Archives of Plastic Surgery-APS最新文献

{"title":"Long-Term Functional Outcomes of Posttraumatic Complex Extensor Tendon Reconstruction in Hand and Forearm Using Composite Anterolateral Thigh Free Flaps: A Case Series and Literature Review.","authors":"Hui Yuan Lam, Wan Azman Wan Sulaiman, Arman Zaharil Mat Saad, Ahmad Sukari Halim","doi":"10.1055/a-2844-9708","DOIUrl":"10.1055/a-2844-9708","url":null,"abstract":"<p><p>Complex dorsal hand and forearm injuries with extensor tendon and soft tissue loss are challenging to manage. Single-stage reconstruction using composite anterolateral thigh (ALT) fasciocutaneous free flaps with vascularized fascia lata may reduce the need for multiple surgeries and accelerate functional recovery, but clinical evidence is limited. We conducted a retrospective case series of nine patients with complex extensor tendon and soft tissue defects who underwent single-stage reconstruction with composite ALT flaps between 2009 and 2018. Six patients were available for long-term follow-up (average 2-3 years). Data included demographics, injury characteristics, operative details, complications, and functional outcomes assessed using Miller's criteria. One donor site hematoma resolved without sequelae. Functional assessment revealed that two patients achieved excellent and poor outcomes in wrist and finger extension, respectively, while one patient demonstrated good and fair results . Poor outcomes were associated with missed follow-up, prolonged immobilization, and concomitant skeletal injuries. All patients returned to work and reported satisfaction with their functional status. This approach offers durable soft tissue coverage, restores tendon continuity, and allows early rehabilitation with minimal donor site morbidity.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":"53 3","pages":"257-266"},"PeriodicalIF":1.4,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139352","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":"Ultrasonographic Evaluation of Nasal Tip Anatomy for Rhinoplasty Planning.","authors":"Chuong Dinh Nguyen, Ngoc Ba Nguyen, Hue Minh Ho, Anh Ngoc Hoang, Tung Thanh Nguyen, Quynh Ngoc-Thuy Ho, Tho Thi-Kieu Nguyen","doi":"10.1055/a-2802-5847","DOIUrl":"10.1055/a-2802-5847","url":null,"abstract":"<p><strong>Background: </strong>Rhinoplasty outcomes are heavily influenced by nasal tip anatomy, particularly the thickness of the soft tissue envelope (STE) and the underlying cartilaginous framework. Traditional assessment methods are subjective, prompting exploration of objective techniques such as ultrasonography. This study evaluates nasal tip anatomy using high-resolution ultrasound imaging and correlates quantitative findings with surgical implications.</p><p><strong>Methods: </strong>This prospective study enrolled 35 adult patients at a tertiary referral hospital. Patients with prior nasal surgery, injections, fractures, congenital anomalies, or significant skin disease were excluded. A 12-MHz ultrasound probe was used to measure STE thickness at the nasion, rhinion, and nasal tip, septal cartilage thickness and dorsal length, and the internal nasal valve angle (INVA).</p><p><strong>Results: </strong>STE thickness was greatest at the nasion (4.11 ± 0.51 mm), followed by the nasal tip (3.95 ± 0.54 mm), and thinnest at the rhinion (2.49 ± 0.16 mm). The mean septal cartilage thickness was 2.09 ± 0.30 mm at the premaxilla and thinner at the dorsum (1.54 ± 0.26 mm). The mean dorsal septal length was 22.8 mm. Male patients consistently exhibited thicker STEs and septal cartilage than female patients ( <i>p</i>  < 0.001). The INVA averaged 25.7 degrees bilaterally.</p><p><strong>Conclusion: </strong>Ultrasonography provides a reliable, objective assessment of nasal anatomy for surgical planning. Recognition of variations in soft tissue and septal morphology facilitates tailored approaches, improving both aesthetic and functional outcomes, especially in patients with thick nasal skin.