Annals of Plastic Surgery最新文献

{"title":"Comparative Efficacy of Regenerative Therapies for Diabetic Foot Ulcers: A Network Meta-analysis.","authors":"Hsi-An Yang, Ren-Jun Hsu, Wun-Long Jheng, Feng-Ju Weng, Jian-Jr Lee","doi":"10.1097/SAP.0000000000004192","DOIUrl":"10.1097/SAP.0000000000004192","url":null,"abstract":"<p><strong>Background: </strong>Diabetic foot ulcer (DFU) is one of the most dreaded complications of diabetes mellitus and is associated with a high risk of lower limb amputation and mortality. Because the efficacy of conventional treatments for DFUs is often limited, regenerative medicine therapy, such as growth factors and stem cells, may provide a solution to chronic wound healing. In this study, we compared several kinds of regenerative therapy for treating DFUs in terms of efficacy.</p><p><strong>Methods: </strong>We systemically searched relevant studies on PubMed, Cochrane Library, and EMBASE. Randomized clinical trials on conventional treatment combined with platelet-rich plasma (PRP), epidermal growth factor (EGF), or stem cell therapy, compared with conventional treatment alone in patients with DFUs, were included in this study.</p><p><strong>Results: </strong>A total of 1454 patients from 23 randomized controlled trials (RCTs) were included in the network meta-analysis. In terms of the number of completely healed ulcers, no significant difference was noted between PRP, stem cell therapy, and EGF group. We also performed surface under the cumulative ranking curve analyses to predict the rank of each intervention by the number of completely healed ulcers. The predicted ranking was as follows: stem cell, PRP, EGF, and the control group (conventional treatment alone). Furthermore, when we compared the mean of the wound healing time of DFUs among these four interventions, we found that the PRP group achieved significantly earlier ulcer healing than the stem cell, EGF, and control groups. No significant difference was observed in the time needed for wound healing between the stem cell and EGF groups. Funnel plot analysis demonstrated no publication bias.</p><p><strong>Conclusions: </strong>PRP combined with conventional treatment significantly accelerates wound healing for DFUs. The mean wound healing time was similar between the stem cell and EGF groups. However, additional reviews of rigorous, large, well-designed RCTs are warranted for further validation of our findings.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 3S Suppl 1","pages":"S24-S32"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490169","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":"Keloid Excision With Primary Closure Combined With Superficial Radiation Therapy (SRT-100).","authors":"Sheng-Lin Tsai, Yu-Chi Tsai, Yu-Tse Weng, Wen-Yen Huang, Chih-Hsin Wang","doi":"10.1097/SAP.0000000000004187","DOIUrl":"10.1097/SAP.0000000000004187","url":null,"abstract":"<p><strong>Background: </strong>Surgery plus radiotherapy is associated with fewer recurrences after keloid treatment. However, the side effects of radiotherapy are of concern. Superficial radiation therapy has a low energy, targets the skin, and spares deeper structures, making it ideal for keloid treatment. Many studies have reported good outcomes after surgery combined with superficial radiation therapy. This study provided data on Taiwanese patients who underwent keloid excision with simple primary closure and superficial radiation therapy.</p><p><strong>Methods: </strong>We retrospectively collected data from patients who underwent keloid excision with postoperative radiotherapy at our hospital. All patients underwent keloid excision and primary wound closure without Z-plasty or a local flap. Subsequently, patients underwent 2 or 3 fractions of superficial radiation therapy (SRT) on postoperative days 0, 1, and 2 (in 3 fractions). We collected data on the patients' preoperative Vancouver Scar Scale (VSS), 2-month follow-up VSS score, recurrence, and side effects.</p><p><strong>Results: </strong>In total, 16 keloids in 12 patients were treated with excision, primary closure, and superficial radiation therapy. The mean preoperative VSS was 8.69 ± 1.79, whereas the mean 2-month postoperative VSS was 3.56 ± 0.70. Most of the keloids were followed up for more than 6 months. No keloid recurrence was observed. A side effect of radiotherapy is hyperpigmentation of the skin surrounding the surgical scar.</p><p><strong>Conclusions: </strong>Keloid excision with primary closure combined with postoperative SRT leads to a good outcome with no recurrence and a shorter incision wound that satisfies patients and reduces the complications of hyperpigmentation.