Looped Penrose Drainages of Acute Hand Infections in Vulnerable Populations.

Purpose: Acute hand infections (AHIs) remain a challenge for hand surgeons and represent a condition for which clinical outcomes are considerably affected by social barriers. We previously described the looped Penrose drainage technique, where a drain is sutured to itself in a loop and the outflow tract of egress is maintained, thus obviating the need for large incisions, wound closure, or repeat packing, thereby reducing the follow-up burden. In the face of escalating numbers of socioeconomically vulnerable patients, especially in urban settings, we aimed to characterize the clinical features and outcomes of this technique in an urban population of patients with AHI.

Onlay Resorbable Biosynthetic versus Underlay Biologic Mesh Ventral Hernia Repair in Contaminated Fields.

Introduction: Abdominal wall reconstruction (AWR) with ventral hernia repair (VHR) in the setting of contamination poses unique and controversial challenges. The purpose of this study was to examine the efficacy of onlay resorbable biosynthetic mesh against underlay biologic mesh in contaminated VHR with AWR.

Methods: A single-center retrospective review from 2015 to 2021 was performed examining subjects who underwent VHR with AWR in contaminated fields (Centers for Disease Control wound class II-IV).

Word of the Wise: A Propensity-Matched Comparative Analysis of Breast Reduction Incision Patterns on Clinical Outcomes and Quality of Life.

Introduction: Breast reduction surgery addresses both functional complaints and aesthetic concerns. Two commonly used incision patterns in the US are the Wise and vertical patterns, but there are limited data comparing their clinical and quality of life (QoL) outcomes. This study evaluates and compares these outcomes between the two techniques.

Multimodal Pilot Evaluation of a Hyaluronic Acid Infraorbital Filler Using Precise, Multipositional, 3-Dimensional Imaging Quantification, Patient-Reported Outcomes, and Anatomic Cadaveric Assessments.

Background: Despite the high demand of filler in the infraorbital area, there remains debate on injection practices, precise anatomical placement, and hyaluronic acid (HA) filler behavior.

Objectives: We aimed to contribute to the clinical and anatomic understanding of infraorbital HA injection through a prospective patient injection study in combination with a cadaveric analysis.

Methods: Patients were injected with Volbella XC (JUVÉDERM, Allergan Aesthetics, an AbbVie Company, Irvine, CA) into the tear trough region by a single experienced aesthetic plastic surgeon.

Diversity in the US Academic Microsurgery Pathway.

Although the representation of women and ethnic minority students in the US medical schools has recently increased, discrepancies in representation among plastic surgery residents and faculty continue. The state of sex and ethnic diversity in academic microsurgery remains minimally investigated. We aimed to evaluate the sex, race, and ethnicity demographics among academic microsurgeons and identify underrepresentation along the leadership pathway.

A Longitudinal Evaluation of Collaboration in Plastic Surgery Clinical Research.

Background: Few dedicated, funded clinical research fellowship positions exist in plastic surgery. This study provides insights from an established clinical research fellowship, highlighting its educational impact and confirming the impact of positive institutional support and a collaborative-first approach.

Methods: All research fellows within the program from 2008 to 2020 were examined during their year of employment and subsequent 2 years.

Marijuana and Its Implications in Breast Reduction Surgery Outcomes and Quality of Life: A Matched Analysis.

Background: With marijuana use on the rise, its influence on surgical outcomes, particularly for breast reduction, warrants investigation. This study aims to clarify marijuana's effects on breast reduction surgery outcomes, given its limited research focus despite potential perioperative implications.

Methods: A retrospective review was conducted from 2016 to 2022 of patients with/without marijuana use undergoing breast reduction.

Unplanned 180-day Readmissions and Health Care Utilization after Immediate Breast Reconstruction for Breast Cancer.

Background:  To assess the burden of postdischarge health care utilization given by readmissions beyond 30 days following immediate breast reconstruction (IBR) nationwide.

