Pub Date : 2024-07-18eCollection Date: 2024-07-01DOI: 10.1055/a-2268-6986
Woo Yeon Han, Yeongsong Kim, Pyeong Hwa Kim, Eun Key Kim
Although many studies reported the safety and efficacy of high-intensity focused ultrasound (HIFU) therapy, there are still worries about internal organ injury. However, reports of abdominal wall hernias after HIFU therapy are rare. We present three cases of abdominal wall hernias without skin injury after HIFU therapy in uterine adenomyosis or fibroids. The diagnosis was often delayed because of vague symptoms, inadequate clinical suspicion, and delayed proper image studies. Abdominal wall hernia should be recognized as a possible complication after HIFU and be suspected when the patient presents with unordinary abdominal swelling and/or pain that lasts for more than a few months after the procedure.
{"title":"Abdominal Wall Hernias Following High-intensity Focused Ultrasound Therapy: Three Case Reports.","authors":"Woo Yeon Han, Yeongsong Kim, Pyeong Hwa Kim, Eun Key Kim","doi":"10.1055/a-2268-6986","DOIUrl":"10.1055/a-2268-6986","url":null,"abstract":"<p><p>Although many studies reported the safety and efficacy of high-intensity focused ultrasound (HIFU) therapy, there are still worries about internal organ injury. However, reports of abdominal wall hernias after HIFU therapy are rare. We present three cases of abdominal wall hernias without skin injury after HIFU therapy in uterine adenomyosis or fibroids. The diagnosis was often delayed because of vague symptoms, inadequate clinical suspicion, and delayed proper image studies. Abdominal wall hernia should be recognized as a possible complication after HIFU and be suspected when the patient presents with unordinary abdominal swelling and/or pain that lasts for more than a few months after the procedure.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11257745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-18eCollection Date: 2024-07-01DOI: 10.1055/a-2351-9736
Joon Pio Hong, Jaume Masià
{"title":"\"Funducation\"-The New Age of Learning, Intersection of Education, and Fun.","authors":"Joon Pio Hong, Jaume Masià","doi":"10.1055/a-2351-9736","DOIUrl":"https://doi.org/10.1055/a-2351-9736","url":null,"abstract":"","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11257739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-14eCollection Date: 2024-07-01DOI: 10.1055/a-2258-2586
Sunkyu Park, Inhoe Ku, Ji-Ung Park
Carotid-cavernous fistula (CCF) is a rare condition. However, it should be suspected when there are traumatic facial fractures, because if not diagnosed, it can lead to permanent damage such as blindness. Traumatic CCF often presents delayed symptoms, and delayed diagnosis without prompt treatment can lead to permanent injuries in optic and cranial nerves III, IV, V, and VI as well as intracranial hemorrhage. The routine initial modality for patients with suspected facial bone fractures is noncontrast computed tomography (CT) to identify any fracture lines and check for intracranial hemorrhage. We report a post-traumatic CCF case with a 4-day symptom delay, where left superior ophthalmic vein (SOV) enlargement was observed on the routine noncontrast facial CT with ipsilateral orbital wall fracture. When the patient first presented to the emergency room (ER), we did not detect vein enlargement on CT. Afterwards, the patient developed delayed symptoms of CCF and was readmitted to the ER. When we reanalyzed the first CT scan, an enlarged SOV was confirmed. The diagnosis was confirmed via magnetic resonance imaging angiography, and the patient was successfully treated with embolization of the fistula. Thus, we recommend reviewing ophthalmic vein enlargement that is readily identifiable through noncontrast CT for patients injured by craniofacial trauma to suspect the presence of delayed CCF at their initial presentation.
