Microsurgery最新文献

{"title":"Comments on \"Intraoperative Evidence of Early Neovascularization in a SCIP Flap Following Postoperative Trauma: A Case Report\".","authors":"Yanis Berkane, Paul Girard, Nicolas Bertheuil, Frédéric Bodin","doi":"10.1002/micr.70188","DOIUrl":"https://doi.org/10.1002/micr.70188","url":null,"abstract":"","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"46 1","pages":"e70188"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146052895","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":"Impact of SPY Elite Fluorescence Imaging on Complications and Healthcare Utilization in DIEP Flap Breast Reconstruction: An Interrupted Time Series Analysis","authors":"Sofie Meng Zhang,&nbsp;Cecilie Mullerup Laustsen-Kiel,&nbsp;Mathias Ørholt,&nbsp;Mikkel Herly,&nbsp;Lea Juul Nielsen,&nbsp;Mette Stueland Wolthers,&nbsp;Lisa Toft Jensen,&nbsp;Peter Stemann Andersen,&nbsp;Peter Vester-Glowinski,&nbsp;David Hebbelstrup Jensen","doi":"10.1002/micr.70166","DOIUrl":"10.1002/micr.70166","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The deep inferior epigastric perforator (DIEP) flap is a favored option for autologous breast reconstruction. However, complications related to insufficient perfusion, such as flap loss and fat necrosis, remain significant concerns. SPY Elite Fluorescence Imaging enables real-time tissue perfusion assessment during surgery, potentially reducing complications through superior visualization compared with clinical assessment alone. This study evaluates surgical outcomes and healthcare utilization patterns before and after the implementation of SPY imaging for DIEP flap breast reconstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>This retrospective study examined 271 breast cancer patients undergoing DIEP flap reconstruction at Rigshospitalet, Copenhagen (November 2016–June 2024), with 164 in the SPY group and 107 in the non-SPY group. Outcomes included flap complications and frequency of postoperative visits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The interrupted time series revealed a significant decrease in complications over time (<i>β</i> = −0.110, <i>p</i> &lt; 0.001) with SPY implementation. Overall rate of flap complications saw a relative risk reduction of 21.3%, explained by a reduction in rates of flap infection, flap loss, and seroma. Healthcare utilization decreased across all categories: hospital visits (−21.6%), doctor visits (−17.4%), and nurse visits (−23.6%). The number needed to treat to prevent one complication was 6.0.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SPY imaging implementation was associated with significant reductions in flap complications and healthcare utilization. While our interrupted time series design strengthens causal inference by accounting for temporal trends and learning curves, the observational nature precludes definitive causal claims. The technology shows potential clinical and economic value. Prospective studies are needed to validate these findings and establish standardized protocols for optimal application.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145863681","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":"Clinical Comparative Analysis of Vertical Versus Transverse Skin Island Designs in Free Flaps Based on the Superficial Palmar Branch of the Radial Artery (SUPBRA)","authors":"M. Baver Acaban,&nbsp;Alper Aksoy,&nbsp;Fatih Kabakaş","doi":"10.1002/micr.70162","DOIUrl":"10.1002/micr.70162","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The superficial palmar branch of the radial artery (SUPBRA) flap provides glabrous, sensate, and pliable skin, making it a valuable option for digital reconstruction. The flap's skin island can be oriented either vertically or transversely; however, no prior study has compared these designs. This study presents the first clinical comparison of these two orientations, highlighting their anatomical and functional differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between 2018 and 2022, 29 patients underwent free SUPBRA flap reconstruction. Fourteen received vertical skin islands (vSupbra) and 15 received transverse designs (tSupbra). Flap anatomy, surgical parameters, sensory recovery, joint mobility, and donor-site aesthetics were evaluated using standard clinical and statistical methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average skin island size was 9.0 ± 2.1 cm² for vSupbra and 10.2 ± 2.4 cm² for tSupbra. The vSupbra flap had a significantly longer pedicle (2.0 ± 0.6 vs. 1.6 ± 0.4 cm, <i>p</i> = 0.0385), whereas the tSupbra flap had thinner skin (2.0 ± 0.5 vs. 3.4 ± 0.8 mm, <i>p</i> = 0.0043). Three complications occurred in each group, with no total flap loss. Functional outcomes showed better active range of motion (93.1° ± 2.4° vs. 80.4° ± 1.8°, <i>p</i> = 0.0139) and donor site aesthetics (VAS 8.4 ± 0.6 vs. 6.7 ± 0.7, <i>p</i> = 0.0030) in the vSupbra group. Sensory recovery did not differ significantly between groups (S2PD 5.7 ± 0.8 vs. 6.1 ± 0.9 mm, <i>p</i> = 0.6987).