Plastic and reconstructive surgery最新文献

{"title":"Remote Incisions as an Alternative to Mastectomy Scars for Breast Tissue Expander-to-Implant Exchange: A Propensity Score-Matched Analysis.","authors":"Vignesh Chennupati, Franklin Gergoudis, Barite Gutama, Ricardo A Torres-Guzman, Muhammad Daiem, William Lineaweaver","doi":"10.1097/PRS.0000000000012486","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012486","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192282","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":"Use of Text-to-Image Artificial Intelligence Model in Preoperative Counseling for Lip-Lift Procedures.","authors":"José Mauricio Barragán-García, José Barragán-Cabral, Miguel Angel Gaxiola-García","doi":"10.1097/PRS.0000000000012456","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012456","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131719","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":"Tie2 activation enhances vascularized lymph node transfer in lymphedema by improving lymphatic endothelial integrity.","authors":"Do Young Park, Bo-Yoon Park, Dong Hyun Seo, Tae Hyun Kong, Sang-Oh Lee, Kyoo-Ri Kwon, Du-Hyong Cho, Yong-Ha Kim, Choong-Kun Lee, Il-Kug Kim","doi":"10.1097/PRS.0000000000012473","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012473","url":null,"abstract":"<p><strong>Background: </strong>Lymphedema is characterized by inadequate interstitial fluid drainage due to disrupted lymphatic vasculature. Despite the pivotal role of angiopoietin (Ang)-Tie2 signaling in lymphatics, the therapeutic potential of Tie2 modulation in lymphedema remains unknown.</p><p><strong>Methods: </strong>To investigate the molecular and pathological changes associated with lymphedema, fat tissues were collected from lymphedema patients and subjected to immunohistochemistry and transcriptomic analyses. Additionally, a mouse hindlimb lymphedema model was established by obstructing superficial and deep lymphatic drainage, allowing the evaluation of structural, functional, and molecular alterations accompanying lymphedema. The effects of systemically administered Ang2-binding and Tie2-activating antibody (ABTAA) on lymphedema were assessed, both independently and in combination with vascularized lymph node transfer (VLNT).</p><p><strong>Results: </strong>Immunohistochemistry and transcriptomic analyses of tissues from lymphedema patients revealed significant impairment of lymphatic endothelial cell (LEC) junctions and alterations in Ang-Tie2 signaling. A mouse hindlimb lymphedema model demonstrated the hallmarks of lymphedema, including fluid drainage impairment along with tissue edema, disintegrated LECs, and remodeling of lymphatic vessels. ABTAA significantly improved all the features of lymphedema by activating lymphatic endothelial Tie2, leading to increased LEC junctional stability. Notably, ABTAA exerted an additive effect in relieving lymphedema when combined with VLNT, which was supported by transcriptomic analysis results that indicated enhanced lymphatic vascular integrity, reduced inflammation, and increased vasculogenesis upon treatment.</p><p><strong>Conclusions: </strong>Tie2 activation with ABTAA ameliorates lymphedema in a mouse model, both independently and in combination with VLNT treatment. These findings suggest that Tie2 activation may present a novel and effective option, potentially improving the current treatment of lymphedema.</p><p><strong>Clinical relevance statement: </strong>The results of the study highlight the potential of ABTAA treatment in enhancing lymphatic stability, offering plastic surgeons a novel therapeutic approach to improving outcomes in patients undergoing vascularized lymph node transfer for lymphedema.</p><p><strong>Graphical abstract: </strong>A graphical abstract is available for this article.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131575","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":"A Rating Scale for Obtaining Specific, Actionable Evaluations of Nasolabial Aesthetics After Unilateral Cleft Lip Repair.","authors":"Thomas J Sitzman, Thomas D Samson, Raymond W Tse, Damir B Matic, David M Fisher, Stephen P Beals, Alexander C Allori, Jeffrey R Marcus, Michael Bezuhly, Helena Hanna","doi":"10.1097/PRS.0000000000012474","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012474","url":null,"abstract":"<p><strong>Background: </strong>Surgeons pursuing improvement in the aesthetic outcomes of their cleft lip repairs may benefit from a granular scale evaluating individual objectives of the repair.