trends and Usages of #PlasticSurgery Before and After COVID-19 COVID-19 前后 #PlasticSurgery 的当前趋势和使用情况

IF 0.7 4区医学

Plastic surgery Pub Date : 2024-03-08 DOI: 10.1177/22925503241238022

Daniela Lee, Iulianna C. Taritsa, Kirsten Schuster, Jose Foppiani, John B. Park, Angelica Hernandez Alvarez, Samuel J. Lin

引用次数: 0

Beware the Boxer's Fracture Imposter: Where Does the Metaphysis End and the Diaphysis Begin? 警惕 "拳击手骨折冒名顶替者"：干骺端和干骺端在哪里？

IF 0.7 4区医学

Plastic surgery Pub Date : 2024-03-07 DOI: 10.1177/22925503241234938

Celina DeBiasio, Ewa Sucha, Richard J. Webster, Sandy Tse, Kevin Cheung

{"title":"Beware the Boxer's Fracture Imposter: Where Does the Metaphysis End and the Diaphysis Begin?","authors":"Celina DeBiasio, Ewa Sucha, Richard J. Webster, Sandy Tse, Kevin Cheung","doi":"10.1177/22925503241234938","DOIUrl":"https://doi.org/10.1177/22925503241234938","url":null,"abstract":"Introduction: Fractures of the fifth metacarpal are a common injury. In children, they are often stable and heal uneventfully, including after closed reduction. Fractures of the metacarpal diaphysis, conversely, tend to be unstable and may require surgical intervention. It is unclear at what point fractures of the fifth metacarpal fracture should be considered unstable. We identify the location at which a fifth metacarpal fracture is at risk for surgical intervention. Methods: A two-year retrospective cohort analysis of all children (age ≤18) with fifth metacarpal fractures presenting to a Pediatric Plastic Surgery clinic was performed. Clinical and radiographical data were acquired from electronic medical records. Fracture location and fracture angulation were measured, descriptive statistics were performed, and multivariable logistic regression was used to identify predictors for surgery. Results: Ninety-eight patients met criteria for review. Mean patient age was 14.0 years (SD 2.2), and 95% were male. Forty-two (44.2%) patients underwent closed reduction, and 12 (12.2%) patients were recommended for surgery. Increased fracture angulation on initial lateral radiograph (OR: 1.08 (1.03-1.14 95% CI), p = 0.006) and more proximal fractures (OR: 0.92 (0.86-0.98 95% CI), p = 0.008) were identified as independent predictors for surgery. Fractures occurring proximal to 70% of metacarpal length resulted in accurate detection of those requiring surgery with 72.4% sensitivity, 75.3% specificity, 95.5% and 27.6% negative and positive predictive value, respectively. Conclusions: In pediatric fifth metacarpal fractures, increased fracture angulation and those occurring proximal to 70% of the metacarpal length were independent predictors for surgery.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140074876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Superiority of the Septal Extension Graft Technique in Rhinoplasty Patient Satisfaction Versus the Intercrural Strut 鼻隔膜延伸移植技术在鼻整形术患者满意度方面优于硬膜间支架技术

IF 0.7 4区医学

Plastic surgery Pub Date : 2024-03-07 DOI: 10.1177/22925503241234939

Enrique Romero-Algara, Damaris Estefanía Navarro-Nuño, Emmanuel Romero-Algara, Quitzia Libertad Torres-Salazar

{"title":"Superiority of the Septal Extension Graft Technique in Rhinoplasty Patient Satisfaction Versus the Intercrural Strut","authors":"Enrique Romero-Algara, Damaris Estefanía Navarro-Nuño, Emmanuel Romero-Algara, Quitzia Libertad Torres-Salazar","doi":"10.1177/22925503241234939","DOIUrl":"https://doi.org/10.1177/22925503241234939","url":null,"abstract":"Background: Considering that rhinoplasty is one of the most demanded surgeries nowadays, it is necessary to analyse the relationship between the final result and the satisfaction of the patients who have undergone surgery. The objective of this study was to measure patient satisfaction by comparing the results achieved 6 months after their surgery following the use of two surgical techniques: the intercrural strut type technique, in contrast to the septal extension graft technique. Methods: Ambispective analytical cohort study in two parallel groups with patients scheduled for rhinoplasty. Sample size was calculated with a confidence level of 95% and a power of 80%, resulting in a minimum of 20 subjects to be included. Fifty-three patients participated: 22 operated with the i ntercrural strut technique and 31 with septal extension grafting. Results: An increase in the nasolabial angle was identified, with similar results between techniques. At 6-month evaluation, a decrease in the nasolabial angle was observed in all patients. Conclusion: The nasolabial angle remained higher at 6 months in the septal extension group compared to the intercrural post group; however, these differences were not statistically significant. Notably, the patient satisfaction survey revealed that only 59.1% of individuals who underwent surgery with the intercrural strut technique expressed satisfaction with the results. Conversely, 100% of the subjects who underwent surgery using the septal extension graft technique reported being satisfied with the final outcome.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140074873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Enhanced Recovery After Surgery in Immediate DIEP Flap Breast Reconstruction: Reducing Length of Stay and Opioid Use 加强即刻 DIEP 乳瓣乳房重建术的术后恢复：减少住院时间和阿片类药物的使用

