Annals of Plastic Surgery最新文献

{"title":"Regarding \"A Comprehensive Flap Classification: Beyond the Reconstructive Ladder\".","authors":"Geoffrey G Hallock","doi":"10.1097/SAP.0000000000004296","DOIUrl":"10.1097/SAP.0000000000004296","url":null,"abstract":"","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 4","pages":"492"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143672956","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":"Approach to the Pediatric Poland Syndrome Patient: A 20-Year Academic Experience and Update of the Literature.","authors":"Gerardo Perla, Mattia Mah'moud, Oksana Jackson, David W Low, Cassandra A Ligh","doi":"10.1097/SAP.0000000000004320","DOIUrl":"10.1097/SAP.0000000000004320","url":null,"abstract":"<p><strong>Background: </strong>Poland syndrome is a spectrum of deformities involving the chest/rib cage, breast bud, nipple-areola complex, upper limb, and surrounding tissue types, with pectoralis major muscle agenesis/hypoplasia as the cardinal feature. Although various surgical approaches exist, there remains a gap in the literature reporting long-term outcomes and patient-reported results for the pediatric population.</p><p><strong>Methods: </strong>A retrospective review identified 47 pediatric patients who underwent surgical reconstruction for Poland syndrome between 2003 and 2024 and subsequently underwent intervention under 18 years of age. Patients were stratified using Foucras and Thorax, Breast, Nipple-areola complex (TBN) classification systems. Data collected included demographics, surgical procedures, complications, and behavioral health notes. Statistical analysis examined relationships between classification systems, surgical interventions, and outcomes.</p><p><strong>Results: </strong>The cohort included 12 males and 35 females. Twenty-four patients (51%) were Foucras class I, 20 (43%) were class II, and 3 (6%) were class III. Initial surgeries offered were fat grafting (45%) and latissimus dorsi muscle reconstruction (55%). Higher Foucras classification correlated with higher number of surgical procedures (P = 0.029, ρ = 0.388). Seven complications occurred: two minor (seroma, wound dehiscence) and five major (infection or implant complications requiring reoperation). Behavioral health assessment revealed appearance concerns (87%), clothing challenges (47%), and pain (20%) as the primary psychosocial stressors. The mean follow-up was 834 days (2.3 years). We present several of our reconstructive principles and techniques relevant to pediatric care, as well as highlight representative clinical cases.</p><p><strong>Conclusions: </strong>This 20-year institutional experience demonstrates that pediatric Poland syndrome reconstruction requires consideration of both immediate and long-term goals while accounting for physical development and psychological maturity. Behavioral health assessment revealed appearance as the predominant concern, emphasizing the importance of addressing psychosocial aspects in treatment. A multidisciplinary approach focusing on patient education, expectation management, and psychological support is crucial for improved outcomes in pediatric Poland syndrome breast and chest wall reconstruction.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 4S Suppl 2","pages":"S194-S202"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750798","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":"Assessing Perioperative Complications and Cost of Nipple-Areolar Complex Neurotization in Immediate Implant-Based Breast Reconstruction Following Nipple-Sparing Mastectomy: A Matched-Paired Comparison.","authors":"Carter J Boyd, Kshipra Hemal, Thomas J Sorenson, Chris Amro, Samantha Lu, Brooke Miller, Nolan S Karp, Mihye Choi","doi":"10.1097/SAP.0000000000004177","DOIUrl":"10.1097/SAP.0000000000004177","url":null,"abstract":"<p><strong>Background: </strong>Reports suggest neurotization can help restore sensation in patients undergoing implant-based breast reconstruction (IBBR) following nipple-sparing mastectomy (NSM). There is a dearth of information regarding the outcomes and cost associated with neurotization of the nipple-areola complex (NAC). The objective of this study is to determine perioperative complications of performing NAC neurotization in IBBR and analyze the added cost of performing this procedure.</p><p><strong>Methods: </strong>A retrospective chart review was performed of patients who underwent NSM with IBBR. Breasts undergoing neurotization of the NAC were compared to breasts that did not undergo neurotization using 2:1 propensity score matching on age, reconstruction type, and BMI. Primary endpoints included 30-day complications and cost. Statistical analysis included descriptive statistics, t tests, and chi-square tests where applicable with a predetermined level of significance of P < 0.05.