JPRAS Open最新文献

{"title":"Letter to the editor regarding “Effectiveness of injected versus topically applied platelet-rich plasma in diabetic foot ulcers: A randomized controlled trial with clinical and histopathological assessment”","authors":"Xiuli Li, Yanwei Sun","doi":"10.1016/j.jpra.2025.10.032","DOIUrl":"10.1016/j.jpra.2025.10.032","url":null,"abstract":"","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 18-19"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145580227","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":"Medical management of acute partial skin necrosis following nipple-sparing mastectomy using an M101-based oxygenating dressing: Two case reports","authors":"Martin Lhuaire ,&nbsp;Victor Pozzo ,&nbsp;Enrica Bentivegna ,&nbsp;Henri Azais ,&nbsp;Tamer Awan ,&nbsp;Ignacio Garrido ,&nbsp;Laurent Lantieri","doi":"10.1016/j.jpra.2025.12.008","DOIUrl":"10.1016/j.jpra.2025.12.008","url":null,"abstract":"<div><div>Postmastectomy skin-flap necrosis after nipple-sparing mastectomy (NSM) is common and exceeds rates after skin-sparing mastectomy (SSM) (0–19.5 %), influenced by patient factors and modifiable intraoperative variables. Presentations range from superficial necrosis to full-thickness necrosis requiring surgical debridement. These events drive reoperation or implant loss, may delay adjuvant therapy, and burden patients psychologically. Clinical examination and ancillary tests poorly discriminate depth; thus, management usually entails close observation until demarcation, followed by targeted intervention. M101, a hemoglobin-based oxygen carrier, demonstrates anti–ischemia–reperfusion effects and promise in advanced wounds. We report two NSM cases with partial skin-flap and nipple–areola complex necrosis managed with an M101-based oxygenating dressing (HemHealing®; Hemarina SA, Morlaix, France), with ultimately no surgical debridement required.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 434-437"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883767","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":"Ultrasound-guided injection of ankle contouring with botulinum neurotoxin","authors":"Kyu-Ho Yi ,&nbsp;Jin-Hyun Kim ,&nbsp;Jong-Keun Song ,&nbsp;Jeremy B. Green ,&nbsp;Thomas Rappl ,&nbsp;Michael H. Gold ,&nbsp;Jeongho Sohn ,&nbsp;Benjamin Ascher ,&nbsp;Roya Zarmehr Zamin ,&nbsp;Rosa Sigrist ,&nbsp;Ximena Wortsman","doi":"10.1016/j.jpra.2025.11.034","DOIUrl":"10.1016/j.jpra.2025.11.034","url":null,"abstract":"<div><h3>Background</h3><div>A slim ankle is considered a hallmark of beauty in modern aesthetics. Excessive muscular hypertrophy, particularly of the deep calf muscle (soleus), can lead to a thick ankle appearance that detracts from an overall refined leg contour. Although surgical approaches have been used historically, they carry risks such as scarring, contracture, and unpredictable outcomes.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the efficacy and safety of ultrasound-guided botulinum toxin type A (JETEMA THE TOXIN, JETEMA Co., Ltd. Korea) injections for improving ankle contour in patients with thick ankles.</div></div><div><h3>Methods</h3><div>Three adult female patients with noticeably hypertrophic calf muscles underwent ultrasound-guided injection of 20 units of botulinum toxin into the soleus muscles. Needles were inserted with ultrasound guidance to ensure precise real-time visualization and accurate injection into the soleus muscles. Ankle circumference and soleus muscle thickness were measured pre-treatment and at 8 weeks post-treatment using standardized methods. Wilcoxon signed-rank test was applied to evaluate statistical significance.</div><div>The manuscript was checked against the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist (Supplemental Appendix).</div></div><div><h3>Results</h3><div>All patients exhibited a reduction in ankle circumference (approximately 6.7–7.1 %) and soleus muscle thickness (around 14–15 %) at the 8-week follow-up. The Wilcoxon test revealed statistically significant differences (<em>p</em> = 0.001) between pre- and post-treatment values. Visual assessment of photographic records further confirmed a noticeably slimmer and more refined ankle contour.</div></div><div><h3>Conclusion</h3><div>Ultrasound-guided botulinum toxin injections appear to be a safe and effective minimally invasive approach for ankle contouring, achieving clinically meaningful reductions in muscle bulk with high patient satisfaction.