Journal of Plastic Reconstructive and Aesthetic Surgery最新文献

英文中文

Clinical validation of a novel risk assessment score for prediction of unplanned reoperations and readmissions in hand surgery

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-04-17 DOI: 10.1016/j.bjps.2025.04.013

Olachi O. Oleru, Nargiz Seyidova, Jamie Frost, Niklas H. Koehne, Prabhjot Singh, Peter J. Taub

引用次数: 0

Comment on “Predictors of seroma after breast reduction: When should drains be considered?”

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-04-15 DOI: 10.1016/j.bjps.2025.04.012

Gaia Ghiringhelli, Eleonora Bulgarelli, Elisa Dolfato, Elisa Bascialla, Manuela Bottoni, Mario Rietjens, Fernando Rosatti, Andrea Vittorio Emanuele Lisa

引用次数: 0

Let’s talk about it: A virtual peer support group for plastic surgeons and trainees to improve confidence and feasibility in family planning

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-04-14 DOI: 10.1016/j.bjps.2025.03.059

Madeleine Givant , Xinfei Miao , Kassandra Carrion , Aileen Gozali , Youssef Aref , Jasmine Chaij , Sarah M. Gubara , Gabriella Tavera , Wendy Chen

引用次数: 0

Intermammary distance and medial breast cleavage: The role of autogenous fat grafting and small volume implants

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-04-10 DOI: 10.1016/j.bjps.2025.04.005

Alexandre Mendonça Munhoz

引用次数: 0

Fat-augmented latissimus dorsi flap and implant-based latissimus dorsi flap: A systematic review

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-04-08 DOI: 10.1016/j.bjps.2025.04.003

Joran Tilkin , Julie Paternoster , Anne Cooreman , Thomas Nevens , Patrick Neven , Jan J. Vranckx

Background

Implant-related concerns have increased the interest in the use of complete autologous latissimus dorsi (LD) flaps in breast reconstruction. To achieve the desired volume without implants, autologous fat transfer can be used to enhance the breast size. Fat-augmented LD (FALD) flap is an alternative technique for volume enhancement that incorporates autologous fat grafting, thereby replacing the need for implants.

Methods

A systematic literature search was performed according to the preferred reporting items for systematic reviews and meta-analyses protocol using the PubMed, Embase, Web of Science, Scopus, CENTRAL, ICTRP and Clinicaltrials.gov databases. Data on patient-reported outcomes and clinical outcomes were extracted.

Results

The electronic database search identified 2606 records, among which 71 met the inclusion criteria. A total of 67 articles were included in the statistical analysis, reporting on 1185 FALD and 3958 implant-based LD flap breast reconstructions. Patient demographics and treatment characteristics were generally comparable across studies. The reported minor complication rate for implant-based LD was 23.9% (95% confidence intervals [CI]: 18.2–30.6%) and 25.1% (95% CI: 17.5–34.5%) for FALD. The major complication rate was 2.4% (95% CI: 1.3–4.4%) in the FALD group and 4.9% (95% CI: 3.4–7.2%) in the implant-based LD group.

Conclusion

This systematic review provides an overview of the current literature on both techniques and presents the available data on complication rates and patient-reported outcomes. The findings suggest that FALD is a safe alternative, with a potential trend towards lower major complication rates. Further high-quality comparative studies are needed to enable direct comparison and to draw more definitive conclusions.

