Plastic and reconstructive surgery最新文献

{"title":"Assessment of Minimally Invasive Surgical Techniques for Sagittal Craniosynostosis: A Multicenter Time Series Study.","authors":"Kayla Prezelski, Mario S Blondin Fernandez, Karen Matsumoto, Lisa R David, Christopher M Runyan, Kamlesh B Patel, Alex A Kane, Rami R Hallac","doi":"10.1097/PRS.0000000000011685","DOIUrl":"10.1097/PRS.0000000000011685","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive strip craniectomy is a well-established treatment for sagittal craniosynostosis; however, the temporality of change in head shape has not been assessed. In this study, the authors performed head shape analysis to compare time-series-based clinical outcomes among 3 different surgical techniques across 3 academic centers for the treatment of sagittal craniosynostosis.</p><p><strong>Methods: </strong>Retrospective, longitudinal 3-dimensional (3D) images were collected from patients who underwent surgery for the correction of sagittal craniosynostosis for up to 5 years postoperation. The surgical methods studied include spring-assisted craniectomy, narrow-strip craniectomy plus orthotic helmet therapy, and wide-strip craniectomy with biparietal and bitemporal barrel stave wedge osteotomies plus orthotic helmet therapy. Postoperative 3D images were binned into 6 age groups. Cranial index measurements were calculated on 3D images. The 3D whole-head composite images were generated for each procedure to visually represent longitudinal outcomes.</p><p><strong>Results: </strong>The median (interquartile range) cranial index measurements at 3- to 5-years postoperative follow-up were 75.9 (73.1 to 78.6) for spring-assisted, 75.9 (75.4 to 78.5) for narrow-strip, and 79.4 (76.4 to 81.9) for wide-strip procedures. The wide-strip cranial index was significantly different from the spring-assisted and narrow-strip groups ( P < 0.001). Concerning 3D analysis, patients receiving spring-assisted procedures showed normalization of frontal bossing and skull height compared with age-matched controls, whereas patients receiving wide-strip procedures showed greater correction of occipital bulleting. Patients receiving narrow-strip procedures had intermediate results between these outcomes.</p><p><strong>Conclusions: </strong>There was no statistically significant regression in longitudinal cranial index measurements across the 3 techniques aimed at treating sagittal craniosynostosis. Longitudinal comparison of 3D head shape outcome demonstrated satisfactory correction of scaphocephalic deformity across all 3 surgical groups.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, III.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"684-692"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110862","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":"Mesenchymal stem cell therapy does not enhance fat graft retention: Cryopreserved and cultured syngeneic and allogeneic MSCs in a rat model.","authors":"Toke Alstrup, Jonas Oute Pedersen, Emma Mader Kjær, Kristine Juul Poulsen, Stig Steinfurth, Michael Pedersen, Bjarne Kuno Møller, Tine Engberg Damsgaard, Marco Eijken","doi":"10.1097/PRS.0000000000012121","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012121","url":null,"abstract":"<p><strong>Background: </strong>Fat grafting is a gentle technique used to correct soft tissue defects but is challenged by low graft survival rates. To enhance retention, mesenchymal stromal cells (MSCs), have been explored. Autologous MSC-therapy have shown promise but come with logistical and cost challenges. Contrary, allogeneic MSC-therapy offer a more feasible solution, with preclinical studies suggesting improved fat graft retention from allogenic MSC-therapy. This study aimed to expand the preclinical research by investigating the use of cryopreserved allogeneic MSC.</p><p><strong>Methods: </strong>Using an immunocompetent rat model for autologous fat grafting, the effect of allogeneic MSCs on 3-month fat graft retention was investigated. In a series of experiments the effect of dosing (0.2 x106 - 25 x106 MSC/mL), allogenicity (allogeneic and syngeneic), and cryopreservation was assessed.</p><p><strong>Results: </strong>Our findings did not indicate any beneficial effect from cryopreserved allogeneic MSC-therapy for fat grafting across the tested concentrations. In fact, increasing the dosage resulted in lower fat graft retention, reduced expression of adipose markers and increased fibrosis. Administration of cryopreserved syngeneic MSCs had no beneficial effect on long term fat graft retention either. Substituting cryopreserved MSCs with freshly harvested MSCs also did not enhance fat graft retention.