JPRAS Open最新文献

{"title":"Enhancing microvascular anastomoses with the Synovis Coupler device: A retrospective analysis of management of vascular diameter discrepancies","authors":"Sergio Razzano ,&nbsp;Carlo Petroccione ,&nbsp;Domenico Mariniello ,&nbsp;Marcello Molle ,&nbsp;Francesca La Torre ,&nbsp;Ilaria Mataro ,&nbsp;Vincenzo Manfellotto","doi":"10.1016/j.jpra.2025.11.010","DOIUrl":"10.1016/j.jpra.2025.11.010","url":null,"abstract":"<div><h3>Background and Introduction</h3><div>Microvascular surgery enables complex tissue repairs with free flaps. The Synovis Coupler has streamlined venous anastomoses, improving speed and precision. However, size discrepancies between donor and recipient vessels continue to cause postoperative complications. This study presents our experience in managing caliber discrepancies, optimizing venous flow, reducing thrombosis risk, and improving free flap survival.</div></div><div><h3>Material and Methods</h3><div>This retrospective observational study analyzed data from patients undergoing free flap reconstruction between January 2018 and January 2024. A total of 84 microvascular free tissue transfers and 86 venous anastomoses were performed using a mechanical coupler system.</div></div><div><h3>Results</h3><div>Eighty-six venous anastomoses were completed, averaging 3.25 min each, with an average coupler size of 2.34 mm. No postoperative returns to the operating room or anastomosis revisions were required. Complications included one infection and one hematoma, both resulting in flap necrosis. The average follow-up was 1.7 years, with no cases of venous ischemia.</div></div><div><h3>Discussion and Conclusion</h3><div>Our experience suggests that adapting the vessel lumen may represent a practical option for managing diameter discrepancies when using couplers. The approach appeared to reduce the need for grafts and allowed efficient anastomosis. However, the retrospective design, limited sample size, and lack of a comparative group constrain the strength of these findings. Further prospective studies are warranted to confirm whether this method offers a consistent advantage over established techniques.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 132-136"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145691458","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":"Combined use of rubber bands and patient’s own hair to optimize scalp surgical field exposure and secure wound dressings","authors":"Jin-Yuan Ma,&nbsp;Ya-Di Li,&nbsp;Xi Chen,&nbsp;Yu-Rong Li","doi":"10.1016/j.jpra.2025.11.023","DOIUrl":"10.1016/j.jpra.2025.11.023","url":null,"abstract":"","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 234-237"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737512","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":"Clinical features, evaluation, and management of speech and swallow complications of facial paralysis: A scoping review","authors":"Mia Vargo ,&nbsp;Peng Ding ,&nbsp;Michelle E. Adessa ,&nbsp;Radhika Duggal ,&nbsp;Ravi Dhamija ,&nbsp;Yiqing Tang ,&nbsp;Trisha Shang ,&nbsp;Katherine Wang ,&nbsp;Mary Schleicher ,&nbsp;Dane J. Genther ,&nbsp;Patrick J. Byrne","doi":"10.1016/j.jpra.2025.10.013","DOIUrl":"10.1016/j.jpra.2025.10.013","url":null,"abstract":"<div><h3>Objective</h3><div>Facial paralysis may lead to complications such as dysarthria, oral residue during deglutition, dysphagia, and sialorrhea. Literature regarding the assessment and treatment of these complications in patients with facial paralysis has historically been limited. However, there continues to be new evidence in this field that aims to fill the gaps in our current understanding of this condition and its implications for patients. The primary aim of this study was to analyze the current literature regarding the effect of facial paralysis on speech and oral competence, discuss treatment options, and assess implications for the future.</div></div><div><h3>Data Sources</h3><div>Ovid® Medline ALL, Ovid Embase, and Cochrane Library from Wiley.</div></div><div><h3>Review methods</h3><div>A scoping review of the literature was conducted to investigate the effects of facial paralysis on speech and oral competence, as well as current evaluation and treatment methods in adult populations. Studies were assessed based on set inclusion criteria relevant to the goals of the review.</div></div><div><h3>Conclusion</h3><div>Facial paralysis may lead to various speech and swallowing challenges. Numerous assessment tools and treatment options exist for facial paralysis, however, evidence regarding their effectiveness in managing oral complications is limited.</div></div><div><h3>Implications for practice</h3><div>There is a need for consideration as well as standardization of the effect of facial paralysis on speech, swallowing, and saliva management. It may be reasonable to consider the inclusion of a speech language pathologist on the care team allowing for the early assessment of oral complications related to communication and deglutition. Additionally, there is need for both subjective and objective evaluation methods throughout the care timeline. Utilizing a broader interdisciplinary approach to management could potentially improve both patient outcomes and experience.