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Perspectives on Plastic, Reconstructive and Hand Surgery
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Perspectives on Plastic, Reconstructive and Hand Surgery

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 12270

Special Issue Editors

Dr. Kamran Harati

E-Mail Website
Guest Editor
1. Department of Plastic and Hand Surgery, Burn Centre, BG University Hospital Bergmannsheil, Ruhr University Bochum, 44789 Bochum, Germany
2. Private Clinic for Plastic and Aesthetic Surgery, Aasee-Park-Clinic, 48149 Muenster, Germany
Interests: sarcoma; plastic surgery; breast surgery; oncology; cell proliferation
Dr. Matthias Aitzetmüller-Klietz

E-Mail Website
Guest Editor
1. Department of Plastic Surgery, University Hospital Muenster, 48149 Muenster, Germany
2. Department for Plastic, Aesthetic, Hand- and Reconstructive Surgery, Klinikum Passau, University Campus Lower Bavaria, 94032 Passau, Germany
Interests: breast surgery; breast reconstruction; facial plastic surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The field of plastic, reconstructive and hand surgery is hugely diverse. Innovations and the ongoing development of new techniques form the core of our discipline and drive the pursuit of excellent patient care.

While basic science puts forth novel ideas, translating them into the clinical setting and ensuring their safety after market approval are of equal importance. 

In this Special Issue, we would therefore like to address the steps involved in the development of such innovations and present the latest advances in the diverse field of plastic, reconstructive and hand surgery—from bench to bedside.

We look forward to receiving your contributions.

Dr. Kamran Harati
Dr. Matthias Aitzetmüller
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • plastic surgery
  • reconstructive surgery
  • hand surgery
  • regeneration

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Published Papers (6 papers)

