Journal of reconstructive microsurgery最新文献

{"title":"The Co-Surgeon Model for Microsurgical Free Flaps: A Survey of Perspectives and Utility.","authors":"Emmanuel Giannas, Brandon Alba, Kelly Harmon, Annie Fritsch, David Kurlander, Deana Shenaq, Christodoulos Kaoutzanis, Christopher Reid, Evan Matros, Babak Mehrara, George Kokosis","doi":"10.1055/a-2540-0835","DOIUrl":"10.1055/a-2540-0835","url":null,"abstract":"<p><p>Reconstructive microsurgery remains a demanding field, requiring technical expertise and long operating hours. This places microsurgeons at increased risk of dissatisfaction and burnout. The co-surgeon model has been developed to mitigate these challenges. This study was designed to evaluate microsurgeon perspectives on the characteristics and impact of the co-surgeon model for microsurgical free flaps.An electronic anonymous survey was distributed via email to attending microsurgeon members of the American Society of Reconstructive Microsurgeons. The survey collected various demographic and practice-related information including Likert scale questions to assess microsurgeon perspectives on the utility of the co-surgeon model.A total of 862 microsurgeons received the survey, with 102 responses available for analysis. The average age of respondents was 46.6 (± 9.7) years. Most of the microsurgeons were male (71%) practicing in the United States (93%), with 74.5% of respondents utilizing a co-surgeon model in their practice. Bilateral breast flaps were the most common microsurgical procedure performed using a co-surgeon (85%), followed by head and neck free flaps (60%), with immediate lymphatic reconstruction being the least common (3.1%). On the day of the co-surgery case, the co-surgeon was more likely than the primary surgeon to have additional cases (68.4 and 36.4%, respectively), with the additional cases being rarely free flaps. More than 80% of microsurgeons stated that the co-surgeon model improves \"very much\" or \"quite a bit\" operative efficiency and duration, as well as surgeon well-being and career longevity.This study provides new insight into the utility of using a co-surgeon for free flap reconstruction by demonstrating that approximately 80% of microsurgeons have a positive perception of the model's impact on procedure efficiency, operative time, surgeon well-being, and career longevity. Therefore, adopting a co-surgeon model for microsurgical free flap reconstruction may be useful in reducing burnout and promoting well-being among microsurgeons.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"810-818"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492529","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":"Impact of Technological Advancements on Short-term Outcomes in Flap Reconstruction after Soft Tissue Sarcoma Resection: A Retrospective Comparative Analysis.","authors":"Ryo Karakawa, Hidehiko Yoshimatsu, Yuma Fuse, Norio Kurosawa, Masanori Saito, Keiko Hayakawa, Taisuke Tanizawa, Keisuke Ae, Seiichi Matsumoto, Tomoyuki Yano","doi":"10.1055/a-2508-6628","DOIUrl":"10.1055/a-2508-6628","url":null,"abstract":"<p><p>Soft tissue sarcomas (STS) are rare malignancies requiring extensive surgical resection, often leading to significant soft tissue defects. Flap reconstruction is crucial for restoring function and appearance. Recent reconstructive microsurgery advancements, including high-resolution indocyanine green (ICG) imaging and ultra-high frequency ultrasonography (UHFU), have revolutionized preoperative planning and intraoperative guidance. We aimed to compare the surgical procedures and short-term outcomes of patients undergoing immediate flap reconstruction before and after our department's adoption of these technologies.We retrospectively analyzed 276 patients who underwent immediate flap reconstruction post-sarcoma resection between May 2014 and December 2023. They were categorized into pre- and post-technology groups based on the introduction of ICG angiography and UHFU in July 2019. We collected demographic, surgical, and postoperative data and compared outcomes using Fisher's exact and <i>t</i>-tests.The muscle preservation rate at the donor site was significantly higher in the post-Tech than in the pre-Tech group (no muscle damage: 65% vs. 37%, incision muscle damage: 25% vs. 26%, and muscle resection: 10% vs. 37%; <i>p</i> < 0.01). The proportions of complications (21% vs. 36%, <i>p</i> = 0.01), flap complications (17% vs. 30%, <i>p</i> = 0.01), partial flap loss (5% vs. 17%, <i>p</i> < 0.01), and flap dehiscence (9% vs. 25%, <i>p</i> < 0.01) were low in the post-Tech group. In the stratified analysis of free-flap reconstruction, the post-Tech group had a shorter operative time (7:01 vs. 8:13, <i>p</i> = 0.03) and fewer takebacks due to compromised flap perfusion (4% vs. 15%, <i>p</i> = 0.03) compared with the pre-Tech group.The introduction of ICG angiography and UHFU has improved surgical outcomes in STS flap reconstructions. These technologies facilitate precise preoperative planning and intraoperative decision-making, resulting in reduced operative times, low complication rates, and enhanced muscle preservation at the donor site.