Plastic and Reconstructive Surgery Global Open最新文献

{"title":"Abdominoplasty With Progressive Tension Sutures Versus Conventional Abdominoplasty: A Comparative Study at a Third-level Institution.","authors":"Víctor C Ledezma Rodríguez, Sandra A López, Alejandro González Ojeda, María F Pérez Gómez, Samantha E González Muñoz, Sergio J Vázquez Sánchez, Gonzalo Delgado Hernández, Gabino Cervantes Guevara, Enrique Cervantes Pérez, Clotilde Fuentes Orozco","doi":"10.1097/GOX.0000000000006646","DOIUrl":"10.1097/GOX.0000000000006646","url":null,"abstract":"<p><strong>Background: </strong>Abdominoplasty is a cosmetic surgery that improves the appearance of the abdominal contour. Among the techniques used to reduce complications are progressive tension sutures (PTSs), which involve the use of sutures that fix a flap at several points to the underlying tissue.</p><p><strong>Methods: </strong>A nonrandomized clinical trial was performed from April 1 to November 30, 2023. Patients older than 18 years who underwent abdominoplasty were included. The variables studied were age, body mass index, comorbidities, surgical time, and postoperative complications.</p><p><strong>Results: </strong>Twenty-eight patients were included, 14 with conventional closure and 14 with PTSs closure, with a mean age of 37.6 (SD 9.1) years and 39.9 (SD 6.8) years, respectively. In the conventional closure group, 3 (21.3%) patients presented complications, 2 (14.3 %) presented seromas, and 1 (7.1%) presented wound dehiscence, whereas the PTS group did not present any complications (<i>P</i> = 0.067). A mean operative time of 137.8 (SD 16.6) minutes was found for conventional closure and 167 (SD 12.0) minutes for PTS closure (<i>P</i> ≤ 0.001).</p><p><strong>Conclusions: </strong>Our study showed that the technique with PTS did not present complications compared with the conventional closure. Our results are comparable with the literature.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 3","pages":"e6646"},"PeriodicalIF":1.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710978","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":"Direct-to-implant Prepectoral Breast Reconstruction in Women Older Than 65 Years: Analysis of Safety and Patient-reported Outcome.","authors":"Adi Maisel Lotan, Yotam Teldan, Ronen Toledano, Shahar Talisman, Shalom Strano, Hadar Goldvaser, Tal Zobok, Yoav Gronovich","doi":"10.1097/GOX.0000000000006647","DOIUrl":"10.1097/GOX.0000000000006647","url":null,"abstract":"<p><strong>Background: </strong>Immediate breast reconstruction following mastectomy has many proven advantages. Although more than half of the patients with breast cancer in the United States are older than 65 years of age, breast reconstruction rates in this age group are low. The goal of this study was to evaluate safety and patient satisfaction of direct-to-implant (DTI) prepectoral breast reconstruction in women older than 65 years of age.</p><p><strong>Methods: </strong>This was a retrospective, single-center study of 56 women (56 breasts) undergoing DTI prepectoral breast reconstruction. Twenty-eight patients were older than the age of 65 years and 28 were younger. Groups were matched for surgical procedure, smoking status, body mass index, and history of radiation therapy. Outcomes were compared between groups, and possible correlations were studied.</p><p><strong>Results: </strong>Twelve patients older than 65 years of age had hypertension (<i>P</i> = 0.007). Perioperative pain management, major complications, total number of surgical complications, reconstruction failure, and duration of hospitalization were similar in both groups. More advanced age was correlated with higher psychosocial well-being, sexual well-being and satisfaction with breasts on the BREAST-Q scale. Median follow-up was 11.5 months (older) and 23 months (younger).</p><p><strong>Conclusions: </strong>Prepectoral DTI breast reconstruction in women older than 65 years of age is safe, reproducible, has high patient satisfaction, and may be performed in this patient cohort.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 3","pages":"e6647"},"PeriodicalIF":1.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711001","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 Landmark-guided Strategy for Computer-assisted Reconstruction of Infrastructure Maxillary Defects Using Free Fibula Flap.","authors":"Songying Wu, Jingya Jane Pu, Edmond Ho Nang Pow, Pui Hang Leung, Xing-Na Yu, Yu-Xiong Su, Wei-Fa Yang","doi":"10.1097/GOX.0000000000006626","DOIUrl":"10.1097/GOX.0000000000006626","url":null,"abstract":"<p><strong>Background: </strong>Computer-assisted surgery in head and neck reconstruction yields predictable and favorable clinical outcomes. However, there is a lack in the optimal arrangement of the fibula bone segments to re-establish the function and aesthetics of the maxilla.