Journal of Plastic Reconstructive and Aesthetic Surgery最新文献

Aesthetic outcomes and surgical complications of acellular dermal matrix in immediate direct-to-implant breast reconstruction: A meta-analysis of comparative studies 脱细胞真皮基质在直接植入乳房重建中的美学效果和手术并发症：比较研究的荟萃分析

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-03-01 Epub Date: 2026-01-12 DOI: 10.1016/j.bjps.2025.12.040

Omar ElSewify , Rawan ElAbd , Leen ElEter , Natasha Barone , Brea Willey , Samuel J. Lin , Joshua Vorstenbosch

Acellular dermal matrix (ADM) is frequently used in implant-based breast reconstruction due to its perceived aesthetic superiority and reduction in postoperative complications. This meta-analysis aims to investigate the aesthetic outcomes and surgical complications of ADM in immediate direct-to-implant (DTI) breast reconstruction. A systematic literature review was conducted using Medline, EMBASE, and Cochrane databases up to November 25, 2024. Comparative studies analyzing aesthetic outcomes and surgical complications of DTI reconstruction with and without ADM were included. Ten articles were eligible, with 416 patients undergoing ADM DTI reconstruction and 339 undergoing immediate reconstruction without ADM. The mean follow-up duration was 25 months. The mean age for cases was 47 ± 6 years, comparable with controls (48 ± 6; p > 0.1). The mean body mass index was similar (23.5 ± 2.7 kg/m²; p > 0.1). Implant volume was comparable at 280 ± 65 versus 265 ± 79 cc; p > 0.1. Drain removal timing (15 vs 13 days) and hospital stay (5 vs 6 days) were similar (p > 0.1). Meta-analysis showed comparable rates of haematoma, capsular contraction, skin necrosis, and wound dehiscence. However, ADM was associated with a higher risk of infection (odds ratio, 3.15, p = 0.0005, I² = 0%). Results for seroma and implant loss should be interpreted with caution. Aesthetic outcomes, although variably measured, were mostly comparable. ADM use in DTI reconstruction offers more comfort with pocket coverage but appears to carry higher risks of infection, implant loss, and possibly seroma. This meta-analysis offers guidance regarding risks, benefits, and costs associated with ADM use in clinical practice.

脱细胞真皮基质（ADM）因其美学优势和减少术后并发症而被广泛应用于假体乳房重建。本荟萃分析旨在探讨ADM在直接植入乳房重建术（DTI）中的美学效果和手术并发症。使用Medline、EMBASE和Cochrane数据库进行系统文献综述，截止到2024年11月25日。对比研究分析了有和没有ADM的DTI重建的美学结果和手术并发症。10篇文章符合条件，其中416例患者接受了ADM DTI重建，339例患者接受了不进行ADM的立即重建。平均随访时间为25个月。病例的平均年龄为47±6岁，与对照组（48±6;p > 0.1）相当。平均体重指数相似（23.5±2.7 kg/m2; p > 0.1）。种植体体积为280±65和265±79 cc；P >；引流时间（15天vs 13天）和住院时间（5天vs 6天）相似（p > 0.1）。荟萃分析显示血肿、包膜收缩、皮肤坏死和伤口裂开的发生率相当。然而，ADM与较高的感染风险相关（优势比为3.15,p = 0.0005, I2 = 0%）。血肿和植入物丢失的结果应谨慎解释。审美结果，虽然测量变量不同，但大多具有可比性。ADM用于DTI重建提供了更舒适的口袋覆盖，但似乎有更高的感染、种植体丢失和可能的血清肿的风险。本荟萃分析为临床实践中使用ADM的风险、收益和成本提供了指导。

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引用次数: 0

Unequal burden: Inguinal sentinel lymph node biopsy and the disproportionate risk of infection in melanoma 不平等的负担：腹股沟前哨淋巴结活检和黑色素瘤感染的不成比例的风险。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-03-01 Epub Date: 2026-01-06 DOI: 10.1016/j.bjps.2025.12.039

Aleksandra Nowak , Jessica Coyle , Abigail Colletta , Veronique Verhoeven , Gino Vissers

Aim

To evaluate surgical site-specific infection rates after sentinel lymph node biopsies (SLNB) for melanoma.

