Journal of plastic, reconstructive & aesthetic surgery : JPRAS最新文献

{"title":"Investigating the relationship between sensation and satisfaction in reduction mammaplasty: A systematic review and meta-analysis.","authors":"Sophia Arbuiso, Sophia Salingaros, Lujain Al-Emadi, Malini Chinta, Ashley Zhang, Paul Christos, Kevin Pain, Clara Choate, David M Otterburn","doi":"10.1016/j.bjps.2024.10.028","DOIUrl":"https://doi.org/10.1016/j.bjps.2024.10.028","url":null,"abstract":"<p><strong>Background: </strong>Reduction mammaplasties are among the plastic surgery procedures with the highest rates of patient satisfaction. However, the loss of postoperative sensation in the breast and nipple-areolar complex remains a concern. In light of increasing interest in nerve-preservation techniques, we sought to investigate the relationship between retained sensation with overall satisfaction in reduction mammaplasty in current literature.</p><p><strong>Methods: </strong>The authors systematically reviewed all studies that reported postoperative sensation and satisfaction in patients who underwent reduction mammaplasty, using the MEDLINE, Embase, Cochrane, CINAHL, and Scopus databases in October 2023. Studies were evaluated for methodological quality using an NIH Quality Assessment Tool. Meta-analyses of proportions were conducted.</p><p><strong>Results: </strong>A total of 48 studies met the eligibility criteria. The median quality assessment score was 8/10. For 28 studies eligible for statistical analysis, random effects pooled proportion for patients that retained preoperative sensation was 0.78 (95% CI: 0.67-0.87), and for patients that report postoperative satisfaction was 0.94 (95% CI: 0.91-0.97). Overall, the studies reported a relatively wide range of sensation outcomes with consistently high satisfaction scores.</p><p><strong>Conclusion: </strong>The results of this systematic review suggest that other surgical factors (e.g., relief of macromastia symptoms, aesthetic appearance) play a greater role in patient satisfaction compared to sensation retention in reduction mammaplasty. Wide variability in assessment methodologies for both sensation and satisfaction was noted. Standardizing and objectifying measurement techniques, particularly for sensation, will help further characterize the relationship between sensation and satisfaction in future studies.</p>","PeriodicalId":94104,"journal":{"name":"Journal of plastic, reconstructive & aesthetic surgery : JPRAS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensory restoration following breast reconstruction with operative reinnervation: A systematic review and meta-analysis.","authors":"Ammara Ghumman, Patrick J Kim, Kristen McAlpine, Fanyi Meng, Laura Snell, Joan Lipa","doi":"10.1016/j.bjps.2024.10.021","DOIUrl":"https://doi.org/10.1016/j.bjps.2024.10.021","url":null,"abstract":"<p><strong>Background: </strong>There is currently no consensus on the efficacy of operative reinnervation at the time of post-mastectomy reconstruction. This review compares postoperative sensation between innervated and non-innervated flaps in breast reconstruction through systematic review and meta-analysis.</p><p><strong>Methods: </strong>EMBASE, Ovid, and CENTRAL were searched from inception to December 6, 2023. The primary outcome was level of sensation postoperatively. Secondary outcomes included presence of sensation, breast-related complications, operative time, and quality of life. Meta-analysis was conducted using mean difference (MD) or standardized mean difference (SMD) for continuous outcomes and odds radio (OR) for dichotomous outcomes. Quality of evidence was appraised using RoB-2/ROBINS-I. Certainty of evidence was assessed with Grading of Recommendations, Assessment, Development and Evaluations.</p><p><strong>Results: </strong>Twenty-eight studies were included; studies were observational studies except one randomized controlled trial. Common flaps were deep inferior epigastric perforator (11/28, 39.3%) and transversus rectus abdominis muscle (9/28, 32.1%). Innervated flaps were significantly associated with improved level of postoperative sensation (SMD: -0.94, 95% CI: [-1.35; -0.53], I²: 78%, p < 0.01), presence of postoperative sensation (OR: 11.4, 95% CI: [5.09; 24.5], I²: 0%, p < 0.01), and improved postoperative BREAST-Q scores (MD: 8.11, 95% CI: [4.33; 11.89], I²: 27%, p < 0.01). However, certainty of evidence was low/very low for all outcomes. Most studies had moderate risk of bias (56.5%). There were no statistically significant differences in breast-related complications or operative time.