Closed-Incision Negative Pressure Therapy Compared to Conventional Dressing Following Autologous Abdominal Tissue Breast Reconstruction: The MACVAC Pilot Randomized Control Trial.

There is equipoise regarding the use of closed-incision negative pressure therapy (ciNPT) versus conventional dressings for abdominal incisions in deep inferior epigastric perforator (DIEP) flap breast reconstruction. The primary objective was to determine the feasibility of conducting a randomized controlled trial (RCT) comparing ciNPT versus conventional dressings for abdominal incisions in DIEP flap breast reconstruction. A parallel, between-group randomized controlled pilot trial was conducted at two academic breast reconstruction centers.

The Use of Negative Pressure Wound Therapy for Breast Surgeries: A Systematic Review and Meta-Analysis.

Negative pressure wound therapy (NPWT) following breast surgery has emerged as a promising intervention theorized to reduce complication rates, improve patient-important outcomes, and enhance cost-effectiveness. This systematic review and meta-analysis aims to determine outcomes of NPWT following breast surgery. MEDLINE, Embase, CINAHL, Web of Science, and CENTRAL were searched to include all English-language, peer-reviewed observational and randomized controlled trials (RCTs) investigating NPWT on the breast or donor site among patients undergoing breast surgery.

Complications and Burden of 2-Stage Tissue Expander to Implant-Based Reconstructive Surgery: A Single-Center Retrospective Study.

Two-stage reconstruction with a tissue expander/implant (TE/I) technique remains the most common breast reconstructive approach following mastectomy. This study analyzes the post-operative complications and burden associated with 2-stage TE/I reconstruction independent of acellular dermal matrix (ADM). A retrospective chart review identified patients that underwent 2-stage, reconstruction with TE/I without ADM.

Pilot Study: A Multicenter, Prospective Study Demonstrating Safety, Usability, and Feasibility of Perioperative 1-hour Electrical Stimulation Therapy for Enhancing Peripheral Nerve Regeneration.

Background: Electrical stimulation (ES) applied for 1 hour following surgical intervention enhances axonal regeneration and functional outcomes. Clinical implementation, however, has been hindered due to the lack of appropriately designed stimulators.

Methods: This multicenter, prospective, open-label study aimed to demonstrate the safety and device feasibility of a novel, single-use stimulator for implementing perioperative ES therapy in a variety of upper extremity surgical procedures.

Clinical evaluation of a novel disposable neurostimulator used to accelerate regeneration of injured peripheral nerves in the hand.

Background: Preclinical and early clinical evidence demonstrates that electrical stimulation (ES) applied for one hour following surgical nerve intervention enhances axonal regeneration and functional outcomes. Wide clinical implementation however, has been hindered by a lack of suitably designed stimulators. The aim of this pilot study was to investigate sensory recovery, safety, tolerability, and RCT feasibility for the use of a novel single-use stimulator to deliver ES therapy in an acute nerve transection cohort.

Factors associated with emergency free flap reoperation in postmastectomy breast reconstruction: A population-based cohort study.

Background: Reoperation shortly after free flap breast reconstruction is a substantial event with impacts on patients and healthcare utilization. The objective of the study was to evaluate the factors associated with the return to the operating room in free flap breast reconstruction patients.

Methods: This retrospective cohort study included patients who underwent postmastectomy free flap breast reconstruction from 2005 to 2020 in Ontario, Canada.

The Impact of Surgical Wait Time and Hospital Stay on the Incidence of Burn Wound Infection and Related Complications at a Single Tertiary Hospital Centre: A 10-Year Experience.

Admitted patients with burn injuries require prompt treatment and shorter hospital stays to avoid hospital-acquired infections and associated complications. This study aimed to determine the impact of time to the first surgery, and total length of hospital stay on the incidence of BWI and associated complications in adult patients with moderate burn injuries at a single tertiary hospital burn center. A retrospective chart review identified burn patients admitted to the Burn Unit between January 2011 and January 2021.

Consecutive Microsurgical Cases Performed by Single Surgeon at a Canadian Tertiary Care Center: A Retrospective Review.

The practice of a microsurgeon evolves over time with experience, changes in clinical interest, and practice setting. Previous reports suggest that complication rates may be influenced by years of practice. The aim of this study was to analyze consecutive microsurgical cases performed by a single surgeon during the first half of their career in a broad microsurgical practice at a Canadian academic tertiary care center.

Ethical Considerations Regarding Financial Incentives in Plastic Surgery-Related Health Research.

