Annals of Plastic Surgery最新文献

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The Satisfaction and Quality of Life of Patients After Breast Reconstruction: A Cross-Sectional Multicenter Study Comparing Immediate, Delayed, and Nonreconstructive Outcomes. 乳房再造术后患者的满意度和生活质量:乳房再造术后患者的满意度和生活质量:比较即时、延迟和非再造结果的跨部门多中心研究。
IF 1.4 4区 医学
Annals of Plastic Surgery Pub Date : 2024-10-01 Epub Date: 2024-07-09 DOI: 10.1097/SAP.0000000000004040
Hisham Alghamdi, Amal Alhefdhi, Khalid A Fayi, Sultan F Alshaalan, Abdulaziz K Alsuhaim, Rahaf H Almutairi, Najla Alkilani, Hayfa Aolayan, Mohamed R Awad
{"title":"The Satisfaction and Quality of Life of Patients After Breast Reconstruction: A Cross-Sectional Multicenter Study Comparing Immediate, Delayed, and Nonreconstructive Outcomes.","authors":"Hisham Alghamdi, Amal Alhefdhi, Khalid A Fayi, Sultan F Alshaalan, Abdulaziz K Alsuhaim, Rahaf H Almutairi, Najla Alkilani, Hayfa Aolayan, Mohamed R Awad","doi":"10.1097/SAP.0000000000004040","DOIUrl":"10.1097/SAP.0000000000004040","url":null,"abstract":"<p><strong>Background: </strong>Breast reconstruction following mastectomy can be performed through various surgical techniques that prioritize the patient's safety and quality of life. Plastic surgeons are trained to choose the most appropriate surgical approach based on the individual patient's needs and medical history. The safety of the patient is always the primary concern, followed by considerations such as aesthetic outcomes and long-term health implications.</p><p><strong>Objectives: </strong>The aim of this study was to assess and document patients' satisfaction and quality of life after breast reconstruction across Saudi Arabia.</p><p><strong>Methods: </strong>This is a cross-sectional multicenter study among female patients who underwent mastectomy with or without breast reconstruction between 2015 and 2022. Two hundred eighty patients participated in this study through a call-based Arabic version of the BREAST-Q questionnaire to analyze the quality of their lives and satisfaction.</p><p><strong>Results: </strong>Our results showed that patients who underwent delayed reconstruction had lower satisfaction than those who underwent immediate reconstruction. The average BREAST-Q score was lower in patients who used tissue expanders than those with implant-based reconstruction, autologous reconstruction, or combined approaches. Patients who underwent simple mastectomy had lower satisfaction (M = 66.1) than those who had a skin-sparing mastectomy (M = 71.1) and/or nipple-sparing mastectomy (M = 72.6).</p><p><strong>Conclusions: </strong>This retrospective multicenter study observed a significant association between the time of the reconstructive surgery and patient's satisfaction; patients who underwent immediate reconstruction had higher satisfaction rate. Lower satisfaction rate was associated with tissue expander breast reconstruction. There is a significant association between satisfaction rate and smoking history.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"425-429"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141562466","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}
引用次数: 0
A Comparative Analysis of Patient-Reported Outcomes Following Free Tissue Transfer, Partial Foot Amputation, and Below-Knee Amputation in High-Risk Limb Salvage Patients. 对高风险肢体救治患者进行游离组织转移、足部部分截肢和膝下截肢术后患者报告结果的比较分析》(A Comparative Analysis of Patient-Reported Outcomes Following Free Tissue Transfer, Partial Foot Amputation, and Below-Knee Amputation in High-Risk Limb Salvage Patients)。
IF 1.4 4区 医学
Annals of Plastic Surgery Pub Date : 2024-10-01 Epub Date: 2024-09-03 DOI: 10.1097/SAP.0000000000004078
Christian X Lava, Samuel S Huffman, Karen R Li, John R DiBello, Christopher M Ply, Rachel N Rohrich, John S Steinberg, Jayson N Atves, Kenneth L Fan, Richard C Youn, Christopher E Attinger, Karen K Evans
