Plastic and Reconstructive Surgery Global Open最新文献

{"title":"Total Eyelid Reconstruction in the Anophthalmic Orbit Simplified: The Trilamellar Temporoparietal Fascia Flap.","authors":"Pedro C Cavadas, Juan Ramón Sanz Giménez-Rico, Ana Ruo Lan Cavadas","doi":"10.1097/GOX.0000000000007212","DOIUrl":"10.1097/GOX.0000000000007212","url":null,"abstract":"<p><p>Total eyelid reconstruction poses a challenge to the reconstructive surgeon. In the anophthalmic orbit, the reconstructive goals are more limited than in a functional, seeing eye. Eyeball protection is obviously not an issue, and the goal is to create a cosmetically acceptable autologous structure capable of retaining and accommodating an ocular prosthesis. A number of techniques have been described for the reconstruction of the total loss of both eyelids. However, reconstruction of both eyelids in the anophthalmic orbit has received less attention in the literature. A simplified technique for total eyelid reconstruction in anophthalmic orbits is described herein, with a trilamellar construct using the temporoparietal fascia flap and skin grafts. The palpebral fissure is created under local anesthesia 3 weeks after the index procedure with an acceptable cosmetic result.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7212"},"PeriodicalIF":1.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Utility Analysis of Ligament Reconstruction Tendon Interposition Versus Suture Suspension Arthroplasty for Thumb Osteoarthritis.","authors":"Chloe R Wong, Alice Zhu, David R Urbach, Helene Retrouvey, Christopher Witiw, Heather L Baltzer","doi":"10.1097/GOX.0000000000007186","DOIUrl":"10.1097/GOX.0000000000007186","url":null,"abstract":"<p><strong>Background: </strong>Thumb carpometacarpal joint osteoarthritis (CMCJ OA) is a common degenerative condition that causes pain, stiffness, and disability, reducing quality of life. Surgery is a well-established treatment option when conservative management fails, but the optimal surgical approach remains debated. This study compared the cost-utility of trapeziectomy with ligament reconstruction and tendon interposition (LRTI + T) versus suture suspension arthroplasty (SSA) for CMCJ OA.</p><p><strong>Methods: </strong>A Markov microsimulation model was developed to compare LRTI + T and SSA from a hospital payer perspective. Outcomes included incremental cost-effectiveness ratio, quality-adjusted life years (QALYs), total cost, and net monetary benefit. Clinical outcomes such as complication rates and revision surgery were also evaluated.</p><p><strong>Results: </strong>LRTI + T had a higher complication rate (14.6%) than SSA (9.8%), but SSA had a slightly higher revision rate (7.1% versus 5.7%). Over a lifetime, SSA provided an incremental gain of 0.25 QALYs but was marginally more expensive ($2855 versus $2842). SSA yielded an incremental cost-effectiveness ratio of $53.80 per QALY, making it the more cost-effective strategy.</p><p><strong>Conclusions: </strong>SSA is a cost-effective alternative to LRTI + T, offering valuable insights for clinicians and policymakers optimizing care for CMCJ OA patients.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7186"},"PeriodicalIF":1.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Computed Tomography Angiography and 3-dimensional Reconstruction in Cervicofacial Burn Scar Flap Reconstruction: Erratum.","authors":"Qiang Ma, Zhibin Yang, Yun Huang, Tao Guo, Qiyun Luo, Haidong Hu","doi":"10.1097/GOX.0000000000007236","DOIUrl":"10.1097/GOX.0000000000007236","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1097/GOX.0000000000006852.].</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7236"},"PeriodicalIF":1.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain Drain for Brain Gain: Potential Applications of Robotic-assisted Lymphatic Microsurgery in the Management of Neurological Disorders.","authors":"Jennifer A Watson, Samuel Knoedler, Donata von Reibnitz, Carmen E Zurfluh, Carlotta Imholz, Giuseppe Esposito, Simon J Schreiner, Epameinondas Gousopoulos, Aijia Cai, Sedef Kollarik, Pietro Giovanoli, Christian Baumann, Nicole Lindenblatt","doi":"10.1097/GOX.0000000000007191","DOIUrl":"10.1097/GOX.0000000000007191","url":null,"abstract":"<p><strong>Background: </strong>The central nervous system (CNS) was long believed to be devoid of lymphatic drainage. However, the discovery of the glymphatic system and meningeal lymphatics has revolutionized our understanding of cerebrospinal fluid homeostasis and neuroimmune interactions. The glymphatic system facilitates perivascular cerebrospinal fluid-interstitial fluid exchange and promotes neurotoxic waste clearance, whereas meningeal lymphatics serve as conduits between the CNS and peripheral lymphatic circulation. Dysfunction in these lymphatic efflux pathways has been implicated in the pathogenesis of neurological disorders such as Alzheimer disease, Parkinson disease, traumatic brain injury, and intracranial hemorrhage, where impaired waste removal contributes to protein aggregation, neuroinflammation, and hence, disease onset and progression.