Plastic and Reconstructive Surgery Global Open最新文献

{"title":"Robotic Reconstruction of a Surgically Absent Rectum Using AlloDerm.","authors":"Reade Otto-Moudry, Elijah Castle, Gaines Blasdel, Kirtishri Mishra, Jeffery Lin, Rachel Bluebond-Langner, Lee Zhao","doi":"10.1097/GOX.0000000000006919","DOIUrl":"10.1097/GOX.0000000000006919","url":null,"abstract":"<p><p>This case report and accompanying technique video demonstrate the robotically assisted reconstruction of a surgically absent rectum following prior proctectomy to facilitate receptive anal sex. This novel technique uses AlloDerm to provide the full extent of soft tissue coverage without donor site morbidity and provides a promising avenue for anal canal reconstruction.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6919"},"PeriodicalIF":1.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485564","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":"Optimizing Costs in Plastic Surgery: A Systematic Review of Time-driven Activity-based Costing Applications.","authors":"Emily L Isch, Gabrielle Kozlowski, D Mitchell Self, Theodore E Habarth-Morales, Sydney Somers, Ahilan Sivaganesan, David Kim, Heather McMahon, Andrew Newman, Matthew Jenkins","doi":"10.1097/GOX.0000000000006865","DOIUrl":"10.1097/GOX.0000000000006865","url":null,"abstract":"<p><strong>Background: </strong>The rising complexity and cost of healthcare in plastic surgery, particularly in resource-intensive procedures like free flap and breast reconstruction, pose significant financial challenges. Time-driven activity-based costing (TDABC) offers a method to accurately assess these costs by mapping each step of the care cycle based on time and resources consumed. Although TDABC has been utilized in high-cost fields such as neurosurgery and spine surgery, its application in plastic surgery remains underexplored. This systematic review evaluates the literature on TDABC use in plastic surgery to identify key cost drivers and propose strategies for cost-efficiency.</p><p><strong>Methods: </strong>A systematic review was conducted on studies applying TDABC, activity-based costing, and cost-to-charge ratio in plastic surgery, sourced from PubMed. Inclusion criteria focused on peer-reviewed studies from the last decade assessing costing strategies in aesthetic and reconstructive plastic surgery, resulting in 17 studies that provided empirical data on cost drivers and resource allocation.</p><p><strong>Results: </strong>Operating room time, staffing, and postoperative care are identified as primary cost contributors in complex reconstructive surgery, with TDABC highlighting inefficiencies such as prolonged operating room time and unnecessary intensive care unit stays. Cost-saving opportunities were found in optimizing postoperative care and reallocating tasks to lower-cost personnel.</p><p><strong>Conclusions: </strong>TDABC provides a framework for cost optimization in plastic surgery by offering granular insights into resource utilization, allowing for targeted interventions that reduce expenses without compromising care quality. Future research should explore the application of TDABC to cosmetic procedures and assess its long-term cost-effectiveness in plastic surgery.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6865"},"PeriodicalIF":1.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485563","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 After Subpectoral and Prepectoral Tissue Expander Placement in Women Undergoing Postmastectomy Radiation Therapy.","authors":"Seamus Caragher, Alisha Paranzino, Stephen Stearns, Libby Copeland-Halperin, Jessica Erdmann-Sager","doi":"10.1097/GOX.0000000000006867","DOIUrl":"10.1097/GOX.0000000000006867","url":null,"abstract":"<p><strong>Background: </strong>Placement of tissue expanders is a critical tool in breast reconstruction, particularly with postmastectomy radiation. Prepectoral tissue expander placement has rapidly gained popularity. As such, the precise effects of tissue expander plane selection on outcomes following radiotherapy remain a key question.</p><p><strong>Methods: </strong>All patients undergoing mastectomy and tissue expander placement followed by radiation at a single center between 2019 and 2021 were retrospectively examined. Clinical, oncological, surgical, and radiation treatment variables, as well as rate of complications before and after radiation, were collected. Multivariate analysis was performed.</p><p><strong>Results: </strong>The 2 groups had similar baseline clinical and oncological characteristics. Prepectoral placement was more common in bilateral reconstruction and had smaller final tissue expander volume to mastectomy specimen weight ratio. There was no difference in the rate of postoperative or radiation complications based on tissue expander location (17% versus 18%). Multivariable analysis identified acellular dermal matrix as a significant protective factor against perioperative complications (odds ratio [OR]: 0.15; 95% confidence interval [CI]: 0.03-0.78). Increased age and the use of neoadjuvant chemotherapy were significant risk factors for radiation-related complications (age OR: 2.6; 95% CI: 1.02-6.63; Chemo OR: 16.7; 95% CI: 1.55-180).