Plastic and reconstructive surgery最新文献

{"title":"Comparative Analysis of Surgical Outcomes in Syndromic Craniosynostosis: Insights from CHOP and CHLA.","authors":"Jinggang J Ng, Maura R Guyler, Idean Roohani, Benjamin B Massenburg, Daniel Y Cho, Meagan Wu, Jordan W Swanson, Scott P Bartlett, Mark M Urata, Jesse A Taylor","doi":"10.1097/PRS.0000000000013527","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013527","url":null,"abstract":"<p><strong>Background: </strong>This study compares syndromic craniosynostosis treatment approaches of the Children's Hospital of Philadelphia (CHOP) and Children's Hospital Los Angeles (CHLA).</p><p><strong>Methods: </strong>A retrospective review was performed of patients with Apert, Crouzon, Pfeiffer, Muenke, or Saethre-Chotzen syndromes treated at CHOP or CHLA. Inclusion required treatment according to each institution's respective management algorithms. Primary outcomes were type, timing, and number of craniofacial surgeries.</p><p><strong>Results: </strong>Sixty-one patients were included. All CHOP patients underwent posterior vault distraction osteogenesis (PVDO) at age 10.2±7.5 months. In the CHLA cohort, 11 (36.7%) underwent early PVDO at 3.9±0.9 months of age, and all underwent fronto-orbital advancement (FOA) at age 9.6±3.3 months. For patients ≥10 years (n=28), the number of major craniofacial procedures in the first 10 years of life was greater in the CHOP cohort (2.3±0.6 vs. 1.8±0.6, p=.023), but the number of frontofacial procedures was fewer (1.2±0.7 vs. 1.7±0.5, p=.044) in comparison to the CHLA cohort. Among those with Apert, Crouzon, and Pfeiffer syndromes, CHOP patients were more likely to undergo midface surgery at a younger age (6.0±1.2 years vs. 7.5±1.5 years, p=.003) via a transcranial approach (61.9% vs. 20.8%, p=.005). Midface distractions were performed using external devices at CHOP and internal at CHLA.</p><p><strong>Conclusions: </strong>CHOP patients underwent more major craniofacial procedures but fewer frontofacial interventions compared with CHLA patients. CHOP patients with Apert, Crouzon, or Pfeiffer syndromes were more likely to undergo an earlier midface procedure via a transcranial approach. Further investigation is necessary to evaluate the impact of each protocol on outcomes.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183823","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 Facial Size: Frame-Based Photogrammetric Analysis of Hairline Correction as Non-Skeletal Upper Facial Contouring.","authors":"Jae Hyun Park","doi":"10.1097/PRS.0000000000013532","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013532","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183832","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 Impact of Tumescent Local Anesthesia on Opioid Use in DIEP Flap Breast Reconstruction.","authors":"Maria J Escobar-Domingo, Amir-Ala Mahmoud, Valeria P Bustos, John B Park, Daniela Lee, Benjamin Rahmani, Charlotte Thomas, Reinnard Knerr, Manuela Neira, Helen Xun, Sarah J Karinja, Samuel J Lin, Bernard T Lee","doi":"10.1097/PRS.0000000000013529","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013529","url":null,"abstract":"<p><strong>Background: </strong>The opioid epidemic, which cost over $1.02 trillion in 2017, continues to be a major public health concern. To improve postoperative pain control and reduce opioid misuse, our team implemented tumescent local anesthesia with bupivacaine (TLA) in DIEP flap breast reconstructions at both breast and abdominal donor sites.</p><p><strong>Methods: </strong>We conducted a retrospective study of DIEP flap reconstructions from 2019-2023, comparing patients who received TLA (tumescent fluid with bupivacaine as TAP, intercostal, and local blocks) to those who received the standard TAP block alone. Unpaired t-tests and Fisher's Exact tests assessed group differences; multivariable regression models evaluated postoperative complications.</p><p><strong>Results: </strong>A total of 481 patients were included: 271 (56.3%) in the TLA group and 210 (43.7%) in the control group. Patients receiving TLA were younger (50.3 vs. 53.7 years; p=0.025), while hormonal therapy (43.8% vs. 34.7%; p=0.047) and prior radiation (52.9% vs. 39.1%; p=0.003) were more common in controls. TLA patients had lower breast hematoma rates (2.2% vs. 6.2%; p=0.033). Linear regression showed reduced inpatient opioid use (29.4 MME lower; 95% CI: -45.29 to -13.45; p<0.001), discharge opioid prescriptions (36.1 MME lower; 95% CI: -58.27 to -13.98; p=0.001), and shorter hospital stays (3.4 vs. 3.9 days; p<0.001).</p><p><strong>Conclusions: </strong>TLA significantly reduces inpatient and discharge opioid use and hospital stay length without compromising pain control. Further study is needed to evaluate long-term opioid use and refill rates post-discharge.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183844","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":"Career Barriers, Awards, and Advancement Priorities Among Female Members of the American Association of Plastic Surgeons.","authors":"Malia Voytik, Margaret M Hornick, Robyn B Broach, Andrea L Pusic, Ivona Percec","doi":"10.1097/PRS.0000000000013526","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013526","url":null,"abstract":"<p><strong>Introduction: </strong>Barriers to professional development among female plastic surgeons are well documented. This study surveyed women members of the American Association of Plastic Surgeons to characterize career stage specific barriers, professional supports, and perceptions of awards and honors.