{"title":"A Comparative Analysis of Patient-Reported Outcomes Following Free Tissue Transfer, Partial Foot Amputation, and Below-Knee Amputation in High-Risk Limb Salvage Patients.","authors":"Christian X Lava, Samuel S Huffman, Karen R Li, John R DiBello, Christopher M Ply, Rachel N Rohrich, John S Steinberg, Jayson N Atves, Kenneth L Fan, Richard C Youn, Christopher E Attinger, Karen K Evans","doi":"10.1097/SAP.0000000000004078","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004078","url":null,"abstract":"<p><strong>Background: </strong>The surgical decision for limb-salvage with free tissue transfer (FTT), partial foot amputation (PFA), or below-knee amputation (BKA) for complex lower extremity (LE) wounds hinges on several factors, including patient choice and baseline function. However, patient-reported outcome measures (PROMs) on LE function, pain, and QoL for chronic LE wound interventions are limited. Thus, the study aim was to compare PROMs in patients who underwent FTT, PFA, or BKA for chronic LE wounds.</p><p><strong>Methods: </strong>PROMs were collected via QR code for all adult chronic LE wound patients who presented to a tertiary wound center between June 2022 and June 2023. A cross-sectional analysis of patients who underwent FTT, PFA, or BKA was conducted. The 12-Item Short Survey (SF-12), PROM Information System Pain Intensity (PROMIS-3a), and Lower Extremity Functional Scale (LEFS) were completed at 1, 3, and 6 months and 1, 3, and 5 years postoperatively. Patient demographics, comorbidities, preoperative characteristics, and amputation details were collected.</p><p><strong>Results: </strong>Of 200 survey sets, 71 (35.5%) underwent FTT, 51 (25.5%) underwent PFA, and 78 (39.0%) underwent BKA. Median postoperative time points of survey completion between FTT (6.2 months, IQR: 23.1), PFA (6.8 months, IQR: 15.5), and BKA (11.1 months, IQR: 21.3) patients were comparable (P = 0.8672). Most patients were male (n = 92, 76.0%) with an average age and body mass index (BMI) of 61.8 ± 12.6 years and 30.3 ± 7.0 kg/m2, respectively. Comorbidities for FTT, PFA, and BKA patients included diabetes mellitus (DM; 60.6% vs 84.2% vs 69.2%; P = 0.165), peripheral vascular disease (PVD; 48.5% vs 47.4% vs 42.3%; P = 0.790), and chronic kidney disease (CKD; 12.1% vs 42.1% vs 30.8%; P = 0.084). No significant differences were observed between FTT, PFA, and BKA patients in mean overall PROMIS-3a T-scores (49.6 ± 14.8 vs 54.2 ± 11.8 vs 49.6 ± 13.7; P = 0.098), LEFS scores (37.5 ± 18.0 vs 34.6 ± 18.3 vs 38.5 ± 19.4; P = 0.457), or SF-12 scores (29.6 ± 4.1 vs 29.5 ± 2.9 vs 29.0 ± 4.0; P = 0.298).</p><p><strong>Conclusion: </strong>Patients receiving FTT, PFA, or BKA for chronic LE wounds achieve comparable levels of LE function, pain, and QoL postoperatively. Patient-centered functionally based surgical management for chronic LE wounds using interdisciplinary care, preoperative medical optimization, and proper patient selection optimizes postoperative PROMs.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"93 4","pages":"510-515"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339830","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}
引用次数: 0
Two-Stage Surgical Management of Accessory Breast Tissue With Pedicled Breast Tissue: A Case Report of Asymmetry Correction. 乳腺附属组织的两阶段手术管理与茎状乳腺组织:不对称矫正病例报告。
IF 1.4 4区 医学
Annals of Plastic Surgery Pub Date : 2024-10-01 Epub Date: 2024-07-09 DOI: 10.1097/SAP.0000000000004034
İsmail Tekfiliz, Atakan Sahiner, Emrah Kagan Yasar, Murat Sahin Alagoz
{"title":"Two-Stage Surgical Management of Accessory Breast Tissue With Pedicled Breast Tissue: A Case Report of Asymmetry Correction.","authors":"İsmail Tekfiliz, Atakan Sahiner, Emrah Kagan Yasar, Murat Sahin Alagoz","doi":"10.1097/SAP.0000000000004034","DOIUrl":"10.1097/SAP.0000000000004034","url":null,"abstract":"<p><strong>Abstract: </strong>Accessory breast tissue is a relatively common variant of ectopic breast tissue. It defines a tissue that can be seen in conjunction with a nipple, areola, and underlying glandular tissues and can develop in addition to the normal breast tissue. While swelling may be accompanied by symptoms such as pain that worsens with the menstrual period, lactation, and limitation of shoulder joint movements, aesthetic concerns also constitute an important part of the surgical needs of patients. An 18-year-old patient without any known comorbidities attended because of a developmental disorder in her left breast that has existed since birth and an accessory breast tissue containing the nipple and areola in the upper-outer quadrant of the left breast. The surgical aim was to excise the patient's accessory breast tissue and ensure symmetry, and a two-stage surgical intervention was planned. In the first stage, the accessory breast tissue in the upper-outer quadrant of the breast was transposed preserving the 2nd and 3rd Internal Mammary Artery-based perforators by passing it through a subcutaneous tunnel and folding it in its ideal place. At second stage, the reduction mammoplasty surgery was performed on the right breast to ensure symmetry with the left breast, and resection was performed on the nipple in the middle lower quadrant of the left breast. At the end, acceptable symmetry and patient satisfaction were achieved.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"430-433"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141562467","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}
