Seminars in Plastic Surgery最新文献

{"title":"Congenital Forearm Deformities: Characteristics, Diagnosis, and Management.","authors":"Lance R He, Benjamin D W Belfort, Daniel S Wang, Samuel H Cole, Bryce R Bell","doi":"10.1055/a-2886-1508","DOIUrl":"https://doi.org/10.1055/a-2886-1508","url":null,"abstract":"<p><p>Congenital forearm and wrist deformities, including Madelung's deformity, congenital radial head dislocation, and proximal radioulnar synostosis, present reconstructive challenges for upper extremity surgeons. While etiologically distinct, these developmental anomalies disrupt forearm rotation, elbow stability, and aesthetic appearance. This review examines the natural histories and management strategies necessary to restore form and function in pediatric patients. Madelung's deformity, characterized by distal radial physeal growth arrest and a tethering Vickers ligament, requires corrective osteotomies to address progressive pain and deformity. Congenital radial head dislocation necessitates radiographic evaluation to distinguish it from acquired trauma and is managed conservatively. Proximal radioulnar synostosis causes functional restrictions requiring derotational osteotomies in symptomatic patients. Precise anatomical understanding and individualized clinical judgment are essential to restore joint kinematics.</p>","PeriodicalId":48687,"journal":{"name":"Seminars in Plastic Surgery","volume":"40 3","pages":"237-243"},"PeriodicalIF":1.4,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13485378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polydactyly.","authors":"Julian J Gonzales, Vamsi C Mohan, Samuel P Griffin, Richard Appel, Andrea C Tian","doi":"10.1055/a-2880-1171","DOIUrl":"https://doi.org/10.1055/a-2880-1171","url":null,"abstract":"<p><p>Polydactyly of the hand is among the most common congenital anomalies of the upper extremity and encompasses a broad range of anatomic and functional presentations. It is characterized by a duplicated digit, which may occur as an isolated finding or in association with genetic syndromes. Based on the location and characteristics of the duplication, polydactyly is commonly classified as preaxial, postaxial, or central. Proper evaluation requires an understanding of limb embryology, genetic influences, and classification systems, as these factors directly inform surgical planning. Treatment strategies can range from simple excision of rudimentary digits to complex reconstruction aimed at restoring stability, alignment, mobility, and appearance. This chapter focuses on hand polydactyly, reviewing its embryologic and genetic foundations, classification systems, and approaches to surgical management. Emphasis is placed on technique selection, timing of intervention, and considerations that influence functional and aesthetic outcomes.</p>","PeriodicalId":48687,"journal":{"name":"Seminars in Plastic Surgery","volume":"40 3","pages":"210-215"},"PeriodicalIF":1.4,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13485365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innervated Muscle Transfer for Dynamic Abdominal Wall Reconstruction: Principles, Techniques, and Outcomes.","authors":"Chih-Hung Lin, Chung-Chen Hsu","doi":"10.1055/a-2823-0802","DOIUrl":"https://doi.org/10.1055/a-2823-0802","url":null,"abstract":"<p><p>Abdominal wall defects (AWDs) represent a significant reconstructive challenge, necessitating restoration of both structural integrity and dynamic function. While static reconstruction can address structural deficits, it often fails to replicate the dynamic properties of the native abdominal wall musculature, potentially resulting in compromised core strength and increased hernia recurrence. This article reviews the principles and techniques of dynamic abdominal wall reconstruction utilizing innervated muscle transfer, emphasizing its advantages in restoring core strength, minimizing hernia recurrence, and improving overall functional outcomes, particularly in complex cases. We will outline surgical planning, donor site selection, operative techniques, and reported clinical outcomes.</p>","PeriodicalId":48687,"journal":{"name":"Seminars in Plastic Surgery","volume":"40 2","pages":"151-154"},"PeriodicalIF":1.2,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13241195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroplastic and Augmented Reality Integration in Moyamoya Revascularization: A Reconstructive Microsurgical Paradigm.","authors":"Chieh-Tsai Wu, Chih-Hung Lin, Chung-Kan Tsao, Yau-Zen Chang","doi":"10.1055/a-2842-2242","DOIUrl":"https://doi.org/10.1055/a-2842-2242","url":null,"abstract":"<p><p>Cerebrovascular revascularization for moyamoya disease remains one of the most technically demanding procedures in neurosurgery, requiring meticulous microvascular anastomosis and precise intraoperative execution. The success of these operations depends on advanced microsurgical skill, careful teamwork, and refined perioperative planning. This review outlines the emerging neuroplastic approach-a collaborative model between neurosurgeons and plastic microsurgeons-and its integration with augmented reality (AR) technologies to enhance surgical precision, planning, and education. Drawing on recent evidence, neuroplastic collaboration improves graft patency, reduces ischemic complications, and shortens hospital stay in moyamoya revascularization. Parallel advances in AR enable immersive three-dimensional visualization, microvascular simulation, and intraoperative guidance. The combined neuroplastic-AR workflow enhances surgical accuracy, training efficiency, and patient safety, offering a sustainable framework for the next generation of cerebral revascularization.