Plastic and Reconstructive Surgery Global Open最新文献

{"title":"Smartphone Scanning and Machine Learning for Automated Presurgical 3D-printed Plate Fabrication From Cleft Impressions.","authors":"Prasad Nalabothu, Hemwati Nandan, Srinivas Gosla Reddy, José Wittor de Macêdo Santos, Andreas A Mueller","doi":"10.1097/GOX.0000000000007134","DOIUrl":"10.1097/GOX.0000000000007134","url":null,"abstract":"<p><p>Capturing accurate palatal impressions in newborns with cleft lip and palate is essential for early intervention, yet traditional methods using plaster casts are often challenging and uncomfortable for infants. We present an innovative digital workflow utilizing a smartphone scanning application and a machine learning tool for presurgical plate generation. This protocol employs an open-source mobile app to capture high-resolution 3-dimensional scans of the infant's palate directly at the point of care. The process includes positioning of the infant, scanning technique, and file exportation. The resulting 3-dimensional model is then processed through a custom machine learning tool, which automates the design of a presurgical orthopedic plate with nasal stents. The method is simple, portable, and cost-effective, making it feasible in outpatient settings and especially advantageous for resource-limited environments. By eliminating the need for stone models and expensive intraoral scanners, this workflow streamlines the production of presurgical plates while enhancing patient comfort and safety. This digital approach introduces a new standard in early cleft care, offering a reproducible, accessible, and efficient protocol for clinicians aiming to modernize and simplify presurgical treatment.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 9","pages":"e7134"},"PeriodicalIF":1.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186605","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 Method of Estimation of Blood Loss During Large-volume Liposuction and Lipoabdominoplasty.","authors":"Amer Salman Almansory, Ula Abd Al-Hussain Habash","doi":"10.1097/GOX.0000000000007035","DOIUrl":"10.1097/GOX.0000000000007035","url":null,"abstract":"<p><strong>Background: </strong>Liposuction and/or abdominoplasty is one of the most common procedures in plastic surgery. Safety is a primary concern for both patients and surgeons. In this study, we aimed to more accurately estimate perioperative blood loss to prevent and manage early decreases in hemoglobin percentage (HB%).</p><p><strong>Methods: </strong>A prospective study was conducted between March 2022 and March 2024, involving 12 patients, both men and women, who underwent liposuction and/or abdominoplasty under general anesthesia. Samples were taken from aspirated fluid, fat, and drain, and a manual hematocrit calculation method was used. The volume of blood in the lipoaspirate was calculated based on the loss in the supernatant, fat, and drain fluids. Blood was replaced according to the study formula. Patients were assessed for postoperative decreases in HB% and stability of vital signs.</p><p><strong>Results: </strong>The mean aspirate volume was 7400 mL, with a nontrivial volume of blood loss, and the mean postoperative decrease in HB% was 1.8 g/dL. After correcting for blood loss through transfusion according to the study formula, all patients were vitally stable, with no postural hypotension and normal pulse rates.</p><p><strong>Conclusions: </strong>This study introduced a new method for intraoperative hematocrit calculation of blood loss in large-volume liposuction, allowing for accurate estimation of the volume of blood loss that may need to be replaced. This method improves the safety of the procedure, predicts postoperative decreases in HB%, and supports the decision to continue or halt the procedure safely.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 9","pages":"e7035"},"PeriodicalIF":1.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186620","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":"Trends in Facial Reanimation Surgery: A Bibliometric Analysis.","authors":"Antonioenrico Gentile, Alessandra Ceccaroni, Raed Alderhali, Mohammad Alzaid, Roshan Singh Rupra, Benjamin Fink, Kian Daneshi, Ankur Khajuria","doi":"10.1097/GOX.0000000000007138","DOIUrl":"10.1097/GOX.0000000000007138","url":null,"abstract":"<p><strong>Background: </strong>Facial paralysis profoundly affects physical, psychological, and social well-being. Facial reanimation surgery (FRS) uses various static and dynamic procedures to restore function and appearance. This bibliometric analysis of the top 100 most-cited FRS articles identifies trends, gaps, and methodological quality, offering insights into the field's evolution, guiding future research, and supporting evidence-based clinical practices to enhance patient outcomes.</p><p><strong>Methods: </strong>The top 100 most-cited articles related to FRS were identified through a comprehensive Web of Science search covering publications from 1976 to 2024. Data including citation count, study focus, and Oxford Centre for Evidence-Based Medicine levels of evidence (LOEs) were extracted.</p><p><strong>Results: </strong>The most-cited articles on FRS amassed a total of 6872 citations, involving 5601 patients, with citations per article ranging from 31 to 535. Most studies were LOE 3 (n = 52), with fewer at higher evidence levels (LOEs 1 and 2). Surgical technique was the primary focus (n = 65), whereas validated patient-reported outcome measures appeared in only 8 studies.