Methods

This single-centre retrospective analysis of prospectively collected data included 422 patients who underwent SLNB between January 2020 and January 2025. Negative post-operative outcomes within 31 days were recorded: infection, seroma, wound dehiscence, haematoma, lymphedema and other complications. Clinical variables included: demographics, SLNB site and result, comorbidity, prophylactic antibiotic use and American Joint Committee on Cancer stage. Multivariable logistic regression was used to identify predictors of infection. This study adheres to the STROBE guidelines (Supplementary Appendix).

Results

Across the 422 patients in the cohort (mean age 59.1 years, range 6–89 years), infection accounted for 55 cases (13%). Rates varied markedly by site: inguinal 23.9%, axilla 7.8%, knee 29.4% and head/neck 3.0%. All infections were managed with antibiotics, and none required re‑operation. Multivariable analysis revealed that inguinal site (OR 5.01, 95% CI 2.50–10.04, p < 0.001) and male gender (OR 2.57, 95% CI 1.30–5.09, p = 0.007) independently predicted postoperative infection. Age and comorbidity were not associated with increased risk in our cohort.

Conclusion

Within this UK cohort, the SLNB anatomical site emerged as the strongest driver of postoperative infection, with inguinal procedures carrying the greatest increase in risk. Male patients were also at a higher risk of infection. These findings highlight the value of targeted prevention strategies and close postoperative surveillance for high-risk groups.

目的：评价黑色素瘤前哨淋巴结活检（SLNB）后手术部位特异性感染率。方法：这项单中心回顾性分析前瞻性收集的数据包括422名在2020年1月至2025年1月期间接受SLNB的患者。术后31天内阴性结果：感染、血肿、创面裂开、血肿、淋巴水肿等并发症。临床变量包括：人口统计学、SLNB部位和结果、合并症、预防性抗生素使用和美国癌症分期联合委员会。使用多变量逻辑回归来确定感染的预测因素。本研究遵循STROBE指南（补充附录）。结果：在队列中的422例患者（平均年龄59.1岁，范围6-89岁）中，感染占55例（13%）。不同部位的发病率差异显著：腹股沟23.9%，腋窝7.8%，膝关节29.4%，头颈部3.0%。所有感染均使用抗生素治疗，无一例需要再次手术。多变量分析显示腹股沟部位（OR 5.01, 95% CI 2.50-10.04, p）。结论：在英国队列中，SLNB解剖部位成为术后感染的最强驱动因素，腹股沟手术风险增加最大。男性患者感染的风险也更高。这些发现强调了有针对性的预防策略和对高危人群术后密切监测的价值。

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引用次数: 0

Optimizing outcomes in pediatric microvascular mandibular reconstruction: A 23-year institutional experience 优化儿童下颌骨微血管重建的结果：23年的机构经验。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-03-01 Epub Date: 2026-01-06 DOI: 10.1016/j.bjps.2025.12.030

Theodor B. Lenz, Dominic J. Romeo, Allison C. Hu, Jacob R. Thomas, Patrick Akarapimand, Scott P. Bartlett, Jesse A. Taylor, Eric J. Granquist, Cassandra A. Ligh, Jordan W. Swanson

Background

The vascularized free fibula flap (VFFF) is a well-established technique for addressing critical-sized mandibular defects, including those in pediatric patients. However, surgical risk factors and impact on growth potential are not well understood, particularly in skeletally immature patients, nor are the methods to optimize growth and outcomes.

Methods

We retrospectively reviewed children who underwent mandibular reconstruction using VFFF between 2001 and 2024 at our institution. Complications were classified using the Clavien–Dindo scale. Data were analyzed using Pearson’s r correlation, Fisher’s exact tests, and chi-squared analysis.

