Journal of Plastic Reconstructive and Aesthetic Surgery最新文献

{"title":"Comparative outcomes of allograft with vascularized fibula graft vs vascularized fibula graft alone for post-oncologic lower extremity salvage – Systematic review and meta-analysis","authors":"Abdulaziz Elemosho,&nbsp;Stefan Czerniecki,&nbsp;Sami Ramadan,&nbsp;Syed Farhan,&nbsp;Kerry-Ann S. Mitchell,&nbsp;Jason M. Souza","doi":"10.1016/j.bjps.2025.06.026","DOIUrl":"10.1016/j.bjps.2025.06.026","url":null,"abstract":"<div><h3>Background</h3><div>Vascularized fibular grafts (VFGs) can be combined with an allograft (Capanna technique) or used alone. Our study aims to compare the outcomes of these two widely used techniques in lower limb salvage.</div></div><div><h3>Methods</h3><div>PUBMED, EMBASE, Scopus and Web of Science databases were queried, and relevant articles were selected following PRISMA guidelines. Only cohort studies and case series in English and with complete data were included.</div></div><div><h3>Results</h3><div>Thirty-three studies comprising 560 patients were included. In pediatrics, Capanna and VFG had similar rates: fibula fracture (32.1% vs. 41.0%, <em>p</em> = 0.33), non-union (26.0% vs. 22.7%, <em>p</em> = 0.83), infection (16.8% vs. 11.5%, <em>p</em> = 0.85), reoperation (42.2% vs. 42.9%, <em>p</em> = 1.00), and overall complications (53.3% vs. 48.9%, <em>p</em> = 0.70). Union and weight bearing times were 9.4/11.6 months (Capanna) vs. 8.5/14.1 months (VFG). In adults, Capanna had fewer fibula fractures (17.2% vs. 35.0%, <em>p</em> = 0.03) but more reoperations (49.6% vs. 26.5%, <em>p</em> = 0.005); non-union (14.8% vs. 20.6%, <em>p</em> = 0.35), infection (8.5% vs. 19.5%, <em>p</em> = 0.15), and overall complications (53.4% vs. 40.9%, <em>p</em> = 0.15) were not significantly different. Across all groups, adjuvant chemotherapy was associated with significantly increased odds of non-union (OR: 10.1, 95% CI: 3.3–30.6; p &lt; 0.0001).</div></div><div><h3>Conclusion</h3><div>The Capanna technique and VFG alone offer comparable overall complication rates and functional outcomes in both pediatric and adult patients. However, the Capanna construct is associated with higher reoperation rates in adults, despite a lower incidence of fibula fractures. Adjuvant chemotherapy significantly increases the risk of non-union and should be carefully considered during surgical planning.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"108 ","pages":"Pages 75-85"},"PeriodicalIF":2.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679759","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":"Financial toxicity negatively impacts outcomes in lower extremity trauma patients","authors":"Chao Long Azad ,&nbsp;Natasha S. McKibben ,&nbsp;Matthew J. Heron ,&nbsp;Sabrina M. Wang ,&nbsp;Moreen W. Njoroge ,&nbsp;Franca Kraenzlin ,&nbsp;Nathan N. O’Hara ,&nbsp;Tim de Jong ,&nbsp;Scott T. Hollenbeck ,&nbsp;Mark J. Gage ,&nbsp;Lily R. Mundy","doi":"10.1016/j.bjps.2025.06.025","DOIUrl":"10.1016/j.bjps.2025.06.025","url":null,"abstract":"<div><h3>Background</h3><div>Financial toxicity describes the adverse economic effects of injury, including both direct costs, such as the price of medical care, and indirect costs, such as lost wages. Financial toxicity is associated with worse health-related quality of life, as well as worse psychological and clinical outcomes. We aimed to characterize financial toxicity in an international cohort of lower extremity trauma patients.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional survey of patients with a history of traumatic lower extremity injury distal to the mid-femur. We collected demographic, clinical, and patient-reported outcomes (PROs) data using the LIMB-Q. Our primary outcome was the LIMB-Q Financial Burden score (range 0–100, lower scores indicate greater financial toxicity).</div></div><div><h3>Results</h3><div>We collected data from 301 respondents. Mean age was 42 years (SD 16). Most respondents were men (64%), White (65%), and American (71%) with less than a college degree (56%) and annual incomes of less than $30,000 (29%). The median time from injury was 2 years (IQR: 1–4). Most respondents underwent fracture fixation only (56%), followed by soft tissue reconstruction (28%), and amputation (16%). The mean LIMB-Q Financial Burden score was 56 (SD 20). Amputation was associated with the greatest financial toxicity (p&lt;0.05). Black race, lower education level, and lower income were associated with greater financial toxicity (p&lt;0.05). Greater financial toxicity was associated with worse scores on LIMB-Q Symptoms and Psychological scales (p&lt;0.01). Financial toxicity did not change with increasing time from injury (p&gt;0.05).