Eplasty最新文献

{"title":"Design of Buccinator Flaps for Oronasal Fistula Repair: A Technical Review and Case Series.","authors":"Molly MacIsaac, Alexzandra Mattia, Jordan Halsey, S Alex Rottgers","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Oronasal fistula (ONF) repair remains a significant challenge in patients with cleft lip and palate, particularly when local palatal tissue is insufficient. Regional flaps, including the buccal myomucosal flap (BMMF) and the facial artery musculomucosal (FAMM) flap, offer reliable reconstructive options. This study reviews the surgical anatomy, design, and clinical outcomes of these buccinator-based flaps in ONF repair.</p><p><strong>Methods: </strong>This retrospective case series included 13 patients who underwent ONF repair using a BMMF or a FAMM flap between 2017 and 2024. Patient demographics, fistula characteristics, surgical details, postoperative care, and outcomes were collected and analyzed.</p><p><strong>Results: </strong>Six patients underwent BMMF reconstruction, while 7 received FAMM flaps. Successful fistula closure was achieved in 66.7% of patients in the BMMF group, with flap dehiscence occurring in 2 cases, both associated with digital manipulation. The FAMM flap cohort had a 100% fistula closure rate but exhibited a high incidence (86%) of postoperative scar contracture, with 4 patients requiring contracture release.</p><p><strong>Conclusions: </strong>Based on this experience, the authors propose an algorithm for flap selection in ONF repair. Posteriorly based BMMFs are well suited for fistulas at the junction of the hard and soft palate (Type III) and the posterior third of the hard palate (Type IV). Superiorly based FAMM flaps are preferred for anterior ONFs, particularly those extending into the alveolus. The central hard palate remains a reconstructive challenge, with FAMM flaps offering better reach, though they require staged inset and debulking. Both BMMF and FAMM flaps provide vascularized tissue for ONF closure with minimal donor site morbidity. Strategic flap selection based on fistula location optimizes outcomes while mitigating complications.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"26 ","pages":"e1"},"PeriodicalIF":0.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12980017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470644","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":"Correspondence on \"Performance of ChatGPT on the Plastic Surgery In-Training Examination\".","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"e43"},"PeriodicalIF":0.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446549","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":"Single-Stage Breast Reconstruction With Immediate Free Nipple Grafting in Goldilocks Mastectomy Using Composite Nipple Graft and \"Donut\" Areolar Full-Thickness Skin Graft Shared From Noncancerous Breast.","authors":"Colton H Connor, Shriya Dodwani, Quinton L Carr, Claire Fell, Sierra Shockley, Ryan Cantrell, Wilson Huett, Bradon J Wilhelmi","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"QA10"},"PeriodicalIF":0.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12981228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470561","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":"An Analysis of Risk Factors for Complication Following Upper Extremity Amputation.","authors":"Dhruv Mendiratta, Connor Fletcher, Isabel Herzog, Ashok Para, Tej Joshi, Michael M Vosbikian, Irfan H Ahmed","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Upper extremity amputations (UEAs) comprise anywhere from 14% to 50% of amputations. Risk factors for lower extremity amputations (LEA), such as diabetes, have been established in the literature. The authors attempt to illuminate similar associations with UEA, which have been studied to a lesser degree. In this study, the authors explore preoperative risk factors that may predispose patients to complications after UEA.</p><p><strong>Methods: </strong>The American College of Surgeons National Surgical Quality Improvement Program Database was queried from 2006 to 2018 for patients undergoing various levels of UEA using current procedural terminology codes. Demographic and comorbidity data were collected, including level of amputation; levels included shoulder disarticulation (SD), transhumeral/elbow disarticulation, transradial/wrist disarticulation, and transcarpal. Outcomes included major systemic complications, prolonged length of stay (LOS), unplanned reoperation, surgical site infection (SSI), and death. Chi-squared and multivariate binary regression analysis were used to determine odds ratios.</p><p><strong>Results: </strong>Overall, 3907 patients undergoing UEA were identified. Upon multivariate binary regression analysis, hyponatremia, hypoalbuminemia, history of cardiac disease, and SD were independent risk factors for major systemic complications. SD amputation was an independent risk factor for major systemic complications, shock/septic shock, and prolonged LOS. History of cardiac disease was an independent risk factor for major systemic complications, prolonged LOS, and death. Diabetes was an independent risk factor for prolonged LOS, unplanned reoperation, and SSI.