Case Reports in Plastic Surgery and Hand Surgery最新文献

{"title":"Infections following medical leech therapy for rhizarthrosis: a case series.","authors":"Laura Coenen de Salazar, Stefan Weber, Martin Lautenbach","doi":"10.1080/23320885.2026.2741520","DOIUrl":"10.1080/23320885.2026.2741520","url":null,"abstract":"<p><p>Medical leech therapy is used as an alternative treatment for chronic pain conditions, including rhizarthrosis. During leech therapy, the leech releases a variety of bioactive substances that are intended to alleviate symptoms and relieve pain. The procedure is often described as a 'natural' and risk-free form of naturopathic treatment. However, medical leech therapy is associated with risks and potential complications, among which infection is one of the most common. According to the literature, these infections may be caused by Aeromonas spp. as well as other pathogens. Treatment typically consists of intravenous antibiotic therapy combined with surgical intervention. We report a case series of five patients who presented to the Department of Hand Surgery at Waldfriede Hospital with infections following medical leech therapy for rhizarthrosis. No consistent microbiological pattern of causative pathogens was observed. Several strategies for preventing infections associated with medical leech therapy have been described in the literature. Nevertheless, serious infectious complications cannot be entirely excluded.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"13 1","pages":"2741520"},"PeriodicalIF":0.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216956","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":"Layered PLLA with monopolar RF for facial rejuvenation: a case report.","authors":"Xi Yang, Ling Tang, Juntian Liu, Ying Liu","doi":"10.1080/23320885.2026.2748235","DOIUrl":"10.1080/23320885.2026.2748235","url":null,"abstract":"<p><p>With the continuous expansion of facial rejuvenation techniques, the combination of energy-based devices and biostimulatory fillers has become a focal point in clinical research. Monopolar radiofrequency (MRF), such as Thermage, can achieve immediate tissue tightening, while poly-L-lactic acid (PLLA), a collagen stimulator, enables volumetric restoration and lifting through progressive collagen regeneration. This article describes a sequential treatment protocol combining MRF followed by layered PLLA injection in three patients with facial laxity and volume loss. Clinical photographs and Wrinkle Severity Rating Scale (WSRS) assessments were collected during follow-up. A split-face approach was applied in Case 1, with combination therapy (MRF + PLLA) administered to the more affected side and MRF alone to the contralateral side. Improvements in facial contour appearance, nasolabial fold severity, and facial symmetry were observed during follow-up. No treatment-related adverse events were reported during the observation period. These cases provide preliminary short-term clinical observations regarding this sequential treatment strategy; however, the contribution of each modality cannot be distinguished and further controlled studies are required.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"13 1","pages":"2748235"},"PeriodicalIF":0.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216978","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":"Lower limb varicose veins in free fibula flap reconstruction: a surgical case report and scoping review.","authors":"Sebastian Holm, Reza Tabrisi","doi":"10.1080/23320885.2026.2742738","DOIUrl":"10.1080/23320885.2026.2742738","url":null,"abstract":"<p><strong>Background: </strong>Mandibular reconstruction using a vascularized free fibular flap (FFF) remains a gold standard following oral cancer resection. Lower-limb varicose veins are a common manifestation of chronic venous disease, but their potential impact on free-flap viability is largely unexplored in the surgical literature.</p><p><strong>Case presentation: </strong>We present a case of FFF reconstruction in a patient with lower extremity varicose veins, detailing the intraoperative management of venous congestion and the postoperative course.</p><p><strong>Methods: </strong>We conducted a scoping review to identify publications addressing venous disease or abnormal venous findings in the context of FFF reconstruction.</p><p><strong>Results: </strong>The scoping review identified only two relevant publications.</p><p><strong>Conclusion: </strong>This report identifies an evidence gap regarding the relevance of donor-site venous findings in FFF reconstruction. The present case and limited literature are hypothesis-generating and do not establish a causal relationship between superficial varicose veins and flap compromise. Further research is needed to clarify whether targeted venous assessment has a role in selected patients.