Journal of reconstructive microsurgery最新文献

{"title":"Impact of Judicious Fluid Administration in the Setting of Abdominally Based Free Flaps.","authors":"Lyndsay A Kandi, Nicole Van Spronsen, W Nicholas Jungbauer, Jaime Sexton, Nellie Movtchan, Yu-Hui Chang, Edward Reece, Alanna M Rebecca, William J Casey","doi":"10.1055/a-2616-4598","DOIUrl":"10.1055/a-2616-4598","url":null,"abstract":"<p><p>Abdominally based free flaps are commonly utilized in the context of breast reconstruction. Historically, postoperative care of these patients involved liberal amounts of intravenous fluid administration; however, overadministration of fluids puts patients at risk of developing flap edema via fluid shifts, electrolyte imbalances, wound dehiscence, and other sequelae. The purpose of this study is to assess fluid administration trends in this cohort at the authors' institution and assess its impact on patient outcomes.A retrospective review was performed on patients who underwent free-flap breast reconstruction. Patient demographics and hospitalization data were collected, and type of abdominal flap and reconstruction timing was noted. Perioperative fluid administration volumes were tracked, and primary outcomes included complication rate and type (e.g., acute blood loss anemia [ABLA], partial/total flap loss, etc.). Multivariable logistic regression was performed to assess the impact of fluid volume on patient outcomes.A total of 115 patients (mean age of 51.3 ± 10.5 years) underwent 188 abdominally based free flaps. Deep inferior epigastric artery perforator flaps were performed most often (<i>n</i> = 91), followed by muscle-sparing transverse rectus abdominis flaps (<i>n</i> = 88). Multivariable logistic regression demonstrated that high perioperative fluid administration (≥9,000 mL) was associated with increased odds of medical complications (odds ratio [OR] = 21.7; confidence interval [CI]: 5.54-84.5; <i>p</i> < 0.001). Patients with high fluid administration volumes experienced an increased (but nonstatistically significant) flap complication rate (OR = 2.96; CI: 0.89-9.88; <i>p</i> = 0.08) and developed ABLA at a higher rate (OR = 15.86; CI: 5.30-46.4; <i>p</i> < 0.001).High-volume resuscitation (≥9,000 mL) was associated with increased odds of ABLA as well as a greater likelihood of medical and flap complications in patients undergoing abdominally based free flaps for breast reconstruction. These data should be used to guide the development of protocols within institutions, which perform free flaps for breast reconstruction.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110905","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":"https://doi.org/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":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-16","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":"Ultrasonographic Quantification of Blood Flow in Microsurgical Breast Reconstruction: Correlation with Indocyanine Green Angiography.","authors":"Hyung Bae Kim, So Min Oh, Hyun Ho Han, Jin Sup Eom","doi":"10.1055/a-2616-4817","DOIUrl":"10.1055/a-2616-4817","url":null,"abstract":"<p><p>Although autologous breast reconstruction using the deep inferior epigastric artery perforator (DIEP) flap is a standard procedure, flap perfusion-associated complications remain a concern. This study aimed to investigate the correlation between blood flow information obtained through color Doppler ultrasonography (CDU) and flap perfusion assessed by indocyanine green (ICG) angiography.This prospective study included 30 female patients who underwent DIEP flap breast reconstruction between August 2023 and June 2024. Preoperative flow parameters, including arterial peak velocity, arterial volume flow, and venous peak velocity, were measured using CDU. Flap perfusion was evaluated using ICG angiography.The study demonstrated a positive correlation between venous flow and overall flap blood flow. Arterial peak velocity (<i>r</i> = 0.368, <i>p</i> = 0.046), arterial volume flow (<i>r</i> = 0.455, <i>p</i> = 0.011), and venous peak velocity (<i>r</i> = 0.399, <i>p</i> = 0.029) all showed significant associations with ICG-stained area percentages. These findings suggest that venous flow data can provide valuable information for predicting flap viability.This study demonstrates a significant correlation between flow information obtained through CDU and flap perfusion assessed via ICG angiography in patients undergoing DIEP flap breast reconstruction. Both arterial and venous flow data were shown to be crucial for predicting flap viability, with venous flow exhibiting a notable positive correlation with flap blood flow.