</p><p><strong>Methods: </strong>A working group of nine surgeons convened to develop an assessment scale for nasolabial aesthetics after unilateral cleft lip repair. The group identified objectives of the repair that could be evaluated using two-dimensional facial photographs. Scale items were developed to appraise success or failure in achieving each objective. Scale items were iteratively tested and refined. The scale was subsequently implemented as part of a continuing medical education course that included self-evaluation and peer-to-peer education, culminating in the formation of individual plans for improvement.</p><p><strong>Results: </strong>Twelve distinct objectives of unilateral cleft lip repair were identified, of which ten could be evaluated using photographs routinely obtained in clinical practice. A comprehensive scale was developed incorporating these ten objectives. Each scale item takes the form of a binary (yes/no) question evaluating a specific aesthetic concept, with accompanying reference images. Intra-rater reliability for each item ranged from moderate to substantial [κ = 0.57-0.81]. Inter-rater reliability ranged from fair to substantial [κ = 0.27-0.81]. When implemented in a continuing medical education course, the scale enabled surgeons to identify specific opportunities for improvement in their repair and specific surgical maneuvers to adopt in pursuit of these improvements.</p><p><strong>Conclusion: </strong>A new scale for evaluating outcomes of unilateral cleft lip repair is presented. The scale provides specific, actionable evaluations for individual objectives of the repair.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131597","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":"Eponychial reconstruction in digits with a novel Digital Artery Perforator Flap (EDAP flap).","authors":"Yong Chiang Kang","doi":"10.1097/PRS.0000000000012469","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012469","url":null,"abstract":"<p><p>The eponychium and nail fold of the digits have unique anatomy with limited options for reconstruction. Six consecutive cases between 2019 and 2024 with eponychial and nail fold loss were reconstructed successfully with a novel digital artery perforator flap (EDAP flap). The flap is vascularized by a dorsal sub-branch of the transverse branch of the digital artery proper. In this paper, the technique and nuances in design, and outcomes are described. Variations in design are illustrated according to defect size and location. This like-for-like yet simple reconstruction provides a functional and aesthetic outcome. It provides a simple solution to an otherwise challenging reconstruction.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131611","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":"Botox versus Surgery: Evaluating Patient Treatment Choices for Post-Paralysis Facial Synkinesis.","authors":"Sahejbir S Bhatia, Benjamin Rail, Dominic Henn, MinJae Lee, Shai M Rozen","doi":"10.1097/PRS.0000000000012476","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012476","url":null,"abstract":"<p><strong>Background: </strong>Treatment selection for post-paralysis facial synkinesis (PPFS) is a multifaceted decision for patients. This study aims to identify patient factors influencing treatment choice between chemodenervation with onabotulinumtoxinA (Botox) alone and synkinesis surgery.</p><p><strong>Methods: </strong>PPFS patients presenting between 2009 and 2024 were grouped into those choosing only chemodenervation and those choosing synkinesis surgery. Excluded were untreated patients and those without qualifying photos at least 16 months post-paralysis onset. eFACE was used to quantify synkinesis severity. The primary outcome was choice of treatment type, and the secondary outcome was time from synkinesis diagnosis to surgery. Each was analyzed for associations with patient characteristics using univariable and multivariable analysis.</p><p><strong>Results: </strong>Of 549 PPFS patients, 231 patients met inclusion criteria. Factors independently associated with selecting surgical treatment included living more than 100 miles from our institution (p < 0.001) and moderate or severe synkinesis (p = 0.010). Time from synkinesis diagnosis to surgery was significantly longer for female patients compared to male patients (adjusted mean difference 441 days; p = 0.025) and for non-White patients compared to White patients (adjusted mean difference 355 days; p = 0.042). Other variables including socioeconomic vulnerability were not found to be independently associated with selection or timing of treatment.</p><p><strong>Conclusions: </strong>Patients living farther from our institution and those with more severe synkinesis were more likely to choose surgical synkinesis treatment over chemodenervation alone. The time from synkinesis diagnosis to surgery was significantly longer for female compared to male patients and for non-White compared to White patients.