Annals of Plastic Surgery最新文献

{"title":"Timing of Renal Replacement Therapy in Burn Patients With Acute Kidney Injury: A Retrospective Cohort Study.","authors":"Xue Heng, Haisheng Li","doi":"10.1097/SAP.0000000000004178","DOIUrl":"10.1097/SAP.0000000000004178","url":null,"abstract":"<p><strong>Introduction: </strong>Acute kidney injury (AKI) is common in severe burns with high mortality. Previous studies confirmed the renal replacement therapy (RRT) as an effective strategy in burn patients. However, the optimal timing of RRT initiation with AKI is rarely investigated.</p><p><strong>Methods: </strong>We conducted a single-center, retrospective cohort study at a large burn center in Chongqing, China, from 2010 to 2020. Patients were grouped into early (initiated at Kidney Disease: Improving Global Outcomes stage 1 or 2 of AKI) and delayed RRT (initiated at Kidney Disease: Improving Global Outcomes stage 3 of AKI). The primary outcome was in-hospital mortality. The secondary outcomes included renal function recovery, length of stay, and RRT-related complications.</p><p><strong>Results: </strong>Of the included 79 patients, 42 and 37 were in early and delayed RRT group, respectively. The mean burn area was 68.82%. The in-hospital mortality tended to be higher in the early group (42.86%) than in the delayed group (29.73%, P = 0.227), although the difference was not statistically significant. The rate of partial remission of renal function at 48 hours after RRT discontinuation was significantly higher in the delayed group (78.26%) than early group (36.84%, P = 0.003). Furthermore, multivariable Cox and logistic regression analysis found that interval from AKI occurrence to RRT initiation was protective factors for 90-day mortality (hazard ratio 0.514, 95% confidence interval 0.349-0.756, P = 0.001), but fluid overload, acute respiratory distress syndrome, and multiple organ dysfunction syndrome were risk factors for mortality. Subgroup analysis revealed that patients with stage 1 or 2 AKI who received RRT within 24 hours after AKI had the lowest survival rate. In contrast, patients with stage 3 AKI who received RRT beyond 24 hours after AKI had the highest survival rate. The delayed group had higher rate of bleeding and lower rate of catheter-related infection than the early group.</p><p><strong>Conclusions: </strong>Delayed initiation of RRT seemed to have similar survival benefits to early RRT initiation in burn patients with AKI, needing further confirmation by large randomized clinical study in future.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"528-535"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799009","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":"High-Fidelity, Low-Cost Microvascular Training Clamps: Expanding Training Opportunities for Microsurgery.","authors":"Garrison A Leach, Tyler Dorobek, Shannon Alsobrooks, Riley A Dean, Ahmed S Suliman, Chris Reid","doi":"10.1097/SAP.0000000000004276","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004276","url":null,"abstract":"<p><strong>Background: </strong>One significant barrier to training and supporting microvascular surgeons is the cost of obtaining high-quality equipment, particularly in resource-limited environments. Currently available synthetic solutions lack the durability to allow for resterilization with limited long-term durability. The authors aimed to develop and describe a reproducible process of creating low-cost, high-fidelity microvascular clamps that can be self-manufactured to improve access to microsurgical training and education worldwide.</p><p><strong>Methods: </strong>Using 18-8 stainless steel sheets, templates were cut using a laser cutter (Fig. 1). Using a combination of needle nose pliers and a custom 3D-printed crimping tool, the template was folded on itself to fashion the micro clamp (Figs. 2, 3). The training clamps were then compared to standard Acland clamps using a constant pressure simulator and a force sensitive resistor to determine ability to impede flow as well as to ensure no excess force was applied to create trauma on the vessels. A cost analysis between conventional Acland microvascular clamps and training clamps was performed. A fidelity questionnaire was administered to a focus group of plastic surgery residents to assess training clamp performance relative to standard Acland clamps.</p><p><strong>Results: </strong>No significant differences were found between the force applied from conventional Acland clamps and the training clamps. Training clamps were consistently able to occlude flow up to 160 mm Hg. The focus group found no significant differences in device handling, ease of use, or feel between the products. The cost to create each training clamp was $4.13, whereas Acland clamps cost ~$50 to purchase from the manufacturer. The average folding time was just under 5 minutes.