Microsurgery最新文献

{"title":"Pedicled Vascularized Common Peroneal Nerve Graft in Sciatic Nerve Reconstruction With Involvement of Inner Pelvic Lumbar and Sacral Nerve Roots: A Case Report and Literature Review","authors":"Rou Wan,&nbsp;Aida K. Sarcon,&nbsp;Alejandra Aristizabal,&nbsp;Mehmet Furkan Tunaboylu,&nbsp;Mattew T. Houdek,&nbsp;Steven L. Moran","doi":"10.1002/micr.70064","DOIUrl":"https://doi.org/10.1002/micr.70064","url":null,"abstract":"<div>\u0000 \u0000 <p>Long segment losses exceeding 10 cm in the sciatic nerve are challenging in both the reconstructive techniques and optimizing sensory and motor function recovery. This case report and literature review describes our experience of using a pedicled vascularized common peroneal nerve graft to repair a 14-cm sciatic nerve defect, involving L4, L5, and S1 nerve roots. Additionally, we conducted a literature review of various types of nerve autografts for large sciatic nerve defects, summarizing their characteristics and outcomes to aid clinicians in decision-making and expected results in different scenarios. The patient, a 23-year-old female diagnosed with neurofibromatosis type I, underwent R0 tumor resection of the proximal left sciatic nerve due to a malignant peripheral nerve sheath tumor. She received an ipsilateral pedicled vascularized common peroneal nerve graft. The reconstruction included the L4, L5, and S1 nerve roots beyond the greater sciatic foramen into the inner pelvis. The patient's postoperative course was uneventful. At the 26-month follow-up, she showed MRC grade 4/5 strength in hamstrings with 90°knee flexion and a steady gait pattern. At the 32-month follow-up, she could ambulate very well with an ankle-foot orthosis. The outcomes support the use of a pedicled vascularized common peroneal nerve graft in a single-staged surgery to restore motor function for large sciatic nerve defects. Our literature review revealed that in cases where sural nerves are insufficient or injured for sciatic nerve reconstruction, the common peroneal nerve is a viable alternative to help patients regain functional independence.</p>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143875630","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":"Critical Review of Targeted Muscle Reinnervation (TMR) Studies in Neuroma Management","authors":"Benjamin L. Savitz,&nbsp;Yomna E. Dean,&nbsp;Alake Myers,&nbsp;Huseyin Karagoz,&nbsp;J. Bradford Hill,&nbsp;Panambur Bhandari,&nbsp;Shady Elmaraghi,&nbsp;William Lineaweaver","doi":"10.1002/micr.70061","DOIUrl":"https://doi.org/10.1002/micr.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In modern surgical practice, targeted muscle reinnervation (TMR) and regenerative peripheral nerve interface (RPNI) offer amputees promising options for painful neuroma management, with the potential to significantly reduce pain and enhance prosthetic control. Despite these advancements, a lack of consensus on the standard of care persists, largely due to methodological inconsistencies in the current literature. Variations in control group selection, small sample sizes, and inadequate follow-up periods obstruct the reproducibility and generalizability of findings, complicating clinical decision-making. This critical review identifies key limitations in existing TMR studies, including biases introduced by heterogeneity in study design and an absence of direct comparisons between TMR and RPNI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review was conducted following PRISMA guidelines to identify controlled TMR studies related to neuroma management. The data extracted included control group selection, sample size, TMR cohort size, and mean follow-up period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eleven studies evaluating TMR for neuroma management were analyzed. Control groups varied significantly, including amputation without reinnervation, neuroma excision, nerve burial, or preoperative pain assessments of participants. The heterogeneity in study design and small sample sizes limited further interpretation across studies. Moreover, only one randomized clinical trial was identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Recommendations are proposed for standardizing methodologies, implementing robust control groups, and prioritizing randomized controlled trials with extended follow-up periods. Bridging these gaps in future research can pave the way for