A Retrospective Review of Patient-reported Outcomes after Postaxial Polydactyly Ligation and Surgical Excision
Background:. Interventions for type B postaxial polydactyly include suture ligation and surgical excision, yet there is a paucity of literature comparing the outcomes of these procedures. This study sought to compare patient-reported long-term outcomes of postaxial digit excision. Methods:. A six-qu...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2024-01-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005557 |
| _version_ | 1797341065429123072 |
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| author | Nakul Ganju, BS Esperanza Mantilla-Rivas, MD Paul F. Martinez, BS Monica Manrique, MD Joseph M. Escandón, MD Samay Shah, BS Ashley E. Rogers, MD Michael J. Boyajian, MD Albert K. Oh, MD Gary F. Rogers, MD, JD, LLM, MBA, MPH |
| author_facet | Nakul Ganju, BS Esperanza Mantilla-Rivas, MD Paul F. Martinez, BS Monica Manrique, MD Joseph M. Escandón, MD Samay Shah, BS Ashley E. Rogers, MD Michael J. Boyajian, MD Albert K. Oh, MD Gary F. Rogers, MD, JD, LLM, MBA, MPH |
| author_sort | Nakul Ganju, BS |
| collection | DOAJ |
| description | Background:. Interventions for type B postaxial polydactyly include suture ligation and surgical excision, yet there is a paucity of literature comparing the outcomes of these procedures. This study sought to compare patient-reported long-term outcomes of postaxial digit excision.
Methods:. A six-question survey was distributed from January 2021 to March 2022 to patients who underwent treatment for type B postaxial polydactyly at a single pediatric institution from 2010 to 2016. Patients were queried about the incidence of pain sensitivity, keloid healing, and/or persistent presence of bump (“nubbin”) at the treatment site.
Results:. A total of 158 responses accounting for 258 digits were attained for a 53% response rate. The majority of digits (67.4%, n = 174) were surgically excised. Median age at procedure was 49 days: 13.0 days for ligation, 63.0 days for surgical excision. Median age at survey was 8 [IQR 5.4–10.2] years. Short-term (<30 days after procedure) complications rate was 1.6%. The rate of a raised or sensitive scar was 39.5% (ligation 51.5% versus surgery 35.4%, P < 0.05). The likelihood of postoperative sensitivity (P = 0.80) was similar among groups. However, the odds of a residual bump or raised scar at the surgical site was significantly higher in the ligation group (P = 0.001). These findings remained significant in the adjusted analysis.
Conclusion:. This study suggests that suture ligation can be used in select cases without increasing the prevalence of long-term pain or sensitivity, albeit with greater risk of a bump or raised scar at the excision site compared with surgical excision. |
| first_indexed | 2024-03-08T10:12:29Z |
| format | Article |
| id | doaj.art-3222a0f3841a473abdfff8b90ec778f6 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-03-08T10:12:29Z |
| publishDate | 2024-01-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-3222a0f3841a473abdfff8b90ec778f62024-01-29T07:01:16ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742024-01-01121e555710.1097/GOX.0000000000005557202401000-00041A Retrospective Review of Patient-reported Outcomes after Postaxial Polydactyly Ligation and Surgical ExcisionNakul Ganju, BS0Esperanza Mantilla-Rivas, MD1Paul F. Martinez, BS2Monica Manrique, MD3Joseph M. Escandón, MD4Samay Shah, BS5Ashley E. Rogers, MD6Michael J. Boyajian, MD7Albert K. Oh, MD8Gary F. Rogers, MD, JD, LLM, MBA, MPH9From the Division of Plastic and Reconstructive Surgery, Children’s National Hospital, Washington, D.C.From the Division of Plastic and Reconstructive Surgery, Children’s National Hospital, Washington, D.C.From the Division of Plastic and Reconstructive Surgery, Children’s National Hospital, Washington, D.C.From the Division of Plastic and Reconstructive Surgery, Children’s National Hospital, Washington, D.C.From the Division of Plastic and Reconstructive Surgery, Children’s National Hospital, Washington, D.C.From the Division of Plastic and Reconstructive Surgery, Children’s National Hospital, Washington, D.C.From the Division of Plastic and Reconstructive Surgery, Children’s National Hospital, Washington, D.C.From the Division of Plastic and Reconstructive Surgery, Children’s National Hospital, Washington, D.C.From the Division of Plastic and Reconstructive Surgery, Children’s National Hospital, Washington, D.C.From the Division of Plastic and Reconstructive Surgery, Children’s National Hospital, Washington, D.C.Background:. Interventions for type B postaxial polydactyly include suture ligation and surgical excision, yet there is a paucity of literature comparing the outcomes of these procedures. This study sought to compare patient-reported long-term outcomes of postaxial digit excision. Methods:. A six-question survey was distributed from January 2021 to March 2022 to patients who underwent treatment for type B postaxial polydactyly at a single pediatric institution from 2010 to 2016. Patients were queried about the incidence of pain sensitivity, keloid healing, and/or persistent presence of bump (“nubbin”) at the treatment site. Results:. A total of 158 responses accounting for 258 digits were attained for a 53% response rate. The majority of digits (67.4%, n = 174) were surgically excised. Median age at procedure was 49 days: 13.0 days for ligation, 63.0 days for surgical excision. Median age at survey was 8 [IQR 5.4–10.2] years. Short-term (<30 days after procedure) complications rate was 1.6%. The rate of a raised or sensitive scar was 39.5% (ligation 51.5% versus surgery 35.4%, P < 0.05). The likelihood of postoperative sensitivity (P = 0.80) was similar among groups. However, the odds of a residual bump or raised scar at the surgical site was significantly higher in the ligation group (P = 0.001). These findings remained significant in the adjusted analysis. Conclusion:. This study suggests that suture ligation can be used in select cases without increasing the prevalence of long-term pain or sensitivity, albeit with greater risk of a bump or raised scar at the excision site compared with surgical excision.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005557 |
| spellingShingle | Nakul Ganju, BS Esperanza Mantilla-Rivas, MD Paul F. Martinez, BS Monica Manrique, MD Joseph M. Escandón, MD Samay Shah, BS Ashley E. Rogers, MD Michael J. Boyajian, MD Albert K. Oh, MD Gary F. Rogers, MD, JD, LLM, MBA, MPH A Retrospective Review of Patient-reported Outcomes after Postaxial Polydactyly Ligation and Surgical Excision Plastic and Reconstructive Surgery, Global Open |
| title | A Retrospective Review of Patient-reported Outcomes after Postaxial Polydactyly Ligation and Surgical Excision |
| title_full | A Retrospective Review of Patient-reported Outcomes after Postaxial Polydactyly Ligation and Surgical Excision |
| title_fullStr | A Retrospective Review of Patient-reported Outcomes after Postaxial Polydactyly Ligation and Surgical Excision |
| title_full_unstemmed | A Retrospective Review of Patient-reported Outcomes after Postaxial Polydactyly Ligation and Surgical Excision |
| title_short | A Retrospective Review of Patient-reported Outcomes after Postaxial Polydactyly Ligation and Surgical Excision |
| title_sort | retrospective review of patient reported outcomes after postaxial polydactyly ligation and surgical excision |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005557 |
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