Journal of Plastic Reconstructive and Aesthetic Surgery最新文献

{"title":"Clinical validation of a novel risk assessment score for prediction of unplanned reoperations and readmissions in hand surgery","authors":"Olachi O. Oleru, Nargiz Seyidova, Jamie Frost, Niklas H. Koehne, Prabhjot Singh, Peter J. Taub","doi":"10.1016/j.bjps.2025.04.013","DOIUrl":"10.1016/j.bjps.2025.04.013","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"105 ","pages":"Pages 123-125"},"PeriodicalIF":2.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Donor site in anterolateral thigh (ALT) free flaps: A systematic review of closure techniques and introduction of a management algorithm","authors":"Chad Chang ,&nbsp;Ivan Rodriguez-Mantilla ,&nbsp;Andrés Camilo Herrera ,&nbsp;Luis Arturo Molina ,&nbsp;Giuseppe Antonio D’Amico ,&nbsp;Juan Enrique Berner ,&nbsp;Marco Marcasciano ,&nbsp;Hung-Chi Chen","doi":"10.1016/j.bjps.2025.04.008","DOIUrl":"10.1016/j.bjps.2025.04.008","url":null,"abstract":"<div><div>The anterolateral thigh (ALT) free flap is widely used in reconstructive microsurgery for its versatility and reliability, yet donor site management becomes challenging when flap dimensions exceed those for tension-free primary closure. The flap width-to-thigh circumference ratio (FW/TCR) is a potentially valuable objective decision-making tool. Given the heterogeneity of the reported closure techniques, this review aimed to map current techniques, identify gaps in evidence and propose a FW/TCR-based algorithm to standardise ALT donor site closure.</div><div>A review of PubMed/MEDLINE, EMBASE, Cochrane Library and AMED databases was conducted from inception to October 2023, including English-language studies focused on ALT donor site closures. Data on closure techniques, outcomes, and complications were extracted.</div><div>Overall, 27 studies met the inclusion criteria, describing direct primary closure, locoregional flaps, skin grafting, and adjunctive methods such as negative pressure wound therapy, acellular dermal matrices and tissue expansion. Direct primary closure was generally reported as feasible for FW/TCR &lt; 16%. Once FW/TCR exceeded 30%, skin grafting or alternative solutions such as ‘kiss’ (split skin paddle) flaps were more frequently described. In the intermediate range (16–30%), locoregional flaps were commonly employed to avoid graft-related morbidity.</div><div>Drawing on these findings, we propose a FW/TCR-based algorithm: (1) direct closure for FW/TCR &lt; 16%, (2) locoregional flaps for FW/TCR 16–30%, and (3) grafting or alternative techniques if FW/TCR exceeds 30%. Standardising closure strategies using these thresholds may reduce donor site morbidity and optimise patient outcomes. Further high-level comparative studies are necessary to validate and refine these recommendations.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"105 ","pages":"Pages 243-259"},"PeriodicalIF":2.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143900066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of closed-incision negative pressure therapy in donor-site complications in DIEP flap breast reconstruction: Analysis of 705 patients and 1125 flaps","authors":"Maria J. Escobar-Domingo ,&nbsp;Valeria P. Bustos ,&nbsp;Amir-Ala Mahmoud ,&nbsp;Micaela J. Tobin ,&nbsp;John B. Park ,&nbsp;Daniela Lee ,&nbsp;Benjamin Rahmani ,&nbsp;Reinhard M. Knerr ,&nbsp;Chamilka Merle ,&nbsp;Joshua A. Bloom ,&nbsp;Samuel J. Lin ,&nbsp;Bernard T. Lee","doi":"10.1016/j.bjps.2025.04.010","DOIUrl":"10.1016/j.bjps.2025.04.010","url":null,"abstract":"<div><h3>Background</h3><div>Closed-incision negative pressure therapy (ciNPT) has been shown to reduce complication rates in breast reconstruction (BR). This study aimed to evaluate postoperative outcomes in deep inferior epigastric perforator (DIEP) donor-site incisions managed with ciNPT compared to standard dressings.