Plastic surgery最新文献

{"title":"Iliac Crest Bone Graft Harvest for Alveolar Cleft Repair: A Systematic Review Comparing Minimally Invasive Trephine and Conventional Open Techniques.","authors":"Anna R Todd, Shannon Fitzpatrick, Thomas R Cawthorn, Frankie O G Fraulin, A Robertson Harrop","doi":"10.1177/22925503221088840","DOIUrl":"10.1177/22925503221088840","url":null,"abstract":"<p><p><b>Background:</b> In the course of developing a standardized pathway for alveolar cleft repair, we conducted a systematic review comparing minimally invasive trephine with conventional open technique for iliac crest bone graft harvest in a pediatric population. <b>Methods:</b> A systematic review was conducted of studies comparing open with minimally invasive trephine techniques in pediatric populations undergoing alveolar cleft repair. Exclusion criteria included reviews, case series, editorials, abstracts, and those with adult-only populations. Data were compiled with outcome variables selected <i>a priori</i>. <b>Results:</b> Of 422 manuscripts screened, five met criteria. These comprised 257 patients (116 open, 141 trephine). Average age was 11 years. Patients undergoing trephine harvest had reduced length of stay (1.0-5.0 days trephine vs 1.25-5.4 days open), time to unassisted ambulation (16-46 hours vs 20-67 hours open), and less postoperative narcotic use (0.31 mg/kg vs 1.64 mg/kg IV morphine). Volume of cancellous bone was reported as 2.53 mL for open versus 1.22 mL for trephine in one study, and trephine graft was supplemented with demineralized bone in 54% of cases in another study. The use of anesthetic adjuncts was inconsistent but had a significant effect on postoperative pain and ambulation. <b>Conclusions:</b> Compared to open techniques, the minimally invasive trephine bone graft harvest is associated with a shorter time to discharge, slightly lower infection rates, and reduced opioid use. The possible benefits of trephine harvest must however be balanced against the risk of insufficient graft harvest. Finally, the choice of perioperative analgesic adjuncts significantly impacts patient outcomes regardless of the technique employed.</p>","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/PMC10902489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49459314","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}

{"title":"Complications of Aesthetic Liposuction Performed in Isolation: A Systematic Literature Review and Meta-Analysis.","authors":"Albaraa Aljerian, Jad Abi-Rafeh, Thomas Hemmerling, Mirko S Gilardino","doi":"10.1177/22925503221078693","DOIUrl":"10.1177/22925503221078693","url":null,"abstract":"<p><p><b>Introduction:</b> Aesthetic liposuction represents one of the most commonly performed cosmetic procedures worldwide. The purpose of this article is to examine and synthesize reported complication rates and explore the analytical prospect of possible patient or procedure-related predictive factors associated with specific complications. <b>Methods:</b> A systematic review was performed using the Pubmed, Cochrane, and Embase databases in line with specific criteria set to ensure an accurate assessment of complication rates; extracted data was synthesized through a random-effects model and meta-analysis of proportions. <b>Results:</b> A total of 60 studies were included in the meta-analysis, representing 21,776 patients undergoing aesthetic liposuction. Most studies followed an observational design. The overall complication rate was 12% (95% confidence interval [CI] 8%, 16%). When stratifying according to specific complications, the incidence of contour irregularities was determined to be 2% (95% CI 1%, 2%), seroma 2% (95% CI 1%; 2%), hematoma 1% (95% CI 0%, 1%), surgical site infection 1% (95% CI 1%, 2%), fibrosis or induration 1% (95% CI 1%, 2%), and pigmentary changes 1% (95% CI 1%, 1%), among others. A meta-regression to identify patient- or procedure-related factors associated with greater complication rates proved infeasible given the nature of the available data. <b>Conclusion:</b> Overall, liposuction demonstrated a relatively low complication rate profile, however, a considerable degree of heterogeneity exists within the examined literature preventing the recognition of predictive risk factors. While this calls for efforts to establish consensus on unified methods of outcomes reporting, the present meta-analysis can serve to provide practitioners with an evidence-based reference to improve informed consent and inform clinical guidelines, specifically pertaining to the incidence of commonly encountered complications in aesthetic liposuction, of which presently available survey studies and database queries remain devoid.</p>","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/PMC10902471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49588550","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}

