Plastic and reconstructive surgery最新文献

{"title":"Confronting Racial Disparities in Breast Reconstruction: A Former Medical Student's Journey through Breast Cancer and Advocacy for Equity in Health Care.","authors":"Tokoya Williams","doi":"10.1097/PRS.0000000000012130","DOIUrl":"10.1097/PRS.0000000000012130","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"628e-630e"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773063","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 Fails to Improve Fat Graft Retention: Cryopreserved and Cultured Syngeneic and Allogeneic Mesenchymal Stem Cells 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":"10.1097/PRS.0000000000012121","url":null,"abstract":"<p><strong>Background: </strong>Fat grafting is a gentle technique used to correct soft-tissue defects, but it is challenged by low graft survival rates. To enhance retention, mesenchymal stromal cells (MSCs) have been explored. Autologous MSC therapy has shown promise, but comes with logistical and cost challenges. Allogeneic MSC therapy offers 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 MSCs.</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 × 10 6 to 25 × 10 6 MSCs/mL), allogenicity (allogeneic and syngeneic), and cryopreservation was assessed.</p><p><strong>Results: </strong>The authors' 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, the authors' 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, this study underscores the importance of further investigations to evaluate the efficacy of MSC therapy in enhancing fat graft retention.</p><p><strong>Clinical relevance statement: </strong>The authors 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 that further research is needed before clinical application.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"499e-508e"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","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":"Deep Plane Face Lift in Asian Patients.","authors":"Chin-Ho Wong, Michael Ku Hung Hsieh, Bryan Mendelson","doi":"10.1097/PRS.0000000000012102","DOIUrl":"10.1097/PRS.0000000000012102","url":null,"abstract":"<p><strong>Background: </strong>The deep plane face lift has the technical advantages of being more effective in mobilization of soft tissues of the anterior face and allowing for more direct fixation of these tissues. These attributes of the deep plane face lift make it advantageous for Asian faces.</p><p><strong>Methods: </strong>Between January of 2021 and August of 2023, 61 Asian patients with a mean age of 52 years (range, 38 to 75 years) underwent the deep plane face lift. The authors' surgical technique and refinements in performing this procedure were demonstrated in detail. These included specific mobilization endpoints; a systemic approach to suture fixation, with each fixation suture targeting specific landmarks in the anterior face for tightening; and a systematic system of skin flap inset to ensure precise and tension-free closure. The mean follow-up was 19 months. Patient satisfaction was assessed with a targeted survey covering their appearance and quality of life.</p><p><strong>Results: </strong>Long-term results were good. Patient satisfaction was high, with 98% reporting that they were satisfied or highly satisfied with their results. Patients reported improvement of both their appearance and quality of life after surgery. Complication rates were low and included superficial epidermolysis behind the ears ( n = 2 [3%]), hypertrophic scarring ( n = 1 [1.6%]), and facial nerve neurapraxia ( n = 1 [1.6%]). There was no hematoma.</p><p><strong>Conclusions: </strong>The deep plane face lift is a very effective face-lift technique for Asian patients. The technical refinements presented in this article allow the procedure to be performed safely and predictably.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, IV.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"485e-496e"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780584","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":"The Use of Technology in Improving Multidisciplinary Care in Low-Resource Settings.","authors":"Vamsi C Mohan, Winston R Owens, Pierce C Hollier, Solomon Obiri-Yeboah, Peter Donkor","doi":"10.1097/PRS.0000000000012369","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012369","url":null,"abstract":"<p><strong>Background: </strong>A multidisciplinary team comprising providers from several specialties is needed for comprehensive cleft care. Although multidisciplinary cleft teams may be readily available in high-income countries, in low- and middle-income countries (LMICs), there are often barriers preventing patients from accessing and receiving treatment from multidisciplinary teams. The purpose of this article is to discuss technology's role in facilitating the sustainability of multidisciplinary cleft care in low-resource settings.