Indian Journal of Plastic Surgery最新文献

{"title":"Augmentation of the Ulnar Motor Nerve Repair with Anterior Interosseous Nerve in High Ulnar Nerve Palsy: Our Clinical Experience.","authors":"Gopika Jith, Kaushik Mahadik, Santanu Suba, Sanjay Kumar Giri","doi":"10.1055/s-0044-1801805","DOIUrl":"10.1055/s-0044-1801805","url":null,"abstract":"<p><p>Following proximal ulnar nerve repair, there will be a delay in innervating the distally placed intrinsic muscles of the hand, which can lead to irreversible damage to the intrinsic motor end plates. Supercharging with end-to-side anterior interosseous nerve (AIN) transfer can augment the results of nerve repair by babysitting the motor end plates and thus preventing its denervation. Recently, there have been discussions regarding whether AIN, which contains only 500 axons, can augment the ulnar motor branch, which contains approximately 1,500 axons. In one of our cases, electromyogram following surgery showed activity in the first dorsal interossei and abductor digiti minimi without any signs of reinnervation in the flexor carpi ulnaris. This may support the contribution of AIN in supplying the intrinsic muscles. Considering the low morbidity of the procedure and potential improvements in muscle strength, all patients undergoing ulnar nerve repair in high ulnar nerve palsies can be counseled to undergo an end-to-side AIN transfer.</p>","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"58 3","pages":"218-221"},"PeriodicalIF":0.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555325","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":"Eklavya-Do-It-Yourself Model: A Rolled Latex Sheet Conduit for Microsurgical Training.","authors":"Girish Mirajkar, Uday Bhat, Amit Peswani, Sushrut Raut, Husain Adenwala, Sayali Samudre","doi":"10.1055/s-0045-1802555","DOIUrl":"10.1055/s-0045-1802555","url":null,"abstract":"<p><strong>Objective: </strong>To introduce a simple and innovative low-fidelity microsurgical model using daily articles available in any plastic surgery operation theatre and to determine its quality, ease of use and cost-effectiveness.</p><p><strong>Materials and methods: </strong>The model is essentially made by rolling a loose disposable glove upon a K-wire to create a true micro-vessel (< 2 mm). Adjustment in the size and thickness of the conduit can be made. Model was assessed by data obtained from subjective questionnaire to 29 experienced microsurgeons with more than 5 years of independent microsurgical practice. This experience of our model was compared with their experience with other material and animal tissue.</p><p><strong>Results: </strong>The chicken femoral is the best compared to rat model overall, but rolled latex is as good or second best as far as some of the features assessed.</p><p><strong>Conclusion: </strong>\"Eklavya\" microsurgical model provides a valuable alternative to traditional animal models, allowing trainees to practice and hone their skills without the ethical and financial concerns associated with live animal use.</p>","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"58 4","pages":"292-297"},"PeriodicalIF":1.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974040","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":"Changing Trends in Maxillofacial Trauma: A Single-Center Retrospective Study in India.","authors":"Kapil S Agrawal, Vivek Gupta, Mudunuri Ravi Teja, Raghav Shrotriya, Vinita A Puri","doi":"10.1055/s-0045-1802556","DOIUrl":"10.1055/s-0045-1802556","url":null,"abstract":"<p><strong>Background: </strong>Maxillofacial trauma is quite commonly encountered either in isolation or in association with polytrauma. The present observational study aims to analyze the changing trends of maxillofacial injuries and mull over some probable reasons for the same.</p><p><strong>Materials and methods: </strong>This is an observational retrospective study done at a tertiary care center in Mumbai, India, for a period of 12 years (2008-2019) after getting clearance from the institutional ethics committee. All patients who were admitted in the plastic surgery unit with maxillofacial trauma were included in the study and data were collected from case record sheets in the archives of the department. The data obtained were tabulated and analyzed.</p><p><strong>Results: </strong>A total 1,046 patients were included in the study. The most common age group involved was 21 to 30 years (50.19%). Males outnumbered females in terms of hospital admissions (92.7 vs. 7.3%). Road traffic accidents (RTA) were found to be the major etiological factor (72.27%). Out of 756 RTA victims, 533 (70.5%) were due to two-wheeler accidents. In the present study, the zygomaticomaxillary complex (middle third) was most commonly fractured (40.73%) followed by the mandible (38.91%). Panfacial fractures (i.e., those involving at least two facial thirds) comprised 10.71% of all the cases.</p><p><strong>Conclusion: </strong>The incidence of maxillofacial trauma is showing an increasing trend in the recent past. The majority of the patients are victims of RTAs and two-wheeler accidents are increasingly responsible for such injuries. The classical injury patterns and the fracture patterns that were described in the past are not routinely observed now. The injury and fracture pattern itself has become more complex. We observed a statistically significant raise in midface fractures in our study.</p>","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"58 4","pages":"251-258"},"PeriodicalIF":1.