</p><p><strong>Results: </strong>A total of 15 patients (26 breasts) were in the neurotized cohort and matched to 30 patients (52 breasts) in the nonneurotized cohort. Mean follow-up period was 10 months and significantly lower in neurotized group (P < 0.001). Rates of major and minor complications did not vary by neurotization (P > 0.05). Cases of neurotization added a mean cost of $7839 per breast.</p><p><strong>Conclusions: </strong>As NAC neurotization introduces increased complexity from coordination with the oncologic surgeons, use of microsurgical instruments, and additional implantable devices, it is important to compare perioperative outcomes to standard breast reconstruction. As our institution begins to offer this new technique, we have identified no increased risk of perioperative complications with NAC neurotization.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 4S Suppl 2","pages":"S118-S120"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750799","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":"Breast Sensation and Quality of Life: Correlating Cutaneous Sensitivity of the Reconstructed Breast and BREAST-Q Scores.","authors":"Ashley Zhang, Hao Huang, Marcos Lu Wang, Sophia Arbuiso, Grant G Black, Angela Ellison, David M Otterburn","doi":"10.1097/SAP.0000000000004258","DOIUrl":"10.1097/SAP.0000000000004258","url":null,"abstract":"<p><strong>Background: </strong>Impaired breast sensation can be a devastating consequence of mastectomy and breast reconstruction with significant impacts on quality of life. Few studies have examined the relationship between objective breast sensory results and patient-reported outcomes. Herein, we the relationship between cutaneous sensation of different anatomic regions of the breast and BREAST-Q scores in patients with autologous and alloplastic breast reconstruction.</p><p><strong>Methods: </strong>Patients with postmastectomy breast reconstruction completed the BREAST-Q and underwent breast sensory testing with a pressure-specified sensory device. BREAST-Q responses and sensation measurements were paired; any instance without both outcomes was dropped from the analysis. Univariate linear regression models assessed the relationship between sensation of various breast regions and BREAST-Q scores. Breast regions significant on univariate analysis were included in a multivariate linear regression analysis.</p><p><strong>Results: </strong>One hundred ninety-four patients were included: 112 had autologous reconstruction and 82 had alloplastic reconstruction. In autologous patients, nipple-areolar complex (NAC) sensitivity was independently associated with higher Psychosocial Wellbeing [β = -0.20 (-0.36, -0.04); adjusted R2 = 0.09; P = 0.01] and Sexual Wellbeing scores [β = -0.26 (-0.46, -0.06); adjusted R2 = 0.05; P = 0.04]. Sensation in all areas of the breast was associated with higher Satisfaction with Breasts scores; these associations were not significant on multivariate analysis. In alloplastic patients, only NAC sensitivity was associated with Sexual Wellbeing scores [β = -0.10 (-0.16, -0.04); R2 = 0.03; P = 0.002]. No other significant associations were observed between Breast Sensitivity and Psychosocial Wellbeing, Physical Wellbeing of the Chest, and Satisfaction with Breasts scores in the alloplastic cohort.</p><p><strong>Conclusions: </strong>NAC sensitivity significantly correlates with breast reconstruction patients' psychosocial and Sexual Wellbeing, particularly in patients undergoing neurotized autologous reconstruction, while overall breast sensitivity is associated with breast satisfaction. Weaker correlations in the alloplastic cohort suggest that breast sensitivity may play a more substantial role in patient-reported outcomes for patients receiving autologous reconstruction. These findings underscore the importance of restoring NAC sensation during breast reconstruction. Future research incorporating sensation-specific patient-reported outcome measures and examining additional sensory domains will further enhance our understanding of sensory recovery's impact on postreconstruction quality of life.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 4S Suppl 2","pages":"S276-S282"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750800","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":"Quantifying the Learning Curve in Robotic Peritoneal Flap Vaginoplasty.","authors":"Kshipra Hemal, Gaines Blasdel, Augustus Parker, Chris Amro, Charlie Dubach-Reinhold, Lee C Zhao, Rachel Bluebond-Langner","doi":"10.1097/SAP.0000000000004265","DOIUrl":"10.1097/SAP.0000000000004265","url":null,"abstract":"<p><strong>Background: </strong>The learning curve (LC) is the process of mastering a new technique. This study assesses the LC for robotic-assisted peritoneal flap gender-affirming vaginoplasty (RPGAV).