{"title":"Neglected Superior Ophthalmic Vein Enlargement before Delayed Symptom of Carotid-Cavernous Fistula in a Blowout Fracture: A Case Report and Literature Review.","authors":"Sunkyu Park, Inhoe Ku, Ji-Ung Park","doi":"10.1055/a-2258-2586","DOIUrl":"10.1055/a-2258-2586","url":null,"abstract":"<p><p>Carotid-cavernous fistula (CCF) is a rare condition. However, it should be suspected when there are traumatic facial fractures, because if not diagnosed, it can lead to permanent damage such as blindness. Traumatic CCF often presents delayed symptoms, and delayed diagnosis without prompt treatment can lead to permanent injuries in optic and cranial nerves III, IV, V, and VI as well as intracranial hemorrhage. The routine initial modality for patients with suspected facial bone fractures is noncontrast computed tomography (CT) to identify any fracture lines and check for intracranial hemorrhage. We report a post-traumatic CCF case with a 4-day symptom delay, where left superior ophthalmic vein (SOV) enlargement was observed on the routine noncontrast facial CT with ipsilateral orbital wall fracture. When the patient first presented to the emergency room (ER), we did not detect vein enlargement on CT. Afterwards, the patient developed delayed symptoms of CCF and was readmitted to the ER. When we reanalyzed the first CT scan, an enlarged SOV was confirmed. The diagnosis was confirmed via magnetic resonance imaging angiography, and the patient was successfully treated with embolization of the fistula. Thus, we recommend reviewing ophthalmic vein enlargement that is readily identifiable through noncontrast CT for patients injured by craniofacial trauma to suspect the presence of delayed CCF at their initial presentation.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11257734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-14eCollection Date: 2024-07-01DOI: 10.1055/s-0044-1787002
Mona Haj, S N Hakkesteegt, H G Poldermans, H H W de Gier, S L Versnel, E B Wolvius
Background The best timing of closure of the hard palate in individuals with cleft lip, alveolus, and palate (CLAP) to reach the optimal speech outcomes and maxillary growth is still a subject of debate. This study evaluates changes in compensatory articulatory patterns and resonance in patients with unilateral and bilateral CLAP who underwent simultaneous closure of the hard palate and secondary alveolar bone grafting (ABG). Methods A retrospective study of patients with nonsyndromic unilateral and bilateral CLAP who underwent delayed hard palate closure (DHPC) simultaneously with ABG at 9 to 12 years of age from 2013 to 2018. The articulatory patterns, nasality, degree of hypernasality, facial grimacing, and speech intelligibility were assessed pre- and postoperatively. Results Forty-eight patients were included. DHPC and ABG were performed at the mean age of 10.5 years. Postoperatively hypernasal speech was still present in 54% of patients; however, the degree of hypernasality decreased in 67% ( p < 0.001). Grimacing decreased in 27% ( p = 0.015). Articulation disorders remained present in 85% ( p = 0.375). Intelligible speech (grade 1 or 2) was observed in 71 compared with 35% of patients preoperatively ( p < 0.001). Conclusion This study showed an improved resonance and intelligibility following DHPC at the mean age of 10.5 years, however compensatory articulation errors persisted. Sequential treatments such as speech therapy play a key role in improvement of speech and may reduce remaining compensatory mechanisms following DHPC.
{"title":"Speech Outcomes after Delayed Hard Palate Closure and Synchronous Secondary Alveolar Bone Grafting in Patients with Cleft Lip, Alveolus and Palate.","authors":"Mona Haj, S N Hakkesteegt, H G Poldermans, H H W de Gier, S L Versnel, E B Wolvius","doi":"10.1055/s-0044-1787002","DOIUrl":"10.1055/s-0044-1787002","url":null,"abstract":"<p><p><b>Background</b> The best timing of closure of the hard palate in individuals with cleft lip, alveolus, and palate (CLAP) to reach the optimal speech outcomes and maxillary growth is still a subject of debate. This study evaluates changes in compensatory articulatory patterns and resonance in patients with unilateral and bilateral CLAP who underwent simultaneous closure of the hard palate and secondary alveolar bone grafting (ABG). <b>Methods</b> A retrospective study of patients with nonsyndromic unilateral and bilateral CLAP who underwent delayed hard palate closure (DHPC) simultaneously with ABG at 9 to 12 years of age from 2013 to 2018. The articulatory patterns, nasality, degree of hypernasality, facial grimacing, and speech intelligibility were assessed pre- and postoperatively. <b>Results</b> Forty-eight patients were included. DHPC and ABG were performed at the mean age of 10.5 years. Postoperatively hypernasal speech was still present in 54% of patients; however, the degree of hypernasality decreased in 67% ( <i>p</i> < 0.001). Grimacing decreased in 27% ( <i>p</i> = 0.015). Articulation disorders remained present in 85% ( <i>p</i> = 0.375). Intelligible speech (grade 1 or 2) was observed in 71 compared with 35% of patients preoperatively ( <i>p</i> < 0.001). <b>Conclusion</b> This study showed an improved resonance and intelligibility following DHPC at the mean age of 10.5 years, however compensatory articulation errors persisted. Sequential treatments such as speech therapy play a key role in improvement of speech and may reduce remaining compensatory mechanisms following DHPC.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11257747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Fixation Techniques to Maintain Position for a Cross Leg Flap: Technical Tips and Algorithmic Approach.","authors":"Vinita Puri, Raghav Shrotriya, Chandrashekhar Chalwade","doi":"10.1055/s-0044-1786194","DOIUrl":"10.1055/s-0044-1786194","url":null,"abstract":"","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11257742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-13eCollection Date: 2024-07-01DOI: 10.1055/a-2317-4520