{"title":"Keystone Flap for Closure of Skin Cancer Defects on the Upper Extremity.","authors":"Travis Gordon, Andrew P Golin, Alexander Anzarut","doi":"10.1177/22925503221094106","DOIUrl":"10.1177/22925503221094106","url":null,"abstract":"<p><p><b>Background:</b> We sought to examine the efficacy of the Keystone Design Perforator Island Flap (KDPIF) for the reconstruction of skin cancer excision defects isolated to the upper extremity. In particular, to examine the size of defects repaired and the complications associated with the keystone flap procedure isolated to the upper extremity. <b>Methods:</b> This is a retrospective chart review including all patients older than 18 years of age who received a KDPIF procedure between February 2013 and February 2019 for the oncologic reconstruction of skin cancer defects isolated to the upper extremities by a single surgeon. All procedures were done according to the original description by Behan. <b>Results:</b> A total of 32 patients, 18 (56%) male and 14 (44%) female, received 35 keystone flaps between February 2013 and February 2019. The mean age of the males and females was 70.5 and 79.7 years of age, respectively. Thirty-five lesions suspicious for cancer were excised and 14 (40%) basal cell carcinoma (BCC), 11 (31%) squamous cell carcinoma (SCC), 9 (26%) melanoma, and 1 (3%) actinic keratoses diagnoses were histopathologically determined. Skin defect excisions varied from 3.53 cm² to 31.42 cm². No intraoperative or postoperative complications occurred. <b>Conclusions:</b> The keystone flap is a successful versatile flap procedure with a low or absent complication rate for the reconstruction of skin cancer excision defects of various locations (eg arm, hand, elbow, forearm, shoulder, and wrist), cancer pathologies, and sizes on the upper extremity. When needed, a Doppler may successfully identify adequate perforating blood vessels for the relatively larger flaps.</p>","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/PMC10902476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44197219","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}

{"title":"Chronic Local Injected Corticosteroid Use Increases Likelihood of Postoperative Morbidity Following Median Nerve Decompression for Carpal Tunnel Syndrome.","authors":"Matthew Rich, Victor Vakayil, Abhinav Lamba, Thomas J Sorenson, Umar Choudry, Ashish Y Mahajan","doi":"10.1177/22925503221094102","DOIUrl":"10.1177/22925503221094102","url":null,"abstract":"","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/PMC10902482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42808504","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}

{"title":"Decoding Plagiarism and Academic Dishonesty: Correspondence.","authors":"Rujittika Mungmunpuntipantip, Viroj Wiwanitkit","doi":"10.1177/22925503221085368","DOIUrl":"10.1177/22925503221085368","url":null,"abstract":"","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/PMC10902492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48084259","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}

{"title":"The Most-Cited Publications in Gender-Affirming Surgery: A Cross-Sectional Bibliometric Analysis.","authors":"Olachi O Oleru, Christine H Rohde","doi":"10.1177/22925503221088845","DOIUrl":"10.1177/22925503221088845","url":null,"abstract":"<p><p><b>Background:</b> Gender-affirming surgery is becoming more common among reconstructive surgeons. Bibliometric analyses are statistical evaluations of published scientific correspondence and are a validated method of measuring influence in the scientific community. As no such bibliometric analysis has been done as of yet, the purpose of this study is to identify the characteristics of the 50 most-cited peer-reviewed articles on gender-affirming surgery. <b>Methods:</b> The Scopus abstract and citation database was utilized in April 2020 to search for English-language publications related to gender-affirming surgery. The 50 most-cited publications that met inclusion criteria were reviewed for various metric tabulations. <b>Results:</b> The 50 publications have been cited a total of 4402 times. Thirty-one (62%) were published in 2000 or later. Phalloplasty was the most discussed surgical technique, and 18 of the articles focused on female-to-male (FtM) patients. Case series (46%) and review articles (24%) were most common and there were no Level I or Level II studies. The Netherlands contributed the most, with 13 articles. Among the most frequent keywords in the 50 abstracts were \"flap\" and \"complication\". The earliest author keywords used were \"transsexual\" and \"sex reassignment\". <b>Conclusions:</b> The keyword usage in these abstracts over time seems to follow the trend of a more socially inclusive lexicon. A focus on studies with a higher level of evidence may optimize surgeon education and more appropriately guide clinical practice. This study reveals that the most influential and commonly referenced studies may not be sufficient to appropriately guide clinical practices.</p>","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/PMC10902473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42070223","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}

