JPRAS Open最新文献

{"title":"Corrigendum to “Prophylactic versus reactive leech therapy for venous congestion after fingertip replantation: A retrospective comparative study and literature review” [JPRAS Open 46 (2025) 216-229]","authors":"Yusuke Kameda , Makoto Motomiya , Naoya Watanabe , Mitsutoshi Ota , Norimasa Iwasaki","doi":"10.1016/j.jpra.2025.12.001","DOIUrl":"10.1016/j.jpra.2025.12.001","url":null,"abstract":"","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Page 350"},"PeriodicalIF":1.8,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategies to prevent seroma formation after mastectomy surgery: A systematic review and meta-analysis","authors":"Abdulrahman Makhseed ,&nbsp;Sara Alneamah ,&nbsp;Mark Mofid Atnasious Abdelmaseeh ,&nbsp;Sarah Al youha","doi":"10.1016/j.jpra.2025.11.021","DOIUrl":"10.1016/j.jpra.2025.11.021","url":null,"abstract":"<div><h3>Background</h3><div>Seroma formation is a frequent and challenging complication after mastectomy surgery, with incidence rates ranging from 3 % to over 85 % (1). Despite numerous proposed interventions, no universally accepted standard for prevention exists.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis was conducted following PRISMA guidelines. PubMed was searched for randomized controlled trials, cohort studies, and systematic reviews published in the past 10 years that evaluated interventions to prevent seroma after mastectomy surgery. Thirty-four studies met inclusion criteria. Data were extracted on study design, intervention, comparator, seroma incidence, seroma volume, and statistical outcomes. Pooled odds ratios (OR) and 95 % confidence intervals (CI) were calculated for each intervention group using a random-effects model. Heterogeneity was assessed with the I² statistic.</div></div><div><h3>Results</h3><div>Quilting sutures demonstrated the greatest efficacy, reducing seroma incidence by 76 % compared to standard closure (pooled OR 0.24, 95 % CI: 0.11–0.52, I² = 0 %). Flap fixation also significantly reduced seroma rates (pooled OR 0.43, 95 % CI: 0.26–0.70, I² = 0 %). Steroids and selected adjuncts (OK-432, hemostatic powders, diuretics) were associated with a 59 % reduction in seroma incidence (pooled OR 0.41, 95 % CI: 0.26–0.64, I² = 36 %). Drain management strategies showed that early or no drain removal may increase seroma risk (pooled OR 1.99, 95 % CI: 0.96–4.14, I² = 54 %), though not statistically significant. Tissue adhesives (TissuGlu®, fibrin glue, cyanoacrylate) and harmonic scalpel showed modest or inconsistent benefits (adhesives pooled OR 0.63, 95 % CI: 0.35–1.14, I² = 57 %; harmonic scalpel pooled OR 0.59, 95 % CI: 0.36–0.96, I² = 0 %). Nitroglycerin ointment did not significantly reduce seroma formation (pooled OR 0.78, 95 % CI: 0.31–1.96, I² = 0 %).</div></div><div><h3>Conclusions</h3><div>Quilting sutures and flap fixation are the most effective interventions for preventing seroma after mastectomy surgery, with strong supporting evidence and minimal heterogeneity. Output-based drain management and selective use of steroids or adjuncts may further reduce risk in high-risk patients. Routine use of tissue adhesives, harmonic scalpel, or nitroglycerin ointment is not supported by current evidence. Future research should focus on standardized outcome reporting and direct comparisons of effective strategies, particularly in the setting of mastectomy reconstruction.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 483-499"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to ‘Horizontal versus vertical scapular free flap reconstructions in total maxillectomies without orbital exenteration—a systematic review and clinical case series’ [JPRAS Open. 2025;46:534–550]","authors":"Eleonora O.F. Dimovska ,&nbsp;Francina W. Cobben ,&nbsp;Andreas Thor ,&nbsp;Andrés Rodriguez-Lorenzo","doi":"10.1016/j.jpra.2025.11.030","DOIUrl":"10.1016/j.jpra.2025.11.030","url":null,"abstract":"","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Page 403"},"PeriodicalIF":1.8,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145836428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The inframammary fold: Structure, clinical considerations, and reconstructive techniques","authors":"Camellia Richards ,&nbsp;Sonam Patel ,&nbsp;Hannah Markham ,&nbsp;Jajini Varghese ,&nbsp;Ramsey I Cutress","doi":"10.1016/j.jpra.2025.11.022","DOIUrl":"10.1016/j.jpra.2025.11.022","url":null,"abstract":"<div><div>The inframammary fold is a defining structure of breast position and form. Disruption, relocation and reconstruction of the Inframammary fold is therefore significant and may present surgical challenges. Furthermore, the inframammary fold’s anatomy, structure, relationship to other key thoracic landmarks and how these factors impact reconstruction is debated in the literature.