</p><p><strong>Conclusions: </strong>Prepectoral tissue expander placement can be safely used with postmastectomy radiation. These results highlight acellular dermal matrix use as a major protective factor against complications in these patients. Independently, increased age and the use of neoadjuvant chemotherapy increased the risk of radiation-induced complications. The lack of significant risk with other variables can further assure surgeons of the safe use of prepectoral expanders in radiation-bound patients.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6867"},"PeriodicalIF":1.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476348","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":"Successful Sternal Cleft Repair With Rib Graft and SurgiMend.","authors":"Reem Saleh Alrajhi, Qutaiba N M Shah Mardan, Abdullah M AlZahrani, Nora AlSaud, Mohamed Amir Mrad","doi":"10.1097/GOX.0000000000006817","DOIUrl":"10.1097/GOX.0000000000006817","url":null,"abstract":"<p><p>Early in development, driven by mostly unknown factors, a malformed sternum can manifest as a cleft. This is not innocuous, as surgical repair is required to mitigate the deleterious effects of unprotected thoracic organs, impaired respiratory function, and susceptibility to chest infections. We aimed to enrich the literature on this topic by presenting the case of a 10-month-old boy diagnosed with a sternal cleft who underwent reconstruction using a rib cartilage bridging graft supported with fascia and acellular dermal matrix. Management outcomes are expected to improve as surgical approaches evolve from simple primary sternal closure to using cartilaginous or bony grafts and leveraging adjacent soft tissue for added coverage.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6817"},"PeriodicalIF":1.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476350","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":"First-in-human Testing of a Novel Sutureless Drain Securement Device: A Randomized Clinical Trial.","authors":"Mary L Duet, Eric Zeng, Michael K Boyajian, Donald T Browne, Abigail Peoples, Marion Tapp, Robert Siska, Thomas Steele, Bennett W Calder, Christopher Runyan, Lisa R David","doi":"10.1097/GOX.0000000000006888","DOIUrl":"10.1097/GOX.0000000000006888","url":null,"abstract":"<p><strong>Background: </strong>Suture-based drain securement is nonstandardized and causes discomfort, particularly at the site of fixation as drain movement is transmitted to a focal point. Patients may experience skin irritation, pain, skin tugging, and loosening or unintended loss of the drain. A novel sutureless drain securement device, K-LOCK, was designed with patient safety and comfort in mind to reduce risks associated with drain displacement and loss, potentially leading to complications or additional interventions.</p><p><strong>Methods: </strong>After institutional review board approval, 21 patients were enrolled in a randomized control trial after obtaining informed consent. Inclusion criteria required patients to be 18 years of age or older and undergoing a surgery involving placement of bilateral drains. Those with adhesive allergies were excluded. Patients were randomized to receive a right or left K-LOCK with the contralateral site undergoing suture-based drain securement. Outcomes included time to secure drains, adverse outcomes, patient satisfaction, and a blinded evaluation of skin sites at drain removal. Analysis was performed using paired <i>t</i> tests.</p><p><strong>Results: </strong>No drain securement failure was encountered. The average duration of drain placement was 9 days. Securement of the K-LOCK was significantly faster (<i>P</i> = 0.0008) when compared with traditional suture. Blinded skin site evaluations concluded there was no significant difference in erythema and blistering (<i>P</i> = 0.9384, <i>P</i> = 0.6058, respectively). Patients overwhelmingly favored the K-LOCK in all surveyed categories.</p><p><strong>Conclusions: </strong>The K-LOCK enhances the patient experience with surgical drains and offers a reliable, standardized alternative to traditional drain securement. Although these findings are promising, larger multicenter trials with long-term follow-up will be necessary to comprehensively assess the device.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6888"},"PeriodicalIF":1.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476349","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":"Comparing the Efficacy of Endoscopic Carpal Tunnel Repair Versus Open Surgery: A Systematic Review and Meta-analysis of Randomized Control Trials.","authors":"Yazeed A Almojel, Hussam A Alhathlol, Yazeed A Asery, Nawaf K Nahhas, Mohammed I Alhumaidan, Maan Almaghrabi, Mohammed D Alqarni, Alaa Alsahli, Turki S Alhassan","doi":"10.1097/GOX.0000000000006887","DOIUrl":"10.1097/GOX.0000000000006887","url":null,"abstract":"<p><strong>Background: </strong>Surgical decompression of carpal tunnel syndrome by the standard open carpal tunnel release (OCTR) technique was associated with postoperative pain and tenderness. Thus, the endoscopic carpal tunnel release (ECTR) has been introduced to reduce the complications of open surgery through a shorter incision to decrease scar pain and achieve rapid recovery. In this study, we aimed to compare the outcomes between OCTR and ECTR, according to randomized controlled trial evidence.