Journal of reconstructive microsurgery最新文献

{"title":"Beyond the Anastomosis: Is Pedicle Length the Critical Determinant of Thrombosis in Free Flaps?","authors":"İhtişam Z Cengiz, Ensari Yavuz, Önder Tan","doi":"10.1055/a-2858-3671","DOIUrl":"https://doi.org/10.1055/a-2858-3671","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the effect of vascular pedicle length on arterial and venous thrombosis rates in free flap surgery.</p><p><strong>Methods: </strong>This retrospective study evaluated 546 patients who underwent free flap reconstruction with a single arterial and venous anastomosis between 2015 and 2024. Patients were categorized based on pedicle length (3-5, 6-8, and 9-15 cm). The relationship between pedicle length, anastomosis type, and thrombosis was analyzed using chi-square tests and multivariate logistic regression analysis.</p><p><strong>Results: </strong>A total of 546 flaps were analyzed. The overall venous thrombosis rate was 10.1%, and the arterial thrombosis rate was 4.2%. A statistically significant relationship was found between increasing pedicle length and higher rates of venous thrombosis (5.8% for 3-5 cm, 8.3% for 6-8 cm, and 13.4% for 9-15 cm; <i>p</i> < 0.05). While a similar trend was observed for arterial thrombosis, it did not reach statistical significance (<i>p</i> > 0.05). Multivariate logistic regression on a patient subgroup confirmed that pedicle length was an independent predictor of thrombosis (<i>p</i> = 0.022), whereas anastomosis type was not (<i>p</i> = 0.986).</p><p><strong>Conclusion: </strong>Increased pedicle length is a significant and independent risk factor for venous thrombosis in free flap surgery. Surgeons should consider pedicle length a critical parameter during surgical planning to minimize thrombotic complications and improve flap survival rates. The study provides therapeutic, level III evidence.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Postoperative Recovery Following Intraoperative Microvascular Complications in Autologous Breast Reconstruction.","authors":"Kerilyn N Godbe, Erin E Rauber, Niaman Nazir, Rebecca Farmer, Katie G Egan, Julie Holding, James Butterworth, Eric Lai","doi":"10.1055/a-2858-3537","DOIUrl":"10.1055/a-2858-3537","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative microvascular complications in autologous breast reconstruction may increase the risk of immediate postoperative flap complications, such as congestion, thrombosis, and flap loss. The impact of specific intraoperative complications on patient outcomes remains unclear.</p><p><strong>Methods: </strong>A retrospective chart review of microsurgical breast reconstruction cases from 2017 to 2023 was performed to determine intraoperative and postoperative complications, as well as patient outcomes. Statistical analysis was conducted to determine associations between intraoperative complications and outcomes.</p><p><strong>Results: </strong>A total of 1,005 flaps were performed in 620 patients, with intraoperative complications experienced in 15.1% (152/1,005) flaps. Pedicle/perforator injury was the most common (5.3%). Difficult flap pedicle dissection was a predictor of the need for a blood transfusion (17.7% vs. 8.3%, OR: 2.4 [95% CI: 1.1-5.0], <i>p</i> = 0.04). Hematoma was not associated with any intraoperative complications. In comparison, postoperative flap ischemia was associated only with intraoperative arterial thrombosis (8.3% vs. 0.7%, OR: 2.8 [95% CI: 1.5-113.0], <i>p</i> = 0.003). Postoperative flap congestion was associated with both intraoperative complications of alternate venous outflow (40% vs. 1.9%, OR: 34.4 [95% CI: 5.4-218], <i>p</i> = 0.004) and pedicle/perforator injury (10.5% vs. 1.9%, OR: 6.0 [95% CI: 1.3-27.7], <i>p</i> = 0.01). Prolonged length of stay greater than the expected 3 days was associated with difficult flap pedicle vessel dissection (52.9% vs. 31.5%, OR: 2.4 [95% CI: 1.4-4.3], <i>p</i> = 0.001) and intraoperative arterial thrombosis (63.6% vs. 32.3%, OR: 3.7 [95% CI: 1.1-12.7], <i>p</i> = 0.04). Length of stay greater than 4 days was solely associated with intraoperative thrombosis (36.4% vs. 9.9%, OR: 5.4 [1.6-18.7], <i>p</i> = 0.019). The intraoperative complications of venous anastomosis revision and difficult internal mammary vessel dissection had no significant association with the postoperative course.</p><p><strong>Conclusion: </strong>Specific intraoperative complications are associated with higher rates of postoperative complications. Awareness of the tendency for a complex postoperative recovery is warranted.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLP-1 Receptor Agonist Use and Wound Outcomes After Free Flap Breast Reconstruction.","authors":"Joy Ha, Ethan R Lester, Henning De May, Sydney Somers, Devin Eddington, Jayant P Agarwal, Alvin C Kwok","doi":"10.1055/a-2858-3774","DOIUrl":"10.1055/a-2858-3774","url":null,"abstract":"<p><strong>Background: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1s) are increasingly used for glycemic control and weight loss, but their impact on surgical wound complications remains unclear. Some studies suggest GLP-1s reduce complications such as infection and dehiscence, while others report increased risk in certain procedures. This study evaluates whether preoperative GLP-1 use is associated with postoperative wound complications in free flap breast reconstruction.