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":"53 2","pages":"142-150"},"PeriodicalIF":1.4,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13030928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575910","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":"State-of-the-Art Medical Imaging Supporting Supermicrosurgery: A Scoping Review, Practical Guidelines, and Illustrative Case Report.","authors":"Jos Velleman, Jin Geun Kwon, Changsik John Pak, Hyunsuk Peter Suh, Joon Pio Hong","doi":"10.1055/a-2798-0198","DOIUrl":"10.1055/a-2798-0198","url":null,"abstract":"<p><p>In the era of supermicrosurgery, clinicians need more precise imaging modalities to know the exact microvascular and lymphatic anatomy of the patient. The goal of this review is to answer the research question \"What are the state-of-the-art medical imaging modalities supporting supermicrosurgery?\" This study is a scoping review and case report. Computed tomography angiography (CTA) and magnetic resonance angiography (MRA) are well-known current standard imaging modalities in flap surgery. In lymphatic surgery, lymphoscintigraphy is the gold standard. (Ultra)high-frequency ultrasound (UHFUS) has taken a major role in preoperative planning of flap surgery and lymphatic surgery. Practical guidelines on the use of UHFUS in flap planning and lymphatic surgery are described in this review article. Indocyanine green angiography and near-infrared fluorescent lymphography have also become key elements in modern flap surgery and lymphatic surgery. Moreover, contrast-enhanced magnetic resonance lymphography produces high-resolution imaging of superficial as well as deep lymphatic vessels. Laser tomography and photoacoustic imaging are promising experimental imaging techniques in lymphatic surgery. This review article describes and compares possible imaging modalities for preoperative planning and intraoperative guidance with the aims of enhancing surgical outcomes, reducing operative time, and preventing complications in supermicrosurgery. Moreover, a case report is described in order to illustrate the practical imaging work-up in daily practice.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":"53 2","pages":"178-190"},"PeriodicalIF":1.4,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13030926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575886","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 HIROSHIMA Study: A High-Volume, Institutional, Retrospective, Observational Study of Hidden Non-Incisional Suture Double Eyelid Surgery for Multivariate Analysis of Crease Loss.","authors":"Kyosuke Inoguchi, Takahiko Tamura, Hiromichi Okuma, Ryoichi Matsumoto, Michinori Yasuda, Takashi Yamauchi, Hiroo Teranishi","doi":"10.1055/a-2796-6824","DOIUrl":"10.1055/a-2796-6824","url":null,"abstract":"<p><strong>Background: </strong>Non-incisional double eyelid surgery is widely performed in East Asia, but crease loss remains a major concern, leading to patient dissatisfaction and revision. The relative impact of surgical technique, anatomical characteristics, and surgeon experience on crease retention has not been fully clarified.</p><p><strong>Methods: </strong>This retrospective, observational study included 513 consecutive patients who underwent transcutaneous, non-incisional double eyelid surgery between July 2021 and July 2022. Patients were stratified by surgeon experience (<100 vs. ≥100 prior cases). Baseline variables included age, sex, crease design, fixation method, puffy eyelid status, and surgeon experience. Crease loss was defined as the need for revision due to patient-reported fading or disappearance of the crease. Kaplan-Meier analysis and Cox proportional hazards regression were used to evaluate predictors of crease survival, including interaction terms for potential effect modification.</p><p><strong>Results: </strong>Of 513 patients, 264 were treated by beginner surgeons, and 249 by experienced surgeons. Experienced surgeons more frequently used the continuous buried suture method ( <i>p</i>  < 0.001), whereas baseline characteristics such as age, sex, and crease design were comparable between groups. Overall prevalence of puffy eyelids was 54.5%, with substantial interrater agreement (κ = 0.72). Kaplan-Meier analysis demonstrated significantly superior outcomes with continuous fixation compared to interrupted fixation (log-rank <i>p</i>  < 0.001), and with non-puffy compared to puffy eyelids (log-rank <i>p</i>  < 0.001). Surgeon experience showed no significant effect ( <i>p</i>  = 0.441). In multivariable Cox regression, continuous fixation (HR = 0.29, 95% CI 0.19-0.44, <i>p</i>  < 0.001) and non-puffy eyelids (HR = 2.47, 95% CI 1.62-3.78, <i>p</i>  < 0.001) were independent predictors of crease retention. A significant interaction between fixation method and puffy eyelid was identified (HR = 0.34, 95% CI: 0.13-0.87, <i>p</i>  = 0.024), indicating that the protective effect of continuous fixation was particularly pronounced in patients with puffy eyelids.