JPRAS Open最新文献

{"title":"A needle in a haystack: Assessing the radiographic detectability of microsurgical suture needles using a human cadaveric model","authors":"Lukas P. O’Brien ,&nbsp;Kasie O’ Reilly ,&nbsp;Mary Ellen McMahon ,&nbsp;Antonina Tcacenco ,&nbsp;Ronan Cahill ,&nbsp;Barry O’Sullivan ,&nbsp;Shirley M. Potter","doi":"10.1016/j.jpra.2026.01.033","DOIUrl":"10.1016/j.jpra.2026.01.033","url":null,"abstract":"<div><div>Intraoperative loss of surgical needles represents a rare but significant challenge in operative settings, particularly in microsurgical procedures involving free tissue transfer where fine sutures (8–0 to 10–0) are employed. Current hospital protocols typically use intraoperative portable radiography to localize misplaced needles. However, the diagnostic utility of X-ray imaging in detecting small-caliber needles remains poorly defined.</div><div>Following ethical approval, a cadaveric study was conducted using a range of monofilament Ethilon™ needles (3–0 to 10–0 caliber), which were inserted at four anatomically relevant surgical sites. Anteroposterior radiographs were obtained using a standard intraoperative C-arm. A total of 53 participants - including consultant surgeons, radiology trainees, nursing staff, and surgical registrars—were asked to identify needle number and location using blinded image review. Radiographic identification of needles was accurate for calibers 3–0, 4–0, 5–0, and 6–0, with identification rates approaching or exceeding 99%. Smaller needle calibers showed a dramatic decline in detection accuracy. The 8–0 needles were correctly localized in 3.77% of attempts, just one 9–0 needle was successfully identified. None of the 10–0 needles were detected across all anatomical sites.</div><div>While portable radiography remains a reliable modality for locating surgical needles of caliber 3–0 to 6–0, it proves ineffective for the detection of finer microsurgical needles (≥8–0). These results have important implications for operative protocols and clinical decision-making. The routine X-ray imaging in cases of microsurgical needle loss warrants reconsideration to favor evidence-informed strategies that minimize intraoperative delays, prolonged anesthesia and unnecessary radiation exposure.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 965-975"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285543","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":"Corrigendum to “Utility of the caprini risk assessment model in guiding venous thromboembolism prophylaxis after abdominoplasty” [JPRAS Open 46 (2025) 305–315]","authors":"Abdulaziz Asiry ,&nbsp;Anas Sayegh ,&nbsp;Dimitri Gangloff ,&nbsp;Hatan Mortada ,&nbsp;Silvia Gandolfi ,&nbsp;Elise Lupon","doi":"10.1016/j.jpra.2026.01.001","DOIUrl":"10.1016/j.jpra.2026.01.001","url":null,"abstract":"","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Page 711"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167240","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":"Wrist-arthroscopy treatment of carpal bone cysts","authors":"Zhihu Ma ,&nbsp;Xingsheng Zhang ,&nbsp;Yantao Pei ,&nbsp;Lei Zhu ,&nbsp;Gang Wang ,&nbsp;Yuliang Sun","doi":"10.1016/j.jpra.2025.11.032","DOIUrl":"10.1016/j.jpra.2025.11.032","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the therapeutic efficacy and clinical outcomes of wrist arthroscopy in the management of intraosseous carpal bone cysts through a retrospective analysis of surgical cases.</div></div><div><h3>Methods</h3><div>A case series analysis was performed on 14 patients with intraosseous carpal bone cysts treated in the Department of Hand and Foot Surgery at Qilu Hospital of Shandong University between January 2019 and August 2022. The cyst distribution was as follows: 11 cases in the lunate bone, 1 case involving both the scaphoid and lunate bones, 1 case in the scaphoid bone, and 1 case in the hamate bone. Preoperative imaging assessments included standard radiography (X-ray), computed tomography (CT), and magnetic resonance imaging (MRI). All patients underwent wrist arthroscopic cyst debridement with autologous iliac bone grafting. Intraoperative evaluation of wrist stability was performed, followed by Kirschner wire fixation or external fixation as indicated. Pathological specimens were obtained for histopathological examination. Postoperative rehabilitation protocols were implemented under supervised guidance.