Results

Twenty-nine patients underwent 31 mandibular reconstructions using VFFFs at a median age of 14 years old (range: 3.5–18.9 years), most commonly after ameloblastoma resection (n=10, 32%). Twenty-nine (94%) flaps were successful, and 17 complication events transpired among 13 (42%) operations, most commonly hardware exposure (n=4, 24%). Complications decreased with increased institutional experience (after 2016, p=0.011) and with the use of two rather than one venous anastomosis (p=0.002). Recipient site complications were more common in patients under 12 years of age (p=0.026). Although flap viability was high; two flap failures occurred with single venous anastomosis, and none with two venous anastomoses. Hardware removal was planned on an average 15.7 months after nine operations (29%) to maintain growth potential; subsequent corrective orthognathic surgery was performed following four flaps (13%).

Conclusion

Pediatric mandibular reconstruction using VFFF is safe and effective, with the majority maintaining functional occlusion with growth. Complication rates are comparable to those in the adult population and may be mitigated via multiple vein anastomoses and institutional experience.

背景：带血管的游离腓骨瓣（VFFF）是一种成熟的技术，用于解决临界大小的下颌骨缺损，包括那些儿童患者。然而，手术风险因素和对生长潜力的影响还不清楚，特别是在骨骼不成熟的患者中，也没有优化生长和结果的方法。方法：我们回顾性分析了2001年至2024年间在我院使用VFFF进行下颌骨重建的儿童。采用Clavien-Dindo量表对并发症进行分类。数据分析采用Pearson’s r相关、Fisher’s精确检验和卡方分析。结果：29例患者使用VFFFs进行了31次下颌重建，中位年龄为14岁（范围：3.5-18.9岁），最常见的是成釉细胞瘤切除术（n= 10.32%）。29例（94%）皮瓣成功，13例（42%）手术中发生17例并发症，最常见的是硬体暴露（n= 4,24%）。随着机构经验的增加（2016年以后，p=0.011）和使用两次静脉吻合术而不是一次静脉吻合术（p=0.002），并发症减少。受体部位并发症在12岁以下患者中更为常见（p=0.026）。虽然皮瓣活力高；单静脉吻合术有2例皮瓣失败，双静脉吻合术无皮瓣失败。为保持增长潜力，9次手术后平均需要15.7个月（29%）进行硬体移除；随后的矫正正颌手术在4个皮瓣后进行（13%）。结论：使用VFFF重建儿童下颌骨是安全有效的，大多数人在生长过程中保持了功能咬合。并发症发生率与成人相当，可以通过多静脉吻合术和机构经验来减轻。

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引用次数: 0

Closed-suction fat harvest using a drain bottle: A practical modification 用引流瓶封闭吸脂：一种实用的改进。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-03-01 Epub Date: 2026-01-29 DOI: 10.1016/j.bjps.2026.01.033

Vasiliki Fesatidou , Abdulla Ibrahim , Kavan S Johal , Pari-Naz Mohanna

Autologous fat grafting is a well-established technique for tissue augmentation, with various methods having been reported. None of them, however, has demonstrated clear superiority. We describe a simple modification of a well-established technique using a standard liposuction cannula connected to a closed-suction drain bottle for fat harvesting. Connecting the closed-suction drain bottle to a surgical suction unit, rather than relying on its inherent vacuum, allows for continuous control of the suction pressure and reduces harvest time by preventing the loss of negative pressure when the cannula is removed. This simple adaptation is cost-effective, versatile, and is an operator-controlled method for fat harvesting utilising readily available equipment.

