Annals of Plastic Surgery最新文献

{"title":"Professional Development for Early-Career Plastic Surgeons: A Snapshot of Opportunities for Involvement in Societies and Organizations.","authors":"Aniekanabasi I Ufot, Emily E Zona, Armin Edalatpour, Jacqueline S Israel","doi":"10.1097/SAP.0000000000004401","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004401","url":null,"abstract":"<p><strong>Background: </strong>Professional development is relevant to physicians at all stages of one's career, including early in practice. Specialty society membership offers opportunities for personal and professional growth and collaboration in many realms, including clinical practice, education, research and leadership. For early-career plastic surgeons, engagement in professional societies can facilitate career development as young surgeons navigate decision making and challenges at the start of their practices. The purpose of this article is to provide information regarding opportunities for early-career involvement and growth in professional societies related to plastic surgery.</p><p><strong>Methods: </strong>We sought to collate a single resource for early-career plastic surgeons as they hone their \"brand\" and seek additional engagement with their field. After web-based searches and seeking expert opinion from a variety of plastic surgeons, we generated a list of professional organizations and relevant opportunities.</p><p><strong>Results: </strong>For each professional organization, we created tables with programs and corresponding descriptions in the categories of leadership development, mentorship, research, and financial awards and scholarships. We identified dozens of opportunities for early-career plastic surgeons, from leadership committees to advocacy groups to grant funding.</p><p><strong>Conclusions: </strong>Regardless of practice type, given the many advantages of pursuing opportunities within and supported by professional societies, we advocate for engagement of early-career plastic surgeons in these organizations.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155914","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":"Investigating the Impact of Operative Time on Breast Augmentation Outcomes.","authors":"Samuel Knoedler, Filippo A G Perozzo, Marina T Dietrich, Sarah Friedrich, Joanna Kempa, Giuseppe Sofo, Thomas Schaschinger, Jennifer A Watson, Sören Könneker, Dennis P Orgill, Adriana C Panayi, Bong-Sung Kim","doi":"10.1097/SAP.0000000000004405","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004405","url":null,"abstract":"<p><strong>Background: </strong>Breast augmentation is a widely performed aesthetic surgery, yet the impact of operative time on postoperative outcomes remains unclear. While longer operative times have been linked to increased risks across a wide array of surgical disciplines, this association has not been thoroughly validated in breast augmentation. This multi-institutional study aims to investigate the relationship between operative time and outcomes after breast augmentation with implants.</p><p><strong>Methods: </strong>The American College of Surgeons National Surgical Quality Improvement Program database (2008-2022) was queried to identify adult female patients who underwent elective breast augmentation with implants. Preoperative, intraoperative, and postoperative variables, including operative time and 30-day complications, were evaluated. Multivariable logistic regression was used to assess the impact of operative time, analyzing it as both a continuous and a dichotomized variable.</p><p><strong>Results: </strong>A total of 6531 female patients with a mean age of 34.9 ± 10.1 years and a mean body mass index of 22.9 ± 4.0 kg/m2 were included. One hundred eighteen patients (1.8%) experienced complications, the majority of which were reoperations (n = 69; 1.1%) and surgical complications (n = 30; 0.5%). Multivariable analysis revealed a significant association between operative time and both surgical complications (odds ratio [OR] = 1.01, P = 0.0003) and any complications (OR = 1.01, P = 0.003). For every 10-minute increase in operative time, the risk of surgical and any complications increased by 7.2% and 4.5%, respectively. A critical threshold of 91 minutes was identified, beyond which the odds of complications increased significantly (OR = 1.93, P = 0.001).</p><p><strong>Conclusions: </strong>Prolonged operative time is associated with an increased risk of complications following breast implant augmentation. A threshold of 91 minutes was identified, implying that procedures exceeding this duration carry higher postoperative morbidity. These findings underscore the importance of optimizing surgical efficiency to minimize risks and enhance patient outcomes after breast augmentation.