Plastic and Reconstructive Surgery Global Open最新文献

{"title":"Reliable Detection, Unreliable Clinical Decision-making: Artificial Intelligence Models in Burn Assessment.","authors":"Ibrahim Güler, Uzay Cambaz, Armin Kraus, Gerrit Grieb, Henrik Stelling","doi":"10.1097/GOX.0000000000008141","DOIUrl":"https://doi.org/10.1097/GOX.0000000000008141","url":null,"abstract":"<p><strong>Background: </strong>Multimodal artificial intelligence (AI) systems are increasingly used for visual interpretation tasks. Whether commercially available models can be applied to burn surgery, and to what extent, remains unclear. We evaluated a clinical chain from visual recognition (distinguishing burns from nonburned skin) to treatment decision-making (debridement versus immediate skin grafting), including accuracy, output consistency, and skin tone subgroup performance.</p><p><strong>Methods: </strong>Four multimodal large language models (GPT-5.4 Pro, Grok 4.1, Gemini 3.1 Pro, and Claude Opus 4.6) evaluated 50 cropped clinical photographs (25 burns and 25 nonburns) across 5 independent runs (n = 4000 total assessments). Models classified burn presence and treatment recommendation. Ground truth was established by expert consensus among plastic surgeons. Reproducibility was assessed using Fleiss κ.</p><p><strong>Results: </strong>Burn detection was near-perfect (97.2%-100%, κ = 0.896-1.000) and equivalent across Fitzpatrick skin tone strata. Treatment accuracy in burn cases ranged from 24.8% to 72.8%, with 3 models performing below the majority-class baseline. Reproducibility for treatment decisions dropped to κ = 0.132-0.385 in 3 models, with inconsistent recommendations for identical images. Error patterns were systematic and opposing across models.</p><p><strong>Conclusions: </strong>AI systems reliably detected burns but failed to reliably recommend treatment. Reproducibility remained high for visual recognition but substantially lower for clinical decision-making. The clinical chain breaks at the transition from perception to decision, limiting the current applicability in burn surgery. The high sensitivity (94.4%-100%) and specificity (100%) for burn detection suggest that visual recognition may serve as a reliable foundation for future AI-assisted triage in burn care.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 10","pages":"e8141"},"PeriodicalIF":1.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183732","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":"Palatal Island Flap With Adjuvant Radiotherapy for Hard Palate Adenoid Cystic Carcinoma: 2-year Outcomes.","authors":"Pattana Ongkasuwan","doi":"10.1097/GOX.0000000000008168","DOIUrl":"https://doi.org/10.1097/GOX.0000000000008168","url":null,"abstract":"<p><p>Adenoid cystic carcinoma (ACC) of the minor salivary glands most commonly arises in the hard palate and exhibits perineural invasion, indolent growth, and late recurrence, often requiring multimodal therapy. Reconstruction must restore oronasal separation, speech, and deglutition; data regarding the tolerance of palatal island flaps to postoperative radiotherapy and long-term functional outcomes remain limited. A 35-year-old woman with T1N0M0 ACC of the right hard palate (American Joint Committee on Cancer, 8th edition) underwent wide local excision with partial palatal ostectomy followed by reconstruction using a contralateral palatal island flap. After complete mucosal healing, adjuvant intensity-modulated radiotherapy (66 Gy in 33 fractions) was administered. Two-year outcomes were assessed using Thai-language validated versions of the EORTC QLQ-C30, EORTC QLQ-HN43, FACT-H&N, and UW-QOL questionnaires. Final pathology demonstrated cribriform and tubular ACC with perineural invasion. The tumor approached the medial (0.4 mm) and lateral (1.7 mm) margins, which were close but uninvolved. Acute toxicity consisted of grade 2 donor-site oral mucositis treated with topical triamcinolone. At 2-year follow-up, surveillance with magnetic resonance imaging of the skull base, computed tomography of the chest, and bone scintigraphy demonstrated no evidence of locoregional recurrence or distant metastasis. Speech was fully intelligible on speech-language pathology assessment, the Functional Oral Intake Scale score was 7, and quality-of-life outcomes remained favorable across all instruments. This case suggested that a palatal island flap may tolerate adjuvant radiotherapy when irradiation is delivered after complete flap healing, with favorable oncological, functional, and quality-of-life outcomes at 2 years.