{"title":"Fat-augmented latissimus dorsi flap and implant-based latissimus dorsi flap: A systematic review","authors":"Joran Tilkin , Julie Paternoster , Anne Cooreman , Thomas Nevens , Patrick Neven , Jan J. Vranckx","doi":"10.1016/j.bjps.2025.04.003","DOIUrl":"10.1016/j.bjps.2025.04.003","url":null,"abstract":"<div><h3>Background</h3><div>Implant-related concerns have increased the interest in the use of complete autologous latissimus dorsi (LD) flaps in breast reconstruction. To achieve the desired volume without implants, autologous fat transfer can be used to enhance the breast size. Fat-augmented LD (FALD) flap is an alternative technique for volume enhancement that incorporates autologous fat grafting, thereby replacing the need for implants.</div></div><div><h3>Methods</h3><div>A systematic literature search was performed according to the preferred reporting items for systematic reviews and meta-analyses protocol using the PubMed, Embase, Web of Science, Scopus, CENTRAL, ICTRP and Clinicaltrials.gov databases. Data on patient-reported outcomes and clinical outcomes were extracted.</div></div><div><h3>Results</h3><div>The electronic database search identified 2606 records, among which 71 met the inclusion criteria. A total of 67 articles were included in the statistical analysis, reporting on 1185 FALD and 3958 implant-based LD flap breast reconstructions. Patient demographics and treatment characteristics were generally comparable across studies. The reported minor complication rate for implant-based LD was 23.9% (95% confidence intervals [CI]: 18.2–30.6%) and 25.1% (95% CI: 17.5–34.5%) for FALD. The major complication rate was 2.4% (95% CI: 1.3–4.4%) in the FALD group and 4.9% (95% CI: 3.4–7.2%) in the implant-based LD group.</div></div><div><h3>Conclusion</h3><div>This systematic review provides an overview of the current literature on both techniques and presents the available data on complication rates and patient-reported outcomes. The findings suggest that FALD is a safe alternative, with a potential trend towards lower major complication rates. Further high-quality comparative studies are needed to enable direct comparison and to draw more definitive conclusions.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"105 ","pages":"Pages 136-147"},"PeriodicalIF":2.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of the beauty standards for forehead morphology in Black women: Implications in surgical and non-surgical forehead contouring

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-04-07 DOI: 10.1016/j.bjps.2025.04.001

Palak P. Oza , Andrew H. Lee

Owing to its importance in gender perception, forehead feminizing cranioplasty represents one of the most impactful components of facial feminization surgery. However, aesthetic standards for these procedures are informed largely by Caucasian beauty standards, which may not fully reflect those of other populations. This study evaluated the differences in forehead shape between conventionally beautiful Black and similarly identified Caucasian women. Two lists published by an independent publication (StyleCraze), “26 Most Beautiful African Women” and “52 Most Beautiful Women in the World,” were used to identify Black and White women for comparison. Side profile images of the women were analyzed and compared using elliptical and piecewise linear models via multiple anatomic slope, angle, and eccentricity measurements. Black women were found to have a reduced forehead eccentricity (0.91 vs. 0.94, Cohen’s d=0.88), indicating greater roundness of the forehead. In the piecewise linear model, there was a more acute angle of the inferior forehead in the Black women (160.72° vs. 170.01°, Cohen’s d=1.57); this region, in particular, was responsible for the increased roundedness of the forehead in the Black models. Thus, the forehead shape in conventionally beautiful Black women has significant differences compared to similarly identified Caucasian women. Surgical planning for feminizing cranioplasty in this population should consider this underlying morphological variation for optimal cosmetic outcomes. Furthermore, we demonstrated a novel methodology using elliptical and piecewise linear models to approximate the curved surface of the forehead, which may provide a basis for future studies.

{"title":"Evaluation of the beauty standards for forehead morphology in Black women: Implications in surgical and non-surgical forehead contouring","authors":"Palak P. Oza , Andrew H. Lee","doi":"10.1016/j.bjps.2025.04.001","DOIUrl":"10.1016/j.bjps.2025.04.001","url":null,"abstract":"<div><div>Owing to its importance in gender perception, forehead feminizing cranioplasty represents one of the most impactful components of facial feminization surgery. However, aesthetic standards for these procedures are informed largely by Caucasian beauty standards, which may not fully reflect those of other populations. This study evaluated the differences in forehead shape between conventionally beautiful Black and similarly identified Caucasian women. Two lists published by an independent publication (<em>StyleCraze)</em>, “26 Most Beautiful African Women” and “52 Most Beautiful Women in the World,” were used to identify Black and White women for comparison. Side profile images of the women were analyzed and compared using elliptical and piecewise linear models via multiple anatomic slope, angle, and eccentricity measurements. Black women were found to have a reduced forehead eccentricity (0.91 vs. 0.94, Cohen’s d=0.88), indicating greater roundness of the forehead. In the piecewise linear model, there was a more acute angle of the inferior forehead in the Black women (160.72° vs. 170.01°, Cohen’s d=1.57); this region, in particular, was responsible for the increased roundedness of the forehead in the Black models. Thus, the forehead shape in conventionally beautiful Black women has significant differences compared to similarly identified Caucasian women. Surgical planning for feminizing cranioplasty in this population should consider this underlying morphological variation for optimal cosmetic outcomes. Furthermore, we demonstrated a novel methodology using elliptical and piecewise linear models to approximate the curved surface of the forehead, which may provide a basis for future studies.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"105 ","pages":"Pages 117-122"},"PeriodicalIF":2.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sitting vs. standing: The impact of surgeon posture on patient perception of visit duration in the outpatient plastic surgery clinic

