Eplasty最新文献

{"title":"Case Series of Reconstruction Applying NovoSorb Biodegradable Temporising Matrix: Preliminary Practice and Findings in the United Kingdom.","authors":"Simpson Shiu Chung Tam, Kirsten Taylor, Pankaj Patel, Patrick Goon, Manaf Khatib","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Biodegradable temporizing matrix (BTM) is a novel synthetic dermal matrix for wound reconstruction and an alternative to biological dermal substitutes such as Integra (Integra LifeSciences). It provides a scaffold for dermal regeneration and acts as a temporizing device prior to skin graft application, reducing the need for autologous tissue donor sites such as local or free-flap transfer.</p><p><strong>Methods: </strong>This retrospective case series involved 12 patients whose surgery was completed with BTM from October 2021 to February 2023. The inpatient stay, subsequent procedures, and any complications were also reviewed.</p><p><strong>Results: </strong>The median time for inpatient stay was 3.5 days, and patients who required skin grafts after full BTM integration were treated as a day case. Only 1 case had the complication of postoperative infection.</p><p><strong>Conclusions: </strong>The study supports the application of BTM products to heal wounds with exposed bone or tendon. This is considered a low-risk option to reduce complications and improve reconstructive and cosmetic outcomes, particularly in the head and neck region.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"e20"},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639022","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":"Surgical Management of Biopolymer Induced Granulomatous Hypercalcemia and Renal Insufficiency: A Case Report and Literature Review.","authors":"Dieter Brummund, Angela Chang, Christopher Salagdo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Volumetric enhancement is a key component of body contouring, with injections of natural or synthetic biopolymers being one of the most common methods used. Biopolymers, however, are associated with both acute and chronic complications including the risk of granulomatosis and hypercalcemia. Unrecognized and untreated, biopolymer-induced granulomatous hypercalcemia can lead to renal failure, metastatic calcifications, and death. Medical management is the primary treatment for biopolymer-induced granulomatous hypercalcemia, with corticosteroids and other drugs targeting calcium metabolism and immunomodulation. In cases refractory to medical management, surgical excision of biopolymer granulomatous tissue can normalize serum calcium and improve renal function. This case report of 2 patients and literature review of 4 patients investigates the rare surgical management of patients with biopolymer-induced granulomatous hypercalcemia, the morbidity of such a procedure, and adjunctive techniques that may be utilized to facilitate biopolymer removal and reduce complications.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"e19"},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639057","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":"Rare Benign Tumor: Elastofibroma Dorsi.","authors":"Adrian Frunza, Luca Avram","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"QA2"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661314","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":"Pediatric Granular Cell Tumor of the Digital Nerve: A Case Report and Literature Review.","authors":"Caleb H Bercu, Raghavee Neupane, Ashley Ramirez, Carole Brathwaite, Aaron J Berger","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Granular cell tumors (GCTs) are rare soft tissue neoplasms thought to originate from Schwann cells of the peripheral nervous system. These tumors predominantly occur in the head and neck regions. Instances of GCTs affecting peripheral nerves of the upper extremity, particularly in the hand, are exceptionally rare.</p><p><strong>Methods: </strong>A 9-year-old girl presented with a rapidly growing mass on the left index finger. Ultrasound and magnetic resonance imaging revealed a mass encasing the neurovascular bundle extending to the dermal surface. Biopsy confirmed the presence of a GCT. Intraoperatively, the tumor, which was embedded within the radial nerve and adherent to the tendon sheath, was excised. Nerve reconstruction was performed with a posterior antebrachial cutaneous nerve graft.</p><p><strong>Results: </strong>Histopathology showed pleomorphic polygonal cells with granular cytoplasm and mild nuclear atypia. Immunohistochemical staining was positive for S100, CD68, SOX10, NKI/C3, inhibin, and TFE3, confirming the diagnosis of a benign GCT. The tumor was successfully excised with clear margins.</p><p><strong>Conclusions: </strong>Here we present the 5th documented case of GCT originating from the digital nerve and first-ever case treated with excision and posterior antebrachial cutaneous nerve graft reconstruction. The successful use of a nerve graft in this case underscores the value in preserving sensory function after tumor excision. Long-term follow-up is essential to monitor for recurrence and ensure favorable outcomes.