World Journal of Plastic Surgery最新文献

{"title":"Utilising the Flap Vein of a Pedicled TRAM Flap for LYMPHA: A Case Report.","authors":"Steven L Zhang, Jolie Hwee, Allen W Wong","doi":"10.61882/wjps.14.3.86","DOIUrl":"https://doi.org/10.61882/wjps.14.3.86","url":null,"abstract":"<p><p>Upper extremity lymphedema is a common and disabling complication of breast cancer treatment, especially following axillary lymph node dissection (ALND). Its risk may be reduced with the Lymphatic Microsurgical Preventive Healing Approach (LYMPHA) procedure, which involves anastomosis of one or more upper limb lymphatic channels to a recipient vein, usually a branch of the axillary vein within the axilla. However, these branches may sometimes be difficult to identify or even not be in suitable condition, especially if extensive electrocautery was used during ALND. If autologous breast reconstruction is performed simultaneously, a flap vein may serve as a reliable recipient vein for anastomosis. We describe a simple and potentially useful technique of utilizing the flap vein (deep inferior epigastric vein) of a pedicled transverse rectus abdominis myocutaneous flap, as a recipient vein for the lymphaticovenular anastomosis in LYMPHA.</p>","PeriodicalId":23736,"journal":{"name":"World Journal of Plastic Surgery","volume":"14 3","pages":"86-90"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12842965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094258","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":"Qualitative Comparison of Stress Distribution of Different Fixation Techniques of Sagittal Split Ramus Osteotomy (SSRO) in Mandibular Setback Surgery in Asymmetric Cases Using Three-Dimensional Finite Element Analysis (FEA).","authors":"Saeedeh Khajehahmadi, Abdolrahim Shams, Hadis Tahami, Amin Rahpeyma","doi":"10.61186/wjps.14.2.33","DOIUrl":"10.61186/wjps.14.2.33","url":null,"abstract":"<p><strong>Background: </strong>Bilateral sagittal split osteotomy (BSSO) is the most common procedure in orthognathic Surgey of mandible also in asymmetries. However, the methods of fixation are different. Few studies worked on asymmetric cases especially with the use of finite element analysis (FEA). We aimed to evaluate stress distribution of two different Fixation techniques in mandibular setback surgery in asymmetric cases using FEA.</p><p><strong>Methods: </strong>A 3-dimensional model of asymmetric mandible was obtained. SSRO with modified osteotomy was simulated unilaterally and another side osteotomized as common. Then differential set back was done and rigid fixation of that modified side with miniplate and monocortical screws was simulated then rigid fixation of other side by different fixation technics include 2 or 3 bicortical screws. With the force of 132N and 300N on the occlusal surface of first molars, the Von Mises Stress (VMS) distribution was calculated.</p><p><strong>Results: </strong>Stress distribution in threads of screws in use of three bicortical screws was higher than two bicortical screws (161%). VMS distribution in spongy bone of left ramus in use of three bicortical screws was higher than the use of two bicortical screws (78% difference). VMS distribution in cortical bone of mandible body in use of three bicortical screws was significantly higher than the use of two bicortical screws (1.3% difference) (P<0.5).</p><p><strong>Conclusion: </strong>The use of modified osteotomy and fixation with rigid fixation of two bicortical screws can create a more predictable and uniform stress distribution in mandibular setback surgery in asymmetric cases.</p>","PeriodicalId":23736,"journal":{"name":"World Journal of Plastic Surgery","volume":"14 2","pages":"33-45"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186079","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":"Clinical Characteristics of ASIA Syndrome in Patients with Silicone Breast Implants: A Scoping Review.","authors":"Ospina-Gómez Juan Esteban, Latorre-Arévalo María Gabriela, Ayala-Gutierrez María Camila, Monsalve-Suárez Edgar Felipe, Amaya-Muñoz María Camila, Caceres-Ramírez Catalina, Alviar-Rueda Juan Darío, Camacho-López Paul Anthony","doi":"10.61186/wjps.14.2.11","DOIUrl":"10.61186/wjps.14.2.11","url":null,"abstract":"<p><strong>Background: </strong>Adjuvant-induced autoimmune syndrome (ASIA), described in 2011, includes autoimmune reactions triggered by environmental adjuvants, such as silicone breast implants (SBI). Symptoms include fatigue, sleep disturbances, appetite changes, muscle pain, fever, among others, with pathophysiology involving a combination of genetic predisposition and adjuvant exposure, leading to abnormal immune responses. We aimed to define clinical profiles and outcomes of patients with SBI, clarify ASIA's clinical implications, and guide future research.