Journal of Plastic Reconstructive and Aesthetic Surgery最新文献

{"title":"Effective minimally invasive strategy for mixed-type gynecomastia using vacuum-assisted mastectomy and power-assisted liposuction","authors":"Yu-Chi Wang ,&nbsp;Shu-Hung Huang ,&nbsp;Fang-Ming Chen ,&nbsp;Ping-Fu Yang ,&nbsp;Li-Chun Kao ,&nbsp;Ya-Wei Lai","doi":"10.1016/j.bjps.2024.09.040","DOIUrl":"10.1016/j.bjps.2024.09.040","url":null,"abstract":"<div><h3>Introduction</h3><div>Mixed-type gynecomastia is a benign male breast condition characterized by the proliferation of glandular and adipose tissues. Conventional open surgery has been the main approach for treating gynecomastia. However, this method has been associated with complications, including breast deformity, noticeable scar, nipple necrosis, and hypoesthesia. In contrast, vacuum-assisted biopsy systems and liposuction have demonstrated significant advantages in minimally invasive breast surgery.</div></div><div><h3>Aims</h3><div>Our study aimed to investigate the effectiveness of combining vacuum-assisted mastectomy with power-assisted liposuction (VAM+PAL) for patients with mixed-type gynecomastia compared to conventional open surgery.</div></div><div><h3>Methods</h3><div>Sixty patients with mixed-type gynecomastia, treated between January 2019 and June 2023, were included in this study. VAM+PAL was performed on 30 patients (59 breasts), and open excision with periareolar approach was performed on 30 patients (59 breasts). The efficacy, complications, outcomes, scar cosmesis, and patient satisfaction were assessed.</div></div><div><h3>Results</h3><div>Compared to open excision group for gynecomastia, the VAM+PAL group demonstrated a substantial reduction in incision size (4.47 ± 1.21 cm vs. 0.97 ± 0.74 cm, <em>p</em> &lt; 0.001) and lower scores of Vancouver scar scale (3.23 ± 2.27 vs. 1.10 ± 1.47, <em>p</em> &lt; 0.001). No drainage tubes were required for postoperative hematoma/seroma prevention. The patients in the VAM+PAL group had significantly lower complication rates (18.64% vs. 3.39%, <em>p</em> = 0.008), particularly in bruise and hypoesthesia. All VAM+PAL patients reported superior satisfaction with the outcomes in breasts and nipples.</div></div><div><h3>Conclusion</h3><div>The combination of vacuum-assisted mastectomy and power-assisted liposuction can be used as an efficient minimally invasive method to treat mixed-type gynecomastia with acceptable complications, superior scar cosmesis, and satisfying outcomes.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"99 ","pages":"Pages 175-184"},"PeriodicalIF":2.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396359","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}

{"title":"Reconstruction trends in New York City: A multi-decade, multi-institutional experience before and after the implementation of the Breast Cancer Provider Discussion Law","authors":"Yunchan Chen ,&nbsp;Chase Alston ,&nbsp;Paul Asadourian ,&nbsp;Grant G. Black ,&nbsp;Christine H. Rohde ,&nbsp;David M. Otterburn","doi":"10.1016/j.bjps.2024.09.029","DOIUrl":"10.1016/j.bjps.2024.09.029","url":null,"abstract":"<div><h3>Introduction</h3><div>The potential benefits of breast reconstruction for achieving greater patient satisfaction, wellbeing, and functional outcomes after mastectomy have been widely acknowledged. However, sociodemographic and economic disparities exist in accessing reconstruction. This study aimed to characterize the influence of various factors on access to reconstruction and investigate the impact of the Breast Cancer Provider Discussion Law (BCPDL), legislation that mandates patient education and referral to plastic surgery at the time of breast cancer diagnosis, on utilization of reconstructive services.</div></div><div><h3>Methods</h3><div>Retrospective chart review was performed to collect data on patients who underwent mastectomy at two institutions within the New York-Presbyterian system from 1998–2019. Sociodemographic, past medical history, and treatment approach information were recorded. Interrupted time series analysis and logistic regression were used for statistical analysis.