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 425-433"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883905","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":"Innovative septum suspension technique with a cantilever graft for effective keystone region reconstruction","authors":"Saori Yamazumi ,&nbsp;Naoko Takeuchi ,&nbsp;So Moriyama ,&nbsp;Nobuyoshi Otori ,&nbsp;Takeshi Miyawaki","doi":"10.1016/j.jpra.2025.10.031","DOIUrl":"10.1016/j.jpra.2025.10.031","url":null,"abstract":"<div><h3>Background</h3><div>Saddle nose deformity caused by disruption of the keystone area remains surgically challenging. We developed a septum suspension technique using a rib bone cantilever graft to restore keystone continuity and improve airflow.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 41 consecutive cases (2016–2024) undergoing the suspension technique. Deformity type, etiology, concomitant procedures, complications, and CT findings were recorded. Outcomes included visual analogue scale (VAS) scores for nasal ventilation and appearance, and radiological evaluation of graft integrity. Paired analyses were conducted at 12 months using Wilcoxon tests, Hodges–Lehmann estimates, effect sizes, and sensitivity analysis (≥6 months).</div></div><div><h3>Results</h3><div>The cohort comprised 31 men and 10 women (mean age 38.5 years). Ventilation VAS improved from 2.0 to 9.0 (HL +7.0; <em>p</em> &lt; 0.01) in nine paired cases, with very large effect sizes (Hedges’ g = 3.01). All patients achieved the minimal clinically important difference (MCID). Appearance VAS improved from 3.0 to 10.0 in four paired cases (HL +7.0), with all reaching MCID, though underpowered for significance. Sensitivity analyses confirmed consistent improvements. Complications occurred in five patients (trauma, <em>n</em> = 1; screw loosening, <em>n</em> = 3; hypertrophic donor-site scarring, <em>n</em> = 1). No pneumothorax or infection was observed.</div></div><div><h3>Conclusions</h3><div>Septum suspension with a rib-bone cantilever graft provided substantial and robust improvement in nasal ventilation, with aesthetic gains also observed. The technique was particularly useful in post-septoplasty saddle nose. Despite limitations of sample size and incomplete follow-up, findings suggest this method is a safe and effective option warranting validation in larger prospective studies.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 373-385"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790784","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":"Mitigating facial nerve injury risks in aesthetic surgery: A narrative review of surgical practices and anatomicsal challenges","authors":"Abdallah Abushehab ,&nbsp;Sean Huu-Tien Nguyen ,&nbsp;Jordan Sauve ,&nbsp;Pravin Meshram ,&nbsp;Daniah ALNafisee ,&nbsp;Victor Vakayil ,&nbsp;Warren Schubert ,&nbsp;Raeesa Kabir ,&nbsp;Neej Patel ,&nbsp;Andrew Fazio ,&nbsp;Anthony J Weinhaus ,&nbsp;James Harmon Jr.","doi":"10.1016/j.jpra.2025.10.026","DOIUrl":"10.1016/j.jpra.2025.10.026","url":null,"abstract":"<div><div>Facial nerve injuries pose challenges in cosmetic surgery. We comprehensively reviewed the anatomy of the facial nerve, with a focus on its five major branches—temporal, zygomatic, buccal, marginal mandibular, and cervical— and explored the clinical implications of nerve injuries during cosmetic procedures. Surgical damage to any branch of the facial nerve can lead to functional impairments, including facial asymmetry, impaired eye closure, speech difficulties, and reduced oral competence. Furthermore, aesthetic consequences, including facial drooping and altered appearance, can profoundly affect patients' psychological well-being. This review provides a detailed discussion of strategies for preventing nerve injury, including surgical techniques and landmark identification that underscores the importance of meticulous preoperative planning and intraoperative execution. This review highlights the importance of comprehensive anatomical knowledge in optimizing patient safety and satisfaction in facial cosmetic surgery.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 41-55"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624266","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":"Refractory chronic seroma following latissimus dorsi flap breast reconstruction successfully treated by surgical excision: A case report","authors":"Taejung Kim ,&nbsp;Yushi Suzuki ,&nbsp;Masahiro Toriumi ,&nbsp;Junji Takano","doi":"10.1016/j.jpra.2025.11.006","DOIUrl":"10.1016/j.jpra.2025.11.006","url":null,"abstract":"<div><div>Chronic seroma is a common complication following latissimus dorsi (LD) flap breast reconstruction, but prolonged, treatment-resistant cases are rare. We report a case of a refractory seroma that developed in the early postoperative period and persisted for over four years despite 79 aspirations (including 37 combined with corticosteroid injections and 5 minocycline