Annales De Chirurgie Plastique Esthetique最新文献

{"title":"Beyond the LRINEC Score: A stratified diagnostic algorithm for subacute and atypical necrotizing fasciitis.","authors":"A Schmitt, C Barani, M Pividori, P Curings, R Bayoux, M Vantomme, D Voulliaume","doi":"10.1016/j.anplas.2026.04.002","DOIUrl":"https://doi.org/10.1016/j.anplas.2026.04.002","url":null,"abstract":"<p><strong>Background: </strong>While typical Necrotizing Soft Tissue Infections (NSTI) are clinically overt, atypical and subacute presentations pose a complex diagnostic challenge. These forms-characterized by subacute evolution, deceptive local signs, or atypical pathogens-often defy standard recognition patterns. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score is frequently utilized for emergency risk stratification; however, its sensitivity remains contested in contemporary literature.</p><p><strong>Methods: </strong>We conducted a retrospective observational study (2007-2025) of 37 confirmed NSTI patients at a regional tertiary Plastic Surgery referral center. We analyzed admission physiology, microbiological profiles, and calculated retrospective LRINEC and SIARI (Site, Immuno, Age, Renal, Inflam) scores. To validate findings against potential data handling bias, a sensitivity analysis comparing zero-imputation versus complete case analysis was performed.</p><p><strong>Results: </strong>Despite high clinical severity (43.2% septic shock), the LRINEC score yielded a false negative rate of 18.9% (7/37 patients classified as \"Low Risk\"). These failures correlated with atypical profiles: head and neck localization, prior administration of non-steroidal anti-inflammatory drugs (NSAID), and subacute pathogens (Cutibacterium acnes, Actinomyces). Sensitivity analysis confirmed the statistical stability of these findings (P=0.66). Conversely, the SIARI score correctly reclassified all LRINEC false negative cases as high risk (Score ≥ 3).</p><p><strong>Conclusion: </strong>The LRINEC score exhibits insufficient negative predictive value to safely exclude atypical and subacute NSTIs, potentially causing hazardous delays in surgical intervention. We propose a stratified clinical algorithm designed to enhance surgical vigilance and reduce the risk of missed diagnosis.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Pressure ulcer following compression otoplasty garment: A rare but severe case report].","authors":"R Goron, A Balkoula, P Pujol, F Leclere, J Alexandre","doi":"10.1016/j.anplas.2026.01.008","DOIUrl":"https://doi.org/10.1016/j.anplas.2026.01.008","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Otoplasty is a common procedure in plastic surgery. A compression garment is frequently recommended by surgeons after the procedure; however, it is not free from risk of serious complications. We report the case of a pressure ulcer following otoplasty, associated with the use of an inappropriate compression garment.</p><p><strong>Case presentation: </strong>A 7-year old girl was evaluated for correction of prominent ears. The procedure was uneventful. On the day after surgery, the compression garment that had been prescribed during the preoperative consultation could not be checked. She was discharged home with a custom-made compressive dressing and instructed to replace it the following day with the recommended compression headband. At the postoperative follow-up visit on day 10, she presented with a stage-4 pressure ulcer sore of the left external ear, located over the antihelix. The compression garment in place did not correspond to the one initially recommended. The patient was readmitted, and the compression was immediately removed. Daily local wound care was initiated, including debridement of fibrin under nitrous oxide analgesia, application of petrolatum-based dressings, and prophylactic antibiotic therapy. The clinical course was favorable, allowing discharge after a few days. Close outpatient follow-up was organized. Three months later, she exhibited no aesthetic sequelae.</p><p><strong>Discussion: </strong>Pressure ulcer sore following otoplasty is a rare complication and is scarcely mentioned in the literature. Its potential severity should not be overlooked. Although postoperative compression is widely used, its benefit after otoplasty-and more broadly after other procedures in plastic surgery-has not been demonstrated in the literature. Its prescription must therefore be approached with caution, with careful selection of the device, patient education and close monitoring.