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"761-771"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922012","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 in Morbidly Obese Patients Undergoing Free Flap Breast Reconstruction.","authors":"Kristen L Stephens, Robert G DeVito, Scott T Hollenbeck, Chris A Campbell, John T Stranix","doi":"10.1055/a-2506-1763","DOIUrl":"10.1055/a-2506-1763","url":null,"abstract":"<p><p>Enhanced recovery after surgery (ERAS) pathways have been widely implemented across many surgical practices, including autologous breast reconstruction. However, the benefits of ERAS in the morbidly obese population have yet to be defined.A retrospective chart review of patients undergoing deep inferior epigastric artery perforator (DIEP) flap breast reconstruction at our institution from 2017 to 2022 was performed. Length of stay (LOS), intensive care unit (ICU) utilization, opioid usage, cost, and flap outcomes were analyzed in patients with body mass index greater than 35 before and after ERAS implementation.Thirty-five morbidly obese patients receiving DIEP flap breast reconstruction were identified before ERAS and 18 after ERAS. There were no differences in unilateral versus bilateral or immediate versus delayed reconstruction. LOS decreased with ERAS (3.43 vs. 2.06 days, <i>p</i> < 0.0000001). ICU utilization decreased with ERAS (0.94 vs. 0.0 days, <i>p</i> < 0.0001). Daily and total opioid usage decreased with ERAS (41.8 vs. 17.9 morphine milligram equivalent [MME], <i>p</i> < 0.0001; 190.5 vs. 54.7 MME, <i>p</i> < 0.0001). Financial metrics improved with ERAS, including decreased total cost ($33,454 vs. $25,079, <i>p</i> = 0.0002) and increased cost margin ($4,458 vs. -$8,306, <i>p</i> = 0.004). There were no differences in donor or recipient site outcomes including flap loss, deep venous thrombosis/pulmonary embolism, hernia/bulge, delayed wound healing, revisions, and blood loss.ERAS pathways maintain benefits in the morbidly obese population undergoing abdominally based autologous breast reconstruction, including decreased LOS, ICU utilization, opioid use, and cost while maintaining successful reconstruction outcomes.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"733-740"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864461","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":"Simultaneous Symmetrizing Surgery on the Contralateral Breast in Unilateral Autologous Breast Reconstruction Is Cost-Effective.","authors":"K Lynn Zhao, Alexander J Kammien, Elena Graetz, Miranda S Moore, Brogan G Evans, Eric B Schneider, Haripriya S Ayyala","doi":"10.1055/a-2517-0803","DOIUrl":"10.1055/a-2517-0803","url":null,"abstract":"<p><p>Simultaneous symmetrizing surgery (SSS) at the time of unilateral free flap reconstruction has been described as a method to facilitate single-stage breast reconstruction. However, the impact on cost and number of additional procedures is not well described.Patients with unilateral free flap reconstruction were identified in national administrative data from 2017 to 2021 and followed for one year. Patients were stratified by immediate and delayed reconstruction, then further stratified into groups with and without SSS. Thirty-day complications included transfusion, wound dehiscence, surgical site infection, hematoma/seroma, and thromboembolism. The costs of initial hospitalization and subsequent surgeries were determined. Deferred symmetrizing surgeries within one year were identified. Chi-squared and Fisher exact tests and Wilcoxon tests were used for statistical analysis.A total of 1,136 patients were identified, out of which 638 were delayed reconstructions: 75 with SSS and 563 without. There were no significant differences in patient characteristics or 30-day complications. Within one year of index reconstruction, fewer patients with SSS underwent revision surgery (29% vs. 51%, [<i>p</i> = 0.001]) or at least one additional procedure (36% vs. 57%, <i>p</i> < 0.001). Patients with SSS had lower total costs ($35,897 vs. $50,521, <i>p</i> = 0.005). There were 498 immediate reconstructions: 63 with SSS and 435 without. There were no significant differences in patient characteristics, 30-day complications, subsequent surgeries, or total costs.Symmetrizing procedures at the time of unilateral reconstruction may decrease the cost and number of subsequent surgeries without increasing complications.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"787-793"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007249","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":"Applying the Modified Five-Item Frailty Index to Predict Complications following Lower Extremity Free Flap Reconstruction in Trauma Patients.","authors":"Miguel Gonzalez, Maeson Zietowski, Ronak Patel, Anmol Chattha, Courtney N Cripps, Maureen Beederman","doi":"10.1055/a-2508-6716","DOIUrl":"10.1055/a-2508-6716","url":null,"abstract":"<p><p>Free flap reconstruction in the setting of lower extremity trauma continues to be a challenging clinical problem fraught with a high risk of complications including flap compromise. Although studies have described certain risk factors that predispose these patients to poor outcomes, there remains a paucity of literature detailing frailty as a risk factor. As such, the aim of our study was to examine the application of the 5-item modified frailty index (mFI-5) in trauma patients undergoing lower extremity free flap reconstruction.The 2012 to 