</p><p><strong>Methods: </strong>Recent preliminary evidence suggests that surgical modulation of lymphatic drainage may offer novel therapeutic avenues for these disorders, with lymphatic microsurgery, particularly deep cervical lymphovenous anastomosis (LVA), proposed as an innovative procedure to enhance CNS lymphatic outflow. The first case reports in Alzheimer disease patients demonstrated not only the operative feasibility of LVA but also postoperative cognitive improvements. Despite these promising findings, systematic (pre)clinical studies remain scarce, calling for further research.</p><p><strong>Results: </strong>This article examined the role of the brain lymphatic system in neurological disorders and discussed the potential of lymphatic microsurgery as a novel therapeutic intervention. We also highlight ongoing clinical trials and potential future innovations, including surgical robotic assistance, and report on 2 cases of deep neck LVA for central lymphatic disorders.</p><p><strong>Conclusions: </strong>By combining neurolymphatic research with surgical advances, LVAs have the potential to redefine therapeutic paradigms in CNS disorder management.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7191"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rebalancing the Skin Envelope Using Dorsal Preservation and Septal Extension Graft in Secondary Bilateral Cleft Rhinoplasty.","authors":"Akimitsu Sato, Nariaki Takamura, Yu Yusa, Koji Hara, Yoshimichi Imai","doi":"10.1097/GOX.0000000000007199","DOIUrl":"10.1097/GOX.0000000000007199","url":null,"abstract":"<p><p>In bilateral cleft lip and palate patients, secondary rhinoplasty is often complicated by a limited skin envelope, which restricts nasal tip projection despite the use of septal extension grafts (SEGs). We proposed a technique based on the concept of rebalancing the existing skin envelope, without the use of local flaps, skin grafts, or composite grafts. We reported 2 cases of adult male patients with bilateral cleft lip and palate who underwent secondary cleft rhinoplasty. Both patients exhibited a cleft-specific configuration characterized by an underprojected nasal tip and a relatively high dorsum at the rhinion. In addition, 1 patient presented with a broad nose deformity, and the other exhibited a crooked nose. A dorsal preservation technique-either push-down or let-down-was applied to reduce dorsal height at the rhinion and create redundancy in the skin envelope. An SEG using costal cartilage was then used to reconstruct and project the nasal tip. Structural grafts were additionally used to correct nasal asymmetries when necessary. At 1-year postoperative follow-up, both patients demonstrated marked improvements in nasal profile, symmetry, and tip projection. No complications were noted. Rebalancing the skin envelope through targeted reduction at the rhinion may allow for improved tip projection in cleft rhinoplasty. This approach may expand the applicability of SEGs in challenging cleft cases and warrants further study.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7199"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Functional and Hemodynamic Outcomes Across Lower Extremity Amputation Levels.","authors":"Anvitha R Madhavaram, Fatima Khan, Catherine A Cash, Richard Simman","doi":"10.1097/GOX.0000000000007183","DOIUrl":"10.1097/GOX.0000000000007183","url":null,"abstract":"<p><strong>Background: </strong>Lower extremity amputations (LEAs) significantly alter an individual's long-term functional capabilities and cardiovascular health. These outcomes vary significantly across LEA levels, affecting mobility, independence, and overall quality of life.</p><p><strong>Methods: </strong>This article reviews current literature to analyze these outcomes across different LEA levels including hemipelvectomy, hip disarticulation, above-knee amputation, knee disarticulation, below-knee amputation, Syme amputation, Chopart amputation, Lisfranc amputation, and toe disarticulation to elucidate outcomes, understand variations, and suggest directions for future research and informed clinical management.