</p><p><strong>Conclusions: </strong>Using a single sheet of stainless steel and a crimping tool, single and double-opposing microvascular clamps can be created with reproducible design that is low cost, with high-fidelity, and can be manufactured by microvascular surgeons in resource-limited environments. Supplies can easily be shipped around the world and assembled. The stainless steel used to create these clamps is amenable to conventional sterilization methods and projected long-term durability. Further study is required to determine safety and device longevity for use in human populations.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 5S Suppl 3","pages":"S412-S416"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960136","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":"Conflict of Interest and Recommendations for Explantation in Asymptomatic Patients Concerned About BIA-ALCL Risk.","authors":"Eric Swanson","doi":"10.1097/SAP.0000000000004247","DOIUrl":"10.1097/SAP.0000000000004247","url":null,"abstract":"","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"493-499"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057835","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":"Single-Stage Ear Reconstruction Simultaneous With Piezoelectric Osia® Bone Conduction Implantation.","authors":"Courtney Leonard, Michelle Oberoi, Caitlyn Belza, Daniela Carvalho, Amanda Gosman, Samuel Lance","doi":"10.1097/SAP.0000000000004280","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004280","url":null,"abstract":"<p><strong>Background: </strong>Single-stage, alloplastic ear reconstruction is often met with the challenge of coordinating bone-anchored hearing aid implantation. Modern digital piezoelectric stimulation, such as the Cochlear™ Osia® System (Sydney, Australia), contains integrated circuitry preventing the use of monopolar cautery after implantation and is larger than other devices, thus presenting several surgical challenges during simultaneous implantation. This study presents the first series of patients outlining a stepwise technique for safe and effective single-stage ear reconstruction and Osia implantation. Furthermore, it highlights the advancing technologies in hearing restoration and navigation of ear reconstruction in coordination with these modern devices.</p><p><strong>Methods: </strong>A retrospective analysis of patients who underwent single-stage ear reconstruction using alloplastic implants with simultaneous implantation of an Osia piezoelectric hearing system was performed. Patient demographics, surgical techniques, and outcomes were assessed.</p><p><strong>Results: </strong>A total of 8 patients meeting the above criteria were identified. The median patient age at the time of surgery was 8 years old. All but one patient presented with grade 3 microtia. The temproparietal fascial (TPF) flap was used for coverage of the alloplastic ear construct in 7 of the 8 cases with the occipital fascial (OF) flap used in the remaining case. Periauricular incisions were used in all TPF cases with an extension into an existing coronal incision for the OF patient. For Osia implant coverage, the pericranium was retained in all cases and raised as a separate, inferiorly based flap taking care to preserve the venous outflow to the ear reconstruction flaps. The average total surgery time was 9.3 hours with Osia implant placement consuming an average of 53 minutes. All Osia implants produced functional hearing, and there were no exposures of the Osia implants in this series.</p><p><strong>Conclusions: </strong>Single-stage alloplastic ear reconstruction with simultaneous implantation of the Osia piezoelectric implant is a safe and efficient method that provides the most advanced hearing restoration and an aesthetic microtia reconstruction. Craniofacial surgeons should maintain awareness of the advances in bone conduction technology and the implications regarding surgical approach and operative planning.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 5S Suppl 3","pages":"S441-S445"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953192","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":"Ergonomics for Cleft Providers: A Systematic Review.","authors":"Jose A Garcia, Wassim Najjar, Dana Andari, Roland K Assaf, Beyhan Annan, Adam Johnson, Raj Vyas, Jordan W Swanson, Usama S Hamdan","doi":"10.1097/SAP.0000000000004346","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004346","url":null,"abstract":"<p><strong>Background: </strong>Cleft care providers, particularly surgeons, are at high risk for work-related musculoskeletal disorders (MSDs) due to prolonged and repetitive procedures. Despite increasing recognition of ergonomics, comprehensive strategies to address this issue remain underexplored. This systematic review consolidates evidence on ergonomic challenges, practices, and interventions for cleft care surgeons to enhance their musculoskeletal well-being and optimize performance.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, Google Scholar, and Cochrane databases was conducted for studies published between January 1, 2000, and July 20, 2023. Eligible studies focused on ergonomic challenges and interventions among cleft care surgeons. Screening, data extraction, and risk of bias assessment were performed in duplicate following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Nineteen studies met the inclusion criteria.