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127897","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 After Microsurgery Fellowship: A 10-Year Analysis.","authors":"Elaine Lin, Tara Pillai, Victoria N Yi, Ann Marie Flusche, Sakshi Chopra, Melissa Tran, Ash Patel, Kristen M Rezak","doi":"10.1055/a-2616-4716","DOIUrl":"10.1055/a-2616-4716","url":null,"abstract":"<p><p>Over the past 10 years, microsurgery fellowship programs and positions have increased by 50%, underscoring the need to understand graduate career paths and provide trainees context about future practice. This study analyzed who pursues microsurgery fellowships and factors associated with academic careers.This cross-sectional analysis examined graduates from the past 10 years from fellowships recognized by the American Society of Reconstructive Microsurgery or graduates of international fellowships who completed residency in the United States. Demographic variables included gender, race, residency location, and integrated versus independent plastic surgery residency. bibliometric indices at the time of graduation and October 2024 were measured. Initial and current practice settings were categorized as academic (full-time faculty), \"private affiliated\" (involved in teaching but not full-time faculty), or private practice.Overall, 423 graduates were identified. The majority were male (62.9%) and White (63.4%). Most completed Integrated residency (72.6%). Five fellowships accounted for 48.0% of graduates: MD Anderson (80), Memorial Sloan Kettering (46), University of Pennsylvania (38), Stanford University (23), and The Buncke Clinic (16). After fellowship, 68.0% of graduates entered academia, and 63.2% of graduates are in academia currently out of 419 analyzed. Fellowship location was associated with initial academic practice (<i>p</i> = 0.01), many graduates from International (80.0%), and Southern (78.4%) fellowships entering academia. Graduates in initial academic practice had higher median initial <i>g</i>-index (13 vs. 10, <i>p</i> = 0.03) and median initial publications (15 vs. 11, <i>p</i> = 0.02). Multiple logistic regression found initial publications and fellowship location to be the best predictors of initial academic practice.While most graduates pursue academia, a significant number enter private practice, indicating it is a viable option. Southern or International fellowships send more graduates into academia, but this is likely influenced by popular fellowships. Nuanced factors like personal preference, financial considerations, and networking likely play a significant role in career choices.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110631","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":"Characterization of Soft Tissue Reconstruction Following Chordoma Resection.","authors":"Shanmuga Priya Rajagopalan, Danielle Sim, Waldemar A Rodriguez-Silva, Ananya Dewan, Siam Rezwan, Pritika Papali, Abdel-Hameed Al-Mistarehi, Andrew Hersh, Daniel Lubelski, Carisa M Cooney, Salih Colakoglu","doi":"10.1055/a-2616-4532","DOIUrl":"https://doi.org/10.1055/a-2616-4532","url":null,"abstract":"<p><p>Chordomas are rare, malignant bone tumors of the axial skeleton. Soft tissue reconstruction is often needed postextirpation to reduce the risk of peritoneal content herniation. The purpose of this study is to describe presurgical factors associated with postchordoma resection reconstruction and evaluate postoperative outcomes.We retrospectively reviewed patients who underwent reconstruction postexcision of chordomas derived from the lumbar or sacral regions at a single institution between 2012 and 2023. Wilcoxon rank sum test, chi-square test, Fisher's exact test, and Kruskal-Wallis test were used to compare outcomes based on reconstruction method.Among 68 patients who met the inclusion criteria, 67 underwent sacrectomy. Patients primarily received gluteus muscle (GM) flaps (<i>n</i> = 36, 53%). Vertical rectus abdominus myocutaneous (VRAM) and paraspinous muscle (PSM) flaps were the second most common, each used in 12 patients (18%). Eight patients (12%) underwent reconstruction with fasciocutaneous local flaps only. GM and VRAM flaps were primarily used to reconstruct defects at the level of the sacrum (<i>n</i> = 47, 98%) while PSM flaps were used for lumbar (<i>n</i> = 7 [58%]) and sacral (<i>n</i> = 5 [42%]) reconstruction, respectively. The median tumor volumes were 468 cm³ (271-1,592) for VRAM flaps, 92 cm³ (12-246) for GM flaps, 77 cm³ (34-239) for PSM flaps, and 25 cm³ (16-86) for non-muscle reconstruction; tumor volume was significantly greater in patients who underwent VRAM flap reconstruction. Median defect diameter managed by VRAM flaps was significantly longer compared with GM flaps (33 [30-46] cm vs. 22 [15-30] cm, respectively; <i>p</i> = 0.001). VRAM and PSM flap reconstruction were more often associated with hardware placement (<i>p</i> < 0.01). Median follow-up was 34 months. Neither reconstruction type nor hardware placement was associated with the incidence of postoperative complications.We found that surgical reconstruction following chordoma resection varied depending on the chordoma spinal level, tumor volume, and defect diameter. Complication rates were similar among the included reconstructive options.