Plastic and Reconstructive Surgery Global Open最新文献

{"title":"Using Descending Genicular Artery as the Recipient Artery for Free Superficial Circumflex Iliac Artery Perforator Flap.","authors":"Maiko Shirota, Ryo Karakawa, Tomoyuki Yano, Hidehiko Yoshimatsu","doi":"10.1097/GOX.0000000000006184","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006184","url":null,"abstract":"<p><p>This case report presents the use of the superficial circumflex iliac perforator (SCIP) flap for soft tissue reconstruction of the knee, using the descending genicular artery (DGA) as the recipient vessel. A 14-year-old female table-tennis player presented with a right knee mass diagnosed as angiomatoid fibrous histiocytoma. Following resection of the mass, which left a 6.5 × 5.5 cm soft tissue defect over the patella, a free SCIP flap was harvested and used for reconstruction. The SCIP flap was chosen for its thinness and flexibility, making it suitable for the highly mobile knee joint. The superficial circumflex iliac artery (1.2 mm) was anastomosed to the DGA (1.5 mm) in an end-to-end fashion. The flap and deepithelialized skin paddle were routed through a subcutaneous tunnel, and the donor site was closed directly over a drain. The flap survived completely with no postoperative complications. Six months later, despite hyperpigmentation of the scar, the contour was satisfactory with no limitations in knee range of motion. This case underscores the advantages of the SCIP flap, particularly its compatibility with the DGA, reduced donor site morbidity, and excellent aesthetic and functional outcomes. The SCIP flap, combined with the DGA as the recipient vessel, provides an effective solution for complex knee reconstructions, offering a primary option for similar cases.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293284","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 Novel Hybrid Injectable for Soft-tissue Augmentation: Analysis of Data and Practical Experience.","authors":"André Braz, Camila Cazerta de Paula Eduardo, Alexander Pierce, Alexandra Grond, Artem Kutikov, Lauren Nakab","doi":"10.1097/GOX.0000000000006190","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006190","url":null,"abstract":"<p><strong>Background: </strong>HA/CaHa (HArmonyCa, Allergan Aesthetics, an AbbVie Company) is a hybrid injectable filler developed for aesthetic purposes that contains calcium hydroxyapatite microspheres suspended in a hyaluronic acid gel. This review describes preclinical and clinical data, recommendations for use based on the primary author's clinical experience, and case studies that illustrate implementation of product use recommendations and patient outcomes.</p><p><strong>Methods: </strong>Preclinical data on the lift capacity and tissue integration of the HA/CaHa hybrid injectable and clinical data on its safety, efficacy, and real-world use were extracted from poster presentations, published literature, manufacturer instructions for use, and proprietary data files. Case studies were presented based on clinical experience.</p><p><strong>Results: </strong>The HA component of HA/CaHa provides an immediate and noticeable filling and lifting effect, whereas CaHa microspheres result in neocollagenesis. In preclinical studies, HA/CaHa demonstrated higher lift capacity (<i>P</i> < 0.05) and faster tissue integration than a CaHa filler and led to collagen I gene and protein expression. Clinical studies showed clinical safety and effectiveness with high patient satisfaction. The most common adverse event was injection-site response. Clinician recommendations for achieving desired aesthetic results while minimizing or preventing adverse events are reviewed, including patient selection and assessment, treatment approaches based on face shape, injection technique, and postprocedure care.</p><p><strong>Conclusion: </strong>The novel hybrid injectable consisting of HA with incorporated CaHa microspheres in a single marketed product may help achieve aesthetic goals by immediately restoring volume and potentially improving skin architecture and soft-tissue quality over time.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293221","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":"Combination of Cultured Epidermal Autograft and Meshed Skin Graft Enables Full-thickness Excision of Giant Congenital Nevus.","authors":"Chie Kobori, Makoto Hikosaka, Wataru Tsugu, Koki Sakurai, Yukari Nakajima, Hikaru Kono, Akira Kikuchi, Yuki Nakajima, Miho Sumi, Kosuke Kuwahara, Tsuyoshi Kaneko","doi":"10.1097/GOX.0000000000006157","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006157","url":null,"abstract":"<p><p>Giant congenital melanocytic nevus (GCMN) is a skin condition characterized by an abnormally dark, noncancerous skin patch. Two main issues with GCMN are aesthetics and malignant transformation. Various methods of treatment are reported, but each method has its own disadvantages, such as risk of recurrence or restriction in the treatable area. We report three cases of GCMN treated with full-thickness excision and immediately covered with cultured epidermal autograft (CEA) combined with split-thickness skin graft (STSG). This is a single-center, single-arm, retrospective report of three cases. The nevus was excised at full skin thickness. Meshed STSG taken from scalp was grafted to the defect, and CEA was grafted over simultaneously. Two weeks later, CEA was applied again as a booster. The same procedures were performed until all nevi were excised. In all cases, nearly complete epithelialization was achieved at several weeks after operation. The reconstructed skin was elastic, and there was no persistent joint contracture. Vancouver Scar Scale score was 4-8. Mesh-like appearance was observed. A hypertrophic scar appeared in the area without meshed STSG. An intractable keloid was observed in one patient. No recurrence of the nevus was observed during the follow-up period. The donor site scar on the scalp was well hidden by the hair. Our method enables full-thickness resection and reconstruction of a wider area in a single operation while improving the take rate of CEA, with reasonable degree of scarring compared with conventional methods.