</p><p><strong>Conclusion: </strong>Fixation method and eyelid puffiness were the primary determinants of crease retention, whereas surgeon experience was not an independent predictor. Continuous fixation provided superior outcomes, especially for patients with puffy eyelids. These findings suggest that, within standardized training systems, surgical technique and individualized anatomical consideration are more critical than case volume for achieving durable results in non-incisional double eyelid surgery.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":"53 2","pages":"135-141"},"PeriodicalIF":1.4,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13030923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575913","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":"Does Exsanguination Enhance Skin Microcirculation in Remote Ischemic Conditioning Using a Tourniquet? A Randomized Controlled Trial on 50 Healthy Subjects.","authors":"Carola Rist, Jens Rothenberger, Adrien Daigeler, Andrea Wenger","doi":"10.1055/a-2779-2935","DOIUrl":"10.1055/a-2779-2935","url":null,"abstract":"<p><strong>Background: </strong>Remote Ischemic Conditioning (RIC) improves cutaneous microcirculation in free flap surgery. As no universal RIC protocol exists, refinements have mainly focused on cycle duration and number. We aimed to assess whether ischemic stimulus intensity, using a tourniquet with additional exsanguination, affects cutaneous microcirculation.</p><p><strong>Methods: </strong>In this randomized controlled trial, 50 healthy volunteers were randomized into two groups (25 each). Both underwent an RIC protocol of three cycles of 10-minute ischemia followed by 10-minute reperfusion. In the control group (Tourniquet, T), ischemia was induced with a surgical tourniquet inflated to 250 mm Hg on the right upper arm. In the experimental group (Tourniquet with exsanguination, T ^e ), the arm was additionally exsanguinated using an Esmarch bandage. Cutaneous microcirculation parameters (oxygen saturation [SO ₂ ], blood flow [BF], and relative amount of hemoglobin [rHb]) were assessed non-invasively with the oxygen to see (O2C) device.</p><p><strong>Results: </strong>Both groups showed significant changes in all microcirculatory parameters compared with baseline. Although SO ₂ and BF values tended to be higher during reperfusion in the experimental group (T ^e ), overall differences were not statistically significant (except at the end of the first reperfusion phase in BF [T _mean 1.33 ± 0.54 vs. T ^e _mean 1.93 ± 0.91; <i>p</i>  = 0.017] and at the beginning of the second reperfusion phase in SO ₂ [T _mean 1.05 ± 0.18 vs. T ^e _mean 1.13 ± 0.17; <i>p</i>  = 0.045], respectively).</p><p><strong>Conclusion: </strong>Exsanguination, in addition to tourniquet application, does not enhance cutaneous microcirculation in RIC protocols. The relatively small sample size remains a limitation and restricts generalizability. Future studies should confirm these findings in larger and more diverse cohorts and explore potential clinical applications.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":"53 2","pages":"199-207"},"PeriodicalIF":1.4,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692879","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":"Comparing the Readability and Content Quality of Online Patient Education Materials and ChatGPT-Generated Patient Education Materials for Breast Cancer Surgery and Reconstruction.","authors":"Nikhil Sriram, Anitesh Bajaj, May Li, Tarifa Adam, Antoinette Nguyen, Jeewon Chon, Robert D Galiano","doi":"10.1055/a-2794-9984","DOIUrl":"10.1055/a-2794-9984","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing breast cancer surgery and reconstruction seek information using online patient education materials (OPEMs). The National Institutes of Health (NIH) and American Medical Association (AMA) recommend a sixth-grade reading level for OPEMs. In recent years, Chat Generative Pre-Trained Transformer (ChatGPT), a large language model (LLM), has shown potential utility in patient education. This study compares the readability and content quality of OPEMs on breast cancer surgery and reconstruction with ChatGPT-generated materials.