Annals of Plastic Surgery最新文献

{"title":"Factors Associated With Delays in Discharge for Patients Undergoing Chronic Wound Reconstruction.","authors":"Rachel H Park, Jennifer Smith, Robert G DeVito, Jesse Chou, Ashley Zhang, Brent R DeGeorge","doi":"10.1097/SAP.0000000000004414","DOIUrl":"10.1097/SAP.0000000000004414","url":null,"abstract":"<p><strong>Background: </strong>Delay in discharge following chronic wound reconstruction is a concern that adds to the national hospital bed shortage crisis. This study aims to identify and analyze the factors associated with delay in discharge after wound reconstruction.</p><p><strong>Methods: </strong>A retrospective chart review of all patients who underwent chronic wound reconstruction by a plastic surgeon at a single tertiary academic hospital from January 2019 to December 2021 was performed using CPT codes. Patients admitted with other primary diagnoses or to the ICU were excluded. Demographic data as well as socioeconomic factors, insurance status, disposition, and other discharge needs were recorded and analyzed in relation to days delay in discharge. A univariate negative binomial count model was used for statistical analysis.</p><p><strong>Results: </strong>A total of 131 encounters were included in the study with 61 encounters in delay group and 70 in no delay group. Delay group experienced mean discharge delay of 3.03 days. There were no significant differences in medical comorbidities between the 2 groups. Patients with commercial insurances had shorter mean delay (0.79 days) compared to that of patients with government-issued insurances (1.52-1.69 days). Those discharging to a facility like rehabilitation center, skilled nursing facility, or long-term acute care had about 3.5 days of delay compared to those going home. Other requirements such as IV antibiotics, home VAC, or durable medical equipment did not significantly affect discharge timing in discharge.</p><p><strong>Conclusion: </strong>Delays in discharge after chronic wound reconstruction are common, and socioeconomic factors including insurance status and disposition were the 2 most significant predictors of delay.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"402-407"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324342","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}

{"title":"Vascularized Fibular Epiphyseal Transfer for Pediatric Oncoplastic Reconstruction: Two Case Reports.","authors":"Alexander F Dagi, Nikhil A Gangoli, Michael B Amrami, Sarah E Diaddigo, Wakenda K Tyler, Christine H Rohde, Adam Jacoby, Jarrod T Bogue","doi":"10.1097/SAP.0000000000004485","DOIUrl":"10.1097/SAP.0000000000004485","url":null,"abstract":"<p><strong>Abstract: </strong>Vascularized fibular epiphyseal transfer (VFET) has emerged as a reconstructive option for pediatric patients requiring limb salvage with preservation of growth potential. We presented 2 cases of VFET to the humerus following oncologic resection for osteosarcoma in children aged 11 and 5 years. Both cases demonstrated growth plate viability postoperatively, with serial imaging confirming annual growth rates of 0.8-1.2 cm/y. Despite successful bone growth, both patients developed persistent foot drop at donor sites requiring ankle-foot orthoses. We described our surgical technique, functional outcomes, and neurovascular complications. Additionally, we described a cost-effective growth monitoring method using a radio-opaque ruler, particularly valuable in resource-limited settings. This report contributes to the limited literature on VFET outcomes and highlights the need for improved techniques to mitigate donor site morbidity.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"390-393"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793325","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}