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131661","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":"Quantification of Cannula Influence on Negative Pressure in Syringe Assisted Liposuction.","authors":"Alexander Bartsch, Andreas Eigenberger, Oliver Felthaus, Brian W Booth, Lars Krenkel, Thomas Schratzenstaller, Lukas Prantl","doi":"10.1097/PRS.0000000000012477","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012477","url":null,"abstract":"<p><strong>Summary: </strong>To make the results of the autologous fat transfer more satisfactory, all parameters of suction, preparation, and reapplication must be well understood. Since syringe-assisted liposuction is frequently used for small-volume procedures, we quantified the influence of the cannula on negative pressure.For these experiments, we used a digital manometer to which a syringe and one of seven different cannulas were connected. Data was collected and analyzed using LabVIEW and Matlab. The volume of our measurement setup was calculated using Boyle-Mariotte's law to ease interpretation, which revealed a volume of 2.82 ± 0.03 mL.We demonstrate that the volume of the measurement setup significantly affects the measurement results. Consequently, we accounted for this factor and calculated the theoretical values accordingly. Statistical analysis shows a significant influence on negative pressure across different cannulas, except for two pairs, which had minimal volume differences. Exemplary, for cannulas with volumes under 1.75 mL, a 2 mL syringe plunger pull was sufficient to create a - 0.5 bar (- 14.8 inHg) negative pressure.The present data indicate that the size of the suction cannula must be considered in syringe-assisted suction to ensure a specific negative pressure is not exceeded. Other research groups have demonstrated that adipocyte vitality and the amount of stromal vascular fraction are reduced by excessively strong negative pressure.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138446","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":"Debulking and osteotomy procedures to correct severe macrodactyly deformity of hand in young patients.","authors":"Aiping Yu, Lei Huang, Xinyi Dai, Shengbo Zhou, Yongkang Jiang, Bin Wang, Wenhai Sun","doi":"10.1097/PRS.0000000000012470","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012470","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to propose and evaluate early debulking combined with corrective osteotomy for treating hand macrodactyly in young patients.</p><p><strong>Methods: </strong>A retrospective study included 31 young patients (mean age 12.7 years) with severe hand macrodactyly. All underwent microsurgical debulking based on multiple pedicled flaps and osteotomy to reduce the volume soft tissues and shape the deformed finger, with a mean follow-up of 3.1 years. Clinical evaluations included ratios of finger length, circumference, and nail dimensions to the intact finger, as well as the range of motion (ROM) of metacarpophalangeal joint (MCPJ), and functional scores (Kapandji, ARAT, Barthel) before and after surgery. Vancouver Scar Scale scores, parent satisfaction, and complications were also assessed.</p><p><strong>Results: </strong>The procedure preserved the finger, avoided ablation, and restored near-normal appearance. Preoperatively, affected fingers were 1.3 times longer, with PIPJ and DIPJ circumferences 1.5 and 1.7 times larger than intact fingers. At the last follow-up, these ratios improved to 1.1, 1.2, and 1.2, respectively. Nail length and width, initially 1.7 and 1.6 times larger, normalized to 1.0 and 1.1 times. MCPJ ROM improved from 41° to 69°. Functional scores rose significantly: Kapandji from 6 to 9, ARAT from 33 to 53, and Barthel from 95 to 98. Vancouver Scar Scale averaged 2, and all parents expressed satisfaction.</p><p><strong>Conclusion: </strong>This approach reduces finger volume, preserves fingers, improves functional outcomes, and minimizes adverse impacts on quality of life, offering a promising option for severe hand macrodactyly.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131605","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":"Use of Text-to-Image Artificial Intelligence Model in Preoperative Counseling for Lip-Lift Procedures: Comments.","authors":"Ungi Tei, Makoto Shiraishi, Yuta Moriwaki, Kou Fujisawa, Mutsumi Okazaki","doi":"10.1097/PRS.0000000000012478","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012478","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131716","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":"Management of the Infected Tissue Expander.","authors":"Camilla F Nielsen, Mathilde N Hemmingsen, Mathias Ørholt, Tim K Weltz, Mikkel Herly","doi":"10.1097/PRS.0000000000012465","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012465","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131600","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}