</div></div><div><h3>Methods</h3><div>We performed a retrospective study of patients ≥18 years who underwent DIEP flap BR from 2015 to 2023. Patients who underwent reconstruction with alternative flaps or converted to transverse rectus abdominus myocutaneous were excluded. Patients were categorized according to the use of ciNPT vs. standard dressings. The unpaired t- and Fisher’s Exact tests were used to assess the differences between the groups. Multivariable logistic regression models were used to evaluate postoperative complications.</div></div><div><h3>Results</h3><div>A total of 705 patients were included, with 68 (9.6%) managed with ciNPT. Patients treated with ciNPT had significantly higher mean body mass index (BMI) (34.0 vs. 28.5 kg/m²; p&lt;0.001) compared to the control group. Higher rates of alcohol use (59.2% vs. 41.2%; p=0.006) and hormonal therapy use (41.3% vs. 17.9%; p&lt;0.001) were found in the standard dressing group. Univariate analyses showed no significant differences in donor-site postoperative outcomes across the groups. However, multivariate logistic regression models demonstrated a reduced likelihood of surgical site infection (OR 0.187; 95% CI 0.045–0.768); p=0.020), and wound dehiscence (OR 0.338; 95% CI 0.155–0.738); p=0.006) among the ciNPT users. Particularly, in patients with BMI &gt;30 kg/m², ciNPT use (OR 0.282; 95% CI 0.098–0.812; p=0.019) was found to be a significant protective factor against wound complications compared to the standard of care.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that ciNPT may improve wound complication rates in DIEP flap donor sites, especially in patients with high BMI. Further research is necessary to elucidate the cost-effectiveness of ciNPT based on the patient risk profiles.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"105 ","pages":"Pages 177-184"},"PeriodicalIF":2.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The implications of bariatric surgery in the burns patient","authors":"Samuel Chu ,&nbsp;Natalia Ziolkowski ,&nbsp;Benjamin Chia,&nbsp;Rachael Baines,&nbsp;Edward Raby,&nbsp;Fiona Wood,&nbsp;Mark Duncan-Smith,&nbsp;Helen Douglas","doi":"10.1016/j.bjps.2025.04.014","DOIUrl":"10.1016/j.bjps.2025.04.014","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"105 ","pages":"Pages 281-282"},"PeriodicalIF":2.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of peripheral nerve blocks on opioid use following flap reconstruction involving the lower extremity: A systematic review and meta-analysis","authors":"Matthew J. Heron ,&nbsp;Katherine J. Zhu ,&nbsp;Lily Zhu ,&nbsp;Alexandra J. Davis ,&nbsp;Sami Alahmadi ,&nbsp;Isabel A. Snee ,&nbsp;Alec J. Chen ,&nbsp;Ala Elhelali ,&nbsp;Lily R. Mundy","doi":"10.1016/j.bjps.2025.04.009","DOIUrl":"10.1016/j.bjps.2025.04.009","url":null,"abstract":"<div><h3>Background</h3><div>Peripheral nerve blocks (PNBs) are recommended by several multimodal pain regimens, but the evidence supporting their use in lower extremity surgery is limited. This study aimed to evaluate the association between PNBs and opioid use for free flap reconstruction involving the lower extremity.</div></div><div><h3>Methods</h3><div>We conducted a systematic review on the use of PNBs in lower extremity surgery, followed by a blind, dual extraction of the study outcomes. Variables of interest included opioid use (intravenous [IV] morphine milligram equivalents [MMEs]), patient-reported pain, length of surgery (hours), and length of stay (days). We then performed meta-analyses using random effects models for mean difference (MD).