Plastic and reconstructive surgery最新文献

{"title":"Pelvic Ring Reconstruction with Vascularized Bone Flaps Reduces Compensatory Scoliosis After External Hemipelvectomy.","authors":"Praneet S Paidisetty, Karthik Tappa, Rami Elmorsi, Margaret S Roubaud, Matthew M Hanasono, David M Adelman, Shalin S Patel, Justin E Bird, Valerae O Lewis, Patrick P Lin, Alexander F Mericli","doi":"10.1097/PRS.0000000000012241","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012241","url":null,"abstract":"<p><strong>Background: </strong>External hemipelvectomy (EH) is a complex amputation that removes the hemipelvis and leg, most commonly performed to resect a locally advanced pelvic malignancy. This destabilizes the spinopelvic anatomy and may result in a compensatory scoliosis (CS) to maintain an upright posture. We hypothesized pelvic ring reconstruction with vascularized bone (VB) will reduce CS and improve functional outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients who underwent an EH between 1/2004 and 5/2023. Patients were categorized by use of VB or not (NVB). The primary outcome was CS (Cobb angle >10 degrees on imaging >10 months post-procedure). Secondary outcomes included surgical complications and functional outcomes.</p><p><strong>Results: </strong>We identified 58 reconstructions (29 VB; 29 NVB). Median follow-up (months) for VB was 25.9 (interquartile range=34.6) and NVB was 16.1 (interquartile range=114.9). For VB, fibula (41.4%) and tibia (37.9%) flaps were most common, including 15 pedicled and 14 free filet flaps. Median time to full union in months was 8.8 (range=3.4-11). CS was diagnosed in 22.2% and 78.6% of VB and NVB patients, respectively (p=0.004). Median Cobb angle for VB was 8 degrees (range=2-21) and 15.1 degrees (range=3-30) for NVB (p=0.02). The overall complication rate was not different between the two groups. Similar proportions of VB and NVB patients tolerated prostheses (34.5% vs. 32.1%) and were reliant on a wheelchair (65.5% vs. 60.7%), respectively.</p><p><strong>Conclusion: </strong>Pelvic ring reconstruction with VB after EH appears to reduce the incidence and severity of CS, without increasing complication rates.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258643","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":"Evaluation of velopharyngeal morphology and surgical recovery in cleft palate patients with different types of velopharyngeal functions.","authors":"Che Wang, Min Wu, Jinbo Zhou, Heng Yin, Hongying Hu, Bing Shi, Qian Zheng, David Low, Meng You, Chenghao Li","doi":"10.1097/PRS.0000000000012244","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012244","url":null,"abstract":"<p><strong>Background: </strong>To investigate key factors related to the velopharyngeal insufficiency (VPI) by evaluating velopharyngeal morphology, soft palate mobility and surgical recovery in cleft palate patients with different types of velopharyngeal function.</p><p><strong>Methods: </strong>CT data was used to compare morphology in 49 postoperative velopharyngeal competence (VPC), 39 VPI, and 49 non-cleft individuals. Ultrasound assessed surgical recovery in 87 VPC, 77 VPI, and 75 non-cleft individuals. Soft palate mobility was evaluated in 20 VPC and 17 VPI patients through cephalometric X-rays.</p><p><strong>Results: </strong>In terms of velopharyngeal morphology, both VPC and VPI groups exhibited shorter velar and hard palate ratios, longer pharyngeal ratio, and lower VP ratio compared to the non-cleft group (p < 0.05), but there were no significant differences between VPC and VPI (p > 0.05). Both groups exhibited significantly lower echo intensity (EI), higher intensity dispersion index (IDI) and lower logarithm unit color velocity (LUCV) values compared to the non-cleft group (p < 0.05). However, the differences in EI, IDI and LUCV between the VPC and VPI groups were not statistically significant (p > 0.05). In contrast, VPC group showed significantly better soft palate mobility compared to VPI, with greater elevation angle (p = 0.042) and higher closure rate (p = 0.001) during speech.</p><p><strong>Conclusion: </strong>The VPC group showed significantly improved soft palate mobility compared to the VPI group; however it was interesting to note the lack of significant differences in velopharyngeal morphology and surgical recovery in postoperative cleft palate patients with VPC and VPI.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266954","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":"Evaluating the Detection Accuracy of AI-Generated Content in Plastic Surgery: A Comparative Study of Medical Professionals and AI Tools.","authors":"Keenan S Fine, Emily E Zona, Aidan W O'Shea, Ellen C Shaffrey, Pradeep K Attaluri, Peter J Wirth, Aaron M Dingle, Samuel Poore","doi":"10.1097/PRS.0000000000012242","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012242","url":null,"abstract":"<p><strong>Background: </strong>The growing use of artificial intelligence (AI) in academic writing raises concerns about the integrity of scientific manuscripts and the ability to accurately distinguish human-written from AI-generated content. This study evaluates the ability of medical professionals and AI-detection tools to identify AI involvement in plastic surgery manuscripts.</p><p><strong>Methods: </strong>Eight manuscript passages across four topics were assessed, with four on plastic surgery. Passages were human-written, human-written with AI edits, or fully AI-generated. Twenty-four raters, including medical students, residents, and attendings, classified the passages by origin. Interrater reliability was measured using Fleiss' kappa. Human-written and AI-generated manuscripts were analyzed using three different online AI detection tools. A receiver operator curve (ROC) analysis was conducted to assess their accuracy in detecting AI-generated content. Intraclass correlation coefficients (ICC) were calculated to assess the agreement among the detection tools; these tools identify AI-generated content within the passages in terms of percentage generated by AI.