Plastic surgery最新文献

{"title":"Comparing Immediate Breast Reconstruction Rates in Rural and Urban Populations: A Global Systematic Review and Meta-Analysis: Comparer les taux de reconstruction mammaire immédiate dans les populations rurales et urbaines : une analyse systématique et méta-analyse globales.","authors":"Alexis E Mah, Damoon Ranjbar, Brandon Chai, Laura M Snell","doi":"10.1177/22925503261436341","DOIUrl":"10.1177/22925503261436341","url":null,"abstract":"<p><p><b>Background:</b> Immediate breast reconstruction (IBR) contributes to comprehensive breast cancer care. Rural patients often face barriers to healthcare access and worse health outcomes versus urban counterparts. We sought to (1) compare rates of IBR among rural and urban residents; (2) identify sociodemographic and economic factors associated with breast reconstruction rates. <b>Methods:</b> In this systematic review and meta-analysis, MEDLINE, Embase, Web of Science, and CENTRAL were searched from inception to May 15, 2025, for studies comparing IBR rates among rural versus urban individuals globally. Risk of bias was assessed using the Risk of Bias in Non-Randomized Studies - of Exposures tool. The primary outcome was the literature-pooled odds ratio (OR) of rural patients receiving IBR versus urban patients, evaluated with a random-effects meta-analysis, followed by sensitivity and leave-one-out analyses. Univariate meta-regression was conducted to explore whether mean age, socioeconomic status (SES), and data collection year explain heterogeneity and rural-urban IBR disparities. <b>Results:</b> Fifteen studies were included, encompassing 46 986 rural and 1 833 906 urban mastectomy patients. Rural patients were significantly less likely to undergo IBR (OR 0.67; 95% confidence interval [0.57-0.79], <i>I</i> ² = 97%). There was no temporal trend suggesting changes in geographic disparities in IBR rates. Mean age, SES, and midpoint data collection year did not significantly explain heterogeneity nor rural-urban IBR disparities. <b>Conclusions:</b> Rural patients were approximately 33% less likely to receive IBR versus urban patients. However, considerable heterogeneity suggested the need for research on moderators to explain this association and inform strategies to promote equitable IBR access, including ride-share programs and increased plastic surgeon density in rural communities.</p>","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":" ","pages":"22925503261436341"},"PeriodicalIF":1.2,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594083","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 on: Recommendations for a Canadian Breast Implant Registry.","authors":"Paul J Oxley","doi":"10.1177/22925503261434946","DOIUrl":"10.1177/22925503261434946","url":null,"abstract":"","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":" ","pages":"22925503261434946"},"PeriodicalIF":0.6,"publicationDate":"2026-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594085","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":"Validation Study on Movement Sonification of the Hand as a Rehabilitation Tool.","authors":"Alexander Platt, Martin J Giuffre, Robert T Moore, Emma Yanko, Ryan Hoeve, Maleka Ramji, Aaron Knox, Justin Yeung","doi":"10.1177/22925503261429452","DOIUrl":"10.1177/22925503261429452","url":null,"abstract":"<p><p><b>Introduction:</b> Hand injuries can lead to lasting impairments that limit one's ability to perform activities of daily living. Many individuals who undergo surgery following a hand injury participate in post-operative rehabilitation. Evidence suggests that geographical and socioeconomic barriers may hinder rehabilitation progress and limit recovery after surgery. Telemedicine and augmented reality may be useful tools for addressing issues concerning accessibility and adherence in rehabilitation. This study validates the use of a novel movement sonification interface that uses Google's MediaPipe hand-tracking technology to map single-digit PIP joint motion to real-time auditory feedback. <b>Methods:</b> Nineteen healthy adults (mean age 32 years; 10 males, 9 females) with no prior exposure to movement sonification participated. Through webcam, participants interacted with a web-based program that mapped fourth digit PIP joint flexion and extension to musical pitch changes (low pitch for extension, high pitch for flexion). Construct, face, content, and predictive criterion validity were assessed through structured surveys after participants viewed and explored the