Plastic and Reconstructive Surgery Global Open最新文献

{"title":"New Paradigms in Rejection Monitoring: Lymphocyte Subsets as Noninvasive Graft Markers in Vascularized Composite Allotransplantation.","authors":"Sachin R Chinta, Alay R Shah, David L Tran, Wen-Yu Lee, Massimo Mangiola, Bruce E Gelb, Daniel J Ceradini, Eduardo D Rodriguez","doi":"10.1097/GOX.0000000000006598","DOIUrl":"10.1097/GOX.0000000000006598","url":null,"abstract":"<p><strong>Background: </strong>In vascularized composite allotransplantation, face transplantation stands as a transformative intervention for patients with severe facial disfigurement. Monitoring of graft rejection, however, remains a critical challenge. This study aimed to investigate the role of lymphocyte subsets in the early detection and monitoring of graft rejection in face transplantation.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of 3 face transplant recipients who underwent face transplantation at our institution. Peripheral blood samples were analyzed for lymphocyte subsets at multiple time points posttransplantation. A linear mixed-effects model was used, aiming to identify any upregulation associated with episodes of graft rejection.</p><p><strong>Results: </strong>A statistically significant relationship was found between clinically treated episodes of rejection, ultimately confirmed by histology, and several lymphocytic subsets. CD3⁺ and CD3⁺CD4⁺ cell lineages were found to be significantly upregulated during times of rejection (<i>P</i> = 0.0147 and <i>P</i> = 0.0153, respectively). Furthermore, CD3⁺CD8⁺ and CD16⁺CD56⁺ cell lineages were also found to be significantly associated with rejection (<i>P</i> = 0.0490 and <i>P</i> = 0.0019, respectively). Further stratification with tacrolimus as a fixed effect demonstrated that CD3⁺, CD3⁺CD4⁺, and CD15⁺CD56⁺ cell lineages remained significantly associated with rejection (<i>P</i> = 0.0167, <i>P</i> = 0.0223, and <i>P</i> = 0.0015, respectively).</p><p><strong>Conclusions: </strong>Our study demonstrates that monitoring specific lymphocyte subsets offers a promising adjunct for graft surveillance that is less invasive when compared with traditionally used punch biopsies. This approach not only enhances the precision of rejection monitoring but also improves patient comfort and compliance, thereby contributing to better long-term graft outcomes.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 3","pages":"e6598"},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573583","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":"An Innovative Lip Boosting Technique Using Polynucleotides: \"4-point Cannula Technique\".","authors":"Noury Adel","doi":"10.1097/GOX.0000000000006567","DOIUrl":"10.1097/GOX.0000000000006567","url":null,"abstract":"<p><p>The new concept in aesthetic medicine is heading toward regenerative medicine and the use of skin boosters in our practice, so the present case report aimed to evaluate the efficacy of injecting a polynucleotide into the lips for lip rejuvenation. Five female Middle Eastern patients were included in the study who wanted to have a lip rejuvenation treatment aiming to provide a lip hydration effect without any volumization. All patients were injected with polynucleotide using a micro cannula. Standardized photographs were taken before and after the injection procedure for evaluation of the results. All patients reported a high degree of satisfaction immediately after the injection, and there was also a marked improvement in the lip texture and elasticity where this improvement lasted 6 months after the procedure. Using polynucleotide as a skin booster for lip rejuvenation can provide a hydrating effect for the lips without any volumization, along with improvement in the lip texture, where this improvement lasts for 6 months after the procedure.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 3","pages":"e6567"},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573582","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":"Novel Windmill Nonischemic Free Bilateral Deep Inferior Epigastric Perforator Flap for Extensive Defect Reconstruction.","authors":"Matthew H Loper, Collin E Gonce, Dakota St Pierre, Mohamed Elkahly, Guilherme C Barreiro","doi":"10.1097/GOX.0000000000006580","DOIUrl":"10.1097/GOX.0000000000006580","url":null,"abstract":"<p><p>Reconstructing extensive lower extremity soft tissue defects can present significant challenges for plastic surgeons. Determining a donor site for a flap of adequate surface area to cover critical structures while minimizing donor-site morbidity is difficult. We describe a novel windmill nonischemic free bilateral deep inferior epigastric perforator (DIEP) flap as a suitable option for the reconstruction of extensive lower extremity defects. Our