Plastic and Reconstructive Surgery Global Open最新文献

{"title":"Umbilical Piercing Tract Closure: A Novel Solution for a Common Problem.","authors":"Andrew F Emanuels, Sara M Hussein, Aida K Sarcon, Basel A Sharaf","doi":"10.1097/GOX.0000000000007084","DOIUrl":"10.1097/GOX.0000000000007084","url":null,"abstract":"<p><p>Umbilical piercings are popular among young individuals for aesthetic body enhancement. However, umbilical piercings can lead to complications such as infections, hypertrophic scarring, and epithelialized tracts that require surgical intervention. This case report presents a novel, minimally invasive technique using a lacrimal probe and iris scissors under local anesthesia to excise the epithelialized piercing tracts. A 23-year-old patient underwent the procedure, resulting in minimal scarring and high satisfaction at an 11-month follow-up. Compared with the existing methods, this approach ensures complete tract removal while preserving the natural umbilical contour. Given the limited literature, this technique offers an effective solution with excellent cosmetic outcomes.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 9","pages":"e7084"},"PeriodicalIF":1.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065504","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":"A Workflow for Fibula Free Flap Maxillomandibular Reconstruction With Immediate Prosthodontic Rehabilitation.","authors":"Alexander De Moor, Michel Bila, Thomas Aerden, Karel Missinne, Véronique Christiaens, Robin Willaert, Yi Sun","doi":"10.1097/GOX.0000000000007111","DOIUrl":"10.1097/GOX.0000000000007111","url":null,"abstract":"<p><p>Computer-aided surgical planning has improved functional and aesthetic outcomes in maxillofacial reconstructive surgery. Immediate dental implantation is now being increasingly performed in conjunction with the fibula free flap, with high success rates in maxillomandibular reconstructions. The success of this approach relies on careful patient selection, meticulous surgical planning, and prosthetic implementation. Patient-specific surgical templates for resection, repositioning, and implant placement facilitate this process, allowing successful installation of prefabricated prosthetic dental arches during surgery and ensuring a stable postoperative occlusion. Achieving optimal results is contingent upon collaboration among surgical, prosthodontic, and engineering expertise, particularly in the precise computer-aided design/computer-aided manufacturing positioning of bone flaps and implants. This article aimed to introduce a workflow for immediate loading of implants in fibula free flap maxillomandibular reconstruction. The use of a patient-specific implant to improve lower facial contour in mandibular reconstructions and an occlusion-based reverse planning is highly recommended to achieve optimal results.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 9","pages":"e7111"},"PeriodicalIF":1.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065511","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":"Antegrade Kirschner Wire Transfixation of Interphalangeal and Metacarpophalangeal Joint in a Comminuted Thumb Proximal Phalangeal Fracture.","authors":"Jui-Chien Wang, Yi-Chao Huang, Jung-Pan Wang","doi":"10.1097/GOX.0000000000007095","DOIUrl":"10.1097/GOX.0000000000007095","url":null,"abstract":"<p><p>Comminuted proximal phalangeal fractures of the thumb are inherently unstable injuries requiring surgical fixation to provide stability and restore function. Current fixation methods include plate and screw fixation, which is associated with stiffness (in 64% of cases), extensor lag, and hardware complications requiring further operations. Moreover, intramedullary screws carry the risk of cartilage damage and fracture displacement during insertion. These modalities requiring extensive soft tissue dissection correlate with poor functional outcomes due to fibrosis and vascular disruption. A simplified surgical technique was presented through a case of open comminuted thumb proximal phalangeal fracture managed with antegrade intramedullary Kirschner wire transfixation of both the metacarpophalangeal joint (MCPJ) and interphalangeal joint. This approach acknowledges the biomechanical reality that thumb function primarily relies on carpometacarpal joint mobility, with the MCPJ contributing substantially less to functional opposition, making temporary MCPJ immobilization well tolerated. Extended stabilization is critical, as evidenced by a documented case report showing loss of reduction between 9 and 14 weeks postoperatively, even with a rigid fixation method. The technique presented offers several advantages: minimal soft tissue disruption preserving vascularity essential for healing, no pin tract infection despite nonburied wire fixation, simplified removal without additional anesthesia, and economic benefits through reduced operating time and the absence of expensive implants. Radiographic union was achieved by 16 weeks, with good functional recovery and no complications. This technique represents a valuable balance between stability requirements and soft tissue preservation, particularly in open injuries where extensive surgical approaches may be contraindicated.