Jenisa Amanda Sandiarini Kamayana, Agus Roy Rusly Hariantana Hamid, Tjokorda Gde Bagus Mahadewa, I Gusti Putu Hendra Sanjaya, I Made Darmajaya, I Gusti Ayu Sri Mahendra Dewi
Background The risk of flap necrosis in tissue reconstruction surgery is elevated in patients with vascular disorders, such as diabetes mellitus. Chronic hyperglycemia causes endothelial cell dysfunction and increases inflammatory process, causing vascular insufficiency. Platelet-rich plasma (PRP) contains high levels of platelets, growth factors, and fibrinogens. Its regenerative properties spark interest in supporting flap survival in relation to diabetic complications. Methods Thirty Wistar rats were divided into three groups. The first group included diabetic rats without PRP injection, which underwent flap procedure. The second group included diabetes-induced rats receiving PRP subcutaneous injection 1 day prior to flap procedure. The third group included nondiabetic rats receiving PRP injection 1 day prior to flap procedure. Flap tissue samples were taken on the seventh day to measure vascular endothelial growth factor (VEGF) levels using enzyme-linked immunosorbent assay method; angiogenesis and collagen density were measured from histopathology examination, and flap viability was analyzed using digital measurements. Results Analysis showed that flap viability, angiogenesis, and VEGF levels were significantly higher in the PRP-injected diabetic rats compared with diabetic rats that did not receive PRP. The levels of VEGF, angiogenesis, and viability of flaps in diabetic rats given PRP did not differ significantly compared with nondiabetic rats that received PRP. Conclusion Flap preconditioning through local injection of activated PRP enhances flap viability, VEGF levels and angiogenesis, in random skin flaps in diabetic rats, to the level where it does not differ significantly to nondiabetic rats that were given PRP.
{"title":"Preconditioning Local Injection of Activated Platelet-Rich Plasma Increases Angiogenesis, VEGF Levels, and Viability of Modified McFarlane Flap in Diabetes-Induced Rats.","authors":"Jenisa Amanda Sandiarini Kamayana, Agus Roy Rusly Hariantana Hamid, Tjokorda Gde Bagus Mahadewa, I Gusti Putu Hendra Sanjaya, I Made Darmajaya, I Gusti Ayu Sri Mahendra Dewi","doi":"10.1055/a-2317-4520","DOIUrl":"10.1055/a-2317-4520","url":null,"abstract":"<p><p><b>Background</b> The risk of flap necrosis in tissue reconstruction surgery is elevated in patients with vascular disorders, such as diabetes mellitus. Chronic hyperglycemia causes endothelial cell dysfunction and increases inflammatory process, causing vascular insufficiency. Platelet-rich plasma (PRP) contains high levels of platelets, growth factors, and fibrinogens. Its regenerative properties spark interest in supporting flap survival in relation to diabetic complications. <b>Methods</b> Thirty Wistar rats were divided into three groups. The first group included diabetic rats without PRP injection, which underwent flap procedure. The second group included diabetes-induced rats receiving PRP subcutaneous injection 1 day prior to flap procedure. The third group included nondiabetic rats receiving PRP injection 1 day prior to flap procedure. Flap tissue samples were taken on the seventh day to measure vascular endothelial growth factor (VEGF) levels using enzyme-linked immunosorbent assay method; angiogenesis and collagen density were measured from histopathology examination, and flap viability was analyzed using digital measurements. <b>Results</b> Analysis showed that flap viability, angiogenesis, and VEGF levels were significantly higher in the PRP-injected diabetic rats compared with diabetic rats that did not receive PRP. The levels of VEGF, angiogenesis, and viability of flaps in diabetic rats given PRP did not differ significantly compared with nondiabetic rats that received PRP. <b>Conclusion</b> Flap preconditioning through local injection of activated PRP enhances flap viability, VEGF levels and angiogenesis, in random skin flaps in diabetic rats, to the level where it does not differ significantly to nondiabetic rats that were given PRP.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11257746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-13eCollection Date: 2024-07-01DOI: 10.1055/s-0044-1782142
Federico Facchin, Elmar Fritsche, Alberto Franchi
Persistent lymphocele of the groin is a complication of groin surgery that can severely impact the quality of life. The restoration of the interrupted lymphatic pathway is considered by many authors the ideal treatment to prevent a recurrence. However, multiple aspiration procedures and surgical revisions can compromise the availability of local veins needed for a lymphovenular bypass surgery. In addition, surgical debridement of a long-standing lymphocele can generate extensive dead space and contour deformity. A flap delivering additional venules for trans-flap lymphovenular anastomoses (LVAs) can overcome both problems by providing soft tissue and competent veins harvested outside the zone of injury. A successful case of severe groin lymphocele treated with trans-flap LVAs from an abdominal-based flap is presented. The patient was referred to us for a recurrent lymphocele developed in the right groin after lipoma excision that persisted despite multiple surgical attempts. After the identification of patent and draining inguinal lymphatic vessels, a pinch test was used to design a mini-abdominoplasty superficial inferior epigastric artery flap. The superficial veins of the cranial incision were identified and anastomosed to the lymphatic vessels after the pedicled flap harvested and insetted in the groin. The early restoration of lymphatic drainage and the optimal aesthetic outcome supports the combined approach offered by trans-flap LVAs as a valuable therapeutic option for severe and persistent lymphocele.