{"title":"Abdominal Panniculectomy: Determining the Impact of Diabetes on Adverse Outcomes and Complications.","authors":"Ankhita R Samuel, Christopher Campbell, Brent R DeGeorge, Jonathan Black, John T Stranix","doi":"10.1177/22925503221078850","DOIUrl":"10.1177/22925503221078850","url":null,"abstract":"<p><p><b>Background:</b> Despite its association with obesity, the relation between diabetes and the abdominal panniculectomy is less well-established. The purpose of this study was to evaluate the result of diabetes on post-panniculectomy complications in a large cohort and to establish the risk factors associated with unfavorable post-operative outcomes. <b>Methods:</b> Patients that underwent a panniculectomy between 2010 and 2018 were identified in PearlDiver, a national insurance claims database, and identified by Current Procedural Terminology code 15380. Patient demographics and comorbidities were elucidated, and various complications were then identified. Descriptive statistics as well as a multivariate analysis were used to evaluate the association of risk factors and complications. <b>Results:</b> A total of 8282 panniculectomy patients were identified-4245 with diabetes, 4037 without. Obesity, tobacco use, and diabetes were all identified as significant risk factors in developing a surgical site infection, wound disruption, as well as needing to undergo reoperation. Diabetic panniculectomy patients had a higher rate of readmission as well as reoperation and sustained a higher rate of surgical complications, even when matched for. <b>Conclusion:</b> Diabetic panniculectomy patients are at a greater risk for developing complications. Identifying potential risk factors in this patient population could help reduce post-operative complications following a panniculectomy.</p>","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/PMC10902484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42184977","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}

{"title":"Carbon Neutral Hand Surgery: Simple Changes to Reduce Carbon Footprint.","authors":"Yangmyung Ma, Seunghee Han","doi":"10.1177/22925503221088839","DOIUrl":"10.1177/22925503221088839","url":null,"abstract":"<p><p><b>Introduction:</b> Rapid climate change poses a major challenge to healthcare. The operating room is especially responsible for carbon emission, with 20% to 70% of hospital waste traced back to the operating room. This literature review aims to suggest changes that can be made in hand surgery for a more sustainable practice. <b>Methods:</b> A literature search was conducted from PubMed, Medline, and other online search engines with the keywords \"carbon footprint, environmental health, carbon neutral, plastic surgery, hand surgery, surgery.\" <b>Results:</b> \"Reduce, Reuse, Recycle, Research, Rethink and Culture\" was the framework used to recommend a more carbon neutral practice. In reduction, techniques such as cutting down oversupply of materials, adopting protocols to perform cases in ambulatory settings, and simple measures to reduce energy were identified as valuable methods. Modified sterilization techniques and reprocessing single-use devices were techniques identified for reuse and recycling involved single-stream recycling, staff training, and donation of basic surgical supplies. Research involved adopting data-driven programs for life cycle assessment of all equipment in the operating room, while the use of telemedicine and \"green meetings' were suggested for rethinking. Finally, strategies to encourage a team approach to environmental responsibility were discussed. <b>Conclusion:</b> Carbon neutral practice must be implemented to safeguard sustainable and cost-effective operating rooms and healthcare systems. Hand surgery can pave the way for other specialties through the use of available resources to develop guidelines for carbon neutral practice. This requires active effort from hand surgeons to act as role models for other healthcare professionals.</p>","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/PMC10902490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45060517","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}

{"title":"Commentary: Carbon Neutral Hand Surgery: Simple Changes to Reduce Carbon Footprint.","authors":"Douglas J Courtemanche","doi":"10.1177/22925503221101953","DOIUrl":"10.1177/22925503221101953","url":null,"abstract":"","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/PMC10902485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43472037","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}

{"title":"A Computed Tomography Scan Near Miss of an Intraorbital Wooden Foreign Body.","authors":"Armin Farahvash, Annie M Q Wang, Felipe Cardemil, Hall F Chew, Harmeet S Gill, Oleh M Antonyshyn","doi":"10.1177/22925503221101954","DOIUrl":"10.1177/22925503221101954","url":null,"abstract":"<p><p>When intraorbital wooden foreign bodies are missed, the consequences can be devastating. While the gold standard diagnostic imaging is computed tomography (CT), it has low sensitivity. We present a 61-year-old man with a bamboo injury to his right eye. He underwent two CT scans that failed to raise the possibility of intraorbital foreign bodies. Upon additional review, a rectangular-shaped pocket of air was identified in the orbit which was most consistent with wooden foreign bodies based on the clinical history. A combined mid-lid approach followed by a transconjunctival and transcaruncular extension were employed to remove several wooden splinters. Postoperatively, due to recurrent orbital compartment syndrome, he required a second decompression with an inferior rim osteotomy. He had good recovery at 3 months follow-up. Overall, intraorbital wooden foreign bodies are challenging to diagnose due to imaging limitations. Providing a clear history and suspected diagnosis to radiology is critical for diagnosis.</p>","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/PMC10902474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46651975","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}