</div><div>Several reconstructive techniques have been proposed since the IMF was first described as a distinct structure. These are commonly used in isolation or in combination, however there is a lack of direct comparison between different reconstruction methods. Much of the current literature is based on level IV or level V evidence often with small sample sizes.</div><div>The inframammary fold’s anatomy is discussed in this review on a macro- and microscopic level. Indications and procedures for inframammary fold reconstruction are discussed. The distinct challenges presented by different reconstructive techniques, gender-affirming surgery, inframammary fold insufficiencies and pathologies are considered.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 457-472"},"PeriodicalIF":1.8,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic infrared thermography in free flap surgery: A systematic review","authors":"Warre Clarys ,&nbsp;Valentine Hotome ,&nbsp;Stefan Hummelink ,&nbsp;Simon Verspeek ,&nbsp;Veronique Verhoeven ,&nbsp;Wiebren A.A. Tjalma ,&nbsp;Gunther Steenackers ,&nbsp;Filip Thiessen","doi":"10.1016/j.jpra.2025.11.027","DOIUrl":"10.1016/j.jpra.2025.11.027","url":null,"abstract":"<div><h3>Background</h3><div>Dynamic infrared thermography (DIRT) is increasingly being utilized for perforator selection and perfusion assessment in reconstructive microsurgery, particularly in procedures such as deep inferior epigastric perforator (DIEP) flap reconstructions. This systematic review evaluates the current evidence regarding the diagnostic performance, clinical applicability, and recent advancements of DIRT in free flap surgery.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in accordance with PRISMA guidelines across the PubMed, Scopus, and Web of Science databases, including studies published up to December 2024. Inclusion criteria comprised primary studies employing DIRT in free flap surgery using a dynamic cold challenge, while static thermography experiments were excluded. Data on study characteristics, diagnostic accuracy, and recent technological developments were extracted and assessed using the QUADAS-2 tool.</div></div><div><h3>Results</h3><div>A total of 31 studies were included, ranging from case reports to prospective cohort studies. DIRT demonstrated sensitivities between 84 % and 95 % for perforator detection, comparable to computed tomography angiography (CTA) and superior to hand-held Doppler (HHD). Despite limitations such as lower resolution and shallow detection depth, recent innovations, including augmented reality (AR), smartphone integration, and artificial intelligence (AI), offer promising solutions for enhanced reliability and user-friendliness.</div></div><div><h3>Conclusion</h3><div>DIRT is an effective, non-invasive technique with diagnostic accuracy comparable to CTA for preoperative and intraoperative perforator selection in free flap surgery. Further standardization and large-scale clinical studies are warranted to establish DIRT as a standard diagnostic tool in reconstructive microsurgery.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 281-304"},"PeriodicalIF":1.8,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extended reality for perforator visualization in deep inferior epigastric perforator autologous breast reconstruction: A systematic review","authors":"Killian Zijlstra ,&nbsp;Chien Nguyen ,&nbsp;Koen Willemsen ,&nbsp;Henk Coert ,&nbsp;Eveline Corten ,&nbsp;Wiesje Maarse","doi":"10.1016/j.jpra.2025.11.025","DOIUrl":"10.1016/j.jpra.2025.11.025","url":null,"abstract":"<div><h3>Background</h3><div>Extended Reality (XR) technology is rapidly advancing and has shown promise in improving perioperative outcomes across various surgical specialties.</div></div><div><h3>Objective</h3><div>This systematic review aimed to evaluate the use of XR for perforator vessel visualization in autologous breast reconstruction.