Plastic and Reconstructive Surgery Global Open最新文献

{"title":"Optimizing Primary Closure of Anterolateral Thigh Flap Donor Sites Through Literature Review and Clinical Analysis.","authors":"Ching-En Chen, Chun-Yu Ma, Tien-Hsiang Wang, Yu-Chung Shih, Chih-Hsun Lin, Szu-Hsien Wu, Hsu Ma, Cherng-Kang Perng","doi":"10.1097/GOX.0000000000007193","DOIUrl":"10.1097/GOX.0000000000007193","url":null,"abstract":"<p><strong>Background: </strong>The anterolateral thigh (ALT) flap is widely used in reconstructive surgery due to its reliable vascular pedicle, abundant perforators, and favorable donor site. Although skin grafting is common for donor-site closure, it has limitations such as reduced durability and functional restrictions. This study proposed a comprehensive algorithm for ALT flap donor-site closure.</p><p><strong>Methods: </strong>A literature review was performed to summarize existing strategies for ALT flap donor-site closure. Based on these findings, an initial algorithm was proposed to guide donor-site closure. This algorithm was subsequently applied in clinical practice by a single surgeon between 2021 and 2023. A retrospective analysis of patients who underwent ALT flap reconstruction during this period was conducted to evaluate clinical outcomes.</p><p><strong>Results: </strong>A total of 37 patients were managed using the initial clinical algorithm, most of whom were men and underwent reconstruction for head and neck cancer. Primary closure was achieved in 91.9% of cases, including 70.3% by direct closure. In cases where direct closure was not feasible, supplementary flaps were used to achieve tension-free closure. Both flap width and postharvest defect width were identified as key factors influencing the feasibility of direct closure, with an optimal flap width cutoff of 7.75 cm. These findings guided the refinement of the clinical decision-making algorithm.</p><p><strong>Conclusions: </strong>Donor site management remains an important consideration in ALT flap reconstruction. A stepwise approach combining planning and surrounding supplementary flaps enabled primary closure in most cases.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7193"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233280","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 Clinical Evaluation of Cross-Linked Hyaluronic Acid Dermal Filler (30 mg) for Facial Rejuvenation.","authors":"Debraj Shome, Devendra Khalsa, Bhargav Joshi, Depti Bellani, Ashwin Prabhughate, Alivia Basu, Atrey Pai Khot, Rinky Kapoor","doi":"10.1097/GOX.0000000000007149","DOIUrl":"10.1097/GOX.0000000000007149","url":null,"abstract":"<p><strong>Background: </strong>Cross-linked hyaluronic acid dermal fillers are being used increasingly for aesthetic enhancements, including lip enhancement, cheekbone augmentation, and nasolabial fold improvement. This study aimed to assess the safety and performance of a newly introduced dermal filler across different skin types.</p><p><strong>Methods: </strong>This is a prospective, single-arm clinical study that evaluates the safety and effectiveness of cross-linked sodium hyaluronate injection in patients undergoing treatment for facial wrinkles and lip enhancement. Participants underwent assessments at baseline; immediately at postoperative day 0; and at 3 months, 6 months, and 1 year after the procedure. The safety and effectiveness were evaluated through physical examinations, wrinkle severity ratings, full face global aesthetic assessments, cheekbone augmentation, nasolabial fold severity, and lip enhancement evaluations.</p><p><strong>Results: </strong>The study cohort included 122 participants, 41 men and 81 women, predominantly with Fitzpatrick skin types 3 (59%) and 4 (41%). Physical examinations revealed a significant reduction in facial wrinkles, with 81.14% (left side) and 84.42% (right side) of patients showing no wrinkles after 1 year. Full face aesthetic improvements were noted, with 36.88% of patients being \"very much improved.\" Cheekbone augmentation showed no wrinkles in 55.74% of patients (left side) and 72.13% (right side) at 1 year. Nasolabial fold severity decreased most significantly between 6 months and 1 year.</p><p><strong>Conclusions: </strong>The novel cross-linked hyaluronic acid dermal filler is safe and effective for enhancing lips, augmenting cheekbones, and improving nasolabial folds across various skin types. Significant improvements were observed in wrinkle severity, overall facial aesthetics, and specific enhancement areas.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7149"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233305","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":"Exosome Therapy for Chronic Wound Healing.","authors":"Lucas Basamage, Hee Jin Ahn, Ho-Sung Choi, Carlos Roberto Antonio, Alessandro Louza Alarcão, Shirley Nogueira Silva, Zeisa Teixeira Hohl, Jovian Wan, Kyu-Ho Yi","doi":"10.1097/GOX.0000000000007200","DOIUrl":"10.1097/GOX.0000000000007200","url":null,"abstract":"<p><strong>Background: </strong>Chronic lower-extremity ulcers linked to diabetes, venous insufficiency, or smoking are difficult to heal because of impaired vascularity, persistent inflammation, and extracellular matrix dysfunction. Exosome therapy-a cell-free regenerative approach-may address these deficits by delivering proangiogenic and immunomodulatory cargo. We evaluated its clinical usage in a case series.