Must-read articles chosen by the Southeastern Society of Plastic and Reconstructive Surgeons:  

April 2022

Safety and Efficacy of Local Tranexamic Acid for the Prevention of Surgical Bleeding in Soft-Tissue Surgery: A Review of the Literature and Recommendations for Plastic Surgery

Ausen, Kjersti M.D., Ph.D.; Fossmark, Reidar M.D., Ph.D.; Spigset, Olav M.D., Ph.D.; Pleym, Hilde M.D., Ph.D.

Plastic and Reconstructive Surgery: March 2022 - Volume 149 - Issue 3 - p 774-787

The authors conduct a thorough review of all the existing studies on the use of topical TXA in soft tissue surgery.  They include their own studies on breast reduction and breast reconstruction.  TXA has been the subject of several randomized controlled trials and the evidence is compelling that it can reduce surgical bleeding.  TXA may have an important role in preventing bleeding related complications, as the use of anticoagulants for VTE prophylaxis become more prevalent.

Link: https://journals.lww.com/plasreconsurg/Fulltext/2022/03000/Safety_and_Efficacy_of_Local_Tranexamic_Acid_for.49.aspx?WT.mc_id=HPxADx20100319xMP

Seromas: How to Prevent and Treat Them—a 20-Year Experience

David M Turer, MD, MS, Al Aly, MD

Aesthetic Surgery Journal, Volume 42, Issue 5, May 2022, Pages 497–504

The authors share their extensive experience with the treatment of postoperative seromas in body contouring surgery.  Rational treatment algorithms are presented.  Using their protocols, which include quilting sutures, postoperative diuretics, serial aspiration, sclerosing agents, and passive external drainage, they have not had to reoperate for a seroma in 20 years.

Link: https://academic.oup.com/asj/article/42/5/497/6430785

A Practical Guide to Managing Patients With Systemic Symptoms and Breast Implants

Patricia McGuire, MD, Daniel J Clauw, MD, Jason Hammer, MD, Melinda Haws, MD, William P Adams, Jr, MD

Aesthetic Surgery Journal, Volume 42, Issue 4, April 2022, Pages 397–407

The authors present a fair review of the current literature on breast implant illness.  They present their experience with patients who present with silicone implants and a variety of medical complaints, and review the steps necessary to rule out the potential causes.  A valuable resource for plastic surgeons and primary care physicans as well.

Link:https://academic.oup.com/asj/article/42/4/397/6409230

October 2022

Clinical Relevance of Sensory Nerve Coaptation in DIEP Flap Breast Reconstruction Evaluated Using the BREAST-Q

Bijkerk, Ennie M.D.; Beugels, Jop M.D., Ph.D.; van Kuijk, Sander M. J. Ph.D.; Lataster, Arno M.Sc., M.Ed.; van der Hulst, René R. W. J. M.D., Ph.D.; Tuinder, Stefania M. H. M.D., Ph.D.

Plastic and Reconstructive Surgery, Volume 150, Issue 5, November 2022, Pages 959e-969e

This nonrandomized prospective cohort study compared 65 innervated and 55 noninnervated DIEP breast reconstructions.  There was roughly an even split between delayed and immediate reconstructions. Outcome measures included a Breast-Q completed at 12 months’ follow up and Semmes-Weinstein monofilament testing. The study demonstrated that nerve coaptation in delayed DIEP flap breast reconstruction resulted in higher mean BREAST-Q scores in the physical well-being of the chest domain.  Statistically significant differences were not observed in immediate reconstruction.  Results of monofilament testing correlated with the Breast-Q scores.  The study suggests there may be a benefit of innervated DIEP flaps, specifically in delayed reconstructions where there is a larger skin component.

https://journals.lww.com/plasreconsurg/Fulltext/2022/11000/Clinical_Relevance_of_Sensory_Nerve_Coaptation_in.8.aspx

A Multicenter, Randomized, Controlled, Clinical Trial Evaluating Dehydrated Human Amniotic Membrane in the Treatment of Venous Leg Ulcers

Serena, Thomas E. M.D.; Orgill, Dennis P. M.D., Ph.D.; Armstrong, David G. D.P.M., M.D., Ph.D.; Galiano, Robert D. M.D.; Glat, Paul M. M.D.; Carter, Marissa J. Ph.D.; Kaufman, Jarrod P. M.D.; Li, William W. M.D.; Zelen, Charles M. D.P.M.

Plastic and Reconstructive Surgery, Volume 150, Issue 5, November 2022, Pages 1128-1136

This prospective randomized trial enrolled 60 patients with chronic venous leg ulcers, assigned to three groups: weekly applications of dehydrated human amnion and chorion allograft with layered compression dressing, biweekly application, and layered compression dressing alone.  At 12 weeks, there were significantly more venous leg ulcers healed in the two dHACA-treated groups (75 percent) than in the group treated with compression boot alone (30 percent), even after adjustment for wound size.  There was no difference observed between the weekly and biweekly application groups.

https://journals.lww.com/plasreconsurg/Fulltext/2022/11000/A_Multicenter,_Randomized,_Controlled,_Clinical.39.aspx

Fat Grafting With Expanded Adipose-Derived Stromal Cells for Breast Augmentation: A Randomized Controlled Trial

Peter V Vester-Glowinski, MD,  Mikkel Herly, MD,  Mathias Ørholt, MD,  Bo S Rasmussen, MD, Felix C Müller, MD,  Jens J Elberg, MD,  Carsten Thomsen, MD,  Krzysztof T Drzewiecki, MD

Aesthetic Surgery Journal, Volume 42, Issue 11, November 2022, Pages 1279–1289

This was a double-blind, randomized controlled trial comparing breast augmentation with ASC-enriched fat grafting to placebo-enriched fat grafting.  Participants were randomly assigned to undergo a 300- to 350-mL breast augmentation.  The primary outcome was fat graft volume retention at 12 month follow-up measured with MRI. Ten participants completed the trial. Fat graft volume retention after 1 year was 54.0% in the breasts treated with ASC-enriched fat grafting and 55.9% in the contralateral breasts treated with placebo-enriched fat grafting (p = 0.566).  The findings of this trial do not support that ASC-enriched fat grafting is superior to standard fat grafting for breast augmentation.

https://academic.oup.com/asj/article-abstract/42/11/1279/6608925?redirectedFrom=fulltext