Journal of Plastic Reconstructive and Aesthetic Surgery最新文献

{"title":"Using large language models in Plastic Surgery may be unethical","authors":"Robert Browne ,&nbsp;Kevin C. Cahill","doi":"10.1016/j.bjps.2025.06.006","DOIUrl":"10.1016/j.bjps.2025.06.006","url":null,"abstract":"<div><div>This correspondence serves to highlight the potential ethical issues associated with the use of large language models in plastic surgery.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"107 ","pages":"Pages 68-70"},"PeriodicalIF":2.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144313728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of indocyanine green fluorescence angiography in improving the reliability of pedicled flaps in head and neck reconstruction","authors":"Snigdha Elaprolu ,&nbsp;P Kishore ,&nbsp;Jimmy Mathew ,&nbsp;Deepak Balasubramanian ,&nbsp;Lakshmi Ravunniarth Menon ,&nbsp;Sam Thomas ,&nbsp;Krishnakumar Thankappan ,&nbsp;Subramania Iyer","doi":"10.1016/j.bjps.2025.06.005","DOIUrl":"10.1016/j.bjps.2025.06.005","url":null,"abstract":"<div><div>Pedicled flaps are frequently used for reconstructing the head and neck area. Partial or complete loss can be debilitating, affecting speech, swallowing, and appearance. This is a prospective interventional study conducted in head and neck cancer patients undergoing reconstruction with pedicled flaps from August 2022 to May 2023, where the Indocyanine green–fluorescence angiography (ICG-FA) technique was employed to improve the outcomes of flap surgery. Retrospective data of pedicled flaps performed from 2021 to June 2022 were collected from medical records to compare outcomes with the prospective group. Demographics, surgery details, and flap outcomes were obtained for both groups. Data from 46 patients in the prospective group and 77 patients in the retrospective group were analyzed. Each group was further categorized into laryngeal and non-laryngeal subgroups. Distribution of age, sex, history of prior surgery, and previous radiotherapy was similar between the two groups.</div><div>In the non-laryngeal group, the prospective intervention arm versus the retrospective arm had partial flap loss in 5.6% versus 22.9%. The occurrence of flap loss (partial/total) was significantly lower in the prospective group within the non-laryngeal subgroup (p=0.025). In the laryngeal subgroup, salivary leaks were used as a proxy for outcome, and there was no significant difference between both the groups (p=1.00). The prospective group experienced fewer secondary procedures, second flap surgeries, though these differences did not reach statistical significance.</div><div>ICG-FA appears to be a valuable tool for assessing flap perfusion. Further research is essential to obtain objective measures of perfusion and to apply ICG-FA in specific cases to enhance cost-effectiveness.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"107 ","pages":"Pages 39-48"},"PeriodicalIF":2.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144280497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effective strategies for reducing carbon emissions in plastic surgery","authors":"Ciara Walsh ,&nbsp;Dónal Murphy ,&nbsp;Niall McInerney ,&nbsp;Maire-Caitlin Casey ,&nbsp;Alan Hussey","doi":"10.1016/j.bjps.2025.06.003","DOIUrl":"10.1016/j.bjps.2025.06.003","url":null,"abstract":"<div><h3>Background</h3><div>Global warming is the biggest health threat of the 21st century. If healthcare were a country, it would be the 5th largest greenhouse gas emitter on the planet. The operating theatre produces 21–30% more waste than the rest of the hospital. This study aimed to implement carbon and cost saving measures in plastic surgery from minor operations to free flap reconstruction.</div></div><div><h3>Method</h3><div>Evaluate current departmental use of disposable sets and consumables. Perform a financial and environmental cost analysis comparing disposable and reusable minor plastic surgical sets. Repeat the same analysis and apply findings on rationalising main theatre plastics sets. Jamovi (2.3.28) built on R statistical language was used for statistical analysis.</div></div><div><h3>Results</h3><div>Introducing new minor plastics sets to main theatre with a 77% reduction in instruments from the previous major plastics sets for smaller cases can save €50310 and 2900–3388kgCO2e. Microsurgical breast reconstruction set contents were decreased by 55% along with reducing single use consumables, amounting to an annual saving of €10696 and 155–181kgCO2e. Up to 6500 disposable minor surgical sets per year are consumed in the three plastic surgery units within the HSE West Hospital Group. By removing disposable sets from one unit entirely, our projected savings will be €13173 and 2199.35 kgCO2e.</div></div><div><h3>Conclusion</h3><div>We have improved our environmental and economic impact on the hospital, with potential savings of over €74′000 and 5.7 t CO2e with no deficits to patient care. These carbon savings are the equivalent to the emissions produced by a new car driving approximately 1.33 times around the Earth’s circumference. These changes can be easily replicated across other departments to affect more widespread savings.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"107 ","pages":"Pages 85-92"},"PeriodicalIF":2.