</p><p><strong>Methods: </strong>This study proposed a novel anatomical landmark-guided strategy for the virtual surgical planning (VSP) of infrastructure maxilla reconstruction using a free fibula flap. The optimal positioning of fibula segments was validated with a retrospective clinical study. Patients who underwent computer-assisted infrastructure maxillectomy and reconstruction with a free fibula flap from May 2017 to April 2024 were reviewed. Reproducibility of the landmarks and associated clinical parameters was assessed in VSP compared with the preoperative maxilla. Additionally, a structured quantitative approach was adopted for postoperative surgical outcome analysis by comparison of the postoperative maxilla and the VSP.</p><p><strong>Results: </strong>Twenty patients fulfilled the criteria of this study. In 11 cases, we conformed to the proposed reconstruction strategy (group A). In 9 cases, we adopted a modified approach (group B) with deviations in the count of fibula segments and positioning strategy. In group A, the pooled median landmark error was 2.19 mm (interquartile range, 1.63-2.91 mm) in the VSP compared with the preoperative maxilla; in group B, the error was 4.54 mm (interquartile range, 2.05-6.15 mm). The clinical parameters demonstrated satisfactory recapture of the alveolar arch and maxillary width.</p><p><strong>Conclusions: </strong>This anatomical landmark-guided strategy was validated with satisfactory reproducibility of the quantitative metrics in the VSP. The anatomical landmarks and associated clinical parameters provided a structured quantitative approach for postoperative analysis of computer-assisted maxillary reconstruction using FFFs.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 3","pages":"e6626"},"PeriodicalIF":1.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701285","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":"Targeted Nipple Reinnervation in Gender-affirming Mastectomy: A \"How To Do It\" Technical Primer.","authors":"Blair R Peters, Michelle Bonapace-Potvin, Jaya K Dhami, Brynn A Hathaway, Elizabeth Shepard","doi":"10.1097/GOX.0000000000006657","DOIUrl":"10.1097/GOX.0000000000006657","url":null,"abstract":"","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 3","pages":"e6657"},"PeriodicalIF":1.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700763","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 Use of Acellular Dermal Matrix for the Treatment of Posttraumatic Radioulnar Heterotopic Ossification.","authors":"Jessica J Farzan, Ovninder Johal, Brian Jao, Douglas M Rothkopf","doi":"10.1097/GOX.0000000000006661","DOIUrl":"10.1097/GOX.0000000000006661","url":null,"abstract":"<p><p>Posttraumatic distal radioulnar heterotopic ossification (DRU HO) is a rare condition characterized by impaired pronosupination due to bone formation between the radius and ulna. Proposed management techniques have included physical therapy, radiation, medication, limited resection, ostectomy, and arthrodesis. However, no single technique has emerged as the standard of care due to high rates of persistence and recurrence. Some authors have described the use of autologous interposition grafting or the placement of cadaveric tensor fasciae latae, but these methods are associated with donor-site morbidity and difficulty with availability, respectively. We report the application of human acellular dermal matrix (ADM) as an interposition material for the treatment of posttraumatic DRU HO in a 21-year-old male patient. The patient sustained displaced distal radius and ulnar fractures following a motorcycle collision, which were treated with open reduction and internal fixation, along with volar forearm fasciotomy. After the initial treatment, the patient developed stiffness and discomfort. Imaging revealed severe ossification, prompting resection and ADM placement. Postsurgery, the patient experienced significant improvement, achieving nearly full motion with 90 degrees of supination and 70 degrees of pronation, with no complications or recurrence after 11 months. This is the third case of successful treatment with ADM interposition material, adding to evidence for its use as a simple and durable option for posttraumatic DRU HO. ADM offers numerous benefits over other techniques, including no donor-site morbidity, low cost, and wide availability, making it a safe and effective alternative.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 3","pages":"e6661"},"PeriodicalIF":1.