Plastic and Reconstructive Surgery Global Open最新文献

{"title":"Multidisciplinary Approach to Managing Recurrent Cerebrospinal Fluid Leak in a Pediatric Patient Following Myelomeningocele Repair.","authors":"Rawad Chalhoub, Kareem Makkawi, Edwin Chrabieh, Tarek El Hachem, Marwan Hajjar, Amir Ibrahim","doi":"10.1097/GOX.0000000000006945","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006945","url":null,"abstract":"<p><p>This case report describes the management of a 6-year-old girl with a cerebrospinal fluid (CSF) leak following trauma after a previous myelomeningocele repair. The patient initially presented with a recurrent CSF leak, wound dehiscence, and infection. In an attempt to close the pseudomeningocele, a bilateral latissimus dorsi musculocutaneous flap procedure was performed. Despite this intervention, she developed a persistent CSF leak, which led to infection and dehiscence of the wound at the midline. She then required secondary repair of the dural defect and insertion of a lumbar drain, while the plastic surgery team applied an Integra dermal regeneration template combined with vacuum-assisted closure (VAC) therapy. One week later, the wound showed no signs of infection, and the VAC was removed. One week later, for optimal lumbar drainage, a ventriculoperitoneal shunt was inserted. The patient's postoperative course was complicated by fever and ileus, both of which resolved with bowel rest and antibiotics. The patient was discharged in stable condition with no further leakage. On follow-up 4 months later, the patient reported no issues. This case illustrated the successful use of a multidisciplinary approach in managing CSF leaks following myelomeningocele repair by using Integra combined with VAC therapy and a ventriculoperitoneal shunt for optimal wound closure and healing.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 7","pages":"e6945"},"PeriodicalIF":1.5,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609065","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":"Secondary Rhinoplasty: Clinical Findings and Alternative Structures for Nasal Reconstruction in Latin American Patients.","authors":"Wilder A Perez Willis, Diana C Bazan Lazaro, Wilder A Perez Soto","doi":"10.1097/GOX.0000000000006971","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006971","url":null,"abstract":"<p><strong>Background: </strong>Revision rhinoplasty for patients with Latin American nasal characteristics presents a significant surgical challenge owing to complex anatomical and structural factors. A structured and systematic approach is essential for improving outcomes, and a statistical evaluation of the results and management techniques is needed to achieve optimal patient satisfaction.</p><p><strong>Methods: </strong>In total, 86 patients (69 women, 17 men; age range: 18-55 y) with nasal characteristics commonly associated with Latin American noses participated in this study. Each patient underwent secondary rhinoplasty using surgical techniques performed by the authors, which used costal cartilage structures for nasal reconstruction.</p><p><strong>Results: </strong>The most frequently observed clinical issues were excessive dorsal reduction in the upper third (37.2%), mid-vault deviation in the middle third (53.5%), and underprojection of the nasal tip (68.6%). Of the 5 structural categories used for reconstruction, type 1 was the most frequent (35.9%), whereas type 5 was the least frequent (1.3%).</p><p><strong>Conclusions: </strong>A successful revision rhinoplasty for patients with Latin American nasal characteristics requires an in-depth evaluation of each patient. The surgical methodology detailed in this work provides surgeons with the tools to address these complex cases effectively.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 7","pages":"e6971"},"PeriodicalIF":1.5,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608979","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 Free Chimeric Great Toe and Second Toe Pulp Flap for Reconstruction of Complex Digital Defects.","authors":"Luigi Troisi, Stephanie Hili, Alessandro Mastroiacovo, Francesco Zanchetta, Macarena Vizcay, Giorgio E Pajardi","doi":"10.1097/GOX.0000000000006954","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006954","url":null,"abstract":"<p><p>Toe-to-hand transfers have been extensively described in the literature and are nowadays a fairly common tool in the armamentarium of the reconstructive hand surgeon. Despite this, little has been reported about the chimeric use of flaps based on the first dorsal metatarsal artery. We report here an innovative technique for harvesting the great toe and second toe pulps in a chimeric fashion, which we have found particularly useful in reconstructing digital defects in cases of complex hand trauma involving multiple digits. We describe the technique for flap harvest and illustrate its usefulness through 4 cases of complex hand trauma where we have successfully used it to retain length and function of the digits.