Case Reports in Plastic Surgery and Hand Surgery最新文献

{"title":"Upper limb compartment syndrome requiring fasciotomies following a <i>Vipera ammodytes</i> (horned viper) snakebite: a case report.","authors":"Bisera Nikolovska, Elizabeta Miovska, Jasmina Dobrevska, Emilija Markovikj, Marko Spasov","doi":"10.1080/23320885.2026.2662057","DOIUrl":"https://doi.org/10.1080/23320885.2026.2662057","url":null,"abstract":"<p><p>The clinical severity of snakebite envenomation depends on several factors, including the snake species, the amount of venom injected, the site of envenomation, the timing of antivenom administration, and patient-specific factors. Compartment syndrome is a rare but serious complication of severe envenomation, caused by toxin-induced tissue damage and swelling. We present a case of a 71-year-old man with extensive swelling and ecchymosis of the right upper limb, signs of hand ischemia, and systemic effects, including hypotension, anuria, bradycardia, bradypnea, and somnolence, two days after a Vipera ammodytes (horned viper) bite to his right forearm. Delayed initial treatment and antivenom administration (six hours post-bite due to the heavy influence of alcohol) aggravated the clinical course. Emergency fasciotomies were performed to decompress all compartments of the upper limb. Wound closure was achieved with progressive tension closure, split-thickness skin graft, and platelet-rich plasma (PRP) to the volar side of the forearm. The patient achieved complete recovery with full functional restoration of the upper limb. Post-snakebite compartment syndrome (PSCS) results from a multifactorial cascade of venom-induced local tissue injury, leading to increased intracompartmental pressure and microvascular ischemia. Prompt surgical treatment is necessary if symptoms persist or worsen despite antivenom administration.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"13 1","pages":"2662057"},"PeriodicalIF":0.6,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13112878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784550","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":"The octopus technique: a technical modification for tension-free closure in abdominoplasty.","authors":"Adnan G Gelidan, Hatan Mortada, Hisham Alghamdi, Amr Youssef Arkoubi","doi":"10.1080/23320885.2026.2648257","DOIUrl":"https://doi.org/10.1080/23320885.2026.2648257","url":null,"abstract":"<p><p>This paper describes the Octopus Technique, a technical modification for tension-free abdominoplasty closure using short vertical relaxing incisions for multidirectional tension redistribution. In 12 consecutive patients, no wound dehiscence or flap necrosis occurred. Preliminary results suggest it is safe and reproducible.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"13 1","pages":"2648257"},"PeriodicalIF":0.6,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692874","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":"Abdominal defect reconstruction due to advanced lobomycosis with anterolateral thigh (alt) flap: a case report.","authors":"Frank Andrés Álvarez Vásquez, Iván Enrique Rodríguez Mantilla, Nicol Daniella Cala Gómez","doi":"10.1080/23320885.2026.2655578","DOIUrl":"https://doi.org/10.1080/23320885.2026.2655578","url":null,"abstract":"<p><p>Lobomycosis, also known as lacaziosis, is a chronic subcutaneous mycosis caused by <i>Lacazia loboi</i> and endemic to tropical regions of South America. Medical therapy alone has demonstrated limited efficacy, and wide surgical excision remains the mainstay of treatment, particularly in extensive or long-standing disease. However, radical resection may result in complex soft tissue defects requiring advanced reconstructive strategies. We report the case of a 42-year-old male with advanced lobomycosis involving the left lower hemiabdomen. Wide local excision with 2 cm macroscopic margins was performed, resulting in exposure of the anterior rectus sheath and external oblique aponeurosis. Immediate reconstruction was achieved using a pedicled anterolateral thigh (ALT) flap based on musculocutaneous perforators of the descending branch of the lateral circumflex femoral artery. The flap was rotated 180 degrees to increase its arc of reach and allow tension-free inset without microvascular anastomosis. The donor site was managed with split-thickness skin grafting. Postoperatively, adjuvant systemic itraconazole therapy was administered. The flap demonstrated complete viability with no vascular compromise, and satisfactory functional and aesthetic outcomes were achieved. This case highlights the pedicled ALT flap as a safe, versatile, and reliable reconstructive option for extensive abdominal defects secondary to deep mycoses, offering robust vascularity and low donor-site morbidity while preserving abdominal wall function.