</p><p><strong>Conclusions: </strong>Unlike previous preclinical studies, our experiments did not reveal a beneficial effect of supplementing fat grafts with MSCs. Given the limited success in translating MSC assisted fat grafting to clinical settings, our study underscores the importance of further investigations to evaluate the efficacy of MSC therapy in enhancing fat graft retention.Clinical Relevance Statement: Our study found no benefit of cryopreserved or freshly cultured allogeneic or syngeneic MSC therapy in improving fat graft retention, challenging the clinical relevance of MSC supplementation for fat grafting and suggesting further research is needed before clinical application.</p><p><strong>Clinical relevance statement: </strong>Our study found no benefit of cryopreserved or freshly cultured allogeneic or syngeneic MSC therapy in improving fat graft retention, challenging the clinical relevance of MSC supplementation for fat grafting and suggesting further research is needed before clinical application.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773066","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":"AI Risk Prediction Tools for Alloplastic Breast Reconstruction.","authors":"Jonlin Chen, Ariel Gabay, Minji Kim, Uchechukwu Amakiri, Lillian A Boe, Carrie Stern, Babak J Mehrara, Chris Gibbons, Jonas A Nelson","doi":"10.1097/PRS.0000000000012124","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012124","url":null,"abstract":"<p><strong>Introduction: </strong>Accurate risk prediction for patients undergoing breast reconstruction with tissue expanders (TEs) can improve patient counseling and shared decision-making. This study aimed to develop and evaluate traditional statistical and machine learning (ML) approaches to predicting complications in alloplastic breast reconstruction.</p><p><strong>Methods: </strong>Patient characteristics, surgical techniques, and complications were collected for all women undergoing immediate TE placement from 2017-2023 at Memorial Sloan Kettering Cancer Center. Multivariable logistic regression and ML models were developed to predict TE loss, infection, and seroma. ML model performance was optimized using ten-fold cross validation with hyperparameter tuning. Evaluation metrics included area under the receiver operating curve (AUC), sensitivity, specificity, and Brier score.</p><p><strong>Results: </strong>This study included 4,046 women undergoing 6,513 immediate TE placements. TE loss occurred in 7.6% of patients (4.8% of TEs), infection in 10% of patients (7.2% of TEs), and seroma in 11.5% of patients (6.2% of TEs). Traditional multivariable regression demonstrated AUCs of 0.63-0.69 and ML models demonstrated AUCs of 0.71-0.73 in predicting TE complications. SHAP analysis highlighted BMI, prepectoral placement, and chemotherapy as key predictors of TE complications. Top-performing models were built into nomograms and a web-based prediction application to provide real-time risk estimates based on patient-specific information.</p><p><strong>Conclusion: </strong>Accurate risk prediction tools using nomograms and ML models were developed to predict complications in alloplastic breast reconstruction. These findings support incorporating both traditional statistics and machine learning analyses into preoperative assessments of patients undergoing alloplastic breast reconstruction to enhance data-driven, personalized care.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773058","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":"Long-Term LIMB-Q Scores Following Severe Lower Extremity Traumatic Injuries.","authors":"Sabrina M Wang, Natasha S McKibben, Melanie Major, Matthew J Heron, Moreen W Njoroge, Tim de Jong, Nathan N O'Hara, Scott T Hollenbeck, Mark J Gage, Lily R Mundy","doi":"10.1097/PRS.0000000000012123","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012123","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic lower extremity injuries can have devastating, long-lasting impacts on patients' lives. However, it is not well understood how patient-reported outcomes (PROs) evolve following such injuries. We aimed to measure LIMB-Q scores in patients following severe lower extremity traumatic injuries to determine temporal trends in PROs.