引用次数: 0
Gender Diversity Among Reconstructive Microsurgery Studies Based on the Relative Citation Ratio: An 18-Year Analysis. 基于相对引用比的整形显微外科研究中的性别多样性:18 年分析。
IF 1.4 4区 医学
Annals of Plastic Surgery Pub Date : 2024-10-01 Epub Date: 2024-07-05 DOI: 10.1097/SAP.0000000000004038
Dominick J Falcon, Valeria P Bustos, Amir-Ala Mahmoud, Bernard T Lee
{"title":"Gender Diversity Among Reconstructive Microsurgery Studies Based on the Relative Citation Ratio: An 18-Year Analysis.","authors":"Dominick J Falcon, Valeria P Bustos, Amir-Ala Mahmoud, Bernard T Lee","doi":"10.1097/SAP.0000000000004038","DOIUrl":"10.1097/SAP.0000000000004038","url":null,"abstract":"<p><strong>Background: </strong>Gender disparities in plastic surgery authorship have been previously described in the literature. The relative citation ratio (RCR) index is a new metric that normalizes citation rates for field and time, which can be utilized to compare authors. This study aims to evaluate differences in gender authorship in reconstructive microsurgery (RM) papers, as well as the impact of gender on the RCR index.</p><p><strong>Methods: </strong>A PubMed query isolated RM studies between 2002 and 2020 across the 3 highest impact PS journals. Author names and RCR information were collected from NIH iCite. The likely gender was adjudicated by using NamSor-Software. Unpaired Wilcoxon rank-sum and chi-square tests were used to assess differences between groups.</p><p><strong>Results: </strong>Of 1146 articles (2172 authors), there was a significant difference between the proportion of females as senior authors compared to first authors ( P < 0.001). Overall, females represented 15.4% of all authors, 19.7% of first authors, and 11.3% of senior authors. Males had a significantly higher weighted RCR ( P < 0.0001) and number of publications ( P < 0.0001), which remained significant when stratified by first and senior author. Female authors collectively had a higher mean RCR ( P = 0.008) and among first authors ( P < 0.0001), with no significant difference among senior authors ( P = 0.47).</p><p><strong>Conclusion: </strong>A considerably greater number of males are publishing in reconstructive microsurgery compared to females, with significantly more males being senior authors compared to first authors. Males had higher weighted RCR scores and publications compared to females. This study suggests that equity in gender authorship within the field is yet to be achieved.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"413-417"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141562525","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}
引用次数: 0
Medical Tourism: A Balancing Act, With a Special Consideration for the Transgender Community. 医疗旅游:兼顾各方利益,特别关注变性人群体。
IF 1.4 4区 医学
Annals of Plastic Surgery Pub Date : 2024-10-01 Epub Date: 2024-07-09 DOI: 10.1097/SAP.0000000000004060
Luis Alejandro Morales Ojeda, Veronica Stefania Montero Arcila
{"title":"Medical Tourism: A Balancing Act, With a Special Consideration for the Transgender Community.","authors":"Luis Alejandro Morales Ojeda, Veronica Stefania Montero Arcila","doi":"10.1097/SAP.0000000000004060","DOIUrl":"10.1097/SAP.0000000000004060","url":null,"abstract":"","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"536"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141562529","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}
引用次数: 0
Trends in Top Surgery Patient Characteristics, Wound Complications, and CPT Code Use by Plastic Surgeons: A Decade-Long Analysis. 整形外科医生在顶级手术患者特征、伤口并发症和 CPT 代码使用方面的趋势:十年分析。
IF 1.4 4区 医学
Annals of Plastic Surgery Pub Date : 2024-10-01 Epub Date: 2024-07-15 DOI: 10.1097/SAP.0000000000004047
John B Park, Oluwaseun D Adebagbo, Maria J Escobar-Domingo, Benjamin Rahmani, Micaela Tobin, Mohammed Yamin, Daniela Lee, James E Fanning, Matthew Prospero, Ryan P Cauley
