Plastic and reconstructive surgery最新文献

{"title":"Discussion: Does Dangling the Lower Extremity after Free Flap Reconstruction Reduce Partial Flap Loss? A Multicenter Randomized Controlled Trial.","authors":"Eric I Chang","doi":"10.1097/PRS.0000000000011969","DOIUrl":"10.1097/PRS.0000000000011969","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 1","pages":"170-171"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497596","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: Evaluating the Accuracy of Relative Value Unit and Operative Time Changes in Breast Reconstruction.","authors":"Sahil K Kapur","doi":"10.1097/PRS.0000000000012012","DOIUrl":"10.1097/PRS.0000000000012012","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 1","pages":"185-186"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497597","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: The Evolution of Unicoronal Synostosis Correction: Long-Term Aesthetics of Fronto-Orbital Distraction versus Advancement.","authors":"Jeffrey A Fearon","doi":"10.1097/PRS.0000000000011845","DOIUrl":"10.1097/PRS.0000000000011845","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 1","pages":"117-118"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497601","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":"Ryan S Huang, Michael Balas, Flora Yan, Allan E Wulc","doi":"10.1097/PRS.0000000000011860","DOIUrl":"10.1097/PRS.0000000000011860","url":null,"abstract":"<p><strong>Summary: </strong>Text-to-image models powered by artificial intelligence offer a promising tool for enhancing patients' comprehension of cosmetic surgery outcomes and providing personalized visual forecasts of their appearance after the procedure. This study explores the efficacy of text-to-image AI models, specifically DALL·E2, in improving preoperative counseling for patients undergoing lip-lift procedures. Preoperative photographs of 4 patients, who had given their consent, were processed using DALL·E2, which allows users to modify specific areas of an image and input text descriptions to visualize anticipated changes. The authors successfully demonstrated the ability of DALL·E2 to generate accurate visual predictions within a short timeframe of 2 minutes. Selected images provided realistic expectations of the postoperative appearance, aiding in better patient understanding and expectation management.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 1","pages":"47e-50e"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497609","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":"Diagnosis and Screening of Velocardiofacial Syndrome by Evaluating Facial Photographs Using a Deep Learning-Based Algorithm.","authors":"Rong-Min Baek, Anna Cho, Yoon Gi Chung, Yonghoon Jeon, Hunmin Kim, Hee Hwang, Jiwon Kang, Yujin Myung","doi":"10.1097/PRS.0000000000011792","DOIUrl":"10.1097/PRS.0000000000011792","url":null,"abstract":"<p><strong>Background: </strong>Early detection of rare genetic diseases, including velocardiofacial syndrome (VCFS), is essential for patient well-being. However, the rarity of these diseases and limited clinical experience of physicians make diagnosis challenging. Deep learning algorithms have emerged as promising tools for efficient and accurate diagnosis. This study investigates the use of a deep learning algorithm to develop a face recognition model for diagnosing VCFS.</p><p><strong>Methods: </strong>The study used publicly available labeled face data sets to train the multitask cascaded convolutional neural networks model. Subsequently, the authors examined the binary classification performance for diagnosing VCFS using the most efficient face recognition model. A total of 98 VCFS patients (920 facial photographs) and 91 non-VCFS controls (463 facial photographs) were randomly divided into training and test sets. In addition, the authors analyzed whether the classification results matched the known facial phenotype of VCFS.</p><p><strong>Results: </strong>The face recognition model demonstrated high accuracy, ranging from 94% to 99%, depending on the training data set. The accuracy of the binary classification diagnostic model varied from 81% to 88% when evaluating with photographs taken at various angles, but reached 95% evaluating with frontal photographs only. Gradient-weighted class activation mapping heat map revealed the high importance level of perinasal and periorbital areas, exhibiting consistency with the conventional facial phenotypes of VCFS.</p><p><strong>Conclusions: </strong>This study shows the feasibility and effectiveness of multitask cascaded convolutional neural network-based model for detecting VCFS solely from facial photographs. The high accuracy underscores the potential of deep learning in aiding early diagnosis of rare genetic diseases, facilitating timely interventions for patient care.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"112e-119e"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366233","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":"Outcomes of All-Dorsal Augmented Intercarpal Ligament Reconstruction.","authors":"Jennifer L Colwell, Matthew M Florczynski, Jeanne M Riggs, Hyungjin M Kim, Patricia B Burns, Kevin C Chung","doi":"10.1097/PRS.0000000000011912","DOIUrl":"10.1097/PRS.0000000000011912","url":null,"abstract":"<p><strong>Background: </strong>Scapholunate and lunotriquetral ligament injuries are frequently undiagnosed and can lead to progressive loss of wrist function and chronic pain. Many surgical reconstruction options exist, but outcomes are suboptimal, and no superior approach has been established.</p><p><strong>Methods: </strong>Consecutive candidates for scapholunate and/or lunotriquetral ligament reconstruction using an all-dorsal augmented intercarpal ligament reconstruction (ADAIR) were evaluated in this prospective case series. The Michigan Hand Outcomes Questionnaire (MHQ) and the Patient-Rated Wrist Evaluation were administered, and range of motion and grip and pinch strength were tested preoperatively and at postoperative visits up to 12 months.</p><p><strong>Results: </strong>Twenty-two patients (24 wrists) were included in the study, with 17 wrists followed up to 6 months and 15 wrists to 12 months postoperatively. In the operated extremity, overall MHQ scores improved over 12 months by a mean of 17.2 points ( P < 0.001). All MHQ domain scores except aesthetic and work domains showed significant improvement. Overall Patient-Rated Wrist Evaluation scores improved by 24.1 points by 12 months ( P < 0.001). At 12 months, all clinical outcomes, including grip and pinch strength, wrist range of motion, and radiographic measurements, were improved or similar to baseline.