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"13 1","pages":"2742738"},"PeriodicalIF":0.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138556","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":"Correction.","authors":"","doi":"10.1080/23320885.2026.2743460","DOIUrl":"https://doi.org/10.1080/23320885.2026.2743460","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1080/23320885.2024.2335275.].</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"13 1","pages":"2743460"},"PeriodicalIF":0.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138639","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":"Isolated dorsal interosseous compartment syndrome of the hand following distal transradial access for percutaneous coronary intervention: a case report.","authors":"Katsuya Hayakawa, Tomoyuki Kato, Shohei Iwabu","doi":"10.1080/23320885.2026.2742075","DOIUrl":"10.1080/23320885.2026.2742075","url":null,"abstract":"<p><p><b>Introduction:</b> Distal transradial access (dTRA) preserves the forearm radial artery and may be useful in patients who require future dialysis access. However, dorsal hand hematoma after dTRA may lead to compartment syndrome. We report an 89-year-old man receiving hemodialysis and dual antiplatelet therapy who developed isolated dorsal interosseous compartment syndrome after percutaneous coronary intervention via right dTRA. Approximately 18 hours after the procedure, he presented with severe dorsal hand pain, tense swelling, and markedly restricted active finger motion, despite a soft, well-perfused palm. Dorsal interosseous compartment pressures ranged from 24 to 44 mmHg, with a minimum differential pressure of 30 mmHg. Emergency fasciotomy was performed approximately 21 hours after PCI, and all four dorsal interosseous compartments were decompressed through two longitudinal incisions; a localized hematoma was evacuated. His pain resolved immediately, and full, painless finger motion was restored by 2 months after surgery. Progressive dorsal swelling and disproportionate pain after dTRA should prompt urgent assessment, as preserved ulnar flow and palmar perfusion do not exclude dorsal interosseous compartment syndrome.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"13 1","pages":"2742075"},"PeriodicalIF":0.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138610","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":"Staged multimodal correction of implant rippling after prepectoral breast reconstruction with thin mastectomy flaps: a case report.","authors":"Tony Kazzi, Suzanne Youness, Antoine Abi Abboud, Hady Rihani","doi":"10.1080/23320885.2026.2739821","DOIUrl":"https://doi.org/10.1080/23320885.2026.2739821","url":null,"abstract":"<p><p>Rippling is a recognized aesthetic complication of prepectoral implant-based breast reconstruction, and thin mastectomy flaps markedly increase its risk. We report a 35-year-old physically active woman with recurrent bilateral fibroadenomas who underwent bilateral nipple-sparing subcutaneous mastectomy with immediate prepectoral implant reconstruction; the prepectoral plane was chosen to avoid animation deformity, weighed against her thin flaps. Visible rippling attributable to thin soft-tissue coverage developed at three months. Autologous fat grafting gave only partial, temporary correction. Four months later, a single staged, combined procedure achieved definitive correction: bilateral exchange to highly cohesive silicone gel implants, conversion to a subpectoral pocket, Wise-pattern mastopexy, and adjunctive lipofilling, with a right local inferior-pedicle rotation flap correcting a medial contour defect. At 12 months, rippling had resolved with a satisfactory aesthetic outcome. Thin flaps were considered the principal contributing factor, although a single case cannot establish causation. Because prepectoral reconstruction relies on the soft-tissue envelope for implant camouflage, thin flaps may favor considering primary subpectoral or dual-plane placement, or planned soft-tissue support such as acellular dermal matrix or autologous coverage. Salvage addresses the determinants of rippling in combination: fat grafting to thicken tissue, pocket conversion to add muscular coverage, mastopexy to tighten the skin envelope, and exchange for a more cohesive implant, although simultaneous performance precludes isolating any single component's contribution. Thin mastectomy flaps appear to be an important risk factor, potentially informing patient selection. Once rippling occurs, a staged multimodal approach can restore contour.