Methods:  Women with breast cancer who underwent mastectomy and concurrent IBR (autologous and implant-based) were identified within the 2010 to 2019 Nationwide Readmission Database. Cox proportional hazards and generalized linear regression controlling for patient- and hospital-level confounders were used to determine factors associated with 180-day unplanned readmissions and incremental hospital costs, respectively.

The Use of Tranexamic Acid in Breast Reduction and Abdominoplasty: A Review of a Multicenter Federated Electronic Health Record Database.

Background: Tranexamic acid (TXA), a fibrinolysis inhibitor, is widely used in various surgical fields to minimize blood loss. However, its efficacy and safety in plastic surgery, especially in reduction mammaplasty and abdominoplasty, remain underexplored. This study investigates the utility of intravenous (IV) TXA in these procedures, focusing on reducing postoperative complications and evaluating its safety in the context of venous thromboembolism (VTE).

Reevaluation of Recipient Vessel Selection in Breast Free Flap Reconstruction.

Background: Current consensus has established the internal mammary vessels (IMV) over the thoracodorsal vessels (TDV) as the preferred recipients for microvascular breast reconstruction due to their superior flow rates and long-established outcomes. Yet, there are occurrences where the IMVs are not reliable and may subsequently prompt intraoperative decision-making. Several options exist, including the contralateral IMVs, thoracoacromial vessels, and TDVs.

Mesh exposure after ventral hernia repair with onlay biosynthetic mesh: a retrospective review of associated risk factors and management strategies.

Background: Although intraperitoneal and retromuscular mesh placement in ventral hernia repair (VHR) are associated with lower recurrence rates, the onlay plane remains a well-established option for certain clinical scenarios. A knowledge gap remains regarding resorbable biosynthetic onlay mesh and mesh exposure. We aim to determine exposure rate, risk factors, and treatment options.

The Godina Principle in the 21st Century: Free Flap Timing after Isolated Lower Extremity Trauma in a Retrospective National Cohort.

Background:  The timing of free flap reconstruction after lower extremity trauma has been a controversial debate since Marko Godina's original 72-hour recommendation. Recent advances in microsurgery warrant an evaluation of the optimal time to reconstruction.

Methods:  The Nationwide Readmission Database (2014-2019) was used to identify patients undergoing free flap reconstruction after lower extremity trauma.

An Update on the Independent Plastic Surgery Match (2019-2022): Trends, Predictors, and Program Leaders' Perspectives.

Background: A previous study by the authors noted a decline in independent plastic surgery residency programs and rising applicant participation. This study provides updates on match trends and influential predictors, and gathers program leaders' views on the future of the independent track.

Methods: Match data (2019-2022) were obtained from the San Francisco match after American Council of Educators in Plastic Surgery approval.

Unveiling the Need to Improve Personalized Applicant Tools: A Critical Evaluation of the Reliability of the Texas STAR database in Predicting Match Success for Plastic Surgery Applicants.

Objectives: Using Texas STAR (seeking transparency in application to residency), we aimed to 1) examine predictors of matching success in integrated plastic surgery residency programs and 2) assess the reliability of the tool.

Design, Setting, And Participants: A retrospective analysis of self-reported nationwide data of plastic surgery residency applicants between 2021 and 2023 across 146 participating medical schools were included. A comparison analysis was performed between matched and unmatched applicants using chi-squared tests, t-tests, and logistic regression models.

Balancing the Scales: Caution in Reduction Mammaplasty Recommendations for Obesity Class III Patients.

Introduction: The prevalence of obesity has risen worldwide, posing a problem to surgeons as obesity is a well-known risk factor for surgical outcomes. While prior studies have suggested performing reduction mammaplasty (RM) in patients with obesity, the variance in outcomes and quality of life (QoL) for obesity classes are ill-defined. We investigated whether obesity classes should be considered for RM by examining the surgical outcomes and QoL across different weight classes, aiming to pinpoint when outcomes become less favorable.

Impact of Implant Exchange Timing after Postmastectomy Radiation in Immediate Tissue Expander Breast Reconstruction.

