Correlation between complication rate and patient satisfaction in abdominoplasty.

Abdominoplasty has become one of the most frequently performed procedures for improving body contour. Numerous reports exist focusing on postoperative complications with even more studies suggesting technical modifications to decrease their occurrence. However, the impact of complications on patient satisfaction has not been sufficiently addressed to date. A retrospective analysis was performed investigating the occurrence of complications following abdominoplasty and their effect on patient satisfaction. Patient satisfaction was assessed by means of the client satisfaction questionnaire-8. From June 1994 to April 2004 a total of 139 patients underwent an abdominoplasty. Minor and major complications were encountered in 40 (28.8%) and 16 (11.5%) patients, respectively. The median client satisfaction questionnaire-8 score among those patients with and without complications was 29. Thus, it seems that postoperative complications after abdominoplasty do not negatively affect patient satisfaction.

Pedicled and free flaps for intrathoracic fistula management.

OBJECTIVES: Intrathoracic fistulae are among the potential sequelae of radiation therapy, empyema and abscess clearance and surgical tumour resections. Interdisciplinary plastic-reconstructive flap surgery is a helpful tool for the successful treatment of intrathoracic fistulae. METHODS: From February 2006 to April 2016, 13 patients (3 females and 10 males) underwent flap surgery for bronchial (n = 5), tracheal (n = 2), oesophageal (n = 2), post-pneumonectomy bronchopleural fistula (n = 2), tracheo-oesophageal (n = 1), gastrobronchial (n = 1) and oesophagobronchial (n = 1) fistulae. Patient characteristics, identified pathogenic micro-organisms, treatment and decision criteria, long-term outcome and postoperative complications were evaluated by analysing patient charts and surgical reports. RESULTS: The mean age of the 13 patients who underwent reconstructive surgery was 55.5 years (range: 42-66 years). The median follow-up time was 31.4 months (range: 2-96 months). American Society of Anaesthesiologists classification was II for 1 patient, III for 8 patients and IV for 4 patients. In total, 18 flaps were performed (7 latissimus dorsi pedicled flaps, 7 pectoralis major pedicled flaps, 2 rectus abdominis myocutaneous flaps, 1 free temporo-parietal fascia flap and 1 intercostal muscle flap). A second flap was indicated in 5 cases (38.5%) due to fistula recurrence; of these, 1 patient developed a bronchial fistula after successful reconstruction of a gastrobronchial fistula. Eight of the 13 patients (61.5%) were evaluated postoperatively at regular intervals for at least 1 year and showed no signs of fistula recurrence. CONCLUSIONS: Our study showed that plastic-reconstructive flap surgery, although associated with significant morbidity and mortality, can be a life-saving tool for intrathoracic fistula reconstruction. CLINICAL TRIAL REGISTRATION: DRKS00010447.

Soft-tissue mobility of the lower face depending on positional changes and age: a three-dimensional morphometric surface analysis.

BACKGROUND: Reliable evaluation of the complex three-dimensional anatomy of the face has proven to be extremely difficult. Three-dimensional surface scanning technology has not yet reached widespread acceptance in clinical research in plastic surgery. This study aimed to describe two parameters that allow quantification of soft-tissue movements and to compare the surface changes of the lower face during positional changes and with increasing age. METHODS: Two groups, each with 20 voluntary female subjects aged 20 to 35 and 45 to 60 years, were examined with a three-dimensional surface scanner in both supine and sitting positions. After registration of the two surface scans, the soft-tissue mobility of the lower face was examined using two new parameters. Deformability describes the mean distance between the surfaces and stretchability describes the relative stretching of one surface when mapped onto the other. RESULTS: Both parameters show highly significant differences for tissue mobility of young versus old lower faces. The trend for the soft tissues to lose projection in the upper posterior aspect and gain projection in the lower anterior aspect increases strongly. In the older subjects, larger parts of the examined area show tissue displacements of up to 6 mm, whereas in the young faces the displacement is far less and does not exceed 4 mm. CONCLUSION: Computational analysis of the authors' experimental results using two new parameters shows a statistically significant increase of facial tissue displacement and surface stretching when comparing young and old subjects.