Microsurgery最新文献

{"title":"Relationship Between Preoperative Coagulation Parameters and Risk of Flap Pedicle Thrombosis Following Free Flap Breast Reconstruction","authors":"Liwen Zhu,&nbsp;Boyang Xu,&nbsp;Wenyue Liu,&nbsp;Shangshan Li,&nbsp;Zhaohan Chen,&nbsp;Hao Dong,&nbsp;Siyu Hou,&nbsp;Xiaomu Ma,&nbsp;Ao Fu,&nbsp;Chunjun Liu","doi":"10.1002/micr.70275","DOIUrl":"10.1002/micr.70275","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Flap pedicle thrombosis is a frequent cause of flap compromise, which is a major complication following free flap breast reconstruction. This study aims to investigate the relationship between preoperative coagulation parameters and the risk of postoperative flap pedicle thrombosis, providing guidance for preoperative assessment and perioperative management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted on all patients who underwent free flap breast reconstruction at our institution between January 2021 and August 2025. Patient demographics, surgical details, preoperative coagulation test results (including prothrombin time, activated partial thromboplastin time, fibrinogen, thrombin time, and D-dimer) and outcomes were recorded. Patients were categorized according to their preoperative coagulation test results. Demographics, surgical information, and incidence of flap pedicle thrombosis were compared between groups. Furthermore, patients were divided according to the occurrence of flap pedicle thrombosis. Preoperative coagulation parameters were compared between the two groups, and a multivariate logistic regression was performed to identify potential risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 154 patients (160 breasts) were included. Fifty-two breasts (32.5%) were categorized to the asymptomatic hypercoagulable group, and 108 breasts (67.5%) to the non-hypercoagulable group. Postoperative flap pedicle thrombosis occurred in nine breasts (5.6%), including two arterial thromboses and seven venous thromboses. No significant difference in postoperative flap pedicle thrombosis was observed between the two groups (9.6% vs. 3.7%, <i>p</i> = 0.152). Multivariate logistic regression indicated that immediate flap breast reconstruction might be an independent risk factor (<i>p</i> = 0.028).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study suggested no significant association between preoperative coagulation parameters (including PT, APTT, FIB, TT, and D-dimer) and flap pedicle thrombosis following free flap breast reconstruction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"46 6","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673953","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":"Correction to “Does the Timing, Type, and Method of Flap Coverage After Open Tibia Fracture Fixation Influence the Rate of Deep Infection?”","authors":"","doi":"10.1002/micr.70279","DOIUrl":"10.1002/micr.70279","url":null,"abstract":"<p>\u0000 <span>Khan, U.</span>, <span>K Gray</span>, <span>S. Ghidei</span>, et al. <span>2025</span>. “ <span>Does the Timing, Type, and Method of Flap Coverage After Open Tibia Fracture Fixation Influence the Rate of Deep Infection?</span>” <i>Microsurgery</i> <span>45</span>, no. <span>6</span>: e70110. https://doi.org/10.1002/micr.70110.\u0000 </p><p>We accidentally omitted one author from the published version. This oversight occurred during the submission process. Alexandra Blake, MPH, at Dominion Plastic Surgery, should be listed as the third to last author (after Johnson and before Goch). She meets all authorship criteria including protocol development, data collection, analysis, critical manuscript review, and editing.</p><p>The corrected author list is as follows:</p><p>Umar Khan¹, Kennedy Gray², Senay Ghidei³, Caitlin Quigley³, Vineet Mehan⁴, Earl Johnson⁴, Alexandra Blake⁴, Abraham Goch³, Greg Gaski³</p><p>We apologize for this error.</p>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"46 6","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673973","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}

{"title":"A Chimeric SCIP Flap With a Sartorius Muscle Component for Single-Stage Reconstruction of Late-Onset Navicular Osteomyelitis Following Degloving Injury: A Case Report","authors":"Shigeki Ishibashi,&nbsp;Toko Umamoto,&nbsp;Maya Kanasaki,&nbsp;Reiko Tsukuura,&nbsp;Nana Yamamoto,&nbsp;Takumi Yamamoto","doi":"10.1002/micr.70277","DOIUrl":"10.1002/micr.70277","url":null,"abstract":"<p>In degloving injuries without associated fracture, osteomyelitis may be difficult to recognize, potentially delaying definitive treatment. We report a case and describe the role of a chimeric superficial circumflex iliac artery perforator (SCIP) flap with a sartorius muscle component for simultaneous dead-space obliteration and soft-tissue resurfacing. A 44-year-old man underwent free anterolateral thigh flap coverage 1 month after a medial ankle degloving injury. Two years later, a painless noninflammatory cystic lesion developed on the flap and recurred over 4 years despite three local debridements. At 6 years after injury, ultrasound, computed tomography, and magnetic resonance imaging demonstrated a sinus tract communicating with the navicular bone. Definitive debridement identified a retained anchor fragment within the navicular fistula and purulent