</p><p><strong>Results: </strong>Work-related MSDs were prevalent, with rates ranging from 47.5% to 97%. The most commonly reported symptoms occurred in the neck, shoulders, and lower back. Risk factors included years in practice, poor posture, and lack of ergonomic training. Recommendations included adopting visualization tools (eg, videoscopes, prismatic glasses), ergonomic devices, robotic-assisted surgery, and posture feedback systems. Ergonomic training and curricula were highlighted as essential for early intervention and long-term prevention. Barriers such as accessibility, cost, and implementation feasibility in resource-limited settings were noted.</p><p><strong>Conclusions: </strong>MSDs are pervasive among cleft care providers, underscoring the urgent need for ergonomic interventions. Integrating ergonomic principles into practice, enhancing surgical training, and promoting tailored interventions for all cleft care disciplines are critical to improving provider health and career longevity. Implementing ergonomic strategies and integrating them into clinical practice can significantly improve provider well-being, reduce musculoskeletal disorders, and ensure career longevity across diverse clinical settings.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 5","pages":"612-622"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953587","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":"Trainee Perspectives After Nonvoluntary Plastic Surgery Program Closures: Lessons Learned and Steps Forward.","authors":"Puja M Jagasia, Nicholas O'Sick, Megan E Fracol, Arya Andre Akhavan, Brian C Drolet, Matthew E Pontell","doi":"10.1097/SAP.0000000000004397","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004397","url":null,"abstract":"<p><strong>Background: </strong>In the last decade, only 3 plastic surgery programs have faced nonvoluntary closure by the Accreditation Council of Graduate Medical Education. These closures all occurred unexpectedly in April 2021 and affected 23 trainees. Although the dust has largely settled from this event, the insights of the affected trainees remain uncharacterized.</p><p><strong>Methods: </strong>The Program Closure Working Group of the American Society of Plastic Surgery's Resident Council created a 30-item questionnaire and distributed it to displaced trainees 1 year after program closures to capture their perspectives.</p><p><strong>Results: </strong>Seventeen trainees (84%) responded to the survey with respondents from all postgraduate year years, including incoming interns. Only 24% (4/17) trainees were notified of program closure on the day of closure decision, and 18% (3/17) never received official notice from their program. All trainees (100%, 17/17) reported that their home institution did not provide guidance regarding the relocation process, which cost a median of $10,000 and up to $50,000. No incoming intern was informed about potential program closure prior to rank list submission. The most difficult part of the relocation process was mental hardship (59%, 10/17), followed by finding an available residency spot (47%, 8/17). Department/division chairs (76%, 13/17) and program directors (71%, 12/17) were predominantly viewed as unsupportive and antagonistic.</p><p><strong>Conclusion: </strong>The plastic surgery community needs to be proactive in ensuring the support of trainees during nonvoluntary program closures. Fortunately, these events are rare, but when they do occur, they can be devastating. Moving forward, we propose tasking a single party to be responsible for (a) timely dispersion of information during program closures, (b) creating a protocol for leadership, (c) allocating a relocation stipend for trainees, and (d) facilitating the delivery of mental health resources to trainees.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Hand Surgery Simulation.","authors":"Jacob A Becerra, Idean Roohani, Neil U Parikh, Marah I Jolibois, Katelyn Kondra, Mark Swerdlow, Luke T Nicholson, Joseph N Carey","doi":"10.1097/SAP.0000000000004311","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004311","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic and duty hour restrictions illuminated a role for surgical simulation in hand surgery training that permits meaningful technical experience outside the operating room. Implementation of surgical simulation infrastructure alongside clinical training accounting for complexity and cost should be considered. This systematic review analyzes cadaveric, benchtop, 3D-printed, augmented/virtual reality, and animal models that may effectively simulate hand surgical techniques and procedures with subjective or objective competence assessment.