</p><p><strong>Methods: </strong>Using the PRISMA-ScR framework, a scoping review was conducted to identify clinical profiles, preexisting conditions, prosthetic anomalies, and outcomes of patients with ASIA syndrome associated with SBI. Searches were performed in Medline, Scopus, Lilacs, and Google Scholar to locate relevant studies.</p><p><strong>Results: </strong>Of 35 selected studies, 21 were case reports, 6 case series, and 8 cohort studies, identifying 848 patients, predominantly from the Netherlands (n=513), with an average age of 45-47 yr. Common medical histories included autoimmune diseases and breast cancer, while frequent implant-related anomalies were capsular contracture and rupture. Musculoskeletal symptoms and fatigue were the most prevalent, and implant explantation was the primary treatment, resulting in symptom improvement for most patients.</p><p><strong>Conclusion: </strong>This review highlights the clinical features of ASIA syndrome in patients with SBI, particularly musculoskeletal symptoms, fatigue, and the presence of positive antinuclear antibody as a potential marker. However, the relationship between SBI and ASIA remains controversial. Despite limitations in current evidence, ongoing clinical monitoring and further research are crucial to better understanding and managing ASIA syndrome in patients with SBI.</p>","PeriodicalId":23736,"journal":{"name":"World Journal of Plastic Surgery","volume":"14 2","pages":"11-20"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186835","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":"Surgical Management of Gynecomastia in Asian Men - Clinical Experience and Considerations for Different Patient Types.","authors":"Ivan Boon Kwang Puah","doi":"10.61882/wjps.14.3.101","DOIUrl":"https://doi.org/10.61882/wjps.14.3.101","url":null,"abstract":"<p><p>Gynecomastia, the excess growth of glandular breast tissue in males, is a common condition associated with hormonal imbalance or the use of certain drugs. Although medically benign, persistent gynecomastia often causes psychological distress and adversely affects quality of life. Published literature on the evaluation and management of patients seeking surgical treatment for gynecomastia is predominantly from Western populations. Here, we present insights from our practice in a multi-ethnic Asian population, with >550 cases treated at Amaris B. Clinic, Singapore from 2018-2023. We illustrate these insights and principles with a representative selection of 6 patient cases. We discuss specific considerations for optimizing the consultation process and outcomes in Asian patients, with reference to profiles commonly seen in our local setting. These were: adult males, the most encountered patient profile who are typically overweight/obese; young (adolescent) males, typically overweight, had a history of recent significant weight loss, or lean and experiencing gynecomastia due to puberty-related hormonal changes; males with drug-induced gynecomastia, typically athletes/bodybuilders. Our experience highlights several important considerations, including management of the consultation process, the range of patient expectations, and addressing surgical aspects of management to achieve the desired aesthetic outcomes.</p>","PeriodicalId":23736,"journal":{"name":"World Journal of Plastic Surgery","volume":"14 3","pages":"101-107"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12843043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094161","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":"Cleft Lip Techniques and Surgical Outcome in Patients Referred To Abuzar Children's Hospital in Ahvaz, Southern Iran.","authors":"Mehran Peyvasteh, Vahid Ayati, Mahmoud Khosh Khabar, Shahnam Askarpour, Hoda Ilkhani Pak","doi":"10.61186/wjps.14.2.86","DOIUrl":"10.61186/wjps.14.2.86","url":null,"abstract":"<p><strong>Background: </strong>Cleft lip in infants is associated with severe morphological and functional disorders. Cleft lip is particularly important, which can lead to psychological changes in the patient if the treatment result is not satisfactory. Different surgical methods have been developed in the past decades. We aimed to investigating cleft lip techniques and surgical outcome in patients.