Plastic and Reconstructive Surgery Global Open最新文献

{"title":"A Retrospective Observational Study of Combination Treatment of Thread Lift and High-intensity Focused Ultrasound for Facial Aging.","authors":"Yu-Ching Weng, Chia-Hsien Hsieh, Ben Chung-Pin Liang","doi":"10.1097/GOX.0000000000006899","DOIUrl":"10.1097/GOX.0000000000006899","url":null,"abstract":"<p><strong>Background: </strong>Current literature lacks guidelines on the optimal treatment number of threads for specific indications and provides limited evidence on the efficacy of combining thread lift with other materials or devices for synergistic effects.</p><p><strong>Methods: </strong>This study evaluates the therapeutic outcomes of combining thread lift therapy with high-intensity focused ultrasound. Fifty-eight participants, divided into 2 groups of 29, received 3 treatments, each involving unilateral insertion of four 17-cm-long barbed Miracle threads and 200 lines of ultrasound therapy with a 4.5-mm UTIMS probe on the middle and lower face.</p><p><strong>Results: </strong>Wilcoxon signed-rank tests showed significant improvements in physician-evaluated Merz aesthetic scores between the second and first visits (Z = -6.057, <i>P</i> < 0.01), the third and second visits (Z = -5.112, <i>P</i> < 0.01), and between the photograph session and both the third (Z = -5.425, <i>P</i> < 0.01) and first visits cumulatively (Z = -4.943, <i>P</i> < 0.01). Additionally, Wilcoxon 2-tailed signed-rank test revealed significant reductions in jowl fat pad distance across treatment sessions.</p><p><strong>Conclusions: </strong>The treatment sequence did not affect facial lifting outcomes, and 3 sessions of combined thread lift and high-intensity focused ultrasound therapy sustained effects in partial participants.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6899"},"PeriodicalIF":1.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302637","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":"Neck Surgical Emphysema Post Bilateral Breast Implant Exchange Procedure.","authors":"Thendo T Netshiongolwe, Agnes R Sema-Ramashala, Elias Ndobe","doi":"10.1097/GOX.0000000000006895","DOIUrl":"10.1097/GOX.0000000000006895","url":null,"abstract":"<p><p>Breast reconstruction using implants is a common and well-established practice in plastic surgery. Some patients who undergo this method of reconstruction later request implant exchange, either due to complications or for cosmetic reasons. Repeated operations can be associated with an increased risk of complications. Although the focus is often on surgical complications, anesthetic complications should also be considered when treating such patients. Our case report describes a patient who underwent a bilateral breast implant exchange procedure for cosmetic reasons and presented on postoperative day 1 with a sore throat, difficulty swallowing, and crepitus in the neck region. A clinical diagnosis of surgical emphysema was made and confirmed by radiological investigations. The patient was examined by an otorhinolaryngologist (ear, nose, and throat surgeon), who confirmed the diagnosis, and was treated nonsurgically, showing significant improvement with complete resolution of the condition within a week. This is the first reported case of surgical emphysema in a patient undergoing bilateral breast implant surgery. As more older patients present requesting exchange procedures, surgeons undertaking these procedures need to be aware of both surgical and anesthetic complications associated with operating on older patients and take all precautionary measures to prevent these risks.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6895"},"PeriodicalIF":1.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302652","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":"Molar Extraction and Bone Grafting to Optimize Bone Stock for Future Mandibular Distraction.","authors":"Aaron I Dadzie, Sydney Somers, Mitchell Dunklebarger, Laurel Ormiston, Duane Yamashiro, Barbu Gociman","doi":"10.1097/GOX.0000000000006891","DOIUrl":"10.1097/GOX.0000000000006891","url":null,"abstract":"<p><p>Mandibular distraction osteogenesis is a major modality in treating micrognathia associated with severe class II malocclusion. Shortcomings associated with mandibular distraction are often secondary to lack of adequate bone at the level of the osteotomies, either from insufficient original bone stock or paucity of bone secondary to previous surgical procedures. To address the challenge of limited bone