Background: The use of postmastectomy radiation therapy (PMRT) in the setting of immediate 2-stage breast reconstruction is becoming increasingly widespread. However, the timeframe of tissue expander exchange for permanent implant placement following PMRT is not well defined, and it remains unclear what time interval optimizes surgical outcomes and patient satisfaction.

Methods: A systematic review conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 was completed.

Increased Patient Age as a Risk Factor Following Free Flap Reconstruction after Breast Cancer: A Single Institutional Review of 2,598 Cases.

Background:  Autologous breast reconstruction (ABR) after mastectomy is increasing due to benefits over implant-based reconstruction. However, free flap reconstruction is not universally offered to patients of advanced age due to perceived increased perioperative risk.

Methods:  Patients undergoing free flap breast reconstruction at our institution from 2005 to 2018 were included.

Accelerating Fleur-de-lis Panniculectomy with the Absorbable Dermal Stapler-A Study of Efficiency, Aesthetics, and Quality-of-life.

Background: Fleur-de-lis panniculectomy (FDL), a contouring technique involving vertical and horizontal tissue resections, often involves longer operative times and potential complications. This study assessed operative time, postoperative outcomes, and patient-reported quality of life (PRO) with Insorb Absorbable Subcuticular Skin Stapler versus traditional sutures during FDL.

Methods: A retrospective review from 2015 to 2022 of FDL patients excluded those with complex concomitant procedures.

Reconstructing Nasal Defects With Acellular Dermal Matrix After Mohs Micrographic Surgery: A 12-year Experience.

Background And Objective: Large defects of the nose after Mohs surgery pose a significant reconstructive challenge to both dermatologic and reconstructive surgeons. The authors present their 12-year experience utilizing acellular dermal matrices for nasal reconstruction.

Methods: A retrospective review of patients undergoing Mohs surgery and alloplastic nasal reconstruction with acellular dermal matrices between 2010 and 2022 was performed.

Extracorporeal Membrane Oxygenation-Associated Compartment Syndrome: Review of a National Database.

Introduction: Extracorporeal membrane oxygenation (ECMO)-associated compartment syndrome (CS) is a rare complication seen in critically ill patients. The epidemiology and management of ECMO-associated CS in the upper extremity (UE) and lower extremity (LE) are poorly defined in the literature. We sought to determine the epidemiology and characterize treatment and outcomes of UE-CS compared to LE-CS in the setting of ECMO therapy.

Outcomes and Quality of Life After Resorbable Synthetic Ventral Hernia Repair in Contaminated Fields.

Introduction: The ideal mesh type for hernia repair in a contaminated field remains controversial. Data regarding outcomes beyond 1 year and the impact on quality of life (QoL) are unknown. This study aims to evaluate the long-term surgical outcomes and patient-reported outcomes (PROs) after contaminated repair with poly-4-hydroxybutyrate (P4HB) mesh.

Comparative Analysis of Ventral Hernia Repair and Transverse Abdominis Release With and Without Panniculectomy: A 4-Year Match-Pair Analysis.

Introduction: Amid rising obesity, concurrent ventral hernia repair and panniculectomy procedures are increasing. Long-term outcomes of transverse abdominis release (TAR) combined with panniculectomy remain understudied. This study compares clinical outcomes and quality of life (QoL) after TAR, with or without panniculectomy.

Genetic and biologic risk factors associated with hernia formation: A review.

Background: This systematic review aims to identify genetic and biologic markers associated with abdominal hernia formation.

Methods: Following PRIMSA-guidelines, we searched PubMed, MEDLINE, Embase, Scopus, and COCHRANE databases.

Results: Of 5946 studies, 65 were selected, excluding parastomal hernias due to insufficient data.

Factors associated with late surgical correction of craniosynostosis: A decade-long review of the United States nationwide readmission database.

Late-repair craniosynostosis (LRC), defined as craniosynostosis surgery beyond 1 year of age, is often associated with increased complexity and potential complications. Our study analyzed data from the 2010-2019 Nationwide Readmissions Database to investigate patient factors related to LRC. Of 10 830 craniosynostosis repair cases, 17% were LRC.