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285038","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":"Insurance Coverage for Hyperbaric Oxygen Therapy in Acutely Compromised Tissues.","authors":"Matthew J Heron, Katherine J Zhu, Annie B McVeigh, Siam K Rezwan, Carisa M Cooney, Kristen P Broderick","doi":"10.1055/a-2616-3981","DOIUrl":"https://doi.org/10.1055/a-2616-3981","url":null,"abstract":"<p><p>Beyond its indication for chronic wounds, hyperbaric oxygen therapy (HBOT) is an adjunct to managing acutely compromised grafts and flaps. Because physicians have reported challenges obtaining insurance coverage for HBOT, this cross-sectional analysis reviews policy requirements and presents an algorithm to enhance the odds of successful reimbursement.We identified the 60 largest health insurers by market share and enrollment and collected their policies on HBOT. We then conducted a dual, blind extraction of policy details (e.g., continuing and prior authorization, documentation, treatment guidelines) and compiled these data into an insurance reimbursement algorithm to assist prescribing physicians.Fifty-three health insurers (88.3%) had policies on HBOT; 47.2% (<i>n</i> = 25) required prior authorization, and 61.9% (<i>n</i> = 13) required continuing authorization after a set number of HBOT sessions (median: 20 sessions, interquartile range [IQR]: 12-30 sessions). Thirty-eight (71.7%) permitted clinical judgment when defining flap or graft \"compromise,\" and 35.7% (<i>n</i> = 15) considered any pressure greater than 1 atmosphere absolute to be \"hyperbaric.\" Twenty-two insurers (41.5%) outlined documentation requirements for HBOT reimbursement; the most often requested documentation were medical records (<i>n</i> = 19, 86.4%), signs of healing (<i>n</i> = 12, 54.5%), images (<i>n</i> = 10, 45.5%), treatment goals (<i>n</i> = 8, 36.4%), and dive parameters (<i>n</i> = 5, 22.7%).Most insured Americans are eligible for 12 sessions of HBOT; however, medical necessity must be established early and reconfirmed often to increase the likelihood of reimbursement. Additionally, prescribing physicians should be aware that insurers differ in their documentation, prior authorization, and continuing authorization requirements.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285039","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 Postoperative Hyperglycemia on Adverse Outcomes in Microvascular Free Tissue Transfer for Limb Salvage.","authors":"Joseph A Lewcun, Brooks Kelly, Megan McCaughey, Guiliano Melki, Benjamin Vanderkwaak, Deaquan Nichols, Alvin Wong, Paschalia M Mountziaris","doi":"10.1055/a-2616-4656","DOIUrl":"https://doi.org/10.1055/a-2616-4656","url":null,"abstract":"<p><p>Postoperative hyperglycemia has been associated with higher rates of complications and prolonged hospitalization. This study aimed to evaluate the effect of postoperative hyperglycemia on outcomes after microvascular free tissue transfer for upper and lower limb salvage.This was a retrospective review of all patients undergoing free tissue transfer for limb salvage at our institution from 2014 to 2024. Rates of surgical site infection (SSI), wound healing complications, flap loss, length of stay, and readmission were compared between patients with postoperative hyperglycemia (≥140 mg/dL within 48 hours of surgery) and normoglycemic patients.One hundred forty-one patients had perioperative glucose values measured and thus were included. Fifty-nine point five seven percent (<i>n</i> = 84) were normoglycemic, while 40.43% (<i>n</i> = 57) had postoperative hyperglycemia. Hyperglycemic patients had higher rates of SSI (33.33% vs. 9.52%, <i>p</i> < 0.01) and wound healing complications (35.09% vs. 21.43%, <i>p</i> = 0.07) compared to normoglycemic patients. The mean length of stay was longer (41.00 vs. 32.83 days, <i>p</i> = 0.04) for hyperglycemic compared to normoglycemic patients. On multivariate analysis, postoperative hyperglycemia was a significant predictor of SSI. Notably, the diagnosis of diabetes mellitus was not a significant predictor of complications (<i>p</i> > 0.05).Postoperative hyperglycemia following free tissue transfer for limb salvage is associated with increased length of stay, and with higher rates of SSI and wound healing complications. Maintenance of perioperative normoglycemia after free tissue transfer is important to optimize patient outcomes.