Plastic and reconstructive surgery最新文献

{"title":"Three-Dimensional Facial Morphology in Patients with Craniofacial Microsomia and Microtia.","authors":"Elsa M Ronde Md, Guido A de Jong PhD, Jitske W Nolte Md Dmd PhD, Marloes E L Nienhuijs Md Dmd PhD, Neil W Bulstrode Frcs Plast, Thomas J J Maal PhD, Alfred G Becking Md Dmd PhD, Corstiaan C Breugem Md PhD","doi":"10.1097/PRS.0000000000011831","DOIUrl":"10.1097/PRS.0000000000011831","url":null,"abstract":"<p><strong>Background: </strong>Craniofacial microsomia (CFM) is classified using the subjective orbit, mandible, ear, nerve, and soft tissue (OMENS) tool. Digital stereophotogrammetry (ie, 3-dimensional [3D] photography) can be used to capture facial shape objectively. This case-control study assessed the applicability of 3D photography in distinguishing between patients with CFM and individuals without a craniofacial condition, as well as classifying the severity of facial involvement.</p><p><strong>Methods: </strong>The 3D photographs of patients with CFM or microtia from Amsterdam UMC, Radboudumc, or Great Ormond Street Hospital, and of individuals without craniofacial conditions, were assessed. Differences between patients and controls were explored through asymmetry index (ASI) and facial signature (FS) scores, as well as principal components analysis of FS scores and logistic regression. Correlations between OMENS scores and ASI, FS, and principal components scores were evaluated.</p><p><strong>Results: </strong>A total of 179 patients and 210 controls were analyzed. ASI and FS scores differed significantly between patients and controls ( P < 0.001), and were correlated with several OMENS subscales. The logistic regression model distinguishing between patients and controls showed increasing asymmetry of the mandible and orbits with increasing Pruzansky-Kaban score. Patients with isolated microtia deviated from controls in the midface.</p><p><strong>Conclusion: </strong>Clinically significant differences in the facial morphology of patients with CFM and microtia were found compared with controls, suggesting that 3D photography can be used to assess the severity of facial involvement in a novel, objective, and safe way in these patients.</p><p><strong>Clinical question/level of evidence: </strong>Diagnostic, IV.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"304-315"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546781","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":"Effect of Age, Harvest Site, and Body Mass Index on the Cell Composition of the Stromal Vascular Fraction.","authors":"Zi-Han Yang, Tian-Yu Zhang, Fang-Zhou Chen, Yun Xie, Poh-Ching Tan, Qing-Feng Li, Shuang-Bai Zhou","doi":"10.1097/PRS.0000000000011970","DOIUrl":"10.1097/PRS.0000000000011970","url":null,"abstract":"<p><strong>Background: </strong>The stromal vascular fraction (SVF) of adipose tissue has now been widely used in plastic surgery operations, clinical trials, and therapies. However, the cell composition of SVF undergoes dynamic changes during aging and obesity, which may influence the efficacy of the SVF. This study analyzed the effects of age, harvest site, and body mass index on the cell composition of the SVF.</p><p><strong>Methods: </strong>A study was performed on 162 patients. The age ranged from 13 to 88 years old, with body mass index (BMI) less than 25 kg/m 2 or greater than or equal to 25 kg/m 2 . Fat tissue was harvested from the abdominal region, hips, thighs, or arms, and the SVF was isolated for flow cytometry.</p><p><strong>Results: </strong>The authors' results demonstrated that the declines of adipose-derived stem cells (ADSCs) and endothelial cells (ECs) first occurred in donors aged 40 to 49 years. Subsequently, the percentages of endothelial progenitor cells, preadipocytes, and M2 macrophages started to decrease in donors aged 50 to 69 years. Lower percentages of ECs and M2 macrophages were found in donors with a higher BMI.</p><p><strong>Conclusions: </strong>This study demonstrated that the percentages of ADSCs and ECs of SVF decreased significantly starting from donors older than 40 years, followed by changes in other cell subpopulations. Furthermore, donors with a BMI greater than or equal to 25 kg/m 2 had lower percentages of ECs and M2 macrophages.</p><p><strong>Clinical relevance statement: </strong>This study provides a more comprehensive understanding of the changes in adipose tissue composition during aging and obesity, which is important for the use of the SVF in clinical practice.