{"title":"LVAs in a Pedicled SIEA Flap for the Treatment of Recurrent Lymphocele of the Groin Using Superficial Veins of the Flap for Lymphovenous Anastomosis: A Case Report and Literature Review.","authors":"Federico Facchin, Elmar Fritsche, Alberto Franchi","doi":"10.1055/s-0044-1782142","DOIUrl":"10.1055/s-0044-1782142","url":null,"abstract":"<p><p>Persistent lymphocele of the groin is a complication of groin surgery that can severely impact the quality of life. The restoration of the interrupted lymphatic pathway is considered by many authors the ideal treatment to prevent a recurrence. However, multiple aspiration procedures and surgical revisions can compromise the availability of local veins needed for a lymphovenular bypass surgery. In addition, surgical debridement of a long-standing lymphocele can generate extensive dead space and contour deformity. A flap delivering additional venules for trans-flap lymphovenular anastomoses (LVAs) can overcome both problems by providing soft tissue and competent veins harvested outside the zone of injury. A successful case of severe groin lymphocele treated with trans-flap LVAs from an abdominal-based flap is presented. The patient was referred to us for a recurrent lymphocele developed in the right groin after lipoma excision that persisted despite multiple surgical attempts. After the identification of patent and draining inguinal lymphatic vessels, a pinch test was used to design a mini-abdominoplasty superficial inferior epigastric artery flap. The superficial veins of the cranial incision were identified and anastomosed to the lymphatic vessels after the pedicled flap harvested and insetted in the groin. The early restoration of lymphatic drainage and the optimal aesthetic outcome supports the combined approach offered by trans-flap LVAs as a valuable therapeutic option for severe and persistent lymphocele.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11257738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-09eCollection Date: 2024-05-01DOI: 10.1055/a-2166-8783
Lucía Sisternas Hernández, Susana López Fernández, Paúl D Zamora Alarcón, Carmen Vega García, Laura Torrano Romero, Manuel Fernández Garrido
The superficial circumflex iliac artery (SCIA) perforator (SCIP) flap has been used for scrotal reconstruction after Fournier's gangrene, skin cancer, or infections. However, there are few publications with regard to penoscrotal reconstruction after a traumatic injury with this flap. In this article, we propose a new SCIP flap variation, the "extended" or "direct" SCIP flap, to effectively reconstruct a wide scrotal defect after a traumatic injury. The "extended" SCIP flap is designed medial and cranial to the anterosuperior iliac spine (ASIS) using the superficial branch of the SCIA as the main pedicle.