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 3S Suppl 1","pages":"S18-S23"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490410","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":"Reconstruction of Posttraumatic Distal Limb Defects With Free Superficial Circumflex Iliac Artery Perforator Flap.","authors":"Yuan-Chang Tung, Yen-Kai Chen, Ying-Sheng Lin","doi":"10.1097/SAP.0000000000004198","DOIUrl":"10.1097/SAP.0000000000004198","url":null,"abstract":"<p><strong>Introduction: </strong>Soft tissue defects in the distal limbs are common after traumatic injury. Repairing such defects is challenging because of the lack of adjacent soft tissue for direct closure or use of a local flap, and functional and aesthetic issues are more prominent in the hands and feet. Thin, unbulky free tissue transfer is ideal for achieving functional and aesthetically pleasing reconstructions. This study reports the use of free superficial circumflex iliac artery perforator (SCIP) flap to reconstruct posttraumatic distal limb defect.</p><p><strong>Patients and methods: </strong>Thirteen patients with distal limb defects following traumatic injury underwent microsurgical reconstruction with SCIP flap between 2017 and 2022. The defects were located in the upper extremities in 8 patients and lower extremities in 5 patients. Flap thinning was performed to minimize bulkiness, thus restoring functionality and an aesthetically satisfactory appearance.</p><p><strong>Results: </strong>The patients' average age was 39.8 ± 15.3 years. The average flap size was 13.5 ± 3.4 × 6.7 ± 1.5 cm, and the average pedicle length was 5.2 ± 1.3 cm. Two flaps failed because of unsalvageable venous thrombosis, whereas 2 flaps had salvageable vessel thrombosis. Other flaps survived without major complications. During the average follow-up duration of 7.4± 4.8 months, the functional and aesthetic outcomes were satisfactory after an average of 1 ± 1.2 times of flap revisions.</p><p><strong>Conclusions: </strong>With a thin skin paddle, SCIP flap is an available option for posttraumatic distal limb defect reconstruction without much effort of further revisions.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 3S Suppl 1","pages":"S13-S17"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490429","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":"Correction of Secondary Exophthalmos Caused by Lateral Orbital Rim Recession: Add-on Implants Through a 3D Approach.","authors":"Sotatsu Fukuyama, Takafumi Saito, Lun-Jou Lo","doi":"10.1097/SAP.0000000000004202","DOIUrl":"10.1097/SAP.0000000000004202","url":null,"abstract":"<p><strong>Abstract: </strong>Improving exophthalmos is a crucial aspect of treatment for patients with syndromic craniosynostosis. However, in patients who have undergone previous treatments including fronto-orbital advancement and Le Fort III distraction osteogenesis and who have reached skeletal maturity, the recurrence of exophthalmos is not uncommon. The severity of the exophthalmos may vary. Whether secondary correction involving osteotomy should be performed or symptomatic treatment strategies should be adopted is a dilemma, and the patient's symptoms and background and the invasiveness of the surgery should also be considered. Additionally, the accurate measurement and treatment of exophthalmos require the expertise of surgeons. This report introduces self-developed orbital wall implants generated through 3-dimensional simulation and 3-dimensional printing. The patient was a 23-year-old woman with Crouzon syndrome and recurrent exophthalmos. After surgery, the exophthalmos and facial appearance were improved. The use of custom-made implants provides advantages over the conventional osteotomy method; it is less invasive, involves a simple surgical procedure, and offers cost and time savings.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 3S Suppl 1","pages":"S82-S86"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490389","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":"The Seven-Day Method: A Refined Labia Minora Reduction Technique With Swift, Week-Long Recovery.","authors":"Eiko Tanaka, Andy Deng-Chi Chuang, Wen-Kuan Chiu, Chia-Hsuan Tsai","doi":"10.1097/SAP.0000000000004216","DOIUrl":"10.1097/SAP.0000000000004216","url":null,"abstract":"<p><strong>Introduction: </strong>Aesthetic reduction of the labia minora has increased in popularity over the recent decades. Numerous surgical techniques have surfaced, each with their advantages and shortcomings. Regardless of resection technique, recovery period of up to 6 weeks after labia minora reduction surgery has been recommended.</p><p><strong>Method: </strong>A modification of the edge resection technique described herein eliminates the need for suture removal and allows for expedited recovery within a week. Patients receiving the eponymously named seven-day method at a single aesthetic center were evaluated for aesthetic outcome, complications, reoperation rate, and overall patient satisfaction.</p><p><strong>Results: </strong>Of the 80 patients surveyed, aesthetic outcome and patient satisfaction were either \"satisfied\" or \"very satisfied\" in 96.9% and 87.5% of the patients, with a mean score of 4.6 and 4.2 out of 5, respectively. Complications included bleeding, uneven contour, dehiscence, swelling, stitch exposure, pain, and itching. Overall reoperation rate was 3.8% and were all for elective and aesthetic purposes.