Journal of Plastic Reconstructive and Aesthetic Surgery最新文献

英文中文

Association of flap transfer versus excision with secondary healing on patient satisfaction in nasal mass surgery: A cohort study 鼻部肿块手术中皮瓣转移与切除与患者满意度的二次愈合的关联：一项队列研究。

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-01-01 DOI: 10.1016/j.bjps.2024.11.037

Xinyu Li , Datao Li , Yiyuan Li, Feng Xu, Zhicheng Xu, Qun Zhang, Xia Chen, Ruhong Zhang

Background

Nasal cutaneous tumors impact appearance and function, affecting the patients’ well-being. This study compares the outcomes of second intention healing, where wounds heal naturally, with flap transfer in nasal defect repair after tumor resection to evaluate its viability as an alternative.

Methods

In this multi-center study, 80 patients who underwent second intention healing and 70 patients who received flap transfer after nasal tumor resection between July 2018 and June 2023 were included. Patient demographics, tumor characteristics, operative details, and wound healing time were collected. Scar outcomes were evaluated at 6 months postoperation using the Vancouver scar scale and visual analog scale.

Results

The second intention healing group showed significantly better outcomes compared to the flap transfer group. The Vancouver scar scale score was lower in the second intention group (3.51 ± 0.22 vs. 3.98 ± 0.68, P = 0.02), indicating better scar quality. Superior outcomes were observed in vascularity, pigmentation, and pliability on the observer patient and observer scar assessment scale (POSAS) scale. Patients reported better color, irregularity, and higher satisfaction with wound care experience. The overall patient satisfaction score was significantly higher in the second intention group (7.59 ± 0.24 vs. 7.16 ± 0.10, P = 0.02).

Conclusion

This cohort study suggests that second intention healing is associated with higher patient satisfaction in nasal cutaneous tumor surgery compared to flap transfer. These findings support the possibility of using second intention healing as an alternative in nasal cutaneous tumor treatment. Further research is needed to validate these results.

背景：鼻腔皮肤肿瘤影响外观和功能，影响患者的健康。本研究比较了第二次意向愈合（伤口自然愈合）与皮瓣移植在肿瘤切除后鼻腔缺损修复中的效果，以评估其作为替代方案的可行性。方法：在本多中心研究中，纳入2018年7月至2023年6月期间80例鼻肿瘤切除术后第二次意向愈合患者和70例皮瓣转移患者。收集患者人口统计学、肿瘤特征、手术细节和伤口愈合时间。术后6个月采用温哥华疤痕量表和视觉模拟量表评估疤痕结果。结果：第二次意向愈合组较皮瓣转移组疗效显著提高。第二意向组温哥华疤痕评分较低（3.51±0.22比3.98±0.68,P = 0.02），表明瘢痕质量较好。在观察患者和观察疤痕评估量表（POSAS）上观察到血管、色素沉着和柔韧性方面的优越结果。患者报告更好的颜色，不规则性和更高的满意度伤口护理经验。第二意向组患者总体满意度得分显著高于第二意向组（7.59±0.24比7.16±0.10,P = 0.02）。结论：该队列研究表明，与皮瓣转移相比，鼻皮肤肿瘤手术的第二次意向愈合与更高的患者满意度相关。这些发现支持使用第二次意向愈合作为鼻皮肤肿瘤治疗的替代方法的可能性。需要进一步的研究来验证这些结果。

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引用次数: 0

Availability and quality assessment of Clinical Practice Guidelines on orthoplastic surgery treatment of open fractures of the lower limb using AGREE II tool: A systematic review 使用 AGREE II 工具评估下肢开放性骨折整形外科治疗临床实践指南的可用性和质量：系统回顾。

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-01-01 DOI: 10.1016/j.bjps.2024.11.061

Martin Iurilli , Sara Dentice , Marco Di Nitto , Daniela Coclite , Antonello Napoletano , Velia Bruno , Gianluca Canton , Vittorio Ramella , Luigi Murena , Giovanni Papa

Introduction

Orthoplastic surgery, which combines orthopedic and plastic surgery principles, plays a crucial role in the treatment of open fractures of the lower limb. Clinical Practice Guidelines (CPGs) are valuable tools for standardizing and improving patient care.