</p><p><strong>Conclusions: </strong>Our findings highlight the need for better research methods and wider use of validated patient-reported outcome measures in FRS studies. Standardized tools and high-quality, multicenter research are crucial for improving patient care. This analysis offers insights into FRS evolution and recommends collaborative, interdisciplinary studies to advance the field.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 9","pages":"e7138"},"PeriodicalIF":1.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186525","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":"Safety and Outcomes in Plastic Surgery Medical Tourism: A Review of 2324 Patients and 7141 Procedures.","authors":"Alex Campbell, Carolina Restrepo, Tatiana Luna-Pisciotti, Mariana Hernandez","doi":"10.1097/GOX.0000000000007113","DOIUrl":"10.1097/GOX.0000000000007113","url":null,"abstract":"<p><strong>Background: </strong>Medical tourism for cosmetic surgery is expanding due to demand for high-quality, safe, and affordable procedures. This study built on prior research by analyzing a larger cohort of plastic surgery patients in Colombia, a leading destination for international patients seeking superior quality, service, and value. We presented the largest review to date on safety and outcomes in plastic surgery medical tourism, comparing our results with benchmark publications from board-certified plastic surgeons in the United States.</p><p><strong>Methods: </strong>A retrospective observational study was conducted on 2324 international patients (7141 procedures) who underwent cosmetic surgery at a private practice in Cartagena, Colombia, from 2013 to 2024. Patient demographics, procedures, and surgical sites were recorded. Postoperative outcomes were analyzed using medical charts of 1363 patients (4244 procedures) treated from 2020 to 2024.</p><p><strong>Results: </strong>Patient demographics and procedure trends align with data from the International Society of Aesthetic Plastic Surgery. Eighty-nine percent of patients traveled from the United States or Canada, and the majority were well-educated professionals. The overall complication rate was 6.2% per patient (2.2% per procedure), which compares favorably with published benchmarks from board-certified plastic surgeons in the United States.</p><p><strong>Conclusions: </strong>Plastic surgery medical tourism, when performed in high-volume, well-regulated centers, can achieve outcomes equivalent to leading practices in the United States, reinforcing its viability as a safe and effective option for international patients. A center of excellence model and strict safety protocols contributed to these favorable outcomes.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 9","pages":"e7113"},"PeriodicalIF":1.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186537","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":"A New Algorithm for Implant Choice in Aesthetic Breast Procedures Based on the Polytech Portfolio.","authors":"Paolo Montemurro, Carlo Mirra, Barbara Cagli","doi":"10.1097/GOX.0000000000007117","DOIUrl":"10.1097/GOX.0000000000007117","url":null,"abstract":"<p><strong>Background: </strong>Aesthetic breast surgery remains among the most requested procedures in plastic surgery. Since their introduction, breast implants have significantly evolved in terms of composition, surface, and shape. Due to the wide variability in patient anatomy and expectations, no single implant type can universally address all clinical scenarios. Therefore, achieving the best outcome requires a tailored approach.</p><p><strong>Methods: </strong>This study presented a decision-making model developed by the first author (P.M.). The model aims to obtain fully personalized outcomes using the Polytech implant catalog, which offers an extensive range of different breast implant types (such as microtextured, polyurethane, smooth, and lightweight implants), allowing tailored solutions to meet individual patient needs.</p><p><strong>Results: </strong>The model is based on the \"Akademikliniken method\" by Hedén, a biodimensional method that promotes a nonvolumetric, proportion-oriented approach to breast augmentation. Supported by a comprehensive implant portfolio, it enables tailored surgical planning for primary augmentations, revision procedures, and combined procedures such as mastopexy. The structured algorithm guides surgeons in selecting the most appropriate implant based on individual clinical parameters.</p><p><strong>Conclusions: </strong>The decision-making model described provides a practical and adaptable framework to support surgeons in optimizing surgical outcomes. The breadth of the Polytech portfolio is key to delivering truly personalized outcomes: it not only enhances procedural precision by offering a wide range of tools and options, but also supports professional development through informed, case-specific choices.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 9","pages":"e7117"},"PeriodicalIF":1.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186580","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":"Safety Evaluation of the RibXcar Technique Using the Piezotome: An Analysis of Surgical Complications.","authors":"Raul Martín Manzaneda Cipriani, Héctor Durán Vega, David Andrew Sieber, Alejandro César López Echaury, José Maria Zepeda Torres","doi":"10.1097/GOX.0000000000007130","DOIUrl":"10.1097/GOX.0000000000007130","url":null,"abstract":"<p><strong>Background: </strong>This study analyzed the incidence of minor and major complications associated with rib remodeling performed by punctures (RibXcar surgical technique), specifically using the piezotome instrument. Variables such as learning method, practice time, use of ultrasound support, and type of instrument used were evaluated to determine their relationship with the occurrence of major complications such as pneumothorax and hemothorax.