自体脂肪移植是一种成熟的组织增强技术，已有各种方法的报道。然而，它们都没有表现出明显的优势。我们描述了一个简单的修改一个完善的技术，使用一个标准的吸脂插管连接到一个封闭的吸干引流瓶脂肪收集。将封闭吸液引流瓶连接到外科吸液装置上，而不是依赖其固有的真空，可以连续控制吸液压力，并通过防止拔管时负压的损失来减少收集时间。这种简单的调整具有成本效益，用途广泛，并且是一种操作员控制的方法，可以利用现成的设备进行脂肪采集。

引用次数: 0

Corrigendum to “Effect of hydration time on the microstructure of a porcine acellular dermal matrix for breast reconstruction: a pilot study” [J Plast Reconstr Aesthet Surg 106 (2025) 319–328] “水化时间对猪脱细胞真皮基质在乳房再造中的微观结构的影响：一项初步研究”[J].整形美容外科杂志，2006(10):319-328。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-03-01 Epub Date: 2026-02-16 DOI: 10.1016/j.bjps.2026.01.036

Claudia Di Santo , Carlo Di Pietrantonj , Stefania Crivellari , Giuseppe Sanese , Fausto Cella

引用次数: 0

Patient satisfaction following scar revision: A systematic review and meta-analysis 疤痕修复后患者满意度：一项系统回顾和荟萃分析。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-03-01 Epub Date: 2026-01-24 DOI: 10.1016/j.bjps.2026.01.021

Abdulaziz Almodumeegh , Maha Alkharisi , Ghaida Assiry , Leen Almutairi , Sara Alotaibi , Nasser Alowaimer , Alanoud Albalkhail , Rawan Alotaibi , Lana Turson , Amjad Abdullah Aljulayyil , Abdulaziz Alotaibi , Alanood Almusaiteer , Mona Talic

Background

Scar revision aims to improve the esthetic appearance and functional impact of scars. However, evidence synthesizing patient-reported satisfaction following these procedures remains limited.

Methods

We systematically searched PubMed/MEDLINE, EMBASE, and Google Scholar (2010–2024) for studies reporting patient satisfaction after scar revision in adults. The primary outcome was patient-reported satisfaction measured through validated patient-reported outcome measures (PROMs) or structured surveys. Secondary contextual outcomes included esthetic severity scores (patient and observer scar assessment scale (POSAS), observer scar assessment scale (OSAS), Vancouver scar scale (VSS)) and complication rates. Data were pooled using random-effects single-arm meta-analysis.

Results

Thirty studies involving 5230 patients met the inclusion criteria, including 8 RCTs, 5 systematic reviews (narrative only), and 17 observational studies. Surgical interventions demonstrated the most favorable POSAS scores (2.71, 95% CI 2.32–3.11), compared with non-surgical procedures (3.32, 95% CI 2.92–3.71). Across 25 studies (1432 patients), the pooled patient satisfaction rate was 78.6% (95% CI 74.3–82.8). Satisfaction was the highest among patients with traumatic scars (88.3%) and lower in those with burn scars (74.5%). Minor complications occurred in 8.6% of the patients, with higher rates in post-acne and post-surgical scars. No major complications were reported.

Conclusions

Scar revision is associated with high patient satisfaction, with surgical approaches generally producing superior patient-reported outcomes. Satisfaction varies according to scar etiology and follow-up duration, emphasizing the importance of expectation setting and ongoing assessment. Secondary outcomes support the overall safety and effectiveness of current techniques. Standardized PROMs and improved reporting of psychosocial and contextual factors are needed to strengthen future evidence and enhance patient-centered care.