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 337-349"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790787","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":"Delayed-onset functional ischemia 16 years after digital replantation: A Raynaud’s-like vasospasm case report","authors":"Ziyu Wu,&nbsp;Yixin Ren,&nbsp;Zhen Liang,&nbsp;Baoqiang Song","doi":"10.1016/j.jpra.2026.01.018","DOIUrl":"10.1016/j.jpra.2026.01.018","url":null,"abstract":"<div><div>Reports of long-term complications following finger replantation are scarce. Vascular crises occurring more than a decade after surgery are particularly rare. We present the case of a 27-year-old male who developed with acute cyanosis and reduced skin temperature of the left index finger, occurring 16 years after digital replantation. The patient had undergone replantation of the left index and middle fingers in childhood. He reported chronic smoking and frequent cold-water exposure prior to symptom onset. Imaging demonstrated narrowing of the proper palmar digital artery of the index finger, with diminished distal perfusion and no evidence of mechanical obstruction. Ambulatory blood pressure monitoring revealed uncontrolled hypertension (141/101 mmHg). Based on his risk factors and imaging findings, a diagnosis of vasospastic ischemia, consistent with a Raynaud’s-like phenomenon likely triggered by tobacco use and cold exposure, was made. The patient responded well to infrared thermotherapy and vasoactive agents (nifedipine, bisoprolol, and beraprost sodium), with complete resolution of symptoms. This case highlights that replanted digits, due to incomplete reconstruction of the microvascular network, may remain vulnerable to vasospastic insults even many years later. It underscores the importance of lifelong risk mitigation, particularly the avoidance of reversible triggers such as smoking and cold exposure.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 868-872"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187711","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":"Anatomy of the prepuce of the clitoris: Introducing the collar of the clitoris, a novel anatomical subdivision of the clitoral prepuce","authors":"Matthew J. Zdilla","doi":"10.1016/j.jpra.2026.01.016","DOIUrl":"10.1016/j.jpra.2026.01.016","url":null,"abstract":"<div><div>The anatomy of the clitoral prepuce is surgically important, especially as female genital mutilation remains common and genital plastic, reconstructive, and aesthetic surgeries are performed with increasing frequency. Despite its surgical importance, basic anatomical study of the clitoral prepuce has been limited, and confusion exists regarding the fundamental gross anatomical structure of the prepuce. This study identifies novel anatomical structures of the clitoral prepuce including a distinct band of preputial tissue located around the neck of the clitoris, a structure which has not yet been described in the literature. The aforementioned structure, referred to here as the collar of the clitoris, was assessed through a review of digital images taken of 141 donor bodies. The presence of the collar was confidently identified in images of 130:141 bodies (80:83 unembalmed donor bodies; 50:58 embalmed donor bodies); the absence of the collar was confidently identified in 0:141; and the presence/absence of the collar was unclear in 11:141 (3:83 unembalmed donor bodies; 8:58 embalmed donor bodies). Thus, the collar of the clitoris was present in ≥92.2% of donor bodies and absent in ≤7.8%. This report posits that the typical clitoral prepuce consists of two main components: a superficial clitoral hood and an underlying clitoral collar. Further, this report presents a method for characterization of preputial anatomical variation by means of considering the clitoral collar as a fundamental anatomical structure. This study improves the understanding of the clitoral prepuce and has important implications for genital plastic, reconstructive, and aesthetic surgeries.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 846-856"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187712","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 systematic review and meta-analysis of the morbidity of the donor-site of flaps harvested based on the first intermetatarsal artery","authors":"Virginia E Knutson ,&nbsp;Giorgio Pajardi ,&nbsp;Giulia Del Vecchio ,&nbsp;Macarena Vizcay ,&nbsp;Stephanie Hili ,&nbsp;Francesco Zanchetta ,&nbsp;Luigi Troisi","doi":"10.1016/j.jpra.2026.01.009","DOIUrl":"10.1016/j.jpra.2026.01.009","url":null,"abstract":"<div><h3>Background</h3><div>Free tissue flaps from the foot have become an increasingly reliable tool in modern reconstructive surgery; however, the field lacks an empirical analysis focused on donor-site morbidity. This systematic review and meta-analysis aimed to evaluate the incidence of donor-site morbidity following dorsalis pedis and free toe flap harvest.