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973873","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":"Immediate versus Delayed Wound Closure in Hidradenitis Suppurativa Surgery: A Comparative Outcomes Study.","authors":"Ehud Fliss, Gon Shoham, Tariq Zoabi, Ariela Hafner, Benjamin Meilik, Sharon Manheim, Daniel J Kedar, Yoav Barnea, Eyal Gur, Eran Otremski","doi":"10.1055/s-0045-1802326","DOIUrl":"10.1055/s-0045-1802326","url":null,"abstract":"<p><p><b>Background</b>  Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease affecting approximately 1% of young adults. Severe and refractory disease commonly requires surgical excision of the affected skin. To date, there is no consensus regarding the most appropriate reconstructive algorithm. <b>Materials and Methods</b>  We conducted a retrospective cohort study including all HS patients who underwent surgical excision in the framework of our multidisciplinary clinic. Operative data and postoperative outcome measures were compared between patients who underwent immediate versus delayed reconstruction. Additionally, reconstructive methods were compared and risk factors for adverse postoperative outcome were identified. <b>Results</b>  A total of 103 patients underwent 158 surgeries for HS excision. The overall complication rate was significantly higher in patients who underwent immediate versus delayed wound closure (31 vs. 16%, <i>p</i>  = 0.039). Any intervention for wound closure (immediate or delayed) was associated with increased risk of postoperative complications in comparison to secondary healing (33 vs. 4%, <i>p</i>  < 0.001). With delayed closure, the average time to wound closure was 85.4 days with secondary healing only and 57 days with negative pressure wound therapy assisted closure. <b>Conclusion</b>  Risk factors for adverse postoperative outcome in HS surgery are multifactorial and involve both timing and method of reconstruction in addition to various patient factors. The findings of this study strengthen the notion that delayed closure of post-HS excision wounds leads to the most uneventful course in regard to postoperative adverse events; however, this may take up to 3 months. Upon deciding on a reconstructive plan, the risk-to-benefit ratio should be assessed individually weighing the pros and cons of immediate closure and delayed secondary intention.</p>","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"58 3","pages":"191-198"},"PeriodicalIF":0.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555328","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":"Nonsurgical Elementary Rhinoplasty: A Volumetric Standardized Hyaluronic Acid Filling Technique in Five Steps.","authors":"Luddi L Oliveira, André Braz, Eliandre Palermo, Maria C A Issa","doi":"10.1055/s-0045-1802317","DOIUrl":"10.1055/s-0045-1802317","url":null,"abstract":"<p><p>Hyaluronic acid filling to correct the nose contour has gained popularity in recent years. Although many techniques are described about the amount of the product and steps to follow to obtain, practitioners still need clarification about the amount of product and steps to follow obtain natural and safe results. We aim to demonstrate a new technique with a systematic sequence that considers the anatomy and individual characteristics. The nonsurgical elementary rhinoplasty (NOSER) technique is performed in five steps using cannulas, a high G prime hyaluronic acid, and two injection entry points. The areas to be treated and the specific quantity of filler to be used are based on the assessment. Steps 1 to 3 are for the tip's projection, support and lift, and step 4 is for filling the radix area and straightening the dorsum. Step 5 is used for refinement and softening of the supratip. All five steps are done in small aliquots in the central area, at the deep plane. Through the procedure, it is possible to achieve an aesthetic improvement in the nose by widening the labial columellar angle, exposing the columella, projecting the tip, and aligning the dorsum (disguising the hump), even without performing all five steps. This technique could be a good and highly reproducible alternative for upgrading the nose contour.</p>","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"58 2","pages":"139-145"},"PeriodicalIF":0.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095181","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":"Work-Related Musculoskeletal Disorders among Practicing Plastic Surgeons in India: A Cross-Sectional Survey.","authors":"Aditya B Marathe, Piyush V Bamnodkar, Ankur S Karanjkar, Parag B Sahasrabudhe, Nikhil S Panse","doi":"10.1055/s-0045-1802328","DOIUrl":"10.1055/s-0045-1802328","url":null,"abstract":"<p><strong>Introduction: </strong>Work-related musculoskeletal disorders (WRMDs) are a less discussed entity in the medical profession, with surgical specialties being more prone to them. Little is known about these types of injuries in plastic surgeons specifically. Data on WRMDs among Indian plastic surgeons are lacking. The goals of this study were to evaluate the prevalence, nature, particular contributory causal factors and behaviors, and potential remedies of these musculoskeletal injuries among plastic surgeons in India.</p><p><strong>Materials and methods: </strong>An online voluntary survey was conducted among plastic surgeons in India, collecting their demographics, workload characteristics, musculoskeletal issues, causal factors, and corrective measures, taken using Google Forms. Data were extracted into an MS Excel spreadsheet and analyzed. The prevalence of WRMDs was calculated and the predictors were evaluated with a univariate analysis.</p><p><strong>Results: </strong>Thirty-three percent of 297 respondents had work-related musculoskeletal injuries or disorders, with the majority experiencing pain (82%), with the neck being the most common site (61%); this was followed by stiffness (61%) and fatigue (52%). The most common causative factors were sustained posture (81%), awkward posture (72%), and inadequate breaks (34%). Age ( <i>p</i>  = 0.041) and average operative hours per week ( <i>p</i>  = 0.036) were found to be statistically significant ( <i>p</i>  < 0.05). The corrective measures cited were stretching exercises, core-strengthening exercises, maintaining proper posture, taking frequent breaks, and yoga.