</p><p><strong>Conclusions: </strong>The seven-day method is a relatively simple and undemanding technique that allows quick postoperative recovery without the need for follow-up, promising good patient satisfaction and outcome.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 3S Suppl 1","pages":"S33-S37"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490433","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":"Abdominal Fascial Plication and the Risk of Venous Thromboembolism in Abdominoplasty Patients: A Systematic Review of the Literature.","authors":"Eric Swanson","doi":"10.1097/SAP.0000000000004149","DOIUrl":"10.1097/SAP.0000000000004149","url":null,"abstract":"<p><strong>Background: </strong>Repair of the abdominal fascia at the time of abdominoplasty is a valuable method to improve the contour of the abdomen. However, this maneuver has been linked to an increased risk of venous thromboembolism (VTE). This review was undertaken to evaluate the evidence.</p><p><strong>Methods: </strong>An electronic literature review was conducted to identify publications on the subject of abdominal fascial repair during abdominoplasty and VTE risk. Key words included abdominoplasty, fascial plication, intra-abdominal pressure, and venous thrombosis.</p><p><strong>Results: </strong>Three large clinical studies were identified. One retrospective study using matched comparisons reported nearly identical VTE rates for patients treated with and without abdominal fascial plication (1.5% vs 1.7%). Another retrospective study reported significantly more VTEs (2.3%) in abdominoplasty patients undergoing fascial repair compared with panniculectomy patients who did not undergo fascial plication (0.36%). The author also recommended a modified Caprini score, adding fascial repair as a risk factor. Only 1 prospective study reported a large number of consecutive plastic surgery outpatients evaluated with Doppler ultrasound. This group included 188 abdominoplasty patients, all treated with fascial plication and without muscle paralysis. Only 1 VTE was diagnosed on the day after abdominoplasty (0.5%).</p><p><strong>Discussion: </strong>Retrospective studies are susceptible to confounders and confirmation bias. Caprini scores do not have a scientific foundation. Chemoprophylaxis increases the risk of bleeding without reducing the risk of VTE.</p><p><strong>Conclusions: </strong>The best available evidence supports performing a fascial repair. An effective and safe alternative to Caprini scores and chemoprophylaxis is avoidance of muscle paralysis and early detection of VTEs using ultrasound screening.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"378-383"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142943310","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":"Changing Perspectives in Mastectomy: The Case for Nipple Preservation.","authors":"Eric Swanson","doi":"10.1097/SAP.0000000000004239","DOIUrl":"10.1097/SAP.0000000000004239","url":null,"abstract":"","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"263-268"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11902608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188141","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":"Clinical Outcome Features of Non-HIV Kaposi's Sarcoma and the Role of Wide Excision on Survival: A Retrospective Cohort Study.","authors":"Chia-Kai Hsu, Fang-Yu Hsu, Hung-Chi Chen, Chang-Cheng Chang","doi":"10.1097/SAP.0000000000004189","DOIUrl":"10.1097/SAP.0000000000004189","url":null,"abstract":"<p><strong>Abstract: </strong>This single-center retrospective study enrolled 22 patients, who were divided into two groups: those who underwent wide excision (group A) and those who did not (group B). Group A included 13 patients, and group B included 9. Most of the cases fell into early stages (I and II). In group A, six patients solely underwent wide excision, whereas seven received additional treatments such as radiotherapy or chemotherapy. Conversely, in group B, four patients received chemotherapy, four received radiotherapy, and one was managed through observation alone. The mean follow-up times were 60.15 and 43.44 months in groups A and B, respectively, with no significant difference observed. In group A, nine patients died, whereas, in group B, six died during the follow-up period. Lesion-free intervals after surgery were observed predominantly in group A, whereas, in group B, seven patients never experienced freedom from skin lesions. Kaplan-Meier survival curve analysis demonstrated a significant difference between the survival curves of the two groups (P = 0.046). Group A exhibited a more favorable outcome in the survival curve analysis. This significant difference could be attributed to the higher survival rates observed in group A during the first 5 years of follow-up. This finding underscores the potential benefit of surgical intervention in the management of non-HIV Kaposi's sarcoma, particularly in the short- to medium-term survival outcomes. Among patients with non-HIV Kaposi's sarcoma, especially those in the early stages, wide excision appears to play a role in treatment.