</div></div><div><h3>Results</h3><div>All patients were followed up for 3–6 months postoperatively. Following structured rehabilitation, significant alleviation of wrist pain was observed in all cases, with full functional recovery enabling a return to normal occupational activities.</div></div><div><h3>Conclusion</h3><div>Wrist arthroscopic surgery combined with bone grafting represents an effective treatment modality for intraosseous carpal bone cysts, facilitating accurate pathological diagnosis and promoting rapid functional recovery when supplemented with postoperative rehabilitation.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 473-482"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883766","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":"Exosomes in trichology: A literature review","authors":"Kar Wai Alvin Lee ,&nbsp;Olena Sydorchuk ,&nbsp;Jong Keun Song ,&nbsp;Sa Rang Lee ,&nbsp;Eunwoo Yu ,&nbsp;Sea Hwan Kim ,&nbsp;Tae-Hyun Kim ,&nbsp;Han Ah Reum Song ,&nbsp;Seung Yong Shim ,&nbsp;You-kyoung Cho ,&nbsp;Han Earl Lee ,&nbsp;Arash Jalali ,&nbsp;Kyu-Ho Yi","doi":"10.1016/j.jpra.2025.11.011","DOIUrl":"10.1016/j.jpra.2025.11.011","url":null,"abstract":"<div><h3>Background</h3><div>Exosomes, nano-sized extracellular vesicles derived from various cell types, have emerged as a promising therapeutic modality in trichology. These vesicles deliver bioactive molecules, such as growth factors, cytokines, and microRNAs, that regulate key cellular processes, including proliferation, differentiation, and signaling, which are critical for hair follicle regeneration.</div></div><div><h3>Aim</h3><div>This review synthesizes findings from preclinical and clinical studies published on the applications of exosomes for treating hair loss conditions such as androgenetic alopecia (AGA), alopecia areata (AA), and chemotherapy-induced alopecia (CIA).</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted using databases including MEDLINE, PubMed and Ovid databases for relevant studies published on clinical trials, diagnosis and treatment. Some papers were further reviewed using a double-blinding approach, sample size, control usage, randomization usage and objective endpoint measurements. All studies were classified according to the Oxford Center for evidence-based medicine evidence hierarchy.</div></div><div><h3>Results</h3><div>Preclinical studies demonstrate that exosomes derived from mesenchymal stem cells (MSCs), adipose stem cells (ASCs), dermal papilla cells (DPCs) and plant sources enhance dermal papilla cell (DPC) proliferation, activate signaling pathways such as Wnt/β-catenin, VEGF, and PI3K/AKT, and promote the transition of hair follicles from the telogen to anagen phase. Clinical data, although limited, show promising results, with improvements in hair density, thickness, and follicular health. Systematic reviews and case series have highlighted the favorable safety profile of exosome-based therapies, with minimal adverse effects reported.</div></div><div><h3>Conclusion</h3><div>Exosome therapy is a promising, minimally invasive approach for AGA, AA, and CIA, supported by robust preclinical biology but preliminary and heterogeneous clinical data. Progress to routine practice will require adequately powered, multicenter randomized trials with standardized outcomes, along with harmonized manufacturing and regulatory frameworks (GMP-compliant production, batch-level quality control) to ensure reproducibility and safety.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 567-584"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924714","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 analysis of complete survival outcomes in digital replantation with a focus on avulsion injuries","authors":"Yoshitaka Matsuura ,&nbsp;Ryuji Uozumi ,&nbsp;Akiko Shoji-Pietraszkiewicz ,&nbsp;Koji Kimura ,&nbsp;Seita Inoue ,&nbsp;Toshihiro Ishiko","doi":"10.1016/j.jpra.2025.11.028","DOIUrl":"10.1016/j.jpra.2025.11.028","url":null,"abstract":"<div><div>In this study, we defined complete digital survival as the primary outcome and systematically examined preoperative, intraoperative, and postoperative factors influencing this outcome. We enrolled 124 digits replanted and evaluated the correlation between complete survival and preoperative factors such as age, Tamai’s zone classification, injury mechanism, smoking, daily cigarette consumption, diabetes, and complete/incomplete amputation. We considered avulsion to be a factor that could influence intraoperative and postoperative factors. Multiple logistic regression was performed with intraoperative and postoperative variables, such as the number of vessel anastomoses and rescue surgery.