Plastic and Reconstructive Surgery Global Open最新文献

{"title":"Prospective Treatment of First Carpometacarpal Osteoarthritis With Autologous Fat Transfer.","authors":"Emily Saurborn, Seth Noorbakhsh, Jenna Enoch, Raul Cortes, William McClellan","doi":"10.1097/GOX.0000000000006713","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006713","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to analyze the effect of autologous fat transfer on outcomes in patients with basilar thumb arthritis.</p><p><strong>Methods: </strong>Twenty-three patients with carpometacarpal (CMC) arthritis underwent autologous fat transfer under fluoroscopic guidance. Autologous fat was harvested from the abdomen and separated with nonadherent gauze (Telfa). After processing, 2 mL of fat was injected into the CMC joint. All patients were placed in a prefabricated thermoplastic splint for 2 weeks postoperatively. Patients completed the Disability of Arm-Shoulder-Hand Questionnaire (DASH) questionnaire both preoperatively and postoperatively at 1, 6, and 12 months. Paired <i>t</i> tests were used to compare pretreatment to posttreatment DASH scores. Significance was set at a <i>P</i> value less than 0.05 (95% confidence interval [CI]).</p><p><strong>Results: </strong>The average preoperative DASH score was 51.81 (95% CI, 45.85-57.76). Average postoperative DASH score at 1-month follow-up was 26.16 (95% CI, 19.76-32.57), followed by a DASH score at 6-month follow-up of 22.49, 95% CI (15.41-29.54), and a DASH score at 12-month follow-up of 26.62 (95% CI, 17.68-35.56). Improvements in DASH score were as follows: 26.49 at 1 month postoperatively (<i>P</i> < 0.01), 30.64 at 6 months postoperatively (<i>P</i> < 0.01), and 26.89 at 12 months postoperatively (<i>P</i> < 0.01). No major adverse events were observed.</p><p><strong>Conclusions: </strong>Autologous fat transfer for the treatment of CMC osteoarthritis significantly improved hand function in our cohort. Additional studies of fat transfer are warranted to better understand the physiologic mechanisms and therapeutic benefits.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 4","pages":"e6713"},"PeriodicalIF":1.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037933","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":"Systematic Review of Outcomes of Omental Free Flap in the Management of Lymphedema.","authors":"Fizzah Arif, Nida Sehar, Bareera Ahmed Mian, Safdar Ali Shaikh, Mohammad Fazlur Rahman","doi":"10.1097/GOX.0000000000006716","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006716","url":null,"abstract":"<p><strong>Background: </strong>The omentum has unique angiogenic and immunologic properties, and its low risk of donor-site lymphedema makes it an ideal donor site for lymph node transfer. However, it is unpopular due to the technicalities and the possibility of donor site-related abdominal complications during its harvest.</p><p><strong>Methods: </strong>A systematic review was conducted on March 24, 2024, using PubMed, Scopus, and Ovid MEDLINE databases. The search terms \"omental flap,\" \"omentum flap,\" \"lymphedema,\" and \"free flap\" yielded 99 articles. Only 7 full-text articles published within the past 25 years focusing on omental free flap for lymphedema management were included.</p><p><strong>Results: </strong>The review included 7 studies comprising 131 patients, predominantly women, with an average age of 54.75 years, most of whom had secondary lymphedema, primarily due to breast cancer. Clinical outcome measures showed significant limb volume reduction and improved lymphatic drainage, whereas patient-reported outcome measures indicated overall patient satisfaction and improved quality of life. The flap failure rate was 0.75%, and partial flap necrosis occurred in 2.25% of cases. Common donor-site complications included abdominal tension (2.29%) and dyspepsia (1.53%).</p><p><strong>Conclusions: </strong>This systematic review highlights the promising outcomes of omental free flap in lymphedema management, with low complication rates and significant improvements in both clinical and patient-reported outcomes.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 4","pages":"e6716"},"PeriodicalIF":1.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987515","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":"Arborization of Musculocutaneous Perforators in the Skin and Subcutaneous Tissue.","authors":"Yoshiaki Sakamoto, Hideo Nakajima, Nobuaki Imanishi, Toshiharu Minabe, Hak Chang, Satoshi Fukuzumi, Kazuo Kishi","doi":"10.1097/GOX.0000000000006683","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006683","url":null,"abstract":"<p><strong>Background: </strong>The arborization of musculocutaneous (MC) perforators in the skin and subcutaneous tissue has been well studied using cadaver anatomical studies and preoperative imaging such as computed tomography and magnetic resonance angiography. However, the fine arborization of perforators and anastomoses between fine vessels in the skin and subcutaneous tissue remains unreported. Understanding the peripheral arborization and characteristics of these vessels is essential for advancing perforator flap techniques. We performed vascular dissection based on the layered structure to examine the vascular network of the subcutaneous tissue.