</p><p><strong>Conclusion: </strong>Plastic surgeons are at high risk of WRMDs, with a significant prevalence in India. Albeit plastic surgeons in India face a higher case load, implementation of ergonomic principles can help in reducing the incidence of these disorders and in preventing the severity of sequelae.</p>","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"58 4","pages":"276-284"},"PeriodicalIF":1.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974020","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":"An Innovative Technique of Reconstructing Combined Extensor Tendon Zone (z5 and z4) Defect, Utilizing an Adjacent Proximal (z6) Tendon, as a Distally Based Tendon Flip Flap, in the Index Finger.","authors":"Narendra S Mashalkar, Pooja Thoppal Shiva, Joseph Kattady","doi":"10.1055/s-0045-1802316","DOIUrl":"10.1055/s-0045-1802316","url":null,"abstract":"<p><p>Delayed reconstruction of segmental extensor tendon defects of the hand has been described with auto-tendon grafting or by using local flaps harvested from the native tendon. These reconstructive techniques have been described in certain extensor tendon zones, mainly in zones 2, 4, and 5 of the hand. Borrowing auto-tendon grafts will have donor site morbidity. The use of available local tendon as flap may be considered, the tendon harvesting being done from a part of the native tendon from either proximal or distal location. The index and little fingers have the advantage of having two tendons to do the same function and hence these tendons may be utilized as a whole to our advantage as distally based tendon flip flap to reconstruct zone 4 and 5 extensor tendon defects with good functional outcomes.</p>","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"58 3","pages":"226-229"},"PeriodicalIF":0.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555322","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":"A Simplified Working Classification for Planning and Management of Facial Fractures.","authors":"Mukesh K Sharma, Rahul Saini, Bulli B Boyidi, Vaddi S Babu","doi":"10.1055/s-0045-1802344","DOIUrl":"10.1055/s-0045-1802344","url":null,"abstract":"<p><p>Facial fractures are commonly encountered by plastic and maxillofacial surgeons. Although very diversified in nature, their treatment planning requires a thorough knowledge of the facial anatomy and advanced treatment modalities. With the advent of three-dimensional computed tomography, it has become a lot easier to diagnose and treat them accordingly. It is important to categorize facial fractures for an effective liaison between the radiologists, surgeons, and medical staff involved in their management. Various classification schemes have been made to classify them, but they are cumbersome to remember and communicate among treating doctors. We present a new yet simple facial fracture classification that is based on the facial buttresses involved. This helps in better and uniform management of fracture patterns and also anticipates future complications that may arise from such fractures, if any.</p>","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"58 4","pages":"312-316"},"PeriodicalIF":1.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973893","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":"Changes in Medical Education in 21 ^st Century.","authors":"Harish Gupta","doi":"10.1055/s-0045-1802318","DOIUrl":"10.1055/s-0045-1802318","url":null,"abstract":"","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"58 4","pages":"323-324"},"PeriodicalIF":1.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973876","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":"Gynecomastia Surgery: Liposuction Alone versus Liposuction with Endoscope-Assisted Glandular Excision-A Comparative Study.","authors":"Sheikh Sarfraz Ali, Imran Ahmed, Mohammed Fahud Khurram, Noha Rehman, Rupraj Abhishek","doi":"10.1055/s-0045-1802327","DOIUrl":"10.1055/s-0045-1802327","url":null,"abstract":"<p><strong>Background: </strong>Gynecomastia, affecting around 30% of young males, has seen evolving surgical treatments, transitioning from traditional excision methods to contemporary techniques like liposuction. Emotional distress persists when glandular tissue is inadequately addressed, prompting exploration of combined liposuction and glandular excision procedures.</p><p><strong>Materials and methods: </strong>Patients undergoing gynecomastia surgery over a period of 2 years were assessed, considering their demographics, medical history, and gynecomastia grade. Surgical procedures involved liposuction alone or with glandular excision. Endoscopy was used to assess the presence of fibroglandular tissue and the need for glandular excision. Postoperative assessments, clinical photography, and patient questionnaires spanned a 6-month follow-up.</p><p><strong>Results: </strong>Thirty-two breasts (17 in liposuction alone and 15 in liposuction with glandular excision groups) were included. Liposuction alone led to bruising and two hematomas, and \"puffy nipples\" necessitating one redo surgery. Glandular excision resulted in four cases of crater deformity and one case each of superficial skin necrosis, hematoma, and seroma. Cosmetic evaluations showed similar outcomes, with the liposuction alone group having higher redo surgery rates.</p><p><strong>Conclusion: </strong>This study finds that combining liposuction with glandular excision delivers comparable cosmetic results to liposuction alone for gynecomastia. Despite added complexity, the combined approach proves effective and helps in decision-making, emphasizing the need for tailored techniques and ongoing research to optimize treatment strategies.</p>","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"58 4","pages":"269-275"},"PeriodicalIF":1.5,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974012","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}