</p><p><strong>Conclusions: </strong>Operative reinnervation in breast reconstruction is significantly associated with improved level and presence of postoperative sensation and BREAST-Q scores without significant increase in breast-related complications/operative time. More high-quality studies are required to improve the certainty of outcomes.</p>","PeriodicalId":94104,"journal":{"name":"Journal of plastic, reconstructive & aesthetic surgery : JPRAS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical risks, reconstruction, and facial nerve outcomes in parotidectomy: Insights from ACS-NSQIP data.","authors":"Michael J Brenner","doi":"10.1016/j.bjps.2024.09.069","DOIUrl":"https://doi.org/10.1016/j.bjps.2024.09.069","url":null,"abstract":"","PeriodicalId":94104,"journal":{"name":"Journal of plastic, reconstructive & aesthetic surgery : JPRAS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142383017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptance and willingness of patients with chronic facial nerve palsy for an implantable device that assists with eye closure.","authors":"Paul Rozenbroek, Annie Waugh, Gillian Heller, Raymond Hayler, Jacinta Cleary, Shaheen Hasmat, Nigel H Lovell, Gregg Suaning, Jonathan R Clark, Tsu-Hui Hubert Low","doi":"10.1016/j.bjps.2024.09.028","DOIUrl":"https://doi.org/10.1016/j.bjps.2024.09.028","url":null,"abstract":"<p><strong>Background: </strong>Patients with facial nerve palsy often experience lagophthalmos (incomplete eye closure), which can lead to exposure keratitis. The Bionic Lid Implant for Natural Eye Closure (BLINC) is a medical device designed to mimic the more natural blink kinetics than traditional lid loading techniques.</p><p><strong>Aims: </strong>This study aimed to evaluate potential factors that might influence the design of the BLINC device and willingness of participant to undergo the implant placement surgery.</p><p><strong>Methods: </strong>Patients attending a multidisciplinary facial nerve clinic were invited to complete a survey addressing patient acceptance of the BLINC device implantation.</p><p><strong>Results: </strong>Seventy-two patients were mailed the survey, of which 50 returned completed surveys (69%). The most important factor identified by participants was the device function (81% ranked as very important) and the least important factor was cost (16% ranked as very important). Median acceptable device function time was 5 years (range 1-10 years). Ten participants (20%) indicated willingness to be the first to trial BLINC. Women were more likely to rate visual appearance as important (OR 3.32, CI 1.14-9.62, p = 0.028), and less likely to rate user friendliness as important (OR 0.16, CI 0.04-0.52, p = 0.0021). Older participants were more likely to rate the length of recovery period as important (OR 1.04, CI 1.01-1.08, p = 0.006). Participants with complete eye closure were less likely to be willing to trial the implant (OR 0.08, CI 0.00-0.53, p = 0.006, whilst patients with eye irritation were more willing to trial the implant (OR 7.20, CI 1.12-142, p = 0.036).</p><p><strong>Conclusion: </strong>Certain patient demographics impact patient aesthetic and functional preferences and the willingness to trial the BLINC device.</p>","PeriodicalId":94104,"journal":{"name":"Journal of plastic, reconstructive & aesthetic surgery : JPRAS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors and outcomes after surgery for malignant neoplasm of the parotid gland: An ACS-NSQIP study.","authors":"Leonard Knoedler, Samuel Knoedler, Cosima C Hoch, Ali-Farid Safi, Barbara Wollenberg, Michael Alfertshofer, Bohdan Pomahac, Martin Kauke-Navarro, James Clune","doi":"10.1016/j.bjps.2024.09.067","DOIUrl":"https://doi.org/10.1016/j.bjps.2024.09.067","url":null,"abstract":"<p><strong>Background: </strong>Malignant neoplasms of the parotid gland (MPG) are clinically challenging due to aggressive growth and metastasis. Despite tumor resection being the primary treatment, there is a paucity of studies on postsurgical outcomes and preoperative risk factors for MPG.</p><p><strong>Materials and methods: </strong>We queried the American College of Surgeons National Surgical Quality Improvement Program database to identify patients who underwent MPG surgery between 2008 and 2021. 30-day postoperative outcomes and risk factors predisposing to the occurrence of complications were assessed.