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-04-07 DOI: 10.1016/j.bjps.2025.04.006

Evan Rothchild, Isabelle T. Smith, Joseph A. Ricci

Background

Patients commonly feel a medical professional spends more time with them when the provider is seated during a visit rather than standing. However, no empirical evidence supports this claim in the outpatient setting or specifically in plastic surgery clinics. This study aimed to provide quantitative evidence to support or refute this perception.

Methods

We conducted a prospective, randomized, controlled study at a single surgeon’s outpatient plastic surgery clinic. Patients were randomly assigned to either the sitting or standing group, and the surgeon entered the room and conducted the visit as usual with the assigned posture. Data on the timed and perceived interaction times were collected and analyzed.

Results

A total of 131 patients were enrolled. The mean timed visit duration recorded by the student researcher and the mean perceived visit time reported by patients were significantly longer in the sitting group. However, neither the absolute nor proportional difference between timed and perceived visit durations varied significantly between groups.

Conclusion

These results suggest that patients accurately estimated the duration of their visits regardless of the surgeon’s posture. Therefore, the increased perception of time spent with providers during sitting visits is attributable to an actual longer visit duration rather than an illusion created by the provider’s posture. Thus, sitting offers no substantial benefit in enhancing the perception of a longer interaction. The real time spent with the patient ultimately influences the patient’s experience.

{"title":"Sitting vs. standing: The impact of surgeon posture on patient perception of visit duration in the outpatient plastic surgery clinic","authors":"Evan Rothchild, Isabelle T. Smith, Joseph A. Ricci","doi":"10.1016/j.bjps.2025.04.006","DOIUrl":"10.1016/j.bjps.2025.04.006","url":null,"abstract":"<div><h3>Background</h3><div>Patients commonly feel a medical professional spends more time with them when the provider is seated during a visit rather than standing. However, no empirical evidence supports this claim in the outpatient setting or specifically in plastic surgery clinics. This study aimed to provide quantitative evidence to support or refute this perception.</div></div><div><h3>Methods</h3><div>We conducted a prospective, randomized, controlled study at a single surgeon’s outpatient plastic surgery clinic. Patients were randomly assigned to either the sitting or standing group, and the surgeon entered the room and conducted the visit as usual with the assigned posture. Data on the timed and perceived interaction times were collected and analyzed.</div></div><div><h3>Results</h3><div>A total of 131 patients were enrolled. The mean timed visit duration recorded by the student researcher and the mean perceived visit time reported by patients were significantly longer in the sitting group. However, neither the absolute nor proportional difference between timed and perceived visit durations varied significantly between groups.</div></div><div><h3>Conclusion</h3><div>These results suggest that patients accurately estimated the duration of their visits regardless of the surgeon’s posture. Therefore, the increased perception of time spent with providers during sitting visits is attributable to an actual longer visit duration rather than an illusion created by the provider’s posture. Thus, sitting offers no substantial benefit in enhancing the perception of a longer interaction. The real time spent with the patient ultimately influences the patient’s experience.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"105 ","pages":"Pages 85-87"},"PeriodicalIF":2.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Scarpa fascia preservation abdominoplasty combined with precise liposuction for postpregnancy abdomen: A 10-year experience

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-04-07 DOI: 10.1016/j.bjps.2025.04.004

Yi Tian , Yiwen Deng , Ben Wang , Youcai Yan

Background

Abdominoplasty is widely performed in plastic surgery. Currently, there is a high demand for abdominoplasty among women who experience abdominal wall laxity after pregnancy. The aim of this study was to present modified abdominoplasty combined with power-assisted liposuction and ultrasound-assisted liposuction for postpregnancy women with abdominal wall laxity.