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248464","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":"Fortuitous Forty-Year Follow-Up of a Family's Free Flaps-a Fable.","authors":"Geoffrey G Hallock","doi":"10.1055/a-2616-4861","DOIUrl":"https://doi.org/10.1055/a-2616-4861","url":null,"abstract":"","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248463","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":"Validating a Scalable Approach to Microsurgery Education in Resource-Limited Countries.","authors":"Halley Darrach, Cameron Kneib, Jeffrey Friedrich, Suzanne Inchauste, Hellina Legesse Mamo, James Chang","doi":"10.1055/a-2616-4028","DOIUrl":"10.1055/a-2616-4028","url":null,"abstract":"<p><p>Microsurgery remains largely nonexistent in sub-Saharan Africa due to a lack of access to specialized training and microsurgical instruments. However, smartphones with magnification capabilities are globally widespread, even in low-resource nations. The use of smartphones as simulators for microsurgery training has been previously reported, but little is known with respect to skills acquisition over time.A cohort of Ethiopian plastic surgery attendees and residents participated in a microsurgery training workshop. Before and after the workshop, as well as 6 months afterward, participants were recorded performing a synthetic vessel repair using a smartphone for magnification. Video recordings were graded by four microsurgeons using the Stanford Microsurgery and Resident Training (SMaRT) scale, a validated instrument for assessing microsurgical skills.A total of 13 participants were surveyed and recorded. Overall microsurgical performance SMaRT scores significantly improved (2.05 vs. 2.72 on a five-point scale; <i>p</i> = 0.001) upon completion of the workshop, and continued to increase (3.05), but not significantly so (<i>p</i> = 0.201) 6 months afterward. However, improvements were maintained at 6 months. Significant improvement was noted in all SMaRT scale domains postworkshop and further significant improvement in instrument handling was noted at 6 months.Our findings suggest that smartphones can serve as valuable tools for microsurgery training in low-resource settings. Further research is warranted to evaluate the long-term impact of smartphone-based simulation training on skill acquisition and clinical outcomes in low-resource settings, but even in the short-term participants were able to demonstrate significant improvement, as well as maintenance to improvement of skill at 6 months follow-up.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119916","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":"Tensile Strength of Nerve Bridging Models Using Collagen Nerve Conduits.","authors":"Yusuke Hattori, Shinsuke Takeda, Takuya Usami, Ryutaro Shibata, Hiroshi Takahashi, Yuji Joyo, Yohei Kawaguchi, Hideki Okamoto, Hideki Murakami, Permsak Paholpak, Hideyuki Ota","doi":"10.1055/a-2387-3282","DOIUrl":"10.1055/a-2387-3282","url":null,"abstract":"<p><strong>Background: </strong> In the treatment of peripheral nerve injuries with nerve defects, second-generation collagen-based conduits, such as Renerve® (Nipro, Osaka, Japan), have shown the potential for promoting nerve regeneration. However, there is concern related to the weak material properties. No previous studies have addressed the strength of the bridging model using collagen conduits. This study aimed to investigate the tensile strength and failure patterns in nerve defect models bridged with Renerve® conduits through biomechanical research.</p><p><strong>Methods: </strong> Using fresh chicken sciatic nerves, we examined the maximum failure load of four groups: bridging models using Renerve® with one suture (group A), with two sutures (group B), with three sutures (group C), and end-to-end neurorrhaphy models with two sutures (group N). Each group had eight specimens. We also evaluated failure patterns of the specimens.</p><p><strong>Results: </strong> Group N showed a significantly higher maximum failure load (0.96 ± 0.13 N) compared to groups A (0.23 ± 0.06 N, <i>p</i> < 0.0001), B (0.29 ± 0.05 N, <i>p</i> < 0.0001), and C (0.40 ± 0.10 N, <i>p</i> < 0.0001). Regarding failure patterns, all specimens in group A showed nerve-end dislocation from the conduit. Two specimens in group B and three specimens in group C failed due to circumferential cracks in the conduit. Six specimens in group B and five specimens in group C exhibited cutting out of sutures from the conduit.</p><p><strong>Conclusion: </strong> This study suggests that the number of sutures in synthetic collagen nerve conduits has little effect on the maximum failure load. To take advantage of its biomaterial benefits, a period of postoperative range of motion restriction may be required.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"383-389"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141982555","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}