</div><div>The characteristics of this study included 29 % avulsions, 39 % crushes, 29 % blunt cuts, and 6 % clean cuts. The total complete survival rate was 80 %. Multiple logistic regression adjusted for avulsion showed that the number of arteries, veins, and number of vein anastomoses ≥ number of artery anastomoses significantly contributed to complete survival in the whole study. However, the success of the replanted digits that needed rescue surgery was significantly poorer than that in the case without rescue surgery. In addition, the vessel transfer, such as vein grafting, was useful for replanting digits in cases with severe vessel damage.</div><div>We should anastomose as many veins and arteries as possible and perform vessel transfer to replace the damaged vessel during the initial surgery. This effort in replantation may reduce reoperation rates and improve the chances of complete survival.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 305-314"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736975","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":"Evaluating the potential of quantitative assessment of intraoperative fasciocutaneous flap perfusion using microscope-integrated indocyanine green fluorescence angiography","authors":"Lasse W.P. van ’t Hof ,&nbsp;David J. Nijssen ,&nbsp;Richard M. van den Elzen ,&nbsp;Joost R. van der Vorst ,&nbsp;Roel Hompes ,&nbsp;Mark-Bram Bouman ,&nbsp;Mark I. van Berge Henegouwen ,&nbsp;Matthijs Botman ,&nbsp;Caroline Driessen","doi":"10.1016/j.jpra.2026.01.008","DOIUrl":"10.1016/j.jpra.2026.01.008","url":null,"abstract":"<div><h3>Background</h3><div>Perfusion-related complications are a leading cause of morbidity and flap loss in reconstructive surgery. While indocyanine green fluorescence angiography (ICG-FA) is commonly used, its subjective interpretation may miss early signs of perfusion disturbances. Quantitative ICG-FA (Q-ICG-FA) offers a more objective method, but its potential in fasciocutaneous flaps remains insufficiently studied.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed intraoperative ICG-FA data from patients undergoing fasciocutaneous flap reconstruction. Fluorescence-time curves (FTCs) were generated from three regions of interest (ROIs): reference tissue (ROI1), proximal flap (ROI2), and distal flap (ROI3). FTCs and derived quantitative parameters, including time-to-peak (Ttp) and normalized inflow/outflow slopes, were compared between patients with (PRC) and without (No PRC) perfusion-related complications.</div></div><div><h3>Results</h3><div>Twenty patients were included. Seven patients experienced a perfusion-related complication, most commonly venous congestion (<em>n</em> = 5). FTCs of compromised flaps showed delayed fluorescence peaks and reduced washout, most pronounced in ROI3. Quantitatively, the PRC group showed prolonged Ttp in ROI2 (105 vs. 36 s, <em>p</em> = 0.013) and ROI3 (209 vs. 48 s, <em>p</em> = 0.001), lower normalized mean inflow slopes in ROI2 (2.4 vs 0.9%/s, <em>p</em> = 0.029) and ROI3 (4.2 vs. 1.6%/s, <em>p</em> = 0.002), and reduced mean outflow slopes in ROI3 (0.1 vs. 0.2, <em>p</em> = 0.021). Conventional clinical assessments failed to identify all compromised flaps.</div></div><div><h3>Conclusion</h3><div>Q-ICG-FA objectively distinguished flaps with and without perfusion-related complications. Dynamic parameters, particularly Ttp and inflow/outflow slopes, were most associated with perfusion compromise. Larger studies are needed to validate these findings.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 788-800"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187652","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":"Systematic mapping review of applications of extracorporeal shockwave therapy (ESWT) in hand surgery","authors":"Ryan Faderani ,&nbsp;Zhen Yu Wong ,&nbsp;Oluwatobi Adegboye ,&nbsp;Muholan Kanapathy ,&nbsp;Dariush Nikkhah ,&nbsp;Afshin Mosahebi","doi":"10.1016/j.jpra.2025.11.017","DOIUrl":"10.1016/j.jpra.2025.11.017","url":null,"abstract":"<div><h3>Aim</h3><div>This systematic mapping review aims to consolidate and categorize existing evidence regarding the utilization of extracorporeal shockwave therapy (ESWT) in hand surgery.