Plastic and reconstructive surgery最新文献

{"title":"Lyophilized Human Amnion Chorion Membrane Reduces Hypertrophic Scar Formation by Regulating TGFβ and Myofibroblasts.","authors":"Jonathan P Yasmeh, Hudson C Kussie, Andrew C Hostler, Abdelrahman M Alsharif, Claire Pishko, Brodi Stevens, Maia B Granoski, Katharina S Berryman, Eamonn McKenna, Maria Gracia Mora Pinos, Fidel Saenz, Maisam Jafri, Kellen Chen, Geoffrey C Gurtner","doi":"10.1097/PRS.0000000000012746","DOIUrl":"10.1097/PRS.0000000000012746","url":null,"abstract":"<p><strong>Background: </strong>The authors investigated whether a lyophilized human amnion chorion membrane (LHACM), with amnion, intermediate, and chorion layers, could alter or improve hypertrophic scarring.</p><p><strong>Methods: </strong>The authors used their previously published murine model to create human-like hypertrophic scars (HTS) by applying mechanical tension over a healing HTS wound. Treatment with subcutaneous LHACM allograft was administered before wound closure. Scars were explanted on day 19; imaged with hematoxylin & eosin, Masson trichrome, picrosirius red, and immunofluorescent staining; and analyzed with ImageJ, MATLAB, CurveAlign, and CT-FIRE.</p><p><strong>Results: </strong>Mechanical strain induced hypertrophic scarring, consistent with a previously validated model, and served as a basis for evaluating the effects of LHACM treatment. Mechanical strain created wider, deeper, and denser scars compared with no strain controls. Picrosirius red analysis showed that LHACM altered collagen fiber architecture, promoting fibers that were less aligned, straight, and wide than controls. Mechanical strain increased transforming growth factor-β (TGFβ) and α-smooth muscle actin myofibroblast signaling, whereas treatment with LHACM reduced TGFβ and α-smooth muscle actin expression.</p><p><strong>Conclusions: </strong>Subcutaneous treatment with LHACM significantly reduced gross and histologic scar formation and improved collagen fiber arrangement by altering TGFβ and myofibroblast expression. Because available preventative options for HTS remain limited, commercially available LHACM could potentially be used clinically in high-tension wound sites to prevent or treat HTS.</p><p><strong>Clinical relevance statement: </strong>Hypertrophic scars, common after surgery, trauma, or burns, often cause physical and cosmetic impairments with limited preventive options. LHACM may serve as a potential option to mitigate hypertrophic scarring in high-tension areas after injury.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"611-621"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145820464","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 Outcomes of Microform Cleft Lip Repair with Nasolabial Muscle Tension Line Group Reconstruction: A 19-Year Experience.","authors":"Xuanchen Liu, Yilue Zheng, Chanyuan Jiang, Hengyuan Ma, Di Wu, Tao Song, Yongqian Wang, Ningbei Yin","doi":"10.1097/PRS.0000000000012674","DOIUrl":"10.1097/PRS.0000000000012674","url":null,"abstract":"<p><strong>Background: </strong>Microform cleft lip is considered the mildest form of cleft lip, with ongoing debate on its definition, classification, and manifestation. This study evaluates preoperative and long-term postoperative outcomes of unilateral microform cleft lip repair using the nasolabial muscle tension line group reconstruction technique.</p><p><strong>Methods: </strong>This retrospective study included patients who underwent microform cleft lip repair using the nasolabial muscle tension line reconstruction technique from 2010 to 2018. Preoperative and long-term (≥5 years) follow-up outcomes were assessed using subjective visual analog scale and objective anthropometric analysis. The anthropometric indices include 8 ratios and 3 angle measurements.</p><p><strong>Results: </strong>Forty-eight patients were included in this retrospective study. The median follow-up period was 6.01 years (range, 5.06 to 12.01 years). Subjective assessments showed positive aesthetic outcomes, with minimal scarring and improved symmetry. Long-term postoperative anthropometric measurements demonstrated significant improvements in the symmetry of alar, nostril, columella, nasal sill, philtrum, and vermilion.</p><p><strong>Conclusions: </strong>According to the 19 years of experience of the authors, the nasolabial muscle tension line group reconstruction technique is effective for repairing microform cleft lip deformities, offering significant improvements in nasal and labial symmetry. This technique ensures reliable formation of the philtrum and nasal sill through precise reconstruction of muscle tension line groups. Long-term follow-up assessments using this technique revealed sustained nasolabial symmetry over time.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"663e-672e"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796755","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 Outcomes of Corneal Neurotization for Neurotrophic Keratopathy: A Dual-Center, Single-Surgeon Retrospective Study.","authors":"James O Robbins, Avital L Okrent, Elijah Grigore, Mark M Leyngold, Gabriel Eli Morey, Ilya M Leyngold","doi":"10.1097/PRS.0000000000012743","DOIUrl":"10.1097/PRS.0000000000012743","url":null,"abstract":"<p><strong>Background: </strong>Corneal neurotization (CN) is a promising surgical intervention for neurotrophic keratopathy (NK). The objective of the current study was to generate the largest retrospective review of CN to date to characterize its safety, efficacy, and long-term clinical outcomes.