Sarah Sorice, MD

All Publications

• Breast Reconstruction with Free Abdominal Flaps Is Associated with Persistent Lower Extremity Venous Stasis PLASTIC AND RECONSTRUCTIVE SURGERY Momeni, A., Sorice, S. C., Li, A. Y., Nguyen, D. H., Pannucci, C. 2019; 143 (6): 1144E–1150E

  View details for DOI 10.1097/PRS.0000000000005613

  View details for Web of Science ID 000469484200003

• Postoperative analgesia after microsurgical breast reconstruction using liposomal bupivacaine (Exparel). The breast journal Momeni, A., Ramesh, N. K., Wan, D., Nguyen, D., Sorice, S. C. 2019

  Abstract

  Conventional opioid-based regimen for postoperative analgesia after autologous breast reconstruction can be associated with significant side effects. The purpose of this study was to assess the efficacy of an intraoperatively administered transversus abdominis plane (TAP) block with liposomal bupivacaine on postoperative narcotic use in patients undergoing microsurgical breast reconstruction with free abdominal flaps. Patients treated between December 2016 and June 2017 were included in the study. Parameters of interest were patient-reported pain score, total narcotic use (in oral morphine equivalent [OME]) during the hospitalization, length of stay (LOS), and the need for patient-controlled analgesia (PCA). Eighty-two free abdominal flaps were transferred in 46 patients with a mean age of 47.6years and a mean body mass index (BMI) of 28.1kg/m2 . The average LOS was 3.5days (range, 3-5). Postoperatively, 42 patients (91.3%) did not require patient-controlled analgesia (PCA). The mean time to first narcotic use after arrival on the nursing unit was 6hours (range, 0-19hours). The mean total postoperative OME use was 123.2mg (range, 0-285mg). However, analysis of OME use excluding the four patients requiring PCA revealed a mean OME use of 90.3mg (range, 0-167.5mg). Liposomal bupivacaine provides for reliable, safe, and long-acting postoperative analgesia and contributes to a reduction in postoperative narcotic intake. The use of liposomal bupivacaine shows great promise in improving the standard of care in postoperative analgesia in microsurgical breast reconstruction.

  View details for DOI 10.1111/tbj.13349

  View details for PubMedID 31131501

• Breast Reconstruction with Free Abdominal Flaps is associated with Persistent Lower Extremity Venous Stasis. Plastic and reconstructive surgery Momeni, A., Sorice, S. C., Li, A. Y., Nguyen, D. H., Pannucci, C. 2019

  Abstract

  BACKGROUND: Previous work has demonstrated the occurrence of lower extremity venous stasis in the early postoperative period after breast reconstruction with free abdominal flaps. The purpose of this study was to ascertain whether venous stasis persisted through the day of discharge (DOD), thus, potentially exposing patients to an elevated risk of venous thromboembolism (VTE) post-discharge.METHODS: Patients who underwent breast reconstruction with free abdominal flaps were prospectively enrolled and underwent Duplex ultrasound of the common femoral vein (CFV) at the following time points: Preoperatively, POD 1, and DOD. Parameters of interest included CFV diameter, area, and maximum flow velocity (MFV).RESULTS: Thirty patients with a mean age of 50.3 years (range, 29 - 70) underwent breast reconstruction with 52 free abdominal flaps. A significant increase in CFV diameter (19.1%; p < 0.01) and area (46.8%; p < 0.01) correlated with a significant reduction in MFV (-10.9%; p = 0.03) between baseline and POD1. These changes persisted through the DOD (CFV diameter [17.8%; p < 0.01], area [46 %; p < 0.01], MFV (-11.3%; p = 0.01)]. Venous parameters were not influenced by uni- vs. bilateral flap harvest (p = 0.48).CONCLUSION: Postoperative lower extremity venous stasis following autologous breast reconstruction with free abdominal flaps seems to persist through the day of discharge. This finding may explain why patients remain at risk for VTE post-discharge. While our findings are at odds with current VTE prophylaxis recommendations, additional studies are indicated to examine whether these findings translate into VTE events.