Methods

This retrospective study included a total of 190 cases of postpartum women presenting with abdominal wall laxity from January 2015 to April 2023. The patients were divided into 2 groups: the abdominoplasty and abdominoplasty combined with precise liposuction groups. The age, body mass index, reproductive history, abdominal circumference, surgical strategy, surgical details, and complications were considered during evaluation. Patient satisfaction was evaluated using a questionnaire that incorporated the visual analog scale (VAS) and Beck Depression Inventory (BDI).

Results

The average postoperative follow-up period in this study group was 10.1 months. The abdominoplasty combined with precise liposuction group exhibited significantly reduced upper and lower abdominal circumferences compared to the abdominoplasty group (P<0.05). The postoperative VAS score of the combined group was significantly higher than that of the abdominoplasty group (P<0.05), while the postoperative BDI score of the combined group was significantly lower compared to that of the abdominoplasty group (P<0.05). The BDI results revealed a significant reduction in the prevalence of moderate depression among post-surgery patients, declining from 94.2% to 3.6%.

Conclusions

Scarpa fascia preservation abdominoplasty combined with precise liposuction is a suitable procedure for postpregnancy abdomen. The modified abdominoplasty demonstrates favorable therapeutic outcomes, optimal flap blood supply, minimal flap tension, inconspicuous postoperative scar, and meticulous body contouring.

{"title":"Scarpa fascia preservation abdominoplasty combined with precise liposuction for postpregnancy abdomen: A 10-year experience","authors":"Yi Tian , Yiwen Deng , Ben Wang , Youcai Yan","doi":"10.1016/j.bjps.2025.04.004","DOIUrl":"10.1016/j.bjps.2025.04.004","url":null,"abstract":"<div><h3>Background</h3><div>Abdominoplasty is widely performed in plastic surgery. Currently, there is a high demand for abdominoplasty among women who experience abdominal wall laxity after pregnancy. The aim of this study was to present modified abdominoplasty combined with power-assisted liposuction and ultrasound-assisted liposuction for postpregnancy women with abdominal wall laxity.</div></div><div><h3>Methods</h3><div>This retrospective study included a total of 190 cases of postpartum women presenting with abdominal wall laxity from January 2015 to April 2023. The patients were divided into 2 groups: the abdominoplasty and abdominoplasty combined with precise liposuction groups. The age, body mass index, reproductive history, abdominal circumference, surgical strategy, surgical details, and complications were considered during evaluation. Patient satisfaction was evaluated using a questionnaire that incorporated the visual analog scale (VAS) and Beck Depression Inventory (BDI).</div></div><div><h3>Results</h3><div>The average postoperative follow-up period in this study group was 10.1 months. The abdominoplasty combined with precise liposuction group exhibited significantly reduced upper and lower abdominal circumferences compared to the abdominoplasty group (P<0.05). The postoperative VAS score of the combined group was significantly higher than that of the abdominoplasty group (P<0.05), while the postoperative BDI score of the combined group was significantly lower compared to that of the abdominoplasty group (P<0.05). The BDI results revealed a significant reduction in the prevalence of moderate depression among post-surgery patients, declining from 94.2% to 3.6%.</div></div><div><h3>Conclusions</h3><div>Scarpa fascia preservation abdominoplasty combined with precise liposuction is a suitable procedure for postpregnancy abdomen. The modified abdominoplasty demonstrates favorable therapeutic outcomes, optimal flap blood supply, minimal flap tension, inconspicuous postoperative scar, and meticulous body contouring.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"105 ","pages":"Pages 148-157"},"PeriodicalIF":2.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Exoscope-assisted orbital fracture reduction surgery—Clinical assessment by surgeons: A retrospective cohort study

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-04-07 DOI: 10.1016/j.bjps.2025.04.007

Hitomi Kojima, Hiroshi Nishioka, Yoshikazu Inoue, Takayuki Okumoto

Background

Exoscope-assisted digital imaging allows continuous real-time visualization of the surgical site on a large 3D monitor. We evaluated its usefulness in orbital fracture reduction surgery, a procedure with a narrow and deep operative field that restricts direct visibility for the operating surgeon.