availability at the distraction site, our institution has implemented a stepwise protocol in the patients with severe class II malocclusion and insufficient bone stock at the level of the planned osteotomy. Extraction of the mandibular third molar(s), followed by grafting of the resulting defect is performed initially. Either autologous bone graft or the combination graft material consisting of a mixture of demineralized bone matrix, bone morphogenic protein, and freeze-dried bone chips is used. Computed tomography is performed 9 months later to assess the bone stock at the level of the graft site. This technique is presented here with 100% graft take in all 9 grafted sites (6 patients). This technique appears to offer an effective way to prepare the mandible for optimization of subsequent mandibular distraction in patients with severely micrognathic mandibles and insufficient bone stock posterior to the third molar. Of note, both autologous bone and the mixture of demineralized bone matrix, bone morphogenic protein, and freeze-dried bone chips seem equally efficacious.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6891"},"PeriodicalIF":1.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302641","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":"Truth or Myth: Is Breast Implant Illness Really an Illness?","authors":"Rami Hanna, Udi Maor, Meir Retchkiman, Basel Abu-Ganem, Julie Vaynshtein, Eldad Silberstein","doi":"10.1097/GOX.0000000000006881","DOIUrl":"10.1097/GOX.0000000000006881","url":null,"abstract":"<p><strong>Background: </strong>Breast implant illness (BII) represents symptoms linked to silicone gel-filled breast implants. Research on BII remains limited, yielding contradictory conclusions. This study compared symptoms among healthy women with breast implants to those without breast implants.</p><p><strong>Methods: </strong>A single-blind questionnaire-based survey of asymptomatic female patients attending cancer screening was conducted at the Breast Health Center in Soroka Medical Center and at a breast surgeon's community clinic in Beer Sheva, Israel. The study included women with breast implants (implanted group) and those without implants or any other breast procedures (naive group). The questionnaire collected social, medical, and symptom data, stratified using the Index of Symptoms' Severity (ISS) scale.</p><p><strong>Results: </strong>Out of 181 women, 13 were excluded. The implanted group (n = 34) was compared with women without prior breast surgery, including implants (n = 134). Significant differences emerged in dry skin and sleeping problems, with higher rates in the naive group. However, overall symptom severity, measured by the ISS, showed no significant difference. Regression analysis indicated age and rheumatoid history correlated with the ISS, whereas breast implant augmentation was not a significant predictor.</p><p><strong>Conclusions: </strong>This study explored BII prevalence by comparing symptoms in women with breast implants to those without prior breast surgical interventions. Overall, symptom severity demonstrated no significant differences. Age and preexisting rheumatoid conditions may influence symptoms more than breast augmentation. The study's cross-sectional design, small sample size, and self-reported data could limit its findings. Further research is needed to understand BII's impact on well-being and safety.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6881"},"PeriodicalIF":1.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286122","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":"Twenty Years of \"Occasional\" Reconstructive Microsurgery: A Retrospective Review of a Single Surgeon's Experience.","authors":"Fadi H Sleilati","doi":"10.1097/GOX.0000000000006832","DOIUrl":"10.1097/GOX.0000000000006832","url":null,"abstract":"<p><strong>Background: </strong>Microsurgical free flap reconstruction is a highly technical surgery, usually performed in high-volume specialized centers. During the last 20 years, we had to perform occasional microsurgical reconstructions in our plastic surgery department where general and aesthetic plastic surgery is the main activity. The aim of the study was to review the results of our microsurgical activity and compare it with the results published by high-volume microsurgical centers.</p><p><strong>Methods: </strong>We retrospectively reviewed all our microsurgical free flap reconstructions from 2004 to 2024. We collected from the files all the data concerning demographics, indications, flaps used, technical details, complications, and final outcomes.