</p><p><strong>Methods: </strong>Four adults (age 42-62 y) with ulcers present for 6 months or more and refractory to compression, debridement, and topical care received monthly topical applications of adipose-derived stem-cell exosomes (Exo-HL, Primoris International Co., Ltd., Seoul, Korea), 1 × 10¹² particles/mL; 0.1 mL/cm² wound area). Wounds were photographed and measured every 2-4 weeks; Doppler ultrasonography quantified arterial resistive index and venous reflux at baseline and 3-month intervals. Follow-up continued for up to 7 months.</p><p><strong>Results: </strong>Median baseline ulcer area was 12.4 cm² (range, 4.8-26.1 cm²). All wounds showed visible granulation within 2 weeks; 3 achieved complete closure after a median of 94 days (range, 60-180 d). Mean arterial resistive index decreased from 0.93 ± 0.04 to 0.77 ± 0.03, and venous reflux time fell from 2.8 ± 0.3 to 1.4 ± 0.2 seconds. No adverse events or wound infections occurred.</p><p><strong>Conclusions: </strong>Exosome therapy was well tolerated and associated with rapid granulation, improved perfusion, and durable closure of refractory chronic ulcers. Although limited by small sample size and lack of controls, these findings support further controlled trials to define efficacy and optimize dosing.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7200"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233257","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":"Maxillary Stability After Le Fort I Osteotomy With 1.5 mm Microplate Fixation: A Retrospective Study.","authors":"Chinavich Sriyuenyong, Somchart Raocharernporn","doi":"10.1097/GOX.0000000000007032","DOIUrl":"10.1097/GOX.0000000000007032","url":null,"abstract":"<p><strong>Background: </strong>Le Fort I osteotomy is commonly performed to correct maxillary deformities, with most surgeons using 4 miniplates (2.0 mm) for fixation. However, limited evidence exists regarding postoperative skeletal stability when using smaller microplates (1.5 mm). This study aimed to evaluate the 3-dimensional skeletal stability of the maxilla following Le Fort I osteotomy fixed with 1.5-mm microplates in orthognathic surgery patients at the Faculty of Dentistry, Mahidol University.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 30 patients (21 women, 9 men; mean age 26.8 ± 5.7 y) who underwent bimaxillary osteotomies by the same surgeon. Postoperative skeletal changes were assessed using 3-dimensional virtual models generated from cone-beam computed tomography scans taken 1 week (T1) and 6 months (T2) after surgery. Superimposition of these models using an iterative closest point algorithm enabled the measurement of maxillary stability. The root mean square of point-to-point distances between models and positional differences at 9 anatomical landmarks were analyzed.</p><p><strong>Results: </strong>All patients demonstrated satisfactory surgical outcomes. The mean root mean square value between superimposed models was 0.8019 mm (SD 0.413 mm), within clinically acceptable limits (≤2 mm). Differences in bone surface coordinates were within ±0.5 mm, with a mean distance change of -0.182 ± 0.2 mm. No significant surgical relapse was observed at any reference point after 6 months.</p><p><strong>Conclusions: </strong>This is a retrospective study assessing maxillary stability with 1.5-mm microplates. The results indicate that 4-point microplate fixation offers stable and predictable postoperative outcomes in appropriately selected Le Fort I osteotomy cases.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7032"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233285","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 3-Dimensional Facial Analysis of Nasal Geometry Across Ethnicity, Sex, and Nasal Implants.","authors":"Kathleen Hui Xin Ong, Julian Koo, Aymeric Lim, Kyrin Liong, Heow Pueh Lee, Shu Jin Lee","doi":"10.1097/GOX.0000000000007192","DOIUrl":"10.1097/GOX.0000000000007192","url":null,"abstract":"<p><p>Mixed heritage faces have long been celebrated for their beauty, but there is limited data on the nasal characteristics of these faces. We aim to quantitatively compare nasal geometry across ethnicities and sexes to test the hypothesis that the Eurasian nose has an intermediate morphology between Chinese and White noses. To compare nasal geometry, we customized a computer program to quantitatively analyze a database of 72 three-dimensional facial scans of 43 Chinese (25 men, 18 women), 18 Eurasian (7 men, 11 women), and 11 White (9 men, 2 women) people. We then analyzed 3 commercial nasal implants (Bistool, Medpor, and Silicone) to assess how closely each implant simulated the Eurasian nose. Two-dimensional analysis of nasal and prominence indexes revealed that the Eurasian nose had intermediate readings between Chinese and White noses, whereas the Eurasian nasion most closely resembles a saddle shape on 3-dimensional analysis. Based on these findings, we hypothesize that the saddle shape of the nasion possibly creates a saddle point to maximize light scatter and thereby enhance overall facial beauty. Among the implants analyzed, the Bistool implants most closely match the shape index of the human nasion, recreating the saddle point geometry most accurately. Through determining an intermediate nasal morphology, we aim to provide a guideline for rhinoplasty to allow surgeons and patients to reach a more objective consensus on the aesthetic outcomes. Due to the limited sample size of volunteers in this study, future studies are encouraged to further validate the findings of this study for practical implementation.