tissue along the tract, resulting in a 4 × 10 cm soft-tissue defect and an approximately 7 × 8 × 14 mm intraosseous dead space. Single-stage reconstruction was performed using a chimeric SCIP flap with a 12 × 5 cm skin paddle and a 6 × 4.5 cm sartorius muscle segment. The muscle component obliterated the navicular cavity, and the skin paddle resurfaced the medial ankle defect. Culture grew <i>Pseudomonas aeruginosa</i>, and targeted antibiotics were administered for 14 weeks. Healing was uneventful. At 1 year, the patient remained symptom-free without recurrence. The erythrocyte sedimentation rate had returned to the normal range, and MRI showed resolution of navicular marrow edema. This case highlights the importance of thorough imaging in recurrent wound problems after degloving injury, even when the initial injury appears limited to the skin and soft tissue. A chimeric SCIP flap with a sartorius muscle component may be a useful single-stage option for osteomyelitis treatment requiring dead-space obliteration and thin soft-tissue coverage.</p>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"46 6","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670052","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}

{"title":"The Effects of Remote Ischemic Preconditioning on the Inflammatory Cytokine Response to Free Flap Head and Neck Reconstruction: A Randomized Controlled Trial","authors":"Kumanan Rune Nanthan,&nbsp;Julie Brogaard Larsen,&nbsp;Christine Lodberg Hvas,&nbsp;Birgitte Jul Kiil,&nbsp;Andreas Engel Krag","doi":"10.1002/micr.70276","DOIUrl":"10.1002/micr.70276","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Ischemia–reperfusion injury due to vascular pedicle occlusion is one of the most common causes of free flap failure in head and neck cancer reconstruction. Remote ischemic preconditioning (RIPC) has been proposed as an experimental, non-invasive intervention to attenuate flap ischemia–reperfusion injury; however, the tissue-protective mechanisms remain unclear. RIPC may have multiple effects on the inflammatory system, which plays a central part in the pathophysiology of ischemia–reperfusion injury. The aim of the present study was to evaluate the effect of RIPC on inflammatory cytokine plasma levels during free flap reconstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Head and neck cancer patients (<i>n</i> = 60) undergoing tumor resection and subsequent free flap reconstruction between August 2015 and November 2017 at Aarhus University Hospital, Denmark were randomized 1:1 to RIPC or sham intervention in a single-center, single-blinded, randomized controlled trial (RCT) (ClinicalTrials.gov: NCT02548377). The study was approved by The Central Denmark Region Committees on Health Research Ethics (journal no. 1-10-72-140-15) and reported following the CONSORT guidelines. RIPC was administered intraoperatively as four 5-min cycles of upper extremity occlusion and reperfusion with an inflatable tourniquet. Blood samples were collected before surgery, 6 h after RIPC/sham intervention, and on the 1st postoperative day. Tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-13, and interferon (IFN)-gamma were analyzed using a multiplex immunoassay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average age of the RIPC group was 67 years (±10) and 64 years (±12) in the sham group. Plasma levels of the pro-inflammatory cytokines changed significantly between preoperative measures to 1^st postoperative day between RIPC and sham; TNF-α (<i>p</i> &lt; 0.001), IL-6 (<i>p</i> &lt; 0.001), IL-8 (<i>p</i> &lt; 0.001), IL-12p70 (<i>p</i> &lt; 0.001), and IFN-γ (<i>p</i> &lt; 0.001). No significant differences in cytokine levels were shown between groups at any specific time points.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RIPC does not attenuate pro-inflammatory cytokine release in head and neck cancer patients undergoing free flap reconstruction.</p>\u0000 \u0000 <p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT02548377</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"46 6","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/micr.70276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630189","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}

{"title":"The Evolution of Phalloplasty for Masculinizing Gender Affirming Surgery: A Systematic Review of Surgical Techniques and Complications Over the Past 25 Years","authors":"Juan Diego Tinajero,&nbsp;Derek Gar Kit Liang,&nbsp;Sadia Wasay,&nbsp;Miroslav L. Djordjevic,&nbsp;Giuseppe Di Taranto","doi":"10.1002/micr.70273","DOIUrl":"https://doi.org/10.1002/micr.70273","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Gender affirming phalloplasty is aimed at reducing the deleterious effects of gender dysphoria in the trans male population. Despite being first described in 1945, there is no gold standard for gender affirming phalloplasty. Our objective is to systematically review the phalloplasty literature regarding surgical technique, complication profiles, and temporal trends to understand the evolution of phalloplasty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A literature review was conducted using the electronic databases PubMed and Medline separately, Scopus, and Embase. Studies were included if they were original research studies published in English between January 2000 and September 2025, with more than three enrolled patients and gender affirmation as the indication for phalloplasty. Studies were split into two groups based on the year of publication (Group 1: 2000–2010; Group 2: 2011–2025) to allow comparison between older and more recent studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-five articles were deemed suitable after the literature search and screening. Overall, there were 2586 patients. 