patient is a 59-year-old man with a body mass index of 36 kg/m² and a history of 23 kg weight loss after gastric sleeve placement. He presented to our service from the level 1 trauma center after sustaining a high-intensity crush injury to the right lower extremity and undergoing orthopedic reconstruction, which was complicated by wound dehiscence and hardware exposure. Following debridement, the defect measured 65 × 25 cm. A bilateral DIEP flap measuring 70 × 21 cm (among the largest by surface area described) was designed. The flap covered the defect fully, with perfusion obtained outside the zones of injury. A dual pedicle design was used to augment perfusion to the flap, with proximal and distal anastomoses in the lower extremity. Bilateral pedicles and 2 separate rotations across the recipient site allowed for reconstruction with no ischemia time. No complications occurred postoperatively or during the follow-up period (2.25 y). Combined or sequential flap transplantation is widely used in the reconstruction of extensive soft tissue defects. However, the windmill nonischemic free bilateral DIEP flap can cover a massive defect in a single stage with no ischemia time.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 3","pages":"e6580"},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573585","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":"Prophylactic Absorbable Antibiotic Beads: Effect on Postoperative Drain Management Following Breast Reconstruction.","authors":"Shahnur Ahmed, John P Hajj, Ravinder Bamba, Rachel M Danforth, Richard Jason VonDerHaar, Mary E Lester, Aladdin H Hassanein","doi":"10.1097/GOX.0000000000006594","DOIUrl":"10.1097/GOX.0000000000006594","url":null,"abstract":"","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 3","pages":"e6594"},"PeriodicalIF":1.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557636","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":"The Silent Helper: A Helpful Tool in Autologous Breast Reconstruction Surgery.","authors":"Evi M Morandi, Selina Winkelmann, Ralph Verstappen, Christine Brunner, Dolores Wolfram","doi":"10.1097/GOX.0000000000006586","DOIUrl":"10.1097/GOX.0000000000006586","url":null,"abstract":"<p><p>The internal mammary vessels are the standard recipient vessels in autologous breast reconstruction. Rib-sparing techniques have evolved to routine use, limiting the surgical field for vessel preparation to a minimum. An inframammary approach for skin-sparing mastectomy provides aesthetically pleasing results but might impede exposure even further. We have developed a simple yet elaborate technique to expose the surgical field for the preparation of the internal mammary vessels in a staff- and cost-efficient manner while using basic surgical tools.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 3","pages":"e6586"},"PeriodicalIF":1.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557677","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":"Should Every Mummified Toe Be Amputated? Toe Preservation With a Perforator Flap.","authors":"Bo Young Park","doi":"10.1097/GOX.0000000000006564","DOIUrl":"10.1097/GOX.0000000000006564","url":null,"abstract":"<p><strong>Background: </strong>Peripheral gangrene, caused by various etiologies, including diabetes, peripheral artery disease, trauma, and vasopressor use, poses significant challenges. Traditional management often involves proximal amputation, which carries a high risk of major amputation and mortality. This study evaluated the efficacy of perforator flaps for toe preservation in patients with toe necrosis.</p><p><strong>Methods: </strong>Six patients with peripheral gangrene, affecting a total of 9 toes, were retrospectively analyzed. The surgical procedure entailed only soft tissue debridement with minimal to no bone amputation and subsequent coverage using thin perforator flaps. Patient demographics, surgical details, flap outcomes, and additional procedures were also reviewed.</p><p><strong>Results: </strong>Despite potential technical challenges, all but 1 flap survived, with 1 patient requiring partial flap loss management using a full-thickness skin graft. Most patients exhibited successful infection control and wound healing, with a significant emphasis on preserving toe functionality and length.</p><p><strong>Conclusions: </strong>This study demonstrated that toe preservation with \"encircling\" perforator flaps is a viable alternative to traditional proximal amputation for patients with peripheral gangrene. This approach may provide a potential benefit in preserving limb length, but careful patient selection and surgical precision are paramount for achieving favorable outcomes.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 3","pages":"e6564"},"PeriodicalIF":1.