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 10","pages":"e8168"},"PeriodicalIF":1.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183795","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":"Short- and Long-term Patency of Prophylactic and Therapeutic Lymphovenous Anastomosis for Extremity Lymphedema: A Systematic Review.","authors":"Adriano Fabi, Séverin R Wendelspiess, Christian Appenzeller-Herzog, Elisabeth A Kappos","doi":"10.1097/GOX.0000000000008181","DOIUrl":"https://doi.org/10.1097/GOX.0000000000008181","url":null,"abstract":"<p><strong>Background: </strong>The clinical effectiveness of lymphovenous anastomosis (LVA) for extremity lymphedema often decreases after 6-12 months. This waning effect is believed to be associated with loss of anastomotic patency, but patency rates remain poorly defined in the current literature. Consequently, the goal of this systematic review is to summarize the available evidence on short- (≤12 mo) and long-term (>12 mo) patency following supermicrosurgical LVA.</p><p><strong>Methods: </strong>A preferred reporting items for systematic reviews and meta-analyses-compliant systematic literature search for lymphedema, LVA, and patency/imaging was conducted in Embase, Medline (Ovid), and Web of Science. Citation searching via Lens.org, Scopus, and Web of Science supplemented the primary search. Risk of bias was assessed using ROBINS-I and RoB-2.0 tools. Study results were tabulated and summarized narratively.</p><p><strong>Results: </strong>A total of 2011 records were screened, of which twelve observational studies and one randomized controlled trial (1089 patients) met the inclusion criteria. Short-term patency after therapeutic LVA ranged from 32% to 93% and long-term patency from 36% to 97%. Prophylactic LVA demonstrated comparable durability with a patency rate of 80% after 18 months. Importantly, studies utilizing indocyanine green lymphography consistently reported lower short-term patency rates than those using lymphoscintigraphy. The majority of studies exhibited serious risk of bias.</p><p><strong>Conclusions: </strong>Long-term patency after LVA appears achievable in a substantial proportion of patients with extremity lymphedema. However, the marked variability in reported patency rates, serious risk of bias, and heterogeneity in imaging methods and patency definitions highlights the need for standardized postoperative patency assessment.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 10","pages":"e8181"},"PeriodicalIF":1.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183810","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":"Treatment of Scapholunate Ligament Tear: The First Long-term Follow-up of an Innovative Surgical Technique.","authors":"Rahel D Künzle, Voja Lazic, Dirk J Schaefer, Ilario Fulco","doi":"10.1097/GOX.0000000000008157","DOIUrl":"https://doi.org/10.1097/GOX.0000000000008157","url":null,"abstract":"<p><strong>Background: </strong>The scapholunate ligament is essential for carpal stability. Rupture of this ligament can cause scapholunate dissociation, resulting in relevant carpal instabilities. Early diagnosis and treatment of scapholunate rupture has a major impact on outcomes. In this study, we evaluated patients who underwent an innovative surgical technique using a TwinFix screw for intercarpal fixation.</p><p><strong>Methods: </strong>Sixteen patients with scapholunate ligament rupture treated using this surgical technique between 2002 and 2018 were analyzed. Twelve patients were included in the study, and data were assessed using clinical, functional, subjective, and radiological parameters.</p><p><strong>Results: </strong>All patients were able to return to regular work after recovery. A functional range of motion to perform activities of daily living was achieved. Subjectively, our study showed remarkably low numeric rating scale scores, with an average of 0.50, and a highly positive mean Disabilities of the Arm, Shoulder, and Hand score of 6.32. None of the 12 patients developed midcarpal or radiocarpal osteoarthritis over the entire observational period of up to 20 years.