背景：疤痕修复的目的是改善疤痕的美观和功能影响。然而，证据综合患者报告的满意度遵循这些程序仍然有限。方法：我们系统地检索PubMed/MEDLINE， EMBASE和谷歌Scholar(2010-2024)，以报告成人疤痕修复后患者满意度的研究。主要结果是通过有效的患者报告结果测量（PROMs）或结构化调查来测量患者报告的满意度。次要背景结果包括审美严重程度评分（患者和观察者疤痕评估量表（POSAS）、观察者疤痕评估量表（OSAS）、温哥华疤痕量表（VSS））和并发症发生率。采用随机效应单臂meta分析汇总数据。结果：30项研究5230例患者符合纳入标准，包括8项随机对照试验、5项系统综述（仅叙述）和17项观察性研究。与非手术治疗（3.32,95% CI 2.92-3.71）相比，手术治疗表现出最有利的POSAS评分（2.71,95% CI 2.32-3.11）。在25项研究（1432例患者）中，患者满意率为78.6% （95% CI 74.3-82.8）。创伤性疤痕患者满意度最高（88.3%），烧伤疤痕患者满意度较低（74.5%）。8.6%的患者出现轻微并发症，痤疮和术后疤痕发生率更高。无重大并发症报道。结论：疤痕修复术与高患者满意度相关，手术入路通常产生较好的患者报告结果。满意度根据疤痕病因和随访时间而变化，强调期望设定和持续评估的重要性。次要结果支持当前技术的总体安全性和有效性。需要标准化的PROMs和改进的社会心理和环境因素报告，以加强未来的证据和加强以患者为中心的护理。

{"title":"Patient satisfaction following scar revision: A systematic review and meta-analysis","authors":"Abdulaziz Almodumeegh , Maha Alkharisi , Ghaida Assiry , Leen Almutairi , Sara Alotaibi , Nasser Alowaimer , Alanoud Albalkhail , Rawan Alotaibi , Lana Turson , Amjad Abdullah Aljulayyil , Abdulaziz Alotaibi , Alanood Almusaiteer , Mona Talic","doi":"10.1016/j.bjps.2026.01.021","DOIUrl":"10.1016/j.bjps.2026.01.021","url":null,"abstract":"<div><h3>Background</h3><div>Scar revision aims to improve the esthetic appearance and functional impact of scars. However, evidence synthesizing patient-reported satisfaction following these procedures remains limited.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed/MEDLINE, EMBASE, and Google Scholar (2010–2024) for studies reporting patient satisfaction after scar revision in adults. The primary outcome was patient-reported satisfaction measured through validated patient-reported outcome measures (PROMs) or structured surveys. Secondary contextual outcomes included esthetic severity scores (patient and observer scar assessment scale (POSAS), observer scar assessment scale (OSAS), Vancouver scar scale (VSS)) and complication rates. Data were pooled using random-effects single-arm meta-analysis.</div></div><div><h3>Results</h3><div>Thirty studies involving 5230 patients met the inclusion criteria, including 8 RCTs, 5 systematic reviews (narrative only), and 17 observational studies. Surgical interventions demonstrated the most favorable POSAS scores (2.71, 95% CI 2.32–3.11), compared with non-surgical procedures (3.32, 95% CI 2.92–3.71). Across 25 studies (1432 patients), the pooled patient satisfaction rate was 78.6% (95% CI 74.3–82.8). Satisfaction was the highest among patients with traumatic scars (88.3%) and lower in those with burn scars (74.5%). Minor complications occurred in 8.6% of the patients, with higher rates in post-acne and post-surgical scars. No major complications were reported.</div></div><div><h3>Conclusions</h3><div>Scar revision is associated with high patient satisfaction, with surgical approaches generally producing superior patient-reported outcomes. Satisfaction varies according to scar etiology and follow-up duration, emphasizing the importance of expectation setting and ongoing assessment. Secondary outcomes support the overall safety and effectiveness of current techniques. Standardized PROMs and improved reporting of psychosocial and contextual factors are needed to strengthen future evidence and enhance patient-centered care.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"114 ","pages":"Pages 284-295"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260509","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

Erratum to “Early detection of viable microorganisms in “sterile” periprosthetic fluids in implant-based breast reconstruction: A bioelectrochemical approach using screen-printed electrodes” [J Plast Reconstr Aesthet Surg 113 (2026) 353–361] “在假体乳房再造术中早期检测假体周围液体中的活菌：基于丝网印刷电极的生物电化学方法”[J].中国整形外科杂志，2013(6):353-361。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-03-01 Epub Date: 2026-01-20 DOI: 10.1016/j.bjps.2026.01.009