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 9","pages":"e7095"},"PeriodicalIF":1.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065501","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 Versatility of the Fat-extended, Muscle-sparing Latissimus Dorsi Flap in Breast Reconstruction.","authors":"Simone La Padula, Giovanni Esposito, Alessio Ciccarelli, Concetta Errico, Rosita Pensato, Barbara Hersant, Jean Paul Meningaud, Giovanni Roccaro, Francesco D'Andrea, Fabrizio Schonauer","doi":"10.1097/GOX.0000000000007073","DOIUrl":"10.1097/GOX.0000000000007073","url":null,"abstract":"<p><strong>Background: </strong>The latissimus dorsi (LD) myocutaneous flap is widely used in breast reconstruction, often combined with implants, due to its reliable vascular axis. However, traditional techniques can result in functional deficits and complications. The fat-extended muscle-sparing LD flap (FEMSLDF) was developed to optimize breast volume restoration while minimizing complications. This study aimed to evaluate the effectiveness, safety, and patient satisfaction associated with the FEMSLDF.</p><p><strong>Methods: </strong>A prospective study was conducted on 172 patients who underwent FEMSLDF-based breast reconstruction (immediate, delayed, or salvage) between January 2018 and November 2023. The surgical technique prioritized preserving the LD muscle while using surrounding subcutaneous fat for volume restoration. Data on postoperative complications and patient-reported outcomes were collected, including BREAST-Q modules and the Patient and Observer Scar Assessment Scale.</p><p><strong>Results: </strong>The mean age of patients was 47 ± 5.42 years, with a mean follow-up of 18.2 ± 3.2 months. The mean surgical time was 65 ± 23.1 minutes, with an average hospital stay of 2-3 days. Only 1 minor complication (0.58% incidence) was reported. BREAST-Q scores showed significant improvements in psychosocial, sexual, and physical well-being (<i>P</i> < 0.05), whereas the LD module indicated preserved muscle functionality (<i>P</i> = 0.2). Patient and Observer Scar Assessment Scale scores reflected high patient satisfaction with the dorsal scar.</p><p><strong>Conclusions: </strong>The FEMSLDF is a versatile, safe, and effective technique for breast reconstruction, achieving good aesthetic and functional outcomes with minimal complications. It represents a valuable alternative to traditional and hybrid reconstruction methods.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 9","pages":"e7073"},"PeriodicalIF":1.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041089","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":"Use of Lacrimal Retractor in Rhinoplasty: A Boon for the Solo Rhinoplasty Surgeon.","authors":"David A Graham","doi":"10.1097/GOX.0000000000007077","DOIUrl":"10.1097/GOX.0000000000007077","url":null,"abstract":"<p><p>Open rhinoplasty is a complex procedure that requires precise exposure of multiple anatomic structures. Anatomic dissection typically proceeds from the tip cephalad to the dorsum. Although newer open rhinoplasty techniques exist, many surgeons still perform a bidirectional cartilage-splitting approach. This approach requires precise exposure of the septum while retracting the lower lateral cartilages at their midline. This retraction facilitates tip and dorsum dissection and allows adequate visualization of the septum for modification. Current lower lateral cartilage retraction techniques require either surgical assistants to hold hooks or clamps, or the solo surgeon to use weighted hooks or clamps that are simply allowed to fall laterally, thus providing exposure. Furthermore, for septal exposure, the surgeon often must use a nasal speculum in 1 hand while attempting to dissect and modify the septum with the other. In this article, the author described the technique of using a spring-loaded lacrimal retractor to facilitate dissection of the nasal tip, as well as to provide exposure for dorsal and caudal septal modification. This technique provides a constant and predictable retracting force to the midline cartilages; is atraumatic; and, most importantly, allows the operating surgeon to use both hands while performing the operation. The technical advantages of using such a device could serve as a boon to both structural and preservation rhinoplasty surgeons.