Daily Cosmetic Research Analysis

INTRODUCTION: Precision Breast Intraoperative Radiation Therapy (PB-IORT) is a novel form of IORT that combines computed tomography-guided treatment planning with high-dose-rate brachytherapy to deliver individualized radiation that spares the skin and chest wall. We analyzed cosmetic outcomes following PB-IORT as scored by breast clinicians, a plastic surgeon, and patients, and assessed the interrater reliability between the scores. METHODS: As part of a phase II clinical trial, the study cohort included 357 patients treated with PB-IORT who had up to 24 mo of follow-up data. At each follow-up visit, the patient, plastic surgeon, and breast clinicians completed the Harvard Cosmesis Scale and a survey that evaluates changes in breast pigmentation, shape, and size. Interrater agreement was assessed using Kappa statistics. RESULTS: At 24 mo, 88.7% (95% confidence interval [CI]: 84.77, 92.61) of patients rated their cosmesis as "excellent" or "good' with the Harvard Cosmesis Scale; 93.7% (95% CI: 90.80, 96.14) and 80.3% (95% CI: 75.08, 85.50) of patients were rated similarly by the breast clinicians and the plastic surgeon, respectively. There was minimal agreement between patients, breast clinicians, and the plastic surgeon for all variables (Kappa <0.40). Breast clinicians rated cosmesis the most favorably. CONCLUSIONS: PB-IORT delivers a single, high dose of radiation without compromising cosmetic outcomes. Cosmetic outcome scores from patients, breast clinicians, and the plastic surgeon had low interrater reliability. The patient's perspective is paramount when assessing cosmetic outcomes after breast surgery. We advocate that future studies include patient-reported outcomes as the primary means of evaluating cosmetic outcomes.

BACKGROUND: Although traditional sutures are efficient, they can result in complications such as infection and scarring. On the other hand, tissue adhesives have the potential to provide advantages such as reduced application time and postoperative pain. Understanding the comparative outcomes of various procedures can have a substantial impact on clinical periodontal surgery. This systematic review and meta-analysis (PROSPERO CRD42023444615) is designed to synthesize existing research and provide insights into optimizing wound closure procedures for better patient outcomes. The aim of the present systematic review and meta-analysis is to compare the efficacy of tissue adhesives with sutures on wound healing in periodontal flap surgery. MATERIALS AND METHODS: By adhering to PRISMA 2020 standards, the review outlined systematic processes for identifying and selecting relevant studies, which involved an extensive search across databases such as PubMed, Cochrane Library, Embase, Scopus, Web of Science, Google Scholar, and trial registries. The inclusion criteria focused on all prospective human trials conducted between January 2013 and June 2023, allowing for a diverse range of study designs, including randomized controlled trials, clinical trials, non-randomized trials, and split-mouth trials. Ultimately, 10 and 8 studies were included for qualitative synthesis and quantitative analysis, respectively, with data on the degree of wound closure/healing aggregated from studies that shared similar follow-up periods. Forest plots were created appropriately allowing for a clearer interpretation of the comparative outcomes between tissue adhesives and sutures. RESULTS: The assessment of the included studies revealed that most demonstrated a low risk of bias in their methodologies, indicating reliable and robust research practices. However, the forest plot analysis indicated no significant mean difference in the degree of wound healing between tissue adhesives and sutures, despite a high level of heterogeneity ( CONCLUSION: Wound healing with tissue adhesives appears to be better or comparable to that of sutures in periodontal flap surgery. Tissue adhesives may be a non-invasive alternative to sutures in terms of cosmetic outcome and patient satisfaction. Further randomized trials with larger samples and following standard protocols should be undertaken for their clinical use in periodontal flap surgery. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD42023444615, PROSPERO CRD42023444615.

BACKGROUND: Ultrasound guidance (US) may optimize breast-conserving surgery (BCS) by standardizing resection precision, but comparative quantitative data remain limited. This study evaluates whether US improves margin control and tissue preservation versus palpation-guided BCS using a calculated resection ratio (CRR). METHODS: Retrospective analysis of 114 patients with BCS (37 palpation-guided; 77 US-guided [34 palpable and 43 nonpalpable]). PRIMARY ENDPOINTS: positive margin rates, re-excision rates, and CRR. Statistical analysis included Mann-Whitney U tests (CRR) and multivariate logistic regression. RESULTS: US guidance reduced positive margins by 76% (2.2% vs. 9.0% and p < 0.0001) and re-excisions by 81% (2.6% vs. 14.0%). Resection efficiency improved by 40% (median CRR 1.8 vs. 3.0 and p < 0.001), with nonpalpable tumors achieving the lowest CRR (1.6). For a representative 2 cm tumor, US guidance reduced total resection volumes by 78% (17.6 vs. 81.4 cm CONCLUSIONS: US-guided BCS standardizes tissue preservation, reducing resection volumes by 40% while maintaining oncologic safety. CRR emerges as a replicable metric for surgical quality. Despite nonsignificant multivariate results, the magnitude of improvement supports US adoption where expertise exists.