</div></div><div><h3>Conclusion</h3><div>Risk factors for financial toxicity among lower extremity trauma patients included amputation, soft tissue reconstruction, Black race, lower education level, and lower income. Financial toxicity may be a modifiable risk factor for improving clinical outcomes in high-risk patients.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"107 ","pages":"Pages 169-175"},"PeriodicalIF":2.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570710","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":"Selective combined liposuction (SCL) for lipedema treatment: Outcomes in symptoms improvement and aesthetic self-perception","authors":"Nicolás Pereira ,&nbsp;Josefa Venegas ,&nbsp;Antonella López ,&nbsp;Vanessa Oñate ,&nbsp;José Ruiz-Tagle","doi":"10.1016/j.bjps.2025.06.031","DOIUrl":"10.1016/j.bjps.2025.06.031","url":null,"abstract":"<div><h3>Background</h3><div>Lipedema is a chronic, progressive and underdiagnosed condition characterized by bilateral, disproportionate and painful subcutaneous fat accumulation in extremities. Key symptoms include pain, heaviness and easy bruising. Surgical treatment, particularly liposuction, has shown excellent outcomes in symptom reduction and quality of life improvement. This study evaluates clinical outcomes in symptoms and aesthetic self-perception improvements in patients treated with selective combined liposuction (SCL).</div></div><div><h3>Patients and methods</h3><div>A retrospective review of 126 female patients who underwent surgical treatment over a four-year period was performed. Selective tumescent liposuction combining power-assisted liposuction (PAL) with VASER (ultrasound-assisted liposuction) for proximal areas, especially the thighs. Demographic and clinical data, including BMI, medical history and comorbidities were analyzed. Symptoms such as pain, heaviness and edema, and body image perception were assessed preoperatively and six months postoperatively with a structured questionnaire.</div></div><div><h3>Results</h3><div>The mean patient age was 39 years, with a mean BMI of 27.2. The mean aspirated volume was 3270 mL per procedure. In 25.4% of the cases (n=32), a second procedure was required, with an average total aspirated volume of 5150 mL. Significant symptom improvement was observed: 89% reported reduced pain, 92% reduced heaviness, 82% reduced edema. Mobility limitations improved in 91% of patients, while 60% reported enhanced aesthetic perception of their extremities. Additionally, 68% of patients expanded their wardrobe postoperatively.</div></div><div><h3>Conclusions</h3><div>Selective combined liposuction is a safe and highly effective technique for lipedema treatment, providing substantial symptom relief, improved body aesthetic self-perception, which leads to an improvement in the quality of life.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"107 ","pages":"Pages 196-204"},"PeriodicalIF":2.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144595412","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":"3-Step combined technique for correction of involutional lower eyelid entropion: A case series","authors":"Corrado Rubino ,&nbsp;Emilio Trignano ,&nbsp;Stefano Dore ,&nbsp;Antonio Pinna ,&nbsp;Nicola Tsatsaris ,&nbsp;Federico Ziani ,&nbsp;Lucia Sangalli ,&nbsp;Matilde Tettamanzi ,&nbsp;Silvia Rampazzo","doi":"10.1016/j.bjps.2025.06.034","DOIUrl":"10.1016/j.bjps.2025.06.034","url":null,"abstract":"<div><div>Involutional entropion of the lower eyelid is a common condition among the elderly. Numerous surgical techniques have been proposed to address its multifactorial nature, each focusing on different contributing factors. However, no single approach has proven to be superior. This study aims to evaluate the safety and effectiveness of a novel 3-step combined procedure in treating involutional entropion. Patients were treated using a combination of lateral lid-shortening with removal of a base-down triangle, myectomy