</p><p><strong>Methods: </strong>In this cross-sectional analytical study, 32 patients undergoing cleft lip surgery referred to Abuzar Children's Hospital in Ahvaz, southern Iran between 2022 and 2023 were enrolled. According to the surgeon's opinion, the patients underwent cleft lip surgery using the Sommerlad technique. (n=18 or Millard technique (n=14). Surgical Ooutcomes were compared between the two groups.</p><p><strong>Results: </strong>The mean age was 33.58±59.14 months. 65.6% of patients were boys (n=21). The need for rhinoplasty in the Sommerlad and Millard groups was 100% and 84.6%, respectively, and no significant difference was observed between the two groups (P=0.17). The cupids bow was estimated to be good in 28.6% and 38.9% of patients in the Millard and Sommerlad groups, respectively, while this difference between the two groups was not significant (P=0.51). There was no significant difference between the two groups in the vermilion border (P=0.31). No significant difference was observed between the two groups in terms of white roll match, lip length and Scar appearance (P>0.05).</p><p><strong>Conclusion: </strong>No significant difference was observed in the results of lip surgery between the Sommerlad and Millard techniques. Further multicenter studies with larger sample sizes are recommended to validate these results.</p>","PeriodicalId":23736,"journal":{"name":"World Journal of Plastic Surgery","volume":"14 2","pages":"86-91"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186857","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":"Comparison of Analgesic Effect of Inferior Alveolar Nerve Block and Lidocaine Infiltration in Posterior Mandibular Implant Placement: A Split-Mouth Randomized Clinical Trial.","authors":"Nima Dehghani, Mona Mohajeri Tehrani, Mohadeseh Azarsina, Shamim Chinian, Xaniar Mahmoudi","doi":"10.61882/wjps.14.3.45","DOIUrl":"https://doi.org/10.61882/wjps.14.3.45","url":null,"abstract":"<p><strong>Background: </strong>Implantology is a widely accepted treatment, as it restores aesthetics and function, and is the preferred option for replacing missing teeth. In mandibular implant surgery, the Inferior Alveolar Nerve Block (IANB) is the most common anesthetic technique, as it eliminates sensation on one side of the jaw, floor of the mouth, teeth, tongue, and gums. However, its high failure rate is due to the technical difficulty of the injection procedure. Additionally, deep anesthesia from IANB carries risks such as damage to the mandibular canal. In contrast, infiltration anesthesia desensitizes the inferior alveolar nerve locally, allowing patients to perceive pain and alert the dentist if the implant approaches the nerve. We aimed to compare the effects of IANB and local infiltration anesthesia for posterior mandibular implant surgery.</p><p><strong>Methods: </strong>This prospective, randomized, double-blind clinical trial followed a split-mouth design, involving 29 patients undergoing bilateral implant surgery in the posterior mandible within a single session. On one side, IANB anesthesia was used, and on the other, infiltration was administered. Pain was assessed using the Visual Analog Scale (VAS).</p><p><strong>Results: </strong>All 58 implants were analyzed. The VAS scores during surgery were significantly higher for the infiltration technique (P = 0.03). However, no significant difference in pain was observed 24 hours post-surgery (P = 0.223).</p><p><strong>Conclusion: </strong>Both IANB and infiltration anesthesia are effective for mandibular implant surgery, but IANB offers more reliable pain control, making it preferable for complex cases, while infiltration is suitable for less invasive procedures.</p>","PeriodicalId":23736,"journal":{"name":"World Journal of Plastic Surgery","volume":"14 3","pages":"45-52"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12843044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of Simultaneous Contralateral Breast Symmetry Procedure in Unilateral Free Flap Breast Reconstruction.","authors":"Alexander A Argame, Joseph I Chen, Joseph B Eby, Hossein Masoomi","doi":"10.61882/wjps.14.3.63","DOIUrl":"https://doi.org/10.61882/wjps.14.3.63","url":null,"abstract":"<p><strong>Background: </strong>Contralateral breast symmetry procedure is often required to achieve symmetry following unilateral breast reconstruction. No consensus exists regarding timing of contralateral symmetry procedure. We investigated frequency and safety of simultaneous contralateral breast symmetry procedure in unilateral free flap breast reconstruction using a large nationwide database.