{"title":"Posttraumatic Scrotal Reconstruction with a Pedicled \"Extended\" Superficial Circumflex Iliac Artery Perforator Flap: A Case Report.","authors":"Lucía Sisternas Hernández, Susana López Fernández, Paúl D Zamora Alarcón, Carmen Vega García, Laura Torrano Romero, Manuel Fernández Garrido","doi":"10.1055/a-2166-8783","DOIUrl":"10.1055/a-2166-8783","url":null,"abstract":"<p><p>The superficial circumflex iliac artery (SCIA) perforator (SCIP) flap has been used for scrotal reconstruction after Fournier's gangrene, skin cancer, or infections. However, there are few publications with regard to penoscrotal reconstruction after a traumatic injury with this flap. In this article, we propose a new SCIP flap variation, the \"extended\" or \"direct\" SCIP flap, to effectively reconstruct a wide scrotal defect after a traumatic injury. The \"extended\" SCIP flap is designed medial and cranial to the anterosuperior iliac spine (ASIS) using the superficial branch of the SCIA as the main pedicle.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41948579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-04eCollection Date: 2024-05-01DOI: 10.1055/a-2258-2438
Holly D Shan, Samuel S Huffman, John D Bovill, Zoë K Haffner, Parhom Towfighi, Carol D Benedict, Karen K Evans
Background Hidradenitis suppurativa (HS) is associated with a high prevalence of psychiatric disorders. However, no studies examine how psychiatric disorders influence surgical and financial outcomes. This study aimed to assess impact of a psychiatric diagnosis on patients treated for HS. Methods Patients with HS were retrospectively identified at a single institution from 2010 to 2021. Cohorts were stratified by the presence of a psychiatric disorder. Demographics, comorbidities, and disease characteristics were collected. Outcomes assessed included the procedural interventions and emergency department (ED) visits. Financial distress was assessed via the COST-FACIT Version 2 survey. Results Out of 138 patients, 40 (29.0%) completed the survey of which 19 (47.5%) had a preexisting psychiatric diagnosis. No demographic differences were found between cohorts. Mean follow-up was 16.1 ± 11.0 months. The psychiatric cohort had a higher median number of surgeries received (7.0 vs. 1.5, p < 0.001), a higher median number of ED visits (1.0 vs. 0, p = 0.006), and a similar hospital length of stay ( p = 0.456). The mean COST-FACIT score of the overall study population was 19.2 ± 10.7 (grade 1 financial toxicity). The psych cohort had a lower mean COST-FACIT score (16.8 vs. 21.3, p = 0.092) and reported greater financial hardship (3.3 vs. 1.7, p < 0.001). On multivariate analysis, a psychiatric diagnosis was predictive of lower credit scores, more ED visits, and a higher number of surgeries. Conclusion Preexisting psychiatric conditions in patients with HS are associated with increased health care utilization and surgical intervention with substantial financial distress. Plastic surgeons should be cognizant of such comorbid disorders to facilitate holistic care addressing all patient needs.
{"title":"Psychiatric Influences on Hidradenitis Suppurativa: A Call for Help.","authors":"Holly D Shan, Samuel S Huffman, John D Bovill, Zoë K Haffner, Parhom Towfighi, Carol D Benedict, Karen K Evans","doi":"10.1055/a-2258-2438","DOIUrl":"10.1055/a-2258-2438","url":null,"abstract":"<p><p><b>Background</b> Hidradenitis suppurativa (HS) is associated with a high prevalence of psychiatric disorders. However, no studies examine how psychiatric disorders influence surgical and financial outcomes. This study aimed to assess impact of a psychiatric diagnosis on patients treated for HS. <b>Methods</b> Patients with HS were retrospectively identified at a single institution from 2010 to 2021. Cohorts were stratified by the presence of a psychiatric disorder. Demographics, comorbidities, and disease characteristics were collected. Outcomes assessed included the procedural interventions and emergency department (ED) visits. Financial distress was assessed via the COST-FACIT Version 2 survey. <b>Results</b> Out of 138 patients, 40 (29.0%) completed the survey of which 19 (47.5%) had a preexisting psychiatric diagnosis. No demographic differences were found between cohorts. Mean follow-up was 16.1 ± 11.0 months. The psychiatric cohort had a higher median number of surgeries received (7.0 vs. 1.5, <i>p</i> < 0.001), a higher median number of ED visits (1.0 vs. 0, <i>p</i> = 0.006), and a similar hospital length of stay ( <i>p</i> = 0.456). The mean COST-FACIT score of the overall study population was 19.2 ± 10.7 (grade 1 financial toxicity). The psych cohort had a lower mean COST-FACIT score (16.8 vs. 21.3, <i>p</i> = 0.092) and reported greater financial hardship (3.3 vs. 1.7, <i>p</i> < 0.001). On multivariate analysis, a psychiatric diagnosis was predictive of lower credit scores, more ED visits, and a higher number of surgeries. <b>Conclusion</b> Preexisting psychiatric conditions in patients with HS are associated with increased health care utilization and surgical intervention with substantial financial distress. Plastic surgeons should be cognizant of such comorbid disorders to facilitate holistic care addressing all patient needs.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-04eCollection Date: 2022-05-01DOI: 10.1055/s-0043-1777242
Mohamed Ali Mahgoub
{"title":"Commentary: Gluteal Region Reshaping of Massive Weight Loss Patients-A Decision-Making Strategy.","authors":"Mohamed Ali Mahgoub","doi":"10.1055/s-0043-1777242","DOIUrl":"https://doi.org/10.1055/s-0043-1777242","url":null,"abstract":"","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10911891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}