</p><p><strong>Results: </strong>The study population included 3052 patients, the majority of whom were males (n = 1842; 60%) and White (n = 2017; 66%). The average age was 63 ± 16 years. The most common comorbidities were obesity (n = 1182; 39%) and hypertension (n = 1533; 50%). Surgical procedures were performed predominantly in the inpatient setting (n = 1773; 58%) by ENT surgeons (n = 2767; 91%). Overall, complications were reported in 6.8% (n = 209) of patients. Inpatient setting (p < 0.001), renal failure (p < 0.001), smoking (p = 0.012), as well as increased creatinine (p < 0.001) and blood urea nitrogen (BUN) levels (p = 0.001) were identified as risk factors for complications. In addition, concurrent microsurgical procedures such as flap surgery and/or nerve grafting significantly increased the risk of postoperative adverse events (p < 0.001).</p><p><strong>Conclusions: </strong>Our analysis revealed that complication rates were associated with high creatinine and BUN levels, inpatient surgery, renal failure, higher American Society of Anesthesiology classes, and smoking. We also found that concurrent microsurgical procedures were predictive factors for complications. These findings can inform patient counseling, preoperative planning, and risk stratification.</p>","PeriodicalId":94104,"journal":{"name":"Journal of plastic, reconstructive & aesthetic surgery : JPRAS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-centered innovation for facial nerve palsy: Bionic reanimation for the paralytic eyelid.","authors":"Michael J Brenner","doi":"10.1016/j.bjps.2024.09.037","DOIUrl":"https://doi.org/10.1016/j.bjps.2024.09.037","url":null,"abstract":"","PeriodicalId":94104,"journal":{"name":"Journal of plastic, reconstructive & aesthetic surgery : JPRAS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on \"Exploring the use, outcomes, barriers, and facilitators of prehabilitation and rehabilitation in abdominoplasty surgeries: A scoping review\".","authors":"Jing Qin Tay","doi":"10.1016/j.bjps.2024.09.026","DOIUrl":"https://doi.org/10.1016/j.bjps.2024.09.026","url":null,"abstract":"","PeriodicalId":94104,"journal":{"name":"Journal of plastic, reconstructive & aesthetic surgery : JPRAS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adipose-derived exosomes as a preventative strategy against complications in hyaluronic acid filler applications: A comprehensive in vivo analysis.","authors":"Jeonghun Kim, Taehee Jo, Hajin Nam, Byung Jun Kim, Seung Min Nam, Junhyung Kim, Jaehoon Choi, Woonhyeok Jeong","doi":"10.1016/j.bjps.2024.07.071","DOIUrl":"https://doi.org/10.1016/j.bjps.2024.07.071","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to investigate the impact of exosomes derived from adipose-derived stem cells (ASCs) on complications arising from hyaluronic acid (HA) filler injections.</p><p><strong>Methods: </strong>An HA hydrogel blended with adipose stem cell-derived exosomes was prepared and administered to the inguinal fat pads of 16 C57BL/6J mice. The control group received only HA filler (HA group), and the study group was treated with a combination of HA filler and exosomes (exoHA group). Biopsy was performed 1 week and 1, 2, 3, and 6 months after the injections. The effects were assessed using hematoxylin and eosin and Masson's trichrome staining for histological examination, immunohistochemistry for collagen type I and Vascular Endothelial Growth Factor (VEGF), RNA sequencing, and quantitative real-time polymerase chain reaction (PCR) (Il6, Ifng, Hif1a, Acta2, Col1a1).</p><p><strong>Results: </strong>RNA sequencing revealed significant downregulation of the hypoxia (false discovery rate [FDR] q = 0.007), inflammatory response (FDR q = 0.009), TNFα signaling via NFκB (FDR q = 0.007), and IL6 JAK-STAT signaling (FDR q = 0.009) gene sets in the exoHA group. Quantitative PCR demonstrated a decrease in expression of proinflammatory cytokines (Il6, P < 0.05; Hif1a, P < 0.05) and fibrosis markers (Acta2, P < 0.05; Col1a1, P < 0.05) within the exoHA group, indicating reduced inflammation and fibrosis. Compared to the exoHA group, the HA group exhibited a thicker and more irregular capsules surrounding the HA filler after 6 months.</p><p><strong>Conclusion: </strong>The addition of ASC-derived exosomes to HA fillers significantly reduces inflammation and accelerates collagen capsule maturation, indicating a promising strategy to mitigate the formation of HA filler-related nodules.