{"title":"Evaluating Complications of Surgical Reconstructive Approaches for Plantar Melanoma: A Systematic Review and Meta-analysis.","authors":"Noah M Scigliano, Nicholas M Scigliano, Yumeng Gao, Ignacio Garcia Fleury, Joseph A Buckwalter V","doi":"10.1097/SAP.0000000000004498","DOIUrl":"10.1097/SAP.0000000000004498","url":null,"abstract":"<p><strong>Abstract: </strong>Reconstruction of plantar melanoma presents a surgical challenge due to unique qualities of plantar soft tissue and its role as a weight-bearing surface. Therefore, careful design and selection of coverage option are required to optimize functional recovery and limit postoperative complications on the plantar aspect of the foot. The purpose of this study was to perform a systematic review and meta-analysis on the difference in complication rates between 3 coverage options for the reconstruction of plantar melanoma defects: free flaps, pedicle flaps, and skin grafts. Ovid MEDLINE, EMBASE, and Cochrane CENTRAL were utilized to identify articles dating from 2000 to 2023. Nineteen studies met the inclusion criteria for qualitative analysis and 14 studies for quantitative analysis, which comprised retrospective and prospective studies. Seven studies within the quantitative analysis included free flaps, 6 included pedicle flaps, and 2 included skin grafts, totaling 159 reconstruction procedures. A comparative analysis using inverse variance method was applied to compare complication rates across coverage options. No significant difference was found for the incidence rate of at least 1 complication, the total number of complications, or total number of flap loss/total flap necrosis between free flaps, pedicle flaps, and skin graft procedures (all P > 0.05). No superior coverage option for plantar melanoma defects is evident based on pooled complication rates in this study; therefore, factors such as tumor size/depth, vascular status, and anatomic location in relation to weight-bearing status should be used to determine reconstructive choice.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"460-465"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939379","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}

{"title":"A Review of Mammaplasties With Measurements: Evaluating Autoaugmentation, Mesh, Acellular Dermal Matrix, and the Wise Pattern.","authors":"Eric Swanson","doi":"10.1097/SAP.0000000000004455","DOIUrl":"10.1097/SAP.0000000000004455","url":null,"abstract":"<p><strong>Background: </strong>A recent review article summarizes the discussion of mastopexy into 2 \"emerging\" approaches-mastopexy with autoaugmentation and mastopexy with mesh support. These concepts were introduced decades ago. This quantitative review was undertaken to explore the evidence.</p><p><strong>Methods: </strong>An electronic literature review was conducted to identify publications that evaluated mammaplasties using a 2-dimensional measurement method that is (uniquely) capable of comparing important breast parameters, specifically breast projection and upper-pole projection.</p><p><strong>Results: </strong>Measurement data from 20 publications were tabulated. Women treated with vertical mammaplasties showed mean increases in both breast projection (+0.69 cm) and upper-pole projection (+0.64 cm). Patients treated with nonvertical methods lost 0.77 cm of breast projection, on average. Gain in upper-pole projection was marginal (+0.13 cm). Both increments were significantly greater for vertical methods ( P < 0.0001 and P < 0.001). Implants boosted breast projection and upper-pole projection. There was essentially no benefit in breast projection or upper-pole projection in patients who received mesh.</p><p><strong>Discussion: </strong>Despite an intuitive appeal, autoaugmentation methods do not perform. No parenchymal rearrangement can increase volume. An implant is needed to provide substantial upper-pole fullness. Vertical mammaplasties consistently outperform Wise pattern methods because of a more favorable geometry, trading width for projection rather than the reverse. Despite claims of \"support,\" there is no evidence for improved breast shape or durability using mesh or acellular dermal matrix. An \"internal bra\" is a marketing concept with no reliable supportive evidence. Financial conflicts are a major consideration.</p><p><strong>Conclusions: </strong>A recommitment to science and measurements is needed to guide treatment recommendations. Women should not be advised that autoaugmentation can mimic the effect of an implant; nor should they be offered mesh or ADM. The vertical mammaplasty should replace the Wise pattern as the preferred mammaplasty design. Vertical augmentation/mastopexy is a powerful combination.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"438-452"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741016","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":"Optimizing Nasal Tip Position: A Systematic Review of Columellar Strut and Septal Extension Grafts.","authors":"Ricardo O Amador, Ryoko Hamaguchi, Richard A Bartlett, William G Austen","doi":"10.1097/SAP.0000000000004489","DOIUrl":"10.1097/SAP.0000000000004489","url":null,"abstract":"<p><strong>Background: </strong>Nasal tip position is a crucial aspect of rhinoplasty. To stabilize and define the nasal tip, various cartilaginous grafts have been widely utilized. The purpose of this systematic review is to critically evaluate and compare 2 prevalent grafting techniques: columellar strut grafts (CSGs) and septal extension grafts (SEGs). This study aims to 1) review rhinoplasty studies directly comparing CSGs with SEGs, 2) examine variations in graft technique, and 3) compare their impact on nasal tip projection, rotation, and patient-reported outcomes.</p><p><strong>Methods: </strong>A systematic review adhering to the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines was conducted. Screening and full-text review were performed by 2 independent evaluators. Data collection included patient demographics, operative techniques, patient-reported outcomes, and anthropometric measures of projection, and rotation.</p><p><strong>Results: </strong>Ninety-three articles were identified and screened based on predetermined criteria, with 24 undergoing full-text review. Eight studies, involving 571 patients, were included in the final analysis. Of these, 54% (n = 310) underwent SEGs, while 46% (n = 261) underwent CSGs. Patient-reported outcomes were only available in 2 studies. Most studies reported short- and long-term measurements of tip projection and rotation; 1 study provided additional data on nasal tip stiffness.</p><p><strong>Conclusions: </strong>This systematic review provides a comprehensive examination of SEGs and CSGs in open rhinoplasty. While SEGs have been shown to provide superior long-term tip stability, some authors contend that CSGs hold value for specific patients. We propose a patient-specific approach for selecting between CSGs versus SEGs based on existing comparative data.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"350-355"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939349","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}