evidence-based guidelines to improve patient outcomes in postamputation pain management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143836048","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":"Immediate Versus Delayed Skin Grafting of Free Muscle Flaps for Limb Salvage: Does Timing Matter?","authors":"Karen R. Li,&nbsp;Rachel N. Rohrich,&nbsp;Nicole C. Episalla,&nbsp;Sabrina F. Deleonibus,&nbsp;Winnie W. Li,&nbsp;Christian X. Lava,&nbsp;Cameron M. Akbari,&nbsp;Richard C. Youn,&nbsp;Christopher E. Attinger,&nbsp;Karen K. Evans","doi":"10.1002/micr.70055","DOIUrl":"https://doi.org/10.1002/micr.70055","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lower extremity (LE) muscle free flaps (MFF) require split-thickness skin grafts (STSG) for coverage. Medically comorbid patients undergoing MFFs have demonstrated surprisingly high rates of skin graft failure over the MFF. This study therefore characterizes the risks for STSG failure and the effect of staging STSG on graft outcomes in medically comorbid patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review of patients undergoing STSG for LE MFF coverage between 2011 and 2023 was performed. Demographics, comorbidities, MFF details, STSG details, and complications were collected. The primary outcome was graft failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety-one patients underwent MFF and STSG, with 65 (71.4%) undergoing immediate STSG and 26 (28.6%) undergoing delayed STSG, at a median of 12 days (IQR = 9) after MFF. The delayed group had a significantly higher Charlson Comorbidity Index (5.6 vs. 3.7, <i>p</i> &lt; 0.001). The overall graft failure rate was 31.5%, with no differences between groups (immediate: 27% vs. delayed: 42.3%, <i>p</i> = 0.157). On multivariable analysis, elevated preoperative HbA1c (OR: 1.5, CI = 1.1–1.9), low levels of albumin preoperatively (OR: 0.3, CI: 0.1–0.9), and a history of Charcot arthropathy (OR: 8.6, CI: 1.3–55.2) were independent predictors of graft failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Little evidence exists to help guide the decision to perform immediate versus delayed skin grafting of MFFs in a highly comorbid population undergoing limb salvage. Delaying skin grafts in patients with significant comorbidities that threaten flap viability and wound healing capacity may improve graft take. Patient comorbidities, nutritional status, and intraoperative factors should also be considered when determining the timing of skin grafts over MFF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809527","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":"Using Smartphone Thermal Imaging to Determine Safe Window for Cross-Leg Free Flap Detachment","authors":"Pedro Ciudad,&nbsp;Lilyan Llanca,&nbsp;Oscar J. Manrique,&nbsp;Joseph M. Escandón","doi":"10.1002/micr.70062","DOIUrl":"https://doi.org/10.1002/micr.70062","url":null,"abstract":"","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809528","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":"Free Flap Reconstruction of Abdominal Wall Defects: A Systematic Review and Pooled Analysis","authors":"Michael I. Kim,&nbsp;Artur Manasyan,&nbsp;Eloise W. Stanton,&nbsp;Christian Jimenez,&nbsp;Joseph N. Carey,&nbsp;David A. Daar,&nbsp;Emma C. Koesters","doi":"10.1002/micr.70059","DOIUrl":"https://doi.org/10.1002/micr.70059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Reconstruction of extensive abdominal wall defects poses significant challenges, often requiring free tissue transfer when traditional methods are inadequate. This review examines the past decade's literature on free flaps for abdominal wall reconstruction to guide decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review following PRISMA guidelines was conducted on July 17, 2024, using PubMed, Cochrane Library, Web of Science, Embase, and Scopus. Studies from 2013 to 2023 involving free flap reconstruction with at least 3 months follow-up were included. Surgical complications and outcomes were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 2269 articles, 32 met inclusion criteria, involving 104 free flaps. There were no reports of flap loss. The average defect size was 330.0 ± 200.8 cm². Oncologic resection was the leading indication (57%), with the latissimus dorsi flap used most frequently (36%). The most common recipient vessels were the deep inferior epigastric vessels (66.7%). The most common recipient