Plastic Surgery Commons^™

Complications Of Breast Reconstruction: Does The Area Deprivation Index Predict Risk?, Andrew Hannoudi, Noah M. Atisha, Amolak S. Jhand, Kinan Sawar, Dunya M. Atisha

Medical Student Research Symposium

INTRODUCTION: Despite mandated post-mastectomy reconstruction coverage since the Women’s Health and Cancer Rights Act (1998), vulnerable populations may be prone to breast reconstruction complications. The Area Deprivation Index (ADI) reflects neighborhood socioeconomic status utilizing US census data. This study investigates ADI's relationship to breast reconstruction complications.
METHODS: A retrospective study of immediate pre-pectoral direct-to-implant reconstruction patients at a metropolitan healthcare system from 2018-2022 was conducted. Patients were stratified by ADI: <50th percentile (ADI=1-5) and ≥50th percentile (ADI=6-10). Demographics, medical history, treatment history, and postoperative outcomes were compared. Descriptive statistics identified differences between ADI groups. Minor complications were defined as incidence of hematoma, seroma, superficial wounds, full thickness necrosis, or oral antibiotic-treated cellulitis. Major complications were defined as incidence of hospital readmission or return to OR. Long-term complications were defined as incidence of capsular contracture or ≥3 revisions. Logistic regression assessed ADI’s predictive value, accounting for confounds between cohorts.
RESULTS: Of 195 patients, 147 had low ADI and 48 had high ADI. Significant differences in BMI and race were found between groups. Low ADI demonstrated higher …

Surgical Management Of Velopharyngeal Dysfunction: Major Techniques And Trends For The 21st Century, Dominic Alessio-Bilowus, Sadaf Hashemian, Kylie Nikolli, Ahmed Hashem Md

Medical Student Research Symposium

INTRODUCTION: Surgical management of velopharyngeal dysfunction (VPD) has become increasingly complex over recent decades with advances in diagnosis, evaluation and technique, and research focus in this area is expected to shift accordingly. This study aims to educate readers on updates in management of VPD and explore changes in surgical methods through the 21st century.

METHODS: A systematic review was conducted of all literature published on surgical treatment of VPD since the year 2000, following PRISMA reporting guidelines. Adult-acquired VPD, any non-surgical management, implants and prosthetic devices, animal or cadaver models, and case series involving less than 10 subjects were excluded. …

Effects Of Marijuana Use In Patients Undergoing Abdominal Free Flap Breast Reconstruction, Tala Al-Saghir, Kinan Sawar, Alexander Vraa, Dunya Atisha

Medical Student Research Symposium

PURPOSE: Marijuana use is associated with incidence of vascular inflammation and clotting, resulting in endothelial damage and arteritis. As marijuana use rises, few studies have evaluated its impact on surgical outcomes, wound healing, and vascular anastomoses in free flap breast reconstruction.

METHODS: A retrospective cohort study of patients undergoing abdominal free flap breast reconstruction between 2016 and 2022 at a large metropolitan healthcare system was performed. Patient demographics, comorbidities, procedural details, and complications were analyzed. Minor complications were defined as skin necrosis, any wound requiring management in the clinic, hematoma, seroma, or fat necrosis that did not require intervention. Major …

Radiated Immediate Prepectoral Direct To Implant Reconstruction: A Retrospective Cohort Study, Kinan Sawar, Tala Al-Saghir, Jamie Hall, Michael Diffley, Madeleine Gonte, Donna Tepper, Vigen Darian, Maristella Evangelista, Amy Tang, Dunya Atisha

Medical Student Research Symposium

Purpose: Increasing use of prepectoral plane in post mastectomy implant-based reconstruction has made immediate direct to implant (DTI) reconstruction more achievable. There has been increased incidence of post mastectomy radiation therapy (PMRT) making it important to understand the complication profile of immediate DTI reconstruction in patients who may require adjuvant radiation therapy.

Methods: A retrospective cohort study of consecutive patients undergoing prepectoral DTI reconstruction with and without PMRT was performed. Patient and treatment level factors, operative, and post-operative outcomes were extracted on both the patient and breast level for the prepectoral radiated and nonradiated patients. The presence of at least …

Predictive Factors For Length Of Hospital Stay In Pediatric Dog Bite Patients, Dominic Alessio-Bilowus, Nishant Kumar, Elika Ridelman Ph.D, Christina Shanti Md

Medical Student Research Symposium

Title: Predictive Factors for Length of Hospital Stay in Pediatric Dog Bite Patients

Authors: Alessio-Bilowus D¹, Kumar N², Ridelman E¹, Shanti C^2
1Wayne State University, Detroit, MI; ²Children’s Hospital of Michigan, Detroit, MI

Introduction: Dog bite injuries are a source of significant morbidity in the United States, with children being at increased risk compared to adults, yet there is a lack of published data on factors affecting hospital length of stay (LOS) in pediatric patients.

Methods: A full-text retrospective chart review was conducted of all patients presenting to our urban, academic …

Post-Surgical Pyoderma Gangrenosum After Breast Surgery: A Case Series, Jahan Tajran, Daniella Anderson, Arif Chaudhry, Dennis Hammond

Medical Student Research Symposium

Background:

Pyoderma gangrenosum (PG) is a rare inflammatory cutaneous disorder that is thought to be due to innate immune system dysfunction, specifically of neutrophils. PG has been well documented in patients with autoimmune disorders like Ulcerative Colitis and Rheumatoid Arthritis. PG can also present in surgical patients, imitating a potential wound infection and necrotizing fasciitis. Although PG is a diagnosis of exclusion, prompt recognition is essential to attaining desired aesthetic outcomes, especially with breast involvement. We present a case series of four patients who developed PG following breast surgery. We analyze each patient’s medical history, symptoms, wound progression and management …