{"title":"Efficacy and Safety of the Minimal-Scarring Subdermal Adipo-Glandular Rotation Flap for Volume Displacement in Breast-Conserving Surgery: A Preliminary Comparative Study.","authors":"Erika Iguchi, Tomohiro Miyake, Naoki Inafuku, Sakiko Kumata, Haruka Fujimoto, Sae Kitano, Chikage Kato, Midori Morita, Koichi Sakaguchi, Yasuto Naoi","doi":"10.1097/SAP.0000000000004437","DOIUrl":"10.1097/SAP.0000000000004437","url":null,"abstract":"<p><strong>Purpose: </strong>The dermoglandular rotation flap with Burow's triangle is a widely used volume displacement technique in breast-conserving surgery (BCS) for breast cancer, particularly in cases with poor cosmetic prognoses. However, this method often results in extensive scarring. To address this limitation, we developed the subdermal adipo-glandular rotation flap (AGRF), designed to minimize surgical scars while preserving aesthetic outcomes. This study evaluates the efficacy and safety of AGRF.</p><p><strong>Methods: </strong>Between March 2022 and September 2023, 22 patients with breast cancer who underwent BCS with rotation flap reconstruction and sentinel lymph node biopsy were analyzed. Among them, 9 patients received AGRF (AGRF group), while 13 underwent the conventional dermoglandular rotation flap (control group). Surgical outcomes and complications were retrospectively compared.</p><p><strong>Results: </strong>The AGRF group exhibited a significantly shorter median wound length compared to the control group (8.5 cm vs 18 cm, P < 0.001). Cosmetic outcomes were comparable between groups, with similar proportions of patients rated as excellent or good (AGRF vs control: Harvard scale, 100% vs 92%, P = 1.000; BCCT.core, 89% vs 85%, P = 1.000). No significant differences were observed in operative time, blood loss, postoperative pain, or fat necrosis.</p><p><strong>Conclusions: </strong>AGRF effectively reduces surgical scar length without compromising cosmetic outcomes or requiring complex techniques. This makes it a valuable option for volume displacement after BCS, particularly in patients with nonfatty breasts.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"95 4","pages":"356-363"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039014","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}