</p><p><strong>Results: </strong>Raters correctly identified the origin of passages 26.5% of the time. For AI-generated passages, accuracy was 34.4%, and for human-written passages, 14.5% (p=0.012). Interrater reliability was poor (kappa=0.078). AI detection tools showed strong discriminatory power (AUC=0.962), but false-positives were frequent at optimal cutoffs (25%-50%). The intraclass correlation coefficient (ICC) between tools was low (-0.118).</p><p><strong>Conclusions: </strong>Medical professionals and AI detection tools struggle to reliably identify AI-generated content. While AI tools demonstrated high discriminatory power, they often misclassified human-written passages. These findings highlight the need for improved methods to protect the integrity of scientific writing and prevent false plagiarism claims.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258640","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 dual-plane diced cartilage concept for nasal augmentation in ethnic rhinoplasty.","authors":"Bora Ok, Alpay Duran","doi":"10.1097/PRS.0000000000012249","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012249","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to discuss and evaluate the results of a technique known as the dual-plane diced cartilage graft concept designed to improve dorsal nasal and radix augmentation in ethnic rhinoplasty cases. This involves the insertion of diced cartilage in both the sub-superficial musculoaponeurotic system and the subperiosteum.</p><p><strong>Materials and method: </strong>A total of 54 patients underwent surgery between May 2021 and May 2023 were included in the study. These cases were all primary rhinoplasties, and both endonasal (n = 33) and open (n = 21) rhinoplasty techniques were used. The preferred graft was cartilage, specifically costal cartilage. Rectus fascia was used to wrap the diced cartilage grafts. Patients were monitored for possible complications at 1, 3, 6, and 12 months. The results were documented using photographs and evaluated by two blinded plastic surgeons.</p><p><strong>Result: </strong>All patients were followed-up for an average period of 17.3 months. At the one-year evaluation conducted by the surgeons, one case was deemed unsatisfactory, one was an average, two were satisfactory, 24 were very satisfactory, and 26 were outstanding. Notably, no complications, such as graft resorption, infection, or skin circulation issues on the nasal dorsum, were observed in any of the cases.</p><p><strong>Conclusion: </strong>In the current study, it is proposed that the dual-plan diced cartilage graft technique can be used to alleviate junctional irregularities, achieve a more uniform dorsal aesthetic contour, and enhance both augmentation outcomes and graft viability by enlarging the interfacing tissue area.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, IV.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267028","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":"Septorhinoplasty Using Septal L-Strut Extension Graft: A Long-Term Multi-Dimensional Analysis.","authors":"Kyung-Chul Moon, Yu-Kyeong Yun, Eun-Sang Dhong, Seong-Ho Jeong, Sik Namgoong, Seung-Kyu Han","doi":"10.1097/PRS.0000000000012248","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012248","url":null,"abstract":"<p><strong>Background: </strong>Nasal dorsal augmentation using an alloplastic implant and tip projection using a septal cartilage are generally used in Asian rhinoplasty. Excessive submucosal resection weakens septal support, causing problems by a heavy alloplastic implant on the nasal dorsum. If the anterior projection of the cartilaginous dorsum can be solved by cartilage grafts, the amount of dorsal onlaying can be reduced. The purpose of this study was to demonstrate the long-term stability of septal L-strut extension grafts (SLEGs) used for advancement of the lower two-thirds of the cartilaginous nasal dorsum and tip projection.</p><p><strong>Methods: </strong>Between August 2012 and December 2022, a total of 407 patients underwent septorhinoplasty using SLEGs. Patient outcomes were assessed by evaluating satisfaction, hardness of the nasal tip, functional nasal obstruction symptom evaluation scores, and pain scores. Anthropometric analyses were carried out with two- and three-dimensional patient photographs. For the control arm, we also performed anthropometric analyses in patients who underwent nasal tip projection using other grafting techniques along with autologous dorsal onlay grafting to compare the effect of the SLEG.</p><p><strong>Results: </strong>Anthropometric analyses demonstrated that advancement of the lower two-thirds of the nasal dorsum and tip projection were achieved and maintained for a long-term in the SLEG group. In the control group, tip projection were achieved immediately but decreased over time compared to the SLEG group.</p><p><strong>Conclusions: </strong>The present study demonstrated that the SLEG might be an effective technique to achieve a septum-dependent lower two-thirds of the nasal dorsum advancement and tip projection for a long-term.