</p><p><strong>Methods: </strong>In 8 fresh cadavers, the buttocks (single layer of subcutaneous fat) and back (double layer) were examined through radiological and gross observations of MC perforators, with the fine arterial architecture analyzed in relation to the layered structure of the subcutaneous tissue.</p><p><strong>Results: </strong>Thin blood vessels at the periphery of the MC perforator were visualized. The perforator reached the dermis, forming a subdermal plexus, from which twigs ascended to the epidermis and descended to the subcutaneous fat. The vascular plexus in subcutaneous tissue varied with the adipofascial structure, and twigs connecting the subdermal plexus to deep adipose tissue were also observed.</p><p><strong>Conclusions: </strong>The thinning of perforator flaps and the elevation of adipofascial flaps depend on the judgment of clinicians. We believe that understanding the arborization and vasculature of MC perforators will enhance perforator flap procedures, ensuring safer and stable blood flow.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 4","pages":"e6683"},"PeriodicalIF":1.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035656","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":"Enhanced Postoperative Evaluation in Oncoplastic Breast Surgery With Interactive Versus Traditional Dressings: A Comparative Study.","authors":"Cesare Magalotti, Martina Nisi, Elisabeth Pastor Ruiz, Chiara Romiti, Andrea Tinti, Ivan Barillaro, Alessandro Muccitelli, Lisa Franchini, Daniela Brera, Giuseppe Guarro","doi":"10.1097/GOX.0000000000006724","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006724","url":null,"abstract":"<p><strong>Background: </strong>Oncoplastic breast surgery balances tumor excision and aesthetics focusing on patient well-being. Patient-centered care is crucial aligning with contemporary healthcare goals. This study explored the impact of an interactive dressing on postoperative outcomes in oncoplastic breast surgery.</p><p><strong>Methods: </strong>A cohort of 376 patients undergoing bilateral oncoplastic breast surgery was studied. Traditional dressings were applied on one side and the interactive dressing on the other. Patient demographics, procedures, and outcomes were collected. Patient-reported outcomes were assessed using the BREAST-Q questionnaire. Statistical analysis used R software.</p><p><strong>Results: </strong>Comparing the interactive dressing to traditional dressings, 79.26% exhibited improved wound healing, 80.05% reported lower pain, and 80.32% preferred the side with the interactive dressing, according to the BREAST-Q. Efficient resource utilization is crucial. The interactive dressing's potential in wound healing aligns with evolving oncoplastic breast surgery practices.</p><p><strong>Conclusions: </strong>Comparing the interactive dressing with traditional dressings in oncoplastic breast surgery suggests advantages in wound healing, pain management, shorter hospital stays, and higher patient satisfaction. Further research is needed for confirmation. Patient-centric metrics such as the BREAST-Q support a holistic evaluation aligning with healthcare objectives for improved postoperative quality of life.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 4","pages":"e6724"},"PeriodicalIF":1.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029220","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":"Preservation Arthroplasty for Basal Joint Arthritis Using Arthroscopy and Autologous Fat Grafting With Platelet-rich Plasma.","authors":"Peter Deptula, Meghan McCullough, Theodore Brown, Dylan Singh, Kylie Tanabe, Eugene Tsai, David Kulber","doi":"10.1097/GOX.0000000000006720","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006720","url":null,"abstract":"<p><strong>Background: </strong>Prior studies have shown that intra-articular injection of autologous fat may be a viable, less invasive approach for the treatment of carpometacarpal (CMC) joint arthritis, compared with trapeziecetomy. Small joint arthroscopy has also been found to be a useful tool in evaluation and treatment of arthritis. The authors present a treatment for CMC arthritis combining a minimally invasive approach for arthroscopic debridement with autologous fat grafting and platelet-rich plasma (PRP) injection.