</p><p><strong>Conclusions: </strong>The innovative TwinFix screw technique, with its successful and convincing long-term outcomes, is a feasible surgical technique. It imitates physiological carpal conditions allowing the rotation between scaphoid and lunate and showed exceptional results in our patient group. This surgical technique is recommended for treating stages III-IV scapholunate ligament tears.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 10","pages":"e8157"},"PeriodicalIF":1.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183912","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":"Virtual Surgical Planning for Mandibular Reconstruction in Paget Disease With Severe Deformity.","authors":"Eriko Takeshima, Shusaku Maeda, Ayaka N Deguchi, Tadaaki Morotomi, Hisashi Motomura","doi":"10.1097/GOX.0000000000008204","DOIUrl":"https://doi.org/10.1097/GOX.0000000000008204","url":null,"abstract":"<p><p>Paget disease of the mandible is a rare metabolic bone disorder characterized by abnormal bone remodeling, resulting in deformity and structural weakness. Medical therapy, including bisphosphonates, is the most common treatment; however, chronic osteomyelitis is a known complication of mandibular Paget disease, and definitive management with mandibular resection and reconstruction has rarely been reported. Mandibular reconstruction in such cases is particularly challenging because severe deformity obscures normal anatomical landmarks. Virtual surgical planning (VSP) and patient-specific reconstruction systems have been developed to improve surgical accuracy in complex maxillofacial reconstruction. However, their application in Paget disease with severe mandibular deformity has never been described. We report a case of mandibular resection and reconstruction using VSP in a patient with Paget disease of the mandible complicated by chronic osteomyelitis. Due to the absence of reliable anatomical reference, VSP was essential to determine resection margins and reconstruction geometry. Segmental mandibulectomy and free fibular flap reconstruction were performed according to the preoperative plan, resulting in satisfactory postoperative functional and aesthetic outcomes without recurrence of infection. This case suggests the potential utility of VSP for accurate and reliable mandibular reconstruction in Paget disease with severe deformity, where conventional techniques are limited.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 10","pages":"e8204"},"PeriodicalIF":1.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183916","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":"Application and Complications of the Tunnelized Facial Artery Musculomucosal Flap in Repairing Floor of Mouth Defects.","authors":"Qianying Kong, Zixia Wang, Xinbiao Zhu, Tong Li, Lifen Wu, Lizhong Liang","doi":"10.1097/GOX.0000000000008169","DOIUrl":"https://doi.org/10.1097/GOX.0000000000008169","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the efficacy and complications of the tunnelized facial artery musculomucosal (tFAMM) flap for repairing floor of mouth defects, comparing it with the nasolabial island (NLI) flap.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 12 patients who underwent tFAMM flap reconstruction at the Fifth Affiliated Hospital of Sun Yat-sen University from 2018 to 2024. Data from 8 patients receiving NLI flap reconstruction served as a control group. Outcomes included surgical parameters and complications, and we analyzed UW-QOL scores at 1 month postoperatively.</p><p><strong>Results: </strong>The mean age of patients in the tFAMM group was 48.50 ± 11.82 years. All tFAMM flaps survived without revision surgery. The tFAMM group demonstrated significantly earlier nasogastric tube removal (8 versus 13 d, <i>P</i> = 0.001). After adjusting for age, the tFAMM group demonstrated significantly higher total UW-QOL scores (<i>P</i> = 0.044), global quality of life (<i>P</i> = 0.032), and physical function (<i>P</i> = 0.015) compared with the NLI group. Complications included temporary marginal mandibular branch palsy (3 cases) and trismus (2 cases).</p><p><strong>Conclusions: </strong>The tFAMM flap effectively repairs floor of mouth defects with a low complication rate and provides superior early quality of life after age adjustment.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 10","pages":"e8169"},"PeriodicalIF":1.