</p><p><strong>Conclusions: </strong>ADAIR demonstrated encouraging short-term patient-reported and functional outcomes, comparable to other intercarpal reconstructions despite its relative technical simplicity. ADAIR is a promising technique for improving outcomes in these challenging surgical cases.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, IV.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"77-89"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786460","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":"Three Decades of Outpatient Plastic Surgery Safety: A Review of 42,720 Consecutive Cases.","authors":"Rachel N Rohrich, Tal Brown, Stav Brown, John Burns, Sameer Jejurikar, Ricardo Meade, Rod J Rohrich","doi":"10.1097/PRS.0000000000011942","DOIUrl":"10.1097/PRS.0000000000011942","url":null,"abstract":"<p><strong>Background: </strong>Outpatient plastic surgery offers cost-effective solutions and enhanced privacy, but demands careful patient assessment for suitability and vigilant anticipation of adverse events. To provide recommendations to enhance patient safety in outpatient settings, this study analyzed more than 40,000 consecutive cases spanning 3 decades.</p><p><strong>Methods: </strong>The authors retrospectively reviewed all consecutive cases completed by board-certified plastic surgeons at an accredited outpatient surgical center between 1995 and 2023. Patient demographics, operative details, and postoperative complications were recorded to determine risk factors for complications and inpatient admissions. A subgroup analysis for procedures of the face, breast, and body was also performed.</p><p><strong>Results: </strong>A total of 42,720 consecutive cases were performed, with an overall complication rate of 0.74% ( n = 318). Patients who experienced a venous thromboembolism or an inpatient transfer, had a higher body mass index ( P < 0.05), had a longer operative duration ( P < 0.05), and were more likely to have undergone combined procedures ( P < 0.05) were compared with those who did not. Undergoing a combined procedure was the strongest predictive factor for venous thromboembolism and inpatient admissions (OR, 12.65; OR, 3.73; P < 0.05), followed by longer operative time (OR, 1.45; OR, 1.32; P < 0.05).</p><p><strong>Conclusions: </strong>To the authors' knowledge, this is the largest long-term private practice plastic surgery study in accredited outpatient settings spanning almost 30 years, further confirming that outpatient plastic surgery can be performed in a consistent and safe manner with proper preoperative evaluation and patient optimization. Postoperative monitoring should be considered for high-risk patients, particularly those with a body mass index exceeding 26 kg/m², operative times surpassing 3 hours, lipoaspirate volumes greater than 3 liters, and planned combined procedures-particularly in cases involving abdominoplasty.</p><p><strong>Clinical question/level of evidence: </strong>Risk, III.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"49-61"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907533","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: A Conservative Crease-Height-Adjustable Asian Double-Eyelid Surgery Technique Based on Live Anatomical Studies.","authors":"Chin-Ho Wong, Michael Ku Hung Hsieh","doi":"10.1097/PRS.0000000000012103","DOIUrl":"10.1097/PRS.0000000000012103","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 1","pages":"41-44"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497594","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":"Introducing and Discussing National Cleft and Craniofacial Awareness and Prevention.","authors":"Larry H Hollier","doi":"10.1097/PRS.0000000000012017","DOIUrl":"10.1097/PRS.0000000000012017","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 1","pages":"192-193"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497603","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":"Factors Associated with Length of Hospital Stay in Patients Undergoing Lower Extremity Free Flap Reconstruction.","authors":"Omar Moussa, Floris V Raasveld, Seth Fruge, Ian L Valerio, Neal C Chen, Kyle R Eberlin, Krystle Tuaño","doi":"10.1097/PRS.0000000000012283","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012283","url":null,"abstract":"<p><strong>Introduction: </strong>Lower Extremity Free Flap Reconstruction (LE-FFR) is essential for significant soft tissue defects, but prolonged hospital stays can negatively impact patients and healthcare systems. This study aimed to identify factors associated with post-flap surgery length of stay (pfsLOS) in LE-FFR patients to optimize healthcare delivery and outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study included 405 patients who underwent 415 microvascular LE-FFR at two Level I Trauma Centers. The primary outcome was pfsLOS, which was then described in the context of total LOS (tLOS). Statistical analyses involved multivariable linear and Cox regression models, analyzing outcomes as relative percentage changes in pfsLOS.</p><p><strong>Results: </strong>Across all defect etiologies, median pfsLOS (IQR) was 10 days (8-14), with prolonged pfsLOS (>14 days) in 81 patients (20%). Combined initial plastic and orthopaedic surgery treatment (primary multidisciplinary orthoplastic treatment) was associated with a significant decrease in pfsLOS (-13.58%, p=0.047) in multivariable regression analysis, with the greatest benefit observed in high-severity cases. Other factors significantly affecting pfsLOS included the number of plastic surgery operations (14.47% increase per operation, p<0.001), blood transfusion (13.03% increase, p=0.023), and flap surgery duration (0.06% increase per minute, p=0.041). The time between the first surgery and flap surgery was associated with a significant decrease in pfsLOS (-0.90% per day, p=0.046). Sub-analysis showed that discharge to destinations other than home significantly increased pfsLOS (16.45%, p=0.001), particularly in socially deprived areas.</p><p><strong>Conclusion: </strong>Initial combined orthoplastic intervention reduced pfsLOS by 9.10%-13.58% and overall tLOS by 50.00% for LE-FFR patients. Early coordination between services reduces LOS, optimizes resource utilization, and likely improves cost-effectiveness and patient outcomes in LE-FFR.</p><p><strong>Level of evidence: </strong>III - therapeutic.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643145","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}