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 7","pages":"e6954"},"PeriodicalIF":1.5,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608981","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":"Evaluation of Nipple and Areola Sensation in Different Pedicles of Breast Reduction: A Controlled Trial.","authors":"Laila A Aboul Nasr, Ibrahim Adel Ibrahim Botros, Ayman Noaman, Adel M Wilson","doi":"10.1097/GOX.0000000000006937","DOIUrl":"10.1097/GOX.0000000000006937","url":null,"abstract":"<p><strong>Background: </strong>Breast surgery, including augmentation, reduction, and mastopexy, is commonly performed to enhance breast aesthetics.</p><p><strong>Methods: </strong>This study included 45 women (90 breasts) undergoing reduction mammoplasty at the Department of Plastic and Reconstructive Surgery, Kasr Alainy Hospital, between October 2022 and August 2024. Ethical approval was obtained from Cairo University (approval number MD-29-2023). Patients were divided into 3 equal groups: group A (superomedial pedicle), group B (medial pedicle), and group C (inferior pedicle).</p><p><strong>Results: </strong>No significant differences were found in 1-point discrimination using Semmes-Weinstein monofilaments (right and left) across groups preoperatively or postoperatively at 3, 6, and 12 months. Temperature sensation significantly decreased at 3 months in groups A and B compared with group C (<i>P</i> = 0.0002), with no differences at later follow-ups. Crude touch sensation was significantly reduced in group A at 3 and 6 months (<i>P</i> = 0.004), with recovery by 12 months. Pain sensation (<i>P</i> = 0.004) and 2-point discrimination (<i>P</i> = 0.0002) were significantly diminished at 3 months in groups A and B but normalized by 6 and 12 months.</p><p><strong>Conclusions: </strong>Reduction mammaplasty is a safe procedure with low complication rates. Sensory changes in the nipple-areola complex may occur, particularly in the early postoperative period. Sensory recovery is generally observed by 12 months, especially in the inferior pedicle technique.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 7","pages":"e6937"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554177","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":"Enabling Exploration: Examining the Availability and Adequacy of Conference Funding for Medical Students.","authors":"Sophia G Allison, Hannah Soltani, Emily S Chwa, Dana W Shuaibi, Kevin R Allison, Arun K Gosain","doi":"10.1097/GOX.0000000000006903","DOIUrl":"10.1097/GOX.0000000000006903","url":null,"abstract":"<p><strong>Background: </strong>Due to limited funding available for students to attend conferences, we performed a comprehensive review of publicly provided information regarding medical school funding for academic conferences and surveyed medical students to assess accessibility and adequacy of funding.</p><p><strong>Methods: </strong>The admissions website of all schools associated with American Association of Medical Colleges and American Association of Colleges of Osteopathic Medicine (220 programs) was reviewed to collect funding information. A REDCap survey was administered to students who registered for the annual Plastic Surgery the Meeting 2023 conference.</p><p><strong>Results: </strong>A total of 132 medicals schools (60%) had information regarding funding, and 125 (95%) reported that they provided funding for conference attendance. The average number of times that a student could receive funding during their 4 years was 4.1, and the average funding per year was $479. There was no difference in the 4-year total funding between public and private schools ($1924 versus $1992; <i>P</i> = 0.88) or between allopathic and osteopathic schools ($1946 versus $2185; <i>P</i> = 0.76). If the student had no supporting funding source, their average personal contribution was $738.</p><p><strong>Conclusions: </strong>Given that there is already a large financial burden on students applying to competitive specialties from application and away rotation costs, it is important to identify areas where further support is needed. This study demonstrates the inadequacy of funding available for medical students to attend academic conferences. Providing funding for students to complete research will create more equitable access to competitive specialties such as plastic surgery.