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11410316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293231","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":"Characteristics and Clinical Features of Patients with Lipedema in Saudi Arabia: A Cross-sectional Comprehensive Assessment.","authors":"Khalid Alosaimi, Hatan Mortada, Feras Alshomer","doi":"10.1097/GOX.0000000000006173","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006173","url":null,"abstract":"<p><strong>Background: </strong>Lower limb swelling presents a diagnostic challenge with diverse causes, including well-known issues like venous insufficiency and lymphedema, and less-understood conditions like lipedema. Lipedema, involving abnormal fat accumulation in the lower extremities, is frequently misdiagnosed, posing challenges for affected individuals. This research aimed to report and analyze the clinical features of patients presenting with the complaint of lipedema.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted in Saudi Arabia from April to November 2023, involving adult patients from a specialized clinic in lipedema and lymphedema management. Data were collected through clinical evaluation and a comprehensive data collection sheet.</p><p><strong>Results: </strong>In a cohort of 115 female patients (mean age: 38.58), the most common age for disease onset was around 20-29 years. Physical examinations revealed symmetric enlargement (88%), collar sign (43%), orthostatic nonpitting edema (49%), and telangiectasia (64%). Varicose veins were present in 36%, Stemmer signs in 2%, and foot edema in 13%. Clinical diagnosis with lipedema occurred in 71%, with grade 2 (31%) as the most common severity and type 3 (47%) as the prevalent disease type.</p><p><strong>Conclusions: </strong>The current study, the first of its kind in the Middle East and specifically in Saudi Arabia, emphasizes the urgency of increased awareness and intervention due to a high underdiagnosis rate in lipedema. The observed complexity in symptoms and correlations between severity, lymphatic impairment, and body mass index underscore lipedema's multifaceted nature. Future research should explore regional and cultural influences and conduct larger studies to validate and recognize various lipedema features.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11410315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293229","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 OK and W Signs in Pre-/Intraoperative Testing of Lacertus and Cubital Tunnel Syndrome.","authors":"Elisabet Hagert, Ramya Gnanapragasam, Vincent Martinel","doi":"10.1097/GOX.0000000000006179","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006179","url":null,"abstract":"","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11410312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293278","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":"Advanced Management of Distal Lower Extremity Congenital Constriction Bands for Foot Salvage.","authors":"Catherine H Bautista, Alexandra S Vitale, Joanna Chen, Laurel Ormiston, Lucia Collar Yagas, Dana N Johns","doi":"10.1097/GOX.0000000000006181","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006181","url":null,"abstract":"<p><p>Constriction ring syndrome is a rare congenital condition characterized by the formation of fibrous amniotic bands, which can result in limb or digit deformation, malformation, or autoamputation. Surgical intervention is necessary for patients with progressive or severe forms of constriction banding, but the timing and operative approach vary widely. Here, the authors present a case report detailing the successful removal of multiple congenital constriction bands (CBs), uniquely affecting the distal ankle and foot in an infant meeting Patterson type-2 criteria. This type is characterized by CBs resulting in distal deformation with or without swelling. In this case, urgent intervention was prompted by concerns of vascular compromise, and amputation was considered due to the severity of the banding. However, the authors advocated for a staged approach, with the aim of preserving the patient's limb. A series of three separate procedures tailored to the patient's banding pattern and subsequent tissue complications were required to achieve restoration of ankle and foot functions, as well as satisfactory cosmesis. This case report underscores the importance of a customized surgical approach in addressing complex CBs and emphasizes the need for proactive consideration of salvage interventions by surgeons.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11410327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293223","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":"Complex Scalp Reconstruction with Super-thin DIEP Free Flap.","authors":"Sandra Scharfetter, Gottfried Wechselberger","doi":"10.1097/GOX.0000000000006182","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006182","url":null,"abstract":"","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11410311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293232","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":"Diversity Scholarships for Plastic Surgery Subinternships: A National Review of US Residency Programs.","authors":"Luis A Antezana, Jess Rames, Pablo Ochoa, Lucas Kreutz-Rodrigues, Karim Bakri","doi":"10.1097/GOX.0000000000006015","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006015","url":null,"abstract":"<p><strong>Background: </strong>Residency programs have developed monetary initiatives for students underrepresented in medicine (URiM). Our team sought to provide a centralized resource for URiM students seeking plastic surgery subinternships with funded opportunities.</p><p><strong>Methods: </strong>A cross sectional analysis of URiM scholarships offered by US integrated plastic surgery programs (n = 91) between July and September 2023. The study used residency program web domains. Investigators collected information on the monetary value of scholarship, eligibility criteria, and required application documents. Inferential analyses were conducted to investigate whether programs' geographic region or Doximity ranking played a role in likelihood of scholarship existence.