Objective

To assess the availability and quality of international CPGs for orthoplastic treatment of open fractures of the lower limb. A secondary objective was to provide a detailed analysis of the specific recommendations by comparing them among different CPGs.

Methods

A systematic review was conducted in 2023 according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines across major medical databases and gray literature. Inclusion criteria focused on guidelines specific to orthoplastic surgery for lower limb open fractures. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool, a widely accepted instrument for guideline assessment, was utilized to evaluate the methodological rigor and transparency of the selected guidelines.

Results

Three orthoplasty CPGs have been identified, 2 of which were judged reliable according to the AGREE II methodology. Orthoplastic recommendations are no more than 7 per CPG. Consistent agreement was observed on the timing of debridement, the importance of early fixation, and definitive coverage.

Conclusion

CPGs are critical to set up clinical pathways that are safe and evidence-based. Only 3 international CPGs address orthoplastic treatment of open lower limb fractures, 2 of which are judged reliable according to methodology. Therefore, it becomes essential to develop and disseminate high-quality, evidence-based guidelines, which are critical to improving patient outcomes and standardizing clinical practice worldwide.

导读：骨科手术结合了骨科和整形外科的原理，在治疗下肢开放性骨折中起着至关重要的作用。临床实践指南（CPGs）是标准化和改善患者护理的宝贵工具。目的：评价国际通用的CPGs在开放性下肢骨折矫形治疗中的可用性和质量。第二个目标是通过比较不同CPGs的具体建议，对其进行详细分析。方法：根据主要医学数据库和灰色文献的系统评价和荟萃分析（PRISMA）指南的首选报告项目，于2023年进行了系统评价。纳入标准侧重于下肢开放性骨折矫形手术的具体指南。研究和评估指南评估II （AGREE II）工具是一种广泛接受的指南评估工具，用于评估所选指南的方法严谨性和透明度。结果：确定了3个矫形术cpg，其中2个根据AGREE II方法被认为是可靠的。整形建议不超过7 / CPG。在清创时机、早期固定的重要性和最终覆盖范围方面，观察到一致的意见。结论：CPGs对建立安全、循证的临床路径至关重要。仅有3篇国际CPGs涉及开放性下肢骨折的矫形治疗，其中2篇根据方法学被认为是可靠的。因此，制定和传播高质量的循证指南变得至关重要，这对于改善患者预后和规范全球临床实践至关重要。

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引用次数: 0

Preoperative ultrasound mapping of the suprascapular and spinal accessory nerves: A surgeon's guide to precision 肩胛上神经和脊柱附属神经的术前超声绘图：外科医生的精确指南。

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-01-01 DOI: 10.1016/j.bjps.2024.11.039

Pawan Agarwal , Saranya Ravi , Bhrath S , Prabhakar T , Dhananjaya Sharma , Jagmohan Singh Dhakar

Background

The aim of the study was to evaluate the accessibility and localization of spinal accessory and suprascapular nerves in the suprascapular region in healthy volunteers using ultrasonography.

Methods

One hundred healthy volunteers were included and the location of the spinal accessory nerve (SAN) and suprascapular nerve (SSN) was assessed in the right suprascapular region.

Findings

Seventy men and 30 women, (mean age 40.37 years; mean BMI 23.44 kg/m²) participated in the study. Mean distance of SAN from the vertebral spinous process and medial border of the scapula was 3.80 and 0.7 cm, respectively. Mean depth of SAN from the skin was 2.67 cm. The mean distance of SSN from the spine was 7 cm and mean depth of SSN from the skin was 3.28 cm. In overweight and obese individuals, the distance of SAN from the skin and vertebral spinous process and distance of SSN from the vertebral spine increased significantly. According to gender, there was no statistically significant difference in the location of SSN and SAN; however, the distance of SSN from the vertebral spine was significantly increased with increasing age.

Interpretation

The SSN and SAN in the suprascapular region can be consistently and reliably mapped using ultrasound. These data can also help in surface markings of both the nerves, which reduces the operating time and risk of iatrogenic injury.