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 7","pages":"e6903"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554176","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":"Hydrogel Containing an Oxygen Carrier With Hemoglobin From the Marine Worm <i>Arenicola marina</i> (M101) in the Management of Deep Burns.","authors":"Ugo Lancien, Pierre-Joachim Mahe, Aline Lepelletier, Elisabeth Leize-Zal, Laurent Lantieri, Pierre Perrot","doi":"10.1097/GOX.0000000000006930","DOIUrl":"10.1097/GOX.0000000000006930","url":null,"abstract":"<p><p>A 34-year-old patient with no medical history was admitted following severe thermal burns (>85% of the body surface area), including deep second- and third-degree injuries. Surgical management aimed to heal the entire upper body (thorax, abdomen, and back) using topical oxygen therapy (TOT) on the deep second-degree burns, without burn excision or skin grafting, while processing conventional management of the remaining burned areas alongside specialized intensive care. TOT was performed using an innovative oxygenating dressing (HEMHealing, Hemarina SA, Morlaix, France) combined with conventional excisional, allograft, and autograft management (4 surgical steps) on the hands, upper limbs, and lower limbs; the protocol enabled graft-free healing of the abdomen, thorax, and back within around 5 weeks. Despite a prolonged healing time (47 d, beyond the dogma of 2-3 wk), at 12 months follow-up, the scars showed very little inflammation and no hypertrophy on the trunk and the back. The patient did not require compression garments on TOT-treated sites. We report the use of this innovative dressing-in parallel with resuscitation and conventional surgery-and the very favorable evolution of this patient confirms this choice in retrospect. We now need to consider other cases and studies to validate our initial clinical results.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 7","pages":"e6930"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554179","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":"Extramammary Arm Fibroadenoma.","authors":"Ahmed M Abouzaid, Ahmed M AbdelAzim, Karim M Osman, Mohamed M Soffar","doi":"10.1097/GOX.0000000000006936","DOIUrl":"10.1097/GOX.0000000000006936","url":null,"abstract":"<p><p>Fibroadenoma is the most common benign mass that can affect mammary tissue in women, with an incidence of 10% of the female population worldwide being affected by such tumors. It is a painless, nontender, and highly mobile mass that can develop in different sizes and usually affects women of reproductive age (14-35 y). To the best of our knowledge, the lesion has been discovered in extramammary locations on very rare occasions. One previous report described an arm fibroadenoma, and other reports illustrated vulval fibroadenomas. This report presented a 32-year-old woman who complained of the development of a painless swelling within her upper inner right arm in the last 2 years that was investigated and then surgically excised. Histopathological examination confirmed the diagnosis of fibroadenoma.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 7","pages":"e6936"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554178","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":"Buttock Reconstruction With Hatchet-type Lumbosacral Flap After Resecting Diffuse Plexiform Neurofibroma With Methicillin Resistant <i>Staphylococcus aureus-</i>infected Intratumoral Hematoma.","authors":"Taiga Kato, Nobuaki Ishii, Naotaka Serizawa, Rei Ogawa","doi":"10.1097/GOX.0000000000006932","DOIUrl":"10.1097/GOX.0000000000006932","url":null,"abstract":"<p><p>Diffuse plexiform neurofibroma (DPN) typically grows progressively. It can lead to disfigurement and functional impairment and carries a risk of life-threatening intratumoral hemorrhage. Here, an 85-year-old woman presented with a massive 23-cm-diameter DPN in the buttock area that began hemorrhaging after a fall. It was immediately treated with transcatheter arterial embolization, but 18 days later, the hematoma developed a methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) infection. Consequently, after 5 days of anti-MRSA antibiotics, the DPN was entirely resected, and the large skin defect was covered with the hatchet-type lumbosacral flap. Intraoperative bleeding was only 200 mL. Anti-MRSA antibiotics were continued for 2 days. A seroma developed under the skin flap on postoperative day 21. It was readily treated with puncture drainage. Then, it resolved by postoperative day 39 after several single punctures performed every few days over the next 18 days. Flap necrosis was not observed. The patient was discharged 45 days after surgery. No recurrence was observed 2.5 years later. Thus, massive infected DPNs in the buttocks can be completely resected, and the resulting large defect successfully covered with the hatchet-type lumbosacral flap.