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The vSupbra flap provides glabrous, adherent skin suitable for volar defects, while the tSupbra flap is more pliable and favorable for dorsal and articular reconstructions. Flap design should be tailored to the defect's anatomical and functional requirements. Flap selection should therefore be based on the anatomical and functional requirements of the defect. Previous literature has not described that the SUPBRA flap can be designed in two distinct orientations—vertical and transverse. This study is the first to demonstrate that these two skin island designs have different anatomical characteristics that provide distinct reconstructive advantages and limitations, guiding flap selection according to defect requirements.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145857201","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":"Near-Infrared Visualization of Veins for Free Tissue Transfer","authors":"Kazuho Kawashima,&nbsp;Cédric Zubler,&nbsp;Afshin Mosahebi,&nbsp;Dariush Nikkhah","doi":"10.1002/micr.70169","DOIUrl":"10.1002/micr.70169","url":null,"abstract":"","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145857187","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":"Heritage of the Founder of Microsurgical Education in Debrecen—In Memoriam Professor István Furka (1935–2021)","authors":"Norbert Nemeth,&nbsp;Iren Miko,&nbsp;Andrea Furka","doi":"10.1002/micr.70163","DOIUrl":"10.1002/micr.70163","url":null,"abstract":"","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145857242","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":"Factors Associated With Unplanned Return to Theater in Reconstructive Head and Neck Cancer Patients: A Retrospective Risk Factor Analysis","authors":"Jevan Cevik,&nbsp;Hao Zhang,&nbsp;Yuichi Ichikawa,&nbsp;Edward Cheong,&nbsp;Peixuan Li,&nbsp;Amrita Varma,&nbsp;Anand Ramakrishnan","doi":"10.1002/micr.70167","DOIUrl":"10.1002/micr.70167","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Unplanned return to theater (URTT) following head and neck cancer reconstruction presents significant clinical and economic challenges. Identifying risk factors for URTT can aid in surgical planning and patient risk stratification. This study evaluates preoperative and intraoperative factors associated with URTT in patients undergoing free flap reconstruction after head and neck tumor resection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was conducted on patients undergoing head and neck tumor resection with free flap reconstruction between July 2015 and January 2024. Demographic, clinical, and operative data were analyzed using univariable and multivariable logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 609 patients included, 199 (32.7%) experienced URTT within 90 days postoperatively. Common indications for URTT included infected collections (33.7%), hematoma (24.6%), and flap dehiscence (16.1%). On univariable analysis, preoperative PEG tube use (unadjusted odds ratio (OR) 1.78 [95% confidence interval (CI) 1.03–3.07], <i>p</i> = 0.04), higher frailty index scores (1.27 [1.03–1.58], <i>p</i> = 0.03), longer operative duration (1.15 [1.06–1.24], <i>p</i> &lt; 0.001), use of bony free flaps (2.08 [1.44–3.01], <i>p</i> &lt; 0.001), and tracheostomy (2.09 [1.22–3.56], <i>p</i> = 0.01) were associated with URTT. Yet, on multivariable analysis, only higher frailty index score (adjusted OR 1.32, 95% CI 1.03–1.70, <i>p</i> = 0.03) and use of bony free flaps (adjusted OR 1.92, 95% CI 1.19–3.11, <i>p</i> &lt; 0.01) retained statistical significance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings of this study suggest that frailty and the use of bony free flaps are key risk factors for URTT among reconstructive head and neck cancer patients. These findings support patient risk stratification preoperatively and targeted interventions to reduce the risk of URTT and improve resource utilization in head and neck cancer surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145857227","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":"Microvascular Stigmata in Lower Extremity Trauma: Step-By-Step Dissection of the Zone of Injury","authors":"Michalis Hadjiandreou,&nbsp;Youn Hwan Kim,&nbsp;Ilkka Kaartinen,&nbsp;Parviz Lionel Sadigh,&nbsp;Georgios Pafitanis","doi":"10.1002/micr.70168","DOIUrl":"10.1002/micr.70168","url":null,"abstract":"","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145857166","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":"Current Perceptions Toward the Use of Superficial Temporal Vessels in Head and Neck Reconstruction","authors":"Belén Andresen-Lorca,&nbsp;Alberto Pérez-García,&nbsp;Arantxa Blasco-Serra,&nbsp;Eva M. González-Soler,&nbsp;María D. Pérez-del-Caz,&nbsp;Alfonso