Plastic and reconstructive surgery最新文献

{"title":"Comparing Innervated and Noninnervated Glabrous Skin Flaps for Volar Digital Defects: Insights from Patient-Reported Outcomes.","authors":"Ren-Wen Huang, Mu-Chieh Chi, Yun-Huan Hsieh, Chung-Chen Hsu, Yu-Te Lin, Chih-Hung Lin, Cheng-Hung Lin","doi":"10.1097/PRS.0000000000011829","DOIUrl":"10.1097/PRS.0000000000011829","url":null,"abstract":"<p><strong>Background: </strong>Volar soft-tissue defects in digits necessitate reconstructions that restore appearance sensation and minimize complications. This study compared innervated toe pulp (TP) and noninnervated medialis pedis (MP) flaps for reconstructing such defects, focusing on objective and subjective outcomes.</p><p><strong>Methods: </strong>Between 1998 and 2017, 101 free glabrous skin flap reconstructions were performed at the authors' institution for volar digital soft-tissue injuries, comprising 75 TP flaps and 26 MP flaps. Follow-up assessments included the Michigan Hand Outcomes Questionnaire; Disabilities of the Arm, Shoulder and Hand Questionnaire; Foot and Ankle Disability Index; and sensory testing (static and moving two-point discrimination, Semmes-Weinstein monofilament test). Data analysis used the Mann-Whitney U test and Pearson correlation coefficients.</p><p><strong>Results: </strong>The study cohort included 29 participants (TP, n = 15; MP, n = 14) with an average follow-up of 106 months. Functional and sensory outcomes revealed no significant differences between TP flaps and MP flaps. Both flap types achieved satisfactory function and sensibility, with no statistically significant distinctions in patient-reported outcomes. Subjective complaints were similarly distributed across both groups, with a few reports of cold intolerance and discomfort at the donor site in the TP flap group.</p><p><strong>Conclusions: </strong>TP and MP flaps provide adequate coverage and sensory outcomes for volar digital defects without significant differences between innervated and noninnervated flap transfers. The flap choice should be tailored to individual patient needs and defect characteristics, emphasizing the importance of patient-centered decision-making in reconstructive surgery. Further research is required to explore the long-term outcomes of these reconstruction methods, especially for larger defects.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"874e-883e"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505904","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":"Clinical Outcomes of Scapular versus Fibular Free Flaps in Head and Neck Reconstructions: A Retrospective Study of 120 Patients.","authors":"Eleonora Olivera Felicity Dimovska, Markus Aazar, Martin Bengtsson, Andreas Thor, Stina Klasson, Andrés Rodriguez-Lorenzo","doi":"10.1097/PRS.0000000000011818","DOIUrl":"10.1097/PRS.0000000000011818","url":null,"abstract":"<p><strong>Background: </strong>The scapular free flap has increasingly gained popularity as an alternative to the fibular free flap in osseous head and neck reconstruction. The authors evaluated its use in maxillomandibular reconstruction and examined surgical and patient outcomes.</p><p><strong>Methods: </strong>Osseous head and neck defects reconstructed with an angular artery-based scapular flap or fibular flap from 2016 to 2022 at 2 Swedish university hospitals were evaluated for their intraoperative execution (osseous and soft-tissue combinations) and postoperative outcomes. Facial quality of life (QoL) was assessed using the FACE-Q Head and Neck Cancer module. Donor-site morbidity was assessed using the Disabilities of the Arm, Hand, and Shoulder (DASH) and Self-Evaluated Foot and Ankle Score (SEFAS) questionnaires for scapular- and fibular-reconstructed cases, respectively.</p><p><strong>Results: </strong>A total of 120 patients were recruited, 86 with mandibular reconstructions (26 scapulas, 60 fibulas) and 34 with maxillary reconstructions (32 scapulas, 2 fibulas). The concave scapula facilitated fewer osteotomies for curved reconstructions, particularly for lateral mandibular defects ( P = 0.039). Intraoral lining was primarily achieved with muscle accompanying the scapula and skin accompanying the fibula. Using the latissimus dorsi muscle instead of only teres major decreased fistulas, plate/bone exposure, and nonunions ( P = 0.039) in scapular reconstructions. Both flaps demonstrated comparable facial QoL, but the scapula presented superior donor-site outcomes ( P = 0.001). Donor limb outcomes were unaffected by harvesting the latissimus dorsi with the scapula ( P = 0.64) or by resuturing the detached muscles to the remaining scapula ( P = 0.35).</p><p><strong>Conclusion: </strong>The scapular free flap can be advantageous in osseous head and neck reconstructions, enabling nonosteotomized and chimeric reconstructions without compromising surgical outcomes or QoL.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, III.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"865-875"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472439","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":"The Thoracodorsal Artery Perforator Flap for the Treatment of Hidradenitis Suppurativa of the Axilla: A Prospective Comparative Study: Correction.","authors":"Simone La Padula, Rosita Pensato, Chiara Pizza, Francesco D'Andrea, Giovanni Roccaro, Jean Paul Meningaud, Barbara Hersant","doi":"10.1097/PRS.0000000000012088","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012088","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 5","pages":"905-906"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038350","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":"PRS Journal Club: Improving Disparities, Long-Term Outcomes, and Financial Metrics in Breast and Mandibular Reconstruction.","authors":"Ilana G Margulies, Amanda R Sergesketter, Christopher L Kalmar","doi":"10.1097/PRS.0000000000011993","DOIUrl":"https://doi.org/10.1097/PRS.0000000000011993","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 5","pages":"903-904"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033395","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":"Skin Tightening Technologies in Body Contouring.","authors":"Sachin M Shridharani, Joseph G Ribaudo, MacKenzie L Kennedy","doi":"10.1097/PRS.0000000000012005","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012005","url":null,"abstract":"<p><strong>Learning objectives: </strong>After studying this article, the participant should be able to: 1. Understand the role of nonsurgical skin tightening. 