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring health-related quality of life in patients with peripheral vascular malformations with PROMIS® computerized adaptive tests","authors":"Delano J. de Oliveira Marreiros ,&nbsp;Max M. Lokhorst ,&nbsp;Danny A. Young-Afat ,&nbsp;Merel L.E. Stor ,&nbsp;Sophie E.R. Horbach ,&nbsp;Leo D. Roorda ,&nbsp;Michiel A.J. Luijten ,&nbsp;Lotte Haverman ,&nbsp;Chantal M.A.M. van der Horst ,&nbsp;Phyllis I. Spuls","doi":"10.1016/j.bjps.2025.05.036","DOIUrl":"10.1016/j.bjps.2025.05.036","url":null,"abstract":"<div><h3>Background</h3><div>The Patient-Reported Outcomes Measurement Information System (PROMIS) computerized adaptive tests (CATs) have been recommended for measuring health-related quality of life (HRQoL) in rare diseases.</div></div><div><h3>Objective</h3><div>To assess whether PROMIS CATs reliably measure HRQoL core outcome domains in adults with vascular malformations, and if so, to establish reference values for this population.</div></div><div><h3>Methods</h3><div>In this prospective cohort study, adult patients with vascular malformations at our tertiary referral center were invited to complete PROMIS CATs measuring HRQoL core outcome domains, followed by a retest seven days after completing the first questionnaires. Patients completed PROMIS CATs on pain interference, physical function, anxiety, depression, ability to participate in social roles and activities, and the PROMIS numeric rating scale (NRS) on pain intensity. Test-retest reliability was quantified by calculating intraclass correlation coefficients (ICC), standard errors of measurement (SEM) and smallest detectable changes (SDC). An ICC ≥0.7 was considered adequate. Moreover, descriptive statistics for each CAT were calculated and compared against the Dutch general population.</div></div><div><h3>Results</h3><div>One-hundred-twenty-three patients completed at least one CAT and 55 patients completed the retest of at least one CAT. All ICCs were above 0.85, SEMs were under 5 points and SDCs were around 10 points, indicating adequate test-retest reliability and measurement errors. All average CAT scores of patients with vascular malformations were within normal limits compared to PROMIS reference values for the Dutch general population.</div></div><div><h3>Conclusion</h3><div>PROMIS CATs reliably measure physical, mental and social HRQoL in adults with vascular malformations. Reference values for PROMIS CATs in this population were established.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 401-408"},"PeriodicalIF":2.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “The current state of tranexamic acid in mastectomy and breast reconstruction: A systematic review and meta-analysis”","authors":"Shubham Kumar,&nbsp;Renu Sah","doi":"10.1016/j.bjps.2025.05.035","DOIUrl":"10.1016/j.bjps.2025.05.035","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"107 ","pages":"Pages 22-23"},"PeriodicalIF":2.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter comments on: “A 5-point framework for students evaluating plastic surgery research fellowship opportunities”","authors":"Emily E. Zona,&nbsp;Keenan S. Fine,&nbsp;Aidan W. O’Shea,&nbsp;Armin Edalatpour,&nbsp;Kirsten A. Gunderson,&nbsp;Jacqueline S. Israel,&nbsp;Samuel O. Poore","doi":"10.1016/j.bjps.2025.05.032","DOIUrl":"10.1016/j.bjps.2025.05.032","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"107 ","pages":"Pages 19-21"},"PeriodicalIF":2.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144239845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of post-mastectomy pain syndrome in breast cancer patients undergoing subsequent reconstruction: A scoping review","authors":"Arushi Biswas ,&nbsp;Aidan S. Weitzner ,&nbsp;Lily Zhu ,&nbsp;Jeffrey Khong ,&nbsp;Shreya Sriram ,&nbsp;Carisa M. Cooney ,&nbsp;Mehran Habibi ,&nbsp;Kristen P. Broderick","doi":"10.1016/j.bjps.2025.06.001","DOIUrl":"10.1016/j.bjps.2025.06.001","url":null,"abstract":"<div><h3>Background</h3><div>25–60% of mastectomy patients experience chronic pain, known as post-mastectomy pain syndrome (PMPS). However, there is a lack of consensus about the timeline and definition of PMPS. As mastectomy followed by breast reconstruction is commonly utilized by patients with breast cancer, how we define and diagnose PMPS will play a critical role in managing these patients. This review presents the scope of literature about chronic pain in breast cancer patients who received mastectomy and subsequent reconstruction.</div></div><div><h3>Methods</h3><div>Six databases were searched for articles about breast cancer patients undergoing mastectomy and reconstruction who experienced chronic pain. Details about pain and reconstruction type were extracted. Chronic pain definitions were analyzed descriptively.</div></div><div><h3>Results</h3><div>Thirty-six articles described 6906 patients (mean age 48.2 years) who underwent mastectomy and reconstruction between 1996 and 2022. Overall, 47% of patients experienced chronic pain. Six studies defined chronic pain, with one listing symptoms and four mentioning (but not specifying) pain duration. Eleven studies reported time to pain presentation, ranging from 1.3 to 94 months post-surgery. Of the eight that specified etiology, seven were limited to neuropathic pain, while one described musculoskeletal pain. Among patients for whom reconstruction type was specified, 54% of those with implant-based reconstruction (n=1336/2469) reported chronic pain, compared to 47% of those with autologous reconstruction (n=508/1077; p&lt;0.001).