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis was performed according to the PRISMA guidelines. A systematic search of PubMed, Embase, CENTRAL, and <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> was performed on March 3, 2025, to identify eligible studies involving adults who underwent free flap harvest from the toes or dorsum of the foot and reported postoperative donor-site morbidity outcomes. Eligible designs included case series (≥5 patients), observational studies, randomized controlled trials, and controlled clinical trials published in English. Letters, reviews, editorials, conference abstracts, and animal and cadaveric studies were excluded. Two reviewers independently screened studies, extracted data, and assessed bias.</div></div><div><h3>Results</h3><div>We included 394 cases of free flap harvest (three studies on dorsalis pedis flaps and 11 on toe flaps) across 14 studies published between 2000 and 2025. The percentage of patients experiencing objective and subjective donor-site morbidity was 2.99% and 3.32% respectively. Wound dehiscence, delayed healing, and hematoma were the most common objective complications, while daily life disturbance, pain, and numbness occurred most frequently in the subjective morbidity domain.</div></div><div><h3>Conclusions</h3><div>The occurrence of donor-site morbidity is relatively low, although substantial heterogeneity limits the strength of these results. This review offers comprehensive insights into donor-site morbidity of foot free flaps, aiming to improve patient and physician awareness.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 884-901"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187713","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":"Experience with injectables performed at a resident department Aesthetic Surgery Clinic","authors":"Carter J. Boyd,&nbsp;Hani Y. Nasr,&nbsp;Michael F. Cassidy,&nbsp;Zachary M. Borab,&nbsp;Neil M. Vranis,&nbsp;Alexis K. Gursky,&nbsp;Rebecca Gober,&nbsp;Barry M. Zide,&nbsp;Daniel J. Ceradini","doi":"10.1016/j.jpra.2026.01.015","DOIUrl":"10.1016/j.jpra.2026.01.015","url":null,"abstract":"<div><h3>Background</h3><div>The popularity and rapid growth of aesthetic injectables, in conjunction with the influx of competing specialties performing these procedures, underscores the importance of competence of plastic surgery residents and rigorous modalities of plastic surgery training.</div></div><div><h3>Objectives</h3><div>Our objective was to review injectables and outcomes from our plastic surgery resident aesthetic clinic. Outcomes and costs were compared to national averages and reports from the literature.</div></div><div><h3>Methods</h3><div>A retrospective chart review identified all adult injectable patients at the Resident Aesthetic Surgery Clinic at NYU Langone Health in 2021. Patient demographics, procedural data, complications, touch-ups, and surgeon fees were compiled. Factors predictive of return patronage were investigated as well. Data were analyzed and visualized in R.</div></div><div><h3>Results</h3><div>In 2021, 223/233 consultations led to an injection (95.7% conversion rate) for 148 patients. Neurotoxin was most commonly injected into the upper face, while fillers were most commonly injected into the midface. Two complications from fillers (0.9% complication rate) and one touch-up (0.4% touch-up rate) were recorded. Surgeon fees were substantially less than national averages and comparable to other academic settings. Patients who received filler only at their first visit were significantly less likely to be return patrons in the same year.</div></div><div><h3>Conclusions</h3><div>These data represent the largest and most detailed annual report of injectables from a plastic surgery resident aesthetic clinic, demonstrating high volume, low complication and revision rates, and reasonable costs to patients. Altogether, our study supports resident aesthetic clinics as a robust training modality.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 735-745"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182903","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":"Effect of abdominoplasty with transverse plication on rectus diastasis","authors":"Jordi Descarrega ,&nbsp;Joan Fontdevila ,&nbsp;Marta Suñer ,&nbsp;Ferran Escrigas ,&nbsp;Héctor Oyonate ,&nbsp;Erica Segura ,&nbsp;Albert Castro ,&nbsp;Karam Yousef","doi":"10.1016/j.jpra.2026.01.047","DOIUrl":"10.1016/j.jpra.2026.01.047","url":null,"abstract":"<div><div>Transverse plication (TP) abdominoplasty has gained popularity in recent years, as it is the keystone step of the TULUA procedure. This technique can achieve excellent contour results and reduce complications. However, the effect of TP on diastasis recti abdominis (DRA) remains uncertain. This study is the first specific research designed to investigate the effect of TP on the inter-recti distance (IRD). Two different strategies were defined for this purpose. The first is a prospective self-controlled case series study