</div></div><div><h3>Results</h3><div>The cohort included 6122 patients, of which 3737 (61.04%) underwent reconstruction and 2385 (38.96%) did not. Older age, Medicaid/Medicare insurance, higher tumor staging, and Asian American/Pacific Islander identity were negative predictors of undergoing reconstruction. The interrupted time series analysis of the years before and the years after implementation of the 2010 BCPDL revealed that while there was an immediate increase in the proportion of patients who received reconstruction, the effects were not sustained.</div></div><div><h3>Conclusion</h3><div>Our data indicates that patient-physician communication alone may not be sufficient to bridge the gap in reconstructive care. This study highlights the need for consistent plastic surgery referral for sustained equal access to reconstructive services.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"99 ","pages":"Pages 221-229"},"PeriodicalIF":2.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396363","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}

{"title":"The impact of age on outcomes after breast reduction surgery – A multi-institutional data analysis of 40,958 cases","authors":"Samuel Knoedler ,&nbsp;Filippo A.G. Perozzo ,&nbsp;Jun Jiang ,&nbsp;Mychajlo Kosyk ,&nbsp;Michael Alfertshofer ,&nbsp;Thilo L. Schenck ,&nbsp;Barbara Kern ,&nbsp;Giuseppe Sofo ,&nbsp;Leonard Knoedler ,&nbsp;Adriana C. Panayi ,&nbsp;Bohdan Pomahac ,&nbsp;Martin Kauke-Navarro ,&nbsp;Bong-Sung Kim","doi":"10.1016/j.bjps.2024.09.027","DOIUrl":"10.1016/j.bjps.2024.09.027","url":null,"abstract":"<div><h3>Background</h3><div>Reduction mammoplasty is popular among people of various age groups, yet the impact of age on postoperative outcomes remains debated.</div></div><div><h3>Methods</h3><div>The American College of Surgeons National Surgical Quality Improvement Program (2008–2021) was queried to identify adult female patients who underwent reduction mammoplasty. Patients were categorized into 10-year age brackets (i.e., 18–29, 30–39, 40–49, 50–59, 60–69, and &gt;70 years). We compared age-dependent 30-day outcomes via confounder-adjusted multivariate analyses.</div></div><div><h3>Results</h3><div>40,958 female patients (mean age: 41 ± 14 years and mean body mass index: 31 ± 6.1 kg/m²) were identified. Complications occurred in 6.4% (n = 2635) of cases, with 770 (1.9%) and 483 (1.2%) patients requiring reoperation and readmission, respectively. 1706 (4.2%) women experienced surgical complications, whereas medical complications were generally rare (n = 289; 0.7%). Compared with women aged 18–29 years, risks of any, surgical, and medical complications were higher for patients aged 30–39 years (OR: 1.22, <em>p</em> &lt; 0.01; OR: 1.05, <em>p</em> = 0.51; OR: 1.84, <em>p</em> &lt; 0.01), 40–49 years (OR: 1.34, <em>p</em> &lt; 0.01; OR: 1.17, <em>p</em> = 0.04; OR: 1.54, <em>p</em> = 0.03), 50–59 years (OR: 1.45, <em>p</em> &lt; 0.01; OR: 1.31, <em>p</em> &lt; 0.01; OR: 1.78, p &lt; 0.01), 60–69 years (OR: 1.38 years, <em>p</em> &lt; 0.01; OR: 1.29, <em>p</em> = 0.01; OR: 1.71, <em>p</em> &lt; 0.01), and &gt;70 years (OR: 1.25, <em>p</em> = 0.18; OR: 1.01, <em>p</em> = 0.98; OR: 1.86, <em>p</em> = 0.14). Patients aged &gt;30 years were also more likely to require readmissions and reoperations.</div></div><div><h3>Conclusion</h3><div>Patient age significantly affects outcomes after reduction mammoplasty, with the lowest risk in patients aged &lt;30 years. Importantly, the association between age and postoperative morbidity was not linear. These findings can help guide informed decisions, recognizing that while age is a factor, it is not the sole determinant of risk.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"98 ","pages":"Pages 318-330"},"PeriodicalIF":2.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315323","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}

{"title":"Applying 3D scanning to evaluate facial symmetry in Asian populations","authors":"Jun Zhuang ,&nbsp;Hengyuan Ma ,&nbsp;Cheng Wang ,&nbsp;Xiangting Kong ,&nbsp;Yi Chen ,&nbsp;Xueshang Su ,&nbsp;Ziming Zhang ,&nbsp;Qingqian Wei ,&nbsp;Liya Jiang ,&nbsp;Jintian Hu","doi":"10.1016/j.bjps.2024.09.025","DOIUrl":"10.1016/j.bjps.2024.09.025","url":null,"abstract":"<div><h3>Background</h3><div>Facial symmetry enhances attractiveness, with various therapies available to improve it. However, trends in facial asymmetry remain unclear. This study evaluates the differences between specific facial regions using 3D scanning to guide clinical treatment.