</div></div><div><h3>Conclusion</h3><div>Chronic pain can be an unfortunate, multifactorial complication of mastectomy and breast reconstruction. With mastectomy and subsequent reconstruction being a common option for breast cancer management, it is imperative to comprehensively characterize PMPS and its relationship with breast reconstruction.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"107 ","pages":"Pages 73-84"},"PeriodicalIF":2.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Combined latissimus dorsi myocutaneous flap and 3D-printed PEEK implant for reconstruction of a large full-thickness chest wall defect: A retrospective study”","authors":"Renu Sah,&nbsp;Ankita Mathur","doi":"10.1016/j.bjps.2025.05.037","DOIUrl":"10.1016/j.bjps.2025.05.037","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 414-415"},"PeriodicalIF":2.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new surgical treatment of pincer nail deformity using artificial dermis","authors":"Sakurako Murata,&nbsp;Asako Fukuju,&nbsp;Risa Murakami,&nbsp;Hirotaka Suga","doi":"10.1016/j.bjps.2025.05.034","DOIUrl":"10.1016/j.bjps.2025.05.034","url":null,"abstract":"<div><h3>Background</h3><div>Pincer nail deformity is an excessive transverse curvature of the nail plate. It often causes severe pain and reduces the patient's quality of life. Various surgical techniques have been reported for pincer nail deformity, but no studies have reported the use of artificial dermis to resolve the dead space on both sides of the distal phalanx after the deformed nail bed is elevated. We describe our new surgical method placing artificial dermis in these dead spaces, and we provide the results of our evaluation of the method’s effectiveness.</div></div><div><h3>Methods</h3><div>We examined the cases of the patients who underwent surgical treatment using artificial dermis for pincer nail deformity at our hospital between April 1, 2020, and March 31, 2024. The patients’ information was retrospectively reviewed from the medical records. In the surgery, we placed artificial dermis in the dead space on both sides of the distal phalanx. The change in nail curvature was evaluated using the height index (HI).</div></div><div><h3>Results</h3><div>A total of 19 toes of 11 patients were included. Postoperatively, the mean HI value was significantly improved from 64.8% to 12.9% (p&lt;0.05). All 11 patients were relieved of the pain. No early postoperative complications and no recurrences were observed in the patients.</div></div><div><h3>Conclusion</h3><div>Our new method of placing artificial dermis in the dead space on both sides of the distal phalanx is a simple and effective treatment for pincer nail deformity.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 409-413"},"PeriodicalIF":2.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acellular dermal matrix integration in hydrogel scaffolds: A novel approach to cartilage tissue engineering","authors":"Hojin Park ,&nbsp;Min-Sook Kim ,&nbsp;Tae-Yul Lee ,&nbsp;Han-Sang Song ,&nbsp;Deok-Woo Kim","doi":"10.1016/j.bjps.2025.05.038","DOIUrl":"10.1016/j.bjps.2025.05.038","url":null,"abstract":"<div><h3>Background</h3><div>Scaffold materials impact engineered cartilage properties, but current options like hydrogels and PCL have limitations, including insufficient strength and inflammatory responses. This study explored the efficacy of integrating hydrogel scaffolds with an acellular dermal matrix (ADM) to enhance structural integrity and chondrogenesis.</div></div><div><h3>Methods</h3><div>Human third costal cartilage was obtained and processed to isolate chondrocytes, which were assessed via flow cytometry for surface markers (CD44, CD54, CD31, CD45). Chondrocytes were cultured in a gelatin scaffold with (ADM group) or without ADM sheets (Hydrogel group), then implanted in BALB/c nude mice for 12 weeks. Histological staining and ECM analyses, including GAG and type II collagen ELISA, were conducted on harvested constructs.</div></div><div><h3>Results</h3><div>The rectangular shape was better preserved in the ADM group compared to the hydrogel group, indicating less contraction and deformation. The scaffold width in the ADM group was significantly greater (9.20±0.23 mm) than that in the hydrogel group (7.40±0.93 mm, p&lt;0.05). Histological analysis revealed an enhanced ECM formation in the ADM group with uniform ECM distribution. The quantitative assays demonstrated significantly higher glycosaminoglycan content (3.3±0.7 μg/mg) and type II collagen levels (11.3±1.6 μg/mg) in the ADM group compared to the hydrogel group (2.2±0.2 μg/mg and 4.6±0.4 μg/mg, respectively; p&lt;0.05).</div></div><div><h3>Conclusion</h3><div>The ADM-covered hydrogel scaffold effectively maintained its structural integrity and volume in vivo, promoting ECM production compared with the hydrogel-only scaffold. These findings indicate that the ADM-covered hydrogel scaffolds have significant potential for cartilage tissue engineering and reconstructive surgery.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 393-400"},"PeriodicalIF":2.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144220918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}