</div></div><div><h3>Methods</h3><div>Following the <em>Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)</em> guideline, a comprehensive search was performed to identify studies assessing ESWT in hand conditions. Eligible studies required a minimum of 3 months’ follow-up. Data extraction adhered to predetermined criteria, and outcomes were classified into clinical assessment, patient-reported outcome measures (PROMs), neurophysiological tests, and miscellaneous domains.</div></div><div><h3>Results</h3><div>Thirty studies met inclusion criteria, comprising 18 randomized controlled trials (RCTs), 10 case series, and two cohort studies. Evidence was predominantly centered on carpal tunnel syndrome (CTS), with additional studies addressing trigger finger, Dupuytren’s disease, post-carpal tunnel release (post-CTRS) pillar pain and scaphoid wrist nonunions. Most reports demonstrated short-term improvements in clinical and PROM outcomes, with complications infrequent and generally mild. However, treatment protocols varied widely in terms of shockwave type, intensity, and frequency. Observations on dose dependency were inconsistent, and most RCTs carried a moderate to high risk of bias, with all reporting a Fragility Index (FI) of zero.</div></div><div><h3>Conclusion</h3><div>This review highlights ESWT as a promising adjunct with short-term benefits across select soft tissue conditions of the hand. Nevertheless, its role in long-term management remains uncertain. Standardization of treatment parameters and rigorously designed multicenter RCTs with extended follow-up and functional outcomes are required to establish the durability, safety, and clinical utility of ESWT in hand surgery.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 356-372"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790788","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":"Development and impact of virtual reality-based training for the radial forearm free flap: A multi-center prospective feasibility study","authors":"Ameen Mahmood ,&nbsp;Clement Yong Jing Cheng ,&nbsp;Ahmed Salih ,&nbsp;Fay Fathima Imitaz Fareed ,&nbsp;Princewill Ukpeh ,&nbsp;Leena Abdalla ,&nbsp;Andrew Gan ,&nbsp;Kai Jian Chin ,&nbsp;Jason Ha ,&nbsp;Florence Chang Jia Xuan ,&nbsp;Srija Gullapalli ,&nbsp;Krish Gupta ,&nbsp;Keshav Krishnan ,&nbsp;Andrei Balan ,&nbsp;Punn Tannirandorn ,&nbsp;Nicole Salgado Fernandez ,&nbsp;Iihan Ali ,&nbsp;Anoushka Samanta ,&nbsp;Cheuk Ying Kyleen Kiew ,&nbsp;Joshua Lee ,&nbsp;Jagtar Dhanda","doi":"10.1016/j.jpra.2025.10.024","DOIUrl":"10.1016/j.jpra.2025.10.024","url":null,"abstract":"<div><h3>Introduction</h3><div>Surgical education faces growing challenges due to reduced theatre access, variable supervision and limited procedural exposure, particularly for complex reconstructive operations such as the radial forearm free flap (RFFF). Virtual reality (VR) offers an opportunity to deliver immersive, standardized surgical training unconstrained by geography or theatre availability. This study evaluates the effectiveness of a VR-based teaching intervention in improving procedural confidence and anatomical understanding of the RFFF.</div></div><div><h3>Methods</h3><div>A prospective multicenter feasibility study was conducted across 10 UK medical schools and one NHS trust. Participants completed a 60-minute workshop including a 360° VR simulation of the RFFF procedure and a VR anatomical exploration session. Pre- and post-workshop surveys assessed procedural confidence, anatomical understanding and user experience using validated Likert-scale tools.</div></div><div><h3>Results</h3><div>141 participants completed both pre- and post-workshop assessments. The majority were undergraduate medical students (90.8 %), of whom 93.8 % had never previously observed an RFFF. Procedural confidence improved significantly from a median of 2 (IQR 2) to 4 (IQR 1) post-workshop (<em>p</em> &lt; 0.001), with greater improvements in those without prior exposure. Anatomical confidence also increased from 3 (IQR 1) to 4 (IQR 2) (<em>p</em> &lt; 0.001), particularly among pre-clinical medical students. Participants rated the module highly for educational value, immersion and clarity of anatomical and procedural content.