</p><p><strong>Methods: </strong>Using the American College of Surgeons National Surgery Quality Improvement Project database, we examined clinical data of patients who underwent immediate or delayed unilateral free flap breast reconstruction from 2016 to 2020 in the United States. Patients were divided in two groups: with or without simultaneous contralateral reduction mammoplasty or mastopexy.</p><p><strong>Results: </strong>Overall, 5.429 patients underwent unilateral free flap-based breast reconstruction. Simultaneous symmetrization was reported in only 8% of these patients. There was no significant difference in overall complication rate (without: 15.9% vs. with: 15.2%), unplanned return to the operating room rate (without: 10.9% vs. with: 8.3%), mean length of hospital stay (without: 3.8 vs. with: 3.5 day) and unplanned re-admission rate (without: 5.5% vs. with: 4.1%) between two groups. Additionally, multivariate regression analyses showed simultaneous symmetrization was not associated with higher complication rate, higher unplanned return to the operating room rate, higher readmission rate, nor longer length of hospital stay after adjusting for patient's characteristics, comorbidities and immediate versus delayed breast reconstruction.</p><p><strong>Conclusion: </strong>Simultaneous symmetrization was performed infrequently with unilateral free flap breast reconstruction. Our study showed simultaneous symmetrization is safe and associated with a comparable perioperative outcome. Consideration in appropriate patients will likely reduce the number of revisions for those undergoing unilateral free flap breast reconstruction.</p>","PeriodicalId":23736,"journal":{"name":"World Journal of Plastic Surgery","volume":"14 3","pages":"63-69"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12843005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094226","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":"Enhancing Repigmentation in Vitiligo: A Comparative Clinical Trial of Microneedling with Topical 5-Fluorouracil, Fluocinolone, and Microneedling Alone.","authors":"Nader Pazyar, Nasrin Kheirkhah, Reza Yaghoobi, Nima Bakhtiari","doi":"10.61186/wjps.14.1.64","DOIUrl":"10.61186/wjps.14.1.64","url":null,"abstract":"<p><strong>Background: </strong>Vitiligo, a pigmentary skin disorder, poses therapeutic challenges due to its progressive nature and varied treatment responses. We aimed to investigate the efficacy of a novel approach, combining microneedling with topical 5-Fluorouracil (5-FU), compared with microneedling with Fluocinolone and microneedling alone for treating vitiligo lesions.</p><p><strong>Methods: </strong>A single-blinded clinical trial was conducted from Aug 2022 to Feb 2023 at Ahvaz University of Medical Sciences, Ahvaz, Iran. Twenty patients with persistent vitiligo lesions were randomly assigned to three treatment groups. Microneedling was performed using Dermapen cartridge 36 once a week for 12 wk. In patch A, 5% 5-FU cream was applied immediately after microneedling; in patch B, patients used fluocinolone 0.025% cream twice daily; and in patch C, microneedling was performed alone. Clinical repigmentation was evaluated using the G-score scale, and treatment side effects were recorded.</p><p><strong>Results: </strong>Microneedling combined with 5-FU demonstrated significantly higher repigmentation rates, with 70% of lesions showing moderate to excellent responses (P<0.001). In contrast, microneedling with Fluocinolone and microneedling alone exhibited lower response frequencies. Side effects were minimal, with only one patient experiencing burning and itching in the microneedling and 5-FU group. No corticosteroid-related complications were observed. Six months follow-up revealed sustained repigmentation in the microneedling and 5-FU group, contrasting with no response or recurrence in microneedling alone-treated lesions.</p><p><strong>Conclusion: </strong>Microneedling combined with topical 5-FU presents a promising therapeutic strategy for vitiligo lesions, yielding superior repigmentation outcomes compared to other treatments.