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118637","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":"Intraoperative Optimization of Stromal Vascular Fraction for Remediation of Radiated Fracture Repair: Closing the Gap on Clinical Translation of Cell-Based Therapies.","authors":"Alexandra O Luby, Jessie M Nelson, Gina N Sacks, Melissa Daniel, Lauren Buchman, Jeremy V Lynn, Noah S Nelson, Steven R Buchman","doi":"10.1097/SAP.0000000000004407","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004407","url":null,"abstract":"<p><strong>Background: </strong>Mechanical processing techniques to isolate the stromal vascular fraction (SVF) may optimize clinical translation of cell-based therapeutics. Therefore, the purpose of this study was to develop a technique for intraoperative isolation of SVF for immediate therapeutic use with the primary aim of enhancing bone healing at irradiated fracture sites.</p><p><strong>Methods: </strong>Male Lewis rats (n = 29) were divided into groups: fracture, radiation with fracture, and radiation with fracture and SVF implantation. Experimental groups received 35 Gy of targeted radiation. All groups underwent mandibular osteotomy and external fixation. SVF was isolated from inguinal fat pads using Tulip Sizing Transfers, serial filtration, and centrifugation. The resultant cell pellet was implanted at the osteotomy site. After 40 days, bone union and mineralization were evaluated based on gross pathology and micro-computed tomography, respectively, and biomechanical strength testing was performed.</p><p><strong>Results: </strong>SVF treatment increased union rates after radiation (79% vs 20%). Additionally, SVF improved both bone mineral density (666.2 ± 32.0 vs 312.2 ± 51.7; P = 0.000) and bone volume fraction (0.744 ± 0.072 vs 0.350 ± 0.041; P = 0.000) compared with the irradiated control. In fact, SVF treatment into irradiated fracture sites resulted in bone mineral density and bone volume fraction similar to the bone formed at nonirradiated fracture sites, as there was no significant difference between groups. SVF treatment did not significantly improve biomechanical strength compared with the irradiated control.</p><p><strong>Conclusions: </strong>In this study, we developed a novel approach utilizing mechanical methods to enable intraoperative SVF isolation for immediate implantation. SVF demonstrates therapeutic potential for applications in irradiated fracture healing. The results of this study are promising for the long-awaited translation of cell-based therapeutics into the clinical arena.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118636","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":"Double-Wing Flap for Polysyndactyly of the Fifth Toe.","authors":"Junfang Xu, Yunheng Jia, Yanzhao Dong, Guoming Feng, Ruquan Jiang, Yu Liu, Han Xue","doi":"10.1097/SAP.0000000000004408","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004408","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to investigate the long-term clinical outcomes of the double-wing flap in the treatment of polysyndactyly of the fifth toe fused with the fourth toe.</p><p><strong>Methods: </strong>Between January 2016 and November 2019, 31 feet (4 bilateral, 23 unilateral) with polysyndactyly of the fifth toe fused with the fourth toe (27 patients) undergoing surgery using the double-wing flap with a follow-up higher than 5 years were included consecutively and retrospectively. Postoperatively, the toe function, slope and height of the reconstructed web were assessed in all feet and the measurements of the 23 unilateral polysyndactyly were compared with the normal side. D'Arcangelo criterion was used to grade the quality of the toe webbing and Vancouver Scar Scale score describes the quality of scar in all patients.</p><p><strong>Results: </strong>The patients were followed up for 5.1 to 8.3 years, a mean of 6.2 years. Two patients (2 feet) experienced web creep as a long-term complication, while the remaining feet showed no significant complications such as flexion contractures, angulation deformity or clinically significant keloid formation. The toe abduction, the slope and height of the reconstructed web of the 23 unilateral polysyndactyly showed no statistically significant difference compared with the normal side. Based on D'Arcangelo's criterion, 23 webs were rated as good, 6 as fair, and 2 as poor. The median Vancouver Scar Scale score was [1 (1, 2)].</p><p><strong>Conclusions: </strong>The technique is a simple, safe, and easily performed method, which does not require skin grafts. It could be an alternative in the treatment of polysyndactyly of the fifth toe fused with the fourth toe, especially in cases with high cosmetic priority.