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 3S Suppl 1","pages":"S58-S62"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490157","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":"Assessing Readability of Patient Education Materials on Adult-Acquired Buried Penis.","authors":"Sarah M Thornton, Doruk Orgun, Caroline C Bay, Allison J Seitz, Samuel O Poore","doi":"10.1097/SAP.0000000000004229","DOIUrl":"10.1097/SAP.0000000000004229","url":null,"abstract":"<p><strong>Introduction: </strong>Adult-acquired buried penis (AABP) is an increasingly prevalent condition characterized by the penis \"buried\" in prepubic/suprapubic tissue. AABP affects urinary and sexual function, hygiene, and psychosocial well-being. Because many affected individuals are unfamiliar with the condition or hesitant to seek medical help, accessible, high-quality patient education materials (PEMs) are necessary. The American Medical Association recommends that PEMs be written at or below a 6th-grade reading level. This study aimed to assess the readability of the most easily accessible AABP PEMs.</p><p><strong>Methods: </strong>After disabling user account information, the top 10 results for \"buried penis treatment\" from 3 search engines were collected. Academic journal articles, advertisements, and pediatric PEMs were excluded. Plain texts without graphics and extraneous information were copied to the Readability Test Tool (WebFX, Harrisburg, PA) to generate readability scores. Descriptive statistics were used to analyze the data.</p><p><strong>Results: </strong>The top 10 results for each search engine, excluding duplicates, resulted in 12 unique articles. Of 5 readability tests used by the Readability Test Tool, the mean grade level necessary to comprehend resource content was 12.3, or about a 12th-grade level. The mean age estimated for understanding was 17.7, or an age range of 17-18 years old. Complex words comprised on average, 16.6% of a resource's material.</p><p><strong>Conclusions: </strong>This study emphasizes the inadequate readability of current PEMs for AABP. The readability for most accessible materials exceeds the recommended reading level of at or below 6th grade. Providers should aim to publish easily comprehensible online PEMs to promote patient awareness and comprehension.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"269-272"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057830","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":"3D-Printed \"Jigsaw Puzzle\" in Craniomaxillofacial Comminuted Fracture Reduction.","authors":"Tien-Hsiang Wang, Wen-Chan Yu, Yu-Chung Shih, Ching-En Chen, Shyh-Jen Wang, Hsu Ma, Wei-Ming Chen","doi":"10.1097/SAP.0000000000004194","DOIUrl":"10.1097/SAP.0000000000004194","url":null,"abstract":"<p><strong>Background: </strong>Surgical treatment of comminuted and multiple facial fractures is challenging, as identifying the bone anatomy and restoring the alignment are complicated. To overcome the difficulties, 3D-printed \"jigsaw puzzle\" has been innovated to improve the surgical outcome. This study aimed to demonstrate the feasibility of 3D-printed model in facial fracture restoration procedures.</p><p><strong>Materials and methods: </strong>Patients with traumatic craniomaxillofacial fractures treated at a single institution were enrolled in this study. The exclusion criteria included the presence of mandibular fractures, greenstick fractures, isolated fractures, and revision cases. Fine-cut (1-mm thick) computed tomography images of each patient were assembled into a 3D model for preoperative planning. Major fragments were segmented in virtual surgical planning, printed out with a 3D printer as \"jigsaw puzzle\" pieces, and assembled with plates and screws as in surgical rehearsals. We further matched our study group with a control group of patients who underwent the corresponding procedures to compare operative time.</p><p><strong>Results: </strong>Nine patients with craniomaxillofacial fractures were included in the study, including 2 patients with zygomaticomaxillary complex fractures and 7 patients with multiple fractures. No remarkable postoperative complications, such as enophthalmus or optic nerve injury, that require additional or revision surgery were noted. The mean operative time was 391 and 435 minutes in the study and control groups, respectively. The t test results were not statistically significant.</p><p><strong>Conclusions: </strong>Surgeons can perform comprehensive preoperative planning, simulation, and obtain a real-time reference for facial bone reduction by using the 3D-printed \"jigsaw puzzle\" in multiple complicated craniomaxillofacial fractures.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"S3-S8"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142943220","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}