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183553","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":"Biopsy of Secondary Angiosarcoma Arising in Native Mastectomy Skin of a Reconstructed Breast Without Prior Radiotherapy.","authors":"Mina Kamegai, Yohei Iwanaga, Shoichi Tomita, Miwako Fujii, Keisuke Goto, Tsunekazu Hishima, Rei Ogawa, Yasunobu Terao","doi":"10.1097/GOX.0000000000008171","DOIUrl":"https://doi.org/10.1097/GOX.0000000000008171","url":null,"abstract":"<p><p>Secondary breast angiosarcoma usually develops after radiotherapy or in the setting of chronic lymphedema. We report a rare case of non-radiation-associated secondary cutaneous angiosarcoma arising in the native mastectomy skin overlying a reconstructed breast after immediate tissue expander placement and delayed deep inferior epigastric perforator flap reconstruction for breast cancer. The patient's clinical course, imaging, histopathological findings, and treatment were retrospectively reviewed. The clinicopathological features were compared with previously reported cases of angiosarcoma arising after breast reconstruction without radiotherapy before angiosarcoma onset. A 45-year-old woman underwent right mastectomy, axillary dissection, and immediate tissue expander placement for right breast cancer (T2N1M0, stage IIB), followed by delayed deep inferior epigastric perforator flap reconstruction 1 year later. No adjuvant radiotherapy was administered. Three years after the initial breast cancer surgery, progressive purpura and dark violaceous nodules developed in the native mastectomy skin. Skin biopsy confirmed cutaneous angiosarcoma. Histology showed atypical endothelial proliferation forming irregular vascular channels; tumor cells were positive for ETS-related gene and cluster of differentiation 34; the molecular immunology borstel-1 index was approximately 40%; and MYC proto-oncogene expression was observed in 60%-70% of tumor cells. Positron emission tomography-computed tomography showed no distant metastasis. Because the cutaneous disease was diffuse and surgical local control was judged difficult, multimodal treatment with pazopanib and radiotherapy (70 Gy) was initiated, followed by trastuzumab plus paclitaxel for local progression. No distant metastasis was present at the latest follow-up, although local control remained challenging. Persistent or progressive dermatitis-like lesions in postmastectomy breast skin should prompt early biopsy even in patients without prior radiotherapy.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 10","pages":"e8171"},"PeriodicalIF":1.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183627","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":"Bulging of the Masseter Muscle Following Botulinum Neurotoxin Type A Injection.","authors":"Lukas Naef, Epameinondas Gousopoulos, Florian Alexander Huber, Pietro Giovanoli","doi":"10.1097/GOX.0000000000008164","DOIUrl":"https://doi.org/10.1097/GOX.0000000000008164","url":null,"abstract":"<p><p>Botulinum neurotoxin toxin type A is widely used in the management of facial paralysis to reduce synkinesis and improve facial symmetry. Although the masseter muscle is not innervated by the facial nerve, aberrant reinnervation may lead to abnormal activity requiring treatment. We report the case of a 48-year-old woman with long-standing, partially regenerated right-sided facial palsy who developed paradoxical masseter muscle bulging following botulinum neurotoxin toxin type A injection. After a single injection targeting masseter hypertonicity, the patient exhibited a visible bulge during clenching. Ultrasound imaging revealed superficial muscle bulging associated with intramuscular septations. Uneven toxin diffusion caused by internal tendinous barriers within the masseter muscle was identified as the most likely mechanism. This case highlights the importance of understanding masseter anatomy and applying precise injection techniques to minimize adverse effects and optimize therapeutic outcomes.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 10","pages":"e8164"},"PeriodicalIF":1.