Plastic and Reconstructive Surgery Global Open最新文献

{"title":"Modified Dynamic Lymphaticovenular Anastomosis for Surgical Management of Alzheimer Disease.","authors":"Zhegang Zhou, Xuhui Chen, Wei Kou, Fanbin Meng, Longbiao Yu, Jingjing Wen, Johnson Boey, Vitrag Shah, Paloma Malagón","doi":"10.1097/GOX.0000000000007082","DOIUrl":"10.1097/GOX.0000000000007082","url":null,"abstract":"<p><p>Alzheimer disease (AD) is a neurodegenerative disorder that frequently results in progressive cognitive decline. Despite the extensive research conducted on AD, there is presently no solution available due to its increasing prevalence. Recent research has suggested cervical lymphaticovenular anastomosis (LVA) as a therapeutic strategy to improve lymphatic outflow and potentially reduce AD symptoms. We established an amended LVA protocol to mitigate the risk of venous reflux, a prevalent issue associated with the original LVA methodology. A 64-year-old man of Chinese descent exhibited the typical signs and symptoms of AD. The absence of substantial progress with standard medical treatment led to the consideration of LVA. We used a lower limb vein graft for the LVA, anastomosing it to the cervical lymphatic vessels and external jugular vein. The cognitive function of the patient got better after LVA, as shown by higher Mini Mental State Examination and Montreal Cognitive Assessment scores. Fewer β-amyloid and tau protein deposits were observed on positron emission tomography/computed tomography scans. No adverse occurrences or issues were observed. The success in this case demonstrated the potential role of LVA in the management of AD. However, further thorough research is required to evaluate the efficacy of our technique.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7082"},"PeriodicalIF":1.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233254","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":"Predictors of Dissatisfaction After Polydioxanone Thread Lift: A Multicenter Retrospective Analysis.","authors":"Kohki Okumura, Takahiko Tamura, Yusuke Funakoshi, Hiroo Teranishi","doi":"10.1097/GOX.0000000000007190","DOIUrl":"10.1097/GOX.0000000000007190","url":null,"abstract":"<p><strong>Background: </strong>Polydioxanone (PDO) thread lift is a widely used technique for minimally invasive facial rejuvenation. Although the technical outcomes and complications are well-documented, postoperative dissatisfaction remains underexplored, particularly among large multicenter cohorts. This study aimed to identify the predictors of dissatisfaction after PDO thread lift.</p><p><strong>Methods: </strong>We performed a multicenter retrospective analysis of 1500 patients who underwent PDO thread lifts at cosmetic surgery clinics in Japan. Postoperative dissatisfaction was defined as a return visit due to insufficient results. Univariate and multivariate logistic regression analyses evaluated the associations between age, thread count, sex, and dissatisfaction. Receiver operating characteristic curve analysis was performed to determine the optimal cutoff values using the Youden index.</p><p><strong>Results: </strong>Postoperative dissatisfaction was reported in 51 (3.4%) patients, with age (odds ratio = 1.06; 95% confidence interval = 1.03-1.08; <i>P</i> < 0.001) and thread count (odds ratio = 1.09; 95% confidence interval = 1.03-1.16; <i>P</i> = 0.001) as significant predictors. Receiver operating characteristic analysis identified an optimal cutoff of 43 years (area under the curve [AUC] = 0.701; sensitivity = 0.725; specificity = 0.615) and 10 threads (AUC = 0.674; sensitivity = 0.784; specificity = 0.566). The AUC of the combined multivariate model was 0.754.</p><p><strong>Conclusions: </strong>Increased age and higher thread count were independent predictors of dissatisfaction after PDO thread lifts. These findings underscore the need for individualized risk stratification, age- and volume-adapted thread strategies, and preoperative counseling to align expectations with realistic procedural outcomes.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7190"},"PeriodicalIF":1.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233302","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":"Pilot Study: Evaluating Pillar Pain Outcomes Following Carpal Tunnel Release Surgery With Fractional CO₂ Laser Therapy.","authors":"Caroline J Cushman, Brennon G Henderson, Wm Zachary Salter, Andrew F Ibrahim, Evan J Hernandez, Brendan J MacKay","doi":"10.1097/GOX.0000000000007189","DOIUrl":"10.1097/GOX.0000000000007189","url":null,"abstract":"<p><strong>Background: </strong>Carpal tunnel syndrome is the most common peripheral entrapment neuropathy of the upper limb, and pillar pain is a frequent, often debilitating complication following carpal tunnel release (CTR). Traditional treatment modalities, including corticosteroid injections, deep tissue massage, and medications, may fail to adequately relieve symptoms. Fractional carbon dioxide (CO₂) laser therapy has shown promise in scar management and analgesia, but its use for pillar pain remains understudied. This pilot study evaluated the efficacy of fractional CO₂ laser therapy in reducing pillar pain after CTR.