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The need for higher-quality bichectomy content on YouTube™.","authors":"J Chen","doi":"10.1016/j.anplas.2026.01.007","DOIUrl":"https://doi.org/10.1016/j.anplas.2026.01.007","url":null,"abstract":"","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Technical note: Importance of primary reconstruction of orbicular muscle in modiolus defects: A clinical case report].","authors":"M Abellan Lopez, B Bertrand, C Philandrianos, S Tomczak, D Casanova","doi":"10.1016/j.anplas.2026.01.002","DOIUrl":"https://doi.org/10.1016/j.anplas.2026.01.002","url":null,"abstract":"<p><strong>Introduction: </strong>The submental flap, first described by Martin and Baudet in 1990, was originally developed for the reconstruction of defects involving the lower two-thirds of the face. Owing to its reliable vascular pedicle and anatomical proximity, its indications have progressively expanded to include complex soft-tissue losses of the hemiface, particularly at the oral commissure, where both aesthetic and functional demands are high.</p><p><strong>Methods: </strong>We report the case of a 70-year-old patient presenting with a right cheek and labial commissure defect following an animal bite, associated with loss of the modiolus and orbicularis oris muscle sling. Reconstruction was performed in two stages: (1) restoration of the orbicularis continuity and coverage of the defect using an insular submental flap pedicled on the right submental artery, and (2) secondary commissuroplasty four months later to restore labial continence and facial symmetry.</p><p><strong>Results: </strong>The first stage achieved complete coverage of the composite defect and reestablishment of muscular continuity. Following commissuroplasty, the patient recovered satisfactory labial motility, oral opening, and functional continence. Subsequent staged debulking procedures refined the aesthetic outcome while maintaining flap trophicity and hair-bearing skin texture.</p><p><strong>Discussion: </strong>This case highlights the reliability and versatility of the submental flap in commissural reconstruction. Its favorable skin characteristics, robust vascularization, and wide arc of rotation make it an effective alternative to heterolabial flaps, allowing a \"like-with-like\" reconstruction that achieves both durable functional recovery and harmonious aesthetic integration.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI in medicine: Safeguarding human critical thinking and imagination (Comment on: Artificial intelligence and plastic surgery: Between innovation and responsibility).","authors":"Shigeki Matsubara","doi":"10.1016/j.anplas.2026.01.001","DOIUrl":"https://doi.org/10.1016/j.anplas.2026.01.001","url":null,"abstract":"","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Corrigendum to \"Indications for total mastectomy with immediate breast reconstruction in oncology: Surgical strategies tailored to breast morphology and adjuvant treatments\" [Ann. Chir. Plast. Esth. 70/6 (2025) p. 539-550]].","authors":"Lauren Darrigues, Fabien Reyal, Jean-Philippe Binder, Enora Laas, Thomas Gaillard, Jean-Guillaume Feron, Arthur Glorion, Benoit Couturaud","doi":"10.1016/j.anplas.2026.02.001","DOIUrl":"https://doi.org/10.1016/j.anplas.2026.02.001","url":null,"abstract":"","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Reconstruction of extensive internal canthus defects involving both eyelids: A four-step surgical approach utilizing a graft-supplying flap].","authors":"M Abellan Lopez, B Bertrand, C Philandrianos, J Bardot, D Casanova","doi":"10.1016/j.anplas.2026.02.003","DOIUrl":"https://doi.org/10.1016/j.anplas.2026.02.003","url":null,"abstract":"<p><strong>Introduction: </strong>The reconstruction of extensive medial canthal defects involving both eyelids is a rare and complex surgical challenge. The objectives are both functional (preserving mobility and corneal protection) and aesthetic (avoiding a patch-like appearance and restoring the concavity of the canthus).</p><p><strong>Method: </strong>We propose, through a clinical case, a four-step reconstruction procedure: 1) temporary canthopexy: fixation of the tarsal stumps to the orbital rim to protect the cornea while awaiting histopathological results; 2) buccal mucosa graft and frontal flap: a buccal mucosa graft reconstructs the posterior lamella, while a paramedian forehead flap serves as a vascular support (\"graft-supplying flap\"); 3) frontal flap division and skin graft: after 3-4 weeks, the flap is divided, and the cutaneous-fat layer is replaced with a retroauricular skin graft; 4) reconstruction division and second mucosal graft: a thin buccal mucosa graft covers the incision edges to restore symmetry of the palpebral fissures.