</p><p><strong>Methods: </strong>A review of the current literature, observation of teams in LMICs, and the senior author's (P.D.) experience were used to determine the technological modalities available to facilitate multidisciplinary cleft care in low-resource settings.</p><p><strong>Results: </strong>Three-dimensionally printed models, telemedicine, digital educational videos, virtual reality goggles, smart surgical glasses, and artificial intelligence have been demonstrated to benefit education, surgery, speech, and language pathology, and presurgical infant orthopedics, while also exhibiting the potential to benefit other specialties as technology and artificial intelligence continue to develop and advance.</p><p><strong>Conclusions: </strong>Generally, there is a shortage of appropriate multidisciplinary cleft care specialists in many LMICs to constitute traditional in-person teams. New teams will thus have to rely on remotely located specialists for their expertise. It is, therefore, inevitable that technology will play an increasingly important role in the future delivery of team-based comprehensive cleft care services.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 4S-2","pages":"50S-55S"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150339","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":"Financial Disclosure Appendix for \"Advances in Cleft Care\".","authors":"","doi":"10.1097/PRS.0000000000012379","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012379","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 4S-2","pages":"3S-4S"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150344","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":"Do Surgeons Treat Their Patients' Upper Extremity Nerve Palsies as They Would Treat Their Own?","authors":"Nienke A Krijnen, Jose Antonio Arellano, Kitty Y Wu, David Ring, Teun Teunis","doi":"10.1097/PRS.0000000000012044","DOIUrl":"10.1097/PRS.0000000000012044","url":null,"abstract":"<p><strong>Background: </strong>Early surgical intervention in nerve palsies with a high probability of nerve integrity and natural recovery risks unnecessary surgery. Understanding the variables influencing surgeons to offer surgery might provide insight into variations in surgeon beliefs and guide treatment recommendations.</p><p><strong>Methods: </strong>Sixty-nine surgeons of the Science of Variation Group participated in a survey consisting of 6 traumatic and 3 nontraumatic nerve palsy scenarios. Participants were asked what their preferred treatment was and how likely they were to offer surgery on a scale from 0 to 10. Participants were randomized to choose for themselves ( n = 31) or for a patient of their age and sex ( n = 38).</p><p><strong>Results: </strong>There was no difference in the overall likelihood of offering surgery or in the types of treatment offered to patients compared with oneself. Surgery was least recommended for idiopathic palsies and most for ulnar (β = 0.91; 95% CI, 0.10 to 1.7; P = 0.027) or radial (β = 0.92; 95% CI, 0.12 to 1.7; P = 0.025) nerve palsy following closed distal radius or humerus fractures. Longer symptom duration increased the likelihood of offering surgery.</p><p><strong>Conclusions: </strong>Surgeons were moderately likely to recommend surgery for nerve palsies, with no variation in opinions regardless of whether they were deciding for themselves or for patients. For specific nerve palsies with a documented benign natural history, this likely represents overtreatment. Future studies can assess whether balancing awareness of a benign natural history with the pressure to act and the sense that recovery is \"taking too long\" might limit the offer of unnecessary surgery.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"624-632"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449758","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":"Postoperative and Long-Term Patient-Reported Outcomes of Type A Ulnar Polydactyly.","authors":"Holly Cordray, Apurva S Shah, Eliza Buttrick, Benjamin Chang, Kevin J Little, Tamara Al-Muhtaseb, Shaun D Mendenhall","doi":"10.1097/PRS.0000000000012052","DOIUrl":"10.1097/PRS.0000000000012052","url":null,"abstract":"<p><strong>Background: </strong>Type A ulnar or postaxial polydactyly describes a well-developed supernumerary small finger, which may have self-image and functional sequelae even after reconstructive surgery. The authors aimed to characterize postoperative outcomes and substantiate the clinical relevance of the Congenital Upper Limb Differences Ulnar Polydactyly (CUP) Classification.</p><p><strong>Methods: </strong>All cases at 2 major pediatric hospitals from 2012 through 2022 were reviewed. Surgeons classified preoperative radiographs using the CUP Classification. Complication rates were compared using chi-square or Fisher exact tests. Patient-reported outcomes included the Patient and Observer Scar Assessment Scale, Australian Hand Difference Register aesthetics scale, and Patient-Reported Outcomes Measurement Information System (PROMIS); descriptive analyses considered minimum clinically important differences.