</p><p><strong>Methods: </strong>A retrospective chart review of all consecutive patients undergoing RPGAV between 09/2017 and 02/2023 at a single center was performed. Operative times (OT) were analyzed to describe the LC. A cutoff point was determined after which OT stabilized, and this was used to compare perioperative and postoperative outcomes.</p><p><strong>Results: </strong>Five hundred RPGAVs were performed. Median OT was 125 (interquartile range 105-181) minutes and decreased significantly over time. The minimum number of cases required to observe a plateau in OT is 300 patients.After adjusting for the LC, 2 variables significantly affected OT: a 1-point increase in body mass index increased OT by 1.4 minutes [95% confidence interval (1.0, 1.9), P < 0.001] and the single port robot decreased OT by 34 minutes [95% CI 1 (-43.1, -25.0), P < 0.001] as compared to the traditional multiport Xi robot.When comparing the first 300 cases (learning phase) to the last 200 (expert phase), length of stay, blood transfusions, and rates of elective revision surgery were lower in the expert phase.</p><p><strong>Conclusions: </strong>The LC for RPGAV in this large cohort was 300 cases. Patient body mass index causes a dose-response increase in OT and the single port robot dramatically decreases OT. Although OT is just one facet of overall efficiency, differences between learning and expert phases are evident in decreased length of stay, transfusions, and rates of revision surgery.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 4S Suppl 2","pages":"S139-S144"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750841","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":"Reduction of Acute Zygomatic Arch Fractures With Intraoperative Ultrasound: An Underutilized Technique for Resource Scarce Settings.","authors":"Thomas J Sorenson, Jonathan M Bekisz, J Rodrigo Diaz-Siso, Chris Amro, Jenn J Park, Augustus Parker, Vishal D Thanik, Nikhil A Agrawal, Carter J Boyd","doi":"10.1097/SAP.0000000000004167","DOIUrl":"10.1097/SAP.0000000000004167","url":null,"abstract":"<p><strong>Background: </strong>Zygomatic arch (ZA) fractures are a common facial fracture, and reduction is typically performed blind via a Gillies or Keen approach. Postoperative confirmation of reduction thus requires advanced imaging, which may not be readily available in all settings. Thus, there exists a need for an effective, low-cost imaging paradigm to employ in these clinical scenarios. Herein, we introduce the ultrasonic arch reduction (USA Reduction) for ZA fractures.</p><p><strong>Methods: </strong>All consecutive patients with ZA fractures undergoing a USA Reduction at a single public hospital were reviewed. Patients were operated on by two plastic surgeons. A standard Gillies approach was used in all cases in conjunction with real-time intraoperative ultrasound. All relevant patient data were collected and analyzed.</p><p><strong>Results: </strong>Two patients were included in our study. Patient 1 was a 43-year-old man who was assaulted and sustained a right comminuted zygomatic arch fracture without concomitant trauma. Patient 2 was a 35-year-old man who was hit by a train and sustained a left comminuted ZA fracture in addition to traumatic subarachnoid hemorrhage. Both fractures were successfully reduced under ultrasound guidance in under 1 hour of operating room (OR) time without necessitating the use of postoperative CT. To date, both patients endorse positive postoperative satisfaction with their results.</p><p><strong>Conclusions: </strong>Intraoperative ultrasound is a safe and effective tool for confirming reduction of ZA fractures in a resource-limited practice while obviating the need for additional radiation. Further investigations to standardize the technique and approach will be useful to optimize this intraoperative adjunct.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 4S Suppl 2","pages":"S253-S255"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750845","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":"Risk Factors for Obstructive Sleep Apnea in Patients With Cleft Palate.","authors":"Katherine J Zhu, Keith T Kuo, Matthew J Heron, Bashar Hassan, Moreen N Njoroge, Alina Galaria, Atharva Bhagwat, Thalia Liu, Abby Liu, Christopher D Lopez, Jordan Gornitsky, Robin Yang, Richard J Redett","doi":"10.1097/SAP.0000000000004294","DOIUrl":"10.1097/SAP.0000000000004294","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) involves repeated episodes of upper airway obstruction during sleep. Patients with cleft palate (CP) are at higher risk for OSA due to craniofacial anatomical differences. We aimed to characterize the prevalence of OSA and identify risk factors for OSA in patients with CP.