Methods

This retrospective cohort study included all patients who underwent orbital floor fracture reduction with an absorbable plate via a subciliary approach at our institution from January 2022 to December 2024. ORBEYE 3D exoscope system (Olympus, Tokyo, Japan) was used in all cases when available, as the device was shared among several departments in our institution. Surgeries performed with and without the ORBEYE exoscope were compared for the following preoperative variables: (i) years since the surgeon’s graduation and (ii) days from injury to surgery, and outcome variables including (iii) operative time, (iv) blood loss, and (v) absorbable plate size. Surgeons also completed a questionnaire regarding their experience with ORBEYE.

Results

Eleven patients underwent conventional surgery, and 10 underwent ORBEYE-assisted surgery. ORBEYE-assisted surgery resulted in a significantly shorter operative time, while no significant differences were observed in other preoperative or outcome variables. The involved surgeons reported reduced physical strain, particularly in the neck, as well as improved collaboration and education. Despite some disadvantages, all surgeons expressed a positive attitude toward continued ORBEYE use.

Conclusions

ORBEYE-assisted surgery offers significant advantages in orbital floor fracture reduction, including reduced operative time, improved ergonomics, and enhanced teamwork and education. Its drawbacks are relatively minor, and broader adoption in plastic surgery should be considered.

{"title":"Exoscope-assisted orbital fracture reduction surgery—Clinical assessment by surgeons: A retrospective cohort study","authors":"Hitomi Kojima, Hiroshi Nishioka, Yoshikazu Inoue, Takayuki Okumoto","doi":"10.1016/j.bjps.2025.04.007","DOIUrl":"10.1016/j.bjps.2025.04.007","url":null,"abstract":"<div><h3>Background</h3><div>Exoscope-assisted digital imaging allows continuous real-time visualization of the surgical site on a large 3D monitor. We evaluated its usefulness in orbital fracture reduction surgery, a procedure with a narrow and deep operative field that restricts direct visibility for the operating surgeon.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included all patients who underwent orbital floor fracture reduction with an absorbable plate via a subciliary approach at our institution from January 2022 to December 2024. ORBEYE 3D exoscope system (Olympus, Tokyo, Japan) was used in all cases when available, as the device was shared among several departments in our institution. Surgeries performed with and without the ORBEYE exoscope were compared for the following preoperative variables: (i) years since the surgeon’s graduation and (ii) days from injury to surgery, and outcome variables including (iii) operative time, (iv) blood loss, and (v) absorbable plate size. Surgeons also completed a questionnaire regarding their experience with ORBEYE.</div></div><div><h3>Results</h3><div>Eleven patients underwent conventional surgery, and 10 underwent ORBEYE-assisted surgery. ORBEYE-assisted surgery resulted in a significantly shorter operative time, while no significant differences were observed in other preoperative or outcome variables. The involved surgeons reported reduced physical strain, particularly in the neck, as well as improved collaboration and education. Despite some disadvantages, all surgeons expressed a positive attitude toward continued ORBEYE use.</div></div><div><h3>Conclusions</h3><div>ORBEYE-assisted surgery offers significant advantages in orbital floor fracture reduction, including reduced operative time, improved ergonomics, and enhanced teamwork and education. Its drawbacks are relatively minor, and broader adoption in plastic surgery should be considered.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"105 ","pages":"Pages 126-130"},"PeriodicalIF":2.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tissue expansion in the pediatric patient: A 23-year single-institution experience

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-04-07 DOI: 10.1016/j.bjps.2025.04.002

Isabel A. Ryan, Mattia A. Mahmoud, Philip D. Tolley, Nicholas A. Han, Cassandra A. Ligh, David W. Low, Oksana A. Jackson, Scott P. Bartlett, Jordan W. Swanson, Jesse A. Taylor

Background

Given the wide and variable use of tissue expansion in pediatric soft tissue reconstruction, we aimed to characterize its use at our institution over the past 23 years, focusing on clinical outcomes stratified by location, indication, and repeat expansion.