</p><p><strong>Methods: </strong>Patients with Eaton stage II-IV CMC osteoarthritis underwent arthroscopic debridement and injection of autologous fat and PRP into the joint. Pre- and postoperative pain scores, functional outcomes, radiographic improvement in joint subluxation, patient satisfaction, and complications were evaluated.</p><p><strong>Results: </strong>Forty-eight thumb CMC joint arthroscopies with fat grafting and PRP were performed. No intraoperative or immediate postoperative complications were experienced. No patients required revision surgery. Average preoperative pain scores with activity improved from 8.9 ± 0.9 to 3.3 ± 2.2 (<i>P</i> < 0.0001) and at rest improved from 5.0 ± 2.5 to 1.0 ± 1.3 (<i>P</i> < 0.0001). M₁M₂ overlap was used to measure radiographic subsidence. This improved from 4.4 ± 2.8 mm preoperatively to 6.8 ± 2.3 mm postoperatively, reflecting a relative improvement of 70% (<i>P</i> < 0.0042). High patient satisfaction was noted.</p><p><strong>Conclusions: </strong>Treatment of the CMC joint using arthroscopic technique combined with autologous fat and PRP is effective in treating pain and joint subluxation. Additional prospective studies are underway for comparison to traditional arthroplasty techniques and to evaluate this technique's potential for other small joint pathology.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 4","pages":"e6720"},"PeriodicalIF":1.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026988","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":"Docking Methods for Robot-assisted Rhytidectomy and Platysmaplasty.","authors":"Anastasiya S Borisenko, Valentin I Sharobaro, Alexey E Avdeev, Yousif M Ahmed Alsheikh","doi":"10.1097/GOX.0000000000006733","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006733","url":null,"abstract":"<p><strong>Background: </strong>In recent years, the development of robotic surgery has been rapidly evolving as well as the interest in their use due to the advantages they provide, such as precision in dissection, the ability to magnify the visualization of the operative field up to 20:1, and the ability to operate in hard-to-reach areas that otherwise cannot be achieved using the traditional methods. Research is being published constantly on the utilization of such robots within the fields of general surgery, oncology, and urology, with few cases in maxillofacial surgery.</p><p><strong>Methods: </strong>There are no docking algorithms or methods for plastic surgery operations, especially those involving the head and neck area. In this article, we explore different docking methods with da Vinci Si, Xi, and 5 surgical systems for aesthetic facial and neck surgery.</p><p><strong>Results: </strong>The results of the multiple different techniques used highlighted a few possible access points, whereas others were deemed impractical due to certain limitations such as the limited maneuverability of the robot's arms, the angles required for safe access, and the patient's body limiting the movement of the robot. Da Vinci 5 comes with significant advantages compared with its predecessors due to its novel and improved technologies, such as force feedback technology and artificial intelligence greatly enhancing the robot's usability.</p><p><strong>Conclusions: </strong>Robotic surgery is a viable operative method that is beneficial for improving the outcomes when using the appropriate docking methods.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 4","pages":"e6733"},"PeriodicalIF":1.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006708","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":"Modified Lateral Approach to the Anterior Tibial Artery's Origin With Limited Fibular Resection: A Case Report of Free Flap Reconstruction for Lateral Skin Defects in Single-vessel Lower Extremities.","authors":"Hisataka Takeuchi, Sadaki Mitsuzawa, Kazuki Ikejiri, Yoshihiro Tsukamoto, Shinnosuke Yamashita, Takayuki Shimoyama, Satoshi Ota, Eijiro Onishi, Tadashi Yasuda","doi":"10.1097/GOX.0000000000006737","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006737","url":null,"abstract":"<p><p>In free flap surgery for open fractures of the lower leg, selecting recipient vessels can be difficult when multiple vessels are injured. In single-vessel lower extremities, surgeons must choose between using the remaining vessel and a proximal site of an injured one. However, using the remaining vessel risks ischemia and below-knee amputation if complications arise. The proximal site of the anterior tibial artery (ATA) can be exposed using the lateral approach to the tibioperoneal trunk. However, this approach is rarely used because fibular head resection may cause postoperative lateral collateral ligament dysfunction. To overcome this problem, we developed a modified lateral approach that preserved the fibular head. Herein, we present a case of a single-vessel lower extremity with an intact posterior tibial artery and a lateral