JPRAS Open最新文献

{"title":"Validity of a pump-perfused chicken thigh model for microsurgical training","authors":"Jérôme Houdu,&nbsp;Yazan Abu-Shama,&nbsp;Victor Gorzkowski,&nbsp;Cécile Rumeau,&nbsp;Valentin Favier,&nbsp;Patrice Gallet","doi":"10.1016/j.jpra.2026.05.030","DOIUrl":"10.1016/j.jpra.2026.05.030","url":null,"abstract":"<div><h3>Background</h3><div>Microsurgical training has traditionally relied on live animal models. While these offer high anatomical and functional fidelity, their use raises increasing ethical, logistical, and economic concerns and alternatives are needed.</div></div><div><h3>Methods</h3><div>We conducted a prospective observational study to assess the subjective and objective validity of a pump-perfused chicken thigh model for microsurgical training. Forty-five residents and surgeons were categorized by microsurgical experience. Thirteen participants underwent motion analysis and blinded video-based scoring. All participants performed arterial end-to-end anastomoses. Face and content validity were evaluated by experienced participants using Likert-scale questionnaires, while construct validity was assessed by comparing operative performance, Stanford Microsurgery and Resident Training scoring (SMaRT) and motion parameters across experience levels.</div></div><div><h3>Results</h3><div>Face and content validity scores were high, with median values of 7.9 (IQR 7.3–8.3) and 8.8 (IQR 6.4–9.0), respectively. Construct validity was demonstrated by significant improvements with experience, including faster operative times (<em>p</em> = 3.05×10⁻⁶, ε∼0.59), higher success rates and fewer leaks (<em>p</em> = 1.41×10⁻⁵, V(Cramer)∼0.56). Experts displayed smoother, more stable hand movements (lower jerk, tremor, and rotational instability); SMaRT scores effectively distinguished experts from non-experts (<em>p</em> = 0.0014 (<em>r</em> = 1)), and correlated moderately with motion metrics, suggesting complementary roles of expert video assessment and motion analysis in evaluating microsurgical performance. Qualitative differences in motion profiles and gesture structure were apparent between novice and expert participants.</div></div><div><h3>Conclusion</h3><div>The perfused chicken thigh model is a realistic and ethical alternative for microsurgical training with robust face, content and construct validities. Motion analysis might provide an objective complement to expert video-based assessment, suggesting its interest in structured training programs.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"50 ","pages":"Pages 685-698"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353923","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":"Response to correspondence on: Effect of abdominoplasty with transverse plication on rectus diastasis","authors":"Jordi Descarrega ,&nbsp;Joan Fontdevila","doi":"10.1016/j.jpra.2026.03.024","DOIUrl":"10.1016/j.jpra.2026.03.024","url":null,"abstract":"","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"49 ","pages":"Pages 631-632"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147797461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five keypoints in Foucher flap planning and harvesting: Retrospective case series study and literature review","authors":"Mariagiovanna Lombardi ,&nbsp;Martina Ponzo ,&nbsp;Vincenzo Iazzetta ,&nbsp;Ludovica De Gregorio ,&nbsp;Giorgio Squarcia Neri ,&nbsp;Annachiara Cavaliere ,&nbsp;Fabrizio Schonauer","doi":"10.1016/j.jpra.2025.08.031","DOIUrl":"10.1016/j.jpra.2025.08.031","url":null,"abstract":"<div><h3>Introduction</h3><div>The Foucher flap, based on the first dorsal metacarpal artery, is an effective solution for thumb reconstruction following trauma or oncologic resections. This technique allows for the preservation of thumb length and volume while keeping sensitivity and functionality. The success of this surgical approach depends on meticulous planning and execution. This retrospective study analyzes five key aspects related to flap planning and harvesting: defect location, preoperative vascular pedicle identification, flap design, surgical dissection and pedicle insetting.</div></div><div><h3>Patients and Methods</h3><div>A total of 24 patients who underwent Foucher flap thumb reconstruction between 2013 and 2023 were evaluated. The artery was preoperatively identified using Doppler imaging in all cases. Flap transfer was performed either through subcutaneous tunneling or skin incision, depending on the pedicle's characteristics. Functional and aesthetic outcomes were assessed through the Kapandji score, two-point discrimination and patient satisfaction surveys.</div></div><div><h3>Results</h3><div>At an average follow-up of six months, all flaps survived entirely. The mean Kapandji score was 8.17 and two-point discrimination in the skin paddle averaged 5.92 mm. Patient satisfaction was high, with 79 % rating their outcome as ``excellent'' and 21 % as ``satisfactory.'' Clinical evaluations confirmed favorable functional and aesthetic results.</div></div><div><h3>Conclusions</h3><div>The literature review and clinical data support the Foucher flap as a reliable technique for thumb reconstruction. Careful preoperative planning and precise execution are essential to optimizing functional and aesthetic outcomes, minimizing complications and improving patients' quality of life.