Plastic surgery最新文献

{"title":"From Wellness to Competence: The Essential Role of Simulation in Modern Surgical Training.","authors":"Roberta Albanese, Federica Tomaselli, Damiano Tambasco","doi":"10.1177/22925503261477036","DOIUrl":"10.1177/22925503261477036","url":null,"abstract":"","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":" ","pages":"22925503261477036"},"PeriodicalIF":1.2,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revision Interposition Arthroplasty with AlloDerm for Persistent Thumb Carpometacarpal Pain Following TightRope Suspensionplasty: A Case Report.","authors":"Brady Duiker, Alexander Platt, Colborne J Kemna, Brett Ponich, Aaron Knox","doi":"10.1177/22925503261479629","DOIUrl":"10.1177/22925503261479629","url":null,"abstract":"<p><p>Thumb carpometacarpal (CMC) arthritis causes thumb pain and disability, often requiring surgery when conservative treatments fail. Trapeziectomy with ligament reconstruction and tendon interposition remains a standard approach, but TightRope suspensionplasty offers a tendon-sparing alternative that allows early mobilization. This report discusses a 48-year-old police officer with advanced thumb CMC arthritis who underwent trapeziectomy with TightRope suspensionplasty. Although initially successful, she experienced ongoing pain during high-impact activities, especially when operating a firearm, which is essential for her job. The pain, occurring during thumb adduction and forceful loading, did not improve with conservative treatment. Revision surgery with AlloDerm and hardware removal was performed. Serial follow-up at 3, 6, and 12 months demonstrated progressive strength recovery and stable metacarpophalangeal alignment, with return to occupational duties with ergonomic modifications. This case highlights the potential of biologic interposition to manage load-related pain after suspensionplasty in high-demand individuals.</p>","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":" ","pages":"22925503261479629"},"PeriodicalIF":1.2,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of Transgender and Gender Diverse Patients in Accessing Gender-Affirming Chest Masculinization: A Systematic Review and Qualitative Thematic Synthesis of the Literature.","authors":"Emma Lim, Justin Haas, Precious Adekoya, Sophia Hou, Kathleen Armstrong, Helene Retrouvey, Ammara Ghumman","doi":"10.1177/22925503261477385","DOIUrl":"10.1177/22925503261477385","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this review was to synthesize existing qualitative research regarding the experiences of transgender and gender diverse (TGD) individuals undergoing gender-affirming chest masculinization surgery, in order to identify critical barriers and facilitators which may affect access to and quality of care.</p><p><strong>Methods: </strong>We searched eight electronic databases in August 2025 for qualitative results analyzing the experiences of TGD individuals undergoing chest masculinization. We included primary qualitative or mixed-methods studies published in English/French that involved trans masculine or gender-diverse individuals ≥12 years undergoing chest masculinization. Exclusion criteria included cisgender or trans feminine populations, nonsurgical or nongender-affirming care, absence of qualitative data, and nonpeer-reviewed literature. The Critical Appraisal Skills Programme checklist was used to appraise the quality of included studies. A thematic synthesis was conducted following Thomas and Harden.</p><p><strong>Results: </strong>Sixty studies met the inclusion criteria. Four analytical themes were identified: (1) charting a course, (2) interactions with providers, (3) surgical goal setting, and (4) adjusting to oneself.</p><p><strong>Conclusion: </strong>TGD individuals face persistent structural and interpersonal barriers when accessing chest masculinization surgery. The domains identified in the present review form a patient experience-driven framework that healthcare stakeholders and providers can use to improve access to care. Healthcare providers should be aware that nonbinary and binary transgender patients may have varying surgical goals for chest masculinization.</p>","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":" ","pages":"22925503261477385"},"PeriodicalIF":1.2,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary: Cubital Tunnel Release Under Local and Regional Anesthesia: A Scoping Review.","authors":"Donald H Lalonde","doi":"10.1177/22925503261477030","DOIUrl":"10.1177/22925503261477030","url":null,"abstract":"","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":" ","pages":"22925503261477030"},"PeriodicalIF":1.