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"13 1","pages":"2655578"},"PeriodicalIF":0.6,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13055029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640276","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":"Prosthetic nipple areola complex reconstruction after breast reduction: a case report.","authors":"Salvatore Taglialatela Scafati, Fabrizio Schonauer, Dario d'Angelo, Francesco D'Andrea, Annachiara Cavaliere","doi":"10.1080/23320885.2026.2648923","DOIUrl":"https://doi.org/10.1080/23320885.2026.2648923","url":null,"abstract":"<p><p>Total nipple-areola necrosis following breast reduction is a rare and unfortunate event. Several causes may be responsible for it, including compression of the vascular pedicle, venous congestion, infection, hematoma, or inappropriate surgical technique. Considering the importance of the nipple areola complex (NAC) in the overall appearance of a breast mound, it is clear that the complete loss of the nipple areola complex is one of the most traumatizing complications for both the patient and the surgeon. Herein we describe the case of a patient who developed complete NAC necrosis following breast reduction. After initial wound management and stabilization, the patient underwent delayed reconstruction using an innovative NAC implant specifically designed to restore nipple projection and contour. Delayed reconstruction of the left NAC was performed using a silicone implant (FixNip, GC Aesthetics, Caesarea, Israel), specifically designed to restore natural projection and contour. The implant was positioned under local anesthesia as an outpatient procedure. Postoperative course was uneventful. At 8 months, after ultrasound confirmed proper implant integration, medical tattooing of the areola was completed. Implant based NAC reconstruction achieved a stable and well-projected NAC reconstruction. No minor or major complications occurred, and the patient reported high satisfaction with the aesthetic result and psychological benefit from restoration of breast harmony. To our knowledge, this is the first described case demonstrating a successful implant-based NAC reconstruction following total necrosis after breast reduction. The FixNip implant, combined with medical tattooing, provided a safe and reliable solution with excellent cosmetic outcomes.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"13 1","pages":"2648923"},"PeriodicalIF":0.6,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624047","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":"Disseminated <i>Nocardia paucivorans</i> infection in a 64-year-old patient with first manifestation as an ulnocarpal forearm lesion.","authors":"Peter Mohos, Lukas Mathys, Céline Bratschi, Georg Julian Claas, Philipp Honigmann, Marco Keller","doi":"10.1080/23320885.2026.2643076","DOIUrl":"10.1080/23320885.2026.2643076","url":null,"abstract":"<p><p>We report a 64-year-old immunocompromised patient receiving chemotherapy for metastatic colorectal adenocarcinoma who presented with a purulent forearm lesion. Surgical debridement identified <i>Nocardia paucivorans</i>. PET-CT and MRI revealed pulmonary and cerebral involvement. Escalated antimicrobial therapy achieved complete regression of brain lesions; the patient died 11 months later from underlying disease.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"13 1","pages":"2643076"},"PeriodicalIF":0.6,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595312","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":"Reconstruction of extensive craniofacial defect following paraganglioma excision using a chimeric anterolateral thigh flap: a case report.","authors":"Phan Tuấn Nghĩa, Đặng Phương Nam, Trần Thiết Sơn","doi":"10.1080/23320885.2026.2644769","DOIUrl":"10.1080/23320885.2026.2644769","url":null,"abstract":"<p><p>Extended radical excision of aggressive tumors, such as the carotid paraganglioma involving the ethmoid, maxillary and intracranial spaces, results in massive composite craniofacial defects. Successful reconstruction requires simultaneously achieving effective dead space refilling and creating a stable anophthalmic orbital socket. This report highlights the utility of the chimeric anterolateral thigh (ALT) flap in addressing this reconstructive challenge. A 28-year-old man presented with a complex craniofacial defect following the wide excision of an extensive carotid paraganglioma. A chimeric ALT musculocutaneous flap (22 × 10 cm) was harvested, containing two independent skin paddles and a part of the vastus lateralis muscle. One musculocutaneous flap (8 × 14 cm) was de-epithelialized to augment the dead space after total maxillectomy and orbital exenteration. The fasciocutaneous flap (6 × 8 cm) was thinned and molded into a double-layer flap, which was rolled into a socket configuration for orbital reconstruction. Microvascular anastomosis was performed end-to-end to the facial vessels. Intraoperatively, perfusion of all flap components was excellent. The flap remained well perfused postoperatively without congestion or ischemia. At the 25-month follow-up, the patient demonstrated stable healing, a well-contoured midface profile, and adequate socket depth for prosthetic fitting. The chimeric ALT flap offers a highly reliable and versatile solution for the complex reconstruction of massive composite craniofacial defects following extensive tumor resection. This chimeric approach effectively meets the simultaneous requirements for dead-space obliteration and stable orbital socket formation using a single donor site.