</p>","PeriodicalId":94104,"journal":{"name":"Journal of plastic, reconstructive & aesthetic surgery : JPRAS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does post-mastectomy radiation therapy worsen outcomes in immediate autologous breast flap reconstruction? A systematic review and meta-analysis.","authors":"Belle Liew, C. Southall, M. Kanapathy, D. Nikkhah","doi":"10.7244/cmj.2021.04.001.1","DOIUrl":"https://doi.org/10.7244/cmj.2021.04.001.1","url":null,"abstract":"BACKGROUND\u0000There is great uncertainty regarding the practice of immediate autologous breast reconstruction (IBR) when post-mastectomy radiotherapy (PMRT) is indicated. Plastic surgery units differ in their treatment protocols, with some recommending delayed breast reconstruction (DBR) following PMRT. IBR offers significant cosmetic and psychosocial benefits; however, the morbidity of flap exposure to radiation remains unclear.\u0000\u0000\u0000OBJECTIVE\u0000The aim of this review was to comprehensively analyze the existing literature comparing autologous flaps exposed to PMRT and flaps with no radiation exposure.\u0000\u0000\u0000METHODS\u0000A comprehensive search in MEDLINE, EMBASE and CENTRAL databases was conducted in November 2020. Primary studies comparing IBR with and without adjuvant PMRT were assessed for the following primary outcomes: clinical complications, observer-reported outcomes and patient-reported satisfaction rates. Meta-analysis was performed to obtain pooled risk ratios of individual complications.\u0000\u0000\u0000RESULTS\u0000Twenty-one articles involving 3817 patients were included. Meta-analysis of pooled data gave risk ratios for fat necrosis (RR = 1.91, p < 0.00001), secondary surgery (RR = 1.62, p = 0.03) and volume loss (RR = 8.16, p < 0.00001) favoring unirradiated flaps, but no significant difference was observed in all other reported complications. The no-PMRT group scored significantly higher in observer-reported measures. However, self-reported aesthetic and general satisfaction rates were similar between groups.\u0000\u0000\u0000CONCLUSION\u0000IBR should be offered after mastectomy to patients requiring PMRT. The higher risks of fat necrosis and contracture appear to be less clinically relevant as corroborated by positive scores from patients developing these complications. Preoperative and intraoperative measures should be taken to further optimize reconstruction and mitigate post-radiation sequel. Careful management of patients' expectations is also imperative.\u0000\u0000\u0000LEVEL OF EVIDENCE\u0000Level III.","PeriodicalId":94104,"journal":{"name":"Journal of plastic, reconstructive & aesthetic surgery : JPRAS","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88109816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Social Media in Disseminating Plastic Surgery Research: The Relationship between Citations, Altmetrics and Article Characteristics","authors":"Michael C. Grant, K. Scott-Bridge, R. Wade","doi":"10.1101/2020.08.26.20182337","DOIUrl":"https://doi.org/10.1101/2020.08.26.20182337","url":null,"abstract":"Background: Social media (SoMe) enables publishers and authors to disseminate content immediately and directly to interested end-users, on a global scale. Alternative metrics (altmetrics) are non-traditional bibliometrics which describe the exposure and impact of an article on freely available platforms such as Twitter, Facebook, Wikipedia and the news. Altmetrics are strongly associated with ultimate citation counts in various medical disciplines, except plastic surgery which represents the rational for this study. Methods: Altmetric explorer was used to extract altmetrics and citation rates for articles published during 2018 in Plastic and Reconstructive Surgery (PRS), the Journal of Plastic, Reconstructive and Aesthetic Surgery, the Annals of Plastics Surgery and Plastic Surgery (also known as Chirurgie Plastique). Multivariable negative binomial regression was used to estimate the relationship between citations and predictors (presented as the incidence rate ratio, IRR with 95% confidence interval, CI). Results: Overall, 1215 plastic surgery articles were captured which were cited 3269 times. There was a strong and independent association between the number of mentions in SoMe and the number of times an article was cited (adjusted IRR 1.01 [95% CI 1.01, 1.1]), whereby each mention in SoMe (e.g. Tweets or Facebook posts) translated to one additional citation. Evidence synthesis articles (e.g. systematic reviews) were cited twice as often as other articles and again, the use of SoMe to advertise these outputs was independently associated with more citations (IRR 2.0 [95% CI 1.3, 3.2]). Conclusions: Dissemination of plastic surgery research through social media channels increases an articles impact as measured by citations.","PeriodicalId":94104,"journal":{"name":"Journal of plastic, reconstructive & aesthetic surgery : JPRAS","volume":"35 6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75873061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}