</div></div><div><h3>Method</h3><div>The 3dMD face™ system (3dMD Ltd, USA) scanned the faces of 88 participants. Geomagic Wrap 2021 analyzed the left and right sides. Differences in the eyebrow peaks, eyebrow tails, eye ends, and mouth corners were evaluated.</div></div><div><h3>Results</h3><div>Several participants showed a drooping right side of the face in the eyebrow peaks, eyebrow tails, eye ends, mouth corners, tubercula mentale, and mandibular margin positions. A higher proportion had deeper left nasolabial folds and marionette lines, whereas several others had deeper right tear ducts and lateral chin depressions. Several participants exhibited prominent right forehead and parotid masseter region, with prominent left temporal and cheek regions.</div></div><div><h3>Conclusion</h3><div>3D scanning effectively assesses facial asymmetry in clinical practice. Research indicates significant differences in asymmetry between the facial regions. Evaluating these differences pre-treatment can guide the selection of therapeutic methods to improve facial asymmetry.</div></div><div><h3>Level of evidence</h3><div>3 (Diagnostic).</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"99 ","pages":"Pages 11-17"},"PeriodicalIF":2.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142328283","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}

{"title":"Anatomical dissection continues to be a uniquely valuable teaching tool for the future plastic surgeon","authors":"Sebastian Tullie ,&nbsp;Joseph Moneim ,&nbsp;Kai Yuen Wong ,&nbsp;Cecilia Brassett","doi":"10.1016/j.bjps.2024.09.045","DOIUrl":"10.1016/j.bjps.2024.09.045","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"98 ","pages":"Pages 337-338"},"PeriodicalIF":2.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142318452","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}

{"title":"Evaluation of prepectoral reconstruction surgical outcomes: Main operating room vs ambulatory surgery center","authors":"Lexy Anderson ,&nbsp;Kandace Fung ,&nbsp;Ju Young Lee ,&nbsp;Leila Musavi ,&nbsp;Tahera Alnaseri ,&nbsp;Maral Demirjian ,&nbsp;Lorna Kwan ,&nbsp;Cristopher Crisera ,&nbsp;Jaco Festekjian ,&nbsp;Michael DeLong","doi":"10.1016/j.bjps.2024.09.038","DOIUrl":"10.1016/j.bjps.2024.09.038","url":null,"abstract":"<div><h3>Introduction</h3><div>During the height of the recent Coronavirus (COVID-19) pandemic, several surgeries were transitioned to ambulatory surgery centers to reserve inpatient resources and reduce transmission risks. Our study evaluated the surgical outcomes of patients who underwent prepectoral breast reconstruction in the operating rooms of two full-service main hospitals versus their associated surgery centers.</div></div><div><h3>Methods</h3><div>A retrospective chart review was conducted of patients who underwent immediate prepectoral breast reconstruction at a single hospital between 2018 and 2022. Eligible patients had at least 3 months of post-expander follow-up, with the majority also having 3 months of post-implant follow-up. Patient demographics, reconstructive characteristics, post-expander outcomes, and post-implant outcomes were evaluated between the surgery center and main operating room using the chi-squared (or Fisher’s exact) and Wilcoxon ranked-sum tests.</div></div><div><h3>Results</h3><div>This study included 301 patients, outcomes of 509 post-expander breasts, and outcomes of 410 post-implant breasts. The patient characteristics were similar with the only significant difference being the hospital length of stay (increased stay at the main hospital). There were no statistically significant differences in any of the surgical outcomes between the two groups in the post-expander or post-implant period.</div></div><div><h3>Conclusion</h3><div>The COVID-19 pandemic disrupted elective procedures, prompting a shift toward outpatient surgery to optimize hospital resources and reduce inpatient exposure risks. Although breast reconstruction is elective, delays can pose risks for patients with cancer. Our results show that surgical outcomes for prepectoral prosthetic breast reconstruction remain consistent whether performed in outpatient surgical centers or main hospitals.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"98 ","pages":"Pages 406-413"},"PeriodicalIF":2.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402456","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}