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Research

11 pages, 1719 KiB  
Article
Improvement of Predictive Scores in Burn Medicine through Different Machine Learning Approaches
by Sonja Verena Schmidt, Marius Drysch, Felix Reinkemeier, Johannes Maximilian Wagner, Alexander Sogorski, Elisabete Macedo Santos, Peter Zahn, Marcus Lehnhardt, Björn Behr, German Burn Registry, Flemming Puscz and Christoph Wallner
Healthcare 2023, 11(17), 2437; https://doi.org/10.3390/healthcare11172437 - 31 Aug 2023
Cited by 2 | Viewed by 1303
Abstract
The mortality of severely burned patients can be predicted by multiple scores which have been created over the last decades. As the treatment of burn injuries and intensive care management have improved immensely over the last years, former prediction scores seem to be [...] Read more.
The mortality of severely burned patients can be predicted by multiple scores which have been created over the last decades. As the treatment of burn injuries and intensive care management have improved immensely over the last years, former prediction scores seem to be losing accuracy in predicting survival. Therefore, various modifications of existing scores have been established and innovative scores have been introduced. In this study, we used data from the German Burn Registry and analyzed them regarding patient mortality using different methods of machine learning. We used Classification and Regression Trees (CARTs), random forests, XGBoost, and logistic regression regarding predictive features for patient mortality. Analyzing the data of 1401 patients via machine learning, the factors of full-thickness burns, patient’s age, and total burned surface area could be identified as the most important features regarding the prediction of patient mortality following burn trauma. Although the different methods identified similar aspects, application of machine learning shows that more data are necessary for a valid analysis. In the future, the usage of machine learning can contribute to the development of an innovative and precise predictive score in burn medicine and even to further interpretations of relevant data regarding different forms of outcome from the German Burn registry. Full article
(This article belongs to the Special Issue Perspectives on Plastic, Reconstructive and Hand Surgery)
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9 pages, 2421 KiB  
Article
Missed Essex-Lopresti Injury—Development of a Combined Proximal and Distal Radio-Ulnar Joint Prosthesis as a Treatment Option and Proof of Concept
by Simon Oeckenpöhler, Martin Franz Langer and Oliver Riesenbeck
Healthcare 2023, 11(16), 2274; https://doi.org/10.3390/healthcare11162274 - 11 Aug 2023
Viewed by 1780
Abstract
Essex-Lopresti injuries are characterized by injuries to the proximal radio-ulnar joint, the distal radio-ulnar joint, and the interosseous membrane. This can lead to osteoarthritis, impaction syndrome, or instability. If all three structures are injured and lead to instability, the situation is almost unmanageable [...] Read more.
Essex-Lopresti injuries are characterized by injuries to the proximal radio-ulnar joint, the distal radio-ulnar joint, and the interosseous membrane. This can lead to osteoarthritis, impaction syndrome, or instability. If all three structures are injured and lead to instability, the situation is almost unmanageable and many times ends in a one-bone forearm. In this article, we demonstrate a new way to reconstruct the proximal and distal radio-ulnar joint with two patient-specific coupled prostheses. These have been developed with the biomechanical conditions of the forearm in mind, where there are very large forces between the bones. As a result, we are able to present a patient previously severely restricted in the use of his hand and arm via a splint that compressed the forearm, who is now able to perform everyday activities and even light sports, such as badminton, without pain. Full article
(This article belongs to the Special Issue Perspectives on Plastic, Reconstructive and Hand Surgery)
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10 pages, 491 KiB  
Article
Persistent Pain as an Early Indicator for Operative Carpal Tunnel Revision after Primary Release: A Retrospective Analysis of Recurrent and Persistent Carpal Tunnel Syndrome
by Daniel Georg Gmainer, Andrzej Hecker, Petra Brinskelle, Alexander Draschl, Patrick Reinbacher, Lars-Peter Kamolz and David Benjamin Lumenta
Healthcare 2023, 11(14), 2100; https://doi.org/10.3390/healthcare11142100 - 24 Jul 2023
Viewed by 1398
Abstract
Background: Prolonged symptoms of carpal tunnel syndrome (CTS) after primary carpal tunnel release (CTR) can reduce the quality of life and lead to multiple referrals across specialties. The following study aimed to identify differences in symptoms, signs, and intraoperative findings between recurrent and [...] Read more.
Background: Prolonged symptoms of carpal tunnel syndrome (CTS) after primary carpal tunnel release (CTR) can reduce the quality of life and lead to multiple referrals across specialties. The following study aimed to identify differences in symptoms, signs, and intraoperative findings between recurrent and persistent CTS cases to avoid undesired outcomes after primary CTR. Methods: A retrospective analysis was conducted on revision CTRs performed between 2005 and 2015 using literature-based definitions for recurrent (a relapse of symptoms occurs following a symptom-free period of ≥3 months) and persistent (symptoms persisting longer than three months after surgical release) CTS. The parameters assessed were symptoms, clinical signs, and intraoperative findings. Results: Out of 53 cases, 85% (n = 45) were external referrals, whereby our own revision rate was 0.67% (n = 8/1199). Paresthesia and numbness were frequent in both groups; however, abnormal postoperative pain was reported more often in persistent cases (86%; n = 30/35) in comparison to recurrent cases (50%; n = 9/18; p = 0.009). Scarring around the median nerve was observed in almost all recurrent cases (94%; n = 17/18) and in 40% (n = 14/35) of persistent cases (p < 0.001). Incomplete division of the palmar ligament was the primary cause for revision in the persistent cohort (49%; n = 17/35). Conclusions: For patients experiencing symptoms for more than three months after CTR, primarily presenting as pain, it is advisable to consider referring the patient to a certified hand clinic for additional evaluation. Full article
(This article belongs to the Special Issue Perspectives on Plastic, Reconstructive and Hand Surgery)
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21 pages, 2691 KiB  
Article
Patient-Reported Outcomes of Liposuction for Lipedema Treatment
by Fiona Kirstein, Matthias Hamatschek, Henning Knors, Marie-Luise Aitzetmueller-Klietz, Matthias Aitzetmueller-Klietz, Philipp Wiebringhaus, Charalampos Varnava, Tobias Hirsch and Maximilian Kueckelhaus
Healthcare 2023, 11(14), 2020; https://doi.org/10.3390/healthcare11142020 - 13 Jul 2023
Cited by 5 | Viewed by 3812
