Commentary on: Comparison of Reconstructive Plastic Surgery Rates and Thirty-Day Postoperative Complications Between Patients With and Without Psychiatric Diagnoses

Author(s):  
David B Sarwer ◽  
Hamlet Gasoyan
Author(s):  
Emily A Spataro ◽  
Cristen E Olds ◽  
Cherian K Kandathil ◽  
Sam P Most

Abstract Background Psychiatric comorbidity is associated with greater 30-day postoperative complication rates in various surgical specialties, but is not well characterized for reconstructive plastic surgery. Objectives The aim of this study was to compare reconstructive plastic surgery rates and 30-day postoperative complications between patients with and without psychiatric diagnoses. Methods This was a retrospective cohort study comparing patients with and without psychiatric diagnoses. Data for January 1, 2007 to December 31, 2015 were collected from the IBM MarketScan Commercial and Medicare Supplemental Databases. Rates of reconstructive plastic surgery, demographic data, covariant diagnoses, and 30-day postoperative complications were collected. Differences between the 2 groups were assessed by multivariable logistic regression. Results Among 1,019,128 patients (505,715 with psychiatric diagnoses and 513,423 without psychiatric diagnoses) assessed, reconstructive plastic surgery rates were between 4.8% and 7.0% in those with psychiatric diagnoses, compared with 1.6% in patients without psychiatric diagnoses. The greatest odds of undergoing reconstructive plastic surgery were in patients with body dysmorphic disorder (BDD) (adjusted odds ratio [aOR], 3.16; 95% confidence interval [CI], 1.76-5.67) and anxiety disorder (aOR, 3.08; 95% CI, 2.97-3.17). When assessing 1,234,206 patients (613,400 with psychiatric diagnoses and 620,806 without psychiatric diagnoses), all of whom underwent reconstructive plastic surgery, 2-fold greater odds of any 30-day postoperative complication was associated with psychiatric diagnoses (aOR, 2.01; 95% CI, 1.28-3.11), as well as greater odds of specific complications (surgical site infection, bleeding, and hospital admission). Eating disorder diagnosis was associated with the greatest odds of a complication (aOR, 4.17; 95% CI, 3.59-4.86), followed by nasal surgery (aOR, 3.65; 95% CI, 2.74-4.89), and BDD (aOR, 3.16; 95% CI, 1.76-5.67). Conclusions Diagnosis of a psychiatric condition is associated with greater rates of reconstructive plastic surgery, and 2-fold greater odds of 30-day postoperative complications. Level of Evidence: 4


2019 ◽  
Vol 33 (03) ◽  
pp. 155-161 ◽  
Author(s):  
Amjed Abu-Ghname ◽  
Aurelia Trisliana Perdanasari ◽  
Matthew J. Davis ◽  
Edward M. Reece

AbstractPlatelet-rich plasma (PRP) is an autogenously harvested liquid platelet concentrate extracted from a patient's peripheral blood that contains higher than baseline concentrations of growth factors and cytokines. This innovative new technology has demonstrated great promise in the field of plastic surgery, and its use has been evaluated in several clinical settings including wound healing, hair restoration, and skin rejuvenation. The goal of this article is to explain the biology behind PRP and to review the basic principles involved in its preparation. This will be followed by a discussion of some clinical applications of PRP in both aesthetic and reconstructive plastic surgery.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jung Ho Gong ◽  
Ge Bai ◽  
Dominique Vervoort ◽  
Adam E.M. Eltorai ◽  
Aviram M. Giladi ◽  
...  

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