Plastic Surgery Weekly

A meta-analysis of 188 studies in J Plast Reconstr Aesthet Surg pools 6,071 flaps for complex open lower limb fractures. It finds total flap failure of 8.0%, deep infection or osteomyelitis in 12.9% of limbs and amputation in 6.3%; risk of bias was moderate in 64.5% of studies. Two Plast Reconstr Surg papers address body contouring. In a three-arm abdominoplasty trial, complication rates did not differ between wide and limited undermining or with added flap liposuction, and liposuction rather than undermining width drove flap thinning and aesthetic gain. A meta-analysis in the same journal ties GLP-1 receptor agonist exposure to more delayed wound healing and hypertrophic scarring, but to fewer seromas than in post-bariatric patients. Also in Plast Reconstr Surg, preoperative ultrasound localized lymphovenous anastomosis sites with a positive predictive value of 95.4% (272 of 285 sites confirmed at surgery) and measured vessel diameters to within about 0.1 mm. A small randomized trial in Burns from a North Indian tertiary center found that excision within 7 days cut median hospital stay from 28.5 to 13.5 days without more organ dysfunction or transfusion, although graft take was lower. GLP-1 drugs appear again in J Plast Reconstr Aesthet Surg: massive weight loss patients with preoperative exposure had 3.7-fold higher odds of infection after body contouring than those who lost weight through lifestyle change.