Plastic and reconstructive surgery最新文献

{"title":"Assessing Risks in Intramuscular Fat Grafting: A Systematic Review and Meta-Analysis of Complications.","authors":"Forrest Bohler, Zachary Koenig, Kongkrit Chaiyasate","doi":"10.1097/PRS.0000000000012499","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012499","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modulating the infiltrate-to-total aspirate volume ratio to optimize outcomes in liposuction surgery.","authors":"Xiang-Bin Li, Shi-Yue Cui, Chun-Yu Kang, Xi Tao, Xue-Feng Zhang, Hai-Peng Yue, Lei Yang","doi":"10.1097/PRS.0000000000012509","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012509","url":null,"abstract":"<p><strong>Objective: </strong>To explore the impact of varying ratio of infiltration fluid doses and the total aspirate mixture (I/A) on the outcomes of liposuction surgery.</p><p><strong>Methods: </strong>The patients who have undergone liposuction were randomly divided into five groups, the proportion of the planned infusion dose and the total amount of aspirated mixture was 0.3-0.5, 0.5-0.8, 0.8-1.1, 1.1-1.4, 1.4-1.7, respectively. The intraoperative conditions of the five groups were recorded and the I/A was calculated, and the five groups A, B, C, D, E were finally determined according to the different proportions. The postoperative and complications of the five groups were compared, and the differences between the groups were statistically analyzed.</p><p><strong>Results: </strong>The operation time and blood volume in liposuction bottle were closely related to I/A ratio; The number of dressing changes, length of hospital stay, and the degree of bruising, swelling, and pain in group B and C were less than those in the other groups during the hospitalization. At the same time, the I/A ratio will also affect the postoperative satisfaction of patients.</p><p><strong>Conclusion: </strong>I/A ratio in the range of 0.8-1.1 can achieve satisfactory surgical effect, and when it is about 0.9, it is the best ratio, which can provide a reference scheme for clinical practice.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Applications and Indications of Allograft Adipose Matrix: A Systematic Review.","authors":"Sara B A Morel, Neil Vranis, Justin Perez, Andreas Nikolis, Ashkan Ghavami, Tyler Safran","doi":"10.1097/PRS.0000000000012506","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012506","url":null,"abstract":"<p><strong>Background: </strong>Autologous fat transfer remains a staple in aesthetic and reconstructive surgery due to its regenerative capacity and tissue integration. However, limitations such as donor site morbidity and unpredictable volume retention persist. Allograft adipose matrix (AAM), a product made from human fat tissue which serves as a natural scaffold to promote adipogenesis, offers a promising alternative, serving as a scaffold for adipogenesis and delivering key extracellular matrix components. This review examines clinical applications and outcomes in soft tissue augmentation.</p><p><strong>Methods: </strong>A systematic review was conducted via PubMed/MEDLINE/Cochrane/EMBASE using \"Allograft Adipose Matrix,\" \"Decellularized Adipose Matrix,\" \"Renuva,\" and \"Leneva.\" Studies published up to May 30, 2024, involving human or animal AAM treatment were included. Data on demographics, clinical use, injection protocols, outcomes, volume retention, and complications were extracted and analyzed.</p><p><strong>Results: </strong>From 352 studies, 10 involving humans and 9 involving animals were included. Human studies included 93 patients. Indications for AAM included: foot and dorsal hand rejuvenation, abdominal and buttocks contouring, temple atrophy, breast and genitalia augmentation, pressure ulcers, and facial rejuvenation. AAM injection volumes varied, with retention rates ranging from 21.5% to 100%. The most common complications were erythema, swelling, injection site pain, and burning, all resolving easily. Patient satisfaction scores ranged from 72.9% to 100%.</p><p><strong>Conclusion: </strong>AAM provides a promising biomaterial for soft tissue augmentation. Histological analysis supports its role in adipogenesis and neovascularization. Animal studies suggest enhancements through combination therapies, including AAM with autologous fat, platelet-rich plasma, or synthetic scaffolds. Further research is needed to optimize decellularization protocols, improve bioactivity and tissue incorporation.</p><p><strong>Level of evidence: </strong>Level IV, review article.</p><p><strong>Important points: </strong>- Allograft Adipose Matrix is a promising alternative to autologous fat transfer, offering benefits such as regenerative support, scaffold-based adipogenesis, and reduced donor site morbidity, with various applications.- Clinical studies showed favorable outcomes, including high patient satisfaction and manageable, self-resolving complications.- Further research is needed to enhance efficacy, particularly by improving volume retention, standardizing protocols, and exploring combination therapies, as well as conducting larger, long-term clinical studies.