vessels were the deep inferior epigastric vessels (66.7%). Mesh was used in 53% of cases, predominantly in a sublay position. The majority of reconstructions were immediate (52.9%), followed by delayed (31.8%) and staged (15.3%). Complications included partial flap necrosis (5.8%), surgical site infection (5.8%), and hernia development (4.8%). There were no significant differences in outcomes when stratified by reconstruction timing, flap choice, recipient vessels, or mesh characteristics. Infection as the defect etiology independently predicted surgical site infection (<i>p</i> = 0.03), whereas mesh usage (<i>p</i> = 0.07) and diabetes (<i>p</i> = 0.09) trended toward increased infection risk. Donor site complications were minimal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Free flap reconstruction is safe and effective for large abdominal wall defects, with similar outcomes across flap types. Infection as the initial etiology was the strongest predictor of postoperative infection. Further studies are needed to establish guidelines for patient and flap selection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787189","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":"Targeted Nipple Areola Complex Reinnervation in Gynecomastia Mastectomy: A Case Report","authors":"Elizabeth E. Blears,&nbsp;Katya Remy,&nbsp;Silviu Diaconu,&nbsp;Ian L. Valerio,&nbsp;Lisa Gfrerer","doi":"10.1002/micr.70060","DOIUrl":"https://doi.org/10.1002/micr.70060","url":null,"abstract":"<div>\u0000 \u0000 <p>Targeted nipple areola complex (NAC) reinnervation (TNR) to restore nipple and chest sensation has been previously described in patients undergoing breast reconstruction and gender-affirming mastectomy. A healthy 32-year-old male, with grade II gynecomastia with severe skin laxity and a BMI of 25 kg/m², underwent bilateral mastectomy with free nipple grafting (FNG) for persistent gynecomastia and chest wall soft tissue laxity. The mastectomy weight was 242.5 (range: 242–243) grams. Three lateral intercostal nerves (3rd, 4th and 5th) were preserved and directly coaptated to the new NAC on each side. Quantitative and patient-reported sensory evaluation was conducted at 18 months follow-up, revealing a median monofilament detection threshold of 3.61 (range: 2.83–3.61) at the NAC and 2.83 (2.83–3.61) at the chest wall as well as pain from pressure at a median of 100.0 kPa (range: 77.4–122.5) at the NAC and 151.5 kPa (range: 116.6–183.3) at the chest. While the median two-point discrimination was 3.0 cm (range: 1.5–4.0) at the chest wall, two-point discrimination could not be detected at the NAC. The patient was “very satisfied” with nipple and chest sensation and did not report any nipple hypersensitivity, nipple/chest pain, or phantom sensation/pain. TNR was able to restore various quantitative and patient-reported sensory functions at the NAC and chest with high patient satisfaction. This report provides the first quantitative sensory outcomes from TNR for restoration of sensation after mastectomy for the treatment of gynecomastia in a male patient.</p>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762150","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":"Minimally Invasive Bilateral Autologous Breast Reconstruction by Double SCIP-SB Free Flap With Internal Mammary Perforator and Rib-Sparing Internal Mammary Anastomoses: A Case Report","authors":"Federica Martini,&nbsp;Matteo Meroni,&nbsp;Mario F. Scaglioni","doi":"10.1002/micr.70058","DOIUrl":"https://doi.org/10.1002/micr.70058","url":null,"abstract":"<div>\u0000 \u0000 <p>Minimizing invasiveness has become a primary goal in autologous breast reconstruction, with a shift toward perforator-based flaps over musculocutaneous flaps to reduce donor site morbidity. The deep inferior epigastric artery perforator (DIEP) flap is considered the gold standard due to its reliable perfusion and high-level esthetic outcomes; however, it requires intramuscular dissection, which might be tedious and carry the risk of abdominal wall weakening. At the recipient site, traditional anastomosis techniques often involve the removal of costal cartilage, contributing to a higher morbidity and discomfort or long-lasting localized pain. A 56-year-old female patient presenting with a recurrent right breast tumor was referred to our department for a bilateral skin-reducing mastectomy and immediate autologous reconstruction. Preoperative