</div></div><div><h3>Results</h3><div>We included 11 studies comprising 417 patients for analysis. PNBs were significantly associated with reduced 24-hour (MD=−15.4 IV MMEs, p&lt;0.05) but not total postoperative opioid use (MD=−80.3 IV MMEs, p&gt;0.05). Patients who received PNBs reported significantly less pain at 24 h (standardized MD=−0.72 IV MMEs, p&lt;0.05) but not 48 h (standardized MD=−0.21, p&gt;0.05). Length of stay was 0.6 days shorter for patients who received PNBs (p&lt;0.05), but length of surgery was not significantly different (MD=0.06 h, p&gt;0.05). When considering the data from only randomized controlled trials, total opioid use was significantly reduced for patients who received PNBs (MD=−19.62 IV MMEs, p&lt;0,05), but there was no difference in the length of stay (MD=−0.28 days, p&gt;0.05).</div></div><div><h3>Conclusion</h3><div>Peripheral nerve blocks may offer statistically significant reductions in postoperative opioid use, particularly within the first 24-hours postoperatively, but the clinical significance of this reduction is relatively minor (approximately 4 to 6 oxycodone 5-mg equivalents).</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"105 ","pages":"Pages 230-242"},"PeriodicalIF":2.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143900069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Predictors of seroma after breast reduction: When should drains be considered?”","authors":"Gaia Ghiringhelli,&nbsp;Eleonora Bulgarelli,&nbsp;Elisa Dolfato,&nbsp;Elisa Bascialla,&nbsp;Manuela Bottoni,&nbsp;Mario Rietjens,&nbsp;Fernando Rosatti,&nbsp;Andrea Vittorio Emanuele Lisa","doi":"10.1016/j.bjps.2025.04.012","DOIUrl":"10.1016/j.bjps.2025.04.012","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"105 ","pages":"Pages 115-116"},"PeriodicalIF":2.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of epicanthoplasty for child epiblepharon","authors":"Hikaru Watanabe,&nbsp;Kazuhisa Uemura,&nbsp;Yasuhiro Sakata,&nbsp;Maiko Inada,&nbsp;Miki Nakanishi,&nbsp;Gen Yamada,&nbsp;Shinichi Asamura","doi":"10.1016/j.bjps.2025.04.011","DOIUrl":"10.1016/j.bjps.2025.04.011","url":null,"abstract":"<div><div>Epiblepharon is a common disease in Asian children. It may cause astigmatism and amblyopia; hence, some cases require surgical treatment. Although the modified Hotz procedure is a common surgery, some cases of recurrence have been reported. One of the causes is the presence of the epicanthal fold. In this study, we retrospectively investigated the applicability of epicanthoplasty for epiblepharon in children based on the severity of the epicanthal fold. Patients under 13 years of age were evaluated to determine whether the modified Hotz procedure should be combined with epicanthoplasty based on the severity of epicanthal fold and rates of recurrence. The severity of the epicanthal fold was classified into 3 levels (mild, moderate, and severe) according to Wang’s classification based on the degree of epicanthal fold covering the lacrimal caruncle. A total of 58 eyes were investigated with a mean age of 7.6 (4–13) years. The mean observation period was 11 (6–30) months. Thirty patients underwent the modified Hotz procedure alone and it was combined with epicanthoplasty in 28 patients. Although there were no differences in the recurrence rate between the mild and moderate cases, the recurrence rate in the group that underwent the modified Hotz procedure combined with epicanthoplasty was significantly lower than the group that underwent the modified Hotz procedure alone for the severe cases (0% vs. 33.3%). Therefore, it is suggested that the classification of epicanthal fold severity is useful for determining the surgical procedure, and that epicanthoplasty is necessary only in severe pediatric cases.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"105 ","pages":"Pages 317-322"},"PeriodicalIF":2.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orbital exenteration in the management of orbital and periorbital tumours: Factors related to treatment outcomes","authors":"Paula Niinimäki ,&nbsp;Maria Määttänen ,&nbsp;Jyrki Vuola ,&nbsp;Tero T. Kivelä ,&nbsp;Antti A. Mäkitie ,&nbsp;Marita Uusitalo","doi":"10.1016/j.bjps.2025.03.060","DOIUrl":"10.1016/j.bjps.2025.03.060","url":null,"abstract":"<div><div>The aim of this study was to evaluate the indications for surgery, patient and healthcare delays, ophthalmic status, challenges of management, complications, disease-free survival (DFS), and overall survival (OS) of patients treated by orbital exenteration at a tertiary care centre.