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155952","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":"Clinical Efficacy of Double Skin Paddle Anterolateral Thigh Flap in High-Voltage Electrical Burns of the Wrist and Hand.","authors":"Lin Cheng, Qiang Dai, Wei-Li Du, Ke-Xin Che, Tong-Yu Cao, Yu-Ming Shen","doi":"10.1097/SAP.0000000000004370","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004370","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate the clinical efficacy of a free double skin paddle anterolateral thigh (ALT) flap in treating 2 separate high-voltage electrical burn wounds affecting the wrist and hand.</p><p><strong>Methods: </strong>A retrospective observational study was conducted, involving 25 patients who met the inclusion criteria between January 2019 and December 2023. The initial treatment protocol included an early emergency fasciotomy and vascular reconstruction. This was subsequently followed by wound repair employing a double skin ALT flap in the next stage of treatment.</p><p><strong>Results: </strong>Twenty-five double skin paddle ALT flaps were utilized for treating wrist and hand burn wounds in 25 male patients, aged 15-61 years. They comprised 21 cases of classic double skin paddle ALT flaps, 3 cases of artificial double skin paddle ALT flaps, and 1 case of a flow-through double skin paddle ALT flap. The dimensions of skin flaps ranged from 8 cm × 6 cm to 22 cm × 13 cm. Twenty-five ALT flaps were utilized, with 22 surviving completely. Complications included venous congestion (1 case), arterial thrombosis (1 case), and abscess (1 case), all managed surgically. The donor site was directly sutured and healed primarily in 19 cases, while a partial-thickness skin graft was used for closure in the remaining 6 cases. During a follow-up period ranging from 3 to 22 months, both the recipient and donor sites exhibited satisfactory healing, with no reported episodes of infection or abnormal discharge.</p><p><strong>Conclusions: </strong>The utilization of a free double skin paddle ALT flap has led to satisfactory outcomes in treating 2 separate complex high-voltage electrical burn injuries to the wrist and hand. This technique achieves favorable reconstructive results, marked by minimal donor site morbidity, and it provides valuable insights into the management of similar cases.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118619","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":"Practical Lymphatic Ultrasound for Supermicrosurgical Lymphaticovenous Anastomosis: Preoperative Lymphatic Mapping Using Conventional High-Frequency Ultrasound.","authors":"Paloma Malagón, Takumi Yamamoto","doi":"10.1097/SAP.0000000000004406","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004406","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound (US) has many advantages and is useful for mapping lymph vessels and veins for lymphovenous anastomosis (LVA) and improving their outcomes. However, it is operator-dependent and required some experience. Our aim was to describe how to perform preoperative mapping of LVA using high-frequency US (HFUS) in B mode.</p><p><strong>Methods: </strong>Experiences about preoperative planning of LVA surgeries in patients with upper and lower limb lymphedema using HFUS were the basis of our guide. In addition, data of women with secondary lower limb lymphedema who undergone LVA was analyzed. US examination was performed on the previous day of surgery for mapping lymph vessels and veins using a linear transducer of 18 MHz and B mode.</p><p><strong>Results: </strong>A standardized method to perform step by step the preoperative planning of LVA using HFUS was described. A total of 349 incisions performed in 97 lower limbs were analyzed. The overall success rate for identifying lymph vessels was 99.7%. Mean diameters of lymph vessels and veins were 0.65 mm and 0.81 mm, respectively. Skin incision length was 1.97 cm (range, 1.2-3.8 cm). Surgical time for each LVA was 21.7 minutes (range, 13-47 min). There were a reduction of limb volume index (281.2 vs 267.6, P = 0.002) and an improvement in the quality of life of patients (48.3 vs 21.9, P < 0.001).</p><p><strong>Conclusions: </strong>A standardized method can be followed to effectively perform the preoperative mapping of LVA using HFUS to reduce the limb volume and improve the quality of life of patients with lymphedema.