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266955","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":"Staged Delay Procedure in Deep Inferior Epigastric Artery Perforator Flap Breast Reconstruction in Patients with a History of Liposuction.","authors":"Morvarid Mehdizadeh, Justin J Cordero, Leela S Mundra, Ryan P Cauley, Dhruv Singhal, Bernard T Lee, Samuel J Lin","doi":"10.1097/PRS.0000000000012245","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012245","url":null,"abstract":"<p><strong>Summary: </strong>While Deep Inferior Epigastric Artery Perforator (DIEP) flaps are a common option for breast reconstruction, there is limited data on outcomes in patients with a history of abdominal liposuction. Liposuction is one of the most popular aesthetic procedures performed around the world, with over 347,000 procedures performed in the United States in 2023. As the prevalence of both breast cancer and liposuction rises, plastic surgeons increasingly encounter patients interested in autologous breast reconstruction with prior liposuction history. However, the viability of the donor DIEP flap site being potentially compromised by scarring, prior perforator injury, vessel patency issues, and the extent of prior abdominal procedures places patients who have undergone abdominal liposuction at an increased risk of complications due to damaged perforating vessels. A staged delay procedure for DIEP flaps, performed prior to the DIEP flap procedure, may enhance blood flow and vessel caliber through augmentation of choke vessels, offering a potential solution for patients with previous liposuction. In this case series, we present four patients previously deemed unsuitable from outside hospitals for DIEP flap reconstruction due to history of prior liposuction with the majority who successfully underwent autologous breast reconstruction using a staged delay procedure and DIEP flaps. Preoperative imaging with CTA and intraoperative imaging with ICG fluorescence angiography were used. This case series illustrates that staging a delay procedure prior to free flap breast reconstruction can be safely and effectively performed in this patient group, expanding reconstructive possibilities for this growing patient population.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267027","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":"Jonas A Nelson, Perri S Vingan, Francis D Graziano, Max Mandelbaum, Danielle Rochlin, Lillian A Boe, Julia Gutierrez, Evan Matros, Babak J Mehrara, Michelle R Coriddi","doi":"10.1097/PRS.0000000000011809","DOIUrl":"10.1097/PRS.0000000000011809","url":null,"abstract":"<p><strong>Background: </strong>Tissue expander (TE) infection is a critical postoperative complication in 2-stage implant-based breast reconstruction (IBBR). The authors assessed risk factors associated with TE infection and reconstructive loss and examined reconstructive salvage rates.</p><p><strong>Methods: </strong>The authors retrospectively reviewed patients who underwent IBBR with TE placement from 2017 to 2022. Included were patients with TE infection treated with admission and intravenous antibiotics, interventional radiology (IR) drainage, and/or operative management (washout with or without TE removal and TE replacement, TE removal and replacement with implant, and/or TE removal without replacement). Reconstructive success was defined as maintenance of breast reconstruction for 1 year after TE placement.</p><p><strong>Results: </strong>Of 4498 patients who underwent IBBR, 305 (338 TEs) met the inclusion criteria. Cox modeling showed that higher body mass index, hypertension, radiation therapy, bilateral TEs, acellular dermal matrix use, increasing mastectomy weight, and nipple-sparing mastectomy were associated with increased hazard of TE infection. Patients with TE infection had a 54% reconstructive failure rate within 1 year; Cox modeling showed that Black race and Gram-negative cultures were associated with increased hazard of reconstructive failure within 1 year. Patients who underwent TE replacement with an implant had the most favorable success rate following infection.</p><p><strong>Conclusions: </strong>Overall, 46% of patients admitted with a periprosthetic infection had successful salvage. Patients with TE infection should be started on intravenous antibiotics with a low threshold for operative intervention based on examination and culture data. Although IR can guide operative intervention of periprosthetic infections, our practice has shifted away from IR drainage toward definitive operative management.</p><p><strong>Clinical question/level of evidence: </strong>Risk, III.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"961e-973e"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505909","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: Long-Term Volume Retention of Breast Augmentation with Fat Grafting Depends on Weight Changes: A 3-Year Prospective Magnetic Resonance Imaging Study.","authors":"Nishant Ganesh Kumar, Sam S Jejurikar","doi":"10.1097/PRS.0000000000011913","DOIUrl":"https://doi.org/10.1097/PRS.0000000000011913","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 6","pages":"955-956"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161321","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: Radical Overlapping Intravelar Veloplasty during Primary Cleft Palate Repair Results in Decreased Secondary Speech Surgery.","authors":"Carolyn R Rogers-Vizena, Alexander C Allori","doi":"10.1097/PRS.0000000000011756","DOIUrl":"https://doi.org/10.1097/PRS.0000000000011756","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 6","pages":"1009-1010"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161332","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: Skin Graftless Dorsal Metacarpal Island VY Advancement Flap versus Dorsal Rectangular Flap with Skin Grafting in 213 Simple Syndactyly Releases.","authors":"Pradeep K Attaluri, Peter J Nicksic, Brett F Michelotti, Michael L Bentz","doi":"10.1097/PRS.0000000000011998","DOIUrl":"https://doi.org/10.1097/PRS.0000000000011998","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"155 6","pages":"982-983"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161335","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}