with ultrasound evaluation on 16 consecutive post-bariatric patients; the second is based on cadaveric surgery on three specimens. The average IRD reduction after TP in the study was 0.6 cm and 0.7 cm for the two defined measurement points (representing 26% and 28% of the preoperative IRD, respectively). The reduction in IRD after TP was statistically significant. The mean IRD reduction after TP in the three cadaveric specimens was 0.7 cm (25% of the preoperative IRD). If DRA is defined as 2 cm at any IRD point, TP abdominoplasty can correct DRA when the preoperative inter-recti distance is less than 2.5 cm, or between 2.5 and 3 cm in the absence of visceral fat obesity. In conclusion, although TP abdominoplasty reduces IRD, we recommend longitudinal plication abdominoplasty (either isolated or combined with transverse plication) when the IRD exceeds 3 cm, is between 2.5 and 3 cm in the presence of visceral fat obesity, or when complete approximation of the medial edges of the rectus abdominis is desired.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 933-944"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285604","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":"Quality and accessibility of online patient self-education resources for breast reconstruction","authors":"Arashk Ghasroddashti ,&nbsp;Colm Guyn ,&nbsp;Yonatan Fortinsky ,&nbsp;Robert Wesley Edmunds ,&nbsp;Glykeria Martou","doi":"10.1016/j.jpra.2025.12.022","DOIUrl":"10.1016/j.jpra.2025.12.022","url":null,"abstract":"<div><h3>Background</h3><div>With rising interest in breast reconstruction after mastectomy, patients are increasingly turning to online resources to supplement medical consultations. However, the quality and accessibility of these materials remain inconsistent. This study evaluates the readability, understandability, actionability, content coverage, and transparency of online breast reconstruction resources.</div></div><div><h3>Methods</h3><div>The top 20 Google search results were examined for five common breast reconstruction-related queries. Metrics assessed included SMOG readability level, PEMAT scores (understandability and actionability), content coverage, and a modified EQIP score for quality. Statistical analyses examined relationships among these variables and with factors like search rank, author type, and query.</div></div><div><h3>Results</h3><div>Mean content coverage was 49 %, with significant gaps in preoperative planning, treatment side effects, and fat grafting. Readability was poor (mean SMOG 12.3). Understandability was high (80 %), but actionability (37 %) and quality (modEQIP of 40 %) were low. Academic authors produced shorter and lower-quality resources. Higher-ranked resources were generally longer and correlated with better performance across most metrics. Specific queries like ‘DIEP flap’ yielded narrower, lower-quality resources.</div></div><div><h3>Conclusions</h3><div>Online resources for breast reconstruction are highly variable and often fall short in readability, comprehensiveness, and transparency. Although understandability is generally acceptable, low actionability and inconsistent coverage hinder patient utility. Search engine rank modestly correlates with quality, suggesting some alignment between visibility and value. Improving these resources will require targeted efforts to simplify language, address topic gaps, and enhance actionable content—especially for specialized queries where quality remains lowest.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 500-513"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924664","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 rare case of supinator syndrome caused by osteofibrous dysplasia of the radius","authors":"Johannes C. Heinzel ,&nbsp;Luisa Lange ,&nbsp;Julia Wittlinger ,&nbsp;Natalie Winter ,&nbsp;Vladyslav Kavaka ,&nbsp;Adrien Daigeler ,&nbsp;Jonas Kolbenschlag ,&nbsp;Henrik Lauer","doi":"10.1016/j.jpra.2025.12.023","DOIUrl":"10.1016/j.jpra.2025.12.023","url":null,"abstract":"<div><div>We report the case of a 57-year-old male who presented to our emergency room due to progressive paresis of the muscles innervated by the deep branch of the radial nerve in the right forearm. The patient suffered from osteofibrous dysplasia and an x-ray revealed the polyostotic disease had also affected his radius. High resolution ultrasound revealed that an exostosis of the radius had caused compression of the posterior interosseous nerve unusually distally in the supinator tunnel. The patient underwent nerve decompression and recovered full strength in his wrist-, and finger extensors approximately 9 months postoperatively. This case report illustrates a case of a rare disease, i.e. osteofibrous dysplasia of the radius, in conjunction with the first published report of an unusually located nerve compression syndrome, i.e. supinator syndrome, caused by this very disease.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 613-618"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976294","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}