Archives of Plastic Surgery-APS最新文献

{"title":"Lymphatic Mapping with Multi-Lymphosome Indocyanine Green Lymphography in Legs with Lymphedema.","authors":"Hisako Hara, Makoto Mihara","doi":"10.1055/a-2375-8153","DOIUrl":"10.1055/a-2375-8153","url":null,"abstract":"<p><p>It is observed that the locations of the most functional lymphatic vessels in the lymphedematous limbs can differ significantly from those in healthy limbs. The aim of this study was to elucidate the lymphatic map of lymphedematous limbs. We retrospectively analyzed 59 patients (118 limbs) with lower limb lymphedema. Fifty-five were women and four were men. The mean age and duration of lymphedema was 62.4 and 7.7 years, respectively. For the lateral thigh lymphosome, we injected indocyanine green (ICG) at the lateral knee and measured the distance (Dt) between the anterior superior iliac spine (ASIS) and the point where the lymphatic vessels crossed the reference line (the line connecting the ASIS and the patellar center). For the lateral calf lymphosome, we injected ICG at the lateral ankle and measured the distance (Dc) between the inferior patellar border and the point where the lymphatic vessels crossed the reference line (the anterior border of the tibia). In the lateral thigh, the mean Dt was 30.4 ± 0.6 cm (range, 0-41 cm) and the distribution peaked at approximately 30 cm from the ASIS. In the calf, the mean Dc was 13.1 ± 0.9 cm (range, -11 to 32 cm). The distribution of lymphatic vessel locations was highly variable. We could establish the lymphatic map in the lymphedematous legs. The distribution of lymphatic vessels in the thigh and lower legs had one and two peaks, respectively.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":"51 6","pages":"592-596"},"PeriodicalIF":1.3,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11560325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629729","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":"Application of the Relative Citation Ratio to Assess Common Characteristics of the Highest Impact Articles in Reconstructive Microsurgery.","authors":"Amir-Ala Mahmoud, Dominick J Falcon, Valeria P Bustos, Maria J Escobar-Domingo, Bernard T Lee","doi":"10.1055/a-2380-4278","DOIUrl":"10.1055/a-2380-4278","url":null,"abstract":"<p><p><b>Background</b>  The purpose of this review is to characterize themes among the five reconstructive microsurgery articles achieving the highest Relative Citation Ratios (RCRs) published in the past 20 years in the top journals. In doing so, researchers may be better informed on how to propose salient research questions to impact the field and understand future directions in plastic surgery. <b>Methods</b>  A cross-sectional study was conducted with articles published in the top three journals based on the Impact Factor: Plastic and Reconstructive Surgery, Journal of Reconstructive Microsurgery, and Annals of Plastic Surgery. A search strategy with controlled vocabulary and keywords was conducted in PubMed to extract all reconstructive microsurgery (RM) articles published between 2002 and 2020. A two-stage screening process to include only RM studies was performed, with a third reviewer moderating discordances. Articles' RCR data were extracted from the National Institutes of Health iCite. The top five articles with the highest RCRs were selected for analysis. <b>Results</b>  We identified three features reflecting educational and clinical trends within RM that might be representative of super-performance in plastic surgery journals. These include (1) relevance to high-yield techniques in RM such as tissue flap procurement, indications, and outcomes, (2) identification of gaps in current knowledge of these topics, and (3) use of media and algorithms to provide clear recommendations. <b>Conclusion</b>  Researchers hoping to have an impactful contribution should pose research questions that address these key themes. The RCR index is a valuable tool to appreciate performance within microsurgery literature and clinical trends within the field.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":"52 1","pages":"46-52"},"PeriodicalIF":1.3,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025054","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":"Chondrocutaneous Custom-made Graft for Upper Lateral and Alar Cartilage Nose Reconstruction: The T Graft.","authors":"Vania Recchi, Alberto Pau, Davide Talevi, Simone Russo, Matteo Torresetti, Giovanni Di Benedetto","doi":"10.1055/a-2349-9835","DOIUrl":"10.1055/a-2349-9835","url":null,"abstract":"<p><p>Upper lateral cartilage and alar cartilage nose reconstruction secondary to failed aesthetic procedure or tumor excision, surely represents a reconstructive challenge for plastic surgeons, because of the support needed and for the function of the internal nasal valve (INV). Several scientific publications deal with internal nasal reconstructive techniques, including simple homologous or heterologous tissue grafts. We describe a new hybrid chondrocutaneous graft used for reconstruction of the upper lateral cartilage and a portion of the alar cartilage (cephalic part), excised with the adherent nasal mucosa (in correspondence with INV), included in the tumor mass.