Plastic and Reconstructive Surgery Global Open最新文献

{"title":"Bilateral Red Breast Syndrome in Prepectoral Implant-based Immediate Breast Reconstruction Using Bovine Pericardium Acellular Collagen Matrix.","authors":"Angelica Aquinati, Emanuele Filippini, Ortensia Pirro, Enrico Lenti, Gianluca Moroncini, Michele Riccio","doi":"10.1097/GOX.0000000000006941","DOIUrl":"10.1097/GOX.0000000000006941","url":null,"abstract":"<p><p>Red breast syndrome (RBS) is a rare and intriguing clinical phenomenon that remains only partially understood. It is characterized by erythema and warmth of the breast following breast reconstructive surgery. This clinical condition is typically associated with the use of acellular dermal matrix (ADM) over breast implants. Currently, surgeons prefer using ADMs for immediate prepectoral implant-based breast reconstruction to enhance aesthetic outcomes and promote better implant integration. ADMs can induce a local inflammatory response that may mimic an actual implant infection. Although rare, the etiology, diagnosis, and treatment of RBS present a significant challenge for both patients and healthcare professionals due to its enigmatic nature. We present a case of bilateral RBS following bilateral nipple-sparing mastectomy and immediate prepectoral implant-based breast reconstruction using a specific acellular collagen matrix derived from bovine pericardium. We detail our diagnostic approach and treatment strategy, which successfully resolved the syndrome while preserving both the breast implants and the ADMs.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 7","pages":"e6941"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554157","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":"Metastatic Papillary Thyroid Carcinoma in the Hand.","authors":"Christine S W Best, Wenhui Liu, Tao Huang, Kevin C Chung","doi":"10.1097/GOX.0000000000006926","DOIUrl":"10.1097/GOX.0000000000006926","url":null,"abstract":"<p><p>Papillary thyroid carcinoma is the most common thyroid cancer, and metastases can be seen in up to 10% of patients at initial presentation. Metastasis of tumors to the hand is rare. This report describes a patient with painful right thenar and hypothenar masses that were confirmed as metastatic papillary thyroid carcinoma after narrow excision. Intraoperatively, the soft tissue masses did not invade the surrounding musculature or neurovascular bundles. There was improved hand pain and no neurovascular deficits postoperatively. Close monitoring with physical examination without additional radiation was recommended by the multidisciplinary endocrine oncology tumor board. This case highlighted the importance of maintaining suspicion for malignant metastasis in hand masses when there is a history of thyroid carcinoma.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 7","pages":"e6926"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554180","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":"Utility of Computed Tomography Imaging in Assessing Soleus Muscle Viability for Flap Coverage.","authors":"Nikhil Patel, Aaron S Cohen, Griffin Harris, Nicholas Mercier, Sara J Stewart, Emily Finkelstein, Olivia B de Araujo, Jean Jose, Natalia Fullerton","doi":"10.1097/GOX.0000000000006938","DOIUrl":"10.1097/GOX.0000000000006938","url":null,"abstract":"<p><strong>Background: </strong>The use of soleus muscle flaps for traumatic middle-third injuries to the lower leg can have variable viability, as there is no standardized way to evaluate the muscle before flap selection. This case series investigated both the utility and accuracy of computed tomography angiogram (CTA) imaging in determining the viability of the soleus muscle for reconstructive use after traumatic injuries of the lower extremity.</p><p><strong>Methods: </strong>An international review board-approved retrospective chart review was conducted of patients who underwent lower extremity soleus-based flap reconstruction by a single surgeon from January 2020 to December 2022. Patient demographics, comorbidities, and postoperative complications were recorded. Preoperative CTA reports were reanalyzed by a blinded musculoskeletal radiologist. Descriptive statistics were performed.</p><p><strong>Results: </strong>Five patients underwent lower extremity flap reconstruction with soleus muscle over the study period. All patients had lower extremity Gustilo type IIIB or IIIC open fractures. Four out of 5 patients showed no signs of muscle injury on CTA; of those, 2 did not develop postoperative complications, and 2 required repeated irrigation and debridement, but no alternative flap coverage. One patient with preoperative CTA demonstrating soleus muscle injury developed postoperative complications requiring alternate flap reconstruction.