program. <b>Results:</b> Construct validity was 89%, with participants correctly identifying the relationship between fourth digit PIP movement and pitch changes. Both face and content validity were 100%, with participants recognizing the sound-movement relationship and that only the fourth digit produced sound. Predictive criterion validity demonstrated high accuracy, with participants correctly matching hand configurations to sounds (95%) and predicting sounds from muted videos (95%). <b>Conclusions:</b> Results demonstrate excellent construct, face, content, and predictive criterion validity. This supports the feasibility of using music sonification as an intuitive and accessible tool for augmented hand rehabilitation.</p>","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":" ","pages":"22925503261429452"},"PeriodicalIF":1.2,"publicationDate":"2026-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594000","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: The Sunshine Act Open Payment Database: A 7-Year Analysis of Trends Within Plastic Surgery and Its Subspecialties.","authors":"Devra Beyer Becker","doi":"10.1177/22925503261434831","DOIUrl":"10.1177/22925503261434831","url":null,"abstract":"","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":" ","pages":"22925503261434831"},"PeriodicalIF":0.6,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575162","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":"A Cost Analysis of Carpal Tunnel Procedures Performed in an Office Procedure Room Versus a Hospital Operating Room in a Rural Midwest Health System.","authors":"Luke J Hurley, Kyler A Hardie, Robert E Van Demark","doi":"10.1177/22925503261429901","DOIUrl":"10.1177/22925503261429901","url":null,"abstract":"<p><p><b>Introduction:</b> Carpal tunnel release (CTR) is one of the most common performed hand surgery procedures, yet the estimated yearly cost of carpal tunnel syndrome in the United States is $2 billion, resulting in significant costs to both healthcare systems and patients. Recently, there has been a trend to move minor hand surgery cases from the hospital operating room (OR) to a clinic-based procedure room (PR). This study aimed to examine CTR costs within our institution performed in the PR compared to the OR. <b>Methods:</b> All CTR surgeries performed by three fellowship-trained orthopedic hand surgeons in the OR and PR at a rural health system from 2019-2020 were reviewed. The operative times, number of personnel and supplies required in each clinical location were examined to calculate costs. CTR cost and insurance revenue models were created, and total costs, revenue, and net revenue were compared. <b>Results:</b> A total of 1416 CTRs were performed during the study period, with 855 in the OR and 561 in the PR. The average total cost for CTR in the OR was $2196.10 compared to $549.07 in the PR. The average net revenue of CTR was significantly greater when done in the OR versus PR at $1011.06 and $85.87, respectively. The average reimbursement rate was greater in the OR at 55% compared to 30% for CTRs done in the PR. <b>Conclusion:</b> Overall, the average total cost and net revenue for OR CTR were significantly higher than PR CTR, secondary to higher reimbursement rates in the hospital setting.</p>","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":" ","pages":"22925503261429901"},"PeriodicalIF":1.2,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13005752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504680","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":"Head and Neck Cutaneous Melanoma: Is Reduced Radial Margin of Excision Safe?","authors":"Uriel Clemente-Gutierrez, Anouska Agarwal, Kristin Buchko, Mahmoud Seif-Elnasr, Suhail Sayed, Kumar A Pathak","doi":"10.1177/22925503261429463","DOIUrl":"10.1177/22925503261429463","url":null,"abstract":"<p><p><b>Introduction:</b> It is often challenging to achieve recommended excision margins in head and neck cutaneous melanoma (HNCM). This study assessed the impact of reduced radial excision margins on disease-specific survival (DSS), disease-free survival (DFS), and local recurrence-free survival (LRFS) in these patients. Given ongoing uncertainty regarding optimal margin width for melanomas ≥1 mm, a secondary contemporary margin-based analysis was performed. <b>Methods:</b> This population-based study included patients diagnosed with HNCM in Manitoba, Canada, between 1970 and 2020. Radial excision margins were classified as \"recommended\" or \"reduced\" according to National Comprehensive