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118640","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 Political and Human Impact of Major Burn Incidents: A Global Analysis of Mass Casualty Events Between 2010 and 2020.","authors":"Kayvan Shokrollahi, Ascanio Tridente, Nina Dempsey","doi":"10.1097/SAP.0000000000004396","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004396","url":null,"abstract":"<p><strong>Introduction: </strong>Worldwide, burn injuries cause approximately 180,000 deaths annually. Contributing to these figures are those deaths that occur following major burn incidents and explosions. Morbidity and mortality can be significantly high following such events, and well-equipped, specialized burns services are crucial to minimizing the human impact. Notably, major burn incidents are not merely medical emergencies, but catalysts for significant social and political change. We aimed to explore the human and political consequences of major burn incidents, with a view to highlighting the true significance of specialized burn care as a crucial component of disaster preparedness.</p><p><strong>Methods: </strong>We screened the gray literature for reports of major burn incidents across the globe over a 10-year period from 2010 to 2020. We gathered data on the nature of the incident, the geographical location, the number of resulting injuries and deaths, and any resultant political fallout.</p><p><strong>Results: </strong>Twenty-three major burn incidents were identified, across 15 different countries. Incidents included chemical plant explosions, factory and warehouse fires, wildfires, housing block fires, and shopping center fires. The total number of deaths across the 23 reports was 2321. The median number of deaths per incident was 78 (interquartile range, 39-127), whereas the median number of injuries was 321 (interquartile range, 148-557). Eight of these 23 incidents (35%) resulted in the resignation of entire governments or key figures within the government, evidencing the major political fallout from such disasters. Collation of the individual reports revealed many instances of insufficient resource allocation and highlighted broader issues of institutional weakness and the need for comprehensive political reforms.</p><p><strong>Conclusion: </strong>Major burn incidents are often pivotal moments that can expose systemic safety failures, highlight critical infrastructure vulnerabilities, demand comprehensive preventative strategies, and ultimately trigger governmental accountability. Governmental recognition of burn care as a crucial component of disaster preparedness as well as improved resource allocation for burn centers is crucial to ensuring they are better equipped to handle mass casualty events, thereby reducing morbidity and mortality and reducing government accountability following such events. Governments would be well advised to maintain healthy funding and staffing of burn services.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155973","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 Contemporary \"Ertl\": A Functional Below-Knee Amputation for Nontraumatic Comorbid Populations.","authors":"Daisy L Spoer, Rachel N Rohrich, Samuel S Huffman, Lauren E Berger, Arshan Goudarzi, Christian X Lava, Karen Li, Kenneth L Fan, Grant M Kleiber, Christopher E Attinger","doi":"10.1097/SAP.0000000000004394","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004394","url":null,"abstract":"<p><strong>Background: </strong>The osteomyoplastic (Ertl) approach to below-knee amputation (BKA) is an alternative to the \"gold standard\" Burgess technique. This study investigates Ertl's functional outcomes and perioperative considerations performed in a highly comorbid patient population.</p><p><strong>Methods: </strong>Medical records of BKA (Ertl and non-Ertl) performed by a single surgeon between January 2017 and October 2021 were retrospectively reviewed.</p><p><strong>Results: </strong>Our cohort comprised 294 BKAs performed via Ertl (n = 51/294, 17.3%) and non-Ertl (n = 243/294, 83%). Ertl patients were younger (50.1 vs 60.6 years, P < 0.001) and had fewer comorbidities (Charlson Comorbidity Index: 2.7 vs 5.5, P < 0.001). Ertl was associated with higher rates of targeted muscle reinnervation than non-Ertl (n = 48/51, 94.1% vs n = 162/239, 67.8%, P < 0.001). There were no significant differences in short-term complications (n = 52/294, 17.7%) or reoperation (n = 57/294, 19.4%) rates. Bony union was demonstrated at a median of 6.1 months without evidence of nonunion beyond 6 months postoperatively. Ertl conferred a shorter time to ambulation (2.3 vs 3.7 months, P < 0.001) and prosthesis use (2.5 vs 3.5 months, P = 0.008). By a median of 15.6 months, a greater percentage of Ertls were ambulatory (n = 46/51, 90.2% vs n = 162/232, 69.4%, P = 0.002). Postoperative pain was minimal without between-group differences. Mortality occurred less often in the Ertl versus non-Ertl group (Ertl n = 1/51, 2.0% vs non-Ertl 50/236, 20.6%, P = 0.001).