{"title":"Characterizing the Industry Payments Received by Plastic Surgeons at the American Association of Plastic Surgeons 2022 Meeting.","authors":"Ariel J Harsinay, Zachary Tamweber, Katherine Kozlowski, Eric Shuren, Jordan Frey","doi":"10.1097/SAP.0000000000004417","DOIUrl":"10.1097/SAP.0000000000004417","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the financial relationships held by attendees of the American Association of Plastic Surgery (AAPS) conference in 2022 utilizing the Center for Medicare and Medicaid Services (CMS) Open Payments database.</p><p><strong>Methods: </strong>Plastic surgeons practicing in the United States who were listed in the AAPS 2022 program were included in the study. Internet searches were used to obtain demographic information for each participant, including sex, region, fellowship training, years of practice, and practice setting. Industry payments for the year 2022 were collected. Statistical analyses were completed in SPSS.</p><p><strong>Results: </strong>A total of $11,107,403.13 was received in general payments by the 390 plastic surgeons included in this study, with the 10 highest paid physicians encompassing 84% of these total payments. A total of 120 companies provided payments to included physicians. Surgical Innovation Associates, Inc., was responsible for 71.6% of payments made. Over 50% of plastic surgeons included in the AAPS program received payments from the second highest paying company, Allergan Inc. Males with 16-20 years of practice received the greatest industry payments; practice setting, fellowship training, and R1 institution affiliation were not reliable predictors of industry payments.</p><p><strong>Conclusions: </strong>The average plastic surgeon who contributed to the 2022 AAPS program earned significantly more in industry payments compared to the average plastic surgeon nationwide, warranting concerns that conference content may be influenced by the financial relationships held by these speakers.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"417-422"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324339","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}

{"title":"A Single Institution Comparison of Speech Outcomes Following Palatoplasty in Stickler Syndrome.","authors":"Raina K Patel, Valeria Mejia, Melanie Bakovic, Asli Pekcan, Marvee Turk, Alyssa Valenti, Mark M Urata, Jeffrey A Hammoudeh","doi":"10.1097/SAP.0000000000004440","DOIUrl":"10.1097/SAP.0000000000004440","url":null,"abstract":"<p><strong>Introduction: </strong>Stickler syndrome (SS) is a genetic collagenopathy characterized by visual impairment, hearing loss, joint pain, and cleft palate (CP). CP patients without SS typically undergo primary palatoplasty within the first year of life; in the SS population, however, medical comorbidities can result in palatoplasty occurring later than typically advised. In this study, we evaluate the impact of palatoplasty timing on long-term speech outcomes in SS patients.</p><p><strong>Methods: </strong>A retrospective review was conducted of patients with SS who underwent palatoplasty at a tertiary children's hospital between 2006 and 2024. Data collection included patient demographics, medical and surgical history, and postoperative outcomes. Certified speech pathologists assessed speech using perceptual speech ratings. Spontaneous speech scales were used to assess articulation error severity relative to age-appropriate norms.</p><p><strong>Results: </strong>A total of 26 patients were included, of whom 9 (35%) underwent palatoplasty within the first year of life and 17 (65%) underwent late palatoplasty after the first year of life. The overall median age at palatoplasty was 1.5 years. Palatoplasty was most commonly delayed by the need for mandibular distraction osteogenesis (n = 13), followed by respiratory distress and/or upper airway obstruction (n = 8). Late palatoplasty patients had an increased risk of obligatory errors (37.5% vs 0%, P = 0.010), compensatory errors (50% vs 11%, P = 0.044), and altered resonance (76.5% vs 44.4%, P = 0.024). Velopharyngeal insufficiency and nasal regurgitation did not significantly differ between groups.</p><p><strong>Conclusions: </strong>Cleft surgeons should recognize that patients with SS may not adhere to the typical CP treatment paradigm due to additional medical comorbidities and may experience speech deficits as outlined above. Additional studies are required to optimize palatoplasty timing as it relates to speech outcomes in this population.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"375-381"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537841","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}

{"title":"Comment on \"Red Breast Syndrome-Where Has It Gone?\"","authors":"Chandler S Hinson","doi":"10.1097/SAP.0000000000004403","DOIUrl":"10.1097/SAP.0000000000004403","url":null,"abstract":"","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"468-469"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537843","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}

{"title":"Optimizing Chart Review Efficiency in Pressure Injury Evaluation Using ChatGPT: Comment.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1097/SAP.0000000000004445","DOIUrl":"10.1097/SAP.0000000000004445","url":null,"abstract":"","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"470"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537856","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}