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7192"},"PeriodicalIF":1.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233166","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":"Nostril Stenosis Repair Using the Indwelling Flap.","authors":"Dmitry Kotovich, Mor Rittblat, Katya Chapchay, Neta Adler, Alexander Margulis","doi":"10.1097/GOX.0000000000007184","DOIUrl":"10.1097/GOX.0000000000007184","url":null,"abstract":"<p><p>Nasal vestibule stenosis is a rare deformity that can be either congenital or acquired. Various surgical techniques for reconstruction have been described, including the use of skin grafts, composite grafts, and local tissue rearrangement. We present a novel approach using 2 V-Y indwelling advancement flaps. The flaps are raised from the columella and the nostril sill, using local nasal tissue adjacent to the stenotic area. This technique provides sufficient elongation of the nostril diameter on the stenotic site, ensures well-vascularized tissue (flap-only reconstruction) that prevents restenosis, and achieves aesthetically pleasing results. Follow-up at 12 and 24 months postoperatively showed no restenosis with a satisfactory aesthetic result and patient satisfaction.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7184"},"PeriodicalIF":1.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233260","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":"Reliability and Accuracy of Generative Artificial Intelligence Tools in Providing General Information on Migraine Surgery.","authors":"Edoardo Raposio, Ilaria Baldelli","doi":"10.1097/GOX.0000000000007176","DOIUrl":"10.1097/GOX.0000000000007176","url":null,"abstract":"<p><strong>Background: </strong>Numerous publicly available generative artificial intelligence tools have been introduced, aimed at research use or for the general public. The aim of this study was to investigate what information could be obtained by querying 9 of these publicly available software tools regarding the possible outcomes and complications of migraine surgery.</p><p><strong>Methods: </strong>We consulted 9 of the most well-known and widely used generative artificial intelligence tools: ChatGPT, Gemini, Perplexity, Elicit, SciSpace, Consensus, PaperPal, Julius, and Mistral AI. Each tool was asked the same question: \"Detail the outcomes and complications of migraine surgery.\"</p><p><strong>Results: </strong>The results we obtained were, on the whole, very satisfactory. All the tools used, in addition to being extremely fast, provided sensible and scientifically reliable answers, albeit with varying degrees of accuracy. The accuracy of the answers provided was found to be directly proportional to the number of scientific references each tool used to generate its response. The tools that provided the most complete and detailed answers were, in order, Consensus, SciSpace, Perplexity, and ChatGPT.</p><p><strong>Conclusions: </strong>In the answers provided by all the software, the universally accepted principles of migraine surgery were accurately listed, both in terms of outcomes and the rate and severity of complications. Regarding outcomes, the high success rate of the procedure was consistently emphasized.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7176"},"PeriodicalIF":1.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233274","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":"Disparities and Barriers to Care in Plastic and Reconstructive Surgery for Native American and First Nations Populations.","authors":"Forrest Bohler, Madeline N Pham, Tamara Attisha, James R Burmeister, Kongkrit Chaiyasate","doi":"10.1097/GOX.0000000000007159","DOIUrl":"10.1097/GOX.0000000000007159","url":null,"abstract":"<p><strong>Background: </strong>American Indian and Alaska Native and First Nations populations face well-documented health disparities, yet inequities in access to plastic and reconstructive surgery (PRS) remain underrecognized. These communities experience a higher burden of PRS-relevant conditions, including orofacial clefts, trauma, burns, and postoncological defects, but disproportionately low usage of PRS services.</p><p><strong>Methods: </strong>This narrative synthesizes existing literature on disparities in PRS access for Indigenous populations in the United States and Canada. The key focus areas included disease prevalence, barriers to care, and proposed strategies for improving access. Peer-reviewed articles and policy sources were reviewed to identify recurring themes and evidence-based solutions.</p><p><strong>Results: </strong>Indigenous patients face significant barriers to PRS care, including geographic isolation, chronic underfunding of systems such as the Indian Health Service, a shortage of specialized providers in rural regions, socioeconomic hardship, and cultural mistrust rooted in historical trauma. Solutions discussed include expanding telehealth, establishing residency-based domestic outreach programs, supporting short-term training for local providers, and strengthening partnerships between academic institutions and tribal health systems. Increasing Indigenous representation in PRS and promoting tribal self-determination in healthcare are also emphasized as critical components of sustainable change.