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"13 1","pages":"2644769"},"PeriodicalIF":0.6,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13011084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515651","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":"Fibrous dysplasia of the jaws: four cases with conservative and resective surgical management.","authors":"Nandika Desta Dewara, Bramasto Purbo Sejati, Erdananda Haryosuwandito","doi":"10.1080/23320885.2026.2646776","DOIUrl":"10.1080/23320885.2026.2646776","url":null,"abstract":"<p><strong>Introduction: </strong>Fibrous dysplasia (FD) is a slow-growing, benign fibro-osseous tumor with a recurrent character distinguished by replacement with fibrous connective tissue instead of normal bone. The medullary bone is substituted by fibrous connective tissue, leading to immature, poorly mineralized bone. FD is responsible for approximately 2.5% of all bone tumors and 7% of all benign bone tumours. Patients may show involvement of one bone (monostotic FD; MFD) or multiple bones (polyostotic FD; PFD). The present case report describes FD's clinical, imaging and therapeutic aspects in the maxillary and mandibular region.</p><p><strong>Case: </strong>We present four cases of fibrous dysplasia affecting the maxilla and mandibular region, which were identified over 6 months at a single institution. All (<i>n</i> = 4) patients underwent surgical procedures: 2 patients in the mandibular region, one in the maxillary region, and one in the maxillary and mandibular region. No complications occurred at the six-month follow-up.</p><p><strong>Case management: </strong>The diagnosis of FD is established based on clinical, radiographic, and histopathological features. Imaging analysis showed an expansive, non-destructive mass, with a well-circumscribed cortical and appearance of ground glass, involving either the maxilla or mandible. After diagnosis of FD, 3 patients undergo a conservative bone reshaping surgical procedure, and 1 patient undergoes a surgical resection and bone reshaping with primary wound closure.</p><p><strong>Conclusion: </strong>The diagnosis of FD remains challenging because of its clinical, imaging, and histological similarities with other fibro-osseous tumors. A conservative approach of bone reshaping could be adopted as the first line of treatment for patients suffering from FD. A complete surgical removal by resective surgery and immediate reconstructive procedures also produces satisfactory clinical results after adequate follow-up.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"13 1","pages":"2646776"},"PeriodicalIF":0.6,"publicationDate":"2026-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13007420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515602","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":"Forehead dermatofibrosarcoma protuberans treated exclusively with full-thickness skin grafting: a unique case report and review of the literature.","authors":"Youssef Mahfouz, Sara Moussa, Tony Kazzi, Antoine Abi Abboud","doi":"10.1080/23320885.2026.2646811","DOIUrl":"https://doi.org/10.1080/23320885.2026.2646811","url":null,"abstract":"<p><p>Dermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive cutaneous sarcoma. Forehead involvement is uncommon and poses significant reconstructive challenges due to complex aesthetic and functional demands. Most reported reconstructions utilize staged flaps or tissue expansion. To the best of our knowledge and based on a comprehensive literature review, there are no previous reports specifically documenting forehead DFSP reconstruction performed exclusively with full-thickness skin grafting (FTSG) following wide local excision.We report a case highlighting this technique's reconstructive and aesthetic advantages. A 50-year-old woman presented with a long-standing, enlarging paramedian forehead mass above the right eyebrow, measuring approximately 7.5 × 6.5 cm. A punch biopsy and imaging confirmed DFSP. Wide local excision with 3 cm margins was performed, resulting in a 10.5 × 9 cm defect. Reconstruction was achieved using a single-stage FTSG