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557622","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":"Dural Exposure as a Rare Complication in Surgical Management of Temporalis Myositis Ossificans.","authors":"Aref Nassar, Elia Kassouf, Marc Aoude, Nabil Hokayem","doi":"10.1097/GOX.0000000000006563","DOIUrl":"10.1097/GOX.0000000000006563","url":null,"abstract":"<p><p>Myositis ossificans is a rare condition characterized by heterotopic bone formation in soft tissues, often following trauma. Although it can occur in the maxillofacial region, cases involving the temporalis muscle are infrequent. We report a case of a 33-year-old man who developed severe limitation of mouth opening due to myositis ossificans following closed trauma to the temporal region. Surgical excision was performed. The excision resulted in dural exposure and a small tear, requiring repair with a temporalis fascial graft. This case highlights a rare complication of myositis ossificans in the temporalis muscle, emphasizing the importance of a cautious surgical technique to avoid dural injury while achieving adequate removal of heterotopic ossification.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 3","pages":"e6563"},"PeriodicalIF":1.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557597","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":"Intercostal Nerve Transfer as a Novel Technique for Sensation Preservation in Gender-affirming Subcutaneous Mastectomy.","authors":"Walter Lin, Ashley Titan, Veronique Doucet, Brian Pridgen, Bauback Safa","doi":"10.1097/GOX.0000000000006565","DOIUrl":"10.1097/GOX.0000000000006565","url":null,"abstract":"<p><p>Chest-wall contouring surgery is an important step in the transitional journey of many transgender individuals who choose to undergo masculinization procedures. Traditional gender-affirming chest surgery does not include reinnervation of the nipple-areolar complex (NAC) or the mastectomy skin flaps and risks partial or complete denervation of these areas. Efforts to restore sensation have emerged leading to various sensory nerve transfer techniques including direct neurorrhaphy to the repositioned NAC or to underlying dermatosensory elements. Here, we describe a novel technique in which we perform a nerve transfer from the anterior lateral branch of the fourth intercostal nerve (of the breast parenchyma to be resected) to the anterior lateral branch of the third or second intercostal nerve in the mastectomy skin flap. There has been no increased risk of complications, and results so far are promising. As we continue to collect long-term outcome data, the effectiveness of NAC reinnervation using this technique will be presented in a forthcoming publication.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 3","pages":"e6565"},"PeriodicalIF":1.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557631","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":"Submental Microneedles of Botulinum Toxin A for Double Chin After Neck Injection.","authors":"Shuai Qiang, Jie Long, Han Chen, Songjie Li, Xin Dan, Yang Li, Xing Fan","doi":"10.1097/GOX.0000000000006593","DOIUrl":"10.1097/GOX.0000000000006593","url":null,"abstract":"<p><p>Neck injections of botulinum toxin A (BTX-A) are an effective, minimally invasive approach to improve lower face sagging, especially in Asian populations. However, cases of worsened \"double chin\" have been observed postinjection, likely due to the platysma muscle type and limited anterior neck injection range, which may result in compensatory platysma contraction. Five female patients who developed aggravated double chin after BTX-A injections in the lower jaw and neck were treated with microneedle BTX-A injections (10-20 U in 3-4 rows with 0.5-1 cm between points). Effective submental lifting and double chin improvement were observed within 5-10 days, with no reports of voice changes or dysphagia. This microneedle BTX-A injection technique provides a safe, effective solution for enhancing the anterior neck region and can serve as an important adjunct to lower face antiaging treatments.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 3","pages":"e6593"},"PeriodicalIF":1.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557639","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":"Super-fine Nail Art Brush: A Helpful Surgical Marking Pen for Preoperative Design of Double-eyelid Blepharoplasty.","authors":"Junzheng Wu, Xuefeng Su, Xuchuan Zhou, Bin Liu, Jingang Luo","doi":"10.1097/GOX.0000000000006583","DOIUrl":"10.1097/GOX.0000000000006583","url":null,"abstract":"","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 3","pages":"e6583"},"PeriodicalIF":1.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557649","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}