Marta Monari , Stefano Vaccari , Alessandro Marco Lupacchini , Anna Parisi , Nicki Zolesi , Sara Beltrame , Paola Petrillo , Fabio Grizzi , Mohamed Ahmed Ahmed Abdelaziz Hegazi , Riccardo Di Giuli , Francesco Klinger , Roberto Rusconi , Valeriano Vinci

引用次数: 0

Rate of fistula repair following palatoplasty in patients with cleft lip and palate: A systematic review of the literature 唇腭裂患者腭裂成形术后瘘管修复率：文献系统综述

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-03-01 Epub Date: 2026-02-06 DOI: 10.1016/j.bjps.2025.12.032

Dylan G. Choi , Alexander T. Plonkowski , Marvee Turk , Muhammad Daiem , Francesca Calderon , Laura Herrera Gomez , Ghulam Qadir Fayyaz , Caroline A. Yao , Priyanka Naidu , William P. Magee III

Background

Oronasal fistulas are among the most common and burdensome complications of cleft palate repair. Despite exhaustive literature detailing the nature and incidence of palatal fistulas, the reported rates of surgical fistula repair remain contested. The aim of this study was to identify the rate of palatal fistula repair following primary palatoplasty for cleft lip and palate.

Methods

The PubMed, Scopus, and Cochrane databases were queried for studies that focused on the incidence of surgical fistula repair following primary palatoplasty. Studies that included submucous clefts or were written in non-English languages were excluded.

Results

A total of 47 studies met the inclusion criteria. The average reported rate of palatal fistula repair was 6.5±5.3% (range: 0–49%). Stratified by cleft phenotype, the rate of fistula repair was 3.2±3.8% for patients with isolated cleft palate, 4.2±3.3% for patients with unilateral cleft lip and palate (UCLP), and 17.2±12.3% for patients with bilateral cleft lip and palate (BCLP). The rates of fistula repair were significantly different between the UCLP and BCLP groups (p=0.02) as well as between the BCLP and ICP groups (p=0.03). The included studies reported a range of predictors of fistula repair, including palatoplasty timing and surgeon experience, but our meta-analysis did not find an association between timing and fistula repair (p=0.84) in the aggregated data.

Conclusion

Initial analysis demonstrated differences in fistula surgery rate when stratified by phenotype and technique. Standardization of outcomes reporting is necessary to drive more robust conclusions.

背景：鼻瘘是腭裂修复中最常见和最繁重的并发症之一。尽管详尽的文献详细介绍了腭瘘的性质和发生率，但手术瘘修复的报道率仍然存在争议。本研究的目的是确定腭裂一期腭裂成形术后腭瘘的修复率。方法对PubMed、Scopus和Cochrane数据库进行查询，获取有关一期腭裂术后手术瘘管修复发生率的研究。包括粘膜下裂隙的研究或以非英语语言撰写的研究被排除在外。结果47项研究符合纳入标准。报告的平均腭瘘修复率为6.5±5.3%（范围：0-49%）。按裂型分层，单侧唇腭裂（UCLP）患者的瘘道修复率为3.2±3.8%，单侧唇腭裂（UCLP）患者为4.2±3.3%，双侧唇腭裂（BCLP）患者为17.2±12.3%。UCLP组与BCLP组、BCLP组与ICP组的瘘道修复率差异有统计学意义（p=0.02）。纳入的研究报告了一系列瘘修复的预测因素，包括腭成形术的时机和外科医生的经验，但我们的荟萃分析在汇总数据中没有发现时机和瘘修复之间的关联（p=0.84）。结论初步分析显示，根据表型和技术分层，瘘管手术率存在差异。结果报告的标准化对于推动更有力的结论是必要的。