背景：该研究旨在通过超声波检查评估健康志愿者肩胛上区脊髓附属神经和肩胛上神经的可及性和定位：该研究的目的是利用超声造影评估健康志愿者肩胛上区脊髓附属神经和肩胛上神经的可及性和定位：方法：纳入 100 名健康志愿者，评估脊髓附属神经（SAN）和肩胛上神经（SSN）在右侧肩胛上区域的位置：70 名男性和 30 名女性（平均年龄 40.37 岁；平均体重指数 23.44 kg/m2）参加了研究。SAN 距脊椎棘突和肩胛骨内侧边界的平均距离分别为 3.80 厘米和 0.7 厘米。SAN 距皮肤的平均深度为 2.67 厘米。SSN 距脊柱的平均距离为 7 厘米，SSN 距皮肤的平均深度为 3.28 厘米。超重和肥胖者的 SAN 距皮肤和椎棘突的距离以及 SSN 距椎体的距离明显增加。在性别方面，SSN 和 SAN 的位置差异无统计学意义；但随着年龄的增长，SSN 与椎体棘突的距离明显增加：肩胛上区的 SSN 和 SAN 可通过超声波绘制出一致、可靠的地图。这些数据还有助于对这两条神经进行表面标记，从而减少手术时间和先天性损伤的风险。

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引用次数: 0

Personalized preoperative design for reducing complications after upper blepharoplasty 减少上眼睑成形术后并发症的个性化术前设计

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-01-01 DOI: 10.1016/j.bjps.2024.08.053

Ran Duan , Bowen Gao , Jieyu Gu, Boxuan Wei, Xiaolu Huang, Xian Wei, Feng Xie

Background

Upper eyelid blepharoplasty is a common cosmetic surgery among Asians and is associated with several complications that are possibly related to the anatomical characteristics of the eyes.

Methods

A total of 364 upper eyelid blepharoplasties were performed at the Department of Plastic and Reconstructive Surgery between January 2018 and December 2019. The postsurgery complications and related eyelid types were classified as follows: upper eyelid crease too high (too high crease), upper eyelid crease too low (too low crease), medial upper eyelid crease too high (too high medial crease), bloated upper eyelid (bloated crease), and upper eyelid crease asymmetry (asymmetric crease). The correlation between the anatomical characteristics of the upper eyelid and complications was analyzed. Patients seeking upper eyelid blepharoplasty were preoperatively categorized into five types according to their anatomical characteristics, and modified surgical strategies were applied to 117 new blepharoplasties performed between January 2020 and December 2020. Five senior plastic surgeons evaluated the pre- and postoperative photographs of the previous (2018–2019) and modified (2020–2021) blepharoplasties and scored the results on the basis of specific criteria.

Results

The postoperative scores in the modified group increased significantly after the modifications compared to that of the previous surgeries (p ≤ 0.01).

Conclusion

Preoperative classification based on the anatomical characteristics of the eyelid and surgical modifications can reduce the occurrence of the five common complications of double eyelid blepharoplasty.

Level of evidence

上眼睑眼睑整形术是亚洲人常见的整容手术，可能与眼部解剖特点有关，并伴有多种并发症。2018年1月至2019年12月期间，整形与修复外科共进行了364例上睑眼睑整形手术。手术后并发症及相关眼睑类型分为：上眼睑折痕过高（折痕过高）、上眼睑折痕过低（折痕过低）、上眼睑内侧折痕过高（内侧折痕过高）、上眼睑臃肿（臃肿折痕）、上眼睑折痕不对称（不对称折痕）。分析了上眼睑解剖特征与并发症之间的相关性。根据解剖学特征，术前将寻求上眼睑眼睑整形术的患者分为五种类型，并对2020年1月至2020年12月期间新实施的117例眼睑整形术采用了修改后的手术策略。五位资深整形外科医生对以往（2018-2019年）和修改后（2020-2021年）的眼睑整形手术的术前和术后照片进行了评估，并根据特定标准进行了评分。与之前的手术相比，修改后组的术后评分明显提高（P≤0.01）。根据眼睑解剖特点进行术前分类并进行手术修改，可以减少双眼皮成形术常见的五种并发症的发生。四

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引用次数: 0

The next frontier in plastic surgery innovation: Quantum computing 整形外科创新的下一个前沿：量子计算