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Volar Plate Management: A Pilot Study.","authors":"Katie Garland, Sophia Shayan, Trina Stephens, Rebecca Courtemanche, Terence Kwan-Wong","doi":"10.1177/22925503261474467","DOIUrl":"10.1177/22925503261474467","url":null,"abstract":"<p><strong>Background: </strong>Proximal interphalangeal (PIP) joint volar plate injuries are common hand injuries in children. Commonly employed treatments include splinting or buddy taping, with no consensus regarding best practice. This pilot study compares outcomes by treatment protocol for children with PIP joint volar plate injuries and informs a power calculation for a larger study.</p><p><strong>Methods: </strong>A prospective observational pilot study of children with stable PIP joint volar plate injuries was conducted. Standard treatment protocols were: 1 or 2 weeks of splinting followed by buddy taping, or direct to buddy taping. Patient-reported pain and range of motion (ROM) at 1 to 2 weeks and 4-weeks post injury, as well as time to return to activity were analyzed. A power calculation for a future equivalency study was performed.</p><p><strong>Results: </strong>Ten patients per group were included in the study. At 1 to 2 weeks, the direct-to-buddy taping group had significantly greater active ROM and less pain than the 1-week splinting group (ROM 99^o vs 78^o, <i>P</i> = .03; FACES 1.6 vs 5.0, <i>P</i> = .02). At 4-weeks, there were no differences in ROM and pain by treatment group. Only one patient (direct to buddy taping) did not return to activity due to pain. Using pain with active ROM at 4-weeks, a sample size of 27 patients per group for an equivalence study was determined.</p><p><strong>Conclusion: </strong>This pilot study suggests similar outcomes at 4-weeks postinjury by 1 or 2 weeks of splinting followed by buddy taping, or direct to buddy taping treatment. These findings support performing a larger equivalency trial.</p>","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":" ","pages":"22925503261474467"},"PeriodicalIF":1.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Affirming Surgery During Canadian Plastic Surgery Residency: A Survey of Plastic and Reconstructive Surgery Residents' Experiences.","authors":"Camille Zeitouni, Alexandra Speak, Frédérique Leroux, Michelle Bonapace-Potvin, Dominique Tremblay","doi":"10.1177/22925503261471514","DOIUrl":"10.1177/22925503261471514","url":null,"abstract":"<p><strong>Introduction: </strong>Gender affirming surgery (GAS) is an umbrella term for procedures that can be a part of the transition process for transgender and nonbinary individuals. Plastic surgeons play an important role in gender affirming surgical care. Our purpose was to assess the GAS landscape in Plastic and Reconstructive Surgery (PRS) residency programs across Canada, including both the didactic and clinical context, along with assessing PRS residents on their perceived interest and competence relating to performing GAS.</p><p><strong>Methods: </strong>A survey was created based on existing literature relating to gender affirming care in surgical and medical postgraduate education. The survey was distributed to all PRS residents in Canada through their program director. Results were analysed using descriptive statistics.</p><p><strong>Results: </strong>Almost all residents surveyed agreed that transgender care is an important part of PRS. Despite this, little educational content regarding GAS was seen. The majority of individuals had never been exposed to any GAS clinically despite having at least one surgeon who performs GAS affiliated with their institution. For individuals who have had exposure, top surgery was the most common procedure seen. While few residents plan on pursuing a fellowship in GAS, some residents did comment they planned to offer top surgery or facial feminization as general plastic surgeons.</p><p><strong>Conclusion: </strong>The majority of PRS residents demonstrated a positive response towards the importance of GAS in PRS. As access to GAS in Canada remains limited, providing greater exposure to GAS in PRS residency may help in promoting willingness and competence to perform these procedures.</p>","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":" ","pages":"22925503261471514"},"PeriodicalIF":1.