{"title":"Trends in Top Surgery Patient Characteristics, Wound Complications, and CPT Code Use by Plastic Surgeons: A Decade-Long Analysis.","authors":"John B Park, Oluwaseun D Adebagbo, Maria J Escobar-Domingo, Benjamin Rahmani, Micaela Tobin, Mohammed Yamin, Daniela Lee, James E Fanning, Matthew Prospero, Ryan P Cauley","doi":"10.1097/SAP.0000000000004047","DOIUrl":"10.1097/SAP.0000000000004047","url":null,"abstract":"<p><strong>Background: </strong>Gender-affirming top surgery is becoming increasingly common, with greater diversity in the patients receiving top surgery. The purpose of this study was to examine national trends in patient demographics, characteristics, wound complication rates, and concurrent procedures in patients receiving gender-affirming top surgeries.</p><p><strong>Methods: </strong>Patients with gender dysphoria who underwent breast procedures, including mastectomy, mastopexy, breast augmentation, or breast reduction by a plastic surgeon between 2013 and 2022, were identified from the American College of Surgeons National Surgical Quality Improvement Program database. These procedures were considered to be gender-affirming \"top surgery.\" Univariate analyses were performed to examine trend changes in the patient population and types of additional procedures performed over the last decade.</p><p><strong>Results: </strong>There was a 38-fold increase in the number of patients who received top surgery during the most recent years compared to the first 2 years of the decade. Significantly more individuals receiving top surgery in recent years were nonbinary ( P < 0.01). There was a significant decrease in percentage of active smokers ( P < 0.01) while there was an increase in percentage of patients with diabetes ( P = 0.03). While there was a significant increase in the number of obese patients receiving top surgery ( P < 0.01), there were no differences in postoperative wound complications between the years. Significantly more patients received additional procedures ( P < 0.01) and had about a 9-fold increase in distinct number of additional CPT codes from 2013-2014 to 2021-2022.</p><p><strong>Conclusions: </strong>Our study found that there has been (1) a significant increase in the number of top surgery patients from 2013 to 2022 overall and (2) a particular increase in patients with preoperative comorbidities, such as a higher body mass index and diabetes. Understanding current and evolving trends in patients undergoing surgical treatment for gender dysphoria can inform individualized care plans that best serve the needs of patients and optimize overall outcomes.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"530-535"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11436300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141625808","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}
引用次数: 0
Course Review: National Microsurgery Course at the Newcastle Surgical Training Centre March 2024. 课程回顾:2024 年 3 月在纽卡斯尔外科培训中心举办的国家显微外科课程。
IF 1.4 4区 医学
Annals of Plastic Surgery Pub Date : 2024-10-01 Epub Date: 2024-08-15 DOI: 10.1097/SAP.0000000000004080
Leo Gundle
{"title":"Course Review: National Microsurgery Course at the Newcastle Surgical Training Centre March 2024.","authors":"Leo Gundle","doi":"10.1097/SAP.0000000000004080","DOIUrl":"10.1097/SAP.0000000000004080","url":null,"abstract":"<p><strong>Abstract: </strong>Microsurgery is a unique and specific surgical skill, known to have a steep learning curve. Surgical trainees may wish to undertake a microsurgical skills course to learn the rudiments of microsurgery and to direct future practice and skill acquisition. The National Microsurgery Course in Newcastle, United Kingdom, aims to equip early-year surgical trainees with basic microsurgical skills including tissue handling, vessel anastomosis, and nerve coaptation. The course in 2024 gave delegates an excellent opportunity to learn and practice these skills in a well-resourced environment with a high delegate-to-faculty ratio. Overall, the course was an extremely high-quality educational experience with most of the course time allocated to practicing surgical skills. This course is recommended to surgical trainees wishing to learn the basics of microsurgery.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"418-419"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141992211","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}
引用次数: 0
Comparison of Normal Human Skin and Hypertrophic Scar Tissue Samples of Different Ages, Locations, and Stages of Maturity. 不同年龄、位置和成熟阶段的正常人皮肤与肥厚性疤痕组织样本的比较。
IF 1.4 4区 医学