</p><p><strong>Methods: </strong>A systematic review was conducted according to PRISMA-P guidelines using the following databases: PubMed, Medline, Scopus, Embase, Web of Science, and Cochrane. Selected search terms included procedures relevant to hand surgery and various simulation training modalities. Inclusion criteria were English-language peer-reviewed articles about surgical simulation techniques or hand surgery-related training. Abstracts, conference proceedings, non-English literature, and reviews were excluded. Data, including skills and techniques taught and assessed, model type, equipment, cost, and emphasis placed in training for each article, were entered into an electronic database. Additional articles were identified through references from the initial search.</p><p><strong>Results: </strong>Our search criteria identified 2745 articles, 39 of which met the inclusion criteria. Models were described with the following frequency: synthetic benchtop/3D printed (41.0%), animal (25.6%), cadaveric (17.9%), augmented and virtual reality (AR/VR; 10.3%), and other computer simulation (10.3%). Three models incorporated both a physical benchtop and AR/VR components. The procedures most represented by the simulation tools assessed include tendon repair (30.8%), fracture fixation (25.6%), wrist arthroscopy (15.4%), and carpal tunnel release (15.4%). Of all articles, 51.3% evaluated the efficacy of the educational tool. Of these, 40.0% were evaluated via subjective methods only, 10.0% via objective methods, and 50% via both. Eighty-seven percent of articles emphasized the importance of surgical simulation in a surgeon's training.</p><p><strong>Conclusions: </strong>A diverse collection of hand surgical simulation models exists for the practice of various aspects of hand surgery. The existing literature demonstrates their utility for increasing expertise with surgical techniques and procedures in a low-risk setting. Integration into surgical training will depend on program time and budget constraints.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 5S Suppl 3","pages":"S474-S483"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961932","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":"Single-Stage Latissimus-Implant Breast Reconstruction Is Safe and Reliable: A Single Surgeon Series of 207 Flaps.","authors":"Youssef Aref, Yasmina Samaha, Hamzah Almadani, Brianne Mitchell, Edward C Ray, Randolph Sherman, Philip S Brazio","doi":"10.1097/SAP.0000000000004283","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004283","url":null,"abstract":"<p><strong>Background: </strong>The latissimus dorsi flap (LDF) is a historical workhorse and contemporary salvage mainstay for breast reconstruction. There is still debate regarding timing and staging, with some authors advocating for staged reconstruction using tissue expanders. We present a single-surgeon experience with LDF breast reconstruction and compare the results of single-stage reconstruction versus staged approaches.</p><p><strong>Methods: </strong>Patients undergoing LDF breast reconstruction from 2008 to 2021 with a single surgeon (R.S.) were included. Charts were reviewed for demographics, indications, number and type of planned stages, and outcomes. Acute and chronic complications and revisions were compared between indication and staging groups.</p><p><strong>Results: </strong>A total of 156 patients underwent LDF breast reconstruction, of which 111 flaps (53.1%) were bilateral. One hundred seventy-nine (85.6%) flaps were for primary reconstruction, and 30 (14.4%) flaps were for salvage of a previous breast reconstruction. Fourteen (6.7%) flaps were 1-stage LDF alone, 189 (90.4%) were 1-stage LDF with implant, 1 (0.5%) was 2-stage LDF with implant, and 5 (2.4%) were 2-stage LDF with tissue expander then implant. The mean follow-up was 44.9 months (range, 1-164 months). The most common complication was capsular contracture (29%). Overall complication rates were similar between primary and salvage reconstruction (35.8% vs 43.3%, P = 0.426), as was needed for revision (39.1% vs 40.0%, P = 0.926). There was a significant difference in complication rate (P = 0.021) but not revision rate (P = 0.133) between staging groups: 1-stage LDF alone, 7.1%, 14.3%; 1-stage LDF with implant, 40.2%, 41.8%; 2-stage LDF with implant, 0.0%, 0.0%; and 2-stage LDF with expander then implant, 0.0%, 20.0%. After removing capsular contracture, there was no difference in complication rates.</p><p><strong>Conclusions: </strong>Single-staged LDF/implant reconstruction remains a safe and reliable surgical option for both primary and salvage breast reconstruction. High rates of capsular contracture should prompt the deployment of techniques to reduce its incidence.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 5S Suppl 3","pages":"S457-S464"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965740","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":"Traumatic Brain Injury in Patients With Mandibular Fractures.","authors":"Pharibe Pope, Bashar A Hassan, Seray Er, Eric Resnick, Deborah M Stein, Judy Pan, Michael P Grant, Gregory A Lamaris","doi":"10.1097/SAP.0000000000004246","DOIUrl":"10.1097/SAP.0000000000004246","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) associated with facial fractures is a major public health concern worldwide. The rate of TBI in patients with mandibular fractures ranges from 21.3% to 39.6%. However, the risk factors for TBI in patients with mandibular fractures remain unknown. Our study evaluates these risk factors.