</p><p><strong>Methods: </strong>We performed a cross-sectional study of lower extremity trauma patients with injuries distal to the mid-femur who required fracture management, limb salvage, and/or amputation. We collected self-reported clinical and demographic data. We also collected PRO data using the LIMB-Q, a PRO measure specific to lower extremity trauma patients. Primary outcomes were LIMB-Q Function, Symptoms, Life Impact, Psychological, Sex Life, Work, and Decision Satisfaction scales. We conducted linear regressions to evaluate associations between time from injury and LIMB-Q scores.</p><p><strong>Results: </strong>We analyzed responses from 706 patients with a mean time from injury of 6.7 years (SD 9.1). The mean time from injury was 7.6 years in the limb-salvage group, 9.7 years in the amputation group, and 4.7 years in the fracture-management-only group. After controlling for patient and clinical characteristics, time from injury was associated with steady reductions in decision satisfaction among patients who had undergone limb salvage (p<0.001; 95% [-0.95,-0.38]). There was no significant association between time from injury and Decision Satisfaction score among patients who had undergone amputation.</p><p><strong>Conclusion: </strong>This study of PROs in patients following severe lower extremity traumatic injuries provides data to contextualize and interpret LIMB-Q scores in future research.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773065","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 Medial Paramuscular Approach to DIEP flap Pedicle Dissection: Incorporating Rectus Diastasis Repair into Routine Donor Site Closure\".","authors":"Susan A Hendrickson, Joseph R Dusseldorp","doi":"10.1097/PRS.0000000000012126","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012126","url":null,"abstract":"<p><strong>Summary: </strong>Denervation of the rectus abdominis (RA) muscle during deep inferior epigastric artery perforator (DIEP) flap harvest may increase the risk of post-operative muscle weakness, particularly for the increasingly common bilateral or bipedicled unilateral reconstructions. 1-4 As the majority of large perforators arise in the para-umbilical region, fascia and muscle split lengths can be up to 15cm on both sides of the midline in order to harvest the full length of pedicle using conventional muscle-splitting approaches. 5,6 Robotic-assisted surgery enables laparoscopic harvest of the submuscular extent of the deep inferior epigastric artery (DIEA) from the deep aspect of the vessel and preserves crossing motor nerve branches, which travel superficial to it. 7 This minimally-invasive technique only splits muscle fibres directly around the perforator, minimising denervation of the lower rectus muscle.We describe a novel minimally-invasive technique requiring no additional equipment that is, in our experience, as effective at minimising abdominal injury. We propose minimal fascial incisions and muscle splits around the target perforators followed by longer midline or paramedian fascial incisions. This allows the sub-muscular portion of bilateral DIEAs to be dissected from their deep aspect by sweeping under the medial borders of the rectus muscles, thus avoiding the segmental motor nerves which cross superficial to the DIEA pedicle. This technique is particularly suitable when repair of a pre-existing rectus muscle diastasis is planned as part of the donor site closure, because the midline or paramedian fascial incisions are imbricated within the diastasis cavity, making this additional fascial incision almost irrelevant.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773044","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 fat graft reconstructive surgery on prognosis in young women with breast cancer: a study from the French insurance databases.","authors":"Enora Laas, Thomas Gaillard, Benoit Couturaud, Lauren Darrigues, Elise Dumas, Anne-Sophie Hamy, Jean-Guillaume Feron, Fabien Reyal, François Husson, Anne-Sophie Jannot","doi":"10.1097/PRS.0000000000012120","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012120","url":null,"abstract":"<p><strong>Introduction: </strong>Fat graft (FG) is widely used in breast reconstructive surgery (RS) following mastectomy or lumpectomy for breast cancer (BC); however, concerns persist about its oncological safety. This study evaluates the impact of FG reconstruction compared to other techniques on BC survival in young women.