</p><p><strong>Results: </strong>Seventy-one patients were included in the study, with a total of 77 flaps. Patients' age ranged from 7 to 82 years. The operative site was the head and neck in 66 cases, the lower limb in 9 cases, and the abdominal wall in 2 cases. The most frequently used flaps were the latissimus dorsi flap (24 flaps), the radial forearm flap (23 flaps), and the fibula flap (16 flaps). Anastomoses were done mainly under loupe magnification. Ten flaps presented signs of vascular compromise. Salvage rate after confirmed vascular thrombosis was 60%. A total of 4 flaps were lost (94.8% success rate).</p><p><strong>Conclusions: </strong>Provided that some precautions are respected, \"occasional microsurgery\" can have success rates comparable to high-volume microsurgery centers. It can save lives and improve the patients' quality of life, and it does not prevent the surgeon from pursuing a normal general and aesthetic plastic surgery career.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6832"},"PeriodicalIF":1.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286123","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":"Cranial Bone Changes Associated With Intracranial Hypertension in Apert Syndrome: Insights for Early Surgical Intervention.","authors":"Diego A Gomez, Isabelle J Meredith, Skyler K Palmer, Marius George Linguraru, David Y Khechoyan, Phuong D Nguyen, Brooke French, Antonio R Porras","doi":"10.1097/GOX.0000000000006875","DOIUrl":"10.1097/GOX.0000000000006875","url":null,"abstract":"<p><strong>Background: </strong>The presence of intracranial hypertension (ICH) is a key consideration in the surgical management of Apert syndrome (AS). However, cranial signs indicative of ICH are underexplored. We used routinely acquired computed tomographic images to deliver the first quantitative assessment of localized cranial bone and volumetric anomalies associated with ICH in children with AS.</p><p><strong>Methods: </strong>Children with AS with preoperative computed tomographic scans were retrospectively identified at 2 institutions. Patients with preceding craniofacial intervention were excluded. Local cranial bone thickness, cranial density, and intracranial volume (ICV) anomalies were compared among 3 cohorts: AS, nonsyndromic bicoronal craniosynostosis (NSBC), and normative patients without cranial pathology. Adjustments were made for age and sex.</p><p><strong>Results: </strong>A total of 671 patients were included (16 AS, 631 normative, and 24 NSBC). All patients with AS displayed bicoronal suture involvement, and 9 showed additional suture fusions. Patients with AS had significantly increased cranial bone thickness and total ICV, as well as significantly decreased cranial bone density and occipital volume compared with the normative cohort. Compared with NSBC, patients with AS demonstrated greater cranial density loss and ICV increase under the frontal and parietal bones, with no significant differences in the occipital region.</p><p><strong>Conclusions: </strong>Before surgical intervention, children with AS exhibit distinct cranial adaptations to chronic ICH, characterized by increased ICV and decreased cranial bone density, suggesting that earlier surgical intervention may be necessary to prevent the effects of chronic ICH. Furthermore, the predominant volume restriction in the occipital region supports posterior expansion as the initial intervention.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6875"},"PeriodicalIF":1.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286117","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":"Novel Bicomposite Flow-through Osteochondral Free Flap for Mandibular and Condylar Reconstruction.","authors":"Nirvana B Saraswat, Jason D'John, Mohsen Mohktari, Emmanuel Nageeb, Neil Sachanandani, Kongkrit Chaiyasate","doi":"10.1097/GOX.0000000000006862","DOIUrl":"10.1097/GOX.0000000000006862","url":null,"abstract":"<p><p>Mandibular reconstruction in pediatric patients presents significant challenges due to anatomical complexity, functional demands, and considerations for future growth. This case report introduced a novel reconstructive technique, bicomposite flow-through osteochondral joint salvage therapy, applied in a 16-year-old boy undergoing hemimandibulectomy for odontogenic myxoma. The benign but locally aggressive tumor required resection while preserving the ipsilateral condyle. To reconstruct the resulting