Annals of Plastic Surgery最新文献

{"title":"Using the Area Deprivation Index to Assess the Role of Social Factors in Shaping Access and Utilization of Breast Reconstruction.","authors":"Meeti Mehta, Nerone K O Douglas, Shayan Sarrami, Elizabeth A Moroni, Carolyn De La Cruz","doi":"10.1097/SAP.0000000000004341","DOIUrl":"10.1097/SAP.0000000000004341","url":null,"abstract":"<p><strong>Introduction: </strong>Although access to post-breast cancer reconstructive surgeries continues to improve, inequities remain. This study uses Area Deprivation Index (ADI) to assess the impact of sociodemographic factors on access and utilization of breast reconstruction (BR).</p><p><strong>Methods: </strong>This was a retrospective cohort of patients who underwent breast cancer surgery from 2014 to 2019. Patients were stratified by ADI, race, age, median household income, geography, and distance from the hospital. Summary statistics were computed, and multivariate regression was used to calculate odds ratios (OR).</p><p><strong>Results: </strong>A total of 2060 patients underwent mastectomy, of which 737 (36%) underwent immediate BR. For every one-unit increase in ADI, the odds of having BR decreased by 1.2% (OR, 0.988; CI, 0.985-0.992; P < 0.001). African American and Asian patients were significantly less likely to undergo reconstruction than other racial groups (OR, 0.669; CI, 0.456-0.963; P = 0.034 and OR, 0.341; CI, 0.114-0.819; P = 0.028, respectively). For every 1-year increase in age, the odds of receiving BR decreased by 5.6% (OR, 0.944; CI, 0.936-0.951; P < 0.001). For every $10 increase in median annual household income, the odds of having BR increased by 7.2% (OR, 1.007; CI, 1.005-1.009; P < 0.001). Rural patients were significantly more likely to receive reconstruction (OR, 1.391l; CI, 1.049-1.838; P = 0.021) than urban patients. As patients' distance from the hospital increased, White patients were more likely to receive BR (OR, 1.035; CI, 1.0003-1.0713; P = 0.048), whereas non-White patients were less likely to receive BR (OR, 0.965; CI, 0.933-0.999; P = 0.048). There were varying relationships between each measure of disparity and BR types.</p><p><strong>Conclusions: </strong>Disparities in BR exist due to a sum of system-wide issues putting individual neighborhoods at highest risk.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"39-45"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955069","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 1st London Head and Neck Reconstruction Course: Discussion and Review.","authors":"Mariella Williams, Leo Gundle, Nicholas Cereceda-Monteoliva","doi":"10.1097/SAP.0000000000004305","DOIUrl":"10.1097/SAP.0000000000004305","url":null,"abstract":"<p><strong>Abstract: </strong>Performing free flap microsurgery is an important skill in head and neck reconstruction and is associated with a steep learning curve. Learning to raise free flaps can be challenging, and opportunities can be limited in early surgical training. Surgical trainees may wish to undertake a course to develop these fundamental skills outside of clinical practice. The London Head and Neck Reconstruction Course (LHNRC) provided an excellent educational experience for surgical trainees with an interest in head and neck reconstruction. Focused on raising four commonly used free flaps (radial forearm, anterolateral thigh, fibular, and scapular), this course featured 14 hours of training including lectures, demonstration, and simulated practice on cadaveric specimens. Highlights included a high faculty-to-delegate ratio, fresh cadaveric material, and ample time for simulated practice. The LHNRC in its inaugural year was well received and is recommended for surgical trainees interested in head and neck reconstruction.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"10-12"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708092","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 ISAPS Expert Program Review: Curitiba Brazil.","authors":"Claudio Daniel Rojas Gutiérrez","doi":"10.1097/SAP.0000000000004306","DOIUrl":"10.1097/SAP.0000000000004306","url":null,"abstract":"<p><strong>Abstract: </strong>Extensive exposure to aesthetic surgery is not universally available in all plastic surgery residency programs, particularly in less developed countries. Initiatives by organizations such as ISAPS (International Society of Aesthetic Plastic Surgery) help trainees bridge gaps in their education in aesthetic surgery. As a former observer of Prof Ruth Graf, the author shares their experience with the ISAPS Expert Program, offering an overview of the benefits and opportunities provided by such initiatives.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"95 1","pages":"7-9"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274048","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":"Open Surgical Approach and Preoperative/Postoperative Patient Analyzes in Deep Posterior Nasal Septum Deviations With Spur Formation Associated With Nose-Related Facial Pain and Headache.","authors":"Dinçer Altınel","doi":"10.1097/SAP.0000000000004358","DOIUrl":"10.1097/SAP.0000000000004358","url":null,"abstract":"<p><strong>Abstract: </strong>Patients with septal deviation may present with several different complaints. While they may present with nose-specific complaints such as breathlessness, they may also present with complaints such as headache and facial pain. We selected the patients in our study from the cases whose clinical complaints were breathing problems and facial pain/headaches.In this study, we evaluated 65 septorhinoplasty patients between 2010-2022 with breathing problems due to deep posterior spur formations and facial pain/headaches. We used the visual analog scale to evaluate the severity of facial pain and headaches. Computerized tomography images were obtained to evaluate airway. On computerized tomography imaging data, the proximity of the spur formation to the nasal side wall structures in axial and coronal planes and the distances in the passage width after removal in the postoperative period were measured.As a result of the data we obtained, it was observed that spur formation, an osteophytic structure located in the posterior septum, caused serious breathing complaints accompanied by headache. We adopted the view that open septal intervention is more successful in reaching this deformity, which is mostly located in the posterior part of the septum, due to the difficulty in surgical accessibility and our goal of obtaining effective surgical results.