</p><p><strong>Results: </strong>At 6 months, the patient was satisfied. Functionally, there was no lagophthalmos or corneal irritation. Aesthetically, color matching was appropriate, and the concavity of the canthus was restored.</p><p><strong>Discussion: </strong>The frontal flap and buccal mucosa provide adequate coverage, avoiding complications such as entropion.</p><p><strong>Conclusion: </strong>This multi-stage approach, combining a frontal flap and mucosal grafts, seems to be an effective solution for extensive medial canthal defects involving the eyelids.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D bioprinting in regenerative medicine: From skin to organ engineering","authors":"D. Haykal ,&nbsp;A.-C. Benhamou ,&nbsp;T. Lotti ,&nbsp;F. Duteille","doi":"10.1016/j.anplas.2025.06.013","DOIUrl":"10.1016/j.anplas.2025.06.013","url":null,"abstract":"&lt;div&gt;&lt;div&gt;3D skin bioprinting is a transformative innovation in regenerative medicine, offering new possibilities for wound healing, reconstructive surgery, and disease modeling. By enabling the precise fabrication of patient-specific skin grafts, this technology addresses critical medical challenges, including severe burns, chronic ulcers, traumatic injuries, and genetic skin disorders. Advances in bioprinting techniques, bioink formulations, and vascularization strategies have enhanced graft integration and functional restoration, avoiding immune rejection risks. Beyond transplantation, 3D skin models provide a powerful platform for dermatological research, pharmacological testing, and tissue engineering, accelerating drug discovery while minimizing reliance on animal testing. Additionally, 3D bioprinting is revolutionizing cosmetic and reconstructive dermatology, enabling personalized aesthetic procedures, scar treatments, and anti-aging interventions that complement clinical applications. The future of 3D skin bioprinting lies in multi-tissue fabrication, AI-assisted biofabrication, and immunomodulatory grafts, which could revolutionize personalized medicine and regenerative healthcare. Despite ongoing challenges in clinical scalability and regulatory pathways, continued interdisciplinary research is driving the field closer to real-world medical applications. This review provides a structured timeline of advancements, compares bioprinting techniques, and offers specific examples of clinical and commercial applications. It concludes with a discussion of future directions, emphasizing sustainable bioinks, AI-assisted fabrication, and ethical frameworks.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;div&gt;La biopression cutanée tridimensionnelle (3D) représente une avancée majeure en médecine régénérative, ouvrant de nouvelles perspectives dans le traitement des plaies, la chirurgie reconstructive et la modélisation pathologique. En permettant la fabrication précise de greffons cutanés personnalisés, cette technologie répond à des besoins cliniques critiques tels que les brûlures étendues, les ulcères chroniques, les traumatismes complexes et certaines affections génétiques de la peau. Les récents progrès en matière de techniques de biopression, de formulation de bio-encres et de stratégies de vascularisation ont significativement amélioré l’intégration tissulaire et la restauration fonctionnelle, tout en réduisant les risques de rejet immunitaire. Au-delà de ses applications cliniques directes, la biopression 3D permet la création de modèles cutanés in vitro d’une grande pertinence, utilisés dans la recherche dermatologique, les essais pharmacologiques et l’ingénierie tissulaire. Ces modèles accélèrent le développement de nouvelles thérapies et réduisent la dépendance à l’expérimentation animale. En dermatologie esthétique et réparatrice, cette technologie offre de nouvelles solutions personnalisées pour le traitement des cicatrices, le rajeunissement cutané et les interven","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"71 2","pages":"Pages 203-212"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transversal suture of the rectus abdominis muscle in DIEP harvesting to include more than one perforator: Technical note","authors":"A. Auque ,&nbsp;A. Wessels ,&nbsp;F. Bodin","doi":"10.1016/j.anplas.2025.04.004","DOIUrl":"10.1016/j.anplas.2025.04.