</p><p><strong>Methods: </strong>A retrospective chart review was performed at a tertiary referral center between 2021 and 2024. Patients who developed pillar pain after CTR and subsequently underwent fractional CO₂ laser treatment were included. Demographic, clinical, and treatment data were collected, including comorbidities, incision type, laser treatment parameters, and medication use. Outcomes included visual analog scale pain scores and SCAR-Q survey results assessing scar appearance, symptoms, and psychosocial impact. Pre- and posttreatment pain scores were compared using paired <i>t</i> tests with significance set at <i>P</i> < 0.05.</p><p><strong>Results: </strong>A total of 30 procedures in 23 patients were identified. The mean prelaser visual analog scale pain score of 5.23 significantly decreased to 1.87 after treatment (mean decrease 3.37, <i>P</i> < 0.00001). SCAR-Q (Appearance, Symptom, and Psychosocial Impact) scores demonstrated positive outcomes in appearance (73.5), symptoms (85.0), and psychosocial impact (85.0). Most patients (91%) reported improvement in pain, and no adverse outcomes were observed. Patients with higher body mass index reported higher residual pain levels, although still improved compared with baseline.</p><p><strong>Conclusions: </strong>Fractional CO₂ laser therapy significantly reduced pillar pain and improved patient satisfaction following CTR, with no reported complications. This pilot study suggests that fractional CO₂ laser may serve as a safe, effective alternative for refractory pillar pain. Larger, prospective studies are warranted to validate these findings and determine broader applicability.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7189"},"PeriodicalIF":1.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233315","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":"Prophylactic Pectoralis Major Muscle Flap in Esophageal Reconstruction: A Preventive Approach to Anastomotic Leakage.","authors":"Akatsuki Kondo, Hiroki Umezawa, Marie Taga, Rei Ogawa","doi":"10.1097/GOX.0000000000007152","DOIUrl":"10.1097/GOX.0000000000007152","url":null,"abstract":"<p><p>Leakage from gastrointestinal flap anastomoses remains a significant challenge in reconstructive esophageal surgery, occurring in 10%-25% of cases, leading to prolonged hospital stays and high mortality rates. We explored a novel preventive approach, where the flap anastomosis is wrapped with a pectoralis major muscle (PMM) flap. We describe 3 patients (men aged 70-78 y) with esophageal cancer who underwent esophageal reconstruction with a jejunal flap followed by prophylactic PMM flap coverage. In case 1, the jejunal flap was supercharged and underwent esophagojejunal anastomosis. The esophagojejunal anastomosis was covered with the PMM flap. In case 2, pharyngojejunal and jejunogastric anastomoses were performed, and the latter was wrapped with a PMM flap. In case 3, the patient initially underwent a retrosternal gastric pull-up, which failed due to complications. During salvage surgery, a free jejunal flap was used, and the pharyngojejunal and jejunogastric anastomoses were both prophylactically covered with a PMM flap. Anastomotic leakage was not observed on postoperative endoscopy. PMM flap coverage may reduce anastomotic leakage by providing well-vascularized muscle tissue that promotes wound healing and by protecting the anastomosis from gravitational traction forces and mechanical stress. Although preliminary, our results suggest that prophylactic use of PMM flaps may prevent complications after esophageal reconstruction, particularly in patients requiring high-risk esophageal reconstruction.