Journal of plastic and reconstructive surgery最新文献

{"title":"A Cadaveric Study of the Deep and Superficial Dorsal Veins for Penile Transplant.","authors":"Sirai Ramirez, Nawsin Baset, Andrew Brevik, Nathaniel Ballek, Alyssa Kendell, Ryan Schiller, Anthony Olinger","doi":"10.53045/jprs.2023-0033","DOIUrl":"10.53045/jprs.2023-0033","url":null,"abstract":"<p><strong>Objective: </strong>It is crucial to know the lengths of the neurovasculature proximal to a penile allograft to allow for better viability of a penile transplant. We performed a cadaveric exploration focused on the deep and superficial dorsal veins as identified in a microsurgical dissection of the penis to help expand the anatomical knowledge for such a procedure.</p><p><strong>Methods: </strong>We examined 18 cadavers and measured the (1) vertical distance from the pubic symphysis to the point at which the superficial dorsal vein is no longer on the erectile tissue; (2) point at which the superficial dorsal vein is no longer on the erectile tissue to where its tributary meets the great saphenous vein; and (3) point at which the deep dorsal vein is no longer on the external erectile tissue to its contribution into the prostatic plexus near the prostate. Moreover, we noted the variations of the deep and superficial veins of the penis. We used IBM SPSS in all statistical analyses.</p><p><strong>Results: </strong>The average length of the superficial dorsal vein when no longer on the external penis to its tributary was 84.9 ± 10.4 mm. The average length of the deep dorsal vein was 72.9 ± 6.43 mm. Three different drain patterns were observed for the superficial dorsal vein, whereas the deep dorsal vein was consistently midline. No statistically significant correlations were identified between cadaveric demographic data and lengths of venous structures.</p><p><strong>Conclusions: </strong>Further studies regarding the anatomy and dissection of penile allografts would be helpful. More research regarding donor and recipient anatomy and vasculature is needed to establish surgical guidelines.</p>","PeriodicalId":520467,"journal":{"name":"Journal of plastic and reconstructive surgery","volume":"3 3","pages":"134-137"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660269","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 Treatment of Mandibular Condylar Fractures Using an Internal Distraction Device during a 7-year Period.","authors":"Taichi Takada, Naoya Oshima, Yuki Iwashina, Mine Ozaki","doi":"10.53045/jprs.2023-0046","DOIUrl":"10.53045/jprs.2023-0046","url":null,"abstract":"<p><strong>Objectives: </strong>Mandibular condylar fractures are common, accounting for approximately 25%-50% of all mandibular fractures. However, the optimal therapeutic method remains controversial. We have used an internal distraction device for treating mandibular condylar fractures for the past 7 years. The aim of this study was to analyze our clinical outcomes.</p><p><strong>Methods: </strong>We retrospectively analyzed the medical charts of 62 patients with mandibular condylar fractures (84 joints) treated by internal distraction device fixation from April 2015 to June 2022 at our hospital.</p><p><strong>Results: </strong>The patients were 34 males and 28 females (mean age of 49.7 years at surgery). At 3 months postoperatively, the mean mouth opening width was 42.3 mm. Postoperative complications included temporary facial nerve paralysis of a temporal branch (6 patients) and breakage of the device during attachment (22 patients, 24 joints). In all cases in which the device was broken, it was removed within a few weeks, and satisfactory results in terms of mouth opening were obtained.</p><p><strong>Conclusions: </strong>This method is recommended as a treatment option for mandibular condylar fractures because of its simplicity and satisfactory results compared with other methods.</p>","PeriodicalId":520467,"journal":{"name":"Journal of plastic and reconstructive surgery","volume":"3 2","pages":"71-78"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660266","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":"Bilateral Ischial Defect after Treatment of Pressure Ulcers in a Patient with Spinal CORD Injury: Case Report.","authors":"Akihiro Nariyama, Shinji Kumegawa, Takashi Shimoe, Yasuhiro Sakata, Kazuki Ueno, Yoshitaka Wada, Shinichi Asamura","doi":"10.53045/jprs.2023-0028","DOIUrl":"10.53045/jprs.2023-0028","url":null,"abstract":"<p><p>Pressure ulcers are extremely common in individuals with spinal cord injuries, especially ischial pressure ulcers, which have a higher rate of recurrence and are more difficult to treat than those in other regions of the body. We report a case of a 69-year-old man with bilateral ischial defects due to surgical treatment of pressure ulcers. Previous reports have shown that when surgical resection of pressure ulcers extends beyond the ischial tuberosity to the pubic symphysis and acetabulum, the superior psoas and piriformis muscles are easily dislocated, and the pelvic ring can be unstable. Therefore, the region of resection must not extend beyond the acetabulum and pubic symphysis to achieve a stable sitting position. In this article, we discuss an anatomically safe ischial tuberosity resection.