</p><p><strong>Results: </strong>The study found that approximately 52.7% (n = 48) of programs have in place monetary support for underrepresented visiting medical students (eg, stipend or reimbursement). The average monetary support was $1670. A univariate test demonstrated that programs with lower rankings in both reputation and research were less likely to have a scholarship available than higher ranking programs (<i>P</i> = 0.002; <i>P</i> = 0.02, respectively). Programs located in the Midwest regions were 3.5 times more likely to have a diversity scholarship available (<i>P</i> = 0.034). In our multivariate analysis, reputation ranking and geographic region remained significant. A Pearson chi square test showed the greatest proportions of scholarships among geographically similar programs to be in the Midwest (70%), however, not statistically significant.</p><p><strong>Conclusions: </strong>This study provides a centralized resource for URiM students interested in completing away rotations. Further investigation into development of these scholarship opportunities would be of much benefit and could guide other programs in the funding their own diversity scholarships.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11410328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293234","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 Surfactant Properties of Clindamycin as a Useful Adjunct for Removing Ruptured Silicone Implants.","authors":"Tahera Alnaseri, Leila Musavi, Timothy Deming, Jason Roostaeian, Andrew Da Lio, Thomas G Mason, Michael R DeLong","doi":"10.1097/GOX.0000000000006176","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006176","url":null,"abstract":"<p><strong>Background: </strong>Silicone gel removal after breast implant rupture is a difficult task. Silicone is hydrophobic and thus cannot be irrigated effectively with saline. Attempts at mechanical removal with sponges are often partially successful. Incomplete removal results in persistent silicone contamination with possible local inflammation, infection, and silicone granulomata. In this partially quantitative investigation, we assess the de-adhesion ability of different clindamycin formulations against known surfactant controls when combined with silicone gel.</p><p><strong>Methods: </strong>To demonstrate surfactant properties in vitro, clindamycin phosphate, clindamycin hydrochloride, and a known surfactant, sodium dodecyl sulfate (SDS), were compared. An amount of 170 g of silicone gel placed in a dry glass container exhibited strong adherence to the container walls. In separate trials, clindamycin phosphate (300 mg in 100 mL), clindamycin HCl (300 mg in 100 mL), and SDS (1 g in 100 mL) solutions with normal saline were added to the silicone aggregate, and de-adhesion properties were compared.</p><p><strong>Results: </strong>All solutions aided in the de-adhesion of the sticky silicone from glass substrate. The SDS had the strongest effect, followed by clindamycin phosphate and then clindamycin HCl. The observed interactions suggested that all of the solutions behaved as ionic surfactant coating the silicone with negative charges via adsorption. However, the phosphate anionic formulation was associated with a greater surfactant effect than HCl.</p><p><strong>Conclusions: </strong>Clindamycin acts as a surfactant to aid in the clinical removal of ruptured silicone gel. Clindamycin phosphate seems to have a stronger effect than clindamycin HCl, likely related to the negative charges on the phosphate groups.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11410335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293280","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":"Analysis of the Pathogen Distribution and Antimicrobial Resistance after Plastic Surgery of the Urogenital System.","authors":"Fengli Jiang, Qi Chen, Yuanyuan Wu, Jinhao Lin, Xueshang Su, Jun Zhuang, Sien Zhan","doi":"10.1097/GOX.0000000000006165","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006165","url":null,"abstract":"<p><strong>Background: </strong>We aimed to summarize the distribution of pathogenic bacteria for postoperative infection of different genitourinary plastic surgery and the antimicrobial resistance of the major pathogens.</p><p><strong>Methods: </strong>Between January 2011 and December 2021, following plastic surgery of the urogenital system, microbial strains from infected patients were collected, identified, and counted. The antibiotic sensitivity and distribution characteristics of common pathogens in relation with the surgical procedures were studied by WHONET 5.6, along with the main bacteria accounting for early infection.</p><p><strong>Results: </strong>A total of 76 cases were included in the study. Among these, 53 Gram-negative bacteria were detected, with <i>Escherichia coli</i> (18 of 53) and <i>Pseudomonas aeruginosa</i> (nine of 53) accounting for the majority. There were also 23 Gram-positive bacteria, among which <i>Staphylococcus aureus</i> (six of 23) and Coagulase-negative <i>Staphylococcus</i> (five of 23) were the most common. In terms of antimicrobial resistance, <i>E. coli</i> was highly sensitive to amikacin, piperacillin/tazobactam, cefoxitin, and imipenem, whereas <i>P. aeruginosa</i> was highly sensitive to gentamicin, amikacin, cefepime, piperacillin/tazobactam, imipenem, ceftazidime, and ciprofloxacin. Procedures for urethral repair, urethral reconstruction, and lump resection were most commonly associated with infection. Among these, urethral repair was responsible for the majority of infections. The pathogenic bacteria involved in postoperative infections varied overall, but the most prevalent was <i>E. coli</i>.</p><p><strong>Conclusions: </strong>Gram-negative bacteria are the major cause of infection following genitourinary plastic surgery. The specific bacterial strains, degrees of antimicrobial resistance, and length of infection varied among the various procedures. The results of this study may provide references for clinical medication and the prevention and control of such infections.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11410319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293225","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}