IF 0.7 4区医学

Plastic surgery Pub Date : 2024-03-07 DOI: 10.1177/22925503241234935

Jad El-Jebaoui, Cyril J. Awaida, Joseph Bou-Merhi, Christina Bernier, Alain Gagnon, Marion Aribert, Michel Saint-Cyr, Patrick G. Harris, Andrei Odobescu

{"title":"Enhanced Recovery After Surgery in Immediate DIEP Flap Breast Reconstruction: Reducing Length of Stay and Opioid Use","authors":"Jad El-Jebaoui, Cyril J. Awaida, Joseph Bou-Merhi, Christina Bernier, Alain Gagnon, Marion Aribert, Michel Saint-Cyr, Patrick G. Harris, Andrei Odobescu","doi":"10.1177/22925503241234935","DOIUrl":"https://doi.org/10.1177/22925503241234935","url":null,"abstract":"Background: To improve patient outcomes amid reduced healthcare resources during the COVID-19 pandemic, a single Canadian cancer center implemented an Enhanced Recovery After Surgery (ERAS) protocol for autologous DIEP flap breast reconstruction. Methods: This retrospective cohort study included 100 consecutive patients undergoing microsurgical breast reconstruction with DIEP flaps using the ERAS protocol and 100 patients using a standard protocol. Primary outcomes were the hospital length of stay and opioid use. Secondary outcomes included postoperative complications, laxative and antiemetic consumption. Results: In this study, 80% of the patients had immediate reconstruction, while the remaining patients received either delayed immediate or delayed reconstruction. Patients in the ERAS group had shorter hospital stays (2.8 vs 4.5 days; P < 0.001) and lower total opioid use (50.2 vs 136.3 mg; P < 0.001). This reduction was also observed when breaking down opiates per day of hospitalization (30.2 vs 18.2 mg; P < 0.001), and in the first 24 postoperatively hours (35.7 vs 67.6 mg; P < 0.001). The control group had a higher incidence of postoperative complications, including seroma, partial and total flap necrosis, compared to the ERAS group. However, readmission rates were similar between the two groups. Conclusion: Implementing the ERAS protocol for DIEP flap breast reconstruction can significantly reduce hospital length of stay and postoperative opioid requirements without increasing the risk of adverse events. This pattern holds true for immediate reconstructions with DIEP flaps.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140074875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Consecutive Microsurgical Cases Performed by Single Surgeon at a Canadian Tertiary Care Center: A Retrospective Review 加拿大一家三级医疗中心由一名外科医生实施的连续显微外科手术病例：回顾性分析

IF 0.7 4区医学

Plastic surgery Pub Date : 2024-03-01 DOI: 10.1177/22925503241234934

Andrew T. Chen, Jessica Gormley, Oluwatobi Olaiya, Sophocles H. Voineskos, Christopher J. Coroneos, Ronen Avram

{"title":"Consecutive Microsurgical Cases Performed by Single Surgeon at a Canadian Tertiary Care Center: A Retrospective Review","authors":"Andrew T. Chen, Jessica Gormley, Oluwatobi Olaiya, Sophocles H. Voineskos, Christopher J. Coroneos, Ronen Avram","doi":"10.1177/22925503241234934","DOIUrl":"https://doi.org/10.1177/22925503241234934","url":null,"abstract":"Background: The practice of a microsurgeon evolves over time with experience, changes in clinical interest, and practice setting. Previous reports suggest that complication rates may be influenced by years of practice. The aim of this study was to analyze consecutive microsurgical cases performed by a single surgeon during the first half of their career in a broad microsurgical practice at a Canadian academic tertiary care center. Methods: A retrospective chart review of all free tissue transfers between 2007 and 2020 completed by a single academic plastic surgeon was performed. The primary outcomes were the odds of postoperative complications and free flap failure. The secondary outcomes included the annual number and type of free flap cases over time. Results: The surgeon performed 795 free flaps on 537 patients. There were a total of 131 postoperative complications. There was no statistically significant association between the years in practice and odds of a complication. Overall, there were 26 flap failures, yielding a 96.7% success rate. There was no association between flap failure and years in practice. The most common type of reconstruction was breast, followed by lower extremity and head and neck. There was a significant change in the type of reconstruction cases over time ( P < 0.005). Conclusion: The type and volume of free flap reconstruction conducted by the surgeon has changed over time. In this single surgeon career, surgical experience did not have a significant impact on free flap complications. At our center, free tissue transfer remains a valuable tool for reconstruction in both low and high-risk patients.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140017953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lip Wedge Resection with Orbicularis Oris Plication for Facial Paralysis: A Novel Technique. 唇楔状切除加Orbicularis Oris钳治疗面瘫：一种新技术

IF 0.7 4区医学

Plastic surgery Pub Date : 2024-02-01 Epub Date: 2022-03-10 DOI: 10.1177/22925503221085086

Ethan Frank, Traci Bailey, Nathan H Lee, Victoria Cress, Kelli Kam, Jared C Inman

引用次数: 0

A Useful Technique for Templating the Reverse Radial Forearm Flap (RFF) for Thumb Degloving Injuries. 拇指脱套损伤模板化前臂桡侧皮瓣的实用技术

IF 0.7 4区医学

Plastic surgery Pub Date : 2024-02-01 Epub Date: 2022-03-30 DOI: 10.1177/22925503221088843

Georgios Christopoulos, David R Thomson, Martin E Jones

引用次数: 0