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, Web of Science, EBSCO, and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Meta-analysis was performed using Comprehensive Meta-analysis software. Standard mean difference and a 95% confidence interval were used for continuous outcomes, whereas odds ratio with 95% confidence intervals were utilized for dichotomous outcomes.</p><p><strong>Results: </strong>A total of 34 studies were included. ECTR has shown significant lower rates of scar pain and significant shorter recovery compared OCRT. However, we could not find any significant difference between the groups in terms of complication rates, incidences of local pain, mean pain scores, subjective complete or near complete symptom relief rate, subjective complete satisfaction rate, mean satisfaction scores, mean scores of symptom severity, mean scores of functional status, and mean time of operation.</p><p><strong>Conclusions: </strong>Both ECTR and OCTR are safe and effective in management of carpal tunnel syndrome. However, ECTR may be slightly superior in terms of scar pain and postoperative recovery, although other factors not included in this study, including cost and convenience, must be considered.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6887"},"PeriodicalIF":1.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476347","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 of Prosthetic Breast Reconstruction in Prophylactic Versus Therapeutic Mastectomy: A Systematic Review and Meta-analysis.","authors":"Marlene Schelletter, Edward T C Dong, Boran Tekdogan, Carlo M Oranges","doi":"10.1097/GOX.0000000000006904","DOIUrl":"10.1097/GOX.0000000000006904","url":null,"abstract":"<p><strong>Background: </strong>Although not routinely advocated for average-risk patients, contralateral prophylactic mastectomy (CPM) is recommended by current guidelines to reduce mortality in high-risk patients with unilateral breast cancer. This systematic review and meta-analysis aimed to provide a comprehensive quantitative assessment on the risk associated with implant-based reconstruction in CPM versus therapeutic mastectomy (TM).</p><p><strong>Methods: </strong>A priori criteria were applied to perform a systematic review and meta-analysis of all existing comparative studies on postoperative complications associated with implant-based breast reconstruction after CPM or TM. The fixed-effects model was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Five studies were included in the final analysis, representing 3543 patients who underwent 6401 mastectomies (3260 TM and 3141 CPM), followed by prosthetic breast reconstruction including tissue expanders and direct-to-implant procedures. Reconstructions after TM were associated with a statistically significantly higher risk of postoperative infections (OR = 2.03 [95% CI: 1.50-2.73]) and explantation rates (OR = 2.41 [95% CI: 1.77-3.28]). No significant differences were observed between the 2 groups in the occurrence of hematoma, seroma, necrosis, and capsular contracture.</p><p><strong>Conclusions: </strong>Implant-based breast reconstruction after CPM demonstrates a lower risk of postoperative complications compared with TM. This knowledge and the quantification of risk summarized in this article should be integrated in the shared decision-making with patients and in preoperative information.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6904"},"PeriodicalIF":1.5,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333745","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":"Collagen-Povidone Injection as Treatment for Stenosing Tenosynovitis in Older Adults With Type 2 Diabetes Mellitus.","authors":"Jose Luis Segura-Castillo, Elva Dolores Arias-Merino, Alejandro González-Ojeda, Gonzalo Delgado-Hernández, Sergio Jiram Vázquez-Sánchez, José Pablo Gómez-Sierra, Andrea García, Samantha Emily González-Muñoz, Ana Guadalupe Sánchez-Luna, Kathia Dayana Morfín-Meza, Gabino Cervantes-Guevara, Enrique Cervantes-Pérez, Sol Ramírez-Ochoa, Clotilde Fuentes-Orozco","doi":"10.1097/GOX.0000000000006883","DOIUrl":"10.1097/GOX.0000000000006883","url":null,"abstract":"<p><strong>Background: </strong>Diabetes, affecting 415 million adults globally, leads to collagen-related hand issues. Stenosing tenosynovitis, common in patients with diabetes, is often managed nonoperatively. Collagen-povidone, with safety demonstrated in rheumatoid arthritis, emerges as a potential intervention.</p><p><strong>Methods: </strong>A randomized clinical trial conducted between January 2021 and January 2023 compared a povidone-collagen intervention with a placebo in adults aged 60 and older diagnosed with stenosing tenosynovitis. Participants were randomized into case (collagen-povidone) and control (physiological solution) groups. The study systematically assessed clinical outcomes such as the severity of stenosing tenosynovitis, diabetes, pain, functional capacity, and grip strength.</p><p><strong>Results: </strong>The trial included 25 older adults, with both groups showing no significant age difference. Predominant symptoms included pain, limitation of joint movement, pressure pain, and increased volume. Evolution time in stenosing tenosynovitis showed no significant difference. Both groups displayed stage II pain preintervention. Postintervention, the case group demonstrated a significant reduction in pain. The Kapandji test and hand grip strength significantly improved in the case group compared with controls. No complications were observed.