</p><p><strong>Methods: </strong>We identified patients aged 18-45 treated for non-metastatic BC on the French National Healthcare System Database between January 1, 2010, and December 31, 2018. Patients undergoing FG were matched with patients undergoing other RS based on BC subtype, chemotherapy, radiotherapy, and RS timing after BC surgery. Analyses were stratified on breast surgery (mastectomy or lumpectomy).</p><p><strong>Results: </strong>A total of 50,178 patients were included: 28,260 with luminal tumors, 7,982 with TNBC, 7,087 with HER2-positive tumors, and 6,849 with undefined tumors. In the mastectomy and lumpectomy group, 7,333 and 883 patients respectively received FG. In the mastectomy group, after matching, FG was associated with better Disease-free survival (DFS) (HR 0.76, 95%CI 0.65-0.88) and Overall Survival (OS) compared to patients with other RS. FG also showed improved DFS (HR 0.59, 95%CI 0.51-0.69) compared to patient without any RS. No significant differences in DFS or OS were found in the lumpectomy group.</p><p><strong>Conclusion: </strong>FG appears to improve survival outcomes in young women undergoing mastectomy with or without additional RS. In contrast, no significant impact was observed in the lumpectomy group. These findings suggest that FG can be a safe reconstructive option, particularly after mastectomy. Further research is needed to confirm these results and understand the underlying mechanisms.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773067","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":"Assessing Risks in Intramuscular Fat Grafting: A Systematic Review and Meta-Analysis of Complication.","authors":"Gabriel de Almeida Arruda Felix, Felipe Contoli Isoldi, Marcelo Oliveira Mourão Filho, Lydia Masako Ferreira","doi":"10.1097/PRS.0000000000012117","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012117","url":null,"abstract":"<p><strong>Background: </strong>Intramuscular fat grafting has gained popularity in plastic surgery to enhance muscle volume and definition. However, the safety and standardization of this technique remain controversial. This systematic review and meta-analysis aimed to evaluate the complications, safety, and outcomes of intramuscular fat grafting.</p><p><strong>Methods: </strong>This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered with the International Prospective Register of Systematic Reviews (PROSPERO). A comprehensive literature search was performed across multiple databases including EMBASE/Elsevier, Cochrane, Scopus, PubMed/Medline, BVS, SciELO, and Lilacs. This search covered all years and languages. The included studies were assessed for risk of bias using the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) tool to ensure methodological rigor. A total of 36 studies were selected for qualitative synthesis.</p><p><strong>Results: </strong>The meta-analysis included 27 studies with 208,692 observations and 857 events. Among those specifying the target muscle, 25% injected the gluteus, 8.3% targeted the rectus abdominis, and 5.6% targeted the gastrocnemius and soleus. The pooled complication rate was 6.2% (95% CI: 3.06%-12.13%), with substantial heterogeneity among the studies (I² = 98.3%). The most common complications included fat embolism, infection, seroma, hematoma, fat necrosis, asymmetry, and revision surgery. Fat embolism was the most serious complication, with a mortality rate of 1:3,000 cases of gluteal intramuscular fat grafting.</p><p><strong>Conclusion: </strong>Intramuscular fat grafting offers aesthetic benefits but poses risks, notably, fat embolism. Advancements like ultrasound guidance enhance safety, but further research is needed to refine techniques and establish evidence-based guidelines.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731234","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 Breast Reduction or Mastopexy Before Nipple Sparing Mastectomy: A Systematic Review and Meta-Analysis.","authors":"Ella Gibson, Matthew M Farajzadeh, Ara A Salibian","doi":"10.1097/PRS.0000000000012118","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012118","url":null,"abstract":"<p><strong>Background: </strong>Macromastia and breast ptosis have traditionally been considered to be relative contraindications to nipple sparing mastectomy (NSM) due to concerns regarding nipple and mastectomy flap viability. Staged breast reduction or mastopexy (SBRM) prior to NSM has demonstrated promising results in decreasing these complications, though data is limited to single-center studies with small sample sizes.