</p><p><strong>Conclusions: </strong>Further research is required to determine a statistically significant correlation between soleus muscle injury on preoperative CTA and postoperative complications. However, this case series illustrated the need for larger studies and a computed tomography-based standardized grading system for traumatic muscle injury to better predict soleus flap survival.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 7","pages":"e6938"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554182","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":"Winning the Global Surgery War: A Conceptual Framework.","authors":"Peter M Nthumba","doi":"10.1097/GOX.0000000000006920","DOIUrl":"10.1097/GOX.0000000000006920","url":null,"abstract":"<p><strong>Background: </strong>Global surgery (GS), which comprises surgery, obstetrics, and anesthesia, is a complex multidisciplinary enterprise that focuses on the provision of timely, safe, and equitable surgical care to the global population. As with any war, understating the burden of surgical disease risks failure in any crafted strategy, as the measures would be substantially inadequate. Using strategies from successful large-scale interventions, the author proposes a conceptual framework for sustainable GS scale-up.</p><p><strong>Methods: </strong>The author collated GS scale-up strategies from the literature and aligned them with the 6 core indicator metrics as the primary outcome measures.</p><p><strong>Results: </strong>The proposed conceptual framework hangs on the successes of the Marshall Plan for Europe and the World Health Organization multimodal strategy for infection control and prevention to provide funding and intervention models, successively, for GS scale-up. Smile Train and Operation Smile strategies for strengthening surgical systems provide potential learning points for GS scalability. Collaborating with these and other surgical nongovernmental organizations and harnessing their experiences and networks promises potential for success in GS scale-up.</p><p><strong>Conclusions: </strong>The proposed conceptual framework provides potential sustainable GS scale-up, using a nonprescriptive \"bundled\" intervention approach, permitting individual countries to progress at their own pace, while allowing for transparent sharing of learned experiences.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 7","pages":"e6920"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554183","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":"Latissimus Dorsi Flap for Chemotherapy-induced Extensive Forearm Necrosis: Case Study.","authors":"Wentao Liu, Menglin Lu, Dan Li, Xiao Shen","doi":"10.1097/GOX.0000000000006841","DOIUrl":"10.1097/GOX.0000000000006841","url":null,"abstract":"<p><p>Chemotherapeutic drug extravasation represents one of the most prevalent complications encountered during chemotherapy administration in oncology patients. A severe consequence of this complication is the induction of extensive soft-tissue necrosis, for which a definitive clinical management protocol remains elusive. This study presented and analyzed a case of an older male patient who developed extensive soft-tissue necrosis in the forearm due to chemotherapeutic drug extravasation, prompting his admission to our department for treatment. The patient underwent repeated debridement procedures, followed by the application of a latissimus dorsi myocutaneous flap combined with skin grafting to cover the wound surface. A 2-month postoperative follow-up revealed satisfactory growth of both the flap and skin graft. This flap transfer technique offers a novel therapeutic approach for the management of extensive soft-tissue necrosis resulting from chemotherapeutic drug extravasation.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6841"},"PeriodicalIF":1.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529295","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":"Telemedicine in Nerve Surgery: An Effective Method to Determine Indications for Surgery.","authors":"Noah S Llaneras, Ruby L Taylor, Jonah P M Orr, Rachel Alessio, Carolyn Carper, Brendan M Patterson, Susan E Mackinnon","doi":"10.1097/GOX.0000000000006892","DOIUrl":"10.1097/GOX.0000000000006892","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic accelerated the adoption of telemedicine for surgical consultations. Although patient satisfaction has been well documented, limited research exists regarding telemedicine's effectiveness in determining the ability to indicate for surgical care compared with in-office visits. We conducted a retrospective review comparing surgical decision-making via telemedicine versus in-person consultations, hypothesizing that in-office visits would be more effective in establishing a surgical plan than telemedicine.