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"17-23"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109526","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 Role of Diversity in Residency Program Selection: Insights From Applicants to Integrated Plastic Surgery Programs.","authors":"Mia D Do, Jeremiah M Taylor, Thais Calderon, Abra H Shen, Jeffrey B Friedrich","doi":"10.1097/SAP.0000000000004363","DOIUrl":"10.1097/SAP.0000000000004363","url":null,"abstract":"<p><strong>Background: </strong>Prior research has identified criteria valued by residency applicants when assembling their rank lists. However, with the composition of medical trainees continuously diversifying, there has been greater emphasis on creating a physician cohort reflective of the general US census. This study aimed to evaluate if faculty/resident diversity has a similar influence as established program features on residency program selection for current applicants applying to plastic surgery residency.</p><p><strong>Methods: </strong>A survey was administered to candidates of our institution's integrated plastic surgery residency program for the 2022-2023 and 2023-2024 application cycles to gather demographic data and rate the most impactful factors influencing rank list decisions. This was done using a Likert scale to rank program characteristics from 1 (not important) to 5 (extremely important).</p><p><strong>Results: </strong>Our survey response rate was 27% (180/673). Female and underrepresented in medicine (URiM) applicants ranked the presence of URiM faculty within a program ( P = 0.002, P = 0.022), URiM faculty in administrative positions ( P = 0.005, P = 0.012), residents identifying as the same race/ethnicity ( P = 0.001, P < 0.001), and program participation in diversity, equity, and inclusion initiatives ( P = 0.001, P = 0.003) as more important than their male and White counterparts.</p><p><strong>Conclusions: </strong>Although quality of life and perceived fit are universal priorities, female and URiM applicants placed higher importance on diverse faculty, resident representation, and program initiatives related to diversity, equity, and inclusion. These results suggest residency programs may appeal to more applicants by considering these factors in their future recruitment strategies.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"e31-e35"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101054","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 Rebuttal of a Meta-analysis Supporting Breast Implant Pocket Antimicrobial Irrigation.","authors":"Eric Swanson","doi":"10.1097/SAP.0000000000004374","DOIUrl":"10.1097/SAP.0000000000004374","url":null,"abstract":"","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"1-4"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12321332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957788","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":"Encapsulation of Adipose-Derived Stem Cells in Collagen-Based Hydrogel: Regenerative Therapy for Burn Wound Healing.","authors":"Anak Agung Istri Ajeng Sitoresmi, Maria Pramesthi Sabrina Evananda, Anak Agung Gde Ngurah Asmarajaya","doi":"10.1097/SAP.0000000000004418","DOIUrl":"10.1097/SAP.0000000000004418","url":null,"abstract":"<p><strong>Introduction: </strong>Skin graft is still the major treatment for burn injuries, despite its high risk of visible scarring which raises concerns regarding aesthetics and patient quality of life. This study proposes the usage of adipose-derived stem cells encapsulated in type I collagen-based hydrogel as a promoter to enhance wound healing, replace skin, and perfect skin regeneration. One of the potential tools for reconstructive surgery, regenerative treatments, and aesthetic enhancements due to their safety, efficiency, and cost-effectiveness is adipose-derived stem cells.</p><p><strong>Methods: </strong>This review study used a systematic review approach and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline, encompassing preparation, execution, and reporting phases.</p><p><strong>Results: </strong>Based on the study result, adipose-derived stem cells had the potential as adjuvant therapy in the burn recovery process. Application of adipose-derived stem cells enhances tissue regeneration after burn injury by reducing inflammation, stimulating blood vessel growth, releasing growth factors, and developing into various cell types upon appropriate stimulation. To maximize its potential, this modality is constructed in a collagen-based hydrogel which allows greater cell retention and engraftment, regardless of the complex microenvironment of the wound. Topical administration applied as the wound dressing after the skin graft procedure shows great absorption by the body with optimum cell viability and minimum cell retention in a less invasive way.</p><p><strong>Conclusions: </strong>Further studies regarding dosage and long-term side effects are required to obtain maximum usage of this stem cell therapy in the management of burn wound healing.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"95 1","pages":"111-118"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12321337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274071","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":"Pedicled and Free Flap Lower Extremity Reconstruction in Acute Burn Injuries.","authors":"Mario Alessandri Bonetti, Tiffany Jeong, Hilary Y Liu, Jose Antonio Arellano, Sumaarg Pandya, Guy M Stofman, Francesco M Egro","doi":"10.1097/SAP.0000000000004344","DOIUrl":"10.1097/SAP.0000000000004344","url":null,"abstract":"<p><strong>Background: </strong>A paucity of studies investigates the outcomes of flap reconstruction in lower extremity acute burns. The aim of this study is to report outcomes of lower extremity acute burn requiring pedicled or free flap coverage.