</p>","PeriodicalId":23736,"journal":{"name":"World Journal of Plastic Surgery","volume":"14 1","pages":"64-71"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200179","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":"Evaluation of Complications Following Nipple Areola Sparing Mastectomy with Immediate Implant-Based Breast Reconstruction in Patients with Large Ptotic Breasts.","authors":"Mohammad Dehbozorgi, Afsoon Fazelzadeh, Aliakbar Mohammadi, Sedighe Tahmasebi, Malcolm D Paul","doi":"10.61186/wjps.14.1.43","DOIUrl":"10.61186/wjps.14.1.43","url":null,"abstract":"<p><strong>Background: </strong>Nipple sparing mastectomy has become a preferred method in breast cancer patients but safety of this procedure in large ptotic breasts needs to be documented to broaden its application. We aimed to assess complication rates of patients undergoing NSM and immediate implant-based reconstruction with skin reduction to determine the safety of reduction in this patient group.</p><p><strong>Methods: </strong>Patient with breast cancer and ptotic breasts whom received nipple sparing mastectomy and immediate implant-based breast reconstructions were analyzed, operated between April 2020 to last month of 2023 in Shiraz, Iran. Post-operative complications were recorded and analyzed.</p><p><strong>Results: </strong>The mean age and BMI of patients were 40.76 ± 5.0 and 23.72 ± 3.27 year, respectively. The median post-operative24 months (min 14, max 34). None of patients had disease recurrence. The most common complication was the flap full thickness necrosis, occurring in a total of 7 (20%) breasts. The incidence of full thickness necrosis was just seen in patients with ptosis grade III, and the most common site for the necrosis was the suture line [4/7 (12%)]. The other 3 patients had full thickness partial necrosis of NAC. We did not have any complete NAC necrosis.</p><p><strong>Conclusion: </strong>Nipple sparing mastectomy and immediate implant insertion in ptotic breasts, is a valuable method of reconstruction with acceptable rate of complications.</p>","PeriodicalId":23736,"journal":{"name":"World Journal of Plastic Surgery","volume":"14 1","pages":"43-51"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200181","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":"Evaluation of the Appropriate Time of Botulinum Toxin Type A Injection To Increase the Survival of Random Flaps in Rat.","authors":"Sadrollah Motamed, Mohsen Fattahy Dolatabadi, Omid Zehtabvar, Babak Sabet Diveshli, Atoosa Gharib, Tahmineh Mollasharifi, Abdol Reza Rouientan","doi":"10.61186/wjps.14.1.17","DOIUrl":"10.61186/wjps.14.1.17","url":null,"abstract":"<p><strong>Background: </strong>Although many previous studies verified the role of BTX-A in the augmentation of flap survival and decreasing the rate of necrosis in random pattern cutaneous flaps, drug injection at different times has not been investigated in this regard. This study compares the effect of BTX- A injection time at 0, 3, and 7 days before surgery to determine the best and most effective injection time.</p><p><strong>Methods: </strong>In 20 male rats, divided into four equal groups, on different days of pre-operation (0, 3, or 7 days) BTX-A or saline was administered to the whole length of the flap. Random pattern dorsal skin flaps with 4:1 length-to-width ratios were elevated and returned to the original position. Flap survival was evaluated on day 10 and 20 after surgery and a histopathological examination were performed 20 days after flap elevation.</p><p><strong>Results: </strong>The BTX-A group had a greater survival mean compared with the saline group (87.92±16.30 vs 65.60±30.71 or 1.34 fold increase in survival rate) in flaps with a length-to-width ratio of 4:1 (<i>P</i> = 0.05), and If botulinum toxin is injected 7 days before flap elevation, this increase in survival will be 1.5 times (97.5±4.06 vs 65.60±30.71) compared to the saline group (<i>P</i> = 0.02).</p><p><strong>Conclusion: </strong>Preoperative injection of botulinum toxin type A in random pattern skin flaps increases skin flap survival in rats, and the best time for injections is 7 days before flap elevation. We found a reduction in the proliferation of cutaneous myofibroblasts in flaps by injecting BTX-A. It could play a role in increasing blood flow and survival by reducing wound contraction, however, more studies should be conducted to determine the possible mechanism.</p>","PeriodicalId":23736,"journal":{"name":"World Journal of Plastic Surgery","volume":"14 1","pages":"17-27"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200182","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}