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"e18"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639075","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 Vastus Lateralis and Tensor Fascia Lata Flap for Aortic Graft Salvage.","authors":"Dieter Brummund, Angela Chang, Vanitha Vasudevan, Tony Shao, Christopher Salgado","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"QA1"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661313","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":"Artificial Intelligence in Hand and Upper Extremity Surgery Education: Accuracy and Validity of ChatGPT-4o Versus UpToDate as a Learning Tool for Trainees.","authors":"Caleb Bercu, Brianna Rosner, Aneeq Chaudhry, Hannah Korah, Isabel Bernal, Aaron Berger","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The use of artificial intelligence (AI) in medical education has risen rapidly. Trainees can ask ChatGPT-4o (OpenAI) clinical questions and receive management recommendations. Previous studies have assessed the accuracy of ChatGPT, but none have examined hand and upper extremity surgery. This study aimed to evaluate the accuracy of ChatGPT-4o compared to UpToDate (Wolters Kluwer) and categorize the validity of sources provided by ChatGPT-4o.</p><p><strong>Methods: </strong>Five hand and upper extremity surgery cases were entered into ChatGPT-4o. An UpToDate article was selected for each case. Two hand surgeons and 5 medical students completed a survey comparing the resources. Resources were rated on a scale from 1 to 3, with 1 indicating incomplete information and not useful; 2 indicating semi-complete information and somewhat useful; and 3 indicating a complete answer and useful for management. ChatGPT-4o references were scored on a validity scale of 0 to 2.</p><p><strong>Results: </strong>Hand and upper extremity surgeons rated ChatGPT-4o and UpToDate as semi-complete and somewhat useful, with median scores of 2.00 and 2.50, respectively. No significant differences were found between resources. Medical students found ChatGPT to provide semi-complete information and be somewhat useful overall, and rated UpToDate more often as providing a complete answer and being useful. However, no statistically significant differences were found between the resource ratings. Of the 25 references provided by ChatGPT, 28% were accurate, 6% were somewhat accurate, and 66% were inaccurate.</p><p><strong>Conclusions: </strong>The findings indicate overall comparable perceived usefulness of ChatGPT-4o and UpToDate by hand/upper extremity surgeons and trainees. ChatGPT-4o holds promise as an educational tool; however, accuracy concerns remain.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"e17"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639021","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":"Misconceptions in Plastic Surgery: Crowdsourcing Public Perceptions of Plastic Surgery Urban Myths.","authors":"Navya Baranwal, Elijah M Persad-Paisley, Nidhi Shinde, Carole Spake, Jesse E Menville, Raman Mehrzad, Nikhil Sobti, Loree K Kalliainen","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Understanding public misconceptions about plastic surgery can inform plastic surgeons of the knowledge gaps among their patients and non-plastic surgeon colleagues about the field. This deepened understanding may aid in optimizing patient satisfaction and health outcomes. The objective of this study was to investigate the extent to which laypeople agree with common plastic surgery urban myths.</p><p><strong>Methods: </strong>A Likert scale-based survey of 10 popular plastic surgery myths was distributed via Amazon Mechanical Turk. Descriptive analyses and multinomial logistical regressions were performed to assess associations between respondent demographics and the likelihood of agreeing with each myth.</p><p><strong>Results: </strong>A total of 2000 completed surveys were included in this study. Of the respondents, 41% believed that hand dominance is associated with a larger ipsilateral breast, 40% believed that underwire bras cause breast cancer, and 59% believed that typing causes carpal tunnel syndrome. Respondents who were male or younger than 35 years were more likely to believe in inaccurate myths. Health care workers had higher odds of agreeing with the claims that plastic surgery uses plastic (odd ratio [OR] = 2.49 [95% CI, 1.82-3.41]; <i>P</i> <.001) and that plastic surgery is almost always cosmetic (OR = 1.85 [95% CI, 1.32-2.61]; <i>P</i> < .001). Participants who underwent a plastic surgery procedure or consultation were generally more likely to agree with the listed myths.</p><p><strong>Conclusions: </strong>The general public and non-plastic-surgeon health care workers appear to have misconceptions about the scope and practice of plastic surgery. Open-ended patient-physician communication and patient-centered educational resources can potentially overcome plastic surgery misconceptions, thereby optimizing patient health outcomes and satisfaction.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"e16"},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639071","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":"Outcomes of Complex Wound Reconstruction in High-Risk Patients Using Decellularized Extracellular Matrix from Porcine Urinary Bladder.","authors":"Gracie R Baum, Cameron T Cox, Ian L Valerio, Brendan J MacKay","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The treatment of complex wounds remains a challenging aspect of reconstructive surgery, given their diverse nature and the frequent need for high-level surgical procedures. Standard treatment with flap coverage can achieve many goals; however, it is not without difficulties, including technical complexity, extended recovery times, donor site morbidity, and vascular complications, particularly in non-optimized patients. Acellular extracellular matrices, such as porcine urinary bladder matrices, have emerged as an alternative approach to support wound healing without the risks of high-level reconstruction. Urinary bladder matrix provides an extracellular matrix scaffold that supports intrinsic tissue regeneration mechanisms, allowing for stable, well-vascularized wound bed formation.