</p><p><strong>Results: </strong>Although mechanical and hemodynamic systems undergo significant adaptations following all levels of LEA, improved functional and cardiovascular outcomes are a direct result of retained body mechanics, preservation of joint function, and the degree of energy expenditure. Surgical severing of blood vessels and increased effort to effectively supply oxygenated blood throughout the body substantially raise the risk of developing diseases such as myocardial infarction, hypertension, aortic aneurysm, and peripheral arterial disease. Patient comorbidities not only necessitate amputation but also remain factors impacting wound complications, morbidity, mortality, and reamputation rates. Morbidity and mortality rates are notably high for higher level amputations due to the complexity of the surgery and the associated risk of complications. Complications such as infection, phantom limb pain, and deep vein thrombosis vary greatly by level of amputation and often present alongside markers of hemodynamic instability and shock.</p><p><strong>Conclusions: </strong>Recognizing the effects of each LEA level on patient quality and function of life is crucial for optimizing rehabilitation strategies and providing comprehensive patient support.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7183"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Batroxobin on Ischemia-Reperfusion Injury in Epigastric Artery Island Flaps in Rats.","authors":"Kotaro Imagawa, Haruchika Masuda, Daiki Morita, Shizuka Otsuka, Tadashi Akamatsu","doi":"10.1097/GOX.0000000000007188","DOIUrl":"10.1097/GOX.0000000000007188","url":null,"abstract":"<p><strong>Background: </strong>Batroxobin is a thrombin-like enzyme derived from snake venom that exhibits not only antithrombotic effects due to its fibrinogen-degrading effects, but also inflammatory and tissue-protective effects by inhibiting neutrophil extracellular traps (NETs). This study aimed to investigate the effects of batroxobin on NET suppression and flap necrosis reduction in a rat island flap ischemia-reperfusion injury (IRI) model.</p><p><strong>Methods: </strong>An island flap was created on the abdominal wall of a rat. The vascular pedicle was clamped for 6 hours and then released to establish the IRI model. Batroxobin (10 BU/kg) was administered intraperitoneally at the time of clamp release in the experimental group, whereas the control group received normal saline. The extent of blood perfusion within the flap was assessed using laser Doppler imaging, and NET expression was evaluated via S100A9 staining.</p><p><strong>Results: </strong>Laser Doppler imaging exhibited the accelerated reperfusion area in batroxobin-treated rats compared with controls; 7 days postreperfusion, the rate of recovered area was 78.1% in the batroxobin group versus 44.6% in the control group. Histological analysis at 48 hours postreperfusion by S100A9 staining showed significantly reduced NETs in the batroxobin group; the S100A9-positive cells were 199.4 ± 63.7 per low power field in the batroxobin group versus 352.0 ± 76.4 per low power field in the control group. These findings indicate that batroxobin effectively preserved blood perfusion with a protective effect against tissue injury in the flap IRI model.</p><p><strong>Conclusions: </strong>These findings suggest that batroxobin may serve as a promising therapeutic agent for mitigating inflammatory tissue damage caused by IRI.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7188"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Management of Pediatric Ascher Syndrome: A Case Report and Literature Review.","authors":"Ming Yang, Faliang Wang, Xiong Zhao, Chenchen Gong, Xiaojie Yue","doi":"10.1097/GOX.0000000000007187","DOIUrl":"10.1097/GOX.0000000000007187","url":null,"abstract":"<p><p>Ascher syndrome is a rare disorder characterized by a triad of upper eyelid ptosis, lip mucosa hypertrophy, and nontoxic thyroid enlargement. Pediatric cases are extremely rare and often underrecognized due to nonspecific symptoms and the lack of standardized diagnostic criteria. We report the case of an 8-year-old boy with incomplete Ascher syndrome who presented with progressive bilateral upper eyelid laxity and thickened, everted lip mucosa. After comprehensive evaluation, surgical correction was planned to address the functional and cosmetic concerns associated with the lip deformity. The patient underwent mucosal excision with a double inverted \"W\" incision for the upper lip and a horizontal dumbbell-shaped incision for the lower lip. Histopathologic examination revealed characteristic findings, including salivary gland hyperplasia, edema, and reduced elastic fibers. No eyelid surgery was performed due to the absence of visual obstruction. Postoperative follow-up for 3 years demonstrated stable aesthetic results, normal lip function, and no recurrence or visible scarring. This case underscores the importance of early recognition and multidisciplinary planning in pediatric Ascher syndrome. Tailored surgical intervention can yield favorable long-term outcomes, even in young patients. A concise review of the literature is provided to contextualize this rare condition and to inform treatment strategies. Despite limited case volume, this report contributed to the growing clinical understanding of pediatric Ascher syndrome and highlighted the potential of personalized surgical approaches to optimize patient outcomes.