skin defect, requiring the proximal site of the ATA as a recipient vessel. In our modified lateral approach, the tibioperoneal trunk and ATA's origin were exposed similarly to the traditional method. Although a short portion of the ATA was visible before osteotomy, limited resection of the proximal fibula (with the fibular head preserved) improved exposure of the proximal ATA. The vessel's condition was confirmed via adequate bleeding following its incision. A free latissimus dorsi flap was transferred using an end-to-end anastomosis. At the 10-month follow-up, the flap survived without necrosis, and stress radiography of the knee revealed no varus instability. To the best of our knowledge, this is the first report of a modified lateral approach to the ATA's origin, which resolved postoperative knee instability.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 4","pages":"e6737"},"PeriodicalIF":1.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008034","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":"Cadaveric Biomechanical Comparison of Prepectoral and Submuscular Implant-based Breast Reconstruction.","authors":"Kristen L Stephens, Jared M Liston, Parker R Berthelson, Jason L Kerrigan, Matthew B Panzer, Chris A Campbell","doi":"10.1097/GOX.0000000000006742","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006742","url":null,"abstract":"<p><p>Decreased postoperative pain and functional impact have been associated with prepectoral breast implant placement versus submuscular placement; yet no mechanical analyses have quantified this difference. Using 1 postmortem human subject, a 3-dimensional biomechanical tracking system was used to determine the impact of pocket placement on shoulder girdle dynamics for submuscular acellular dermal matrix (ADM)-assisted and prepectoral implants. Smooth silicone breast implants were placed bilaterally-one in the prepectoral plane with anterior ADM coverage and the other in the submuscular ADM-assisted plane. Using tracking nodes at the sternum, clavicles, scapulae, and humeri, each shoulder was tested through serial standardized trials of extension, flexion, lateral extension/flexion, oblique extension/flexion, and abduction using manual manipulations of the shoulder and a counter-weight apparatus before and after implant placement. Bone kinematics (bony displacement and rotation) and kinetics (joint force and moment) were recorded. To achieve equal shoulder extension and flexion maneuvers, submuscular placement was associated with increased scapular, humeral, and clavicular displacement as well as increased scapular and humeral rotation compared with preoperative measurements, whereas prepectoral placement showed no difference. Increased scapular and clavicular rotation with extension and decreased rotation with abduction were noted with both pockets. This cadaveric biomechanical model shows that submuscular implant placement is associated with compensatory increases in bony displacements and rotation required to complete standardized movements consistent with activities of daily living. Further replication of this protocol with varying cadaveric body types and implant sizes would generate predicted postoperative shoulder movement models for implant-based breast reconstruction in different pocket locations.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 4","pages":"e6742"},"PeriodicalIF":1.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035670","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":"Recent Advancements in Robotic-assisted Plastic Surgery Procedures: A Systematic Review.","authors":"George Greige","doi":"10.1097/GOX.0000000000006745","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006745","url":null,"abstract":"","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 4","pages":"e6745"},"PeriodicalIF":1.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031925","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":"Lacertus Syndrome Diagnosis With the Orthogonal Kinesiotaping Test.","authors":"Thomas Apard, Benjamin Ferembach, Vincent Martinel","doi":"10.1097/GOX.0000000000006728","DOIUrl":"https://doi.org/10.1097/GOX.0000000000006728","url":null,"abstract":"<p><p>Lacertus syndrome is a dynamic compression of the median nerve at the elbow, diagnosed clinically using the Hagert triad and additional tests. The orthogonal kinesiotaping test, an evolution of the lacertus antagonist test, provides higher sensitivity (95%) and specificity (89%), enabling comprehensive upper limb assessment. This simple diagnostic tool improves patient understanding and supports both physiotherapeutic and surgical management strategies.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 4","pages":"e6728"},"PeriodicalIF":1.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009654","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}