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"13 1","pages":"2739821"},"PeriodicalIF":0.6,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116115","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":"A rare collision tumour of basal cell carcinoma and malignant melanoma of the lower abdomen with distant metastases: a case report.","authors":"Shota Murakami, Masato Tsuchiya, Mieko Uno, Takaya Ichimura, Ryuichi Azuma","doi":"10.1080/23320885.2026.2725408","DOIUrl":"10.1080/23320885.2026.2725408","url":null,"abstract":"<p><p>Collision tumours are uncommon lesions in which two histologically distinct neoplasms coexist at one anatomical site, creating diagnostic difficulty when one component predominates clinically or histologically. A 70-year-old man presented with a large exophytic pigmented tumour on the lower abdomen that had been present for approximately 20 years and had enlarged rapidly during the preceding 5 years. He was brought to the emergency department because of tumour bleeding, progressive anaemia, poor nutritional status, and difficulty with mobilisation. Contrast-enhanced computed tomography during emergency systemic assessment revealed multiple pulmonary, hepatic, and bilateral lymph node lesions suspicious for distant metastases. Because urgent local control was required, no preoperative incisional biopsy was performed, and complete excision with immediate reconstruction was undertaken as a therapeutic excisional biopsy. Initial histopathological and immunohistochemical evaluation showed basal cell carcinoma with BerEP4 positivity. However, the metastatic pattern was inconsistent with basal cell carcinoma, prompting biopsy of a pulmonary nodule, which demonstrated malignant melanoma. Because primary pulmonary melanoma is extremely rare, the abdominal lesion was re-evaluated. Additional sampling from previously unsampled areas identified a MelanA-positive atypical melanocytic component adjacent to and partially intermingled with the basal cell carcinoma, confirming a cutaneous collision tumour. The distant lesions were interpreted as metastases from the melanoma component. BRAF V600 mutation analysis was negative, and nivolumab plus ipilimumab was initiated. However, the disease progressed rapidly, further systemic therapy was discontinued, and the patient died shortly thereafter from cancer-related complications. This case highlights how sampling bias and clinicopathological discordance can obscure aggressive malignant components in cutaneous collision tumours. In large, heterogeneous, or clinically aggressive cutaneous tumours, systematic multi-site sampling and prompt clinicopathological reassessment are essential when the initial pathological diagnosis does not fully explain the clinical behaviour.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"13 1","pages":"2725408"},"PeriodicalIF":0.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009224","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":"Successful DIEP flap breast reconstruction in a patient with previous urostomy, abdominal liposuction, and caesarean section: a case report overcoming a relative contraindication.","authors":"Muzammil Arif Din Abdul Jabbar, Thilakshi Subasinghe, Charles M Malata","doi":"10.1080/23320885.2026.2732461","DOIUrl":"10.1080/23320885.2026.2732461","url":null,"abstract":"<p><p>The deep inferior epigastric perforator (DIEP) flap is the most popular option in autologous breast reconstruction post-mastectomy. However, extensive prior surgical history, especially abdominal, urological and/or pelvic surgery are generally considered as relative contraindications to DIEP reconstruction. We report a case of a 63-year-old who successfully underwent breast reconstruction using a DIEP flap despite previous urological surgery and indwelling suprapubic catheter with significant adjacent scarring in addition to prior abdominal liposuction and caesarean section. The reconstruction was carried out with several intraoperative precautions, including flap harvest incorporating three perforators to optimise perfusion and reduce the risk of flap necrosis. Additionally, the contralateral abdominal hemi-flap was left attached until successful microvascular anastomoses were confirmed. The urostomy with its indwelling suprapubic catheter was isolated during surgery with a transparent waterproof dressing to reduce contamination of the operative field. To our knowledge, this is the first reported case of successful DIEP flap breast reconstruction in a patient with a pre-existing urostomy. This case further supports the notion that a complex abdominal surgical history should not be viewed as an absolute contraindication to DIEP flap reconstruction.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"13 1","pages":"2732461"},"PeriodicalIF":0.