{"title":"Rate of fistula repair following palatoplasty in patients with cleft lip and palate: A systematic review of the literature","authors":"Dylan G. Choi , Alexander T. Plonkowski , Marvee Turk , Muhammad Daiem , Francesca Calderon , Laura Herrera Gomez , Ghulam Qadir Fayyaz , Caroline A. Yao , Priyanka Naidu , William P. Magee III","doi":"10.1016/j.bjps.2025.12.032","DOIUrl":"10.1016/j.bjps.2025.12.032","url":null,"abstract":"<div><h3>Background</h3><div>Oronasal fistulas are among the most common and burdensome complications of cleft palate repair. Despite exhaustive literature detailing the nature and incidence of palatal fistulas, the reported rates of surgical fistula repair remain contested. The aim of this study was to identify the rate of palatal fistula repair following primary palatoplasty for cleft lip and palate.</div></div><div><h3>Methods</h3><div>The PubMed, Scopus, and Cochrane databases were queried for studies that focused on the incidence of surgical fistula repair following primary palatoplasty. Studies that included submucous clefts or were written in non-English languages were excluded.</div></div><div><h3>Results</h3><div>A total of 47 studies met the inclusion criteria. The average reported rate of palatal fistula repair was 6.5±5.3% (range: 0–49%). Stratified by cleft phenotype, the rate of fistula repair was 3.2±3.8% for patients with isolated cleft palate, 4.2±3.3% for patients with unilateral cleft lip and palate (UCLP), and 17.2±12.3% for patients with bilateral cleft lip and palate (BCLP). The rates of fistula repair were significantly different between the UCLP and BCLP groups (p=0.02) as well as between the BCLP and ICP groups (p=0.03). The included studies reported a range of predictors of fistula repair, including palatoplasty timing and surgeon experience, but our meta-analysis did not find an association between timing and fistula repair (p=0.84) in the aggregated data.</div></div><div><h3>Conclusion</h3><div>Initial analysis demonstrated differences in fistula surgery rate when stratified by phenotype and technique. Standardization of outcomes reporting is necessary to drive more robust conclusions.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"114 ","pages":"Pages 256-265"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146190137","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

Modified lip reduction for hypertrophic lip with mucinous degeneration 改良减唇术治疗肥厚性唇伴黏液变性

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-03-01 Epub Date: 2025-10-24 DOI: 10.1016/j.bjps.2025.10.034

Shuo Liu , Hang Wang , Mei Li , Wei Zheng

Background

Hypertrophic lips caused by mucinous degeneration are exceedingly rare and present both aesthetic and functional challenges. Conventional lip reduction techniques primarily target the vermilion, often overlooking hypertrophy of the white lip and deeper tissues, which may result in suboptimal contour correction.

Methods

A 15-year-old male with diffuse upper lip hypertrophy refractory to repeated conservative treatment underwent a modified layered lip reduction procedure. The surgical approach involved excision of redundant vermilion mucosa combined with selective reduction of subcutaneous tissue, glandular tissue, and segments of the orbicularis oris muscle in both the red and white lip regions. Preoperative and postoperative outcomes were quantitatively evaluated using three-dimensional facial analysis to assess lip volume, convexity, and interlabial angle.

Results

Postoperatively, the patient achieved a natural and symmetrical upper lip contour with preservation of oral muscle function. Quantitative analysis demonstrated a reduction in upper lip volume of 1.41 mL, predominantly in the central region. Mean total lip convexity decreased by 3.79 mm, while convexity at the most anterior point of the lip tubercle decreased by 2.34 mm. The interlabial angle increased from 89.8° preoperatively to 108.5° postoperatively, reflecting improved lip–facial harmony. Dynamic smile assessment confirmed preserved mobility and natural lip movement.

Conclusions

This modified layered lip reduction technique effectively addresses hypertrophy involving both the vermilion and white lip, achieving precise contour control while preserving orbicularis oris muscle function. It represents a safe and effective surgical option for complex lip deformities associated with mucinous degeneration and may offer superior aesthetic outcomes compared with conventional reduction cheiloplasty.