</p><p><strong>Conclusions: </strong>This study reinforces the current literature on Ertl's functional advantages in appropriate, carefully selected patients and extends our previous work demonstrating the utility in nontraumatic lower extremity amputation for multimorbid patients.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109547","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":"Successful Abdominal Wall Reconstruction Following Liposuction Catastrophe: A Case Report and Literature Review.","authors":"Osama Darras, Sara Yacoub, Isaac Mordukhovich, Diwakar Phuyal, Kimberly P Woo, Michael J Rosen, Raffi Gurunian, Sarah N Bishop","doi":"10.1097/SAP.0000000000004404","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004404","url":null,"abstract":"<p><strong>Background: </strong>Devastating abdominal injuries may result from liposuction, which can lead to necrotizing fasciitis and loss of abdominal domain. This may necessitate reconstructing the abdominal wall to improve the patient's quality of life.</p><p><strong>Objectives: </strong>The study aims to raise awareness among the readers of this catastrophic complication. Guidelines for preoperative assessment, and intraoperative measures to reduce abdominal complications along with the importance of early recognition, diagnostic tools, and treatment strategies were provided.</p><p><strong>Methods: </strong>We reported a patient who underwent abdominal wall reconstruction following liposuction-inflicted abdominal injury and necrotizing fasciitis. Subsequently, a literature search was conducted to review abdominal wall reconstructive techniques following liposuction-inflicted abdominal injuries. Algorithms for patient safety followed this.</p><p><strong>Results: </strong>The patient developed necrotizing fasciitis due to liposuction cannula bowel perforation leading to loss of abdominal domain. This was reconstructed with a transversus abdominis release trial with mesh followed by bilateral pedicled neurotized anterolateral thigh flaps with vastus lateralis. The review of the literature included 10 papers describing different techniques of abdominal reconstruction. Common treatment techniques following liposuction-inflicted abdominal injuries were negative pressure wound therapy and skin grafting.</p><p><strong>Conclusions: </strong>Anterolateral thigh flaps are an excellent option that provides functional and structural repair. Neurotization of the muscle helps protect the muscle from atrophy. The review of the literature showed a lack of abdominal wall reconstruction using musculocutaneous flaps following liposuction-inflicted abdominal injuries.Communicating symptom awareness to patients and the medical team is essential for quickly identifying potential visceral injury after liposuction, ensuring prompt management and improved outcomes.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109546","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 Incomplete V-Y Flap: A Useful Design Modification of the Conventional V-Y Flap Exampled With a Case Series of Pilonidal Sinus Excision Defects.","authors":"Luke Conway, Emma Snashall, Joseph Wignall, Laura Cappuyns, Kayvan Shokrollahi","doi":"10.1097/SAP.0000000000004251","DOIUrl":"10.1097/SAP.0000000000004251","url":null,"abstract":"<p><strong>Abstract: </strong>Pilonidal disease is relatively common and can be particularly comorbid for patients, especially in circumstances of chronic abscess or sinus formation. Excision of such disease can require flap reconstruction, one of the most common types being V-Y advancement flap. We present a modification of the V-Y flap that leaves incompletely incised distal edges that theoretically will help to avoid flap tip necrosis while allowing sufficient tissue mobility. Five male patients underwent 7 operations to excise their pilonidal disease with reconstruction using the incomplete V-Y technique modification over a 4-year period. Two patients had further operations due to development of additional disease adjacent to the prior operating site. There were no incidents of wound dehiscence or flap tip necrosis. No admission was required for postoperative complications, and no revisional surgery was necessary. Subjectively, there were no issues raised by patients regarding scar appearance. This V-Y flap modification appears to be safe and reliable in terms of complication rate and flap tip preservation following pilonidal disease excision surgery. In addition, it does not compromise the ability to perform sufficient soft tissue cover in such cases.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"577-580"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623309","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}