</p><p><strong>Conclusions: </strong>The study found that in patients undergoing UEA, there was an increased risk of 30-day complications in those with hyponatremia, hypoalbuminemia, cardiovascular disease, diabetes, and proximal amputations.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"e40"},"PeriodicalIF":0.0,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446429","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":"A Rare Case of Cutaneous Metastasis of Hepatocellular Carcinoma to the Chin: Case Report and Review of Surgical Management.","authors":"Jonathan Ruiz, Jacqueline Ross, Kinsey Rice, Kristen Whalen, Nicole K Le, Lisa Kettlestrings, Wyatt G Payne","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) is a debilitating complication of primary hepatic disease with a significant annual incidence worldwide. Untreated HCC may result in a severe reduction to life expectancy, dependent on staging at diagnosis. Typically, HCC has a propensity to metastasize to the lung, peritoneum, and bone. Cutaneous HCC metastases are rarely encountered, with few described in the literature. The authors present a case of a 66-year-old man with biopsy-proven cutaneous HCC metastasis to the chin. The patient was managed with excision, followed by staged reconstruction. Surgical management and a review of the literature are discussed.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"e41"},"PeriodicalIF":0.0,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446393","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":"Comparison of Multimodal Analgesia and Narcotic Regimen for Postoperative Pain Control of Plastic Surgery Breast Procedures.","authors":"Sarah Moffitt, Bilal Koussayer, Kristina Buller, Meredith G Moore, Mariel McLaughlin, Jenna Stoehr, Riley Schlub, Michael Doarn, Jared Troy, Waylon Zeng, Nicholas Peterman, Audrey Korte, Morgan Parker, Anthony Capito","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Opioid analgesics are commonly used for postoperative pain management in plastic surgery, despite risks regarding dependence and complications. This study evaluates the noninferiority of multimodal analgesia compared with traditional narcotic regimens for postoperative pain management in breast reduction mammoplasty and tissue expander placement following mastectomy.</p><p><strong>Methods: </strong>A retrospective cohort study of 171 patients (107 breast reduction, 64 tissue expander placement) was conducted at a single tertiary academic medical center between 2018 and 2022. Patients received either multimodal analgesia (preoperative acetaminophen 1000 mg, postoperative tramadol 50 mg q6h PRN, and gabapentin 300 mg TID) or narcotic analgesia (hydrocodone-acetaminophen 5-325 mg q6h PRN). Pain intensity was measured using Patient-Reported Outcomes Measurement Information System (PROMIS) pain intensity scores at the 2-week postoperative visit. Supplemental pain medication requests were tracked for analgesic groups as a measure of inadequate pain control.</p><p><strong>Results: </strong>In the breast reduction group, the mean difference in PROMIS scores between multimodal (57.29) and narcotic (56.24) groups was 1.05 (95% CI, -2.81-4.91), below the minimal clinically meaningful difference of 10 points. For tissue expander placement, the mean difference was -2.76 (95% CI, -8.73-3.21). No significant differences were found in supplemental medication requests between groups for either procedure (<i>P</i> > .05).</p><p><strong>Conclusions: </strong>Multimodal analgesia provides pain control comparable to traditional narcotic regimens in breast procedures. This approach may reduce opioid exposure with comparable patient-reported outcomes, supporting multimodal analgesic protocols as a strategy to mitigate opioid use in plastic surgery patients.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"e42"},"PeriodicalIF":0.0,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446415","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":"A Suitable Indication for Crescent Mastopexy: Achieving Optimal Nipple Position in Nipple-Sparing Mastectomies.","authors":"Ryan A Cantrell, Alexander L Mostovych, Claire Fell, Shriya D Dodwani, Colton H Connor, Quinton L Carr, Camille Gorena, Bradon J Wilhelmi","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"QA9"},"PeriodicalIF":0.0,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12981227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470521","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":"Alligator Assault: A Systematic Literature Review and Case Series at a Florida Level 1 Trauma Center.","authors":"Sarah Moffitt, Bilal Koussayer, Kristina Buller, Meredith G Moore, Mariel McLaughlin, Jenna Stoehr, Riley Schlub, Michael Doarn, Jared Troy","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Alligator bites are a rare occurrence, though some literature on injurious human-alligator interactions exists. This report details 3 cases of alligator bite-related wounds with characteristic extensive tissue damage and subsequent reconstruction. We also review the literature on caring for this specific population.