</p><p><strong>Methods: </strong>Google searches were conducted in January 2025 to identify relevant OPEMs for breast cancer surgery and reconstruction. For each search term, ChatGPT 4.0 was prompted to generate patient education guides using two approaches: (1) Standard prompting and (2) simplified prompting to align with NIH/AHA recommendations (\"write the guide like I am in sixth grade\"). Readability and content quality metrics were assessed.</p><p><strong>Results: </strong>Ninety-nine OPEMs and 60 ChatGPT responses (30 standard, 30 simplified) were analyzed. Median Flesch-Kincaid Grade Level (FKGL) was 10.8 for OPEMs, 10.0 for standard ChatGPT responses, and 5.8 for simplified ChatGPT responses. OPEMs and standard ChatGPT responses significantly exceeded NIH/AMA recommendations ( <i>p</i>  < 0.001). Simplified ChatGPT responses aligned with the sixth-grade level and were significantly easier to read than OPEMs and standard ChatGPT responses ( <i>p</i>  < 0.001). DISCERN scores did not significantly differ between OPEMs and standard/simplified ChatGPT responses.</p><p><strong>Conclusion: </strong>OPEMs on breast cancer surgery and reconstruction exceed recommended readability levels. ChatGPT, when prompted to simplify, produced materials consistent with NIH/AMA guidelines while maintaining content quality. Using ChatGPT for patient education may enhance accessibility and patient comprehension of health information.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":"53 2","pages":"191-198"},"PeriodicalIF":1.4,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13030927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575920","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":"Delayed Infection of Tissue Expanders in Immediate Two-Stage Implant-Based Breast Reconstruction.","authors":"Hye Ju Han, Ahran Kim, Min Suk Park, Daiwon Jun, Jiyoung Rhu, Pill Sun Paik, Jung Ho Lee","doi":"10.1055/a-2822-5229","DOIUrl":"10.1055/a-2822-5229","url":null,"abstract":"<p><strong>Background: </strong>While surgical site infection (SSI) is a major complication of implant-based breast reconstruction, delayed infections remain underrecognized despite their clinical significance. This study aimed to identify the risk factors of delayed infection and compare the clinical outcomes of acute and delayed SSI after tissue expander insertion.</p><p><strong>Methods: </strong>Patients who underwent immediate tissue expander-based breast reconstruction between March 2016 and February 2021 were reviewed. Acute SSI (<30 days) and delayed SSI (>60 days) were analyzed and compared with the no-infection group.</p><p><strong>Results: </strong>Among 146 breasts (140 patients), 26 SSIs occurred; 50% ( <i>n</i>  = 13) were delayed. Multivariable analysis identified wound complication as the sole independent risk factor for delayed SSI. Compared with acute SSI, delayed infection was associated with a significantly longer interval from symptom onset to diagnosis (4.15 vs. 0.33 days, <i>p</i>  = 0.0181) and a lower salvage rate (31% vs. 83%), showing borderline significance ( <i>p</i>  = 0.057).</p><p><strong>Conclusion: </strong>Delayed SSI is not rare after expander-based breast reconstruction. Because salvage is challenging due to diagnostic delay, surgeons and patients should remain vigilant, particularly when risk factors for delayed infection of the tissue expander remain.