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-01-01 DOI: 10.1016/j.bjps.2024.12.001

Berk B. Ozmen , Bryan A. Raubenolt , Daniel Blankenberg , Graham S. Schwarz

This work explores the transformative potential of quantum computing (QC) in plastic and reconstructive surgery, highlighting its ability to enhance predictive modeling, surgical planning, and intraoperative guidance. By leveraging QC’s superior computational power, clinicians have the capacity to improve personalized treatment plans and optimize surgical outcomes. Despite the challenges of cost, technical limitations, and ethical considerations, the integration of QC into clinical practice and research promises significant advancements in patient care and surgical innovation.

这项研究探索了量子计算（QC）在整形与重建外科中的变革潜力，强调了量子计算在增强预测建模、手术规划和术中指导方面的能力。利用量子计算的超强计算能力，临床医生有能力改进个性化治疗方案并优化手术效果。尽管存在成本、技术限制和伦理方面的挑战，但将 QC 融入临床实践和研究有望在患者护理和手术创新方面取得重大进展。

引用次数: 0

Prevalence study of body dysmorphic disorder symptoms in plastic surgery 整形外科中身体畸形障碍症状的流行研究。

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-01-01 DOI: 10.1016/j.bjps.2024.11.035

David Boccara , Marc Chaouat , Jeremy Kaplan , Kevin Serror , Sarah Chatelain

Introduction

The objective of this work was to determine the prevalence of Body Dysmorphic Disorder (BDD) symptoms in plastic and aesthetic surgery consultations in a large cohort of patients presenting for initial consultations for various indications.

Results

We conducted a prospective, single-center cohort study between January 2022 and November 2022. A total of 1169 questionnaires were collected, and 842 patients were included in the study.

Among the entire population, 180 patients screened positive test and were thus considered at high risk for BDD. This represented 21.4% of our population.

Regarding the impact on their sexual and/or romantic life, 40% of our patients indicated that their BDD symptoms affected their sexual life, which aligns with the findings of Brito, who found that patients with BDD+ had significantly higher sexual inhibition than those with BDD−, with sexual inhibition reported in 51% of patients with BDD+ compared with 28% of patients with BDD−.

Discussion

The prevalence of BDD symptoms in our population (21.4%) is close to the average found in other prevalence studies on BDD in plastic surgery. Our cohort, which is the largest prospective cohort conducted on the subject to date, is very representative of the population presenting to plastic surgery for consultation. It also presents the most extensive range of surgical indications ever studied in the literature.

Conclusion

BDD most often affects patients under 50 years old who consult for rhinoplasty or otoplasty. Only severe presentations of BDD are risk factors for postoperative dissatisfaction. Therefore, it is essential to diagnose such cases and direct these patients toward psychiatric care rather than operating on them.

导言：这项研究的目的是确定因各种适应症初次就诊的大批患者中，身体畸形障碍（BDD）症状在整形美容外科就诊中的流行率：我们在 2022 年 1 月至 2022 年 11 月期间开展了一项前瞻性单中心队列研究。共收集了 1169 份问卷，842 名患者被纳入研究。在所有人群中，有 180 名患者检测结果呈阳性，因此被认为是 BDD 的高危人群。这占我们研究人群的 21.4%。关于对性生活和/或恋爱生活的影响，40%的患者表示他们的BDD症状影响了他们的性生活，这与Brito的研究结果一致，他发现BDD+患者的性抑制明显高于BDD-患者，51%的BDD+患者有性抑制，而BDD-患者只有28%：讨论：我们研究人群中 BDD 症状的流行率（21.4%）接近其他整形外科 BDD 流行率研究的平均值。我们的队列是迄今为止就该主题进行的最大的前瞻性队列，在整形外科就诊人群中具有很强的代表性。同时，它也是文献中研究过的最广泛的手术适应症：结论：BDD 最常影响 50 岁以下的鼻整形或耳整形患者。只有严重的 BDD 才是导致术后不满意的危险因素。因此，有必要对这类病例进行诊断，并引导这些患者接受心理治疗，而不是对他们进行手术。