</p><p><strong>Methods: </strong>The authors present a systematic literature review on alligator bite-related sequalae and care. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed throughout the systematic literature review. The authors also present a case series of patients wounded by alligators who each presented to a large tertiary academic center on the west coast of Florida.</p><p><strong>Results: </strong>Early debridement, prophylactic antibiotics, soft tissue reconstruction, and interdisciplinary care are the main tenets of care for patients who sustain alligator bites. Case 1 was a 53-year-old man with a left upper extremity bite with significant neurovascular damage and near transradial amputation who underwent emergent revascularization. After multiple attempts at limb salvage, the patient underwent formal transradial amputation. Case 2 was a 77-year-old woman with bites to her left upper and lower extremities, with concern for lower extremity Morel-Lavallée lesion. The lower extremity wound was reconstructed with lateral gastrocnemius muscular and fibularis longus musculocutaneous flaps and split-thickness grafting; ultimately, transradial amputation was necessary for the upper extremity after evidence of devascularization. Case 3 was a 34-year-old man with a facial injury and skull fracture. After initial operative repair of the facial nerve and soft tissue lacerations, the patient required later revision with cranioplasty and temporalis coverage because of a draining wound. All 3 patients survived their severe injuries.</p><p><strong>Conclusions: </strong>This case series represents a unique set of patients maimed by alligators and their subsequent surgical management. Recommendations from the literature review include an interdisciplinary approach, early operative investigation and initiation of broad-spectrum antibiotics, and to consider a staged reconstruction for these injuries.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"e38"},"PeriodicalIF":0.0,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446364","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":"Batwing Mammoplasty Modification as a Treatment for Hurley Stage III Breast Hidradenitis Suppurativa.","authors":"Tatjana Mortell, Jared Rosbrugh, William Aukerman, Kevin Kresofsky, Chris Babycos, Abigail Chaffin","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"QA8"},"PeriodicalIF":0.0,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12981226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470523","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":"Soft Tissue Reconstruction With Synthetic Electrospun Fiber Matrix Following Musculoskeletal Injury: A Retrospective Case Series.","authors":"Christopher Cosgrove","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Restoration of a stable and functional soft tissue envelope following traumatic injury to the musculoskeletal system is critical. Where primary closure is not feasible, other reconstructive options must be considered to achieve soft tissue coverage of critical structures. Skin substitutes have been utilized to stimulate granulation tissue and support incorporation of autografts. This present study aims to investigate the use of a fully synthetic electrospun fiber matrix (SEFM) (Restrata; Acera Surgical, Inc) in the management of post-traumatic soft tissue defects. The objective of the present retrospective case series was to assess healing outcomes, including time to healing and incidence of complications, following a single application of the SEFM to soft tissue trauma surrounding musculoskeletal injury.</p><p><strong>Methods: </strong>Medical charts of patients with soft tissue injury secondary to musculoskeletal trauma and who were treated with the SEFM in the operating room following bony instrumentation or fasciotomy procedures were retrospectively reviewed following institutional review board approval. Included patients were treated with the SEFM in conjunction with negative pressure wound therapy as a means of preparing open wounds for definitive management via split-thickness skin grafting or secondary intention healing.</p><p><strong>Results: </strong>Eleven patients met the inclusion criteria. Injury etiologies included 8 open fractures in both upper and lower extremities, 2 open foot-crush injuries, and 1 incidence of forearm compartment syndrome. Ten patients achieved complete healing with minimal complications.</p><p><strong>Conclusions: </strong>Preliminary results indicate that the SEFM may be a viable adjunctive treatment for open post-traumatic wound beds to promote granulation tissue for definitive closure.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"e37"},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446496","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}