{"title":"Trends in advanced practice providers in plastic and reconstructive surgery, 2013–2021","authors":"Rishub Karan Das,&nbsp;Olivia Bittles,&nbsp;Wesley P. Thayer,&nbsp;Brian C. Drolet,&nbsp;Galen Perdikis","doi":"10.1016/j.bjps.2024.09.034","DOIUrl":"10.1016/j.bjps.2024.09.034","url":null,"abstract":"<div><p>This restrospective cohort study of Medicare payment data found increases in the number of advanced practice providers who bill for plastic and reconstructive surgery care. The growth in advanced practice providers is expected to continue in plastic surgery, and further investigation is needed to effectively integrate these providers into academic centers.</p></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"98 ","pages":"Pages 211-213"},"PeriodicalIF":2.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1748681524005916/pdfft?md5=a4e3ca9e1bb6ffc4313288fb9b325804&pid=1-s2.0-S1748681524005916-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142238356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-image, self-esteem, anxiety, and functional capacity in patients undergoing open-structure rhinoplasty","authors":"Thamy Harumi Cardoso Motoki ,&nbsp;Eduardo Nascimento Silva ,&nbsp;Felipe Contoli Isoldi ,&nbsp;Lydia Masako Ferreira","doi":"10.1016/j.bjps.2024.09.023","DOIUrl":"10.1016/j.bjps.2024.09.023","url":null,"abstract":"<div><h3>Background</h3><div>Rhinoplasty may improve negative psychological aspects, such as mild to moderate body dysmorphic disorder; however, the repercussions on the self-image and quality of life of patients after the procedure are unknown.</div></div><div><h3>Objective</h3><div>To evaluate self-image, self-esteem, anxiety, and functional capacity of patients undergoing open-structure rhinoplasty.</div></div><div><h3>Methods</h3><div>A primary, analytical, clinical, longitudinal, and prospective study was conducted, which included 30 female patients, aged between 18 and 50 years with elongated nose and nasal hump, who underwent open and structured rhinoplasty. All procedures were performed by a team from the Rhinology DCP/Unifesp. The Rosenberg Self-Esteem Scale - EPM, BDSS, BDD-YBOCS, SF-36, SRQ-20, and STAI (T/E) questionnaires were administered before the surgery and at 6, 12, and 18 months after surgery.</div></div><div><h3>Results</h3><div>The results showed statistically significant differences in the Rosenberg scale - EPM (p = 0.017), BDSS (p &lt; 0.001), BDD (p = 0.006), SF-36 (p = 0.041), SRQ-20 (p = 0.012), and STAI-T (p = 0.001) scores in general analyses. Additionally, the statistically significant changes persisted in various stratified postoperative periods. In the qualitative analysis, there was only statistical significance for the classification of the BDSS score, where the “Absent” (absence of body dysmorphism) index increased from 70.0% in the preoperative state to 96.7% in 18 months postoperatively. The “Present” (presence of body dysmorphism) index fell from 30.0% to 3.3% in the same period (p = 0.001).</div></div><div><h3>Conclusion</h3><div>Open-structure rhinoplasty improved the patients’ self-image, self-esteem, anxiety, and mental health.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"99 ","pages":"Pages 88-95"},"PeriodicalIF":2.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142368064","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}

{"title":"Periauricular hair transplantation enhances the cosmetic results of eyebrow transplantation: A retrospective study in Chinese recipients","authors":"Hanxiao Cheng ,&nbsp;Jini Qi ,&nbsp;Fei Zhu ,&nbsp;Zhongxin Sun ,&nbsp;Nanyi Jiang ,&nbsp;Jufang Zhang","doi":"10.1016/j.bjps.2024.09.008","DOIUrl":"10.1016/j.bjps.2024.09.008","url":null,"abstract":"<div><h3>Background</h3><div>Eyebrow transplant surgeries have become increasingly popular in recent years. Periauricular hair, with its slow growth rate and fine caliber similar to eyebrow hair, has been strategically used in eyebrow transplants to achieve enhanced and authentically natural aesthetic results.</div></div><div><h3>Objectives</h3><div>This study aimed to assess the postoperative clinical outcomes of using periauricular hair for eyebrow transplantation.