</p><p><strong>Conclusions: </strong>Efforts to address PRS disparities in Indigenous populations must be multifaceted, combining immediate access improvements with long-term investments in workforce development, infrastructure, and culturally attuned care. A coordinated approach among academic programs, policy stakeholders, and Indigenous communities is essential to achieving surgical equity.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7159"},"PeriodicalIF":1.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233238","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":"Umbilical Aesthetics in Kenya: A Survey of Shape, Position, and Gender Preferences.","authors":"Sama K Fofung, Benjamin Wabwire, Joseph K Wanjeri","doi":"10.1097/GOX.0000000000007171","DOIUrl":"10.1097/GOX.0000000000007171","url":null,"abstract":"<p><strong>Background: </strong>Although the golden ratio (1.62) is frequently proposed for ideal umbilical positioning, aesthetic judgments vary across cultures and individual preferences. This survey examined shape and ratio preferences among Kenyan adults, exploring whether local norms (1.69) or the golden ratio (1.62) better match subjective ideals.</p><p><strong>Methods: </strong>We conducted a cross-sectional online survey with 440 participants recruited from a Kenyan referral hospital. Five umbilical shapes (oval, vertical, T-shaped, horizontal, and distorted/protruded) were digitally positioned at 1.62 or 1.69. Respondents selected their preferred position, identified most/least attractive shapes, and indicated separate choices for masculine versus feminine figures. Statistical analyses were done using χ² tests and logistic regressions.</p><p><strong>Results: </strong>The gender distribution was balanced, with 48.9% men and 51.1% women. Overall, 55% favored 1.62 for oval, vertical, T-shaped, and horizontal shapes, whereas distorted was often chosen at 1.69 (52.5%). The vertical shape was ranked the most attractive overall (39.8%), especially for feminine figures (55.9%). Men showed significantly greater preference than women for distorted shapes (odds ratio = 2.89; <i>P</i> = 0.010). Oval and T-shaped were equally popular for masculine figures (29.1% each).</p><p><strong>Conclusions: </strong>Kenyan preferences lean toward the classic golden ratio in certain shapes, but not universally. Distorted navels garnered significant support at the local 1.69 ratio, underscoring that patient desires do not strictly align with a single numeric standard. This preference-based study complements morphometric data from a companion article, highlighting the interplay between objective norms and subjective ideals in Kenyan abdominal aesthetics.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7171"},"PeriodicalIF":1.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233289","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":"Nerve Repair for Erectile Dysfunction After Radical Prostatectomy: A Systematic Review of Outcomes.","authors":"Edwin Chrabieh, Paul Beaineh, Towfik Sebai, Abdul Jabar Chekfa, Fadi Ghieh, Kareem Makkawi, Bishara Atiyeh, Bassel Bachir, Amir Ibrahim","doi":"10.1097/GOX.0000000000007165","DOIUrl":"10.1097/GOX.0000000000007165","url":null,"abstract":"<p><strong>Background: </strong>Erectile dysfunction (ED) is a prevalent complication after radical prostatectomy (RP), affecting up to 89% of patients within 2-5 years due to cavernous nerve injury. Nerve grafting has been proposed as a strategy to restore erectile function, but outcomes remain inconsistent, and randomized controlled trials have yielded mixed results. This review evaluated the effectiveness of nerve grafting techniques for ED management after RP.</p><p><strong>Methods: </strong>A systematic search of PubMed, MEDLINE, and Embase databases was conducted using terms related to ED, nerve grafting, and cavernous nerve repair. From 239 initial studies, 17 met the inclusion criteria, focusing on human subjects and reporting outcomes of unilateral or bilateral nerve grafting with autologous donor nerves, such as the sural and genitofemoral nerves.</p><p><strong>Results: </strong>Bilateral sural nerve grafting demonstrated the highest recovery rates, with up to 71% of patients regaining erectile function sufficient for intercourse. Adjunctive therapies like sildenafil were frequently used to enhance outcomes. However, randomized controlled trials showed no statistically significant improvements compared with controls, raising questions about the efficacy of nerve grafting. Variability in outcomes seemed to be influenced by donor nerve choice, surgical expertise, and patient characteristics, such as age and baseline function.</p><p><strong>Conclusions: </strong>Although bilateral sural nerve grafting offers promising results, its overall efficacy is uncertain due to inconsistent findings and limitations of existing studies. Larger, standardized trials are essential to clarify its role in ED management after RP and to optimize patient outcomes.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7165"},"PeriodicalIF":1.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233246","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}