</p><p><strong>Methods: </strong>This retrospective case series examines the outcomes of urinary bladder matrix for the treatment of complex wounds in 21 patients deemed high-risk or unfavorable candidates for surgical management with local or free flap techniques. The patients were treated by 2 surgeons at 2 separate level 1 trauma centers from October 2019 through June 2022. Urinary bladder matrix was the primary wound management modality with serial wound debridement, matrix reapplication, and subsequent wound care tailored to each patient until definitive, stable coverage.</p><p><strong>Results: </strong>In all cases, urinary bladder matrix facilitated soft tissue remodeling, permitting complete wound re-epithelization or preparation for skin grafting and/or flap coverage. Four patients' wounds re-epithelized on their own, while 17 patients received subsequent skin graft. In 2 of these cases, the initial split-thickness skin graft failed, requiring a second skin graft and or/flap coverage.</p><p><strong>Conclusions: </strong>Our results demonstrate that urinary bladder matrix facilitates definitive soft tissue reconstruction and can be a valuable adjunct to wound repair, providing a simpler, less morbid treatment option for patients with various comorbidities and injury mechanisms.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"e15"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639074","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":"Effectiveness of Using Autologous Saphenous Vein as Arteriovenous Graft for Patients With Chronic Wounds Undergoing Hemodialysis.","authors":"Masahiro Kuwabara, Hiroto Hosoyamada, Kana Tokuno, Takahiro Hirayama, Eri Ichijo, Naoto Yamamoto","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Although the first choice of vascular access for hemodialysis is still the creation of an arteriovenous fistula, the increasing number of vascular access creations in Japan, as well as the inability of percutaneous transluminal angioplasty to effectively restore patency in stenotic and obstructed native vascular accesses, has resulted in an increase in the rate of arteriovenous grafting for hemodialysis. However, for patients with infected wounds, using a prosthetic graft is generally contraindicated because of the risk of the spread of infection. In such cases, options tend to be limited to less frequently used or novel methods of vascular hemodialysis access, such as basilic vein transposition and autologous vein transplantation. Herein, we report 3 successful cases of arteriovenous grafting using an autologous saphenous vein. Careful preoperative evaluation of the vascular anatomy is necessary to effectively determine the best option for vascular access in such patients.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"e14"},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639066","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":"Facial Aesthetics in Artificial Intelligence: First Investigation Comparing Results in a Generative AI Study.","authors":"Arsany Yassa, Arya Akhavan, Solina Ayad, Olivia Ayad, Anthony Colon, Ashley Ignatiuk","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing facial plastic surgery are increasingly using artificial intelligence (AI) to visualize expected postoperative results. However, AI training models' variations and lack of proper surgical photography in training sets may result in inaccurate simulations and unrealistic patient expectations. This study aimed to determine if AI-generated images can deliver realistic expectations and be useful in a surgical context.</p><p><strong>Methods: </strong>The authors used AI platforms Midjourney (Midjourney, Inc), Leonardo (Canva), and Stable Diffusion (Stability AI) to generate otoplasty, genioplasty, rhinoplasty, and platysmaplasty images. Board-certified plastic surgeons and residents assessed these images based on 11 metrics that were grouped into 2 criteria: realism and clinical value. Analysis of variance and Tukey Honestly Significant Difference post-hoc analysis tests were used for data analysis.</p><p><strong>Results: </strong>Performance for each metric was reported as mean ± SD. Midjourney outperformed Stable Diffusion significantly in realism (3.57 ± 0.58 vs 2.90 ± 0.65; <i>P</i> < .01), while no significant differences in clinical value were observed between the AI models (<i>P</i> = .38). Leonardo outperformed Stable Diffusion significantly in size and volume accuracy (3.83 ± 0.24 vs 3.00 ± 0.36; <i>P</i> = .02). Stable Diffusion underperformed significantly in anatomical correctness, age simulation, and texture mapping (most <i>P</i> values were less than .01). All 3 AI models consistently underperformed in healing and scarring prediction. The uncanny valley effect was also observed by the evaluators.</p><p><strong>Conclusions: </strong>Certain AI models outperformed others in generating the images, with evaluator opinions varying on their realism and clinical value. Some images reasonably depicted the target area and the expected outcome; however, many images displayed inappropriate postsurgical outcomes or provoked the uncanny valley effect with their lack of realism. The authors stress the need for AI improvement to produce better pre- and postoperative images, and plan for further research comparing AI-generated visuals with actual surgical results.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"e13"},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639067","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}