</p><p><strong>Methods: </strong>We retrospectively reviewed patients with CP over a 20-year period. Our primary outcome was OSA diagnosis confirmed by polysomnography. Data extracted included patient demographics, congenital syndromes, Pierre Robin sequence (PRS), and surgeries for OSA. Bivariate analyses and multivariable logistic regression were performed to determine risk factors for OSA. Mann-Whitney U tests were performed to compare the median apnea-hypopnea index before and after surgeries for OSA.</p><p><strong>Results: </strong>Of 441 patients, 19% (84) had OSA. Congenital syndromes were present in 15% (67) of patients, and PRS was identified in 9% (38) of patients. Of 84 patients with OSA, 38% (32) had a congenital syndrome and 32% (7) had a diagnosis of PRS. Most OSA diagnoses were made before CP repair (56, 67%). Among patients with isolated CP (221), those with a congenital syndrome or PRS had significantly greater odds of OSA diagnosis [adjusted odds ratio 95% confidence interval 6.6 (3.1-14.3), 16.6 (6.4-42.8), respectively]. There was a significant decrease in apnea-hypopnea index following mandibular distraction and tonsillectomy and adenoidectomy.</p><p><strong>Conclusions: </strong>We found a high prevalence of OSA in patients with CP, particularly those with congenital syndromes and PRS. Early diagnosis and management of OSA are essential for these patients.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 4S Suppl 2","pages":"S311-S314"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750847","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":"Assessing the Reliability of YouTube Content for Plastic Surgery Patient Information in Africa With the Modified DISCERN and JAMA Scores.","authors":"Umutoni Alice, Shirley S Dadson, Emmanuel Edeh, Mbonu G Ndudi, Piel P Kuol, Theophilus Barasa, Okojie S Ojamah, Kwadwo A B Nkansah-Poku, Emmanuel B Nyarko, Ebenisha Choonya Majata, Ulrick Sidney Kanmounye","doi":"10.1097/SAP.0000000000004186","DOIUrl":"10.1097/SAP.0000000000004186","url":null,"abstract":"<p><strong>Introduction: </strong>YouTube has become a popular source of health information, including plastic surgery. Given the platform's wide reach and potential influence on patient decisions, this study aimed to assess the quality of information available on YouTube for African audiences seeking plastic surgery procedures.</p><p><strong>Methods: </strong>This cross-sectional study extracted data from YouTube videos on plastic surgery relevant to Africa. A search strategy identified videos in English using keywords. The first 50 results for each term were included, with duplicates removed. Next, the metadata of videos published from inception to June 9, 2024, were extracted. Two reviewers independently assessed videos using standardized tools to evaluate reliability (modified DISCERN and JAMA criteria) and engagement (likes-to-views ratio [LVR] and comments-to-views ratio [CVR]). The Mann-Whitney U test was used for unadjusted bivariable comparisons. Then ordinal logistic and beta regression analyses were used to evaluate the primary (modified DISCERN and JAMA scores) and secondary (LVR and CVR) outcomes, with a statistical significance level set at 0.05.</p><p><strong>Results: </strong>Eight hundred ninety-seven plastic surgery videos were analyzed, and 3.9% were published by African entities. Large subscriber count (coefficient = -6.9e-8, 95% confidence interval [CI] [-1.13e-7, -2.9e-8], P = 0.001), African-authored (coefficient = -0.85, 95% CI [-1.44, -0.25], P = 0.005), and advertising (coefficient = -1.01, 95% CI [-1.63, -0.57], P < 0.001) videos had lower modified DISCERN scores. Advertising videos equally had lower JAMA scores (coefficient = -1.29, 95% CI [-1.83, -0.74], P < 0.001). Academic videos had lower LVR (coefficient = -0.48, 95% CI [-0.66, -0.30], P < 0.001), whereas independent videos had higher LVR (coefficient = 0.40, 95% CI [0.26, 0.54], P < 0.001). Academic videos had lower CVR (coefficient = -0.40, 95% CI [-0.67, -0.13], P = 0.003), whereas videos with other purposes had higher CVR (coefficient = 0.37, 95% CI [0.10, 0.64], P = 0.007).</p><p><strong>Conclusions: </strong>This study underscores a potential disparity in the quality of online plastic surgery information based on video sources and purposes.