</p><p><strong>Methods: </strong>A systematic review of PubMed, Scopus, and Cochrane databases was performed to identify all studies analyzing reconstructive outcomes in patients who underwent staged breast reduction or mastopexy before NSM. Descriptive analyses of surgical techniques and reconstructive outcomes were performed for relevant articles included for analysis. Random-effects model meta-analysis was performed to assess complication rates.</p><p><strong>Results: </strong>Eleven studies, with a pooled total of 542 breasts (288 patients) were identified for analysis. The majority of mastectomies were performed prophylactically (79.2%). Staged breast reduction was performed in 75.2% of patients and mastopexy in 24.5%. The mean reduction weight per breast was 354.4 ± 64.0 g and the mean mastectomy specimen weight was 527.5 ± 207.9 g. 39.7% of breasts were reconstructed with autologous techniques, 59.6% had implant-based reconstruction, and 0.7% of cases had hybrid reconstruction. Meta-analysis demonstrated low rates of complications in patients who underwent staged NSM, including NAC necrosis (3.1%, CI 0.8 - 6.3%) and mastectomy flap necrosis (2.4%, CI 0.1 - 6.3%).</p><p><strong>Conclusions: </strong>Systematic review and meta-analysis of outcomes for SBRM demonstrates low rates of nipple and mastectomy flap necrosis. This data suggests prophylactic optimization of breast morphology can improve outcomes and expand candidacy for nipple-sparing procedures.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731237","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":"Long-term outcome of fat grafting to treat facial Systemic Sclerosis: a prospective cohort study.","authors":"Aurora Almadori, Michelle Griffin, Jeon Hyun, Esther Hansen, Christopher P Denton, Peter Em Butler","doi":"10.1097/PRS.0000000000012111","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012111","url":null,"abstract":"<p><strong>Background: </strong>Systemic Sclerosis (SSc) is characterized by subcutaneous tissue loss and dermal fibrosis, with limited facial movement and mouth opening. Fat grafting is a minimally invasive technique used to restore facial volume and improve skin fibrosis.</p><p><strong>Materials and methods: </strong>A cohort of 93 patients were assessed using 3D imaging (3dMD) before and after fat grafting. Secondary outcomes included physician-based assessment, mouth function (MHISS), psychological status, quality of life (DAS, HADS, VAS, BFNES), and patient-based satisfaction.</p><p><strong>Results: </strong>After an average of 2.96 (±2.2) sessions of fat grafting, with an injection volume of 11.9 cc (±6) in each session, the overall retention rate was 53.1% (±0.17) at an average follow-up of 3.11 (±1.73) years. Patients undergoing 5+ interventions presented a higher retention rate (73.1% ±0.08%) than those receiving one or two treatments (45.2% ±0.09 and 50.5% ±0.15 respectively) (P<0.05). Significant improvements were found in mouth function (P<0.0001) and quality of life (P<0.0001).</p><p><strong>Conclusion: </strong>Facial fat grafting is an effective technique for restoring facial volume and improving oral function and quality of life in patients with scleroderma. This study presents the largest number of patients published to date with the longest follow-up period.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731236","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 Foot as Donor Site for Functional Unit Reconstruction in the Hand with Toe Transfer Variations.","authors":"Harvey Chim, Lin Feng Liu, Dong Chul Lee","doi":"10.1097/PRS.0000000000012115","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012115","url":null,"abstract":"<p><p>The foot is an ideal donor site for reconstruction of defects in the hand. While standard toe transfer variants such as great or second toe transfer are commonly used, other variants can be designed depending on the requirements of the defect. In this article we illustrate the use of toe transfer variants to reconstruct different defects in the hand following functional and aesthetic units. Where possible, all ten toes should be preserved. Specifically, we discuss reconstruction of pulp defects, nail complex defects, proximal interphalangeal joint defects, webspace defects, complete finger amputations and rarer indications for vascularised toe joint transfers. Cases from all authors are presented.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731239","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}