</p><p><strong>Methods: </strong>The study included 58 eyes from 58 patients who underwent CN at Duke University Hospital (48 procedures) or the Leyngold Institute for Plastic Surgery (10 procedures) performed by a single surgeon between 2016 and 2024. Demographic data and covariates including Mackie stage of NK, Cochet-Bonnet corneal sensation, best-corrected visual acuity (logMAR), ability to taper medical therapy, ability to reverse tarsorrhaphy, complications, other surface rehabilitative surgery after CN, and use of cenegermin were collected at preoperative, 6- to 12-month postoperative, and last (≥12 months) postoperative visits. Data were analyzed using descriptive and inferential statistics with GraphPad Prism version 9.0.</p><p><strong>Results: </strong>Significant improvements in Mackie stage and corneal sensation were observed at both 6 and 12 months and at the last postoperative visit (median, 30 months [interquartile range, 19 months]) compared with preoperative measures. No significant changes in best-corrected visual acuity were noted between any timepoints. Younger patients and those with peripheral NK (as opposed to central NK) showed greater improvement. Cenegermin did not significantly affect outcomes. Complications, none of which were vision-threatening or disfiguring, occurred in 4 patients. Of those requiring additional rehabilitative ocular surgery, 82% tolerated the procedures well without corneal decompensation.</p><p><strong>Conclusion: </strong>CN is highly effective and well tolerated for managing NK, promoting a robust ocular surface that facilitates future rehabilitative surgery.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"649-657"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811082","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":"\"Butterfly\" Umbilical Hernia Repair and Umbilicoplasty Concomitant Abdominoplasty: A Novel and Safe Surgical Technique.","authors":"Dong Wei, Xu-Feng Shi, Jie Ren, Xin Cui","doi":"10.1097/PRS.0000000000012606","DOIUrl":"10.1097/PRS.0000000000012606","url":null,"abstract":"<p><strong>Summary: </strong>In cases of umbilical hernia, the navel often appears convex and enlarged, which may not only be aesthetically displeasing but also can adversely affect health. The authors propose an innovative surgical technique called \"butterfly\" umbilical hernia repair and umbilicoplasty. This procedure is concurrently performed with abdominoplasty and is capable of not only repairing an umbilical hernia but also reshaping a medium-sized, deep-set, longitudinally oval navel. The authors conducted observations of 50 patients who underwent this surgical technique. Postoperative assessments revealed no significant complications, such as umbilical necrosis, umbilical scarring, or umbilical deformity. None of the patients required reoperation. The postoperative umbilical size was moderate, and patient satisfaction with the surgical outcomes was high. This procedure represents a novel and safe technique. Nevertheless, the study faced limitations in participant enrollment, and the establishment of a control group to assess the benefits of this surgical technique was not feasible. Future research is required to address these limitations.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"628e-631e"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496096","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":"Breast Reconstruction Using Smooth, Nonmagnetic Radiofrequency Identification Port Tissue Expanders.","authors":"Alexandre Mendonça Munhoz, Antonio Tejerina, Angela Garcia Ruano, Rafael Netto, Burcu Celet Ozden","doi":"10.1097/PRS.0000000000012921","DOIUrl":"10.1097/PRS.0000000000012921","url":null,"abstract":"<p><strong>Background: </strong>Most breast reconstructions are implant-based and performed in 2 stages using tissue expanders (TEs). Despite widespread indications for use, conventional TEs can present limitations, especially those containing metallic or magnetic ports. A new generation of TEs that incorporates nonmetallic radiofrequency identification systems (RFID TE) has been introduced. The authors assessed outcomes and risk factors for complications after implant-based reconstruction (IBR) with RFID TE systems.</p><p><strong>Methods: </strong>A retrospective cohort of patients who underwent IBR with RFID TEs was identified. The primary end point was occurrence of complications or identification of risk factors. The authors also evaluated the quality of magnetic resonance imaging scans (T1-weighted and T2-weighted sequences) taken for further diagnosis.