</p><p><strong>Methods: </strong>Female members of the AAPS completed an anonymous 48-item survey administered through Qualtrics from March to April 2025. The survey assessed career characteristics, barriers to career growth, professional supports, award preferences, and barriers to award acceptance. Responses were analyzed descriptively and stratified by current years in practice.</p><p><strong>Results: </strong>Of 113 invited surgeons, 65 (57.5%) responded. The mean participant age was 55.0 years, with 21.7 years in practice. Most respondents (78.5%) worked in academic settings. Barriers differed by career stage. Respondents reflecting on earlier stages of practice frequently cited lack of mentorship, personal and family responsibilities, and limited research funding, whereas respondents later in practice more often reported adversarial colleagues, relative value unit targets, and operating room availability. Desired supports also varied, with leadership training, research support, schedule flexibility, and childcare support emphasized earlier in practice, and board or committee appointments, clinical support, and flexible travel opportunities emphasized later in practice. Across stages, travel burden, perceptions of being too junior, competing responsibilities, and burnout limited award participation.</p><p><strong>Conclusion: </strong>Barriers to advancement differ across career stages, emphasizing the need for tailored support strategies. Practical supports are needed in early career stages, whereas sponsorship becomes increasingly important in later stages. Sponsorship and more accessible, inclusive award structures are key areas for intervention.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183865","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":"Efficacy, Efficiency, and Safety of a Poly-L-lactic Acid Cuff Tube Assisting for Microvascular Anastomosis.","authors":"Yucheng Qiu, Hui Su, Jing Luo, Yue Zhang, Jun Yang, Xianyu Zhou, Yumei Zhang","doi":"10.1097/PRS.0000000000013523","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013523","url":null,"abstract":"<p><strong>Background: </strong>Vascular anastomosis is a cornerstone of microsurgery. Anastomosis time and vessel patency significantly influence surgical success. The disadvantages of the traditional hand-sewn method requires a high technical threshold, prolonged surgical time, and an increased risk of vessel occlusion or leakage. Consequently, developing a reliable device to facilitate vascular anastomosis is essential in microsurgery.</p><p><strong>Methods: </strong>In this study, a poly-L-lactic acid (PLLA) cuff tube with favorable mechanical and biological properties was employed for anastomosis using a nonsuture cuff technique. Its biocompatibility was comprehensively evaluated in vitro. Its surgical feasibility was validated in vivo using a rat syngeneic orthotopic hindlimb transplantation model. Vessel patency and anastomotic time were documented, and histopathological analysis was performed.</p><p><strong>Results: </strong>Both L929 cells viability assay and mammalian chromosomal aberration test showed that the PLLA cuff tubes were noncytotoxic. The mean time of anastomosing a single vessel was 18.9 min using the cuff tube compared with 28.8 min using the hand-sewn method. All vessels remained patent in the cuff technique group, while 3 cases of total occlusion occurred in the hand-sewn group. Histopathological analysis revealed no obvious signs of inflammation or immune response associated with PLLA cuff tube implantation.</p><p><strong>Conclusions: </strong>PLLA cuff tube is a safe and effective alternative to traditional hand-sewn method, with strong potential for clinical application in microvascular anastomosis.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168500","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":"Phantom References: Fabricated Citations in Plastic Surgery Literature.","authors":"Kian Daneshi, Judy Elfakharany, Luke Geoghegan, Shehan Hettiaratchy","doi":"10.1097/PRS.0000000000013524","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013524","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169931","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 Limits: A Clinical Trial on the Safety of Combining Liposuction with Undermining During Abdominoplasty.","authors":"Hisham M El Minawi, Hamed M Kadry, Youssef R Rizkalla, Armin Edalatpour, Ellen C Via, Peter Wirth, Mohammed A Hussein, Ahmed M Afifi","doi":"10.1097/PRS.0000000000013489","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013489","url":null,"abstract":"<p><strong>Objectives: </strong>In spite of the popularity of liposuction with abdominoplasty, there is little objective evidence to the extent of liposuction and width of undermining that is safe. This study aims to objectively evaluate the safety and aesthetic outcomes of liposuction and extensive undermining, alone or combined, in abdominoplasty.