Cancer Network guidelines. A secondary analysis compared outcomes between narrower (∼1 cm) and wider (∼2 cm) excision margins in patients with Breslow thickness ≥1.0 mm. Survival outcomes were evaluated using Kaplan-Meier analysis and multivariable Cox proportional hazards models. <b>Results</b>: A total of 716 patients met inclusion criteria; 177 had recommended margins and 539 had reduced margins. Patients in the reduced-margin group had thicker tumors (2.36 vs 1.72 mm, <i>p</i> = .007) and fewer Stage I melanomas (58.6% vs 78%, <i>p</i> < .001). Local recurrence occurred in 4.3% of reduced-margin and 6.2% of recommended-margin patients. Kaplan-Meier analysis showed no differences in DSS, DFS, or LRFS. On multivariable analysis, margin status was not an independent predictor of survival, whereas advanced stage and scalp location were associated with worse outcomes. In the secondary margin-based analysis, margin width was not independently associated with DSS, DFS, or LRFS. <b>Conclusion:</b> Reduced radial excision margins were not associated with inferior oncologic outcomes in HNCM. These findings support the oncologic safety of selective margin reduction in appropriately selected patients.</p>","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":" ","pages":"22925503261429463"},"PeriodicalIF":1.2,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13005751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503988","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":"Spontaneity Versus Symmetry in Facial Reanimation: A PRISMA-Guided Narrative Review.","authors":"Hargaven Singh Gill, Glenda Sze Ling Chong, Gurveer Kaven Singh Gill","doi":"10.1177/22925503261429923","DOIUrl":"10.1177/22925503261429923","url":null,"abstract":"<p><p><b>Introduction:</b> Facial reanimation aims to restore dynamic smiling and facial symmetry after paralysis. Ipsilateral masseteric nerve transfer, contralateral facial nerve via cross-facial nerve graft (CFNG), and dual innervation approaches each demonstrate distinct profiles in spontaneous activation and movement symmetry during free functional muscle transfers or direct facial nerve reinnervation. <b>Methods:</b> A systematic review of PubMed, Embase, and the Cochrane Library was conducted (January 2000-March 2025) in accordance with PRISMA 2020 guidelines. Studies comparing masseteric nerve innervation, CFNG, and dual innervation in free muscle transfer or direct fifth-to-seventh nerve coaptation were included. Case reports, series with fewer than 10 patients, non-English studies, and those lacking quantitative smile outcomes were excluded. <b>Results:</b> Twenty-eight studies encompassing 7574 patients met inclusion criteria. Fourteen studies evaluated single innervation techniques, and 14 assessed dual innervation. Masseteric nerve innervation produced greater commissure excursion and improved symmetry, particularly early postoperatively, but demonstrated low spontaneous smile rates, typically under 30%. CFNG achieved higher spontaneity-up to 75% in select studies-but was associated with delayed activation and reduced excursion. Dual innervation achieved spontaneous smile rates up to 98% while maintaining strong, symmetric movement. Pediatric patients showed superior excursion and spontaneity, reflecting greater neural plasticity. Patient-reported outcomes favored masseteric innervation early and CFNG or dual innervation for long-term emotional benefit. <b>Conclusions:</b> CFNG optimizes spontaneity but may compromise strength and speed. Masseteric innervation offers rapid, symmetric smiles with limited emotional spontaneity. Dual innervation provides the most balanced outcomes, particularly in pediatric patients.</p>","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":" ","pages":"22925503261429923"},"PeriodicalIF":1.2,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13004710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499664","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":"State of the Art of Artificial Intelligence in Plastic Surgery.","authors":"Nitzan Kenig, Marianna Ostrerova, Elena Benedito Crespo, Javier Montón Echeverría","doi":"10.1177/22925503261429913","DOIUrl":"10.1177/22925503261429913","url":null,"abstract":"<p><p><b>Introduction:</b> Artificial intelligence (AI) raises a fundamental question for modern plastic surgery: will it enable personalized, patient-centered, efficient care, or lead to a dystopian, automated care that diminishes human autonomy, which is dominated by generic \"AI slop\" that