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"253-262"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PRS Journal Club: Evolving Paradigms in Hand Surgery.","authors":"Ilana G Margulies, Amanda R Sergesketter, Christopher L Kalmar","doi":"10.1097/PRS.0000000000012167","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012167","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 2","pages":"347-348"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732770","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 Cost of Policy: Tariffs and Their Potential Ripple Effects in Plastic Surgery.","authors":"Francis D Graziano, Danielle H Rochlin, Babak J Mehrara, Jonas A Nelson","doi":"10.1097/PRS.0000000000012207","DOIUrl":"10.1097/PRS.0000000000012207","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"315e-316e"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049111","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":"Teaching a Surgeon to Think Like a Monk.","authors":"Kinan Sawar, Kevin C Chung","doi":"10.1097/PRS.0000000000012113","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012113","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 2","pages":"201-207"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732773","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 Versatility of the Supinator to Posterior Interosseus Nerve Transfer: Indications and Outcomes-A Case Series.","authors":"Samuel George, Chane Kulenkampff, Tahseen Chaudhry, Liron S Duraku, Dominic M Power","doi":"10.1097/PRS.0000000000011946","DOIUrl":"10.1097/PRS.0000000000011946","url":null,"abstract":"<p><strong>Background: </strong>Transfer of the supinator motor branches to the posterior interosseous nerve (SPIN) was first described as a reliable method of restoration of digit extension in cases of paralysis when there is retained function in the 5th and 6th cervical nerve roots with loss of function in the 8th cervical nerve root.</p><p><strong>Methods: </strong>The authors performed a retrospective review of all SPIN transfers that were performed in their unit over a 6-year period, which included 16 limbs of 14 patients. The median age was 49 years (range, 22 to 74 years). The average follow-up period was 15 months (range, 6 to 24 months). The pathogenesis included spinal cord injury (SCI) in 5, plexus root avulsion in 3, degenerate spondyloradiculopathy in 3, paralysis from oncologic resection in 1, inflammation in 1, and compressive neuropathy in 1.</p><p><strong>Results: </strong>Functional digit extension (Medical Research Council grade 3 or above) was achieved in 12 of 16 limbs. Patients with degenerative spinal lesions had the worst outcome, with a median of Medical Research Council grade 2, and a median time to surgery of 20 months (average age, 67 years), compared with 13 months in the SCI group (average age, 32.8 years) and 4 months in the brachial plexus injuries group (average age, 34.6 years).</p><p><strong>Conclusions: </strong>The SPIN transfer may be performed safely in a wide spectrum of pathologies, including brachial plexus injuries, SCIs, and neuritis. However, in degenerative spondyloradiculopathy, inferior outcomes were obtained, which may be due to late referral, chronic denervation, possible involvement of the donor nerve, an older age group, or potentially diminished rehabilitation and neural plasticity potential.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, IV.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"329-336"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907530","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":"Redefining the Incidence of Infantile Glenohumeral Dysplasia following Brachial Plexus Birth Injury.","authors":"Nathan Khabyeh-Hasbani, Victoria Robbins, Megan Gotlieb-Horowitz, Mandana Behbahani, Erin Meisel, Steven M Koehler","doi":"10.1097/PRS.0000000000012041","DOIUrl":"10.1097/PRS.0000000000012041","url":null,"abstract":"<p><strong>Background: </strong>Glenohumeral dysplasia (GHD) is a well-documented sequela following brachial plexus birth injury (BPBI). Despite its morbidity, the precise incidence of infantile GHD varies widely in the literature.</p><p><strong>Methods: </strong>This prospective cohort study included consecutive patients diagnosed with a nontransient BPBI between November of 2021 and November of 2023. Patients were enrolled into the study from a specialized, high-volume brachial plexus clinic. A diagnosis of GHD was made by an alpha angle measurement on ultrasonography greater than 30 degrees in the setting of abnormal shoulder function, as indicated by Active Movement Scale scores for shoulder abduction, shoulder flexion, and external rotation.</p><p><strong>Results: </strong>Forty-two infants with a diagnosis of nontransient BPBI were initially seen at a mean age of 1.6 months. During continuous follow-up, 50% of patients ( n = 21) were diagnosed with GHD with a mean alpha angle of 35 ± 8 degrees and at a mean age of 3.2 ± 1.4 months. At the time of diagnosis, infants had a median Active Movement Scale score of 4 (interquartile [IQR], 3 to 5) for shoulder abduction, 5 (IQR, 3 to 5) for shoulder flexion, and 4 (IQR, 2 to 5) for external rotation. The presence of upper extremity fracture was significant when comparing BPBI patients with GHD and those without, although the relative risk was not significant.</p><p><strong>Conclusions: </strong>This study demonstrates a high incidence of GHD in a prospective evaluation of infants with BPBI using serial ultrasonography. Those caring for patients with BPBI should be aware of such a common sequela and initiate early screening and management protocols to prevent and treat the deformity.</p><p><strong>Clinical question/level of evidence: </strong>Risk, III.