65.3% had a radial forearm free flap phalloplasty. The tube-in-a-tube technique was the preferred method of neourethral reconstruction, with 85.8% in Group 1 and 64.4% in Group 2 (<i>p</i> &lt; 0.01). Group 2 demonstrated a significant increase in the use of pedicled flaps (<i>p</i> &lt; 0.01) and the use of radial forearm free flap urethroplasty alone (<i>p</i> &lt; 0.01). Group 2 showed an increase in sensory reconstruction (<i>p</i> &lt; 0.01). Complication rates were high at 0.74 and 0.66 complications per patient in Groups 1 and 2, respectively. Urinary complications were also high; urethral fistulas in 25.7% and 36.6% of patients, and urethral strictures in 16.1% and 12.8% of patients in Groups 1 and 2, respectively. Outcomes such as urinary function, tactile sensation, erogenous sensation, and cosmesis were poorly reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This systematic review, to our knowledge, is the first to analyze the evolution of phalloplasty over time, suggesting a shift from traditional free-flap techniques toward more diverse reconstructive approaches, including pedicled and perforator-based options. However, inconsistent outcome reporting limits meaningful comparison between techniques. Standardized, high-quality evidence is required to guide optimal surgical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"46 6","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148616597","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":"Superficial Palmar Branch of the Radial Artery, Medial Plantar Artery Perforator, and Medial Sural Artery Perforator Free Flaps in Digital Soft Tissue Reconstruction: Comparisons of Clinical Outcomes From a Retrospective Institutional Series","authors":"Cansu Yalçın,&nbsp;Naz Keçeci,&nbsp;Safa Manav,&nbsp;Ahmet Kaplan,&nbsp;Sebat Karamürsel","doi":"10.1002/micr.70265","DOIUrl":"10.1002/micr.70265","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Digital defects requiring soft tissue reconstruction are still challenging. There is no first-choice free flap for digital reconstruction, although various free flaps were used to reconstruct the defects to provide functional and aesthetically acceptable results. The aim of this study is to evaluate the functional, aesthetic, and sensory results of medial sural artery perforator, medial plantar artery perforator, and superficial palmar branch radial artery free flap techniques in digital tissue defects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>This retrospective institutional study was conducted in accordance with the STROBE guidelines. Between 2022 and 2023, 28 patients underwent free tissue transfer for their digital soft tissue defects, which were reconstructed with MSAP, MPAP, and SPBRA flaps. The age, sex, etiology of the trauma, and the defect size were noted. The flaps' sizes, recipient vessels, donor site complications, and follow-up durations were also documented. Patient and observer scar assessment scale (POSAS) was used to assess aesthetic satisfaction. To evaluate the functional results, Sollerman hand function test (SHFT) was used. To determine the sensorial improvements, static-2PD test and Cold intolerance scoring scale (CISS) were applied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average ages of the patients were 42.3 ± 13.1, 44.4 ± 14, and 42.5 ± 13.9, respectively. The tests were administered to the patients at an average of 25.3 ± 2.3 months. According to the POSAS scores, patients reported the SPBRA flap to be more comfortable and aesthetically acceptable, and the MSAP flap was associated with drawbacks such as increased thickness and surface irregularity. SHFT scores were comparable among groups (MSAP: 70.56 ± 7.60, MPAP: 70.22 ± 6.61, SPBRA: 71.40 ± 4.67; <i>p</i> &gt; 0.05). The 2PD test showed significantly better results in SPBRA (8.10 ± 1.20) compared to MPAP (11.78 ± 1.39) and MSAP (15.00 ± 2.18) (<i>p</i> &lt; 0.05). CISS scores were significantly higher in SPBRA (48 ± 10.97) than in MPAP (19.56 ± 13.07) and MSAP (15.00 ± 12.58) (<i>p</i> &lt; 0.05). As a result of the correlation analysis, a statistically significant and moderately negative relationship was found between the 2PD and CISS scores (<i>r</i> = −0.536, <i>p</i> = 0.003).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The flaps showed relative strengths depending on the parameters evaluated. Therefore, it is not possible to identify a single flap as the definitive first-choice option.