defect and support temporomandibular joint function, we used a flow-through fibula free flap combined with a medial femoral condyle (MFC) periosteal flap. Using virtual surgical planning and computer-aided design, a left fibula flap was harvested and contoured with a prefabricated osteotomy template. A right MFC periosteal free flap was also harvested and wrapped around the preserved condyle, then fixated to the fibular construct with a miniplate. The reconstruction was secured to the remaining mandible with a rigid plate, and microvascular anastomoses were performed to ensure flap viability. Postoperatively, the patient recovered well, with progressive improvement in function. By 6 months, he had full, pain-free mouth opening, and imaging demonstrated condylar remodeling. Traditional fibula flaps are considered the gold standard for mandibular reconstruction; however, in pediatric patients, using them to reconstruct the temporomandibular joint carries risks of bone resorption and unpredictable growth. The bicomposite flow-through osteochondral joint salvage therapy technique addresses these concerns by incorporating vascularized periosteal tissue from the MFC, promoting healing and minimizing complications such as ankylosis. This innovative strategy offers a tailored solution for complex pediatric mandibular defects, especially when the native condyle can be preserved.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6862"},"PeriodicalIF":1.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286119","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 Fat Grafting in Breast Reconstruction: Comparison Between After Autologous Flap and After Silicone Implant.","authors":"Takanobu Mashiko, Yoshitsugu Hattori, Yoko Horiguchi, Mai Inoue","doi":"10.1097/GOX.0000000000006866","DOIUrl":"10.1097/GOX.0000000000006866","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the impact of secondary fat grafting on patient satisfaction and well-being using the BREAST-Q, in patients who underwent flap- or implant-based breast reconstruction.</p><p><strong>Methods: </strong>The patients who underwent postmastectomy breast reconstruction were divided into 4 groups based on the reconstruction technique: flap followed by fat grafting (Flap-FG), flap alone (Flap-only), implant followed by fat grafting (Imp-FG), and implant alone (Imp-only). Secondary fat grafting was performed for those dissatisfied with their initial reconstruction. One year postoperation, patients completed the BREAST-Q questionnaire, assessing breast satisfaction, outcome satisfaction, psychosocial well-being, and sexual well-being, with scores ranging from 0 to 100.</p><p><strong>Results: </strong>Of the 162 patients, 139 responded to the questionnaire (response rate: 85.8%), including 14 in the Flap-FG group, 38 in the Flap-only group, 23 in the Imp-FG group, and 64 in the Imp-only group. Secondary fat grafting improved scores in both flap- and implant-reconstructed breasts, with the Imp-FG group showing significant improvements in all domains compared with the Imp-only group, including breast satisfaction (<i>P</i> = 0.007), outcome satisfaction (<i>P</i> = 0.041), psychosocial well-being (<i>P</i> < 0.001), and sexual well-being (<i>P</i> < 0.001). The Flap-FG group showed significant improvement only in outcome satisfaction (<i>P</i> = 0.020) compared with the Flap-only group. The Flap-only group had higher breast satisfaction scores than the Imp-only group (<i>P</i> = 0.049), whereas the Imp-FG group had better psychosocial and sexual well-being scores than the Flap-FG group.</p><p><strong>Conclusions: </strong>Secondary fat grafting is highly useful in improving patient satisfaction by correcting breast shape, size, and deformities in cases where dissatisfaction exists with the initial breast reconstruction.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6866"},"PeriodicalIF":1.