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":"53 2","pages":"151-158"},"PeriodicalIF":1.4,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13030930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575934","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":"Innovative Nasal Splitting Technique for Dual Rhinoplasty and Rhinophyma Management: A Case Report and Literature Review.","authors":"Michel L H T Vaena, Bruno Benedetti Pinto, Carlos Weck Roxo","doi":"10.1055/a-2802-3112","DOIUrl":"10.1055/a-2802-3112","url":null,"abstract":"<p><p>Rhinophyma is a deforming disease that affects the nose mainly of Caucasian men. Progressive nasal skin thickening, telangiectasias, and hypertrophy of sebaceous appendages are frequently found in these patients. Many therapeutic modalities have been reported with good results. Among these, tangential excision is established as the surgical modality of choice. In advanced cases, it is not possible to distinguish nasal deformities resulting from rhinophyma from those resulting from malposition of the anatomic components that make up the nasal framework. We describe the use of a mixed technique in which the tangential excision and the open approach complement each other satisfactorily, restoring both shape and structure of the nose. This approach may represent a safe alternative for the simultaneous treatment of rhinophyma and a structured rhinoplasty, and further studies are needed for its full validation in clinical practice.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":"53 3","pages":"247-252"},"PeriodicalIF":1.4,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139349","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":"Novel Use of Chimeric Serratus Anterior Fascia-Latissimus Dorsi Flap for Composite Cranial Defect.","authors":"James Antongiovanni, Nikhil Shah, Chizoba A Mosieri, Sarah Struble, Hoyune E Cho, Medha Vallurupalli, Gabrielle Labove, Miles J Pfaff","doi":"10.1055/a-2778-4044","DOIUrl":"10.1055/a-2778-4044","url":null,"abstract":"<p><p>Effective soft tissue coverage is essential for minimizing complications in large cranial defects. This case report describes the successful application of a chimeric serratus anterior fascia-latissimus dorsi (SAFLD) flap for single-stage coverage of a large cranial defect. This technique is compared to the current literature. A 69-year-old female with a history of glioblastoma and a rapidly growing scalp squamous cell carcinoma underwent en bloc resection and single-stage reconstruction. After cranioplasty, a large defect was covered with an SAFLD flap, ensuring multilayered vascularized soft tissue coverage. Recovery was uneventful, and a 1-year follow-up demonstrated good cranial morphology. This case demonstrates the successful application of a chimeric free flap for dual-layer coverage in cranial reconstruction, potentially reducing complications associated with single-stage repairs and improving patient outcomes. A literature review demonstrating various case applications of this flap is also presented.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":"53 4","pages":"342-346"},"PeriodicalIF":1.4,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713909","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":"Koebner Phenomenon Psoriasis after Right Ankle Free Flap Reconstruction.","authors":"Sophie R Persaud, Nelson A Rodriguez-Unda","doi":"10.1055/a-2780-1435","DOIUrl":"10.1055/a-2780-1435","url":null,"abstract":"<p><p>Isomorphic cutaneous lesion formation in response to trauma in patients with prior cutaneous disease is known as the Koebner phenomenon. To our knowledge, there are no reports of the phenomenon occurring after lower extremity flap reconstruction. A 24-year-old male with no significant medical history underwent right ankle reconstruction using an anterolateral thigh flap following wide excision of a low-grade sarcoma. His recovery was mostly uneventful; however, 6 months later, he developed well-demarcated, erythematous plaques with white scales over both the flap and donor sites. The dermatology department diagnosed him with plaque psoriasis attributed to Koebnerization. Topical corticosteroids were prescribed and resulted in complete resolution within 2 days. At his 8-month follow-up, all surgical sites had healed with no evidence of recurrence. This case highlights a rare occurrence of the Koebner phenomenon following free flap reconstruction in a patient without prior personal or familial history of psoriasis. Early detection and treatment of postoperative dermatoses in partnership with dermatology is crucial to avoiding unnecessary intervention and achieving successful outcomes without complications.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":"53 4","pages":"374-377"},"PeriodicalIF":1.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713912","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}