2020 American College of Surgeons-National Surgical Quality Improvement Program database was queried for lower extremity free flap reconstructive procedures. After excluding nontrauma etiologies, patients were stratified into three cohorts by their respective mFI-5 score (0, 1, and ≥2). Univariate and multivariate logistic regressions were performed to assess the effect of mFI-5 scores on postoperative complications.A total of 219 patients were included (64.8% male) with an average age of 47.6 ± 16 years. A total of 22.4% (<i>n</i> = 49) of patients had at least one complication. An increased mFI-5 score was associated with an increase in any complication (<i>p</i> < 0.001), hematological complication (<i>p</i> = 0.023), and reoperation (<i>p</i> = 0.004) rates. A high mFI-5 score was found to be an isolated risk factor for having at least one complication (mFI-5 ≥ 2: odds ratio [OR]: 3.829; <i>p</i> < 0.007; 95% confidence interval [CI]: 1.445-10.145) and reoperation (mFI-5 ≥ 2: OR: 5.385; <i>p</i> < 0.002; 95% CI: 1.826-15.877).Our results indicate that the mFI-5 can be a helpful assessment tool for lower extremity trauma patients undergoing free flap reconstruction to predict the risk of surgical complications and reoperation rates. Patients with an mFI-5 score > 2 should be counseled preoperatively of their increased risk of complications.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"746-751"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059611","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":"Early Initiation of Dangle Protocol in Lower Extremity Free Flap Microsurgery.","authors":"Shannon Su, Ambika Menon, Carolyn Taillon, Omar Saad, Tyler Merceron, Paul Ghareeb","doi":"10.1055/a-2508-6558","DOIUrl":"10.1055/a-2508-6558","url":null,"abstract":"<p><p>Defects of the lower extremity often require free tissue transfer to provide adequate soft tissue reconstruction. Patients typically undergo a postoperative dangle protocol to condition the flap to withstand the increase in venous pressure. The purpose of this study was to evaluate the safety and postoperative length of stay after early initiation of dangle.A retrospective review of patients undergoing lower extremity free tissue transfer reconstruction at the Grady Memorial Hospital from 2012 to 2022 was conducted. Patient demographics, surgical characteristics, and outcomes were analyzed. Patients were categorized into two groups: early (within 5 days after surgery) and late dangle (day 6 or greater). Univariate and multivariate statistical analyses were performed, with significance determined to be <i>p</i> < 0.05.A total of 83 of 99 available patients met inclusion criteria; 22 patients underwent early and 61 late dangle. Free flap survival was 90.9% in the early and 90.2% in the late group. The mean postoperative length of stay in the early and late groups were 12.3 and 18.8 days, respectively (<i>p</i> = 0.0018). There was no difference in the number of patients who had wound healing complications, flap failure, and a need for amputation in each group.Our results demonstrate that initiation of an early dangle protocol does not affect surgical outcome and leads to a reduction in postoperative length of stay. These results can be used to inform evidence-based recommendations for flap management in lower extremity reconstruction.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"741-745"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921997","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":"Utilizing Lateral Sprouting Axons to Reinnervate a Transferred Free Muscle to Enhance Distal Muscle Recovery When Performing High-Level Nerve Repair: Experimental Rat Study.","authors":"Chung-Kan Tsao, Shih-Ming Jung, David Chwei-Chin Chuang","doi":"10.1055/a-2508-6439","DOIUrl":"10.1055/a-2508-6439","url":null,"abstract":"<p><p>High-level median or ulnar nerve injuries and repairs typically result in suboptimal reinnervation of distal muscles. Functioning free muscle transplantation (FFMT) is increasingly recognized as an effective method to restore function in chronic muscle denervation cases. This study investigates the efficacy of using an additional FFMT, neurotized by lateral sprouting axons from a repaired high-level mixed nerve in the upper limb, to enhance distal hand function.Thirty-five Sprague-Dawley rats were divided into four groups to evaluate the proposed FFMT technique. The infraclavicular median nerve (MN) was transected and repaired in each animal. The nearby musculocutaneous nerve (MCN) was transected, and the terminal nerve after the biceps muscle was divided and embedded into the biceps muscle, creating an FFMT model. The distal stump of the MCN was anchored to the MN, 1.5 mm distal to the MN repair site. Assessments of nerve and muscle function were conducted 4 months postoperatively.Behavioral analysis, along with measurements of biceps muscle weight and tetanic contraction force, indicated significant recovery in the biceps muscle. Histological staining confirmed reinnervation of the MCN from the repaired MN. Additionally, functional examination of the flexor digitorum superficialis muscle revealed no deterioration associated with the repaired MN.The study demonstrates the potentiality of utilizing lateral sprouting axons from a repaired high-level MN to reinnervate an additional FFMT to enhance flexor digitorum superficialis function. The surgical strategy promises recovery of distal muscle function and implies for diverse clinical applications.