</p><p><strong>Methods: </strong>Patients were randomly assigned to one of three groups: (A) Lipoabdominoplasty (limited undermining and liposuction of the abdominal flap), (B) Traditional Abdominoplasty (wide undermining and no liposuction of the abdominal flap), and (C) a Combined Technique (wide undermining and liposuction of the abdominal flap). The parameters assessed included epigastric pinch thickness, horizontal laxity, operative time, aesthetic outcomes, and the complication rates.</p><p><strong>Results: </strong>There were no statistically significant differences in complication rates when comparing individual groups, liposuction versus no liposuction groups, or limited versus wide undermining. Liposuction, with or without wide undermining, was more effective in reducing epigastric pinch thickness and enhancing aesthetic outcomes. Additionally, the extent of surgical undermining did not significantly influence flap thickness, horizontal skin laxity, or overall aesthetic results. Group C exhibited the longest operative time, likely due to the combined demands of extensive dissection, sub-Scarpa's fat removal, and liposuction.</p><p><strong>Conclusions: </strong>Combining wide undermining with liposuction in abdominoplasty is safe. However, liposuction plays a more critical role than undermining in improving aesthetic results and reducing flap thickness and should therefore be prioritized. While wide undermining is safe, it should be employed selectively based on individual patient criteria and surgical goals. Abdominoplasty techniques should be customized to align with the unique anatomical features and expectations of each patient.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168909","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":"Opinion: On the Rise of AI-Generated Medical Illustration.","authors":"James A Mentz, Christopher Williams, Imran Rizvi, Matthew Greives","doi":"10.1097/PRS.0000000000013521","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013521","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164784","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":"Reducing flap ischemia time in robotic-assisted DIEP harvest by maintaining flap perfusion during peritoneal closure and robot undocking.","authors":"Ayla A Hohenstein, Julia Thomé, Cam Tu Nguyen, Nikolaos Liakos, Christian Gratzke, Ingolf Juhasz-Böss, Mark Fricke, Steffen U Eisenhardt, Daniel Kraus","doi":"10.1097/PRS.0000000000013490","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013490","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166690","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":"Impact of Prior Implant-Based Reconstruction and Radiotherapy on Microvascular Outcome in Deep Inferior Epigastric Perforator Flap Breast Reconstruction.","authors":"Yihang Liu, Stina Rittri, Anna L V Johansson, Åsa Edsander Nord, Helena Sackey, Jana de Boniface, Martin Halle","doi":"10.1097/PRS.0000000000013522","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013522","url":null,"abstract":"<p><strong>Background: </strong>Delayed deep inferior epigastric perforator (DIEP) flap breast reconstruction can be performed after either mastectomy alone or implant-based reconstruction (IBR). Fibrosis and capsular contracture after IBR are more pronounced in patients exposed to radiotherapy (RT). We evaluated whether a previous IBR increases microvascular complication rates in delayed DIEP reconstruction in patients exposed to RT.</p><p><strong>Methods: </strong>All patients undergoing delayed DIEP reconstruction for breast cancer at a tertiary referral hospital (2005-2022) were included. Patients were categorized by history of IBR and RT. Primary outcomes were 1) perioperative microvascular re-anastomosis and 2) flap necrosis within 30 days. Logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CI) adjusted for age, body mass index, and smoking.</p><p><strong>Results: </strong>In total, 516 women underwent 577 DIEP reconstructions; 213 (36.9%) had a previous IBR, 441 (77.3%) had received RT, and 170 (38.5%) had both IBR and RT. Perioperative re-anastomosis was more frequent after a previous IBR than after mastectomy alone among irradiated patients (14.7% vs. 7.4%, p=0.013). Rates of flap necrosis (partial or total) did not differ across the groups. Among irradiated patients, IBR was associated with an almost twofold increased risk of re-anastomosis compared with patients without prior IBR (OR 1.98, 95% CI 1.04-3.76). In contrast, previous IBR was not associated with flap necrosis (OR 2.17, 95% CI 0.84-5.62). Vein coupler size was smaller in irradiated than non-irradiated patients (2.03± 1.03 vs. 2.32 ± 0.89 mm, p<0.001).</p><p><strong>Conclusions: </strong>Among irradiated patients, previous IBR was associated with an increased frequency of perioperative arterial re-anastomosis but not flap loss. DIEP reconstruction remains safe in this setting, though surgeons should anticipate increased perioperative complexity.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167461","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}