of the orbicularis oculi muscle, and excision of a skin strip of the lower eyelid. We conducted a retrospective review of clinical data from patients who underwent this procedure between 2012 and 2023. Patient-reported satisfaction with aesthetic and functional outcomes were evaluated three months postoperatively with a custom 5-point Likert scale questionnaire. A total of 27 patients (30 eyelids) were included in the study, with a median follow-up period of 12 months (range 4–144 months). Minor surgical revision was required in one case for early wound dehiscence. One patient presented undercorrection, but reoperation was not needed. No other complications or recurrences were detected at the latest follow-up. All patients reported satisfaction with both functional and aesthetic outcomes three months after surgery. Based on our results, the 3-step combined procedure may represent a valuable addition to the range of surgical techniques for involutional lower eyelid entropion. This approach is associated with a high success rate and stable functional outcomes. Larger studies are warranted to further validate our results.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"107 ","pages":"Pages 162-168"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549572","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":"Post-operative complications in combined versus staged breast reconstruction and risk-reducing gynecologic surgeries: A multi-institution multi-surgeon analysis","authors":"Kassra Garoosi ,&nbsp;Nargis Kalia ,&nbsp;Jubril Adepoju ,&nbsp;Maria J. Escobar-Domingo ,&nbsp;Codi Horstman ,&nbsp;Riley Kahan ,&nbsp;Quinn Fitzpatrick ,&nbsp;Yoo Jin Ahn ,&nbsp;John B. Park ,&nbsp;Ben Grobman ,&nbsp;Daniela Lee ,&nbsp;Deana S. Shenaq ,&nbsp;David Kurlander ,&nbsp;Mamtha Raj ,&nbsp;Sarah Tevis ,&nbsp;Jaime Arruda ,&nbsp;Julian Winocour ,&nbsp;George Kokosis ,&nbsp;Bernard T. Lee ,&nbsp;David W. Mathes ,&nbsp;Christodoulos Kaoutzanis","doi":"10.1016/j.bjps.2025.06.033","DOIUrl":"10.1016/j.bjps.2025.06.033","url":null,"abstract":"<div><h3>Background</h3><div>Combined breast reconstruction and risk-reducing gynecologic procedures (RRGPs) have emerged as an alternative to the traditional staged approach, offering potential advantages such as reduced cumulative surgical burden and streamlined recovery. However, conflicting outcomes in the literature highlight the need for multi-institutional analyses to guide clinical decision-making.</div></div><div><h3>Methods</h3><div>This multi-institutional, retrospective cohort study evaluated postoperative complications within 90 days of surgery among patients undergoing combined versus staged breast reconstruction and RRGPs. Data from three academic centers spanning 2010 to 2023 were analyzed. The primary outcome was the occurrence of complications, stratified by reconstruction type and gynecologic procedures. Secondary outcomes included emergency department visits, reoperations, readmissions, and hospital length of stay. Multivariable analyses controlled for confounding variables, including BMI, prior radiation therapy, and comorbidities.</div></div><div><h3>Results</h3><div>Among 348 patients, 96 underwent combined procedures and 252 underwent staged procedures. Overall complication rates were comparable between groups after adjustment (adjusted OR: 0.85, 95% CI: 0.66–1.10, p = 0.220). Combined procedures were associated with shorter operative times and hospital stays compared to staged surgeries (median 296 vs. 386 min, p &lt; 0.001; mean: 1 day vs. 2 days, p &lt; 0.001). Subgroup analysis revealed a significantly higher risk of seroma/hematoma in tissue expander-based reconstruction within the combined cohort (45% vs. 13%, p = 0.020), while direct-to-implant and autologous reconstructions had similar complication rates between groups. Gynecologic complications were infrequent and did not differ significantly between cohorts.</div></div><div><h3>Conclusions</h3><div>Combined procedures provide a viable alternative to staged approaches, offering logistical advantages without increasing overall complication rates. Careful patient selection and perioperative planning remain critical, particularly for tissue expander-based reconstruction, where complication risk may be higher in combined surgeries. Further prospective studies are needed to refine patient selection criteria and optimize outcomes.