</p><p><strong>Methods: </strong>A retrospective analysis of data obtained from a survey distributed to 113 plastic surgeons using rib remodeling performed by punctures was conducted. Descriptive statistics were used to characterize the sample, and chi-square tests were used to analyze the association between variables and complications. In addition, a logistic regression model was applied to adjust for multiple variables.</p><p><strong>Results: </strong>Of 113 respondents, 2.65% of respondents reported serious complications, such as pneumothorax or hemothorax. No statistically significant association was found between the use of piezotome and a lower incidence of these serious complications (<i>P</i> = 1.0). Logistic regression analysis also indicated no significant difference in the risk of complications depending on the instrument used.</p><p><strong>Conclusions: </strong>The rib remodeling performed by punctures appears to be well adopted and safe according to the surgeons who practice it, with a high acceptance rate of use of ultrasound and piezotome and a low rate of serious complications.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 9","pages":"e7130"},"PeriodicalIF":1.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186563","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":"Efficacy of Intraoperative Indocyanine Green Fluorescence Imaging in Determining the Cutoff Area in Pedicled Transverse Rectus Abdominis Myocutaneous Flap (ICT Study).","authors":"Prakasit Chirappapha, Lakkana Adireklarpwong, Panuwat Lertsithichai, Rathapon Thawatpongthon, Ronnarat Suvikapakornkul, Thongchai Sukarayothin, Monchai Leesombatpaiboon, Yodying Wasuthit","doi":"10.1097/GOX.0000000000007132","DOIUrl":"10.1097/GOX.0000000000007132","url":null,"abstract":"<p><strong>Background: </strong>The circulation of the pedicled transverse rectus abdominis myocutaneous (TRAM) flap is often poor in zone IV, which is usually excised. Indocyanine green (ICG) dye analysis is a modality that can help surgeons predict and remove insufficient tissue perfusion areas. This retrospective study (ICT study) compared clinical flap outcomes following pedicled TRAM flap reconstruction with or without ICG fluorescence imaging.</p><p><strong>Methods: </strong>Patients who underwent pedicled TRAM flap reconstruction from January 2003 to March 2024 were included. In cases using ICG guidance, the boundary of zone IV was identified and separated according to the ICG enhancement.</p><p><strong>Results: </strong>A total of 301 patients were studied, with 254 in the non-ICG group and 47 in the ICG group. The overall flap complication rate was 22.9%. In the non-ICG group, we found 61 in total, of which 40 had mild fat necrosis, 19 had severe fat necrosis, 1 had partial flap loss, and another had complete flap loss. In the ICG group, among 8 patients with complications, 4 had mild fat necrosis and 4 had severe fat necrosis, and no flap losses occurred. There was no significant difference between the groups. Complications were associated with a BMI over 25 and postoperative radiation. In 8 patients (17%), using ICG allowed more of the zone IV area to be preserved, but did not significantly affect flap complications.</p><p><strong>Conclusions: </strong>ICG fluorescence imaging is not significantly different from an anatomy-based technique in pedicled TRAM flap reconstruction, but it still helps surgeons to identify insufficient perfusion areas, leading to a lower incidence of flap complications. High BMI and postoperative radiation are related to flap complications.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 9","pages":"e7132"},"PeriodicalIF":1.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186527","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":"Investigating Outcomes Following Distal Upper Extremity Fractures in Chronic Kidney Disease Patients.","authors":"Daniel Villarreal Acha, Zuhair Zaidi, Muhammad H Harirah, Berkay Basagaoglu, Muaz Wahid, Amber McCranie, Michael E Nissan, Richard Samade, Jennifer Kargel","doi":"10.1097/GOX.0000000000007105","DOIUrl":"10.1097/GOX.0000000000007105","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) affects bone health and fracture healing, with limited research on distal upper extremity fractures. This study evaluated the impact of CKD on fracture outcomes, including healing time, complications, and mortality, to inform surgical management strategies.</p><p><strong>Methods: </strong>A retrospective review was conducted on patients with CKD stages 1-4 and end-stage renal disease who underwent distal upper extremity fracture repair at a level 1 tertiary hospital. Data on demographics, CKD stage, comorbidities, surgical details, and complications were analyzed. Radiographic union time was assessed. A national database was used for external validation and analysis of postoperative risks, including propensity-matched controls.</p><p><strong>Results: </strong>The CKD cohort (n = 29) showed significantly delayed fracture healing compared with controls (68.4 ± 9.2 versus 50.6 ± 8.0 d; <i>P</i> < 0.0001). CKD patients experienced higher rates of postoperative complications, including edema (<i>P</i> = 0.0001) and weakness (<i>P</i> = 0.0001). TriNetX database analysis corroborated these findings and revealed elevated risks for revision surgery (<i>P</i> = 0.018). Superficial surgical site infections were more frequent in CKD patients but did not reach statistical significance (<i>P</i> = 0.086).