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引用次数: 0

Letter to the Editor about the article Capsular contracture in breast reconstruction: A systematic review and meta-analysis 致编辑关于乳房再造中包膜挛缩的文章：系统回顾和荟萃分析。

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-01-01 DOI: 10.1016/j.bjps.2024.11.038

Douglas Carvalho, Davi Neves Coelho, Filipi Fim Andreão

引用次数: 0

Hormonal status and gender identity do not change aesthetic preferences for top surgery 荷尔蒙状况和性别认同不会改变对顶部手术的审美偏好。

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-01-01 DOI: 10.1016/j.bjps.2024.11.043

Benjamin Rahmani, John B. Park, Oluwaseun D. Adebagbo, Micaela Tobin, Tricia Mae Raquepo, Mohammed Yamin, Jose A. Foppiani, Daniela Lee, Maria J. Escobar-Domingo, Adam M. Tobias, Ryan P. Cauley

Background

Chest masculinization surgery (CMS) is becoming increasingly common, especially in the nonbinary population. However, variations in CMS preferences between this group and the transgender population remain undefined. Additionally, it is unknown if concurrent testosterone use may correlate with differing aesthetic preferences. Therefore, we aimed to identify whether aesthetic preferences vary among patients undergoing CMS based on gender identity and hormonal treatment status.

Methods

Patients undergoing masculinizing top surgery participated in an institutional survey identifying their aesthetic preferences through two modified photos representing normal and high BMI. A total of 115 patients completed the survey with 98 non-binary and transgender male patients meeting inclusion criteria. Patients were compared by gender and hormonal status.

Results

Among participants, 32 were non-binary on hormonal therapy, 33 were non-binary without hormonal therapy, and 33 were transgender males on hormonal therapy. Comparisons among transgender males on hormonal therapy and non-binary individuals on and off hormonal therapy revealed no differences in preferences for mean nipple diameter for an example individual with a normal BMI (P=0.64) or an example individual with a high BMI (P=0.42). Preference for the straight scar type remained consistent across all groups for both normal (P=0.88) and high BMI (P=0.28) examples.

Conclusions

Despite our study population’s diversity, hormonal status and gender identity did not correlate with aesthetic preferences. Individual aesthetic preferences should not be implied by gender identity or hormone status and instead may be better understood with a more systematic and collaborative decision-making process.

背景：胸部男性化手术（CMS）变得越来越普遍，特别是在非二元人群中。然而，这一群体和跨性别人群在CMS偏好方面的差异仍不明确。此外，是否同时使用睾酮可能与不同的审美偏好有关尚不清楚。因此，我们的目的是确定在接受CMS的患者中，基于性别认同和激素治疗状况的审美偏好是否存在差异。方法：对接受男性化顶手术的患者进行问卷调查，通过BMI正常和BMI高的两张修改后的照片来确定患者的审美偏好。共有115名患者完成了调查，其中98名非二元和跨性别男性患者符合纳入标准。比较患者的性别和激素状况。结果：接受激素治疗的非二元男性32人，未接受激素治疗的非二元男性33人，接受激素治疗的变性男性33人。在接受激素治疗的跨性别男性和接受或不接受激素治疗的非二元性别个体之间的比较显示，正常BMI个体（P=0.64）和高BMI个体（P=0.42）对平均乳头直径的偏好没有差异。对于正常（P=0.88）和高BMI （P=0.28）的样本，所有组对直型疤痕的偏好保持一致。结论：尽管我们的研究人群具有多样性，但荷尔蒙状况和性别认同与审美偏好无关。个人的审美偏好不应该被性别认同或激素状态所暗示，相反，通过更系统和协作的决策过程可以更好地理解。

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引用次数: 0

Acknowledgement of Reviewers

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2024-12-01 DOI: 10.1016/j.bjps.2024.11.020

引用次数: 0

Commentary on “Exploring the use, outcomes, barriers, and facilitators of prehabilitation and rehabilitation in abdominoplasty surgeries: A scoping review” 关于 "探索腹部整形手术前康复和康复的使用、结果、障碍和促进因素：范围界定综述 "的评论。

IF 2 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2024-12-01 DOI: 10.1016/j.bjps.2024.09.026

Jing Qin Tay

引用次数: 0

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