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"107 ","pages":"Pages 258-266"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568282","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 closed-incision negative pressure wound therapy in abdominal-based autologous breast reconstruction: A systematic review and meta-analysis","authors":"Ahmad Abul ,&nbsp;Ali Abel ,&nbsp;Mohammad Al-Saffar ,&nbsp;Sara Iskeirjeh ,&nbsp;Saif Badran","doi":"10.1016/j.bjps.2025.06.032","DOIUrl":"10.1016/j.bjps.2025.06.032","url":null,"abstract":"<div><h3>Introduction</h3><div>Abdominal-based free tissue transfers, such as the Deep Inferior Epigastric Perforator (DIEP) flap, are widely utilized in autologous breast reconstruction. These procedures are often complicated by wound healing issues at the donor site, including wound dehiscence, seroma formation, and surgical site infections (SSIs). Closed Incision Negative Pressure Wound Therapy (ciNPWT) has been suggested to improve healing outcomes and reduce the incidence of postoperative complications. This synthesis evaluated the efficacy of ciNPWT compared to standard dressings in abdominal-based autologous breast reconstruction.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were conducted following PRISMA guidelines. Randomized controlled trials and observational studies assessing ciNPWT versus standard dressings in patients undergoing abdominal-based free flap breast reconstruction were included. Primary and secondary outcomes analyzed were wound dehiscence, SSIs, seroma formation, and length of stay. Data from multiple databases were independently reviewed and synthesized using Review Manager 5.4 and Microsoft Excel. Studies were rigorously selected and assessed for risk of bias.</div></div><div><h3>Results</h3><div>Of the 348 identified articles, 13 studies met the inclusion criteria, comprising three randomized controlled trials and 10 observational studies, totaling 2882 patients. The ciNPWT group showed a 42% reduction in wound dehiscence (OR 0.58, 95% CI 0.42–0.79; p = 0.0007), with moderate heterogeneity (I² = 36%). No significant differences were found for surgical site infections (OR 0.77, 95% CI 0.50–1.18; p = 0.23) and seroma formation (OR 0.66, 95% CI 0.38–1.12; p = 0.15). Variations in length of stay data prevented quantitative analysis.</div></div><div><h3>Conclusion</h3><div>ciNPWT demonstrates a significant reduction in wound dehiscence, highlighting its value in enhancing postoperative care, especially for high-risk patients. However, further research involving larger, multicenter randomized controlled trials is necessary to fully elucidate ciNPWT's role in reducing other complications and its broader clinical applicability.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"107 ","pages":"Pages 151-161"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144557415","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":"Saving millions: The economic impact of switching to waterless surgical hand scrubs in plastic and reconstructive surgery","authors":"Agustin N. Posso ,&nbsp;Joshua Bloom ,&nbsp;Micaela Tobin ,&nbsp;Audrey Mustoe ,&nbsp;Morvarid Mehdizadeh ,&nbsp;Khoa N. Nguyen ,&nbsp;Maria J. Escobar-Domingo ,&nbsp;Sarah Karinja ,&nbsp;Samuel J. Lin ,&nbsp;Bernard T. Lee","doi":"10.1016/j.bjps.2025.06.027","DOIUrl":"10.1016/j.bjps.2025.06.027","url":null,"abstract":"<div><h3>Background</h3><div>Alcohol-based surgical hand scrubs are a safe, environmentally friendly, and cost-effective alternative to traditional water-based hand antisepsis, supported by the World Health Organization (WHO). These advantages make alcohol-based hand scrubs ideal for various plastic and reconstructive surgery settings. This study evaluates the potential financial savings of transitioning to alcohol-based surgical scrubs within a division of plastic and reconstructive surgery.</div></div><div><h3>Methods</h3><div>Data was collected from a division of plastic and reconstructive surgery at a single institution. Water consumption for traditional surgical hand scrub was measured according to WHO guidelines. Water costs were calculated based on the Boston Water and Sewer Commission rates. The costs of alcohol solution and impregnated brushes were obtained from the hospital’s perioperative services. Annual surgical volume data were used to estimate water consumption and consumable costs. Time savings were calculated based on WHO protocols and converted into cost savings.