  View details for PubMedID 30907811

• Reply: Why Women Request Labiaplasty PLASTIC AND RECONSTRUCTIVE SURGERY Sorice, S., Li, A. Y., Canales, F. L., Furnas, H. J. 2017; 140 (6): 829E-830E

  View details for DOI 10.1097/PRS.0000000000003872

  View details for Web of Science ID 000418597700020

• Social Media and the Plastic Surgery Patient PLASTIC AND RECONSTRUCTIVE SURGERY Sorice, S. C., Li, A. Y., Gilstrap, J., Canales, F. L., Furnas, H. J. 2017; 140 (5): 1047–56

  Abstract

  Many plastic surgeons use social media as a marketing tool to attract and retain patients, but information about how patients use social media and their preferred types of plastic surgery posts have been lacking.To investigate patients' preferred social media networks and the type of posts they wished to see, a cross-sectional study was conducted in a single aesthetic practice of two plastic surgeons by surveying 100 consecutive patients.The age of the patients averaged 44.4 years (range, 17 to 78 years). Facebook had the greatest patient use and engagement, with YouTube second in use, and Instagram second in number of engaged users. Over half used Pinterest, but with little daily engagement. Only one-fourth used Snapchat, but the percentage of users who were highly engaged was second only to Facebook. The least popular network was Twitter, with the fewest patient users and least engagement. Social media played a minor role compared with the practice's Web site in both influencing patients to choose the practice and providing information on the day of the appointment. Patients most wanted to see posts on a plastic surgeon's social media platform related to practice information, before-and-after photographs, and contests. Articles about plastic surgery held the least interest. Among five types of Web site content, patients expressed most interest in before-and-after photographs.This study is the first to articulate the plastic surgery patient perspective regarding social media. The findings aim to help plastic surgeons maximize their influence on their target audience.

  View details for PubMedID 29068943

• Reply to Letter to the Editor: Why Women Request Labiaplasty. Plastic and reconstructive surgery Sorice, S., Li, A. Y., Canales, F. L., Furnas, H. J. 2017

  View details for PubMedID 28820808

• Why Women Request Labiaplasty PLASTIC AND RECONSTRUCTIVE SURGERY Sorice, S. C., Li, A. Y., Canales, F. L., Furnas, H. J. 2017; 139 (4): 856-863

  Abstract

  In recent years, labiaplasty has jumped in popularity, despite opposition to the procedure. In 2007, the American College of Obstetricians and Gynecologists declared the recommendation of cosmetic vaginal procedures to be "untenable," although in 2016 they allowed consideration of labiaplasty in adolescents if symptoms persist. The reasons for labiaplasty requests are not yet fully understood, and physician opposition limits patient access to surgical relief.In this prospective study, 50 consecutive patients consulting about labiaplasty were given a questionnaire assessing 11 physical and appearance-related symptoms associated with elongated labia.The mean patient age was 33.5 years (range, 17 to 51 years). Fifty-eight percent of women had given birth, 52 percent noticed that their labia had become elongated as they got older, and 93 percent had bilateral elongation. When asked about physical symptoms, over half of patients experienced tugging during intercourse, found tight pants uncomfortable, experienced twisting of the labia, and noted labia visibility in yoga pants. Nearly half experienced pain during intercourse, and 40 percent said their labia could become exposed in bathing suits. Regarding appearance, almost all patients were self-conscious and over half felt less attractive to their partner, experienced restricted clothing choice, and noted a negative impact on self-esteem and intimacy. Nearly all patients experienced at least four symptoms.Most patients requesting labiaplasty experience both physical and appearance-related symptoms. Understanding this patient perspective is crucial in assessing surgical outcomes. Furthermore, the better all physicians understand labia symptomatology, the better supported patients will be in seeking surgical relief.

  View details for DOI 10.1097/PRS.0000000000003181

  View details for Web of Science ID 000398956600049

  View details for PubMedID 28350660

• Optimizing functional upper extremity reconstructionSimultaneous free anterolateral thigh flap and tendon transfersA case report MICROSURGERY Sorice, S. C., Press, B., Momeni, A. 2017; 37 (1): 71-74

  Abstract

  Composite upper extremity defects involving muscle-tendon units are amongst the most formidable reconstructive challenges and mandate functional restoration in addition to stable soft-tissue coverage. Here, the authors present a case of a composite defect involving the extensor muscle-tendon units of the forearm resulting from surgical resection of a recurrent Merkel cell cancer. Functional restoration was achieved via multiple tendon transfers followed by soft tissue coverage with a free anterolateral thigh (ALT) flap. No donor- or recipient-site complications were encountered and complete flap survival was noted. Following a 6-week period of immobilization, physical therapy and range of motion exercises were initiated. Excellent functional outcome and high patient satisfaction were noted at 8 weeks postoperatively. In summary, simultaneous tendon transfers and microsurgical tissue transfer may provide a potentially superior approach for upper extremity reconstruction in complex composite defects.