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Microsurgical breast reconstruction using a deep inferior epigastric perforator flap (DIEP) is currently considered the gold standard in autologous reconstruction. In some case, partial sectioning of the rectus abdominis muscle is necessary to include several perforators and make the flap more reliable. This technical note presents an optimized approach to transverse suturing of the rectus abdominis muscle after partial transection.</div></div><div><h3>Technical note</h3><div>A double transverse braided suture is made around the muscle band to be cut then the muscle strip is sectioned transversely. After weaning the flap, the two resulting strips of rectus muscle are joined by separate transmuscular stitches.</div></div><div><h3>Conclusion</h3><div>Transverse suturing of the rectus abdominis muscle after partial transection is a method that allows several perforators to be included in DIEP harvest, while limiting parietal complications.</div></div><div><h3>Introduction</h3><div>La reconstruction mammaire microchirurgicale par lambeau perforant épigastrique inférieur profond (DIEP) est actuellement considérée comme la méthode de référence en matière de reconstruction autologue. Cette note technique présente une approche optimisée de la suture transversale du muscle grand droit après section partielle.</div></div><div><h3>Note technique</h3><div>Une double suture tressée transversale est effectuée autour de la bande musculaire à sectionner, la bandelette musculaire est ensuite sectionnée transversalement. Après sevrage du lambeau, les deux bandelettes de muscle grand droit résultantes sont réunies par des points séparés transmusculaires.</div></div><div><h3>Conclusion</h3><div>La suture transversale du muscle grand droit de l’abdomen après section partielle est une méthode qui permet d’inclure plusieurs perforantes dans le prélèvement du DIEP tout en limitant les complications pariétales.</div></div>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"71 2","pages":"Pages 191-195"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transwomen satisfaction after nonsurgical management of large lower face with botulinum toxin injection of the masseter: A preliminary FACE-Q study","authors":"M. Slimani ,&nbsp;E. Ramelli ,&nbsp;L. Azoulai ,&nbsp;M. Atlan ,&nbsp;A.G. Lellouch ,&nbsp;S. Cristofari","doi":"10.1016/j.anplas.2025.09.003","DOIUrl":"10.1016/j.anplas.2025.09.003","url":null,"abstract":"<div><div>Facial feminization can be considered as an essential element of gender-affirming care and overall well-being of transgender women. This study explores a nonsurgical approach to facial gender-affirming procedures (FGAP) by assessing the efficacy of botulinum toxin (BT) injection for lower face transversal reduction. This cosmetic procedure was evaluated by administering the FACE-Q survey to participants, both pre- and post-procedure and at the three-month follow-up visit. A significant improvement in satisfaction was observed concerning the lower face appearance after BT injection in the masseter (<em>P</em> <!-->&lt;<!--> <!-->0.001). These findings raise awareness towards alternative nonsurgical options in achieving lower facial feminization.</div></div><div><div>La féminisation du visage peut être considérée comme un élément essentiel des soins d’affirmation de genre et du bien-être général des femmes transgenres. Cette étude explore une approche non chirurgicale des procédures d’affirmation du genre (FGAP) en évaluant l’efficacité de l’injection de toxine botulique (BT) pour la réduction transversale du tiers inférieur du visage. Cette procédure médicale a été évaluée par le score FACE-Q, avant et après la procédure et lors de la visite de suivi de trois mois. Une amélioration significative de la satisfaction a été observée concernant l’apparence du visage après injection de BT dans le masseter (<em>p</em> <!-->&lt;<!--> <!-->0,001). Ces résultats orientent vers des options non chirurgicales alternatives et non invasives pour réduire la dimension transversale du tiers inférieur du visage dans la féminisation faciale.</div></div>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":"71 2","pages":"Pages 186-190"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}