背景：由黏液变性引起的嘴唇肥大是非常罕见的，并且呈现出美学和功能上的挑战。传统的减唇技术主要针对朱红色，往往忽略了肥大的白色嘴唇和更深的组织，可能导致次优轮廓矫正。方法一例15岁男性上唇弥漫性肥大，反复保守治疗无效，采用改良的分层缩唇术。手术方法包括切除多余的朱红色粘膜，并选择性地切除红唇和白唇区域的皮下组织、腺组织和口轮匝肌段。术前和术后的结果通过三维面部分析定量评估嘴唇的体积、凸度和唇间角。结果术后患者获得了自然对称的上唇轮廓，并保留了口腔肌肉功能。定量分析显示上唇体积减少1.41 mL，主要集中在中部区域。唇总凸度平均下降3.79 mm，唇结节最前端凸度平均下降2.34 mm。唇间角从术前的89.8°增加到术后的108.5°，反映了唇面和谐的改善。动态微笑评估证实了保留的活动能力和自然的嘴唇运动。结论该改良的分层缩唇技术有效地解决了红唇和白唇的肥大问题，在保持口轮匝肌功能的同时，实现了精确的轮廓控制。它代表了一种安全有效的手术选择，复杂的唇部畸形与黏液变性相关，并可能提供优于传统的复位唇部成形术的美学效果。

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引用次数: 0

Lateralisation of basal cell and squamous cell carcinomas: A UK retrospective cross-sectional study 基底细胞癌和鳞状细胞癌的侧化：一项英国回顾性横断面研究

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-03-01 Epub Date: 2026-01-21 DOI: 10.1016/j.bjps.2026.01.012

Catharina Tao , Emma Guenther , Animesh Patel

This study aimed to determine whether basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) show asymmetrical distribution in a UK cohort, and to identify further patterns through subgroup analysis. Records of patients with biopsy-confirmed BCC or SCC at Addenbrookes Hospital, UK in 2018–2019, were reviewed retrospectively (5153 BCC, 1728 SCC). Lesions on the face/scalp regions were included; midline or unclear lesions were excluded. Chi-squared or Fisher's Exact Tests assessed distribution differences. 2908 BCCs and 832 SCCs in the non-midline facial/scalp region in 2018–2019 were included. Statistically significantly more right-sided BCCs were observed in 2018 and 2018/19 (in 2018–19: 52% right, 48% left, p=0.01), whilst statistically significantly more right-sided SCCs were observed in 2019 and 2018/19 (in 2018–19: 54% right, 46% left, p=0.032). As right-sided predominance was found for both lesion types and several further subgroups in this UK cohort, these findings could contribute to the emerging literature on skin cancer laterality associated with driving side. Further data collection and adjustment for confounding factors could strengthen these conclusions, emphasising an important public health message on sun protection when driving.

本研究旨在确定基底细胞癌（BCC）和鳞状细胞癌（SCC）在英国队列中是否呈现不对称分布，并通过亚组分析进一步确定模式。回顾性分析了2018-2019年英国阿登布鲁克斯医院活检证实的BCC或SCC患者的记录（5153例BCC， 1728例SCC）。包括面部/头皮区域的病变；排除中线或不明显病变。卡方检验或费雪精确检验评估分布差异。包括2018-2019年非中线面部/头皮区域的2908例bcc和832例SCCs。在2018年和2018/19年，右侧bcc的发生率显著增加（2018 - 19年：52%右侧，48%左侧，p=0.01），而在2019年和2018/19年，右侧SCCs的发生率显著增加（2018 - 19年：54%右侧，46%左侧，p=0.032）。由于在这个英国队列中，两种病变类型和几个进一步的亚组中都发现了右侧优势，这些发现可能有助于新出现的与驾驶侧相关的皮肤癌偏侧的文献。进一步的数据收集和对混杂因素的调整可以加强这些结论，强调驾驶时防晒的重要公共卫生信息。

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引用次数: 0