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183668","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":"Prospective Intraindividual Split-face Histological Comparison of Poly-d,l-lactic Acid and Calcium Hydroxylapatite Skin Boosters Using Stem Cell Markers.","authors":"Jong Seo Kim","doi":"10.1097/GOX.0000000000008090","DOIUrl":"https://doi.org/10.1097/GOX.0000000000008090","url":null,"abstract":"<p><strong>Background: </strong>Poly-d,l-lactic acid (PDLLA) and calcium hydroxylapatite (CaHA) are injectable biostimulators increasingly used as skin boosters. Although both promote tissue regeneration, their comparative histological effects in humans remain poorly characterized, particularly regarding differential vascular, collagenous, and elastinrelated responses that may influence individualized treatment strategies and clinical decision-making.</p><p><strong>Methods: </strong>This institutional review board-approved prospective split-face pilot study included 3 female patients (6 cheeks) who received PDLLA injection on one side and CaHA injection on the contralateral side. Biopsies were obtained 3 months after injection from corresponding preauricular or temporal facial regions during the facelift procedure for histological and immunohistochemical evaluation, including hematoxylin and eosin, Herovici, Verhoeff-Van Gieson, and CD31/CD34 immunostaining. Ultrasound (33 MHz) and surface roughness analysis were also performed, alongside Global Aesthetic Improvement Scale scoring.</p><p><strong>Results: </strong>Both PDLLA and CaHA demonstrated regenerative activity, though their predominant effects differed. PDLLA was associated with greater angiogenesis (capillary counts and CD31 staining), fibroblast activation, and early collagen remodeling. CaHA exhibited higher elastin fiber density (13% increase by Verhoeff-Van Gieson staining), stronger CD34 expression, and more pronounced early dermal thickening on ultrasound. Both agents improved clinical skin roughness and Global Aesthetic Improvement Scale scores without major adverse events.</p><p><strong>Conclusions: </strong>PDLLA and CaHA skin boosters each demonstrated distinct yet beneficial biostimulatory profiles in human tissue. PDLLA favored angiogenesis and collagen remodeling, whereas CaHA promoted elastogenesis, progenitor cell activation, and early tissue reinforcement. These findings highlight the complementary roles of PDLLA and CaHA and underscore the need for larger, long-term studies to refine their clinical applications.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 10","pages":"e8090"},"PeriodicalIF":1.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183809","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":"Reverse Anterolateral Thigh Flap for Lower Extremity Reconstruction: A Scoping Review.","authors":"Rohun Gupta, Atharva M Bhagwat, Jason Lin, Sumesh Kaswan","doi":"10.1097/GOX.0000000000008140","DOIUrl":"https://doi.org/10.1097/GOX.0000000000008140","url":null,"abstract":"<p><strong>Background: </strong>There are several reconstructive methods in a plastic surgeon's toolbox for reconstruction of soft tissue deficits in the lower extremity. This study presents a comprehensive review of literature pertaining to reconstruction of the lower extremity with the reverse anterolateral thigh flap.</p><p><strong>Methods: </strong>A scoping review was conducted based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews methodology. A total of 4 databases were used for the literature search. Main outcomes measured included procedure performed, region of soft tissue deficit, complications, follow-up, and the need for reoperation.</p><p><strong>Results: </strong>A total of 985 studies were imported for screening, of which 6 studies were selected based on our inclusion and exclusion criteria. Sixty-nine patients were included, with the majority of defects involving the peripatellar region, followed by the proximal and middle third of the lower extremity, and the thigh. The aggregate complication rate was 21.7% with flap loss occurring in 3 (4.3%) patients. Nine (12.9%) patients required reoperation due to complete flap loss or delayed healing.</p><p><strong>Conclusions: </strong>The reverse anterolateral thigh flap is a versatile option for reconstruction of defects localized to the knee and the proximal and middle third of the lower extremity. Particularly, the flap should be considered in patients that are otherwise not candidates for typical forms of reconstruction with the gastrocnemius or soleus muscles or with a free flap.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"14 10","pages":"e8140"},"PeriodicalIF":1.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183817","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}