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the TriNetX Research Network, a global database of de-identified health records. Adults (≥18 years) undergoing free flap breast reconstruction (2012-2025) were identified with CPT codes. Patients were stratified into cohorts by GLP-1 use within 1 year before surgery. Prescriptions for semaglutide, liraglutide, dulaglutide, exenatide, or tirzepatide defined GLP-1 users. Cohorts underwent 1:1 propensity score matching, and matched groups were analyzed for wound outcomes. Subgroup analyses were performed by diabetes status.</p><p><strong>Results: </strong>In the pooled cohort, GLP-1 users had significantly lower composite wound complication rates compared with non-users (9.0% versus 17.1%, <i>p</i> = 0.002), including reduced surgical site infections (4.1% versus 8.1%, <i>p</i> = 0.026) and wound dehiscence (3.8% versus 7.8%, <i>p</i> = 0.023). No differences were observed in debridement, seroma, or hematoma rates. In subgroup analyses, GLP-1 use was associated with significantly lower composite wound complications in the non-diabetic subgroup (7.9 versus 18.6%, <i>p</i> = 0.007), while overall complication rates in the diabetic subgroup were comparable between users and non-users.</p><p><strong>Conclusion: </strong>Preoperative GLP-1 use was not linked to increased wound complications and may confer benefit, supporting safety when used perioperatively.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-Institution Analysis of Immediate and Delayed Jaw Reconstruction.","authors":"Evan Rothchild, You J Park, Isabelle T Smith, Jina Yom, Caroline Baker, Ivie Odia, Lamorna Coyle, Joseph A Ricci","doi":"10.1055/a-2856-1135","DOIUrl":"10.1055/a-2856-1135","url":null,"abstract":"<p><strong>Background: </strong>Traditional methods of mandibular reconstruction commonly utilize the fibula-free flap with delayed placement of dental prostheses. Recently, immediate prosthesis placement has been introduced to eliminate the period of edentulism. This study aimed to compare the surgical outcomes of patients undergoing immediate jaw reconstruction (IJR) with those undergoing traditional fibula-free flap mandibular reconstruction (FFFMR) at our institution.</p><p><strong>Methods: </strong>Following IRB approval, a retrospective review was conducted on patients who underwent either traditional FFFMR or IJR at our institution between 2015 and 2024. Patients were divided into either the traditional or the IJR cohort. Propensity score matching was used to control for confounding variables, and the surgical outcomes of the two cohorts were compared.</p><p><strong>Results: </strong>A total of 116 patients were included in the study, with 97 in the traditional group and 19 in the IJR group. Demographics and clinical factors were similar between the two groups, although patients in the traditional cohort were more likely to have malignant disease. Following propensity score matching, no significant differences in complication rates were observed between groups. The surgery duration was significantly shorter in the IJR group compared to the traditional FFFMR group in both the unmatched and matched analyses.</p><p><strong>Conclusion: </strong>IJR demonstrated comparable postoperative surgical outcomes to the traditional FFFMR approach. These findings suggest that IJR is not inferior, and support this method as a feasible, safe alternative to provide immediate functional and aesthetic benefits for appropriately selected patients.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensory Recovery of Foot and Ankle Reconstruction with Neurotized ALT Flaps: A Systematic Review.","authors":"Alec J Chen, Isabel A Snee, John D Nguyen, Jeffrey Khong, Elizabeth K Laning, Kitae E Park, Lily R Mundy, Aaron M Dingle, Samuel O Poore","doi":"10.1055/a-2858-3815","DOIUrl":"https://doi.org/10.1055/a-2858-3815","url":null,"abstract":"<p><strong>Background: </strong>The anterolateral thigh flap (ALT) is a reliable soft tissue reconstruction option, especially for lower extremity defects. Recent advancements in flap innervation methods show promise in promoting sensory recovery, yet the current literature lacks a comprehensive summary of its outcomes.</p><p><strong>Methods: </strong>A systematic review of PubMed, Embase, Web of Science, and Scopus was performed by identifying all studies examining sensory recovery outcomes in lower extremity reconstruction using innervated ALT flaps.