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who presented with traumatic mandibular fractures in 2018 and 2019. Excluded were patients with no documentation of Glasgow Coma Scale. Our primary outcomes were: (1) prevalence of concomitant TBI on presentation defined as having a positive head computed tomography scan (hemorrhage, parenchymal contusion, diffuse axonal injury), or a negative scan with Glasgow Coma Scale < 15 or any neurologic symptom/sign; (2) prevalence of posttraumatic neurologic symptoms assessed at ≥4 weeks after injury. The mandibular injury severity score (MISS) was calculated for all patients. Bivariate analysis and multivariable logistic regression were performed.</p><p><strong>Results: </strong>Of 390 patients with mandibular fractures, 165 (42.3%) had concomitant TBI on presentation. Of those, 61% (n = 101) had mild TBI, 12% (n = 20) had moderate TBI, and 27% (n = 44) had severe TBI. Almost half of the mandibular fractures were due to assault (182 [47%]). Older age at injury and the presence of other facial fractures were associated with significantly greater odds of TBI on presentation (adjusted odds ratio 95% confidence interval [CI] 1.016 [1.001-1.032], P = 0.040; 2.457 [1.551-3.891], P < 0.001). Of 195 patients who were assessed at ≥4 weeks after injury, 99 (51%) had neurologic symptoms, most commonly facial numbness (74 [38%]). Mandibular body fracture and a high MISS were associated with significantly greater odds of having neurologic sequelae at ≥4 weeks after injury (adjusted odds ratio [95% CI] 3.12 [1.31-7.50], 1.12 [1.04-1.20]).</p><p><strong>Conclusions: </strong>Older patients and those with mandibular body fractures and a high MISS may benefit from TBI screening and close longitudinal follow-up to identify and manage neurologic sequelae.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"544-551"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405178","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":"Academic Influence and Industry Funding in Acellular Dermal Matrix Research: A Co-authorship Network Analysis.","authors":"McKay D Reese, Yash A Mehta, Robert Craig Clark, Milan M Hirpara, Michael R Haupt, Chris M Reid","doi":"10.1097/SAP.0000000000004164","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004164","url":null,"abstract":"<p><strong>Background: </strong>Previous research has demonstrated correlations between quantity of acellular dermal matrix (ADM) studies published and industry payments received. The present study extends this work by employing a co-authorship network analysis to quantitatively identify a broader cohort of influential investigators in the field of ADM and analyze their financial relationships with industry.</p><p><strong>Methods: </strong>Studies from 11 plastic surgery journals focusing on ADM were retrieved from PubMed. Author names were extracted, cleaned, and placed into an adjacency matrix to generate a co-authorship network. Degree centrality, a representation of influence within the network, was then quantified for each author. Total industry payments received from ADM-producing companies were calculated for authors with exceptional centrality, defined as >11 (95th percentile; n = 99), using the Open Payments database. Spearman's rank correlation and simple linear regression were used to analyze the relationship between centrality and payments received.</p><p><strong>Results: </strong>A total of 1651 authors (nodes) from 535 studies were incorporated into the network, with 9360 co-authorships (ties) between them. Ninety-nine authors attained a centrality >11. Of the 57 US-based clinicians within this cohort of 99, 49 (86%) received at least one payment from an ADM-producing company. The average total payment received for this cohort was $98,756 (SD, $262,405). The grand total for all authors was $4,839,086. Spearman correlation revealed a significant positive correlation between centrality and industry payments (ρ = 0.31; 95% CI, 0.027-0.54; P < 0.05). Simple linear regression demonstrated an estimated 18% increase in total pay per additional unit of centrality (95% CI, 5%-30%; P = 0.007).</p><p><strong>Conclusions: </strong>This study examines academic influence in the realm of ADM research via a co-authorship network analysis and demonstrates a high prevalence of funding among influential authors as well as a significant relationship between centrality and payments received. These findings underscore the need for discussions concerning objectivity in clinical research, although it is uncertain whether academic influence is a target of industry or if industry support bolsters academic success.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 5S Suppl 3","pages":"S465-S468"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960764","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}