Methods

A multi-surgeon retrospective review of all patients who underwent tissue expander (TE) placement from 2001–2024 was conducted. Demographic, operative, and outcomes data were collected and compared. Univariable and multivariable logistic regression were used to identify the predictors of complications and premature explantation.

Results

Overall, 211 patients with 519 TEs met the inclusion criteria. The most common diagnoses were congenital nevus (21.8%, n=46), scarring (21.8%, n=46), and omphalocele (12.3%, n=26). Successful reconstruction was achieved in 93.4% of the patients (n=197); 22.7% (n=48) underwent repeat expansion of the same anatomic location. Complications occurred in 24.5% (n=127) of the expanders and 16% (n=82) required premature explantation. On multivariable analysis, use in conjoined twins (OR 2.6, p=0.006), use for wound reconstruction (OR 6.1, p=0.047), and repeat expansion (OR 2.5, p=0.008) were associated with increased odds of complications. Expander placement at <3.5 years was associated with increased odds of premature explantation (OR 1.9, p=0.047).

Conclusions

Although pediatric tissue expansion allows effective soft tissue reconstruction in a multitude of anatomic locations and conditions, it remains a significant undertaking for families and is not without risk. Repeat tissue expansion, use in conjoined twins, and wound reconstruction are predictive of increased complications. Placement at <3.5 years of age may also increase the odds of premature explantation.

{"title":"Tissue expansion in the pediatric patient: A 23-year single-institution experience","authors":"Isabel A. Ryan, Mattia A. Mahmoud, Philip D. Tolley, Nicholas A. Han, Cassandra A. Ligh, David W. Low, Oksana A. Jackson, Scott P. Bartlett, Jordan W. Swanson, Jesse A. Taylor","doi":"10.1016/j.bjps.2025.04.002","DOIUrl":"10.1016/j.bjps.2025.04.002","url":null,"abstract":"<div><h3>Background</h3><div>Given the wide and variable use of tissue expansion in pediatric soft tissue reconstruction, we aimed to characterize its use at our institution over the past 23 years, focusing on clinical outcomes stratified by location, indication, and repeat expansion.</div></div><div><h3>Methods</h3><div>A multi-surgeon retrospective review of all patients who underwent tissue expander (TE) placement from 2001–2024 was conducted. Demographic, operative, and outcomes data were collected and compared. Univariable and multivariable logistic regression were used to identify the predictors of complications and premature explantation.</div></div><div><h3>Results</h3><div>Overall, 211 patients with 519 TEs met the inclusion criteria. The most common diagnoses were congenital nevus (21.8%, n=46), scarring (21.8%, n=46), and omphalocele (12.3%, n=26). Successful reconstruction was achieved in 93.4% of the patients (n=197); 22.7% (n=48) underwent repeat expansion of the same anatomic location. Complications occurred in 24.5% (n=127) of the expanders and 16% (n=82) required premature explantation. On multivariable analysis, use in conjoined twins (OR 2.6, p=0.006), use for wound reconstruction (OR 6.1, p=0.047), and repeat expansion (OR 2.5, p=0.008) were associated with increased odds of complications. Expander placement at <3.5 years was associated with increased odds of premature explantation (OR 1.9, p=0.047).</div></div><div><h3>Conclusions</h3><div>Although pediatric tissue expansion allows effective soft tissue reconstruction in a multitude of anatomic locations and conditions, it remains a significant undertaking for families and is not without risk. Repeat tissue expansion, use in conjoined twins, and wound reconstruction are predictive of increased complications. Placement at <3.5 years of age may also increase the odds of premature explantation.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"105 ","pages":"Pages 158-169"},"PeriodicalIF":2.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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Journal of Plastic Reconstructive and Aesthetic Surgery

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