</div></div><div><h3>Results</h3><div>The average water consumption per scrub was 7.62 L, with an average of 36.17 L used per surgery. If every plastic surgery procedure used traditional wet scrubs, the annual water consumption would be 87,233.76 L. The cost of water per scrub was $0.05. The consumable cost per scrub was $0.20 for alcohol-based scrubs and $0.52 for wet scrubs. Annually, transitioning to alcohol-based scrubs would save $3090.96 in consumable costs. Adopting waterless scrubs and decreasing scrub time could result in savings of $1316,445.48 annually in our division.</div></div><div><h3>Conclusion</h3><div>Transitioning to alcohol-based surgical hand scrub in plastic and reconstructive surgery may provide significant environmental and economic benefits.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"107 ","pages":"Pages 148-150"},"PeriodicalIF":2.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549573","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 Re: Preoperative perforator mapping of anterolateral thigh perforators via Projected Augmented Reality and Dynamic Infrared Thermography","authors":"Mehreen Qureshi,&nbsp;Febisayo Sidiku,&nbsp;Ramesh Vidyadharan","doi":"10.1016/j.bjps.2025.05.048","DOIUrl":"10.1016/j.bjps.2025.05.048","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"107 ","pages":"Pages 271-272"},"PeriodicalIF":2.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568280","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":"Response to Letter Re: Preoperative perforator mapping of anterolateral thigh perforators via Projected Augmented Reality and Dynamic Infrared Thermography","authors":"Eva L. Meier,&nbsp;Tim de Jong,&nbsp;Dietmar J.O. Ulrich,&nbsp;Stefan Hummelink","doi":"10.1016/j.bjps.2025.06.030","DOIUrl":"10.1016/j.bjps.2025.06.030","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"107 ","pages":"Pages 273-274"},"PeriodicalIF":2.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568283","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":"What is the current Dutch nerve management during amputation surgery?","authors":"CPM van den Berg ,&nbsp;EW DeVinney ,&nbsp;EM van der Linde ,&nbsp;EM Brakkee ,&nbsp;JH Coert","doi":"10.1016/j.bjps.2025.06.015","DOIUrl":"10.1016/j.bjps.2025.06.015","url":null,"abstract":"<div><div>Peripheral nerve management during limb amputation is essential, as neuromas frequently form after nerve transection. Some of which are painful and impair patient quality of life. Selecting the appropriate technique for nerve management is important as it may impact the development of painful neuromas. Diagnosis is often complex, and treatments may yield limited success, highlighting the importance of careful nerve handling at the time of surgery. In this study, we questioned Dutch plastic surgeons about their knowledge and preferred technique(s) in managing nerves during amputation surgery. An email survey was distributed among Dutch (plastic) surgeons. The survey was designed in LimeSurvey. The questionnaire addressed background knowledge, preferred nerve management approaches during amputations, and subsequent neuroma treatments. Data were collected anonymously and analyzed using descriptive statistics. Of 390 surgeons, 72 responded (18.5% response rate; 91.7% plastic surgeons). Most respondents (57%) specialized in hand and wrist surgery, with 69% performing 1–10 amputations annually. Surgeons favoring traction neurectomy had less experience (p=0.027). Muscle burying (n=64) was the most familiar technique, followed by bone burying, end-to-side suturing, and targeted muscle reinnervation. Most respondents addressed nerve pain (93%) or considered revision surgery (95%) postoperatively. This study provides an overview of nerve management and neuroma treatment preferences among Dutch (plastic) surgeons. Awareness of various techniques appears widespread, underscoring the importance of training exposure to enhance procedural competence.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"107 ","pages":"Pages 134-140"},"PeriodicalIF":2.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518187","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}