Annals of Plastic Surgery Pub Date : 2024-10-01 Epub Date: 2024-09-03 DOI: 10.1097/SAP.0000000000004087
Tao Lv, Peichao Zhang, Huirong Shi, Jiaojiao Zhang, Zhiying Zhang, Ran Huo
{"title":"Comparison of Normal Human Skin and Hypertrophic Scar Tissue Samples of Different Ages, Locations, and Stages of Maturity.","authors":"Tao Lv, Peichao Zhang, Huirong Shi, Jiaojiao Zhang, Zhiying Zhang, Ran Huo","doi":"10.1097/SAP.0000000000004087","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004087","url":null,"abstract":"<p><strong>Background: </strong>Scars disrupt the normal structure and function of the skin. The primary goal of plastic surgery is to prevent and reduce scarring. Therefore, we aimed to establish a comparison scheme between normal skin (NS) tissues of different ages and locations; hypertrophic scars (HTS) of different ages, locations, and maturities; and NS and HTS tissues to provide evidence on scar severity for improving treatment evaluation.</p><p><strong>Methods: </strong>Various methods including histology, immunohistochemistry, and immunofluorescence were employed to compare the general appearance, macrophage infiltration, fibroblast activity, degree of angiogenesis, and collagen fiber type and arrangement in human-sourced NS and HTS tissues of different ages, locations, and maturities in seven patients (three with NS and four with HTS) from the Department of Burn and Plastic Surgery of the Shandong Provincial Hospital from January 2019 to December 2020.</p><p><strong>Results: </strong>The thicknesses of the epidermis and dermis of NS tissues varied with age and location. The epidermis of the upper arms, face, and upper eyelids of NS tissues sequentially thickened, whereas the dermis was sequentially thinner. Several glandular structures were identified in the upper eyelids but rarely in the face and upper arms. Histological changes in HTS tissue of different ages, locations, and maturity occur as scar formation time is prolonged, accompanied by increased CD86 levels and fibrosis. As the scar matured, connexin and VEGFR2 expression decreased, indicating reduced inflammation, fibroblast activity, and angiogenesis. The comparison between NS and HTS tissue also revealed significant differences; the positive expression of VEGFR2 and total collagen in HTS tissue was higher than that in NS tissue.</p><p><strong>Conclusions: </strong>We discovered significant differences among NS, HTS, and NS and HTS tissues of different ages, locations, and maturities. Further, this study may provide a basis for clarifying the treatment effect of different methods for HTS compared with those for NS, efficiently individualizing patients' treatment plans and ultimately shortening the scar treatment process.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"93 4","pages":"434-442"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339832","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}
引用次数: 0
The Learning Curve of Total Breast Reconstruction With Autologous Fat Transfer. 自体脂肪移植全乳房重建的学习曲线。
IF 1.4 4区 医学
Annals of Plastic Surgery Pub Date : 2024-10-01 Epub Date: 2024-07-15 DOI: 10.1097/SAP.0000000000004036
Maud Rijkx, Alexander Saelmans, Juliette Hommes, Lloyd Brandts, Daisy De Bruijn, Andrzej Piatkowski, Esther Heuts
{"title":"The Learning Curve of Total Breast Reconstruction With Autologous Fat Transfer.","authors":"Maud Rijkx, Alexander Saelmans, Juliette Hommes, Lloyd Brandts, Daisy De Bruijn, Andrzej Piatkowski, Esther Heuts","doi":"10.1097/SAP.0000000000004036","DOIUrl":"10.1097/SAP.0000000000004036","url":null,"abstract":"<p><strong>Introduction: </strong>Total breast reconstruction with autologous fat transfer (AFT) is a relatively new breast reconstruction method. Although AFT was predominantly used to correct postsurgical defects, the surgical skills of a total breast reconstruction with AFT are different and can be facilitated for novices to accelerate their learning process. This study aims to assess the learning curve of plastic surgeons in total breast reconstruction with AFT in the Netherlands.</p><p><strong>Methods: </strong>A mixed-methods study was performed based on the multicenter randomized clinical BREAST trial data. For the qualitative analysis, semistructured interviews were conducted. To test hypotheses derived from the qualitative data, retrospective data analysis was performed using multilevel linear regression analysis of the patients undergoing AFT as a total breast reconstruction method.