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 9","pages":"e7077"},"PeriodicalIF":1.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041027","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":"Collagen Use in Periorbital Rejuvenation for Chinese Patients: The Restoration Injection for Optimal Rejuvenation Technique.","authors":"Qingyu Hao, Wenrong Tian, Huinan Chang, Jiang Ai","doi":"10.1097/GOX.0000000000007083","DOIUrl":"10.1097/GOX.0000000000007083","url":null,"abstract":"<p><p>Modern periorbital rejuvenation treatments involve a comparison of various injectable materials to optimize therapeutic outcomes. This article highlights the advantages of collagen in periorbital rejuvenation and introduces the restoration injection for optimal rejuvenation (RIO) technique as a precise and safe injection method. Due to the complex anatomical and physiological characteristics of the periorbital area, conventional injectable materials may lead to adverse reactions or suboptimal results. Collagen, however, offers excellent adhesion and minimal migration, and effectively improves both pigmented and structural dark circles. To ensure long-term results and minimize complications, the RIO technique, developed based on the authors' years of injection experience, optimizes collagen application. This low-cost technique is suitable for personalized customization, is safe and effective, and provides patients with a reliable periorbital rejuvenation solution.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 9","pages":"e7083"},"PeriodicalIF":1.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041061","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 First Microsurgery-assisting Robot Equipped With an Automatic Instrument Exchange System and a Miniature Tool Kit.","authors":"Makoto Mihara, Hisako Hara, Kazuhito Wakana, Hirofumi Owaki, Kei Mikami, Atsushi Miyamoto, Munekazu Naito, Ken Masamune","doi":"10.1097/GOX.0000000000007072","DOIUrl":"10.1097/GOX.0000000000007072","url":null,"abstract":"<p><p>Microsurgery requires high precision, stability, and effective teamwork. However, current robotic-assisted surgery faces challenges such as inefficient instrument exchange and dependence on surgical assistants, contributing to prolonged operative times and increased costs. To address these issues and enhance surgical efficiency and surgeon autonomy, we developed a microsurgery-assisting robot equipped with an automated instrument exchange system and a specialized micro tool kit. The robot was tested using chicken-wing arteries and rat vessels with diameters ranging from 0.35 to 0.8 mm. Evaluation parameters included anastomosis time, frequency of instrument exchanges, and vascular patency rates. The automated system completed instrument exchanges accurately within approximately 9 seconds, maintaining a smooth workflow while significantly reducing reliance on assistants. In the rat model, a vascular patency rate of 100% was achieved. Although anastomosis times were slightly longer compared with manual operations performed by skilled surgeons, our system is anticipated to improve accuracy in complex microsurgical procedures involving extremely fine vessels. Conventional microsurgery-assisting robots have primarily focused on performing vascular anastomosis alone; however, our newly developed robot with an automated instrument exchange mechanism effectively facilitates a broader range of tasks, including vessel dissection, trimming, vascular anastomosis, and postoperative patency assessments.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 9","pages":"e7072"},"PeriodicalIF":1.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041094","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":"Considerations for the Use of Glucagon-like Peptide-1 Medications for Obesity in a Plastic Surgery Setting.","authors":"Leah M Schumacher, David B Sarwer","doi":"10.1097/GOX.0000000000007085","DOIUrl":"10.1097/GOX.0000000000007085","url":null,"abstract":"<p><p>In recent years, there has been great interest among the medical community and general public in a new generation of medications for treating obesity. Likely due to this interest, there have been anecdotal reports of plastic surgeons beginning to prescribe these medications in their practices. This Special Topic article provides a brief overview of obesity and its evidence-based treatments, including these newer medications. Particular emphasis is placed on the growing consensus that obesity is a chronic disease that contributes to numerous other comorbidities and requires sustained treatment. Plastic surgeons who are interested in using newer obesity medications in their practices may wish to consider the need for additional training to ensure that they are optimizing patient welfare, guarding against harm, and providing care consistent with clinical guidelines and recommended best practices of obesity medicine.