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"46 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391347","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":"Lymphovenous Anastomosis for Treatment of Breast Lymphedema Following Delayed Autologous Reconstruction: A Case Report","authors":"Brianna M. Peet,&nbsp;Benjamin D. Wagner,&nbsp;Arianna Sidoti,&nbsp;Jonas A. Nelson,&nbsp;Babak J. Mehrara,&nbsp;Hidehiko Yoshimatsu","doi":"10.1002/micr.70267","DOIUrl":"10.1002/micr.70267","url":null,"abstract":"<div>\u0000 \u0000 <p>Breast lymphedema (BLE) is an underrecognized sequela of breast cancer treatment that can lead to chronic swelling, pain, and recurrent infections. While lymphovenous anastomosis (LVA) is well established for the management of extremity lymphedema, its application to BLE has rarely been described. Here, we discuss a case of LVA for refractory BLE following delayed autologous reconstruction. A 49-year-old woman developed severe left-sided BLE after deep inferior epigastric artery perforator flap reconstruction. The clinical course was complicated by nine episodes of cellulitis requiring hospital admission for intravenous treatment despite compliance with prophylactic antibiotics and compression therapy. The patient underwent indocyanine green (ICG)-guided supermicrosurgical LVA within the reconstructed breast. Immediate postoperative decongestion was observed, and substantial reductions in breast pain and improvements in symmetry were reported 1 month postoperatively. At 10 months postoperatively, the patient maintained durable reductions in swelling and infection frequency. Our experience showed that LVA may be safely and effectively performed in the reconstructed breast and may represent a viable physiologic option for patients with refractory BLE unresponsive to conservative therapy.</p>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"46 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391377","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":"Symani-Assisted Microsurgery in Head and Neck Reconstruction: A Systematic Review of Indications, Techniques, and Pooled Analysis of Clinical Outcomes","authors":"Thomas J. Sorenson,&nbsp;Abby Chopoorian,&nbsp;David Tran,&nbsp;Ahmad Al Shammari,&nbsp;Andrew C. Prince,&nbsp;Adam Jacobson,&nbsp;Jamie P. Levine","doi":"10.1002/micr.70262","DOIUrl":"10.1002/micr.70262","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Robot-assisted microsurgery with the Symani surgical system has emerged as a potential adjunct in complex reconstructive procedures. Its application in head and neck reconstruction remains early and incompletely characterized. We performed a systematic review to evaluate indications, technical utilization, and reported clinical outcomes of Symani-assisted microsurgery in head and neck reconstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review was conducted in accordance with PRISMA guidelines. PubMed (MEDLINE), Embase, Scopus, and the Cochrane Library were searched for studies reporting Symani-assisted microsurgery in head and neck reconstruction. Primary outcomes were flap success and anastomotic complications. Secondary outcomes included operative time, conversion to conventional technique, ischemia time, reported learning curve metrics, and risk of bias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of eight studies encompassing 157 patients with 157 flaps were included. Study designs consisted primarily of case reports and retrospective case series. The Symani was used for arterial and/or venous anastomosis in free flap reconstruction, most commonly in radial forearm flaps and most commonly to the facial vessels. Flap success rates were high (&gt; 95%) with only five requiring return to operating room and two flap losses; random-effects meta-analysis demonstrated a pooled flap loss rate of 3.3% (95% CI, 1.1%–9.1%; <i>I</i>² = 0%). Anastomotic complication rates were reported to be low with conversion to conventional technique occurring in one case due to technical malfunction. Anastomosis times were poorly reported across studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Early clinical experience suggests that robot-assisted microsurgery with the Symani surgical system in head and neck reconstruction is technically feasible with acceptable short-term outcomes in selected cases. However, evidence remains limited to small, heterogeneous series. Prospective comparative studies are required to determine whether robotic assistance confers meaningful clinical or efficiency advantages over conventional microsurgery and determine optimal operative indications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"46 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376325","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":"Proposing Objective 3D Facial Surface Scanning to Evaluate Surgical Outcomes in Facial Lymphedema","authors":"Simone Benedetti,&nbsp;Andrea Frosolini,&nbsp;Guido Gabriele,&nbsp;Paolo Gennaro","doi":"10.1002/micr.70264","DOIUrl":"10.1002/micr.70264","url":null,"abstract":"","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"46 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376234","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":"Comments on \"Jaw-in-a-Day Reconstruction: A Scoping Review of Clinical Outcomes and Evidence Gaps\".","authors":"Efsun Somay, Erkan Topkan, Ugur Selek","doi":"10.1002/micr.70274","DOIUrl":"10.1002/micr.70274","url":null,"abstract":"","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"46 5","pages":"e70274"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579401","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}