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipo-Layering: A Serendipitous Step Toward a Non-Engineered, Regenerative Solution for Severe Fingertip Injuries.","authors":"Elias T Sawaya, Benjamin Sommier, Jean Maxime Alet, Maya Ramos Prieto, Olivier Nicod","doi":"10.1097/PRS.0000000000012505","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012505","url":null,"abstract":"<p><strong>Summary: </strong>Reconstructing subtotal or total volar fingertip avulsions remains a complex challenge, particularly in the absence of replantation options. Traditional flap techniques may be contraindicated or associated with significant donor-site morbidity. We describe a simple, reproducible technique using autologous adipose tissue grafting combined with platelet-rich plasma (PRP) - a method we refer to as \"lipo-layering\" - for the treatment of severe pulp avulsion injuries with exposed bone, tendon, and joint.Initially conceived as a temporary biological dressing while awaiting definitive reconstruction, lipo-layering unexpectedly resulted in complete granulation and re-epithelialization without the need for further surgical intervention. Over a 15-month period, six patients with seven injured digits underwent one or two sessions of lipo-layering. All grafts integrated successfully, with full coverage achieved in less than six weeks. No flap procedures or secondary grafts were required. Functional outcomes were favorable: full proximal interphalangeal (PIP) and distal interphalangeal (DIP) joint extension in all cases, near-complete DIP flexion in five out of seven digits, and minimal pain or cold intolerance. Sensory recovery ranged from 1 to 2g monofilament threshold.These results suggest that lipo-layering offers a promising alternative to more invasive techniques for volar fingertip reconstruction, particularly in cases involving deep structural exposure. The technique appears to be associated with minimal morbidity and is compatible with standard wound care protocols, making it a viable addition to the armamentarium of reconstructive hand surgery.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative one fibula - two segmental mandibular reconstruction with a second orthognathic surgery for bilateral mandibular body resorption.","authors":"Hongwei Wang, Dongming He, Kai Liu, Jingshuang Yu, Hao Sun, Feini Zeng, Min Zhu, Lei Zhang, Jian Cao, Xudong Wang","doi":"10.1097/PRS.0000000000012510","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012510","url":null,"abstract":"<p><strong>Summary: </strong>Patients with bilateral mandibular resorption and malunion after bilateral sagittal split osteotomy (BSSO) presented with an anterior open bite, chin retrusion, and facial deformity, necessitating a second orthognathic surgery and jaw reconstruction. Due to the rarity and unclear etiology of this complication, careful selection of repair techniques is imperative for managing such discontinuous mandibular defects. Patient demands, such as concealed surgical incisions, fewer operations, high success rates, and accurate outcomes, should be considered, specifically in young females. Following virtual surgery for occlusion correction, as well as condyle and mandibular ramus repositioning, the extent of bilateral defects can be assessed. After weighing all reconstructive options, two separate vascularized fibula free flaps, prepared from a single fibular donor site, were selected for bilateral reconstruction. To effectively address intraoperative changes and enhance contact area between the fibular segments and mandibular rami, a sliding design, modified step-cut osteotomy, and length-gradient titanium plates were adopted. With the aid of 3D-printed osteotomy guides and titanium plates, the surgical procedure was successfully performed according to the predetermined design through bilateral Risdon incisions. Favorable postoperative healing, a stable occlusal relationship, a well-formed mandible, and improved facial aesthetics were successfully achieved at a two-year follow-up.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Treatment of Capsular Contracture with Acellular Dermal Matrix: 100 Consecutive Cases.","authors":"David A Hidalgo, Andrew L Weinstein","doi":"10.1097/PRS.0000000000012508","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012508","url":null,"abstract":"<p><strong>Background: </strong>Capsular contracture is a challenging entity to treat with consistent success. Recently, acellular dermal matrix (ADM) has been shown to be a highly effective therapeutic adjunct, particularly for patients at high-risk for recurrence.</p><p><strong>Methods: </strong>One hundred consecutive patients with Baker III/IV capsular contracture treated with ADM between 2014 and 2024 were included in this retrospective study. ADM was indicated for patients deemed high-risk for failing conventional surgical therapy. Data collected included patient characteristics, primary breast augmentation and revision procedure history, capsular contracture, surgical and nonsurgical treatments, and follow-up findings. Treatment success was defined as Baker II or better.</p><p><strong>Results: </strong>The success rate of capsular contracture treated surgically with ADM was 90 percent. Among the ten patients who failed ADM treatment, eight had silicone implants of whom two had new silicone implant ruptures. Four others had a history of silicone implant rupture prior to treatment with ADM. Some had additional notable characteristics: two resumed smoking, one had a hematoma, one underwent systemic chemotherapy and another breast radiation therapy. Salvage of ADM treatment failures with ultrasound was successful in two out of five patients, both of whom had saline implants. This increased the overall ADM success rate to 92 percent.