To recruit enough patients to achieve adequate statistical power in clinical research, investigators often rely on financial incentives. The use of these incentives, however, remains controversial as they may cause patients to overlook risks associated with research participation. This concern is amplified in the context of plastic surgery where aesthetic procedures are often more desirable and are not typically covered by public or private insurance plans.

Targeted Muscle Reinnervation and Regenerative Peripheral Nerve Interfaces Versus Standard Management in the Treatment of Limb Amputation: A Systematic Review and Meta-Analysis.

Painful neuromas are a common postoperative complication of limb amputation often treated with secondary reinnervation. Surgical reinnervation include Targeted Muscle Reinnervation (TMR) and Regenerative Peripheral Nerve Interface (RPNI), and can be primary and secondary. The aim of this review is to assess the effects of primary TMR/RPNI at the time of limb amputation on the incidence and intensity of post-operative neuroma and pain.

Reporting bias in breast reconstruction clinical trials: Which and when clinical trials get published.

Background: Reporting bias refers to the phenomenon in which the reporting of research findings is influenced by the nature of the results. Without the totality of evidence, clinical practice may be misguided. The objective of this work was to examine the extent of reporting bias in clinical trials of breast reconstruction surgery.

Co-surgeon versus Single-surgeon Outcomes in Free Tissue Breast Reconstruction: A Meta-analysis.

Background:  Autologous breast reconstruction offers superior long-term patient reported outcomes compared with implant-based reconstruction. Universal adoption of free tissue transfer has been hindered by procedural complexity and long operative time with microsurgery. In many specialties, co-surgeon (CS) approaches are reported to decrease operative time while improving surgical outcomes.

Closed Incision Negative Pressure Therapy Versus Traditional Dressings for Low Transverse Abdominal Incisions Healing by Primary Closure: A Systematic Review and Meta-Analysis.

Closed incision negative pressure therapy (ciNPT) devices may reduce wound healing complications when applied to closed surgical incisions. The aim of this review was to assess the effects of ciNPT versus standard dressings in patients undergoing primary closure of high tension, lower transverse abdominal incisions. This review was registered a priori on PROSPERO (CRD42021252048).

Tension Reduction With Force Modulating Tissue Bridges Reduces Wounds in Breast Surgery.

Background: Tension on healing wounds increases the risk of dehiscence and poor or pathologic scar formation. Force modulating tissue bridges (FMTBs) represent a new class of wound closure and support devices designed to offload tension on healing wounds to improve wound healing and scar outcomes.

Objectives: The study was undertaken to assess the efficacy of FMTBs to reduce the risk of wound healing complications in elective breast surgery.

Postoperative Mechanomodulation Decreases T-Junction Dehiscence After Reduction Mammaplasty: Early Scar Analysis From a Randomized Controlled Trial.

Background: Soft tissue and cutaneous tension is an important contributor to complicated wound healing and poor scar cosmesis after surgery and its mitigation is a key consideration in aesthetic and reconstructive procedures.

Objectives: The study objective was to assess the efficacy of the force modulating tissue bridge (FMTB) ("Brijjit", Brijjit Medical Inc., Atlanta, GA) in reducing mechanical tension on postoperative wounds.

"Spin" in Plastic Surgery Randomized Controlled Trials with Statistically Nonsignificant Primary Outcomes: A Systematic Review.

Background: "Spin" refers to a manipulation of language that implies benefit for an intervention when none may exist. Randomized controlled trials (RCTs) in other fields have been demonstrated to employ spin, which can mislead clinicians to use ineffective or unsafe interventions. This study's objective was to determine the strategies, severity, and extent of spin in plastic surgery RCTs with nonsignificant primary outcomes.

Textbook outcomes in DIEP flap breast reconstruction: a Delphi study to establish consensus.

Purpose: Composite measures, like textbook outcomes, may be superior to individual metrics when assessing hospital performance and quality of care. This study utilized a Delphi process to define a textbook outcome in DIEP flap breast reconstruction.

Methods: A two-round Delphi survey defined: (1) A textbook outcome, (2) Exclusion criteria for a study population, and (3) Respondent opinion regarding textbook outcomes.

Implementation of the Maryland Global Budget Revenue Model and Variation in the Expenditures and Outcomes of Surgical Care: A Systematic Review and Meta-analysis.

Objective: To assess the effect of the Global Budget Revenue (GBR) program on outcomes after surgery.

Background: There is limited data summarizing the effect of the GBR program on surgical outcomes as compared with traditional fee-for-service systems.

Methods: The Medline, Embase, Scopus, and Web of Science databases were used to conduct a systematic literature search on April 5, 2022.