</div><div>Patients who underwent orbital exenteration during an 18-year period (2005–2022) were identified from the Helsinki University Hospital (Helsinki, Finland). Demographic and medical data were retrieved.</div><div>Sixty-nine patients were included. Median age was 74 years (range, 7–93 years). The most common operative indication for exenteration was a malignant tumour (99%). Histopathological types that were most frequently encountered were uveal melanoma in 10 (14%), basal cell carcinoma in 9, (13%) and cutaneous squamous cell carcinoma in 8 (12%) patients. Orbital exenteration could have been avoided in 32 (46%) patients if the primary surgery had been performed with sufficient margins and without delay. The median follow-up time was 16 months (range, 0–169 months). At the end of follow-up, 34 (49%) patients had no evidence of disease, 12 (17%) were alive with disease and 23 (33%) had died of the disease. Kaplan–Meier analysis revealed 1- and 2-year DFS of 74% and 67%, respectively. One- and 2-year OS were 77% and 69%, respectively.</div><div>Selected periorbital malignancies, especially those with insufficient primary treatment or with treatment delay, may warrant exenteration. Given the diverse origins of malignancies, a multidisciplinary approach, including ophthalmological consultation, appears to be the optimal strategy for these patients.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"105 ","pages":"Pages 260-269"},"PeriodicalIF":2.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143900067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Let’s talk about it: A virtual peer support group for plastic surgeons and trainees to improve confidence and feasibility in family planning","authors":"Madeleine Givant ,&nbsp;Xinfei Miao ,&nbsp;Kassandra Carrion ,&nbsp;Aileen Gozali ,&nbsp;Youssef Aref ,&nbsp;Jasmine Chaij ,&nbsp;Sarah M. Gubara ,&nbsp;Gabriella Tavera ,&nbsp;Wendy Chen","doi":"10.1016/j.bjps.2025.03.059","DOIUrl":"10.1016/j.bjps.2025.03.059","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"105 ","pages":"Pages 112-114"},"PeriodicalIF":2.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-dimensional MRI-CT image fusion technique as an innovative strategy for dissolution and removal of facial fillers in specific portions","authors":"Anran Li ,&nbsp;Xinyang Liu ,&nbsp;Jie Dong ,&nbsp;Yuqin Luo ,&nbsp;Miao Xu ,&nbsp;Shuo Fang","doi":"10.1016/j.bjps.2025.03.058","DOIUrl":"10.1016/j.bjps.2025.03.058","url":null,"abstract":"<div><h3>Objectives</h3><div>We explored the potential use of MRI-CT three-dimensional (3D) reconstruction in the extraction of facial fillers.</div></div><div><h3>Methods</h3><div>In this investigation, pre and postoperative MRI-CT 3D reconstructions were performed on a cohort of 28 patients who underwent filler removal therapy. The efficiency of filler removal in critical facial regions was quantitatively assessed, and patient satisfaction was evaluated using a standardized Likert scale.</div></div><div><h3>Results</h3><div>The procedural efficacy analysis revealed an average facial filler clearance rate of 96.84%. Patient-reported outcomes demonstrated complete satisfaction (100%, 30/30) with cosmetic results, 96.67% (29/30) complication-free rate, and unanimous improvement (100%, 30/30) in the quality of life.</div></div><div><h3>Conclusion</h3><div>The 3D MRI-CT fusion images provided precise visualization of the anatomical relationship between filler materials and the facial tissue structures before therapy, highlighting their clinical value.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"105 ","pages":"Pages 198-207"},"PeriodicalIF":2.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}