A. Valverde-Navarro","doi":"10.1002/micr.70164","DOIUrl":"10.1002/micr.70164","url":null,"abstract":"","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145857234","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":"Urethral Reconstruction for Hypospadias Repair Using an Ulnar Forearm Flap: A Report of Long-Term Outcomes of 3 Cases","authors":"Goki Ohashi,&nbsp;Takashi Nuri,&nbsp;Koichi Ueda","doi":"10.1002/micr.70161","DOIUrl":"10.1002/micr.70161","url":null,"abstract":"<div>\u0000 \u0000 <p>Hypospadias is a congenital anomaly affecting 1 in 300 male infants. When urethral stricture develops after the initial surgery, it tends to become intractable, often necessitating multiple corrective surgeries. We previously reported favorable outcomes using an ulnar forearm flap for urethral reconstruction in such refractory cases. Here, we describe the long-term outcomes of three cases treated by this method. All had undergone surgery for hypospadias during childhood and repeated urethral stricture surgeries before undergoing urethral reconstruction using our method. Case 1 was a 40-year-old man who underwent this surgery at age 21. The flap size was 3.0 × 12.5 cm. Postoperatively, the patient had favorable outcomes for 12 years. Subsequently, urethral stricture recurred, requiring corrective surgery using a skin graft. Case 2 was a 58-year-old man who underwent this surgery at age 40 years. The flap size was 3.5 × 10.0 cm. Postoperatively, the patient had favorable outcomes for 11 years. Subsequently, urethral stricture recurred, but symptoms were improved by balloon dilation alone. Case 3 was a 48-year-old man who underwent this surgery at age 45 years. The flap size was 3.2 × 10.0 cm. Postoperatively, urethral stricture recurred at 6 months, necessitating correction using a penile skin flap. The donor site exhibited prominent hypertrophy, suggesting a predisposition for hypertrophic scar development. The follow-up periods were 19 years for Case 1, 18 years for Case 2, and 4 years for Case 3, without stricture recurrence. Compared with long-term outcomes for urethral reconstruction using skin or buccal mucosa grafts, our method showed the potential for more favorable outcomes. This method may be a good treatment option, but may lead to early stricture recurrence depending on the patient's constitution, requiring careful follow-up.</p>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 8","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805118","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":"Thigh-Based Flap Reconstruction for Complex Abdominal Wall Loss of Domain: A 10-Year Retrospective Cohort Study","authors":"Diwakar Phuyal,&nbsp;Filippo A. G. Perozzo,&nbsp;Fuad Abbas,&nbsp;Christopher Jou,&nbsp;Anshumi Desai,&nbsp;Kashyap Tadisina,&nbsp;Juan Rodolfo Mella Catinchi,&nbsp;Risal Djohan,&nbsp;Raffi Gurunian,&nbsp;Sarah N. Bishop","doi":"10.1002/micr.70156","DOIUrl":"10.1002/micr.70156","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Complex abdominal wall reconstruction (AWR) is a technically demanding procedure often required in patients with large fascial defects and significant comorbidities. When primary closure is not feasible, thigh-based flaps can provide durable soft tissue coverage and structural support. However, literature on flap-based AWR remains limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study of patients who underwent thigh-based AWR between 2014 and 2024 at a single tertiary center was conducted. All patients had significant loss of domain and underwent reconstruction with pedicled or free flaps, with or without mesh. Data on demographics, defect characteristics, comorbidities, surgical techniques, and postoperative outcomes were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen patients (9 males, 6 females; mean age 53.7 ± 7 years; BMI 30.8 ± 5.9 kg/m²) underwent reconstruction. Comorbidities were common: 53% had a smoking history, 40% had diabetes, 67% had hypertension, and 93% of patients had a median of 8 previous abdominal surgeries. Defects averaged 840 cm² (fascial) and 504 cm² (skin). Mesh was used in all cases, and 67% of patients required free flaps. Flap types included anterolateral thigh (ALT), chimeric, and vastus lateralis myocutaneous configurations. The median hospital stay was 15 days. Any complications occurred in 80% of patients, with 20% experiencing Clavien-Dindo (CD) grade III events. Long-term outcomes included low rates of abdominal bulge (6.7%) and fistula recurrence (7%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our 10-year experience demonstrates consistent achievement of definitive fascial closure, reliable flap survival, and manageable complication rates, even in the presence of significant comorbidities and prior surgical complexity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 8","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805064","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}