</p><p><strong>Methods: </strong>A retrospective review of the medical records of all new patients presenting to the senior author's nerve surgery clinic at a high-volume quaternary referral center between June 2020 and January 2023 was performed. Surgical consultations were categorized as (1) surgery recommended, (2) surgery not recommended, (3) further screening required, or (4) surgery declined. The Fisher exact test compared the distribution of these categories between consultation types and the proportion of patients who underwent surgery after an initial recommendation.</p><p><strong>Results: </strong>Of the 809 patients, 283 (35%) had in-person and 526 (65%) had telemedicine consultations. Surgery was recommended in 49.5% of in-person consultations compared with 38% of telemedicine consultations (<i>P</i> = 0.03). Among those recommended for surgery at the initial visit, 77.9% of in-person and 77.8% of telemedicine patients ultimately underwent surgery (<i>P</i> = 0.10). Of the telemedicine patients subsequently seen in the office and offered surgery, 84.5% ultimately underwent that surgery.</p><p><strong>Conclusions: </strong>Our findings suggest that telemedicine and in-office visits are equally effective in establishing a surgical plan, suggesting that the expansion of telemedicine could be considered for a broader geographic patient base.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6892"},"PeriodicalIF":1.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12200210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507463","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":"Complications and Satisfaction After Adolescent Breast Reduction for Juvenile Macromastia: Systematic Review and Meta-analysis.","authors":"Ibrahim R Halawani, Shahad Alalawi, Sarah Alyamani, Abdulmalek W Alhithlool, Ferdous A Ahmed, Iraf Asali, Abdulrahman A Alghamdi, Hatem Al Noman","doi":"10.1097/GOX.0000000000006913","DOIUrl":"10.1097/GOX.0000000000006913","url":null,"abstract":"<p><strong>Background: </strong>Juvenile macromastia is a rare condition of significant breast enlargement in adolescents. Reduction mammoplasties offer relief, but data on complications in adolescents are rare as opposed to data on adults. We reviewed the outcomes, complications, recurrence, and patient satisfaction after reduction mammoplasties in adolescents.</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a thorough search across various electronic databases for \"juvenile macromastia\" and \"breast reduction.\" Only studies on women diagnosed with juvenile macromastia before 21 years of age who underwent breast reduction surgery were included. The methodological index for nonrandomized studies was used to assess study quality.</p><p><strong>Results: </strong>This meta-analysis pooled data from 11 studies. The overall pooled postoperative complication rate, based on random-effects models, was 17.5% (95% confidence interval: 9.7%-29.5%). The recurrence rate was 15.6% (95% confidence interval: 8.5%-26.9%), ranging from 0% to 52.9%. Complication rates varied widely across studies, with wound dehiscence, hematoma, and infection being the most common. Severe complications, such as nipple necrosis, were rare. Low publication bias was observed for postoperative complications, but potential bias was noted for recurrence outcomes.</p><p><strong>Conclusions: </strong>The findings emphasize the need for standardized reporting and long-term follow-up to improve the reliability of pooled estimates and to guide clinical decision-making. The high recurrence risk emphasized the need for individualized surgical approaches and careful management of risk factors, such as obesity and smoking, to improve outcomes. Despite the variability, the benefits of surgery generally outweighed the risks, with high patient satisfaction reported in the included studies.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6913"},"PeriodicalIF":1.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12200214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507509","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":"Predicting Postoperative Complications in Older Patients Undergoing Head and Neck Microvascular Reconstruction Using the National Quality Improvement Program Risk Calculator.","authors":"Sebastian Holm, Jenny Löfgren, Johann Zdolsek, Juan Enrique Berner, Fredrik Landström","doi":"10.1097/GOX.0000000000006910","DOIUrl":"10.1097/GOX.0000000000006910","url":null,"abstract":"<p><strong>Background: </strong>Head and neck cancer (HNC) is the seventh most prevalent cancer worldwide, usually requiring a multidisciplinary approach. The National Surgical Quality Improvement Program (NSQIP) risk calculator is a tool for predicting postoperative complications that possibly can help in decision-making, support patient education, and guide the choice between surgical and nonsurgical treatment options. The aim of this study was to assess the reliability of the NSQIP risk calculator as a predictor of postoperative complications following head and neck surgery with microvascular reconstruction.