</p>","PeriodicalId":48687,"journal":{"name":"Seminars in Plastic Surgery","volume":"40 2","pages":"133-138"},"PeriodicalIF":1.2,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13241199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovations in Reconstructive Microsurgery: A Series of Challenging Cases and Novel Techniques.","authors":"Hung-Chi Chen, Yueh-Bih Tang, Chih-Hung Lin","doi":"10.1055/a-2842-1127","DOIUrl":"https://doi.org/10.1055/a-2842-1127","url":null,"abstract":"<p><p>This presentation highlights a series of challenging reconstructive microsurgery cases encountered over the past 45 years. Selected cases from a collection of 500 unusual scenarios demonstrate innovative techniques developed to address complex reconstructive problems, aiming to stimulate discussion and further advancements in the field. These include refinements in microvascular anastomosis, novel approaches to esophageal reconstruction, treatment for intractable chylous ascites, techniques for small vessel anastomosis, solutions for vessel-depleted necks, and strategies for managing complications.</p>","PeriodicalId":48687,"journal":{"name":"Seminars in Plastic Surgery","volume":"40 2","pages":"155-162"},"PeriodicalIF":1.2,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13241197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstructive Microsurgical Training: Global Challenges, Evolving Educational Strategies, and Future Directions.","authors":"Takaaki Sato, Ta-Chun Lin, Fu-Chan Wei","doi":"10.1055/a-2848-4410","DOIUrl":"https://doi.org/10.1055/a-2848-4410","url":null,"abstract":"<p><p>Reconstructive microsurgery is central to contemporary reconstructive surgery, enabling complex restoration of form and function across multiple anatomical regions. As clinical demands increase and operative exposure declines, the need for effective, structured microsurgical training has become more pressing. Despite advances in simulation, assessment, and curriculum design, substantial variability persists in how microsurgical training is delivered, validated, and sustained worldwide. This narrative review synthesizes the current global landscape of microsurgical training, examining key challenges and evidence-based educational strategies. Core components of effective training programs are identified, including technical skills acquisition, objective assessment, theoretical knowledge, research engagement, structured training pathways, and mentorship. A high-volume, longitudinal training model at Chang Gung Memorial Hospital is presented as an illustrative example. Future directions in microsurgical education are explored, with particular emphasis on competency-based curricula and entrustable professional activities. Key challenges include global variability and inequity in training access, limited longitudinal validation of training outcomes, reduced operative exposure, overemphasis on isolated technical skills, and shortages in mentorship capacity. Effective microsurgical training requires integration of technical, cognitive, non-technical, and professional competencies within longitudinal, context-rich educational frameworks. Emerging approaches-including distributed simulation, advanced virtual reality technologies, structured supervision, and international training networks-offer potential solutions to current limitations. Microsurgical education must evolve beyond episodic technical training toward integrated, competency-based frameworks that support progressive autonomy, patient safety, and independent practice. Although no single model is universally replicable, transferable principles from established programs can inform curriculum design across diverse settings. Continued investment in trainer development, outcome-driven educational research, and international collaboration will be essential to ensure the sustainability, equity, and effectiveness of future microsurgical training.</p>","PeriodicalId":48687,"journal":{"name":"Seminars in Plastic Surgery","volume":"40 2","pages":"168-176"},"PeriodicalIF":1.2,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13241196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Microsurgery Club for 10 Years-A New Online Education Platform and Beyond.","authors":"Patrick Szu-Ying Yen, Jung-Ju Huang, Johnny Chuieng Lu, Tommy Nai-Jen Chang","doi":"10.1055/a-2848-4459","DOIUrl":"https://doi.org/10.1055/a-2848-4459","url":null,"abstract":"<p><p>The rapid evolution of digital communication has transformed medical education, a shift accelerated by the COVID-19 pandemic. The International Microsurgery Club (IMC), founded in 2016 as a private Facebook group for verified professionals, exemplifies how social media can democratize microsurgical education on a global scale. By the end of 2025, IMC Facebook group had grown to over 22,600 members from more than 70 countries, facilitating case sharing, peer consultation, and professional recognition beyond geographic and institutional boundaries. Analysis of IMC activity between 2019 and 2025 identified 2,124 unique case-related posts contributed by 526 authors, with wide geographic diversity and high engagement independent of posting frequency. During the pandemic, IMC expanded into a sustained weekly webinar series, delivering nearly 600 sessions featuring international experts. Complemented by an open-access journal, a digital educational Web site, and multi-platform social media integration, IMC has evolved into a comprehensive, sustainable ecosystem for global microsurgical education, offering an effective model that complements traditional academic pathways.