</p><p><strong>Results: </strong>Of 793 unique articles, eight studies (<i>n</i> = 206 patients) met the inclusion criteria. The mean age was 47.9 ± 11.1 (range: 6-80). The most common etiologies of soft tissue defect were trauma (<i>n</i> = 94, 45.6%), diabetic foot ulcers (<i>n</i> = 64, 31.1%), and malignancy (<i>n</i> = 45, 21.8%). There were 108 (52.4%) patients who underwent reconstruction with a neurotized ALT flap, and 98 (47.6%) without. Of patients with neurotized flap reconstruction, nerve coaptation was performed end-to-end (<i>n</i> = 31, 28.7%) or end-to-side (<i>n</i> = 14, 12.9%). Recipient nerves included the medial plantar (<i>n</i> = 16, 14.8%), medial dorsal cutaneous (<i>n</i> = 9, 8.3%), calcaneal (<i>n</i> = 7, 6.5%), posterior tibial (<i>n</i> = 5, 4.6%), superficial peroneal (<i>n</i> = 4, 3.7%), or sural (<i>n</i> = 1, 0.9%) nerves. The overall complication rate was 16.5%, of which 11 (5.3%) were major flap complications requiring a return to the operating room. Overall, three studies found evidence of improved sensory recovery when using neurotized ALT flaps.</p><p><strong>Conclusion: </strong>Lower extremity reconstruction with innervated ALT flaps predominantly involves the foot and ankle region (98.5%), as the improved sensory recovery may be helpful in reducing secondary injury risk, such as diabetic foot ulcers. No cases involving reconstruction of soft tissue defects above the knee were identified.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal Vasodilators in Microsurgery and Their Effects on Blood Vessels.","authors":"Misato Ueda, Tadashi Nomura, Hiroto Terashi, Shunsuke Sakakibara","doi":"10.1055/a-2483-5634","DOIUrl":"10.1055/a-2483-5634","url":null,"abstract":"","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"e1-e2"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronological Changes in Breast and Nipple Position After Autologous Reconstruction in an Asian Population.","authors":"Suphalerk Lohasammakul, Johyun Yoon, Chaiyawat Suppasilp, Jin Sup Eom, Hyun Ho Han","doi":"10.1055/a-2616-4258","DOIUrl":"10.1055/a-2616-4258","url":null,"abstract":"<p><p>The breast shape changes between reconstructed and native breasts in autologous reconstruction, which is important to achieve symmetry. This study was conducted to clarify chronological changes in the shape and nipple position of the reconstructed breast compared with the contralateral breast in the Asian population.Photographic assessments were conducted at baseline and during annual visits of patients who underwent immediate free flap breast reconstruction following unilateral nipple-sparing mastectomy at our institution between June 2017 and December 2019. Univariate and multivariate analyses were performed to identify factors associated with the change in shape and nipple position. This observation was most marked at 1-year postsurgery.Among the 170 patients (mean age, 48.04 ± 7.55 years), 164 (96.47%) had a deep inferior epigastric perforator flap and 8 (4.71%) required further surgery on the contralateral breast for correction of asymmetry. The chronological changes in the breast shape and nipple position significantly differed between the native and the reconstructed breast, with the latter showing a higher degree of retraction. Grading of breast ptosis (grades 0-2) and exposure to radiotherapy were associated with an increased degree of retraction.Retraction may occur after free flap breast reconstruction, particularly in patients with ptosis or those receiving radiotherapy. These findings support careful planning, including volume adjustment and contralateral procedures. While based on an Asian population, the results may inform surgical decisions in similar patient groups.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"286-297"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Enhanced Recovery After Surgery on Racial Inequalities in Prescribing Practices for Autologous Breast Reconstruction.","authors":"Annabel Baek, Rachel Smith, Lesley B Coots, Emily S Andersen, Cindy Song, Hui Yu Juan, Sonia Lele, Paschalia M Mountziaris","doi":"10.1055/a-2632-2565","DOIUrl":"10.1055/a-2632-2565","url":null,"abstract":"<p><p>Enhanced recovery after surgery (ERAS) pathways have improved surgical outcomes and reduced narcotic needs. This study evaluated racial differences in our institution's opioid prescribing practices in autologous breast reconstruction before and after ERAS implementation.This was a retrospective review of consecutive patients undergoing autologous breast reconstruction from 2013 to 2021, pre-ERAS and after ERAS implementation. Primary outcomes were morphine milligram equivalents (MME) for intravenous (IV) and oral (PO) narcotics peri- and postoperatively. Secondary outcomes included infection, delayed wound healing, and need for reoperation.Of 163 patients, 150 met inclusion criteria. The pre-ERAS group comprised 65 patients (35% Black, 65% White), and the ERAS group included 85 patients (44% Black, 54% White). Pre-ERAS, Black patients received more IV narcotics than White patients, 814 versus 505 MME (<i>p</i> < 0.05). There was no difference between inpatient and outpatient PO MME (<i>p ></i> 0.05). ERAS decreased IV MME 10-fold (<i>p</i> < 0.05) and decreased inpatient PO MME approximately 3-fold (<i>p</i> < 0.05). Nevertheless, racial differences existed in IV narcotics (80 vs. 58 MME; <i>p</i> <i><</i>0.05) and inpatient PO narcotics (93 vs. 59 MME; <i>p</i> < 0.05). Black race was a significant positive predictor in univariate and multivariate analyses for IV MME in both pre-ERAS and ERAS.Black patients unexpectedly received more IV narcotics pre-ERAS. Although ERAS decreased inpatient opioid administration, racial differences persisted; Black patients also received more PO narcotics, contrary to literature findings of systemic pain undertreatment. Standardized protocols alone may be inadequate to address complexities of postoperative pain.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"298-305"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extensive Primary Thinning of the Free Functional Gracilis Flap is Safe and Does Not Compromise Functional Outcomes in Dynamic Smile Reconstruction.","authors":"David Chi, Austin Y Ha, Grace Keane, Kenan Tawaklna, Gary B Skolnick, Alison K Snyder-Warwick","doi":"10.1055/a-2616-4437","DOIUrl":"10.1055/a-2616-4437","url":null,"abstract":"<p><p>Facial reanimation surgery using a free functional gracilis muscle transfer is the standard of care in long-standing facial paralysis. Surgical revision rates are high, with most directed toward flap debulking and improving contour. During the index surgery, the muscle can be thinned extensively to potentially avoid revisions, but there is concern for injuring the neurovascular pedicle or weakening contractility. The authors hypothesize that primary flap thinning is safe without compromising smile contractility.Patients undergoing dynamic smile reconstruction with free functional gracilis muscle transfer were retrospectively reviewed over an 8-year period. Functional morphometric outcomes were evaluated with the Emotrics facial expression recognition software. Time to innervation, secondary procedures, and complications were also recorded.In total, 34 facial reanimation procedures met the inclusion criteria. The average muscle flap weight after primary thinning was 17.0 ± 9.3 g (range 5-46 g). Smile excursion improved by 7.7 ± 5.5 mm in the unilateral and 5.7 ± 3.4 mm in the bilateral paralysis groups, with significant improvement from preoperative commissure (<i>p</i> = 0.001) and smile angle (<i>p</i> = 0.003) measurements. One patient required a secondary debulking procedure. Secondary outcomes of improved reinnervation time and smile excursion weakly trended with decreased gracilis weight but did not achieve statistical significance. Complications included one flap loss, one donor site hematoma, one facial abscess, and one facial hematoma.Flap thinning at the time of primary free functional gracilis transfer did not result in increased complications or compromise its ability to produce symmetric smiles of adequate excursion. Compared to published cohorts, this technique may reduce the need for secondary revisions.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"278-285"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Invasive is the Free Gracilis Muscle Flap? A Prospective Study on Donor Site Morbidity.","authors":"Nikolaus Wachtel, Riccardo E Giunta, Maximilian Hirschmann, Marc Hellweg, Tim Nuernberger, Nicholas Moellhoff, Denis Ehrl","doi":"10.1055/a-2632-2663","DOIUrl":"10.1055/a-2632-2663","url":null,"abstract":"<p><p>Free gracilis muscle (GM) flaps represent a reliable workhorse procedure in the field of plastic and trauma surgery. However, only a small number of studies have examined this large group of patients regarding the morbidity of flap harvest. The aim of this prospective study was therefore to objectively investigate the morbidity of free GM flaps.A control group (<i>n</i> = 100) without surgery was recruited to assess interindividual differences in strength and range of motion (ROM) in the hip and knee joint (dominant vs. nondominant side). Additionally, for 50 patients with free GM flap surgery, these parameters were assessed in an identical manner.The control group showed significant interindividual differences in strength for abduction and adduction in the hip joint when comparing the dominant to the nondominant side, but no significant differences in the ROM. GM flap harvest led to no significant differences in maximum force 20.3 (± 13.8) months after surgery in all parameters/movements that were assessed. However, the ROM for abduction in the ipsilateral hip joint was significantly reduced after surgery.The GM flap has a low donor site morbidity and should therefore be considered as a first-line option for microsurgical reconstructive procedures. Moreover, the low morbidity is not affected by preexisting differences in strength when comparing the dominant to the nondominant side.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"306-313"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}