</p><p><strong>Conclusions: </strong>CKD adversely affects outcomes following distal upper extremity fracture repair, emphasizing the need for tailored perioperative management. These findings highlight the importance of early identification of CKD-related risks to optimize patient care and outcomes.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 9","pages":"e7105"},"PeriodicalIF":1.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186532","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":"Quantitative Analysis of Male Versus Female Frontal Bone and Orbital Skeletal Morphology.","authors":"Meagan Wu, Lauren K Salinero, Ashley E Chang, Jonathan H Sussman, Benjamin B Massenburg, Zachary D Zapatero, Mariana O Almeida, Derek M Steinbacher, Jesse A Taylor, Jordan W Swanson, Scott P Bartlett","doi":"10.1097/GOX.0000000000007068","DOIUrl":"10.1097/GOX.0000000000007068","url":null,"abstract":"<p><strong>Background: </strong>As the field of facial feminization surgery expands, plastic surgeons have increasingly sought to better understand differences in skeletal morphology between men and women. This study investigated sex-based differences in the frontal bone and orbital regions by quantitatively describing morphological variability in an adult cisgender population.</p><p><strong>Methods: </strong>We reviewed healthy adults who underwent head computerized tomography imaging before orthognathic surgery. Standardized sets of 501 digital landmarks were used to capture surface morphometrics of the forehead, supraorbital ridges, and orbital rims. All landmarked crania were aligned using Generalized Procrustes Analysis. Principal component analysis evaluated the contribution of sex to the overall variance in coordinates. Using robust rank aggregation, a ranked list of important landmarks or \"features\" most predictive of sex was generated after integrating mean feature differences, linear discriminant analysis, and random forest importance scores.</p><p><strong>Results: </strong>A total of 154 patients were analyzed, including 70 (45%) men and 84 (55%) women imaged at 23.6 ± 7.7 and 26.0 ± 11.1 years of age, respectively. A list of 119 important features with significant aggregate rank scores (<i>P</i> < 0.05) demonstrated the greatest sex-based variability at the (1) upper forehead, (2) glabella and medial brow prominences, and (3) outer infraorbital rims, primarily in the posterior/anterior direction.</p><p><strong>Conclusions: </strong>We identified key anatomical regions of the upper facial third with the greatest sex-based variability. Our findings provide an objective framework upon which continued investigations of skeletal dimorphisms may be performed and provide preliminary data to help guide preoperative counseling and surgical planning for facial feminization surgery.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 9","pages":"e7068"},"PeriodicalIF":1.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150362","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":"Perceptions and Limitations of Free Flap Procedures Among Surgeons in Jordan: A Cross-sectional Study.","authors":"Saleh Abualhaj, Mosleh M Abualhaj, Mohammad Aljaidi, Anas As'ad, Mohammad Aladaileh, Omar S Mansour, Lina Alshadfan","doi":"10.1097/GOX.0000000000007079","DOIUrl":"10.1097/GOX.0000000000007079","url":null,"abstract":"<p><strong>Background: </strong>Free flap procedures are essential in reconstructive surgery, yet their use is influenced by multiple factors, including infrastructure, training, financial constraints, and surgeon experience. This study explored the perceptions of Jordanian surgeons regarding the limitations of free flap procedures.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among Jordanian surgeons, including plastic surgeons, neurosurgeons, ophthalmologists, orthopedic surgeons, and vascular surgeons. Data were collected through a structured questionnaire, assessing infrastructure, resources, training, education, funding, insurance, and surgeon experience. Statistical analysis was performed using R version 4.2.1, and comparisons between plastic and reconstructive surgeons and other surgical specialists were made using chi-square and independent <i>t</i> tests.</p><p><strong>Results: </strong>A survey of 120 surgeons revealed that 70% had access to sufficient resources, but 55% had limited access to specialized tools and concerns about institutional budgeting and equipment maintenance. Additionally, 50% had no formal training in free flap procedures, whereas 40% received training during residency. Financial constraints influenced decision-making, with 53% citing affordability and insurance issues. Experience was a key factor, with 45.8% reporting limited exposure to free flaps and 88% recognizing surgeon expertise as critical to success. Plastic surgeons were more likely to have formal training and greater experience with free flap procedures than other specialists (<i>P</i> = 0.04, 0.002, respectively).</p><p><strong>Conclusions: </strong>The study highlighted challenges in the adoption of free flap procedures in Jordan, such as limited access to specialized tools, inadequate training, financial constraints, and disparities in surgeon experience, emphasizing the need for structured training programs, improved institutional support, and improved insurance policies.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 9","pages":"e7079"},"PeriodicalIF":1.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150378","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}