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Race/Ethnicity and Keloid Formation: A Network Meta-Analysis.","authors":"Hui Jie Gwen Farm, Aaryan Dwivedi, Damoon Ranjbar, Brandon Chai, Michelle Le, Chaocheng Liu","doi":"10.1177/22925503261470272","DOIUrl":"10.1177/22925503261470272","url":null,"abstract":"<p><strong>Background: </strong>Keloids are benign, fibroproliferative skin lesions due to abnormal wound healing. While keloid formation disproportionately varies by race and ethnicity, epidemiological data on racial and ethnic differences remain fragmented. This study aimed to quantitatively compare keloid prevalence among different racial and ethnic groups.</p><p><strong>Methods: </strong>A systematic literature search identified keloid prevalence among different racial (White, Black, Asian, Unknown, and Other/Mixed) and ethnic (Hispanic/Latinx and non-Hispanic/Latinx) groups (CRD420251113908). Pairwise comparisons using a random-effects model and a network meta-analysis were conducted.</p><p><strong>Results: </strong>Eight studies were included in the network meta-analysis on race, encompassing 31,964 keloids and 373,390 nonkeloids. Compared to White individuals, pooled odds ratio (OR) was highest among Black individuals (OR = 6.14; 95% CI: 3.75-10.07), followed by Asian individuals (OR = 3.70; 95% CI: 2.16-6.34), Unknown race (OR = 1.94; 95% CI: 1.06-3.54), and Other/Mixed (OR = 1.93; 95% CI: 1.07-3.49). Four studies were included for the pairwise analysis on ethnicity. Pooled OR of keloid prevalence comparing Hispanic/Latinx with non-Hispanic/Latinx was 1.12 (95% CI 0.41-3.03).</p><p><strong>Conclusions: </strong>This study demonstrates a statistically significant association between race and keloid formation, with greater odds of keloid formation among Black and Asian individuals compared to White individuals. No statistical difference was demonstrated between ethnic groups, although findings were underpowered. Findings support race as an important risk factor for keloid development, further informing prevention strategies, patient counselling, and practices to provide equitable care.</p>","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":" ","pages":"22925503261470272"},"PeriodicalIF":1.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Arnica and Bromelain for Improving Ecchymosis Following Facial Plastic Surgery: A Systematic Review.","authors":"Kimya Manouchehri, Shaishav Datta, Marc Levin","doi":"10.1177/22925503261470270","DOIUrl":"10.1177/22925503261470270","url":null,"abstract":"<p><strong>Introduction: </strong>Individual studies have suggested a benefit in using Arnica and Bromelain for reducing ecchymosis following facial plastic surgery; however, the literature remains inconsistent and methodologically heterogeneous. An up-to-date review is therefore necessary to synthesize the available evidence and provide clearer guidance to clinicians and patients alike. The objective of this study was therefore to investigate the effectiveness of Arnica and Bromelain in reducing postoperative ecchymosis after facial plastic surgery.</p><p><strong>Methods: </strong>A PRISMA-guided search of Medline, Embase, Cochrane databases, Epistemonikos, and ClinicalTrials.gov was conducted up to August 2025. Eligible studies included randomized controlled trials (RCTs) and observational studies evaluating Arnica and/or Bromelain use in facial plastic surgeries. The primary outcome was postoperative ecchymosis. Secondary outcomes included edema, adverse effects, and patient satisfaction.</p><p><strong>Results: </strong>Ten articles were included, comprising 6 RCTs, 3 prospective, and one retrospective cohort study, with a total of 696 patients (mean age 35 years, range 15-78). Most studies examined rhinoplasty (60%), followed by blepharoplasty (30%). Most studies (80%) evaluated Arnica use, of which 63% demonstrated significant reductions in postoperative ecchymosis at various time points. Edema was assessed in 2 Arnica studies, both of which showed significant reductions. Two studies evaluated Bromelain, with one demonstrating reduced ecchymosis by postoperative day 7. Adverse events were rare and mild.</p><p><strong>Conclusion: </strong>Arnica may help reduce postoperative ecchymosis and edema after facial plastic surgery; however, the evidence for Bromelain is limited. Marked heterogeneity in dosing and assessment tools limits the generalizability of findings and the ability to perform meta-analysis.