harvested from the suprapubic region, including a segment of hair-bearing skin aligned to restore the forehead hairline. At 10 month follow-up, the patient had full graft take, preserved frontalis function, and satisfying aesthetic outcome with no recurrence. Forehead DFSP reconstruction typically involves complex, multi-stage flap procedures that risk distortion of key facial landmarks and increased morbidity. Our case demonstrates that immediate full-thickness skin grafting offers a simpler, single-stage alternative preserving eyebrow position, facial symmetry, and function. Harvesting the graft from the suprapubic area, utilizing a prior cesarean scar, allowed restoration of the hairline with hair-bearing skin-an innovative aesthetic advantage not previously reported. This unique case demonstrates that FTSG can provide favorable aesthetic and functional outcomes in selected forehead DFSP cases, representing a valuable addition to reconstructive options.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"13 1","pages":"2646811"},"PeriodicalIF":0.6,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13003884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500120","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":"Autologous fat grafting in a case of Parry-Romberg syndrome: a case report.","authors":"Bhakti Sarda, Sapna Nere, Bhushan Madke, Adarshlata Singh","doi":"10.1080/23320885.2026.2644772","DOIUrl":"https://doi.org/10.1080/23320885.2026.2644772","url":null,"abstract":"<p><p>Progressive hemifacial atrophy, also known as Parry-Romberg syndrome (PRS), is an uncommon condition that causes slow and progressive unilateral soft-tissue atrophy of the face. This atrophy affects the skin and subcutaneous tissue, including fat and muscle, and in some cases, may also involve the underlying bone and muscle. The exact cause of this syndrome is unknown, but several possible factors have been suggested. These include genetic predisposition, autoimmune responses, and infections or trauma. We report a case of a young female who presented with an asymptomatic one-sided atrophy of the face for the last ten years. This case highlights autologous fat grafting as a safe and effective option for restoring facial symmetry in PRS.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"13 1","pages":"2644772"},"PeriodicalIF":0.6,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12990273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475723","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":"Adaptive multi-stage paramedian forehead flap for nasal reconstruction following HSV-related necrosis in a pediatric patient with primary immunodeficiency.","authors":"Hatan Mortada, Shabeer Ahmad Wani, Doaa F Andejani","doi":"10.1080/23320885.2026.2641269","DOIUrl":"https://doi.org/10.1080/23320885.2026.2641269","url":null,"abstract":"<p><p>Large nasal defects in children are rare and create significant reconstructive challenges due to limited donor tissue, ongoing facial growth, and higher perioperative risks. These challenges are amplified in immunocompromised pediatric patients, particularly when infections such as herpes simplex virus (HSV) contribute to tissue destruction. The paramedian forehead flap is a reliable option for major nasal reconstruction in adults, but its use in children remains uncommon. We report a 4-year-old girl with an undiagnosed primary immunodeficiency and recurrent HSV infection who developed a full-thickness defect of the right nasal ala with partial auricular loss. A staged reconstruction was performed adaptively over five stages, including flap elevation with delay, transposition with native nasal skin lining and Matriderm application to reduce wound burden, partial division with alar sculpting, and final inset with eyebrow reconstruction. Intraoperative indocyanine green angiography confirmed adequate flap perfusion at each stage. The patient's postoperative course was uneventful, and she demonstrated improved nasal airway patency, stable alar contour, and high parental satisfaction with cosmetic outcomes. This case suggests that a tailored, multi-stage paramedian forehead flap reconstruction may be safely performed in young children with complex nasal defects, including those with undiagnosed primary immunodeficiency and recurrent HSV infection, though further experience is needed to validate this approach. Careful staging, vascular assessment, and multidisciplinary collaboration were central to achieving successful functional and aesthetic results.</p>","PeriodicalId":42421,"journal":{"name":"Case Reports in Plastic Surgery and Hand Surgery","volume":"13 1","pages":"2641269"},"PeriodicalIF":0.6,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12981270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469646","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}