</p>","PeriodicalId":520467,"journal":{"name":"Journal of plastic and reconstructive surgery","volume":"3 3","pages":"128-133"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660275","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":"Bilateral Internal Mammary Artery Perforator-pedicled Flaps for Anterior Chest Wall Keloid Resection: A Report of Two Cases of Lotus Petal Flaps in the Chest Wall.","authors":"Hidetaka Watanabe, Tetsuji Uemura, Takahiro Chuman, Hiroshige Kawano, Yoshihiro Nagano, Mariko Yoshizumi, Eiji Nakagawa","doi":"10.53045/jprs.2023-0020","DOIUrl":"10.53045/jprs.2023-0020","url":null,"abstract":"<p><p>Complete resection of anterior chest wall keloids and direct closure of wound defects are difficult. Therefore, intrakeloid excision is usually the safest to treat anterior chest wall keloids. Total excision to relieve tension may require tensile suturing of the dermis or skin grafting, which can lead to recurrence or poor cosmetic outcomes. In this study, we performed total resection of the anterior chest wall keloid, followed by defect reconstruction using bilateral lotus petal flaps for the internal mammary artery perforators near the keloid, obtaining satisfactory results. When performing total keloid resection, releasing the precordial tension in the reconstruction area is crucial. The lotus petal flap, which can be elevated from the same precordial chest area, effectively releases tension and thus provides a beneficial treatment strategy.</p>","PeriodicalId":520467,"journal":{"name":"Journal of plastic and reconstructive surgery","volume":"3 3","pages":"115-119"},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660272","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 Relationship between Submucous Cleft Palate and a History of Nasal Regurgitation in Patients during Infancy.","authors":"Tatsuya Ishigaki, Shinsuke Akita, Akikazu Udagawa, Hiroyuki Suzuki, Nobuyuki Mitsukawa","doi":"10.53045/jprs.2022-0046","DOIUrl":"10.53045/jprs.2022-0046","url":null,"abstract":"<p><strong>Objectives: </strong>Submucous cleft palate is a congenital disorder resulting in velopharyngeal insufficiency. Nasal regurgitation is one of the symptoms of submucous cleft palate. This study aims to investigate a relationship between submucous cleft palate and a history of nasal regurgitation in patients during infancy.</p><p><strong>Methods: </strong>This retrospective study includes patients diagnosed with submucous cleft palate at our hospital for 20 years, from 1998 to 2017. Based on the clinical records of these patients, we investigated sex, age at referral to our facility, age at surgery, presence of nasal regurgitation, method of surgery, association of syndromes and mental retardation, and transition of velopharyngeal function.</p><p><strong>Results: </strong>There were fifty-seven patients referred to our facility. Patients with episodes of nasal regurgitation were referred to clinics later than those without nasal regurgitation. The timing of surgery was also the same. The velopharyngeal function of patients with nasal regurgitation was worse than that of those without nasal regurgitation.</p><p><strong>Conclusions: </strong>A history of nasal regurgitation cannot predict submucous cleft palate. However, patients with submucous cleft palate with nasal regurgitation had worse velopharyngeal function than those without nasal regurgitation. An increased understanding of the relationship between submucous cleft palate and nasal regurgitation and further study will predict submucous cleft palate and determine a good timing for surgical interventions.</p>","PeriodicalId":520467,"journal":{"name":"Journal of plastic and reconstructive surgery","volume":"3 3","pages":"99-103"},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660280","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":"Toe Fillet Flap Wound Coverage for a Multiple-ray Amputation Wound: A Case Report.","authors":"Benjamin Chung, Manzhi Wong, Jack Kian Ch'ng","doi":"10.53045/jprs.2023-0023","DOIUrl":"10.53045/jprs.2023-0023","url":null,"abstract":"<p><p>Ray amputation wounds caused by diabetic foot gangrene are often left to heal by secondary intention. They can be large and take a prolonged time to heal, exposing patients to complications and risk of recurrent infection. A 77-year-old male with diabetes and peripheral vascular disease presented to our institution with left 2nd-5th toe gangrene. He underwent a successful left lower limb angioplasty with good flow to the digital arteries. Left 2nd-5th toe ray amputation was performed, with the excess viable skin of the left second toe preserved as a digital fillet flap for wound coverage. The patient was discharged on postoperative day 1. Healing was complicated by a stitch sinus, but the wound completely healed with good epithelialization at 4 months postoperatively. This case report demonstrates the utility of the toe fillet flap in the coverage of ray amputation wounds in patients with diabetes and peripheral vascular disease.