eventually deteriorates the doctor-patient relationship? <b>Methods:</b> This study examines current applications of large language models, generative AI, and neural networks in plastic surgery, assessing AI's roles in surgical planning, automation of repetitive tasks, outcome evaluation, education, and patient communication, alongside associated ethical, legal, and practical risks and considerations. <b>Results:</b> AI has demonstrated utility in evaluating postoperative outcomes, predicting potential surgical complications, assisting with patient inquiries, providing preoperative guidance, and delivering patient education. However, significant challenges accompany these advances, including risks of algorithmic paternalism, cognitive debt, biased decision-making, misinformation, and the use of synthetic images that may create unrealistic patient expectations. Additional concerns include data privacy, accountability, environmental impact, equitable access to AI technologies, and potentially negative patient perceptions or interactions. <b>Conclusions:</b> AI can meaningfully enhance plastic surgery if integrated responsibly, with appropriate human oversight, transparency, and preservation of clinical judgment. The future of the field depends on balancing technological innovation with ethical responsibility while maintaining authenticity, empathy, and patient-centered care. Surgeons must develop AI literacy, monitor public perceptions of AI, establish ethical guidelines, and actively guide responsible adoption to harness AI's benefits while safeguarding human values, creativity, and trust. Future strengths for high-end or boutique practices may lie in emphasizing enhanced human presence, personality, and authenticity rather than excessive reliance on AI.</p>","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":" ","pages":"22925503261429913"},"PeriodicalIF":0.6,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12995731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487073","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":"Comparison of Porcine Tendon to Novel 3D-Printed Silicone Model for Learning Flexor Tendon Repair Techniques.","authors":"Véronique M Doucet, Abby L Rentz, Christian J Petropolis","doi":"10.1177/22925503261424896","DOIUrl":"10.1177/22925503261424896","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical simulation has become an important component of surgical residency. Several animal and synthetic flexor tendon repair simulators have been described, with variable degrees of fidelity. The purpose of this study was to determine the effectiveness of a silicone flexor tendon repair model in comparison to a porcine tendon repair model. <b>Methods:</b> A silicone flexor tendon model was created using polypropylene fibres bound in cured silicone to simulate epitenon with the use of a 3D printed mold. Deep flexor tendons were harvested from porcine forelimbs for comparison. Participants tested the models by completing core and epitendinous tendon repairs. Models were evaluated with 5-point Likert Scale questions and a comment section. <b>Results:</b> Nine plastic surgery residents and three plastic surgeons participated in the study. Simulation realism was 3.9/5 for the silicone model and 4.6/5 for the porcine model (p = 0.001). Educational utility was 4.6/5 for the silicone model and 4.6/5 for the porcine model (p = 0.546). Overall, the silicone model scored 4.3/5 and the porcine model 4.6/5 (p = 0.078). <b>Conclusion:</b> We created a moderate-fidelity tendon repair model that is convenient to use, easily reproducible, and of equal educational utility to a porcine model based on our study results. This model has significant potential for simulation learning in postgraduate surgical education. Further validation is required to confirm its efficacy in postgraduate surgical education and skill transfer to the operating room.</p>","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":" ","pages":"22925503261424896"},"PeriodicalIF":1.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691740","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: Recommendations for a Canadian Breast Implant Registry.","authors":"Mitchell H Brown","doi":"10.1177/22925503261430355","DOIUrl":"10.1177/22925503261430355","url":null,"abstract":"","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":" ","pages":"22925503261430355"},"PeriodicalIF":1.2,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463632","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}