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complex Abdominal Wall Reconstruction Involving Large Bridging Mesh at Organ Transplant Incision Site.","authors":"Madeleine B Landau, William Aukerman, Caleb Fligor, Hoonbae Jeon, Abigail E Chaffin","doi":"10.1097/GOX.0000000000006663","DOIUrl":"10.1097/GOX.0000000000006663","url":null,"abstract":"<p><p>Large-sized recurrent abdominal wall hernias are commonly repaired via component separation, involving the release of lateral abdominal wall muscles to facilitate defect closure. However, in settings without viable abdominal wall muscles or superficial soft-tissue coverage, alternative methods must be considered. This case report describes a technique of hernia repair using large bridging mesh for the treatment of a large-sized recurrent incisional hernia. Two patients with incisional hernia at previous incision measuring 15 × 35 and 23 × 15 cm² underwent repair as a joint case with transplant and plastic surgery teams. Patient 1 had previous placement of bilateral tissue expanders superior to the defect in preparation for hernia repair. The repair in both cases involved excision of the previous skin graft over the bowel, dissection of the fascial edges and costal margin, and placement of an interpositioned reinforced ovine rumen. Coverage of the mesh was completed by utilization of local fasciocutaneous advancement flaps in both patients. The patients were admitted postoperatively. Patient 1 developed a small noninfected seroma at his incision site requiring later percutaneous drainage. No other complications or hernia recurrence have been noted in either case. The surgery and postoperative care required no significant alteration of immunosuppression. Large bridging mesh combined with tissue expansion may be used as an effective technique for the treatment of large abdominal wall hernias in patients with largest losses of abdominal fascia who are not candidates for component separation.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 3","pages":"e6663"},"PeriodicalIF":1.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701286","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":"Deep Inferior Epigastric Perforator Flap Preconditioning Using Selective Vessel Ligation (Delay Procedure) and Thinning Liposuction.","authors":"Alberto Franchi, Caterina Marra, Gian Piero Mantovani, Florian Jung","doi":"10.1097/GOX.0000000000006656","DOIUrl":"10.1097/GOX.0000000000006656","url":null,"abstract":"<p><p>The deep inferior epigastric perforator (DIEP) flap is the gold standard in autologous breast reconstruction, but it is rarely used for superficial limb defects due to its excessive thickness. In this case report, we describe the innovative use of the DIEP flap for reconstructing a large, shallow defect on the anterior thigh of a 21-year-old man, previously treated with split-thickness skin grafts. To achieve a large yet thin and well-vascularized flap, we combined 2 techniques: the surgical delay procedure and liposuction. The patient, with a body mass index of 26 kg/m², sought cosmetic and functional improvement for his left thigh, agreeing to the use of abdominal tissue, which also allowed for volume reduction of the abdomen. However, the abdominal flap was too thick for an aesthetic result, and the flap to be harvested was too large to be adequately vascularized by a single pedicle. After evaluating the vascular anatomy with Doppler ultrasound and computed tomography angiography, we planned a 2-stage operation: first, a surgical delay procedure to enhance perfusion of the main pedicle, and later, liposuction of the subcutaneous tissue before flap transfer. The postoperative course was uneventful, with only minimal superficial necrosis managed conservatively. The patient declined further corrective procedures, as he was satisfied with the result. This case represents the first reported combination of flap thinning through liposuction and the delay technique for a DIEP flap. It offers a novel approach for large superficial defects when immediate coverage is not required, providing a potential solution for obtaining a thin, well-perfused flap.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 3","pages":"e6656"},"PeriodicalIF":1.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700618","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":"Which Characteristics of Applicants and Medical Schools Produce the Most Integrated Plastic Surgery Residents? An Analysis of the 2016-2022 Cohort.","authors":"Madison A Oxford, Grace S Ryu, Mikayla P Borusiewicz, John M Ingraham","doi":"10.1097/GOX.0000000000006623","DOIUrl":"10.1097/GOX.0000000000006623","url":null,"abstract":"<p><strong>Background: </strong>Since the advent of integrated residency programs in the 1960s, the plastic and reconstructive surgery (PRS) match has become increasingly competitive, with 1.8 applicants per available residency position in 2022. The study aimed, first, to determine the characteristics of the 2016-2022 integrated PRS resident cohort that were associated with successful matching and, second, to identify attributes of medical schools that produced the most integrated PRS residents within this 6-year period.