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted to compare the outcomes of patients undergone pedicled versus free flap reconstruction of acute lower extremity burns, between August 2010 and December 2022. Collected data included demographics, injury and flap characteristics, complications, and reoperations. χ 2 tests were used to measure differences in complication rates between pedicled and free flaps.</p><p><strong>Results: </strong>A total of 28 patients were involved in the study. Among them, 17 patients underwent 28 pedicled flap procedures, while 11 patients received a single free flap surgery each. In the free flap group, the overall complication rate was 54.5%. In the pedicled flap group, the overall complication rate was 25.0%. Free flaps showed a significantly higher rate of total flap loss compared to pedicled flaps (18.2% vs 0%, P = 0.021). Other differences were not statistically significant.</p><p><strong>Conclusions: </strong>Flap coverage in lower extremity acute burns is rarely employed. Yet, in case of critical structures exposure it is often necessary. However, it is important to be aware of the high risk of complications, especially for more complex reconstructions requiring free tissue transfer.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"46-50"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974929","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":"Comparative Outcome Study of Gynecomastia Surgery and Gender-Affirming Mastectomy With 100% Nipple Preservation.","authors":"Eric Swanson","doi":"10.1097/SAP.0000000000004308","DOIUrl":"10.1097/SAP.0000000000004308","url":null,"abstract":"<p><strong>Background: </strong>Gynecomastia and gender-affirming top surgery share similarities in objectives. Traditionally, a subcutaneous mastectomy using a semicircular incision has been recommended for most gynecomastia patients. In recent years, mastectomies and nipple grafting have become the most popular treatment for gender-affirming top surgery. Nipple grafting is very debilitating to this unique body part, which also provides erogenous sensation. This study was undertaken to compare methods, complications, and outcomes using an approach that preserves nipples in 100% of patients.</p><p><strong>Methods: </strong>A retrospective study was conducted, comparing all gynecomastia patients and gender-affirming top surgery patients treated by the author over the period 2016-2024. Most (92%) gynecomastia patients were treated with liposuction in combination with a semicircular incision and subcutaneous mastectomy. Twelve top surgery patients (71%) were also treated with this method. Two gynecomastia patients and 5 top surgery patients with pendulous breasts underwent vertical mammaplasties incorporating a medial pedicle. A telephone survey was also administered.</p><p><strong>Results: </strong>Fifty-three patients were evaluated, including 36 gynecomastia patients and 17 top surgery patients. The complication rate was 21%. Three patients (6%) developed hematomas. Five patients (9%) underwent revisions. No patient experienced complications of the nipple/areola complex. All surveyed patients reported that nipple preservation was important. Two patients (11%) reported reduced nipple sensation after surgery. No patient reported scar dissatisfaction. Fifteen patients (83%) were comfortable exposing their chest after surgery, compared with 1 patient (6%) before surgery.</p><p><strong>Discussion: </strong>Today, a major disparity exists in treatment recommendations, with almost all gynecomastia patients being offered nipple-preserving methods and the majority of top surgery patients undergoing mastectomies with nipple grafting, or even without grafting. In view of the importance of nipple sensation, and the success of an alternative approach, surgical priorities should be realigned to preserve nipple/areola complexes.</p><p><strong>Conclusions: </strong>Nipple preservation is offered to all patients. Subcutaneous mastectomies are often sufficient, and limit scarring. Vertical mammaplasties with a medial pedicle are effective in patients with pendulous breasts. Liposuction is offered as a second-stage procedure, although many patients are satisfied with some residual breast fullness. The need for secondary surgery of the nipple/areola complex and scar revisions is minimized.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"e1-e17"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12321345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447727","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":"The University of Chicago Burn Fellowship.","authors":"Dallan P Dargan","doi":"10.1097/SAP.0000000000004347","DOIUrl":"10.1097/SAP.0000000000004347","url":null,"abstract":"<p><strong>Abstract: </strong>The burn fellowship at the University of Chicago Medicine Center is a comprehensive 12-month experience in burn care, encompassing acute and reconstructive surgery, burn resuscitation, laser, critical care, and academia. the burn center performs over 300 operations for burn care per year and treats adults and children with a dedicated 8-bed burn intensive care unit and excellent multidisciplinary team. The fellowship includes an opportunity to spend up to two months in the surgical intensive care unit. Regular outpatient burn clinics allow for follow-up and review of outcomes during the fellowship. The educational content of the burn fellowship is structured and is verified by the American Burn Association.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"13-16"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965709","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}