</p>","PeriodicalId":520467,"journal":{"name":"Journal of plastic and reconstructive surgery","volume":"3 3","pages":"110-114"},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660212","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":"Nipple Malposition after Nipple-sparing Mastectomy with Implant-based Reconstruction: Understanding Its Occurrence and Prevention.","authors":"Tomohiro Shiraishi, Hirotaka Suga, Naoko Tsuji, Kiyonori Harii, Akihiko Takushima","doi":"10.53045/jprs.2023-0026","DOIUrl":"10.53045/jprs.2023-0026","url":null,"abstract":"<p><strong>Objectives: </strong>The reasons for nipple malposition after nipple-sparing mastectomy with implant-based reconstruction are not well characterized, and nipple asymmetry remains a source of patient dissatisfaction. This study employed mathematical simulation to analyze the variables that affect nipple position, developed countermeasures to improve symmetry, and tested them in a case-control cohort.</p><p><strong>Methods: </strong>Patients who underwent nipple-sparing mastectomy followed by two-stage tissue expander and implant reconstruction were recruited and divided into two groups. The study group (N = 57) underwent reconstructive surgery guided by our mathematical simulations and countermeasures. The control group (N = 32) underwent reconstructive surgery using conventional methods.</p><p><strong>Results: </strong>Morphological simulation revealed that the fundamental reason for nipple malposition is inadequate superior pole expansion. Thus, we developed a countermeasure: fixing the nipple areolar complex in a more inferior position, combined with inferior expander placement. Good or excellent symmetry was obtained in 45/57 (79%) patients in the study group and only 8/32 (25%) patients in the control group. In the control group, poorer results were associated with mastectomy weight (ρ = 0.47, P < 0.006), preoperative ptosis grade (ρ = 0.38, P = 0.037), and the difference between the superior pole length (B) and sub-mid-clavicle-to-inframammary fold length (l) (B-l; ρ = 0.067, P < 0.0001). In the study group, the results had no relation with those variables.</p><p><strong>Conclusions: </strong>Morphological simulation found that inadequate superior pole expansion is the primary reason for nipple malposition. On the basis of this result and the patient's breast measurements, we recommend fixing the nipple areolar complex in a more inferior position and possibly pulling the nipple inferiorly, combined with inferior expander placement.</p>","PeriodicalId":520467,"journal":{"name":"Journal of plastic and reconstructive surgery","volume":"3 2","pages":"53-63"},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660136","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":"Craniofacial Suspension and Superficial Musculoaponeurotic System Plication Using a Diffuse Superficial Musculoaponeurotic System Weave: A Bulletproof Adjunct to Long or Short Scar Facelifts.","authors":"Karolina Pieszko, J Brian Boyd","doi":"10.53045/jprs.2022-0056","DOIUrl":"10.53045/jprs.2022-0056","url":null,"abstract":"<p><p>The plethora of facelift techniques described in literature suggests that no single method addresses all age-related changes in facial anatomy. To reduce the limitations of a single approach, a multimodal technique is recommended. Craniofacial suspension and superficial musculoaponeurotic system plication using a diffuse total superficial musculoaponeurotic system (SMAS) weave is an effective and satisfactory method of dealing with the superficial musculoaponeurotic system. It utilizes a continuous barbed polydioxanone suture that is woven throughout the lower superficial musculoaponeurotic system. This technique preserves facial volume while achieving the symmetrical tightening of the superficial musculoaponeurotic system. In this article, the authors describe over 10 years of experience of applying this procedure with success to different patients, including elderly ones and those with a previous facelift history. It can be integrated into the classic minimal access cranial suspension (MACS) lift or used with more extensive facelifts. It is a safe, easy, and powerful tool that should have a wide application in facial rejuvenation procedures.