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 9","pages":"e7085"},"PeriodicalIF":1.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041039","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":"Late Intervention Yet Successful Outcome with High-dose Pulsed Hyaluronidase for Forehead Filler Vascular Complication.","authors":"Manaka Tagaya, Konyo Arai, Krishan Mohan Kapoor","doi":"10.1097/GOX.0000000000007087","DOIUrl":"10.1097/GOX.0000000000007087","url":null,"abstract":"<p><p>Vascular complications following hyaluronic acid filler injections are rare but may lead to ischemia and necrosis. Effective management often relies on the early administration of hyaluronidase to restore perfusion and prevent long-term damage. However, delayed presentations pose unique challenges due to prolonged ischemia and increased risk of tissue necrosis. A 35-year-old woman presented 3 days after forehead filler injection with signs of vascular compromise. Initial treatment with 1800 U hyaluronidase failed. On presentation, she exhibited advanced ischemia with erythema, pustules, and livedo reticularis. A high-dose pulsed hyaluronidase protocol totaling 32,000 U for 4 days was initiated. Rapid improvement followed, with complete epithelialization by day 30 and near-complete recovery by day 90 without scarring. Despite delayed presentation, the high-dose pulsed hyaluronidase protocol successfully reversed ischemia and prevented necrosis, supporting its use in late-stage vascular complications.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 9","pages":"e7087"},"PeriodicalIF":1.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041042","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":"Plastics Makes Perfect: A Collaborative, Cost-effective Approach to Multilevel Cadaveric Learning.","authors":"Kerilyn Godbe, Cole Bird, Dylan Vance, Niaman Nazir, Lyndsey Kilgore, German Berbel, David Megee, Ravi Garg, James Butterworth, Rebecca Farmer","doi":"10.1097/GOX.0000000000007081","DOIUrl":"10.1097/GOX.0000000000007081","url":null,"abstract":"<p><strong>Background: </strong>Medical students are losing hands-on experience during surgical clerkships, and residents and faculty are expected to teach them with minimal educational training. A multilevel cadaveric curriculum (MCC) was implemented to improve surgical education for all groups.</p><p><strong>Methods: </strong>In the MCC, a senior resident verbally guided 2 medical students through a procedure on a cadaver, whereas a junior resident performed the procedure on the contralateral side under faculty guidance. Educational benefits were assessed via pre- and postsurveys, with costs shared between surgical departments.</p><p><strong>Results: </strong>Six MCC laboratory sessions were performed from 2023 to 2024, with a survey response rate of 89.6% (173 of 193). The laboratory sessions increased medical students' confidence in identifying procedural anatomy (3.9 versus 5.3, <i>P</i> < 0.0001), using surgical instruments (4.3 versus 5.3, <i>P</i> < 0.0001), and assisting in the operating room (4.8 versus 5.6, <i>P</i> < 0.0001). Both junior and senior residents, respectively, noted increased confidence in marking incisions (3.1 versus 5.6, <i>P</i> < 0.0001; 4.9 versus 6.2, <i>P</i> < 0.0001), identifying neurovascular structures (2.7 versus 5.1, <i>P</i> < 0.0001; 4.6 versus 6.0, <i>P</i> < 0.0001), completing procedures (2.0 versus 4.3, <i>P</i> < 0.0001; 4.0 versus 5.6, <i>P</i> < 0.0001), and teaching medical students (2.1 versus 4.3, <i>P</i> < 0.0001; 3.8 versus 5.5, <i>P</i> < 0.0001). Faculty reported an increase in overall confidence in teaching ability (6.2 versus 6.5, <i>P</i> = 0.006) and providing feedback (6.2 versus 6.5, <i>P</i> = 0.032).</p><p><strong>Conclusions: </strong>This laboratory was a beneficial educational experience for medical students, residents, and faculty, with improved cadaveric access achieved through cost sharing.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 9","pages":"e7081"},"PeriodicalIF":1.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041053","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}