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":"52 1","pages":"25-29"},"PeriodicalIF":1.3,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025061","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":"Clinical Significance of Hyperhomocysteinemia in Free Flap Failure: A Case Report.","authors":"Abeje Brhanu Menjeta, Hyung Hwa Jeong, Tae Hyung Kim, Seongsu Jeong, Changsik John Pak, Hyunsuk Peter Suh, Joon Pio Hong","doi":"10.1055/a-2336-0262","DOIUrl":"10.1055/a-2336-0262","url":null,"abstract":"<p><p>Failure of a microvascular free flap remains rare, yet multiple failures can occur, particularly in the presence of hypercoagulable conditions. This case series highlights our experience with a rare hypercoagulable state: hyperhomocysteinemia. We present two cases of patients with hyperhomocysteinemia in this report. High-dose heparinization was administered to both patients, resulting in successful salvage of one flap and failure of the other. Notably, one patient had a history of prior free flap failures. However, after correcting hyperhomocysteinemia, subsequent free flaps were successful. In cases of detected complications, a coagulability study is warranted, and adjustments to anticoagulation treatment may be necessary. Furthermore, when a history of flap failures is evident, screening for hyperhomocysteinemia may be warranted, with correction made prior to reconstruction.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":"52 3","pages":"197-201"},"PeriodicalIF":1.3,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095375","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":"Distally Based Lymphatic Microsurgical Preventive Healing Approach-A Modification of the Classic Approach.","authors":"Allen Wei-Jiat Wong, Nadia Hui Shan Sim, Coeway Boulder Thing, Wenxuan Xu, Hui Wen Chua, Sabrina Ngaserin, Shermaine Loh, Yee Onn Kok, Jia Jun Feng, Tan Woon Woon Pearlie, Benita Kiat-Tee Tan","doi":"10.1055/a-2336-0150","DOIUrl":"https://doi.org/10.1055/a-2336-0150","url":null,"abstract":"<p><p>The treatment of breast cancer has seen great success in the recent decade. With longer survivorship, more attention is paid to function and aesthetics as integral treatment components. However, breast cancer-related lymphedema (BCRL) remains a significant complication. Immediate lymphatic reconstruction is an emerging technique to reduce the risk of BCRL, the Lymphatic Microsurgical Preventive Healing Approach (LYMPHA) being the most widely used approach. Despite promising results, it is often difficult to find suitably sized recipient venules and perform the microanastomoses between mismatched vessels deep in the axilla. Moreover, high axillary venous pressure gradients and potential damage from radiotherapy may affect the long-term patency of the anastomoses. From an ergonomic point of view, performing lymphaticovenular anastomosis in the deep axilla may be challenging for the microsurgeon. In response to these limitations, we modified the technique by moving the lymphatic reconstruction distally-terming it distally based LYMPHA (dLYMPHA). A total of 113 patients underwent mastectomy with axillary clearance in our institution from 2018 to 2021. Of these, 26 underwent subsequent dLYMPHA (Group 2), whereas 87 did not (Group 1). In total, 17.2% (15 patients) and 3.84% (1 patient) developed BCRL in Groups 1 and 2, respectively ( <i>p</i>  = 0.018). Lymphatics and recipient venules suitable for anastomoses can be reliably found in the distal upper limb with better size match. A distal modification achieves a more favorable lymphaticovenular pressure gradient, vessel match, and ergonomics while ensuring a comparably low BCRL rate.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":"51 5","pages":"504-509"},"PeriodicalIF":1.3,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11436324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142336964","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":"Safety and Effectiveness of Liposuction Modalities in Managing Lipedema: Systematic Review and Meta-analysis.","authors":"Hatan Mortada, Sultan Alaqil, Imtinan Al Jabbar, Fatimah Alhubail, Nicolas Pereira, Joon Pio Hong, Feras Alshomer","doi":"10.1055/a-2334-9260","DOIUrl":"https://doi.org/10.1055/a-2334-9260","url":null,"abstract":"<p><p><b>Background</b>  Lipedema is a chronic, incurable disorder characterized by painful fat accumulation in the extremities. While the application of liposuction in lipedema management has become increasingly popular, the safety and effectiveness of this approach remain contentious. Our systematic review and meta-analysis aimed to assess various liposuction modalities in lipedema management to verify their safety and efficacy. <b>Methods</b>  In-line with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, we performed a comprehensive literature review from inception until March 2023 using the following electronic databases: CENTRAL, MEDLINE, Google Scholar, and EMBASE. <b>Results</b>  From the 562 initially identified articles, 20 met our inclusion/exclusion criteria for evaluation. Our review encompassed 14 prospective cohort studies, 3 retrospective studies, 2 case series, and 1 cross-sectional study. A meta-analysis of nine articles revealed a notable improvement in the quality of life, pain, pressure sensitivity, bruising, cosmetic impairment, heaviness, walking difficulty, and itching among lipedema patients who underwent liposuction. Although complications such as inflammation, thrombosis, seroma, hematoma, and lymphedema-related skin changes were reported, severe complications were rare. Crucially, no instances of shock, recurrence, or mortality were reported. <b>Conclusion</b>  Liposuction is a safe and beneficial therapeutic intervention for managing lipedema symptoms and enhancing quality of life. However, the impact of liposuction on secondary lymphedema remains unreported in the literature. Further high-quality, large-scale trials are necessary to assess the safety and effectiveness of different liposuction modalities. These studies will contribute valuable insights to optimize liposuction as a therapeutic option for individuals with lipedema. <b>Level of Evidence</b>  I, risk/prognostic study.