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"49 ","pages":"Pages 613-624"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147797463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correspondence On: Effect of abdominoplasty with transverse plication on rectus diastasis","authors":"Francisco J. Villegas","doi":"10.1016/j.jpra.2026.03.012","DOIUrl":"10.1016/j.jpra.2026.03.012","url":null,"abstract":"","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"49 ","pages":"Pages 627-630"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147797460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor regarding “Five keypoints in foucher flap planning and harvesting: Retrospective case series study and literature review”","authors":"J. Terrence Jose Jerome","doi":"10.1016/j.jpra.2025.09.023","DOIUrl":"10.1016/j.jpra.2025.09.023","url":null,"abstract":"","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"49 ","pages":"Pages 625-626"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147797462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence as a surgical advisor before a DIEP breast reconstruction. A blinded comparative study of three large language models","authors":"Reza Tabrisi ,&nbsp;Johann Zdolsek ,&nbsp;Nathalie Mobargha ,&nbsp;Stina Rittri ,&nbsp;Åsa Edsander-Nord ,&nbsp;Ann-Charlott Docherty Skogh ,&nbsp;Oriana Haran ,&nbsp;Mattias Lidén ,&nbsp;Karin Säljö ,&nbsp;Tava Barivan ,&nbsp;Sebastian Holm","doi":"10.1016/j.jpra.2025.12.029","DOIUrl":"10.1016/j.jpra.2025.12.029","url":null,"abstract":"<div><h3>Introduction</h3><div>Large language models (LLMs) are increasingly used in clinical communication, but their accuracy and readability in patient education remain unclear. This study compared three LLMs for preoperative counseling before a DIEP breast reconstruction.</div></div><div><h3>Methods</h3><div>A total of 40 frequently asked preoperative questions regarding DIEP breast reconstruction were collected and categorized using the BREAST-Q framework. These were submitted in English to three LLMs: ChatGPT, Gemini and Copilot (anonymized as Model A-C). Each question was submitted to all three models and the responses were anonymized. An expert panel of eight board-certified plastic surgeons from both Europe and USA. Ratings were made of a 5-point Likert scale for accuracy, informativeness and readability. Together with a general evaluation (easiness, problematic content, incorrectness) and information-material specific evaluation (relevance and lowest reading level).</div></div><div><h3>Results</h3><div>Significant differences were found between models across all domains. ChatGPT achieved the highest accuracy (<em>p</em> = 0.019), Copilot was the most informative (<em>p</em> = 0.041), and both ChatGPT and Copilot produced more readable responses than Gemini (<em>p</em> &lt; 0.001). Copilot had fewer problematic statements, while Gemini generated text at the simplest reading level but with lower accuracy. Agreement among raters was strong for accuracy (κ = 0.96) but weak for qualitative domains.</div></div><div><h3>Conclusion</h3><div>Each LLM showed distinct strength ChatGPT produced the most accurate answers, Copilot the most informative, and Gemini the simplest language. No model was uniformly superior. These findings support supervised, task-specific use of LLMs in patient education for breast reconstruction.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 669-678"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical-based filler injection techniques for the midcheek groove and infraorbital region: Narrative review","authors":"Gi-Woong Hong ,&nbsp;Isaac Kai Jie Wong ,&nbsp;Jin-Hyun Kim ,&nbsp;Kyu-Ho Yi","doi":"10.1016/j.jpra.2025.12.014","DOIUrl":"10.1016/j.jpra.2025.12.014","url":null,"abstract":"<div><h3>Background</h3><div>The infraorbital hollow and midcheek groove (“Indian bands”) are anatomically complex transition zones where ligamentous, vascular, and fat compartments converge. Safe and predictable correction with hyaluronic acid (HA) fillers requires precise, layer-specific anatomical understanding.</div></div><div><h3>Objectives</h3><div>To synthesize anatomy-based injection strategies for the infraorbital–midcheek continuum, including diagnostic triage, technique selection, complication mitigation, and ethnic-specific considerations.</div></div><div><h3>Methods</h3><div>We conducted a narrative review based on a structured search of MEDLINE, PubMed, and Ovid databases using predefined keywords related to “Dark Circle,” “Midcheek Groove,” “Indian Band,” “Dermal Fillers,” and “Facial Anatomy.” Eligible anatomical dissections, imaging-based mappings, and clinical outcome studies were qualitatively synthesized; no original patient data were collected, and no PRISMA flow diagram or quantitative meta-analysis was performed.