sclerotherapy sessions). The patient eventually underwent surgical excision of the fibrous capsule at 48 months postoperatively, with the assistance of intraoperative indigo carmine dye to facilitate accurate capsule delineation. Histopathology revealed a dense fibrous wall with chronic inflammation, and no malignancy or infection. Postoperatively, a compression garment was used for six months. At 16-month follow-up, there was no recurrence. This case highlights the importance of early recognition and surgical consideration in managing chronic seromas unresponsive to conservative therapy. Surgical excision combined with compression may achieve excellent long-term outcomes and improve patient quality of life.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 117-122"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624300","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 modified no vertical scar technique in gender reassignment mastectomy: A description and case report","authors":"Roberto Grella ,&nbsp;Marcello Molle ,&nbsp;Raffele Rainone ,&nbsp;Maria Maddalena Nicoletti ,&nbsp;Francesco Paolo Gesuete ,&nbsp;Giovanni Francesco Nicoletti","doi":"10.1016/j.jpra.2025.12.026","DOIUrl":"10.1016/j.jpra.2025.12.026","url":null,"abstract":"<div><h3>Background and introduction</h3><div>Surgical interventions, such as mastectomies, play a key role in gender affirmation for female-to-male (FtM) transitions, helping to improve psychological well-being. This article explores a modified FtM mastectomy technique that minimizes scarring and maintains NAC integrity.</div></div><div><h3>Materials and methods</h3><div>A 28-year-old transgender male underwent chest masculinization surgery using an inferior pedicle technique. This approach aimed to reduce scarring by avoiding vertical incisions, while preserving the NAC. Liposuction was performed in the upper quadrants to further enhance the masculinization effect. The NAC was repositioned to approximate male chest proportions, with postoperative follow-ups conducted to assess healing and outcomes.</div></div><div><h3>Results</h3><div>The patient’s postoperative recovery was smooth, with no complications. At follow-up, the patient reported high satisfaction with the surgical outcomes, and the TRANS-Q scores demonstrated substantial psychological and social improvements.</div></div><div><h3>Discussion and conclusion</h3><div>Chest masculinization is critical for FtM patients, enhancing self-image and social confidence. The inferior pedicle technique preserves NAC sensitivity and minimizes scarring. This approach represents a promising option for medium to large chest sizes, supporting both aesthetic goals and long-term satisfaction.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 658-661"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037065","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":"Panel evaluation of esthetic result after chest masculinization: Reliability and comparison with patient-reported satisfaction","authors":"Mirjam Saarinen,&nbsp;Sinikka Suominen,&nbsp;Maija Kolehmainen,&nbsp;Kaisu Ojala","doi":"10.1016/j.jpra.2025.11.018","DOIUrl":"10.1016/j.jpra.2025.11.018","url":null,"abstract":"<div><div>Chest masculinization is the most common surgical intervention in transgender men. Patient-reported satisfaction is generally good, but we lack other tools for evaluation of the postoperative result and knowledge about the surgeons understanding of a desirable result. Panel evaluation of the esthetic result has been used widely in other surgical areas. However, regarding chest masculinization, the use of panel evaluation is limited. This study aims to evaluate esthetic postoperative result after chest masculinization by an expert panel and to assess the reliability of panel evaluation. Furthermore, we aim to compare the panel evaluation with patient-reported satisfaction. The data comprised all patients receiving chest masculinization from 2005 to 2018 with sufficient postoperative images. Sufficient images were found for 48 patients, 26 of whom filled in the patient-reported outcome tool BODY-Q Chest Module. The esthetic result was evaluated by a six-person expert panel. On a scale from 1 (worst) to 4 (best), panelists’ overall score yielded a median of 3.2. Inter-rater reliability was low. Scores given by female and male panelists did not differ significantly. When evaluating items scored by both the panelists and the patients, no significant correlation emerged. We conclude that the esthetic result after chest masculinization is generally good. However, even professionals lack a consensus on the desired result. The panel evaluation in this study proved to be unreliable, but due to biases in patient-reported outcomes, we call for the development of a validated clinician-reported tool for assessment of esthetic result after chest masculinization.