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":"51 5","pages":"510-526"},"PeriodicalIF":1.3,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11436335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142336966","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":"Relation of Transversus Abdominis to Rectus Abdominis Muscle in Various Anatomical Landmark Levels: A Cadaveric Study.","authors":"Totsapol Surichamorn, Thiti Tantitham","doi":"10.1055/a-2350-8420","DOIUrl":"10.1055/a-2350-8420","url":null,"abstract":"<p><p><b>Background</b>  Posterior Component Separation (PCS) is a surgical technique used in abdominal wall reconstruction. Understanding the relationship between the rectus abdominis and transversus abdominis muscles and the location of intercostal nerves is crucial for minimizing nerve injury during PCS. This cadaveric study aimed to investigate these anatomical relationships and propose practical guidelines for safer PCS procedures. <b>Methods</b>  Eighteen fresh cadavers were dissected to assess the overlap or separation of the rectus abdominis and transversus abdominis muscles at seven abdominal levels. The distance of intercostal nerves from the lateral border of the rectus abdominis was measured. <b>Results</b>  The study found that the muscles overlapped at the xiphoid and upper abdominal levels but began to separate below the 2/4 upper to umbilicus level. Intercostal nerves entered at varying distances from the lateral edge of the rectus abdominis, suggesting that levels above the 3/4 upper to umbilicus level are relatively safe for dissection. <b>Conclusion</b>  The study recommends initiating the first incision for PCS between the subxiphoid and 2/4 upper to the umbilicus, based on observed muscle relationships and nerve distances. This practical approach enhances safety and simplifies decision-making during surgery.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":"52 1","pages":"3-10"},"PeriodicalIF":1.3,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025182","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 Wall Hernias Following High-intensity Focused Ultrasound Therapy: Three Case Reports.","authors":"Woo Yeon Han, Yeongsong Kim, Pyeong Hwa Kim, Eun Key Kim","doi":"10.1055/a-2268-6986","DOIUrl":"10.1055/a-2268-6986","url":null,"abstract":"<p><p>Although many studies reported the safety and efficacy of high-intensity focused ultrasound (HIFU) therapy, there are still worries about internal organ injury. However, reports of abdominal wall hernias after HIFU therapy are rare. We present three cases of abdominal wall hernias without skin injury after HIFU therapy in uterine adenomyosis or fibroids. The diagnosis was often delayed because of vague symptoms, inadequate clinical suspicion, and delayed proper image studies. Abdominal wall hernia should be recognized as a possible complication after HIFU and be suspected when the patient presents with unordinary abdominal swelling and/or pain that lasts for more than a few months after the procedure.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":"51 4","pages":"363-366"},"PeriodicalIF":1.3,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11257745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735388","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":"\"Funducation\"-The New Age of Learning, Intersection of Education, and Fun.","authors":"Joon Pio Hong, Jaume Masià","doi":"10.1055/a-2351-9736","DOIUrl":"https://doi.org/10.1055/a-2351-9736","url":null,"abstract":"","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":"51 4","pages":"349"},"PeriodicalIF":1.3,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11257739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735387","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":"Revision of the Retracted Posttracheostomy Scar by Anatomical Restoration; Four Layer Closure.","authors":"Jaeyoung Cho, Jimin Lee, Sang Yoon Kang","doi":"10.1055/s-0044-1787294","DOIUrl":"10.1055/s-0044-1787294","url":null,"abstract":"<p><p>Most tracheostomy scars are depressive and adherent to the underlying trachea, which causes up and down movement when swallowing. This tracheocutaneous tethering causes discomfort, pain, dysphagia, and bad appearance. A tracheocutaneous fistula may be accompanied. Here, we present a new method for reconstructing a tracheostomy scar deformity with tracheocutaneous tethering: layer-by-layer restoration of the anatomical structure with a subcutaneous fat tissue blanket. The scar tissue was fully excised, with the associated skin and subcutaneous tissue. The bilateral strap muscles around the scar were dissected proximally and distally and approximated to the midline, secured without tension. Bilateral platysma muscle flaps cover them firmly. The subcutaneous tissue around the incision margin, which included the superficial cervical fascia was elevated to form a fat blanket, closed transversely. The skin was closed after confirming the absence of retraction upon swallowing. From 2010 to 2018, 10 patients with tracheocutaneous tethering and one patient with tracheocutaneous fistula underwent surgery. All patients were functionally and aesthetically satisfied with the results. The only complication was a hypertrophic scar in one patient, which was managed with a triamcinolone injection. An anatomical layer-by-layer restoration with a fat blanket provided consistent, satisfying results for correcting tracheostomy scar deformities without using additional tissue. This simple method was effective for reconstructing tracheocutaneous tethering.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":"51 6","pages":"549-555"},"PeriodicalIF":1.3,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11560328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629829","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}