Indian Journal of Plastic Surgery最新文献

Background  A rapid expansion of study on platelet-rich fibrin (PRF) has gained more attention in the subject. In this study, bibliometrics were used to assess the outputs and trends of relevant PRF studies. An in-depth analysis of the publication patterns and progress in PRF research worldwide was conducted for the purpose of filling in this research gap. Materials and Methods  The analysis included 946 papers sourced from Web of Science that included 842 original articles and 104 reviews. A number of factors including country/region, institution, journal, and author were taken into account. Research on PRF development trends was mapped using the frequency of keywords. Results  In terms of the total number of publications, China ranked first with 199 papers, whereas the United States ranked first on the H-index with 37. PRF is an active research area in stomatology and craniomaxillofacial surgery. Keywords provided by the authors were designated to three clusters: red, green, and blue. "Growth factor," "platelet-rich plasma," and "bone regeneration" were the most frequent keywords in each cluster, which reflect the current interests in corresponding fields. Bone regeneration post-dental extractions is one of the main application directions in the field of oral and maxillofacial surgery. "Membrane," "injectable PRF (I-PRF)," "case report," and "advanced PRF (A-PRF)" were relative recent keywords in all clusters, indicating that manufacturing processes and new applications are promising research hotspots in the field. Conclusion  In the future, the applications of modified PRF, such as I-PRF, are promising research hotspots. Moreover, strict randomized controlled trials on PRF deserve more attention. The results of this analysis may be helpful for all scholars seeking to expand researches and innovations in the field of PRF.

Background:  India, with a large population working in industries, has a considerable amount of nail bed injuries day to day as well as infections and other issues with nails. However, there are no normative data for nail growth in our population. This study aims to measure and analyze the rate of nail growth in the Indian population, which will be a valuable tool for clinical assessment and treatment. Objective: The aim of the study was to estimate the average rate of nail growth of all fingers in the Indian population between the age group of 18 to 40 years. Materials and Methods: Fifty young adults whose 500 fingernails were painted with three coats of nail polish following a standardized protocol, and the rate of the growth of the nails was recorded with a digital Vernier caliper from the nail fold every 10 days for 1 month. Results: The average fingernail growth is 0.103 mm/d. There is no correlation of nail growth with sex or hand dominance. Nail growth is more in the left index finger (0.13 mm/d) and the left thumb, while it is the least in little fingers (0.101 mm/d). Initial fingernail growth was higher in older individuals, however. At the end of the study period, nail growth was equal. The nail growth rate reduces as the days progress. Conclusion: We have reported the normative data of nail growth as 0.103 mm per day. In the majority of the healthy population, this rate would hold true.

Background  The normal ability to distinguish two points from one is known as the two-point discriminative (2PD) sense. This forms an extremely important assessment in patient with injuries to the nerves distributed to the upper extremity. Objective  The aim of this study was to estimate the normal reference values of static 2PD in healthy adults and children. Materials and Methods  A total of 624 normal adults comprising 380 men and 244 women were recruited randomly for the study at three different centers. Additionally, 172 healthy children, comprising 110 boys and 62 girls, were studied. Eight sensory areas in the palmar surface of the hand were delineated. The ability to distinguish the static 2PD was estimated in millimeters by using disk discriminator. The results were tabulated and statistically analyzed. Results  The mean static 2PD in the adult population ranged from 2.78 to 3.5 mm in the fingertips and 5.39 to 7.13 mm in the mid-palm. There was a statistically significant difference between men and women in zones 6, 7, and 8. In children, the observed 2PD values were 2.15 to 3.63 mm in the fingertips and 4.10 to 5.77 mm in the palm. Children have a significantly better 2PD sense when compared with adults. Conclusion  The normal value of static 2PD in the palmar surface of the hand among the Indian pediatric and adult populations was established in the study.

Axillary breasts are a common entity with a reported incidence of 2 to 6% in women and 1 to 3% in men. They are more common amongst Asians than Caucasians, namely amongst South East Asians and Indians, with the highest incidence amongst Japanese. While modalities like CoolScupting™, Kybella™ injections, and BodyTite™ have been used by surgeons for management of axillary breasts, the most effective treatment for this condition remains surgical management involving a combination of liposuction of the axillary breast with excision of the gland and skin. In the author's experience, primary skin excision always leaves a long visible scar that widens over time, at times leading to contractures and restricted axillary movements even when closure looks tension free on the table. Any skin excess is best dealt with secondarily. The author uses a modified protocol without any primary skin excision in axillary breast management to achieve excellent results with minimal scars.