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7187"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to Comprehensive Cleft Care as Perceived by Healthcare Professionals in Sub-Saharan Africa.","authors":"Saleigh Adams, Pien M Verreijdt, Amber Mahieu, Peter M Nthumba, Salome Maswime, Phumzile Hlongwa, Anil Madaree, David Chong, Meshach Onguti, Corstiaan C Breugem","doi":"10.1097/GOX.0000000000007164","DOIUrl":"10.1097/GOX.0000000000007164","url":null,"abstract":"<p><strong>Background: </strong>Cleft lip and palate (CLP) is a common congenital malformation. It results in substantial healthcare utilization and financial burden on families and healthcare services. Research shows that comprehensive cleft care (CCC) leads to better outcomes. To date, little is known about the barriers to CCC in sub-Saharan Africa. Understanding these and their possible solutions is paramount when engaging national policymakers on achieving equity in healthcare. Therefore, the aim of this study was to identify the barriers sub-Saharan African healthcare professionals face in implementing CCC and their potential solutions.</p><p><strong>Methods: </strong>A questionnaire was sent to healthcare professionals representing the Pan African Congress for CLP, Operation Smile, and Smile Train foundations regarding the most important barriers and potential solutions to CCC.</p><p><strong>Results: </strong>A total of 119 professionals participated; 76.5% were men, and 56.3% were surgeons. Most respondents worked in Nigeria or Ethiopia. The most commonly reported barriers were long travel distances and financial constraints, followed by limited public awareness. The most critical improvement identified was financial support for establishing multidisciplinary teams (MDTs). The absence or inadequate function of MDTs was largely attributed to a shortage of trained professionals.</p><p><strong>Conclusions: </strong>Patients' inability to reach hospitals due to travel distance, especially for follow-ups, was the most important barrier. Action to increase geographic accessibility of hospitals is needed. Healthcare professionals overwhelmingly supported establishing MDTs and providing financial aid to patients as the most effective solutions for CCC. To enable MDTs to reach their full potential, a budget for employing and educating healthcare professionals to increase trained staff is needed.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7164"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sternal Cleft Reconstruction: A 12-year Follow-up and Technique Modification.","authors":"Sydney Somers, Ricki Chen, John Tipps, Aaron Dadzie, Michael Traynor, Eric R Scaife, S Adil Husain, Barbu Gociman","doi":"10.1097/GOX.0000000000007198","DOIUrl":"10.1097/GOX.0000000000007198","url":null,"abstract":"<p><p>Management of sternal cleft defects presents a rare reconstructive challenge. The primary goals of surgical repair are to optimize pulmonary mechanics, protect mediastinal structures, maintain the growth potential of the chest wall, and improve cosmesis. In 2013, the senior author first described a technique for a superior partial sternal cleft repair. This approach involved longitudinal division and partial resection of the sternum, followed by bilateral sternoclavicular and costochondral releases of the first and second ribs to facilitate tension-free, anatomic closure of the sternal edges. The resected sternal segments were morcellated and used as a bone graft to bridge the gap between the clavicular heads and the sternum following medialization. Soft tissue coverage was achieved with bilateral pectoralis major muscle flaps. In this report, we present successful 12-year follow-up data from the original patient and an adaptation of this technique, based on the long-term outcomes of the original case. This modified technique may serve as an effective approach for the surgical correction of superior partial sternal clefts.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7198"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}