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7152"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213391","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":"Quantifying Research Productivity From First-year US Integrated Plastic Surgery Residents After USMLE Step I Pass/Fail Conversion.","authors":"Forrest Bohler, Kongkrit Chaiyasate","doi":"10.1097/GOX.0000000000007178","DOIUrl":"10.1097/GOX.0000000000007178","url":null,"abstract":"","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7178"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213371","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":"Anatomical Considerations and Technique for Nasolabial Fold Thread Lifting.","authors":"Gi-Woong Hong, Jovian Wan, Song-Eun Yoon, Isaac Kai Jie Wong, Soo-Bin Kim, Kyu-Ho Yi","doi":"10.1097/GOX.0000000000007150","DOIUrl":"10.1097/GOX.0000000000007150","url":null,"abstract":"<p><p>This review presents a comprehensive analysis of nasolabial fold classification and correction using thread-lifting techniques. Three distinct types of nasolabial folds are identified: those caused by paranasal volume deficiency, differential tissue laxity, and muscular insertions. The study emphasized the importance of Lore fascia as a key anatomical landmark and optimal adhesion point for thread placement, offering advantages over the traditional temporal approach. The technique uses a combination of bidirectional threads (Sihler Bi Lift) for tissue repositioning and volumizing threads (Sihler Volume) for fine line correction. Special consideration is given to the anatomical course of the facial artery and its branches, particularly in Asian populations, where more than 70% of people demonstrate medial crossing of the nasolabial fold. This comprehensive approach enables effective correction while minimizing complications.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7150"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213375","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":"Brachial Plexus Nerve Transfer Under Wide Awake Local Anesthesia No Tourniquet.","authors":"J Terrence Jose Jerome","doi":"10.1097/GOX.0000000000007151","DOIUrl":"10.1097/GOX.0000000000007151","url":null,"abstract":"<p><p>Brachial plexus injuries commonly require nerve transfers, traditionally performed under general anesthesia. We propose the wide awake local anesthesia no tourniquet (WALANT) technique, utilizing lidocaine with epinephrine to achieve anesthesia and maintain a bloodless surgical field without general anesthesia. Our initial experience with nerve transfers (eg, ulnar-to-musculocutaneous for elbow flexion) entirely under WALANT demonstrates excellent patient tolerance, minimal pain, and high satisfaction. Intraoperative nerve identification was enhanced by patient feedback and nerve stimulation without anesthesia-related complications. Recovery was rapid, and functional outcomes matched conventional methods. WALANT offers a safe, cost-effective, and patient-friendly alternative, improving surgical accessibility by reducing anesthesia risks and enabling procedures in resource-limited settings.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7151"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213430","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":"Early Outcomes Using TIGR Mesh in Direct-to-Implant Breast Reconstruction.","authors":"Orr Shauly, Makenna Ash, Shannon Su, Tola Ebunlomo, Melika Deaton, Susan Doh, Joseph S Khouri, Albert Losken","doi":"10.1097/GOX.0000000000007170","DOIUrl":"10.1097/GOX.0000000000007170","url":null,"abstract":"<p><strong>Background: </strong>Direct-to-implant (DTI) breast reconstruction often uses soft tissue support to improve outcomes and reduce implant migration. Synthetic meshes, such as TIGR Matrix, have emerged as potential alternatives to biological materials due to lower costs and complication rates. This study reviewed early outcomes using TIGR Matrix in immediate DTI reconstruction.</p><p><strong>Methods: </strong>A retrospective chart review was conducted on patients who underwent implant-based reconstruction with TIGR Matrix between November 2023 and June 2024 across 2 institutions. Inclusion criteria included DTI reconstruction with at least 6 months of follow-up. Data collected included demographics, oncological and reconstructive details, comorbidities, and postoperative complications. Statistical analysis was performed using MATLAB with <i>t</i> tests and χ² tests.</p><p><strong>Results: </strong>Seventy-one patients (109 breasts) met inclusion criteria. The cohort included 42.2% nipple-sparing, 40.4% skin-sparing, and 11.0% Goldilocks mastectomies. The mean patient age was 52 years. The mean time to first postoperative follow-up was 8.3 days. Major complications included 6 hematomas (5.5%), 3 seromas (2.8%), 2 infections (1.8%), and 3 explantations (2.8%). Eleven (10.1%) patients required reoperation due to complications including infection, necrosis, or residual disease. Minor complications (delayed wound healing, eschar) were observed in 17.4% of breasts. The overall complication rate excluding minor events was 12.8%.