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286121","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":"Reverse Submammary Adipofascial Perforator Flap: Preliminary Results of a Dual-plane, Acellular Dermal Matrix-free, Direct-to-implant Hybrid Reconstruction.","authors":"Diego Ribuffo, Marco Marcasciano, Federico Lo Torto, Jacopo Nanni, Luca Patanè, Lorenzo Calabrese, Davide Marino, Donato Casella, Manfredi Greco","doi":"10.1097/GOX.0000000000006847","DOIUrl":"10.1097/GOX.0000000000006847","url":null,"abstract":"<p><strong>Background: </strong>Single-stage direct-to-implant (DTI) reconstruction, particularly the prepectoral technique, has become prominent due to its reliable outcomes and shorter operative time. This approach spares the pectoralis major muscle, reducing postoperative pain and morbidity, and ensuring quicker recovery. However, limitations such as patient comorbidities and tumor characteristics can limit feasibility, leading to complications and high reconstructive failure rates. In such cases, switching to autologous or 2-stage approaches becomes necessary. This study introduced an innovative acellular dermal matrix-free dual-plane DTI hybrid reconstruction using a reverse submammary adipofascial perforator flap for small-volume breasts.</p><p><strong>Methods: </strong>A prospective noncontrolled cohort study was conducted from January to April 2024, enrolling 10 breast cancer patients eligible for DTI reconstruction. Data collected included preoperative clinical characteristics, intraoperative surgical data, and postoperative outcomes, including complications and patient satisfaction measured using BREAST-Q version 2.0. Breast aesthetics was also evaluated by 12 independent observers at minimum 3 months follow-up.</p><p><strong>Results: </strong>The surgical technique involved a dual-plane pocket with a reverse submammary adipofascial perforator flap, harvested from the inframammary fold, anchored to the pectoralis major muscle for inferolateral pole coverage of the breast implant. Results showed 1 major complication requiring surgical revision and 1 minor skin flap necrosis managed conservatively. All patients reported good satisfaction with their reconstruction results, supported by positive aesthetic evaluations from observers.</p><p><strong>Conclusions: </strong>This acellular dermal matrix-free, dual-plane DTI hybrid technique seems safe and effective for small-volume breasts. It offers a viable alternative for selected cases, warranting further investigation with larger cohorts and longer follow-ups.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6847"},"PeriodicalIF":1.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286120","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":"Diagnostic Accuracy of Microsoft's Copilot Artificial Intelligence in Chronic Wound Assessment: A Comparative Study.","authors":"Kirollos Tadrousse, Catherine A Cash, Madhulika R Kastury, Noelle Thompson, Richard Simman","doi":"10.1097/GOX.0000000000006871","DOIUrl":"10.1097/GOX.0000000000006871","url":null,"abstract":"<p><strong>Background: </strong>Chronic wounds affect approximately 2.5% of the US population and can cause severe complications if not identified and treated promptly. Artificial intelligence tools such as Microsoft's Copilot have the potential to expedite diagnosis, but their clinical diagnostic accuracy remains underexplored.</p><p><strong>Methods: </strong>Ten chronic wound cases were selected from the publicly available database of the Silesian University of Technology. Images and demographic data were entered into Copilot, which generated the top 3 differential diagnoses for each case. Diagnostic accuracy was evaluated using a predefined scoring system. Statistical analysis included descriptive statistics, the Wilcoxon signed-rank test, bootstrapping, the Fisher-Pitman permutation test, Cohen kappa, and Fisher exact test.</p><p><strong>Results: </strong>Copilot correctly identified the primary diagnosis in 30% of cases and included the correct diagnosis within its top 3 differentials in 70% of cases. The mean diagnostic score was 1.7 (median: 2, SD: 1.25, variance: 1.57). The Wilcoxon test indicated no significant deviation from the median reference value (<i>P</i> = 0.6364), whereas bootstrapping yielded a 95% confidence interval of 1-4. The permutation test demonstrated a significant difference from the null hypothesis (<i>P</i> = 0.017), and the Cohen kappa revealed perfect agreement (kappa = 1, <i>P</i> = 0.00157). The Fisher exact test showed no significant association between primary and top 3 diagnostic accuracy (<i>P</i> = 0.20).</p><p><strong>Conclusions: </strong>Microsoft Copilot demonstrated limited diagnostic accuracy in chronic wound assessment, underscoring the need for cautious integration into clinical workflows. Broader datasets and more rigorous validation are crucial for enhancing artificial intelligence-supported diagnostics in wound care.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6871"},"PeriodicalIF":1.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286118","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}