</p><p><strong>Results: </strong>The interviews revealed that plastic surgeons need to perform the procedure several times to learn and experience the technical details of total breast reconstruction with AFT. Learning and improving this technique works best by scrubbing in with an expert. Before plastic surgeons learn the optimal volume of fat reinjection over time, they tend to inject too little fat and subsequently too much fat over multiple procedures. With more experience, the rigottomy technique becomes more important. Besides technical details, managing patient expectations before starting treatment is paramount. Multilevel linear regression revealed a significant decrease ( P < 0.001) in the number of surgical procedures and the total injected volume ( P = 0.002) to complete a total breast reconstruction with AFT.</p><p><strong>Conclusions: </strong>This is the first study that explores the learning curve involved in using AFT as a total breast reconstruction method. The feeling of when fat transfer is sufficient, and how to release scars for a good result without causing seromas, is best learned by scrubbing in with experienced colleagues during several procedures, interchanged with starting one's own practice.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"516-526"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141625807","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}
引用次数: 0
Quality of Video Content Related to Deep Inferior Epigastric Perforator Flap Breast Reconstruction: Social Media Platforms Versus Large Language Models. 与深下上腹部穿孔器皮瓣乳房重建相关的视频内容质量:社交媒体平台与大型语言模型。
IF 1.4 4区 医学
Annals of Plastic Surgery Pub Date : 2024-10-01 Epub Date: 2024-08-02 DOI: 10.1097/SAP.0000000000004045
Manuel Viñuela Florido, Javier Suárez Aguilar, Andrés A Maldonado, Lara Cristóbal Velasco
{"title":"Quality of Video Content Related to Deep Inferior Epigastric Perforator Flap Breast Reconstruction: Social Media Platforms Versus Large Language Models.","authors":"Manuel Viñuela Florido, Javier Suárez Aguilar, Andrés A Maldonado, Lara Cristóbal Velasco","doi":"10.1097/SAP.0000000000004045","DOIUrl":"10.1097/SAP.0000000000004045","url":null,"abstract":"<p><strong>Introduction: </strong>The deep inferior epigastric perforator (DIEP) flap is currently one of the main options in breast reconstruction. The information about this surgery is critical for the patient, in order to choose the breast reconstruction method. Our study aims to analyze and compare the quality and accuracy of the information related to the DIEP flap reconstruction method provided by social media platforms (SMPs) and the new large language models (LLMs).</p><p><strong>Materials and methods: </strong>A total of 50 videos in English and Spanish were selected from the main SMPs (YouTube, Instagram, and Facebook) using the keywords \"DIEP flap\" and \"colgajo DIEP.\" The duration, number of likes, dislikes, number of visits, upload date, author, and the video category (institutional video, media, patient experience, academic, and surgery) were analyzed. 3 specific questions were asked to 2 new LLMs (ChatGPT and Google Bard). The quality of information in SMPs and LLMs was analyzed and compared by 2 independent board-certified plastic surgeons using the Journal of American Medical Association and DISCERN scales.</p><p><strong>Results: </strong>LLMs showed a statistically significant higher quality of information when compared with SMPs based on the DISCERN scores. The average DISCERN scores for answers given by ChatGPT and Google Bard were 54 ± 6.841 and 61.17 ± 6.306, respectively (good quality). In SMPs, the average scores were 2.31 ± 0.67 (insufficient quality) and 32.87 ± 9.62 (low quality) for the Journal of American Medical Association and DISCERN scales respectively. Thirty-eight percent of the videos in SMPs were performed by nonmedical authors.</p><p><strong>Conclusions: </strong>The quality of information for breast reconstruction using DIEP flaps from LLMs was considered good and significantly better than in SMPs. The information found in SMPs was insufficient and of low quality. Academic plastic surgeons have an opportunity to provide quality content on this type of reconstruction in LLM and SMPs.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"409-412"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141992249","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}
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