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"403-408"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891637","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":"Nerve Transfer Strategies for Restoring Bladder, Bowel, Genital, and Lower Extremity Functions in Spinal Cord Injury: A Systematic Review.","authors":"Stuti P Garg, Chirag Goel, Geneviève L Putnam, Joshua P Weissman, Sammer Marzouk, Seong Park, Rena A Li, Peter Ullrich, Robert D Galiano","doi":"10.1097/SAP.0000000000004219","DOIUrl":"10.1097/SAP.0000000000004219","url":null,"abstract":"<p><strong>Background: </strong>Nerve transfers have been proposed solutions for urinary, bowel, and genital dysfunction after spinal cord injury (SCI). However, there remains a need to characterize nerve candidates and other treatment variables for SCI. The objective of this systematic review was to characterize nerve transfer strategies and outcomes for the restoration of bladder, bowel, genital, and lower extremity function after SCI.</p><p><strong>Methods: </strong>PubMed, Cochrane, MEDLINE, and Embase libraries were queried according to the preferred reporting items for systematic reviews and meta-analyses guidelines for articles that presented outcomes after SCI in humans, animals, and cadavers treated with nerve transfer.</p><p><strong>Results: </strong>Thirty-one studies with 471 subjects were included. Thirteen studies were anatomical feasibility, 11 were animal, and 7 were clinical studies. The sacral (n = 218) and pudendal (n = 100) nerves were injured the most. There were 490 nerve transfers, with genitofemoral (n = 113) and femoral (n = 88) nerves transferred the most. Satisfactory bladder void control was regained in 75% of sacral, 100% of intercostal, and 88% of lumbar nerve transfer patients. Spontaneous void of bowel was regained in 78% of lumbar nerve transfer patients. Two patients with lumbosacral plexus nerve root injuries had improved knee extension from grade 0/5 to 2/5 and 3/5 after obturator nerve transfer.</p><p><strong>Conclusions: </strong>This review demonstrates feasibility of transferring genitofemoral, femoral, sacral, and ilioinguinal nerves for the restoration of bladder, bowel, genital, and lower extremity function. While these studies suggest potential nerve transfer options, only 7 studies examined the outcomes in humans. Both the feasibility and applicability of nerve transfer after SCI must be explored further in clinical research.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 4","pages":"479-486"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143672954","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":"Cadaveric Comparison of Work of Flexion Following Flexor Tendon Repair: Knotted Versus Knotless Techniques.","authors":"Alexander J Kammien, Fortunay H Diatta, David L Colen","doi":"10.1097/SAP.0000000000004255","DOIUrl":"10.1097/SAP.0000000000004255","url":null,"abstract":"<p><strong>Background: </strong>Few prior studies have compared work of flexion of digital flexor tendons repaired with barbed suture to those performed with conventional knotted techniques. The available evidence is mixed, with one study indicating no difference between the techniques and another showing increased work of flexion with knotless techniques. This study aimed to bolster the current body of literature by comparing work of flexion and strength of digital flexor tendon repairs using knotted and knotless techniques.</p><p><strong>Methods: </strong>Two knotted and 2 knotless techniques for flexor tendon repair were assessed. Each repair was tested in 12 cadaveric flexor digitorum profundus (FDP) tendons. Work of flexion prior to repair was determined. FDP tendons were lacerated and repaired using 3-0 braided/monofilament or 2-0 barbed suture. Work of flexion measurements was repeated. FDP tendons were removed from the hand, and load to 2-mm gap and failure were recorded. One-way analysis of variance and t tests were used for statistical analysis.</p><p><strong>Results: </strong>Overall, knotless repairs demonstrated greater increases in work of flexion than knotted repairs. There were significant differences in work of flexion by individual technique, with one knotless technique performing similarly to the knotted techniques, while the other performed more poorly. There was no difference in load to 2-mm gap between knotted and knotless techniques, but knotless techniques had lower load to failure.</p><p><strong>Conclusion: </strong>Some knotless techniques for digital flexor tendon repair may perform similarly to knotted techniques in the immediate postoperative period. Further research is required to determine the effects of knotless techniques on tendon healing and rehabilitation.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 4S Suppl 2","pages":"S343-S348"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750801","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}