</div></div><div><h3>Results</h3><div>Cannula-assisted subcision to partially release fibrous retaining bands, followed by deep support (deep malar fat pad/suborbicularis oculi fat [SOOF]) and selective superficial blending, appears to improve midcheek groove correction in published series using Maili Volume and Precise. Management of overfill or surface irregularity relies on hyaluronidase and an understanding of product rheology (elastic modulus G′, cohesivity, elasticity). However, the available evidence remains heterogeneous and predominantly case-series level, with limited standardized outcomes, patient-reported measures, and long-term follow-up.</div></div><div><h3>Conclusion</h3><div>An anatomy-based, layer-specific approach can enhance predictability and safety for infraorbital–midcheek rejuvenation, but current recommendations are largely experience-driven. Future work should prioritize controlled clinical validation, complication registries, and population-specific optimization of technique with robust, quantitative and patient-centered outcomes.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 626-637"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to ‘Horizontal versus vertical scapular free flap reconstructions in total maxillectomies without orbital exenteration—a systematic review and clinical case series’ [JPRAS Open. 2025;46:534–550]","authors":"Eleonora O.F. Dimovska ,&nbsp;Francina W. Cobben ,&nbsp;Andreas Thor ,&nbsp;Andrés Rodriguez-Lorenzo","doi":"10.1016/j.jpra.2025.11.030","DOIUrl":"10.1016/j.jpra.2025.11.030","url":null,"abstract":"","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Page 403"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145836428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"V-Y advancement flap technique for severe cicatricial lower eyelid ectropion: A case report and outcome assessment","authors":"Donghao Yu ,&nbsp;Zeming Zhao ,&nbsp;Jianhua Xu","doi":"10.1016/j.jpra.2025.10.020","DOIUrl":"10.1016/j.jpra.2025.10.020","url":null,"abstract":"<div><div>A 63-year-old male with severe cicatricial lower eyelid ectropion was treated with the V-Y advancement flap technique. This method alters lateral tension to counteract excessive longitudinal tension, effectively correcting ectropion caused by scar traction. The V-Y technique not only simplifies surgical incision design with minimal risk of flap failure but also demonstrates the efficiency and flexibility of tension redistribution. Compared to full-thickness skin grafts or other flap techniques, it provides superior aesthetics and a more natural appearance. This technique serves as a valuable alternative and expands treatment options for cicatricial lower eyelid ectropion.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 36-40"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new treatment algorithmic for congenital contracture of the ulnar digits-based on pathological classification","authors":"Peng Xu ,&nbsp;Fang Lin ,&nbsp;HaiFeng Shi ,&nbsp;YongJun Rui","doi":"10.1016/j.jpra.2025.10.018","DOIUrl":"10.1016/j.jpra.2025.10.018","url":null,"abstract":"<div><h3>Objective</h3><div>To explore a new algorithmic treatment for Congenital Contracture of the Ulnar Digits based on pathological classification.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed on 7 patients with Congenital contracture of the ulnar digits who were admitted and treated from 2019 to 2024, and their clinical characteristics were summarized. During the final follow-up visit, the patients’ finger joint range of motion and flexor digitorum profundus muscle strength were evaluated. Hand function was assessed utilizing the hand function rating criteria established by Wang et al., while the patients’ overall satisfaction was surveyed.</div></div><div><h3>Results</h3><div>All 7 patients completed the scheduled follow-up, with durations ranging from 6 to 74 months and a mean of 26 months. All patients achieved primary wound healing, and no adverse events or complications were documented. At the final follow-up visit, with their wrists maintained in a neutral position, all patients exhibited active extension of the affected fingers to 0° without residual tension, while all digits demonstrated unimpeded flexion. Muscle strength assessment of the flexor digitorum profundus revealed that 5 patients attained Grade 5, with the remaining 2 patients rated at Grade 4. Furthermore, hand function evaluation yielded the following findings: 5 cases were categorized as \"excellent\" and 2 as \"good,\" resulting in an excellent-to-good rate of 100 %. All patients expressed satisfaction with both the functional recovery of their hands and the cosmetic outcome.</div></div><div><h3>Conclusion</h3><div>Congenital contracture of the ulnar digits can be classified into three pathological subtypes—osteophyte subtype, fibrosis subtype and mixed subtype—through the combination of clinical evaluation and surgical exploration. By adopting different treatment algorithms for different pathological subtypes and providing professional rehabilitation therapy, patients can achieve favorable therapeutic outcomes.</div></div><div><h3>Evidence level</h3><div>Level IV</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 155-162"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145691464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}