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 7","pages":"e6932"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554158","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 in Breast Cancer-related Lymphedema: A Systematic Review of Inequities and Barriers in Care.","authors":"Alexzandra Mattia, Nina Hadzimustafic, Rachel Rivero, SeungJu Jackie Oh, Karen Bach, Stav Brown, Siba Haykal","doi":"10.1097/GOX.0000000000006935","DOIUrl":"10.1097/GOX.0000000000006935","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer-related lymphedema (BCRL) is a chronic condition secondary to multimodal cancer treatment. This systematic review summarized the evidence for disparities and barriers surrounding BCRL care, particularly in diagnosis, education, and accessibility to treatment.</p><p><strong>Methods: </strong>A search of PubMed/MEDLINE, Embase, Scopus, and Web of Science following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted from January 1, 1990, through October 3, 2024. Mixed-methods, qualitative, cross-sectional, multiple-case, longitudinal, and randomized controlled trials that reported disparities and barriers surrounding BCRL care were included. Review articles, editorials, commentaries, abstracts, poster papers, translation or validation of patient-reported outcome measures, and non-English articles were excluded.</p><p><strong>Results: </strong>The search yielded 1059 articles, and 39 met inclusion criteria. Themes identified included the following: racial and ethnic disparities; increased risk associated with younger age, low education level, low income, rural geographic location, and presence of medical comorbidities; inadequate provider and patient knowledge; low patient education; burden and challenges with lifelong self-management; and barriers in receiving healthcare provider diagnosis or adequate BCRL management. Subthemes included cumulative cost burden, psychosocial barriers, and the role of patient self-efficacy.</p><p><strong>Conclusions: </strong>Younger non-White women, residents of rural regions, and those with low income or education levels seemed to be at greatest risk for self-reported (rather than physician-diagnosed) BCRL. Patients of diverse racial and ethnic backgrounds and low socioeconomic status were at increased risk for inadequate self-care education and breast cancer survivorship support. Active prevention with multidisciplinary interventions is imperative to lower BCRL rates, empower breast cancer survivors, and strengthen self-efficacy.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 7","pages":"e6935"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554175","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":"Rare Mixed Pseudoaneurysm and Pyogenic Granuloma of the Thumb Radial Digital Artery.","authors":"Jessica J Farzan, Ovninder Johal, Thomas Cervantes, Douglas M Rothkopf","doi":"10.1097/GOX.0000000000006931","DOIUrl":"10.1097/GOX.0000000000006931","url":null,"abstract":"<p><p>Pseudoaneurysms of the digital arteries are rare, with fewer than 20 cases reported. They typically result from partial vessel wall injuries due to trauma, repetitive microtrauma, or iatrogenic causes. Their rarity is attributed to the small diameter of the digital arteries, which makes complete laceration or thrombosis more likely than partial injury. We present the case of a 43-year-old man who developed a thumb radial digital artery pseudoaneurysm after workplace trauma. Initially misdiagnosed, the patient underwent unsuccessful bedside drainage at an urgent care center. Clinical examination revealed a 2 × 2 cm mass on the volar, radial aspect of the proximal thumb phalanx. Doppler ultrasonography confirmed the diagnosis of a pseudoaneurysm. Surgical intervention, performed 10 months postinjury, revealed a 15-mm mass continuous with the radial digital artery. The pseudoaneurysm was successfully resected via artery ligation. Microscopic examination revealed mixed features of both pseudoaneurysm and pyogenic granuloma, presenting an even rarer clinical entity. To our knowledge, this is the first report of a mixed pseudoaneurysm and pyogenic granuloma located in the radial digital artery of the thumb. This case underscored the importance of considering complex vascular anomalies in persistent digital masses posttrauma and emphasized the value of comprehensive histological examination for accurate diagnosis.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 7","pages":"e6931"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554181","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}