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 238-248"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737480","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":"Optimising the unilateral DIEP flap breast reconstruction: A United Kingdom-Netherlands multi-centre comparative study","authors":"Maximilian Jacobi ,&nbsp;Petko Shtarbanov ,&nbsp;Punn Tannirandorn ,&nbsp;Zahra Ahmed ,&nbsp;Stephen Hamilton ,&nbsp;Shadi Ghali ,&nbsp;Afshin Mosahebi ,&nbsp;Sophie Riesmeijer ,&nbsp;Dariush Nikkhah ,&nbsp;Hinne Rakhorst","doi":"10.1016/j.jpra.2026.01.014","DOIUrl":"10.1016/j.jpra.2026.01.014","url":null,"abstract":"<div><h3>Background</h3><div>The deep inferior epigastric perforator (DIEP) flap represents the gold standard in autologous breast reconstruction; however, it is restricted by prolonged operative duration and substantial demands on inpatient capacity. We compared postoperative outcomes across international centres with differing surgical models and perioperative pathways.</div></div><div><h3>Methods</h3><div>A retrospective, two-centre cohort study was undertaken of unilateral DIEP flap reconstructions performed in the United Kingdom (UK) and the Netherlands (NL). The UK cohort (2018–2022) utilised a single-surgeon model with an enhanced recovery after surgery (ERAS) pathway, whereas the NL cohort (2013–2019) employed a co-surgeon model and lean optimisation without ERAS protocols. Patient demographics, operative characteristics, and postoperative complications were compared. Outcomes were analysed by complication severity (Clavien–Dindo), timing (&lt;30 vs. ≥30 days), and potential predictors.</div></div><div><h3>Results</h3><div>The cohort included 203 patients (203 flaps): 103 from the UK and 100 from NL. Immediate reconstruction predominated in the UK (70% vs. 1%, <em>P</em> &lt; 0.001). Mean operative times were longer in the UK (464 vs. 330 min, <em>P</em> &lt; 0.001), yet length of stay was shorter (4.8 vs. 5.9 days, <em>P</em> &lt; 0.001). Overall complication rates were comparable (61% UK vs. 56% NL). Prolonged operative time predicted early minor complications in the UK cohort and was associated with late minor complications in UK-NL combined analyses. Increased BMI, chemotherapy, radiotherapy, and immediate reconstruction variably predicted fat necrosis and minor complications, while prior abdominal surgery was associated with late re-operation in NL. Flap loss rates (4–7%) were equivalent.</div></div><div><h3>Conclusions</h3><div>The present study demonstrates that operative workflow, case-mix, and perioperative pathways may influence efficiency and complication profiles without altering flap survival. Pragmatic improvements include ERAS implementation, co-surgeon operating, lean optimisation, and tailored planning for higher-risk patients.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 746-758"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182860","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 simple solution for a difficult location: Reconstruction of the cymba concha and helical crus using the pre-auricular skin","authors":"Manal IA Patel ,&nbsp;Emily Dunne ,&nbsp;Fatima Aloraifi ,&nbsp;Magelia Kitcat","doi":"10.1016/j.jpra.2026.01.037","DOIUrl":"10.1016/j.jpra.2026.01.037","url":null,"abstract":"<div><div>Reconstruction of preauricular defects, particularly those involving the cymba concha and helical crus with exposed auricular cartilage, presents a notable challenge due to limited local tissue availability and the cosmetic significance of the auriculofacial junction. The rhomboid (Limberg) flap is a simple and geometrically precise transposition flap that recruits adjacent skin with favorable laxity and allows scars to be placed along relaxed skin tension lines. We present two patients with small preauricular defects involving the helical crus following excision of non-melanoma skin cancers. In both cases, defects extended to the perichondrium with focal cartilage exposure and were reconstructed using a rhomboid flap designed within the adjacent preauricular skin. This case series demonstrates that the rhomboid flap is a reliable, reproducible and aesthetically favorable option for reconstruction of preauricular and helical crus defects, offering an effective balance between simplicity, structural preservation and cosmetic outcome in this anatomically complex region.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 976-979"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147311021","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}