</p>","PeriodicalId":48687,"journal":{"name":"Seminars in Plastic Surgery","volume":"40 2","pages":"183-192"},"PeriodicalIF":1.2,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13241190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Establishment, Evolution, and Current Status of the Chang Gung Microsurgical Intensive Unit.","authors":"Ta-Chun Lin, Fu-Chan Wei","doi":"10.1055/a-2837-6469","DOIUrl":"https://doi.org/10.1055/a-2837-6469","url":null,"abstract":"<p><p>For over four decades, Chang Gung Memorial Hospital has maintained a dedicated microsurgical intensive care unit (MICU). This article explicates the role of this specialized unit within this high-volume center characterized by significant surgical complexity, examines its necessity, and offers insights for international colleagues. Established in the early 1980s during Taiwan's rapid industrialization to address severe limb trauma in a young workforce, the unit has evolved to support an increasing volume of complex head and neck, breast, lymphedema, and peripheral nerve reconstruction. Although global trends favor ward-based care, the MICU remains essential within our hospital context to ensure optimal patient care that individual surgical specialties strive for. Alongside clinical outcomes, the unit also aims to reduce the surgeons' postoperative burden, thereby enhancing surgical efficacy and laying the foundation for continued academic pursuit through centralized, comprehensive data collection for all microsurgical cases of the center. We present this model not as a universal advocacy, but as a reference for medical centers in regions with healthcare systems similar to Taiwan, especially those with comparable microsurgical volumes, varieties, and levels of complexity.</p>","PeriodicalId":48687,"journal":{"name":"Seminars in Plastic Surgery","volume":"40 2","pages":"163-167"},"PeriodicalIF":1.2,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13241191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated Lower Extremity Specimens Enhance Efficiency and Cost-Effectiveness in Cadaveric Flap Dissection Training for Clinical Practice-Chang Gung Experience.","authors":"Cheng-Hung Lin, Yun-Jui Lu, Chung-Chen Hsu, Fu-Chan Wei","doi":"10.1055/a-2847-3512","DOIUrl":"https://doi.org/10.1055/a-2847-3512","url":null,"abstract":"<p><p>Conventional microsurgical flap dissection courses typically utilize whole-body cadavers and emphasize the advantage of exposing participants to a greater number of flap dissections within a single course. However, we hold a different perspective. Although this viewpoint has been expressed in various courses and academic forums, it has not generated substantial discussion or adoption. We believe the issue is largely conceptual and psychological. Many participants appear to embrace the notion that \"the more flaps learned, the better,\" and course organizers often respond accordingly by promoting the opportunity to learn as many flaps as possible in one setting. In reality, this approach may overlook a fundamental principle: the essence of microsurgical flap training lies in mastering the core techniques of flap dissection-skills that are transferable across virtually all flap harvest procedures. With this philosophy in mind, the Chang Gung Microsurgery Center initiated an annual cadaveric dissection course using isolated lower extremity specimens soon after the establishment of the hospital's skill laboratory and dedicated cadaveric dissection facilities. In this narrative review, we describe the conceptual framework derived from our high clinical case volume and long-standing surgical education philosophy, together with our unique institutional experience and resources. The curriculum focuses primarily on three \"mother\" flaps that serve as both technical foundations and clinical workhorses-the anterolateral thigh flap, the fibular osteoseptocutaneous flap, and the toe flap-supplemented by other flaps that can be harvested from the lower extremity. We also discuss the transferability of these techniques to other reconstructive applications. Furthermore, we outline how our institution's distinctive resources are integrated to provide participants with a comprehensive understanding of microsurgical practice. The advantages of this lower extremity-focused training model-including improved learning efficiency and reduced financial and administrative burdens for both organizers and participants-are examined. We hope this model may serve as a valuable reference for medical centers currently engaged in, or planning to develop, microsurgical education and training programs.</p>","PeriodicalId":48687,"journal":{"name":"Seminars in Plastic Surgery","volume":"40 2","pages":"177-182"},"PeriodicalIF":1.2,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13241192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chang Gung Experience (Part 4): Organization of a Microsurgical Center for Service Education and Research and Miscellaneous Microsurgical Reconstruction.","authors":"Fu-Chan Wei, Chih-Hung Lin","doi":"10.1055/a-2848-4393","DOIUrl":"https://doi.org/10.1055/a-2848-4393","url":null,"abstract":"","PeriodicalId":48687,"journal":{"name":"Seminars in Plastic Surgery","volume":"40 2","pages":"122-123"},"PeriodicalIF":1.2,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13241189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}