</p><p><strong>Results: </strong>Sixty-four hands of 42 patients underwent surgery (mean age, 15.1 ± 12.2 months). Operative techniques aligned with the CUP reconstructive pathway. Late complications varied significantly by CUP subtype ( P < 0.001), occurring most commonly in A3 (divergent metacarpophalangeal) and A5 (duplicated metacarpal) cases. Differences centered on functional complications, including subjective functional concerns, flexion contractures, and limited flexion (each P ≤ 0.02). Nineteen patients or caregivers completed questionnaires on average 5.9 years postoperatively. Most agreed that surgery improved their hand appearance (median 5 of 5) and endorsed happiness with their hand appearance (median 4 of 5). Approximately half believed that their hands could look better. Patients or caregivers reported good scar quality. Regarding function, mean PROMIS Upper Extremity scores fell more than a minimum clinically important difference below pediatric norms, especially for older children or adolescents (ages 8 to 18 years). Self-reported PROMIS Peer Relationships scores were within normal limits.</p><p><strong>Conclusions: </strong>Most patients were pleased with postoperative results, but many reported room for aesthetic and functional improvement. This study corroborated the clinical relevance of the CUP Classification.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, IV.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"521e-533e"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573516","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":"From Awareness to Advancement: The Breast Reconstruction Issue.","authors":"Joseph J Disa","doi":"10.1097/PRS.0000000000012250","DOIUrl":"10.1097/PRS.0000000000012250","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 4","pages":"661-662"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150479","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: Do Surgeons Treat Their Patients' Upper Extremity Nerve Palsies as They Would Treat Their Own?","authors":"Jonathan M Bekisz, Kyle R Eberlin","doi":"10.1097/PRS.0000000000012143","DOIUrl":"10.1097/PRS.0000000000012143","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"156 4","pages":"633-634"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150505","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":"Prepectoral versus Submuscular Breast Reconstruction after Nipple-Sparing Mastectomy: Complications and Outcomes.","authors":"Jennifer Wang, Ronnie L Shammas, Elizabeth Montes-Smith, Lillian A Boe, Jacob Levy, Francis D Graziano, Carrie S Stern, Jonas A Nelson, Joseph J Disa","doi":"10.1097/PRS.0000000000012096","DOIUrl":"10.1097/PRS.0000000000012096","url":null,"abstract":"<p><strong>Background: </strong>Preprectoral breast reconstruction and nipple-sparing mastectomy (NSM) have both risen in popularity because of advances in reconstructive techniques. However, it is unknown whether exposed lactiferous ducts in an NSM may increase the risk for infection after prepectoral implant-based breast reconstruction. The authors aimed to assess complication rates and BREAST-Q physical well-being of the chest scores in patients who underwent NSM and implant-based breast reconstruction in a prepectoral versus submuscular plane.</p><p><strong>Methods: </strong>A retrospective review was performed of patients who underwent NSM with 2-stage implant-based reconstruction from 2013 to 2023. Patients were grouped by prepectoral or submuscular placement. Postoperative complications and BREAST-Q scores were assessed after surgery.</p><p><strong>Results: </strong>A total of 693 patients were included: 345 underwent prepectoral and 348 underwent submuscular reconstruction. Surgical-site infection occurred in 10% of prepectoral patients and 5.7% of submuscular patients ( P = 0.03). Seroma occurred in 15% of prepectoral patients and 6.6% of submuscular patients ( P < 0.001). Multivariable analysis showed that prepectoral patients had significantly increased odds of developing surgical-site infection and seroma compared with submuscular patients (OR, 1.87; P = 0.04 and OR, 2.52; P < 0.001, respectively). However, prepectoral reconstruction was associated with significantly higher BREAST-Q physical well-being of the chest scores as compared with submuscular implant placement (β, 3.4; P = 0.01).</p><p><strong>Conclusions: </strong>Prepectoral reconstruction following NSM is associated with higher rates of surgical-site infection and seroma but improved physical well-being of the chest compared with submuscular implant placement following NSM. An increased risk of infection and seroma should be weighed against improved patient-reported outcomes when deciding on implant plane placement after NSM.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, III.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"513-520"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658202","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}