  View details for DOI 10.1002/micr.30096

  View details for Web of Science ID 000393458400012

  View details for PubMedID 27580418

• External Tissue Expansion: The New Frontier in Nipple Reconstruction Sorice, S. C., Rustad, K., Li, A. Y., Meyer, S., Dung Nguyen, Gurtner, G. C. ELSEVIER SCIENCE INC. 2016: E162–E163

  View details for DOI 10.1016/j.jamcollsurg.2016.08.414

  View details for Web of Science ID 000395825100358

• Hyperbaric Oxygen Corrects the Peri-Wound Microvascular Flow Sorice, S. C., Lundh, T., Li, A. Y., Rustad, K., Atayan, G. B., Sen, S. K., Chandra, V., Gurtner, G. C. ELSEVIER SCIENCE INC. 2016: S97–S98

  View details for DOI 10.1016/j.jamcollsurg.2016.06.197

  View details for Web of Science ID 000393077500167

• The Role of Stem Cell Therapeutics in Wound Healing: Current Understanding and Future Directions. Plastic and reconstructive surgery Sorice, S., Rustad, K. C., Li, A. Y., Gurtner, G. C. 2016; 138 (3): 31S-41S

  Abstract

  Chronic wounds present unique challenges for healthcare providers as they place patients at increased risk for various morbidities and mortality. Advances in wound care technology have expanded the treatment options available for wound management, but few products fully address the underlying core deficiencies responsible for the development of poorly healing wounds. In the future, addressing these derangements will undoubtedly play a key role in the treatment of these patients. Broad enthusiasm has surrounded the field of stem cell biology, which has shown great promise in repairing damaged tissues across numerous disease phenotypes.In this review, we provide a comprehensive review of the literature and evaluate the present landscape of wound therapeutics while discussing the rationales and allure behind stem cell-based products. We further propose 2 challenges that remain as new stem cell-based therapies are being developed and as this technology moves toward clinical translation.Given the relatively young age of this newer technology in wound healing, numerous challenges continue to surround its effective use including identifying the ideal population of stem cells to use and determining the optimal cell delivery method. However, significant forward progress has been made, with several clinical trials beginning to demonstrate reliable clinical benefit.The upward trajectory of stem cell technologies provides an exciting opportunity to positively impact patient outcomes through the controlled application of regenerative cell-based therapy.

  View details for DOI 10.1097/PRS.0000000000002646

  View details for PubMedID 27556772

• Hyperbaric Oxygen Acutely Increases Wound Circulation as Assessed by Fluorescent Angiography Sorice, S., Lundh, T., Gurtner, G. C., Meyer, S., Sen, S., Robertson, R., Parsley, J., Chandra, V. MOSBY-ELSEVIER. 2016: 100S–101S

  View details for DOI 10.1016/j.jvs.2016.03.112

  View details for Web of Science ID 000376230600161

• Surgical treatment of systemic sclerosis-is it justified to offer peripheral sympathectomy earlier in the disease process? Microsurgery Momeni, A., Sorice, S. C., Valenzuela, A., Fiorentino, D. F., Chung, L., Chang, J. 2015; 35 (6): 441-446

  Abstract

  Systemic sclerosis (SSc) is a rare connective tissue disease associated with significant digital vasculopathy. Peripheral sympathectomy is frequently offered late in the disease process after severe digital ischemia has already occurred with patients being symptomatic for numerous years. The purpose of the present study was to analyze the results of peripheral sympathectomy in patients with a confirmed diagnosis of SSc.A retrospective analysis of 17 patients (26 hands) who underwent peripheral sympathectomy between January 2003 and September 2013 was performed. Data regarding patient demographics, clinical features, and postoperative outcomes were retrieved. Of note, preoperative pain was present in all patients with a mean duration of 9.6 years prior to peripheral sympathectomy.Pain improvement/resolution was seen in 24 hands (92.3%). Digital ulcers healed in all patients with only two patients (two hands; 7.7%) requiring surgical intervention for ulcer recurrence 6 months and 4.5 years later. Minor complications were seen in seven hands (26.9%); including infection, wound opening, and stitch abscess, but none required surgical intervention. Seven of eight patients queried would have preferred surgical treatment at an earlier point in the disease process.Peripheral sympathectomy is a well-tolerated procedure in patients with SSc and is associated with predictable pain relief and ulcer healing in the majority of patients. In light of these findings it seems prudent to offer surgical treatment not as a last resort but rather earlier in the disease process to decrease the duration that patients suffer pain. © 2015 Wiley Periodicals, Inc. Microsurgery, 2015.

  View details for DOI 10.1002/micr.22379

  View details for PubMedID 25585522