</p><p><strong>Conclusions: </strong>TIGR Matrix demonstrates an acceptable early complication profile in DTI breast reconstruction and may serve as a cost-effective alternative to acellular dermal matrices. Additional studies are needed to assess long-term outcomes and comparative effectiveness.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7170"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213383","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":"New Microcannulation Technique for Imaging Contrast and Drug Delivery via the Lymphatics.","authors":"Hiroo Suami","doi":"10.1097/GOX.0000000000007167","DOIUrl":"10.1097/GOX.0000000000007167","url":null,"abstract":"<p><p>A technique for drug delivery using the lymphatics was introduced and tested in animals half a century ago, but was never trialed in human subjects. Recently, surgical manipulation of lymphatic vessels for lymphedema treatment has attracted the interest of plastic surgeons. Assessing the lymphatics through imaging plays a vital role in understanding the pathology of lymphedema and planning surgery. Although various lymphatic imaging techniques are currently used, their indirect method of administering contrast media can cause uncontrollable transit and venous contamination. Pilot and preclinical studies were undertaken to simulate microcannulation into the lymphatic vessels using fresh animal and human cadaver models. In the human cadaver model, the target lymphatic vessels were in the dorsal hand and breast. Indocyanine green lymphography was performed to map the lymphatic vessels, after which a prototype microcannula 0.3 mm in diameter was inserted using a surgical microscope via a 5-mm skin incision into the identified lymphatic vessel. A mixture of blue dye and radiocontrast media was injected into the lymphatic vessel through the microcannula manually with a 1-mL syringe, and radiographs were taken to confirm its successful delivery into the lymphatic vessel without leakage from the needle hole. The preclinical study demonstrated that the technique of microcannulation via the lymphatics is an innovative and promising option for an imaging contrast and drug delivery route. This technique has 2 prospective clinical applications: (1) contrast-enhanced lymphatic imaging and (2) delivery of anticancer drugs targeting lymphogenous metastases.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7167"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213449","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":"Reviving the Chondrocutaneous Conchal Transposition Flap for Auricular Reconstruction After Human Bite Injury.","authors":"Sari M Rabah, Kayan Alotaibi, Ebtesam Almajed, Alya AlZabin, Faisal T Alayed, Salman T Alayed, Saud S Alassaf, Abdulaziz Almohanna","doi":"10.1097/GOX.0000000000007169","DOIUrl":"10.1097/GOX.0000000000007169","url":null,"abstract":"<p><p>Mammalian bites account for 1% of annual emergency room visits and present distinct issues when they involve regions such as the ear. Human bite injuries may cause atypical tissue damage and elevate the risk of infection, thereby compromising ear repair. Diverse surgical methodologies aim to rehabilitate the ear's functionality and appearance. The Orticochea flap, using conchal transposition flaps, is recognized as a prominent single-stage approach for auricular defect reconstruction. A 22-year-old man presented with a human bite injury that led to the total amputation of the upper auricle of the left ear. After the initial reattachment, tissue necrosis necessitated an additional operation. The amputated ear was reconstructed using a conchal chondrocutaneous transposition flap (Orticochea). This treatment reinstated the ear's structural integrity and soft tissue coverage. The flap, tailored to the defect's dimensions, was lifted while preserving its vascular pedicle and rotated to reconstruct the ear. A postauricular full-thickness skin graft was used to cover the donor site and the posterior surface of the flap. Postoperative follow-up indicated exceptional flap viability, satisfactory healing, a natural aesthetic result, and patient satisfaction. Human ear bite injuries are challenging to treat due to their complexity and infection risk. Single-stage reconstruction using the Orticochea flap balances structural integrity and aesthetics. This approach highlights the importance of tailored surgical interventions for optimizing patient satisfaction and functional restoration in auricular reconstructions.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 10","pages":"e7169"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213384","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}