Abstract
Background: Lipedema, as a disabling and consequential disease, is gaining more awareness due to its potential omnipresence. Patients suffering from lipedema show a characteristic painful display of symmetric accumulations of adipose tissue. The combination of swelling, pain and decreased quality of life (QOL) [...] Read more.
Background: Lipedema, as a disabling and consequential disease, is gaining more awareness due to its potential omnipresence. Patients suffering from lipedema show a characteristic painful display of symmetric accumulations of adipose tissue. The combination of swelling, pain and decreased quality of life (QOL) is outstanding for the diagnosis. The aim of this study was to identify the effect of liposuction in terms of the QOL for patients and underline important factors of current and pending research regarding surgical therapy of lipoedema. Methods: Patients suffering from lipedema prior to and after receiving liposuction at our hospital were included in this study. Patients completed a lipedema-specific self-designed 50 item questionnaire: the World Health Organization Quality of Life BREF (WHOQOL-BREF) and the Patient Health Questionnaire 9 (PHQ-9). A linear mixed model was used for outcome analysis. Results: In total, 511 patients completed a questionnaire prior to the surgery at primary presentation to the hospital and a total number of 56 patients completed a questionnaire after liposuction. A total of 34 of these patients filled in both questionnaires prior to and after surgery. The general characteristics of the disease, such as daily symptoms and psychological health, pertinently improved after surgery. Conclusions: Liposuction can have a general improving effect on the QOL of patients, both in private and professional life. Liposuction may currently be the most evident and promising method in the treatment of lipedema. Full article
(This article belongs to the Special Issue Perspectives on Plastic, Reconstructive and Hand Surgery)
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10 pages, 1229 KiB  
Article
Factors Influencing Quality of Life after Massive Weight Loss—What Makes the Difference?
by Matthias Michael Aitzetmüller-Klietz, Laura Raschke, Tobias Hirsch, Maximilian Kückelhaus, Philipp Wiebringhaus, Marie-Luise Aitzetmüller-Klietz and Kamran Harati
Healthcare 2023, 11(8), 1147; https://doi.org/10.3390/healthcare11081147 - 17 Apr 2023
Cited by 2 | Viewed by 1837
Abstract
Although weight reduction in obesity and morbid obesity has been shown to improve associated comorbidities, there is currently no information on what influences quality of life after a large reduction in body weight. The present study looks at differences in patients’ quality of [...] Read more.
Although weight reduction in obesity and morbid obesity has been shown to improve associated comorbidities, there is currently no information on what influences quality of life after a large reduction in body weight. The present study looks at differences in patients’ quality of life classified by mode and amount of weight loss. Material and methods: A cross-sectional study was designed using a validated German version of the BODY-Q questionnaire. The internet-based questionnaire was distributed to patients via social media. Results: 460 patients (443 female, 17 male) were interviewed for this study via “Surveymonkey”. The comparison of conservative and surgical weight loss showed no significant difference in the patients’ quality of life (p > 0.05). A high BMI correlates negatively with body image (p = 0.023 *), as does the specific assessment of most body regions. For example, a negative correlation was found between a high BMI and satisfaction with skin appearance (p < 0.001 *) and satisfaction with the inner thigh (p = 0.011 *). Conclusion: Increased weight loss is associated with a greater ability to maximise quality of life. The type of weight loss, whether conservative or surgical, can be neglected based on the present study. Bariatric surgery cannot be considered a universal solution to obesity. Body contouring interventions should also become a focus of therapy. Full article
(This article belongs to the Special Issue Perspectives on Plastic, Reconstructive and Hand Surgery)
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8 pages, 220 KiB  
Article
Seasonal Impact on Free Flap Surgery in Terms of Flap Loss and Wound Healing Disorders: A Retrospective Cohort Study of 158 Free Flaps
by Marie-Luise Klietz, Chiara Mewe, Philipp Wiebringhaus, Tobias Hirsch, Matthias Michael Aitzetmüller and Maximilian Kückelhaus
Healthcare 2023, 11(3), 403; https://doi.org/10.3390/healthcare11030403 - 31 Jan 2023
Cited by 1 | Viewed by 1354
Abstract
(1) Background: Postoperative flap loss and wound healing disorders are severe complications after microsurgical free flap surgery. Despite multiple clinical observations, a possible influence of season and external temperature on outcome are largely missing. (2) Methods: Retrospectively, data were collected from 151 patients [...] Read more.
(1) Background: Postoperative flap loss and wound healing disorders are severe complications after microsurgical free flap surgery. Despite multiple clinical observations, a possible influence of season and external temperature on outcome are largely missing. (2) Methods: Retrospectively, data were collected from 151 patients receiving microsurgical free flaps from March 2018 to August 2019. Patients were divided into two cohorts. The winter group includes all patients who underwent surgery from October 2018 to March 2019 and the summer group al those who underwent surgery from April 2018 to September 2018. Data included demographic information, pre-existing conditions, flap characteristics, and postoperative complications like flap losses and wound healing problems. External temperatures during the first 14 postoperative days were documented and the predictor of flap loss and wound healing disorders was detected. (3) Results: In the winter group (October-March; Ø 7.24 °C) 72 patients (46 female, 24 males; Ø 57.0 years) and in the summer group (April-September; Ø 18.79 °C) 81 patients (48 female, 33 males; Ø 56.0 years) received free flap surgery. There were no significant differences in demography (age: p = 0.593; gender: p = 0.419; BMI: p = 0.141). We found a significant increase in flap loss during summer (χ2(1) = 6.626; p = 0.010; V = 0.209) strengthened by logistic regression analysis (p = 0.037; Exp(B) = 9.655). Additionally higher average temperatures 14 days postoperatively represents another main driver (p = 0.023, Exp(B) = 1.161) for postoperative flap loss. (4) Conclusions: The data confirm a significantly higher postoperative flap loss in the summer group. This information may potentially contribute to optimization of perioperative management and planning of elective and semi-elective surgeries. Full article
(This article belongs to the Special Issue Perspectives on Plastic, Reconstructive and Hand Surgery)
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