</p><p><strong>Conclusions: </strong>The clinical intervention yielded noteworthy improvements in pain and hand functionality. This study underscored the potential benefits of collagen-povidone in hand complications associated with diabetes, emphasizing the necessity for increased attention and research in this area, given the limited existing literature, which mainly consists of controlled studies.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6883"},"PeriodicalIF":1.5,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333744","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":"Vascular Malformations of the External Ear: A Systematic Review of Clinical Presentation, Diagnosis, and Management.","authors":"Abdullah M Alhusain, Malak Alsaif, Ali M Alkhathami, Sultan Alshaalan, Abdulaziz M Alghamdi, Muhannad Alqirnas, Jullanar Alkhunein, Siham Alsalamah, Fatima Alhije, Fay Alaowid, Asma M Zaki","doi":"10.1097/GOX.0000000000006857","DOIUrl":"10.1097/GOX.0000000000006857","url":null,"abstract":"<p><strong>Background: </strong>Arteriovenous malformations of the external ear are extremely rare but can have significant aesthetic and functional implications. These malformations often originate from disruptions in the embryological development of the external ear, presenting as swelling accompanied by a bruit, bleeding, and a pulsatile mass. This systematic review aimed to examine the presentation, diagnosis, and management of congenital arteriovenous malformations of the external ear.</p><p><strong>Methods: </strong>A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Databases including MEDLINE, Embase, PubMed, and Cochrane were searched, using keywords related to congenital vascular malformations of the external ear without time restriction until September 2024.</p><p><strong>Results: </strong>Sixteen studies involving 40 patients were included. The median age was 19 years, with a male predominance (n = 22, 55%). Clinical presentations frequently included swelling (n = 20, 50%) and bruit/thrill (n = 17, 42.5%). The Schobinger classification of most patients was classified as stage II (n = 27, 67.5%). Angiography (n = 28, 70%) was the most commonly used diagnostic modality. Ethanol embolization was the predominant treatment, followed by combined surgical excision and preoperative embolization. Complications included blistering and skin necrosis, with a recurrence rate of 7.4% over a median follow-up period of 15 months.</p><p><strong>Conclusions: </strong>Ethanol embolization is effective in managing auricular arteriovenous malformations with higher success rates compared with other management approaches. Future studies should aim to optimize embolization protocols and explore combined treatment approaches to improve outcomes for complex vascular malformations of the external ear.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6857"},"PeriodicalIF":1.5,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333773","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":"Extremity Soft-tissue Reconstruction With the Conjoined Latissimus Dorsi-Groin Flap.","authors":"Satsuki Tachibana, Shinichi Asamura, Kazuhiro Hira, Masatoshi Teraguchi, Kentaro Ueda, Shigeaki Inoue","doi":"10.1097/GOX.0000000000006785","DOIUrl":"10.1097/GOX.0000000000006785","url":null,"abstract":"<p><p>Extensive soft-tissue defects in the extremities pose a significant challenge in reconstructive surgery. The combined latissimus dorsi (LD) and groin flap technique, a method developed by Harii et al in 1981, has shown promise in treating such defects. The purpose of this study was to illustrate the technique and results of using combined LD and groin flaps to reconstruct extensive upper and lower extremity defects. We present 4 cases of extensive soft-tissue defects treated with the combined LD-groin flap. The report details the surgical approach, including patient positioning in the semisupine position, flap design, blood supply considerations, and operative results. Our study included patients ranging in age from 20 to 84 years who successfully underwent extremity reconstruction with operative times ranging from 4 to 12 hours and 50 minutes. Various vascular supplies were used based on the defect location in a consistent semisupine position. Cases included an 82-year-old man and an 84-year-old woman with lower extremity necrotizing fasciitis, a 24-year-old man with a complex upper extremity injury, and a 20-year-old man with a severe lower leg wound. Each demonstrated effective flap implementation and recovery with customized flap designs and microvascular anastomoses. The conjoined LD-groin flap technique is effective in treating severe extremity injuries, providing extensive coverage with manageable operative times. Its adaptability to long-axis defects and semisupine positioning contributes to its efficacy in complex reconstructions. With continued advances in microsurgery, this technique has the potential for wider application in reconstructive scenarios.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 6","pages":"e6785"},"PeriodicalIF":1.5,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333772","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}