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"225e-232e"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449759","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":"Benedetto Longo, Martina Giacalone, Gennaro D'Orsi, Alessio Farcomeni, Elettra Gagliano, Lisa Vannucchi, Gianluca Vanni, Claudio Oreste Buonomo, Valerio Cervelli","doi":"10.1097/PRS.0000000000011984","DOIUrl":"10.1097/PRS.0000000000011984","url":null,"abstract":"<p><strong>Background: </strong>Implant-based breast reconstruction (BR) is to date the most popular reconstructive modality. The aim of the study was to evaluate the immediate hybrid 1-stage BR technique, with a dual-plane approach, using prepectoral implants and retropectoral autologous fat transfer (AFT).</p><p><strong>Methods: </strong>The autthors prospectively enrolled patients scheduled for immediate BR using a hybrid approach, which included retropectoral AFT and prepectoral breast implants (group A). This cohort was compared with a retrospective control group of patients who underwent immediate direct-to-implant BR without AFT (group B). Complications, hospitalization days, number of AFT procedures for a complete BR, aesthetic outcomes, and patient satisfaction were analyzed. Fat suuvival rate was assessed through comparison of preoperative and 6-month postoperative MRI scans.</p><p><strong>Results: </strong>Thirty immediate BRs were included in each group. The average amount of AFT in the retropectoral plane was 106.30 cc (SD, 16.54), and the mean breast implant size was statistically higher in group B (P = 0.00026). MRI assessment confirmed an average of 47.90% (SD, 0.14%) retropectoral fat survival at 6 months postoperatively. No statistically significant differences in terms of complications and hospitalization days were observed (P > 0.05), whereas a significant difference was observed regarding additional AFT sessions (P = 0.00062). After a propensity score-weighted analysis, assessment by surgeons and patients showed a significantly higher overall satisfaction in the active group.</p><p><strong>Conclusion: </strong>The immediate hybrid approach for 1-stage BR enabled the use of smaller breast implants, allowed a decrease in AFT procedures with costs reduction, and yielded optimal breast shape and contour by reducing stepoff deformity and rippling alterations, without adding complications.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, III.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 2","pages":"209-222"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732766","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":"Superolateral Pedicle Breast Reduction for Patients with Medially Positioned Nipple-Areola Complexes.","authors":"Christian X Lava, Karen R Li, Nicole C Episalla, Isabel A Snee, Alice C Bell, Kenneth L Fan, Samer F Jabbour","doi":"10.1097/PRS.0000000000011979","DOIUrl":"10.1097/PRS.0000000000011979","url":null,"abstract":"<p><strong>Background: </strong>The superolateral pedicle (SLP) is commonly used in our practice in breast reductions (BR) where the nipple-areola complex is too medial, restricting pedicle movement and positioning. This study demonstrates the safety and efficacy of the SLP.</p><p><strong>Methods: </strong>A retrospective review of BR patients from September of 2022 to January of 2024 was conducted. Demographic data, comorbidities, operative details, and complications were collected.</p><p><strong>Results: </strong>A total of 164 breasts (84 patients) underwent BR: 135 (80.5%) used the superomedial pedicle (SMP) technique and 29 (17.7%) used the SLP technique. Median weight of breast tissue resected in SMP and SLP cohorts were 841.0 g (range, 178 to 9953 g) and 706.0 g (range, 186 to 1250 g), respectively (P = 0.126). In the SLP group, 4 (13.8%) breasts experienced at least 1 complication, including seroma requiring aspiration (n = 3 [10.3%]) and abscess formation requiring antibiotics (n = 2 [6.9%]). In the SMP group, 18 (13.3%) breasts experienced at least 1 complication, including hematoma (n = 7 [5.2%]), abscess formation (n = 4 [3.0%), seroma (n = 3 [2.2%]), dehiscence (n = 2 [1.5%]), partial nipple necrosis (n = 1 [0.7%]), and fat necrosis (n = 1 [0.7%]). There were 5 cases (3.0%) of reoperation, all in the SMP group. In a propensity score matching analysis, complication rates were comparable between the SLP (n = 30 breasts) and SMP (n = 23 breasts) groups (average treatment effects on the treated, 0.067; P = 0.713).</p><p><strong>Conclusions: </strong>The SLP technique for BR is safe and efficacious, showing complication rates comparable to the SMP technique, with no significant differences in resection weight. These findings support its viability as an alternative to traditional pedicle techniques in BR.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, III.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 2","pages":"174e-182e"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732772","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":"2024 ASPS Procedural Statistics Release.","authors":"","doi":"10.1097/01.prs.0001125128.08298.ca","DOIUrl":"https://doi.org/10.1097/01.prs.0001125128.08298.ca","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 2S","pages":"1-44"},"PeriodicalIF":3.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675459","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}