2. Classify different skin tightening devices based on energy mechanism. 3. Recognize the advantages and disadvantages of various skin tightening devices. 4. Identify which skin tightening device to use depending on patient characteristics.</p><p><strong>Summary: </strong>Although surgical excision or cosmetic lift are the standard means of skin tightening, patients often desire nonsurgical options with minimal downtime. Nonsurgical skin tightening modalities vary based on energy type and delivery method. Higher energy modalities, such as laser therapy, have increased pain, downtime, and potential adverse effects. However, these offer the most dramatic results. A balance must be achieved between energy level, patient satisfaction, and safety. Devices also differ in US Food and Drug Administration approval and skin tightening location. Overall, in an ideal candidate, nonsurgical skin tightening devices offer highly satisfactory results with minimal downtime.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 5","pages":"935e-946e"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036873","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":"Patient Characteristics and Provider Specialties Associated with Treatment Expenses for Thumb Carpometacarpal Arthritis.","authors":"Robert L Kane, Jessica I Billig, Zhongzhe Ouyang, Leyi Wang, Lu Wang, Kevin C Chung","doi":"10.1097/PRS.0000000000011702","DOIUrl":"https://doi.org/10.1097/PRS.0000000000011702","url":null,"abstract":"<p><strong>Background: </strong>Thumb carpometacarpal (CMC) arthritis can be treated with a variety of nonsurgical and surgical means. The authors hypothesized that specific groups of providers and patients are associated with increased financial burden from both patient and health care perspectives.</p><p><strong>Methods: </strong>The Optum Clinformatics DataMart Database (2014 to 2018) was used to perform a retrospective population-based study. Patients newly diagnosed with thumb CMC arthritis were identified and divided into 2 cohorts: surgical and nonsurgical treatment only cohort (ie, splint, steroid injection, and hand therapy). The authors identified all treatments received, sociodemographic characteristics, and specialty of the provider. Tobit regression was used to identify correlations with increased total payments by insurer, out-of-pocket expenses, facility fees, and provider fees.</p><p><strong>Results: </strong>A total of 18,766 patients were included; 529 patients (3%) received surgical treatment, and 18,237 patients (97%) received nonsurgical treatment only. Nonsurgical treatment regimens varied widely among provider specialties and were associated with significant discrepancies in direct costs to the patient and the health care system. Nearly 40% of patients who received surgery had attempted only 1 type of nonsurgical treatment prior. Across both treatment cohorts, the largest discrepancies in treatment expenses were related to facility fees, which increased significantly in nonsurgical treatment regimens that used steroid injection.</p><p><strong>Conclusions: </strong>Providers should apply current evidence that supports multimodal nonsurgical treatments before surgical referral for thumb CMC arthritis. From an economic standpoint, it may be worthwhile to consider whether nonsurgical treatment should commence with less expensive alternatives to steroid injection, such as hand therapy exercises and splint.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 5","pages":"827-834"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035613","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":"Discussion: Metabolic Bridge Therapy before Microvascular Breast Reconstruction in Morbidly Obese Patients: A Proof-of-Concept Risk Analysis.","authors":"Nicholas T Haddock","doi":"10.1097/PRS.0000000000011866","DOIUrl":"https://doi.org/10.1097/PRS.0000000000011866","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 5","pages":"761-762"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976299","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":"The Objective Buttocks Assessment Scale: A New and Complete Method to Assess the Gluteal Region: Correction.","authors":"Giovanni Roccaro, Barbara Hersant, Rosita Pensato, Chiara Pizza, Umberto Rega, Francesco D'Andrea, Jean Paul Meningaud, Simone La Padula","doi":"10.1097/PRS.0000000000012090","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012090","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 5","pages":"905"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009286","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":"Discussion: Optic Nerve Sheath Diameter on Computed Tomography Scans Reflects Elevated Intracranial Pressure in Patients with Craniosynostosis.","authors":"Larry H Hollier","doi":"10.1097/PRS.0000000000011723","DOIUrl":"https://doi.org/10.1097/PRS.0000000000011723","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 5","pages":"848-849"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006274","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":"The Less Emphasized Link in Mentorship: The Role of the Mentee.","authors":"Pradeep K Attaluri, Peter J Wirth, Ellen C Shaffrey, Michael L Bentz, Ahmed M Afifi","doi":"10.1097/PRS.0000000000011835","DOIUrl":"10.1097/PRS.0000000000011835","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"958e-960e"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505922","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}