</div></div><div><h3>Conclusion</h3><div>The VRiMS RFFF teaching module significantly improves learner confidence and anatomical understanding, particularly among early-stage trainees. These findings support the use of VR-based platforms as effective and scalable adjuncts to existing surgical education.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 65-79"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624296","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":"Long-term patient-reported outcomes in pediatric partial-thickness burns using Epiprotect® and Biobrane® a retrospective comparative study","authors":"Olivia J. Hartrick ,&nbsp;Bryant Chong ,&nbsp;Ferdinand B. Mayer ,&nbsp;Suraya M. Yusuf ,&nbsp;Rhiannon E. Cope ,&nbsp;Ankit Mishra ,&nbsp;Ameer Khamise ,&nbsp;Alexandra Murray","doi":"10.1016/j.jpra.2025.11.002","DOIUrl":"10.1016/j.jpra.2025.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Larger pediatric partial-thickness (PT) burns are typically managed with debridement and a skin substitute. Epiprotect® has shown comparable acute surgical outcomes and lower infection rates than Biobrane®, but data on long-term outcomes remain limited.</div></div><div><h3>Purpose</h3><div>To compare long-term patient-reported outcomes between Biobrane® and Epiprotect® in pediatric PT burns using the Brisbane Burn Scar Impact Profile (BBSIP).</div></div><div><h3>Methods</h3><div>We included all pediatric patients (&lt;18 years) treated with Biobrane® or Epiprotect® for PT burns at our center between February 2018 and July 2023 who completed the BBSIP survey &gt;12 months after injury. Total BBSIP scores were analyzed using Wilcoxon rank-sum tests and a negative binomial regression, adjusting for total body surface area (TBSA) and burn depth.</div></div><div><h3>Results</h3><div>Forty-eight patients were included (Biobrane® <em>n</em> = 32; Epiprotect® <em>n</em> = 16). Median age was 21 months (8 months–13 years); mean TBSA was 6 % (2–15 %). Total BBSIP scores were significantly better in the Epiprotect® group (median = 7.74) compared to Biobrane® (median = 8.06; <em>P</em> = 0.0145). In the multivariable analysis, Epiprotect® was associated with lower total BBSIP scores compared with Biobrane® (β = –0.22, <em>P</em> = 0.04) adjusting for TBSA (β = 0.059, <em>P</em> &lt; 0.001) and burn depth (β = –0.26, <em>P</em> = 0.006).</div></div><div><h3>Conclusions</h3><div>Epiprotect® was associated with improved long-term outcomes compared to Biobrane®, particularly in larger or deeper burns. These findings support its use when long-term function and well-being are prioritized.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 56-64"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624297","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":"Sensory and vascular improvement following re-release of amniotic band syndrome and reconstruction with free anterolateral thigh flap in late childhood","authors":"Mardhiah Jeffrey ,&nbsp;Liu Yi ,&nbsp;Ahmad Sukari Halim ,&nbsp;Abdul Razak Sulaiman ,&nbsp;Bazli Md Yusoff","doi":"10.1016/j.jpra.2025.10.023","DOIUrl":"10.1016/j.jpra.2025.10.023","url":null,"abstract":"<div><div>We report a 9-year-old boy with a residual amniotic band over the middle of right leg, with absent pain sensation distal to the constriction.</div><div>Patient presented to us at age of 9-year-old with residual amniotic band, with an angiogram showing a dominant peroneal vessel supplying the right leg that gives off a branch to supply the anterior tibial artery distal to the constriction.</div><div>He went through a sequential release of constriction band and soft tissue coverage using an anterolateral thigh fasciocutaneous flap harvested from the contralateral leg. No nerve repair was performed A secondary procedure was performed after 17 days to refashion the flap edge with additional multiple Z plasties.</div><div>Two years after the procedure, the sensation improved and the posterior tibial artery became the dominant artery supplying the foot, passing through the previous constriction band.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 106-110"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624298","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}