</p><p><strong>Results: </strong>A total of 356 patients (mean age, 49.9 ± 9.6 years) received 471 IBR RFID TE systems. The average follow-up was 29.4 ± 16.6 months. A total of 77 patients (21.6%) experienced complications, most frequently seroma (7.8%). A greater number of complications were observed in older patients ( P = 0.005), smokers ( P = 0.009), patients who received radiotherapy ( P = 0.005), and patients who received reconstruction using a premuscular pocket ( P = 0.001). Multivariate regression found that older patients and smokers had odds ratios (ORs) of 2.12 ( P = 0.013) and 2.30 ( P = 0.024) for developing complications, respectively. Radiotherapy (OR, 2.29; P = 0.024) was also an independent risk factor for overall complications. Use of a submuscular pocket was associated with significantly lower odds of developing seroma (OR, 0.21; P = 0.08). Magnetic resonance imaging scans demonstrated excellent quality, with no artifact-related negative effects.</p><p><strong>Conclusions: </strong>Despite extensive research on IBR, previous studies on RFID TEs are limited and did not analyze predictive risk factors. These findings demonstrate that RFID TEs are reliable, with results similar to those of other series using different devices. The absence of significant imaging artifacts facilitates follow-up surveillance and represents an important advantage over traditional TEs.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"523-538"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146181792","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: Relapse to Presurgical Condition after Lymphovenous Anastomosis: Analysis of Risk Factors in a Cohort of 90 Patients.","authors":"Daniel Z Liu","doi":"10.1097/PRS.0000000000012788","DOIUrl":"https://doi.org/10.1097/PRS.0000000000012788","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":"158 4","pages":"562-563"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081680","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 Research Productivity to National Impact: A Career Development Framework for Research-Active Medical Trainees.","authors":"Claudy Sarpong, Saïd C Azoury","doi":"10.1097/PRS.0000000000013046","DOIUrl":"10.1097/PRS.0000000000013046","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"742e-743e"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474972","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":"Artificial Intelligence-Driven Blood Loss Prediction in Large-Volume Liposuction: Enhancing Precision and Patient Safety.","authors":"Fabiano Calixto Fortes de Arruda","doi":"10.1097/PRS.0000000000013009","DOIUrl":"10.1097/PRS.0000000000013009","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"734e-735e"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434788","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":"Topical Nitropaste Reduces Partial Free Nipple Graft Loss in Gender-Affirming Mastectomy: A Randomized Controlled Trial.","authors":"Rachel H Park, Jessica Pawly, Graham Grogan, Robert G DeVito, Benjamin G Ke, Brittany J Behar, John T Stranix","doi":"10.1097/PRS.0000000000012874","DOIUrl":"10.1097/PRS.0000000000012874","url":null,"abstract":"<p><strong>Background: </strong>Topical nitroglycerin has been shown to enhance wound healing and reduce flap necrosis after oncologic mastectomy. However, its impact on gender-affirming mastectomy outcomes, particularly in free nipple grafts, has not been well studied. This study was performed to evaluate the effectiveness of topical nitroglycerin in patients undergoing double-incision mastectomy with free nipple grafts (DIFNG), focusing on graft and wound-related outcomes.</p><p><strong>Methods: </strong>Adult patients undergoing DIFNG between August of 2022 and June of 2024 at a tertiary hospital were randomized into control (bacitracin) and treatment (topical nitroglycerin, 15 mg per side) groups. All procedures followed a standardized surgical technique and perioperative regimen. Outcomes, including partial and total graft loss and wound complications, were assessed during routine bolster removal and postoperative visits. Ordinal logistic regression was performed to control for smoking status.</p><p><strong>Results: </strong>Among 111 patients (56 control, 55 treatment), there were no significant differences in demographic characteristics or preoperative factors. The partial graft loss rate was significantly lower in the treatment group (18.2% versus 36.6%; P = 0.004). Postoperative complication rates, including seroma, hematoma, and wound complications, were not significantly different between the 2 groups. Rates of nipple graft hypopigmentation were significantly higher for Black patients compared with White patients, but not significantly different between the control and treatment groups.</p><p><strong>Conclusion: </strong>Topical nitroglycerin application in DIFNG significantly reduces partial nipple graft loss without affecting wound complications.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"578e-586e"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146106926","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":"Versatility of the Lateral Intercostal Artery Perforator Flap for Enhancing Outcomes of Autologous Breast Reconstruction.","authors":"Fernando Rosatti, Simone La Padula, Adriana Cordova, Francesca Toia, Gaia Ghiringhelli, Francesca De Lorenzi, Giuseppe A G Lombardo","doi":"10.1097/PRS.0000000000013073","DOIUrl":"10.1097/PRS.0000000000013073","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"729e-730e"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504067","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}