</div></div><div><h3>Methods</h3><div>Data from 81 patients (72 women and 9 men) who underwent eyebrow transplantation with periauricular hair between October 2020 and September 2022 were analyzed. They were followed up for 15 months’ post-surgery to evaluate recovery and complications. Patient satisfaction and quality of postoperative life were assessed using a 5-point Likert scale.</div></div><div><h3>Results</h3><div>For female patients, the average total number of transplanted hair grafts and surgery duration were 402.33 ± 158.48 FU (follicular unit) and 193.86 ± 66.69 min, respectively. Contrastingly, male patients exhibited slightly higher values, with an average of 481.78 ± 126.43 FU and 229.00 ± 96.80 min, respectively. No significant complications were reported during the postoperative follow-up. Patients expressed general satisfaction with immediate and 15-month postoperative outcomes, reflected in a mean overall satisfaction score of 4.90. The overall satisfaction of the subjects at 15 months postoperative was significantly higher than the preoperative satisfaction (<em>Z</em> = −8.483, <em>p</em> &lt; 0.001). The eyebrow/forehead surgery did not have a significant impact on postoperative satisfaction (<em>H</em> = 5.355, <em>p</em> = 0.374 &gt; 0.05); however, patients without tattoos tended to report higher levels of postoperative satisfaction (<em>Z</em> = 8.056, <em>p</em> = 0.004 &lt; 0.05). Patient satisfaction ratings for physical function, psychological function, social function, and quality of life post-operation were 5, 4.95, and 4.94, respectively.</div></div><div><h3>Conclusions</h3><div>Eyebrow transplant using periauricular hair can improve cosmetic outcomes and is a viable option in clinical practice.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"98 ","pages":"Pages 309-317"},"PeriodicalIF":2.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1748681524005588/pdfft?md5=a95372093fd952cb5a86426ea6ecb4d0&pid=1-s2.0-S1748681524005588-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 and postoperative complications after plastic surgery procedures: More than just hypercoagulability","authors":"Theresa K. Webster,&nbsp;Lauren S. Lowe,&nbsp;Dylan K. Kim,&nbsp;Christine H. Rohde","doi":"10.1016/j.bjps.2024.09.024","DOIUrl":"10.1016/j.bjps.2024.09.024","url":null,"abstract":"<div><h3>Background</h3><div>Although plastic surgery procedures generally demonstrate less than 2% incidence of venous thromboembolism (VTE) outcomes, the post-COVID era data remain elusive. This study sought to elucidate the relationship between COVID-19 infection and the risk of VTE outcomes across plastic surgery procedures.</div></div><div><h3>Methods</h3><div>Plastic surgery procedures were identified in the 2012–2022 National Surgical Quality Improvement Program databases. The outcomes of interest were the postoperative occurrence of VTE, defined as deep vein thrombosis (DVT) or pulmonary embolism (PE), and postoperative complication. Propensity score matching was used to 1) compare overall rates of VTE between the pre-pandemic era and pandemic era cohorts and 2) compare rates of VTE and overall postoperative complications in cases with and without COVID-19 diagnosis in the years 2021–2022 (<em>p</em> &lt; 0.05).</div></div><div><h3>Results</h3><div>Overall, 269,006 plastic surgery cases were identified, comprising general breast (76%) and trunk (9.4%) procedures. Non-breast free tissue transfer cases were associated with the highest rates of DVT (1.3%) and trunk procedures with the highest rates of PE (0.7%). After propensity score matching, the overall rate of VTE after the onset of the COVID-19 pandemic was not significantly different from the pre-pandemic era (<em>p</em> = 0.40). In a separately matched cohort, COVID-19 diagnosis did not significantly predict the risk for VTE (<em>p</em> = 0.48) but did significantly predict the risk for overall postoperative complications (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Although COVID-19 diagnosis itself did not predict the risk of VTE in matched analysis, it significantly predicted the overall postoperative complications. Future studies may further investigate the effects of COVID-19 infection over longer periods of follow-up.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"98 ","pages":"Pages 287-297"},"PeriodicalIF":2.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315320","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}