Background  The keystone design perforator island flap (KDPIF) was first described by Behan in 2003 as a pliable flap, suitable for all body areas thanks to its curvilinear shape, which made it apt to fit mostly all cutaneous defects. Materials and Methods  In this article, we aim to share our experience using KDPIF for the reconstruction of different defects. A retrospective analysis of patients who underwent cutaneous excision after trauma or tumor resection and reconstruction with a KDPIF at our department from 2020 to 2023 was performed. Patients' characteristics, indications, and operative and postoperative details were analyzed. Results  There was no complete flap loss. One patient experienced partial flap loss without exposure to major structures and needed skin grafting. Conclusion  Mapping of the perforators makes the keystone flap even more manageable, with the possibility to safely stretch and modify its design according to individual necessities.

Background  Gynecomastia results in a feminine appearance of the male chest, leading to social embarrassment and loss of self-esteem in the afflicted males. Grade 4 gynecomastia is expected to have less than perfect results with liposuction and gland excision alone. This study was done to assess the long-term outcome of this surgery for grade 4 gynecomastia. Materials and Methods  From January 2021 to December 2022, 81 patients with grade 4 gynecomastia were treated by us. All the patients underwent vibration amplification of sound energy at resonance (VASER) and suction-assisted liposuction of the chest and side rolls with excision of the gland with crescentic lift in the cases with ptosis. A retrospective study was done to analyze the long-term surgical outcomes in these patients by review of clinical records. Results  Symmetry was achieved in 37/39 patients with grade 4a gynecomastia but only in 33/42 patients with grade 4b gynecomastia. The inframammary fold disappeared in 35/39 patients with grade 4a gynecomastia but only in 25/42 of grade 4b gynecomastia patients. Ptosis was corrected in 35/42 grade 4b gynecomastia patients. The mean follow-up was 15 months (range: 12-24 months). Only seven patients desired a second stage to correct the remaining deformity. Conclusion  Liposuction with gland removal alone in grade 4a gynecomastia and with liposuction with crescentic nipple-areola complex (NAC) lift in patients of grade 4b gynecomastia give satisfactory results in patients with massively enlarged breasts. While grade 4a gynecomastia has overall better results and lesser complications as compared with grade 4b gynecomastia, the latter also has acceptable outcomes. Realistic prognosis needs to be explained to the patient preoperatively.

Background  Treatment of soft-tissue defects in the foot and ankle is a challenge. The use of a retrograde lateral supramalleolar flap is a promising technique for reconstruction. This study aims to assess the efficacy and outcomes of the technique. Materials and Methods  A prospective observational study was conducted from December 2017 to December 2022. Patients with soft-tissue defects in the foot and ankle underwent reconstruction using the retrograde lateral supramalleolar flap. Data on demographics, injury details, flap dimensions, complications, and outcomes were recorded and analyzed. Results  Forty-six flaps were used in the study. The average flap length was 17.47 cm. The maximum size of the flaps was 104 cm ² with an average of 48.43 cm ² . Venous congestion occurred in nine flaps, leading to partial necrosis in four cases. The overall success rate was 91.3%. Conclusion  The retrograde lateral supramalleolar flap is effective in covering soft-tissue defects in the foot and ankle.

Background  The first web space of the hand plays a crucial role in determining the hand's span. Our study aims to examine and quantify the first web space angle in both hands of adult individuals within the Indian population with no upper limb pathologies. The primary objective of this study is to establish normative data. These data will be useful in surgical correction for the first web release, recommending corrective splints, and calculating the percentage of disability in hand function. Materials and Methods  Data from 800 individuals from various regions across India, ranging in age from 20 to 50 years who had no pathology in both upper limbs were collected. A goniometer was used to measure the first web space angle of both hands by keeping the forearm pronated, elbow flexed, and arms adducted. The subjects from different states were divided into various zones. Results  In 800 subjects, the average measurement in the right hand was 97.28 degrees, and in the left hand, 99.76 degrees. In males, the average measurement in the right hand was 97.54 degrees, and in the left hand, it was 99.61 degrees. In females, in the right hand, it was 96.93 degrees, and in the left hand 100 degrees. The result was recorded in subjects from each zone in the country. Conclusion  The large sample size from various parts of the country makes the study more reliable. The technique of measuring the angles was easily reproducible. Our findings provide crucial normative data for clinicians and therapists.

Background  Diwali is a festival that is passionately celebrated by Indians all across the globe. Fire hazards associated with this festival are well known. Our hospital is a tertiary care burn center and caters to a patient population from all over North India. Firecracker burns and diya burns constitute two major causes of burn injuries during the festival of Diwali. Since, diya-related burn injuries have been overlooked in the past, this study was primarily designed to study the demographical data of "diya burns" during Diwali. Materials and Methods  The departmental records were analyzed for 3 days around Diwali festival over a period of 5 years from 2018 to 2022. Results  The results indicated that almost a third of all Diwali-related burns were caused by diyas (32.5%). A "burning diya left on floor" was the main reason for these injuries. Females were the most affected (70.4%). Additionally, one-third of these patients required admission. Conclusion  This study emphasizes the need for raising awareness regarding the proper use of "diyas" to bring down the incidence of such preventable burn injuries.