</p><p><strong>Conclusions: </strong>Adding ADM to conventional surgical techniques has produced the highest success rates in capsular contracture treatment. Given that ADM treatment failure is associated with silicone implant rupture, saline implants are recommended to maximize result longevity. When early ADM treatment failure occurs, ultrasound therapy may salvage those with saline implants.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Moving Toward the Outpatient DIEP Flap: Factors Influencing Early Discharge\".","authors":"Haïzam Oubari, Guillaume Henry, Fabien Boucher, Ali Mojallal","doi":"10.1097/PRS.0000000000012498","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012498","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Nanofat in Wound Healing: A Prospective, Double-Blinded, Randomized Controlled Trial.","authors":"Apinut Wongkietkachorn, Nuttapone Wongkietkachorn","doi":"10.1097/PRS.0000000000012507","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012507","url":null,"abstract":"<p><strong>Introduction: </strong>Nanofat has been shown to contain a variety of growth factors, anti-inflammatory mediators, and adipose-derived stem cells, all of which may significantly contribute to the wound healing process. However, there is limited comparative clinical evidence supporting its use. This study aims to evaluate the effects of nanofat on wound healing in abdominoplasty by comparing outcomes between nanofat-treated and non-treated wounds.</p><p><strong>Methods: </strong>A prospective, double-blinded, randomized controlled trial was conducted using a split-wound model. Each wound was divided and randomized into a nanofat-treated side and a non-nanofat control side. Nanofat was prepared and injected along the wound margins using a standardized dose. Both patients and the surgeons evaluating the wounds were blinded to the treatment allocation. Wound outcomes were assessed six months postoperatively using the Observer Scale of the Patient and Observer Scar Assessment Scale (POSAS).</p><p><strong>Results: </strong>Fifty lipoabdominoplasty patients were included in the study. Wound outcomes were significantly better in the nanofat group compared to the non-nanofat group across all assessed parameters, including vascularity, pigmentation, thickness, relief, pliability, surface area, and overall opinion (p<0.001). No oil cysts or fat necrosis were observed in the nanofat group.</p><p><strong>Conclusions: </strong>Nanofat significantly improved wound outcomes in abdominoplasty patients without associated complications such as oil cysts or fat necrosis.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate Hybrid Breast Reconstruction: Dual-Plane Approach Using Prepectoral Implants and Retropectoral Fat Grafting.","authors":"Alexandre Mendonça Munhoz","doi":"10.1097/PRS.0000000000012497","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012497","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prepectoral vs Subpectoral Implant-Based Breast Reconstruction: Evaluating the Shift.","authors":"Holly Cordray, Salman Khan, Malia Voytik, Justus Zemberi, Gustavo Capone, Ashley E Chang, Robyn B Broach, Saïd C Azoury","doi":"10.1097/PRS.0000000000012480","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012480","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated trends in implant-based breast reconstruction, anticipating a shift toward prepectoral implants instead of subpectoral implants, and correlated these shifts with clinical outcomes.</p><p><strong>Methods: </strong>The cohort included adult patients who received implant-based breast reconstruction at the University of Pennsylvania Health System from 2018-2024. Analyses used linear regression to trend implant plane selection over time, and Chi-square/Fisher's tests with relative risk (RR) to compare postoperative complications by reconstructive approach.</p><p><strong>Results: </strong>Among 686 patients, reconstructions were subpectoral (301 cases) or prepectoral (385 cases). Prepectoral reconstructions rose significantly across the study period (P = .001), from 4.0% of cases in 2018 to 90.2% in 2024. Prepectoral reconstructions showed significantly lower incidence of postoperative fat necrosis (RR 0.3, 95% CI: 0.1-0.9), nipple-areolar complex necrosis (RR 0.2, CI: 0.1-0.5), and chronic pain (RR 0.3, CI: 0.1-0.8). Prepectoral reconstructions showed significantly higher incidence of infection (RR 3.3, CI: 2.0-5.5), delayed healing/dehiscence (RR 2.0, CI: 1.3-2.9), readmission (RR 2.1, CI: 1.2-3.6), and reoperation for complications (RR 2.0, CI: 1.5-2.8). Prepectoral reconstructions showed higher reoperation rates for threatened prosthetic loss (RR 2.9, CI: 1.7-4.9) and prosthetic failure rates (RR 2.8, 1.5-5.2).</p><p><strong>Conclusions: </strong>Implant plane preference reversed across 2018-2024, from subpectoral to prepectoral. Despite certain advantages, prepectoral (vs subpectoral) reconstructions showed twice the risk of readmission and reoperation, including nearly threefold risk of reoperation for threatened prosthetic loss and ultimate failure. These results warrant further study to determine ways to improve outcomes following prepectoral reconstruction or whether surgeons should revisit subpectoral placement in predetermined high-risk cases.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}