</p><p><strong>Methods: </strong>This retrospective study included 99 patients diagnosed with HNC who underwent microvascular reconstruction from January 2016 to February 2021. The observed complications were compared with those predicted by the NSQIP calculator. To assess the discriminatory power of the NSQIP estimates, receiver operating characteristic statistics, logistic regression, and the overall Brier score were used.</p><p><strong>Results: </strong>Forty-four percent of the patients experienced at least 1 postoperative complication, and 27.2% developed serious complications. The receiver operating characteristic analysis for any complications revealed an area under the curve (AUC) of 0.62 (95% confidence interval 0.51-0.73, <i>P</i> = 0.046). For serious complications, the AUC was 0.65 (95% confidence interval, 0.52-0.79, <i>P</i> = 0.021). Both AUC values fell short of the threshold for \"acceptable discrimination\" (0.7-0.8). The overall Brier score was 0.32, with scores less than 0.09 considered to have good accuracy.</p><p><strong>Conclusions: </strong>The results suggest that the NSQIP risk calculator tends to underestimate the likelihood of postoperative complications in patients who are undergoing resection for HNC accompanied by microvascular reconstruction.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6910"},"PeriodicalIF":1.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12200215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507513","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":"Craniosynostosis in Saudi Arabia: A Retrospective Analysis of Subtype Patterns, Syndromic Risk, and Postoperative Outcomes.","authors":"Hanan Alhusainan, Wael A Alshaya, Salman S Qasim, Anas M Alyamani, Bushra A Alhazmi, Muhammad M Ulhaq, Nouf Z Albattal, Alwaleed M Altuwaijri","doi":"10.1097/GOX.0000000000006905","DOIUrl":"10.1097/GOX.0000000000006905","url":null,"abstract":"<p><strong>Background: </strong>Craniosynostosis, the premature fusion of cranial sutures, results in skull deformities and potential complications such as increased intracranial pressure. Although well documented globally, local epidemiological studies and management strategies remain scarce. This study aimed to assess the prevalence, clinical characteristics, and surgical outcomes of craniosynostosis at King Abdullah Specialized Children's Hospital in Riyadh, Saudi Arabia.</p><p><strong>Methods: </strong>A retrospective analysis was conducted, analyzing patients diagnosed with craniosynostosis from October 2019 to June 2023. Demographic, clinical, and surgical data were extracted from electronic medical records. Statistical comparisons between syndromic and nonsyndromic cases were performed using appropriate tests, with significance set at a <i>P</i> value less than 0.05.</p><p><strong>Results: </strong>A total of 77 patients were included, with a male predominance (70%) and a mean age at surgery of 26 months. Trigonocephaly (19%), anterior plagiocephaly (18%), and scaphocephaly (18%) were the most common subtypes. Syndromic cases (23%) were more likely to be complex (78% versus 32%, <i>P</i> < 0.001) and had higher rates of papilledema (33% versus 5.1%, <i>P</i> = 0.004) and increased intracranial pressure (33% versus 8.5%, <i>P</i> = 0.02). Surgical outcomes were favorable, with low complication rates and no postoperative mortality. Syndromic patients had longer hospital stays (median 8 versus 7 d, <i>P</i> = 0.002), but intraoperative blood loss was comparable between groups (<i>P</i> = 0.66).</p><p><strong>Conclusions: </strong>This study provides insights into craniosynostosis in Saudi Arabia, highlighting the need for earlier diagnosis and genetic studies due to high consanguinity rates. The findings contribute to the global understanding of craniosynostosis and may help improve clinical management strategies.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6905"},"PeriodicalIF":1.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12200220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507510","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":"Eliminating Venous-to-lymphatic Reflux by Converting End-to-side to End-to-end Lymphovenous Bypass With Ligation of the Distal Vein.","authors":"Marco Pappalardo, Claudio Gio Francesco Blessent, Alessio Baccarani, Giorgio De Santis, Joseph H Dayan","doi":"10.1097/GOX.0000000000006929","DOIUrl":"10.1097/GOX.0000000000006929","url":null,"abstract":"","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6929"},"PeriodicalIF":1.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12200216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507511","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}