imaging revealed small DIEA perforators and the presence of a suitable perforator of the superficial branch of the superficial circumflex iliac artery (SCIP-SB) bilaterally. Intraoperative ICG evaluation confirmed adequate flap perfusion based on the SCIP-SB, allowing for flap harvest based on these vessels without opening the rectus fascia or performing intramuscular dissection. At the recipient site, on the right side, an internal mammary artery perforator was preserved and used for anastomosis, while on the left side, we isolated the internal mammary vessels in a rib-sparing fashion. This approach minimized morbidity at donor and recipient sites, improving postoperative comfort and recovery. The patient reported mild pain and no complications post-surgery and expressed high satisfaction at 6 months. This case highlights how focusing on the reduction of morbidity at different stages of the reconstructive procedure may allow obtaining better patient-centered outcomes. In this perspective, the SCIP-SB flap represents a viable, minimally invasive option, expanding the possible reconstructive choices in autologous breast reconstruction.</p>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143749848","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":"Editorial Self-Publication in Plastic Surgery Journals","authors":"Emma Levine,&nbsp;William Lineaweaver,&nbsp;Brian Drolet","doi":"10.1002/micr.70057","DOIUrl":"https://doi.org/10.1002/micr.70057","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The general practice of journal editors publishing original articles in their own journals has been examined in several reviews. No such study has been reported for plastic surgery journals. This study analyzes editorial publication practice in plastic surgery journals over an 8-year period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis of twelve PubMed indexed journals, including <i>Plastic and Reconstructive Surgery (PRS), Plastic and Reconstructive Surgery Global Open (PRS-GO), Annals of Plastic Surgery, Aesthetic Surgery Journal, Journal of Plastic, Reconstructive &amp; Aesthetic Surgery (JPRAS), Journal of Plastic, Reconstructive, &amp; Aesthetic Surgery Open (JPRAS-Open), The Journal of Craniofacial Surgery, Archives of Plastic Surgery, the Journal of Plastic Surgery and Hand Surgery, Indian Journal of Plastic Surgery, Microsurgery,</i> and <i>Journal of Reconstructive Microsurgery</i>. We reviewed all articles between 2014 and 2021 to identify articles published by the journal's editor. Editorials and articles appearing in supplements were excluded from this analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The proportion of editor authorship ranged from 0% to 5.88%. We found that editors of <i>PRS</i> and <i>Journal of Plastic Surgery and Hand Surgery</i> had a significantly greater authorship proportion than the other journals reviewed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study found that almost all the studied journals had original articles published by their respective editors. Two journals: <i>PRS</i> and <i>the Journal of Plastic Surgery and Hand Surgery</i> had higher rates of editor article publication compared to the other journals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726757","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":"The Use of “Spare Parts” En Bloc Anterior Compartment Myocutaneous Free Flap to Reconstruct the Transmetatarsal Amputation Stump After Contralateral Below Knee Amputation: Report of Two Cases","authors":"Puja Jagasia,&nbsp;Shivani A. Shah,&nbsp;Kazimir Bagdady,&nbsp;Gregory A. Dumanian,&nbsp;Megan E. Fracol","doi":"10.1002/micr.70054","DOIUrl":"https://doi.org/10.1002/micr.70054","url":null,"abstract":"<div>\u0000 \u0000 <p>The aim of reconstruction after lower extremity amputation is to provide adequate soft tissue coverage that is compatible with prosthetics to optimize functional status. We present two cases where the anterior compartment myocutaneous free flap used in a “spare parts” fashion was valuable in preserving the length of residual limbs for patients needing simultaneous below-knee amputation (BKA) and contralateral transmetatarsal amputation (TMA). The first case involved a 48-year-old woman undergoing TMA and BKA to address bilateral lower extremity necrosis secondary to septic shock. The anterior compartment muscles were taken en bloc as a myocutaneous free flap measuring ~4 × 12 cm based on the anterior tibial artery. A standard BKA was completed with a posterior flap, and the flap was used to cover exposed metatarsals on the opposite limb. After 4 years, she had no complications or additional surgeries and was able to ambulate independently. The second case involved a 55-year-old woman undergoing BKA and TMA for bilateral lower extremity gangrene. Again, the anterior compartment muscles were taken as a myocutaneous free flap measuring ~5 × 15 cm to cover the resulting TMA defect. This patient underwent debulking at 2 and 10 weeks postoperatively, after which she had no complications at 1 year of follow-up and returned to independent ambulation. This technique provided effective soft tissue coverage and successfully preserved limb length without additional donor site morbidity. As a myocutaneous free flap, the anterior compartment muscles may effectively preserve the length of residual limbs in patients undergoing BKA and TMA, allowing for improved functional outcomes and quality of life.</p>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726756","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":"Anatomical Study of SCIAP (Superficial Circumflex Iliac Artery Perforator) and SIEA (Superificial Inferior Epigastric Artery) Flaps for Flap Harvest Training in the Swine Model","authors":"M. d'Alessio,&nbsp;S. Avvedimento,&nbsp;S. Castaldo,&nbsp;V. Manfellotto,&nbsp;D. Ciclamini,&nbsp;E. Grella,&nbsp;G. F. Nicoletti,&nbsp;P. Tos,&nbsp;S. D'Arpa","doi":"10.1002/micr.70056","DOIUrl":"https://doi.org/10.1002/micr.70056","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Microsurgery training necessitates a progression from basic to advanced techniques, utilizing artificial models, cadaver labs, and live animals. Living animals are of paramount importance to simulate flap harvest and have a real-life experience with immediate feedback on the quality of dissection. Pigs are effective models for flap harvest training since the anatomy is comparable to that of humans, and so are many flap models. This study introduces the superficial circumflex iliac artery perforator (SCIAP) and superficial inferior epigastric artery (SIEA) flaps in pigs.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Materials and Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Dissections were performed on 10 female swine (&lt;i&gt;Sus scrofa domesticus&lt;/i&gt;, ssp. Large white; 35–40 kg) during a perforator flaps dissection course organized by the Italian Society for Microsurgery (SIM: Società Italiana di Microchirurgia). Adhering to ethical guidelines and the 3R principles, animals were anesthetized and euthanized humanely post-procedure. Twenty SCIAP and 20 SIEA flaps were harvested: vessel anatomy and presence, anatomical landmarks, pedicle caliber and length, flap viability, and design were evaluated.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The SCIAP and SIEA were present on both sides in all animals (100%). The SCIAP was constantly found between 4 and 6 cm medially to the ASIS. After giving off the SCIAP, the SIEA always arose from the SCIAP continuing medially toward the abdomen, giving off small branches (4–8) to the skin. Mean pedicle length (distance between origin from the femoral vessel end entry into the flap) was 8.035 cm for the SCIAP artery (SD ± 0.09), 8.04 cm for the SCIAP vein (SD ± 0.11), 14.98 cm for the SIEA artery (SD ± 0.10), and 14.98 cm for the SIEA vein (SD ± 0.24). Mean arterial caliber was 2.201 mm for the SCIAP (SD ± 0.24) and 1.89 mm for the SIEA (SD ± 0.217). Mean vein caliber was 2.23 mm for the SCIAP (SD ± 0.18) and 2.14 mm for the SIEA (SD ± 0.162). In total, 20 SCIAP and 20 SIEA flaps were harvested. Two of them (one SCIAP and one SIEA) showed signs of hypoperfusion with a 95% viability rate. The SCIAP flap was located 4–6 cm medial to the ASIS, while the SIEA was found along a line connecting the ASIS and the midpoint of a line connecting the second and third nipples.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The SCIAP and SIEA flaps in pigs offer a valuable addition to microsurgical training, replicating important human flaps. Their consistent anatomy and the ability to harvest them in different positions enhance ","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 3","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/micr.70056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}