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009230","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":"Rapidly reversible total facial paralysis after lipofilling around facial nerve truncus.","authors":"Ersin Yavuz, Emre Berk Bulut, Alp Ercan","doi":"10.1080/23320885.2026.2724721","DOIUrl":"10.1080/23320885.2026.2724721","url":null,"abstract":"<p><p>Autologous fat grafting is widely used for secondary contour refinement following head and neck reconstruction and is generally considered safe. However, irradiated reconstructed tissues exhibit fibrosis and reduced compliance, potentially predisposing patients to uncommon complications. Transient facial nerve paralysis following fat grafting has not previously been reported in an irradiated anterolateral thigh (ALT) free flap. A 57-year-old man underwent extensive oncologic resection for verrucous squamous cell carcinoma involving the temporal bone and parotid region, followed by ALT free flap reconstruction and adjuvant radiotherapy. After flap debulking and an initial lipofilling procedure, a second fat-grafting session (60 mL) was performed five months later for residual preauricular contour deformity. Immediately after surgery, the patient developed House-Brackmann grade V facial paralysis. Systemic methylprednisolone was initiated at 64 mg/day and tapered over five days. Facial function improved rapidly, with complete recovery within 36 hours and no residual deficit. Given the close temporal relationship to fat grafting and rapid recovery, transient pressure-related neuropraxia within the irradiated fibrotic tissue bed was considered a plausible mechanism; however, this remains hypothetical without objective evidence of nerve compression, edema, or ischemia. To our knowledge, this is the first reported case of rapidly reversible total facial paralysis following autologous fat grafting in an irradiated ALT free flap. Reduced tissue compliance secondary to radiation-induced fibrosis may contribute to transient nerve dysfunction. Awareness of this potential complication and cautious, low-pressure injection may be important when performing fat grafting near major nerve structures in irradiated reconstructive fields.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"13 1","pages":"2724721"},"PeriodicalIF":0.6,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876054","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":"Salvage reconstruction of an irradiated and infected scalp-calvarial defect following recurrent atypical meningioma: recipient-vessel strategy and multidisciplinary decision-making.","authors":"Federico Ziani, Sofia De Riso, Silvia Vacca, Matteo Garassino, Paola Pentangelo, Anna Manconi, Michail Sorotos, Sabino Luzzi, Corrado Rubino, Emilio Trignano","doi":"10.1080/23320885.2026.2721213","DOIUrl":"10.1080/23320885.2026.2721213","url":null,"abstract":"<p><p>Reconstruction of complex scalp defects associated with calvarial involvement represents a significant challenge, particularly in patients who have undergone radiotherapy, experienced infection and undergone multiple surgical procedures. In these settings, locoregional reconstructive options are often unreliable and free tissue transfer plays a central role in achieving stable, well-vascularized coverage. We present a case of a 50-year-old woman with recurrent atypical meningioma who underwent multiple neurosurgical resections and radiotherapy. The postoperative course was complicated by wound dehiscence, infection, and cranioplasty failure. Upon evaluation, the patient exhibited a large posterior scalp defect (14 × 5 cm) with exposed calvarium. A multidisciplinary approach was adopted. Following neurosurgical debridement, tumor resection and calvarial reconstruction using a titanium mesh, soft-tissue coverage was achieved with a free latissimus dorsi muscle flap combined with a split-thickness skin graft. Microvascular anastomosis was performed using the superior thyroid artery and the jugular venous system, selected outside the irradiated field. The postoperative course was uneventful, with no signs of flap ischemia or venous congestion. At eight months of follow-up, the patient demonstrated complete wound healing, stable coverage, and a satisfactory morphofunctional outcome, with minimal donor-site morbidity. This report emphasizes that successful salvage reconstruction of irradiated scalp defects complicated by osteomyelitis depends not only on vascularized tissue transfer but also on meticulous recipient vessel selection. In particular, the superior thyroid artery represented a reliable recipient vessel outside the irradiated field, allowing safe microvascular reconstruction despite previous surgery, infection and radiation-induced vascular compromise.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"13 1","pages":"2721213"},"PeriodicalIF":0.6,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851207","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}