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"772-780"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921943","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":"Career Paths of Young Fellowship-Trained Microsurgeons.","authors":"Christopher R Howell, Madeline G Tierney, Allen Westerfield, Amanda K Silva","doi":"10.1055/a-2509-1169","DOIUrl":"10.1055/a-2509-1169","url":null,"abstract":"<p><p>Microsurgery is a highly specialized field requiring years of dedicated training and proper support to sustain a practice. We sought to describe the career paths of young microsurgeons and investigate factors associated with switching jobs.Public data on surgeons who completed a microsurgery fellowship between 2016 and 2020 were collected. Analysis of job switching was determined using the Kaplan-Meier method.One hundred and sixty-seven graduates were analyzed. Most initially practiced microsurgery (92.2%) and 61.7% went into academics. Fifty-two (31.4%) have switched jobs and Kaplan-Meier estimates that 36.0% will switch by 5 years into practice. Over half (58%) changed practice setting type, 19% left academics, and 12% stopped performing microsurgery.Gender, residency training type, taking a job where they trained, and the presence of a microsurgery fellowship had no effect on job switching (<i>p</i> = 0.74, 0.95, 0.71, 0.26). Surgeons in academics were significantly more likely to change jobs (<i>p</i> = 0.04).Gender, residency training type, or taking a job where they trained had no effect on leaving academics (<i>p</i> = 0.89, 0.42, 0.37). Taking a first job where a microsurgery fellowship was present was significantly associated with staying in academics (<i>p</i> = 0.04)Most microsurgery fellows take jobs performing microsurgery. Thirty-six percent will switch jobs in 5 years, more than half will change practice setting type, and about 20% will leave academics. A minority will stop performing microsurgery. Surgeons in academics are more likely to switch jobs. Taking a job where there is a microsurgery fellowship is significantly associated with staying in academics during the switch.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"781-786"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909846","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":"A Review of Minimally Invasive Techniques for Perfusion Optimization of Flaps.","authors":"Micaela Tobin, Charlotte Thomas, Tricia Raquepo, Mohammed Yamin, Audrey Mustoe, Agustin Posso, Jose Foppiani, Ryan P Cauley","doi":"10.1055/a-2540-1044","DOIUrl":"10.1055/a-2540-1044","url":null,"abstract":"<p><p>There is a growing emphasis on minimally invasive techniques as an alternative to surgical delay to promote vessel reorganization and prevent partial and total flap loss. This systematic review evaluates existing literature on these minimally invasive techniques, focusing on their potential applications in preventing ischemia-related complications.A systematic review was conducted in July 2024 using PubMed, MEDLINE, and Web of Science following preferred reporting items for systematic reviews and meta-analysis guidelines. Inclusion criteria were studies that included patients undergoing any flap-based reconstruction treated with minimally invasive delay. Exclusion criteria were non-English papers, other systematic reviews, nonhuman patients, and pediatric patients.Six studies were included (angiographic delay <i>n</i> = 143, heat preconditioning <i>n</i> = 191, ischemic preconditioning <i>n</i> = 60) which examined minimally invasive methods for perfusion optimization. Aggregated data from the three studies on angiographic delay demonstrated a 13% (18/143) combined skin or fat flap necrosis rate, which was lower than that of non-delayed flaps and comparable to more invasive traditional surgical ligation. Ischemic preconditioning showed no significant differences (<i>p</i> = 1.0) g compared with controls, whereas heat preconditioning led to reductions (26% vs. 35%) in flap necrosis and necrosis requiring surgical intervention (11% vs. 17%).Angiographic embolization presents a promising alternative to invasive surgical delay, effectively reducing flap necrosis risk. Heat and ischemic preconditioning also show potential for increasing flap survival, although current studies are limited by small sample sizes. Further research is essential to explore preoperative conditioning interventions to improve surgical outcomes for patients who require less invasive delay techniques.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"794-801"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441198","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":"Corrigendum: The Histologic Effect of Barrier Vein Wrapping of Peripheral Nerves.","authors":"David S Ruch, Robert J Spinner, L Andrew Koman, Venkata R Challa, Dermot O'Farrell, L Scott Levin","doi":"10.1055/s-0044-1782514","DOIUrl":"10.1055/s-0044-1782514","url":null,"abstract":"","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"e1"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318455","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}