</p><p><strong>Methods: </strong>Using publicly available websites, demographic and training characteristics of residents at ACGME-accredited programs, plus class size, affiliated PRS training programs, and presence of Plastic Surgery interest groups (PSIGs) at US medical schools were collected and analyzed.</p><p><strong>Results: </strong>Of the 1122 matched residents, 48% were female, 5% were international medical graduates, 99% held MD degrees, 13% held additional graduate-level degrees, and 33% were awarded AΩA. Georgetown University had the largest number of its graduates match into PRS at 31, and New York University had the largest percentage of its graduates match into PRS at 3.17%. On average, schools with both an integrated and independent program had more graduates enter PRS (10.6), compared to those with integrated only (8.9) or independent only (5.7) (<i>p</i> = 0.01).</p><p><strong>Conclusions: </strong>Nearly all integrated PRS residents in the 2016-2022 cohort graduated from US allopathic medical schools. Additionally, medical schools that produced the greatest number of PRS residents were affiliated with a home training program and/or PSIG. Further exploration of advantageous and disadvantageous factors associated with matching could help identify areas to improve equity and diversity in PRS training.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 3","pages":"e6623"},"PeriodicalIF":1.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700855","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":"Minimally Invasive Strategy for Harvesting Anterolateral Thigh Flaps.","authors":"Ken Matsubara, Jun Araki, Shogo Nakamura, Masashi Hayakawa, Shinya Suzuki, Hiroaki Mori, Junichi Nakao, Hiroshi Fuseya, Yohei Hiiragi, Takashi Mukaigawa, Yoshichika Yasunaga","doi":"10.1097/GOX.0000000000006649","DOIUrl":"10.1097/GOX.0000000000006649","url":null,"abstract":"<p><p>The anterolateral thigh (ALT) flap is one of the most versatile and frequently used flaps in reconstructive surgery. Although techniques for flap harvesting are well established, donor-site morbidities remain a common concern. We report the case of an 83-year-old man who underwent oral cancer resection and reconstruction using a right ALT flap. We used a minimally invasive strategy to reduce donor-site morbidity, including microvascular re-anastomosis of the vascular pedicle. The free flap was successfully transferred, and the postoperative course was uneventful. Lower extremity function tests revealed no dysfunction after surgery. In reconstructive surgery, successful flap transfer and minimal donor-site morbidity are essential. Minimally invasive strategies should be promoted in surgical practice.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 3","pages":"e6649"},"PeriodicalIF":1.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700836","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":"Lipoblastoma of the Scalp in a Pediatric Patient.","authors":"Constant P van Schalkwyk, Alzbeta Novotna, Kevin Ho","doi":"10.1097/GOX.0000000000006632","DOIUrl":"10.1097/GOX.0000000000006632","url":null,"abstract":"<p><p>Lipoblastoma, a rare benign tumor composed of immature fat cells, typically arises in the first 3 years of life. Although commonly found in the extremities and trunk, occurrences on the scalp are exceedingly rare. We present a case report of a lipoblastoma located on the scalp of a 5-year-old female patient. The patient presented with a painless, gradually enlarging mass over a 6-month period. Clinical and radiological evaluation confirmed the presence of a well-defined, lobulated lesion with adipose density. Surgical excision was performed, and histopathologic examination revealed characteristic features of lipoblastoma, including lipoblast-like cells and lobules of adipose tissue, separated by fibrous connective tissue septae of varying thickness surrounded by a fibrocartilaginous capsule. To our knowledge, this is the fourth documented case of lipoblastoma originating in the scalp region in a pediatric patient. Given the rarity of lipoblastoma in this location, this case highlights the importance of considering lipoblastoma as a differential diagnosis when evaluating scalp masses in children. Awareness of atypical presentations and histopathologic features can aid in accurate diagnosis and appropriate management, which usually involves complete surgical resection. Further studies are warranted to explore the genetic and molecular underpinnings of these unique cases, contributing to a better understanding of the pathogenesis of lipoblastomas in various anatomical sites.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 3","pages":"e6632"},"PeriodicalIF":1.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693059","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}