</p>","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":" ","pages":"22925503261470270"},"PeriodicalIF":1.2,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Delivery of a Plastic and Reconstructive Surgery Case-Based Learning Curriculum for Pre-Clerkship Medical Students.","authors":"Dave Gwun, Victoria Tucci, Alexandra D'Souza, Thomas Milazzo, Sophocles Voineskos, David Wallace, Kyle R Wanzel, Shaishav Datta","doi":"10.1177/22925503261470691","DOIUrl":"10.1177/22925503261470691","url":null,"abstract":"<p><strong>Introduction: </strong>Canadian medical students receive limited exposure to Plastic and Reconstructive Surgery (PRS) during pre-clerkship. To address this gap, a longitudinal PRS case-based learning (PRS-CBL) curriculum was developed to parallel the pre-clerkship curriculum, with an aim to increase early exposure to PRS concepts.</p><p><strong>Methods: </strong>Guided by Medical Council of Canada objectives, PRS faculty and residents co-designed a 5-part case-based learning curriculum: Introduction to PRS, Skin and Soft Tissue Infections, Benign and Malignant Skin Lesions, Hand and Wrist Trauma, and Burns. Each session combined a didactic presentation, clinical case with facilitated discussion, and hands-on workshop. Eligible participants were first- and second-year medical students. Presession and postsession tests were compared using the Mann-Whitney <i>U</i> test. Written feedback was analyzed using thematic analysis.</p><p><strong>Results: </strong>From 2023 to 2025, 10 PRS-CBL sessions were delivered, with a mean of 45 (SD 28.8) registrants per session. Of 453 total registrants, 201 were unique participants, with 41% reporting no prior interest in PRS. Significant improvements in presession versus postsession test scores were observed at each session (<i>p</i> < .05), except for session 4. Over 83% of respondents strongly agreed that the learning objectives were met, content was appropriate, and sessions were highly effective. Qualitative themes highlighted the value of hands-on, multimodal teaching and opportunities to interact with PRS faculty and residents.</p><p><strong>Conclusion: </strong>The PRS-CBL curriculum filled a void in the current undergraduate medical curriculum, improved PRS knowledge, received favorable evaluations, and included students without prior interest in PRS. This adaptable model may support early career exploration in PRS and other underrepresented specialties.</p>","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":" ","pages":"22925503261470691"},"PeriodicalIF":1.2,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes After Whole and Fascicular Sural Nerve Biopsies: A Retrospective Review.","authors":"Patrick J Kim, Carolyn Wang, Michael Bonert, Andrew T Chen, Jian-Qiang Lu, Mats Junek, Achilles Thoma, Helene Retrouvey","doi":"10.1177/22925503261461586","DOIUrl":"10.1177/22925503261461586","url":null,"abstract":"<p><strong>Background: </strong>Diagnostic sural nerve biopsies can be taken as whole or fascicular nerve biopsies. It is unclear if this is associated with differences in diagnostic yield or procedural complications. We compared the clinical outcomes of fascicular versus whole sural nerve biopsies.</p><p><strong>Methods: </strong>This was a retrospective chart review of sural nerve biopsies performed between 2011 and 2024 at 4 tertiary academic hospitals in Canada. The primary outcome was the incidence of postoperative nerve-related complications. The secondary outcome was the concordance between the biopsy and the final diagnosis. Fisher's exact test was used to compare the incidence of postoperative complications. Two-sided Cochran-Armitage trend test was used to compare concordance between groups.</p><p><strong>Results: </strong>There were 75 patients who underwent whole sural nerve biopsies and 13 patients who underwent fascicular sural nerve biopsies; 54.6% of patients were male, with a mean age of 59.7 ± 15.9. The average nerve length sampled was 2.86 ± 1.3 cm in the whole nerve biopsy group and 2.35 ± 1.3 cm in the fascicular nerve biopsy group. Only a small proportion of patients had documented follow-up (whole: 26.7%; fascicular: 15.4%), among whom 40.0% in the whole nerve biopsy group and 0.0% in the fascicular group experienced complications (<i>P</i> = 1.00). The most common diagnosis was vasculitis in both groups (whole nerve biopsy: 17.0%, fascicular nerve biopsy: 36.4%). There was no statistically significant shift toward higher concordance in the whole nerve group (Z = 0.63, <i>P</i> = .53).</p><p><strong>Conclusion: </strong>Fascicular and whole sural nerve biopsies demonstrated similar diagnostic concordance. Prospective studies with larger sample sizes are needed to more accurately characterize postoperative complication rates.</p>","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":" ","pages":"22925503261461586"},"PeriodicalIF":1.2,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13303256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}