</p>","PeriodicalId":520467,"journal":{"name":"Journal of plastic and reconstructive surgery","volume":"3 2","pages":"89-93"},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660129","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":"Pedicled SCIA and SIEA Mega Groin Flap-A Staged Reconstructive Approach for Large Forearm Defects.","authors":"Yu-Ming Lai, Jonathan T W Au Eong, Bien-Keem Tan","doi":"10.53045/jprs.2022-0052","DOIUrl":"10.53045/jprs.2022-0052","url":null,"abstract":"<p><strong>Objective: </strong>The pedicled combined superficial circumflex iliac artery and superficial inferior epigastric artery flap has a large vascular territory ideal for coverage of crush-degloving injuries of the upper extremity. We describe our technique of creating a bipedicled flap through a staged inset, first at the wrist and subsequently progressing up the forearm. This process allows primary thinning of the entire flap while facilitating a safe transfer of the flap.</p><p><strong>Methods: </strong>Three patients with crush-degloving injury of the forearm associated with open fractures of the radius and ulnar bones had their defects reconstructed using the aforementioned flap. Patient 3 also had avulsion of the ulnar artery and crush injury of the median and ulnar nerves. Patients 1 and 2 underwent flap delay and training for 1 week prior to inset. Patient 3 did not undergo delay due to the broad-based nature of the flap. The maximal flap size was 25 × 15 cm. The flap was raised thinly until the sufficient length was obtained for the first-stage inset. Over 2 weeks, further elevation and staged inset were performed to maintain uniform thinness and thereby maximize coverage.</p><p><strong>Results: </strong>Complete flap division was accomplished in 3 weeks. All flaps survived with no marginal flap necrosis. Donor sites were closed directly (n = 2) or skin grafted (n = 1).</p><p><strong>Conclusions: </strong>Staged insetting created a bipedicled construct, which allowed primary thinning of the base and bridging portion, thereby allowing maximal use of the entire flap. Maximising the flap was possible because our technique maintained a bipedicled circulation throughout the entire inset process.</p>","PeriodicalId":520467,"journal":{"name":"Journal of plastic and reconstructive surgery","volume":"3 2","pages":"64-70"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660114","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":"Fundamentals for Supermicrosurgical Lymphaticovenular Anastomosis: Part 1 Comprehensive Review of Anastomosis Techniques and Proposal for a Flowchart Algorithm.","authors":"Guido Gabriele, Simone Benedetti, Flavia Cascino, Antonino Ungaro, Paolo Gennaro","doi":"10.53045/jprs.2023-0017","DOIUrl":"10.53045/jprs.2023-0017","url":null,"abstract":"<p><p>Supermicrosurgical lymphaticovenular anastomosis represents an established procedure for lymphedema treatment, the effectiveness of which has been well documented in international literature. Nevertheless, currently, no standards for supermicrosurgical lymphaticovenular anastomosis have been established regarding the type, location, and number of anastomoses so that the approach to surgical scenarios still depends on the surgeons' preference and ability. A comprehensive literature search for articles involving supermicrosurgical lymphaticovenular anastomosis techniques was performed on the PubMed/Medline/SCOPUS databases. Results, including the names of the technique and their characteristics, such as indications, surgical time, and configuration of the vessels, are reported. Each technique included was then performed five times, and for each of them, patency was tested intraoperatively and 30 days after surgery. Moreover, an efficacy score was assigned, taking into consideration the number of lymphatic vessels anastomosed, the average time for anastomosis, and the difficulty of each technique. A total of 148 articles resulted from the literature search. In total, 16 papers met the criteria for inclusion as defined in the methods and were included in the review as a \"supermicrosurgical lymphaticovenular anastomosis technique.\" Efficacy scores ranged from 0.21 to 1, intraoperative patency ranged from 80% to 100%, and the 30-days patency test ranged from 60% to 100%. To perform effective anastomoses and aim to maximize the results of supermicrosurgical lymphaticovenular anastomosis, a modern microsurgeon should be trained to recognize and manage the most common vessel configurations, performing the most adequate one of the several techniques described. Further studies are required to validate and compare the use of the supermicrosurgical lymphaticovenular anastomosis techniques reviewed.</p>","PeriodicalId":520467,"journal":{"name":"Journal of plastic and reconstructive surgery","volume":"3 2","pages":"43-52"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660131","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}