</div></div><div><h3>Method</h3><div>A systematic search was conducted following PRISMA guidelines, consulting Embase, Medline (Ovid), Web-of-Science, Cochrane, and Google Scholar on June 23, 2025. Articles describing the use of XR for perioperative perforator visualization in free flap breast reconstruction were included. Outcome measures included perforator identification rate, virtual model construction time, preoperative planning duration, flap dissection time, usability, complications, and costs.</div></div><div><h3>Results</h3><div>Ten articles were included, all focused on XR in deep inferior epigastric perforator (DIEP) flap breast reconstruction. Three XR modalities were identified: virtual reality (VR), augmented reality (AR) projection, and AR glasses. Perforator identification using XR ranged from 61.7 % to 100 %, with AR outperforming handheld Doppler ultrasound (US) in several studies. XR use decreased operative time, with AR reducing intraoperative perforator localization time from 20 min using handheld Doppler US to 2.3 min. The use of XR did not result in significant additional costs, and no differences in complication rates were identified.</div></div><div><h3>Conclusion</h3><div>XR may assist surgeons in perioperative perforator visualization during DIEP flap breast reconstruction by enhancing anatomical understanding. However, current evidence is constrained by small, low-quality studies and comparisons with handheld Doppler rather than the gold standard computed tomography angiography (CTA). Whether XR offers clinically meaningful advantages over conventional CTA imaging remains uncertain, as this was not explored in the included articles. Larger, high-quality comparative studies are needed to establish its true clinical value.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 253-268"},"PeriodicalIF":1.8,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of cervicofacial flaps: From classical reconstruction to Freestyle Multiperforator Island Flap","authors":"Oswaldo J. Gómez ,&nbsp;Carlos E. Ruiz ,&nbsp;Erika Padilla ,&nbsp;Andrés F. Patiño","doi":"10.1016/j.jpra.2025.11.026","DOIUrl":"10.1016/j.jpra.2025.11.026","url":null,"abstract":"<div><h3>Background</h3><div>This study presents a cost-effective and safe alternative for facial reconstruction, introducing the concept of the Freestyle Multiperforator Island Flap (FMIF) a subcutaneously based flap that can be customized in both location and size. Its versatility stems from the extensive vascular cutaneous territories supplied by the dermal and facial plexuses, which branch in an arborescent pattern to ensure reliable perfusion across multiple facial regions.</div></div><div><h3>Methods</h3><div>A retrospective case series of 34 patients (37 flaps) with cheek defects treated between 2012 and 2022 is presented. Demographic profiles, defect etiology, flap characteristics, and postoperative outcomes were analyzed.</div></div><div><h3>Results</h3><div>A total of 37 flaps were performed in 34 patients. The most common etiology was malignant tumors (83.7 %), squamous cell carcinoma (43.2 %), basal cell carcinoma (29.7 %), and melanoma (10.8 %), followed by benign tumors (10.8 %) and others (5.4 %).</div><div>Twenty-five flaps were used for the reconstruction of the parotid-masseteric subunit, with 54 % designed at a flap-to-defect ratio ranging from 5:1 to 10:1.</div><div>In 29 flaps (78.37 %), the average pedicle area was 16.2 % (range: 10 %–20 %).</div><div>Regarding outcomes, major complications occurred in five flaps, with partial necrosis and dehiscence being the most frequent (5.4 % each). No total flap loss was reported.</div></div><div><h3>Conclusions</h3><div>The FMIF offers a safe, versatile, and cost-conscious option for facial reconstruction, providing reliable perfusion and minimal donor-site morbidity through its adaptable pedicle design. Although early outcomes are favorable, the absence of a control group limits definitive conclusions. Future comparative and anatomical studies are required to validate its vascular basis, safety, and role alongside established reconstructive techniques.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 321-330"},"PeriodicalIF":1.8,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical analysis of complete survival outcomes in digital replantation with a focus on avulsion injuries","authors":"Yoshitaka Matsuura ,&nbsp;Ryuji Uozumi ,&nbsp;Akiko Shoji-Pietraszkiewicz ,&nbsp;Koji Kimura ,&nbsp;Seita Inoue ,&nbsp;Toshihiro Ishiko","doi":"10.1016/j.jpra.2025.11.028","DOIUrl":"10.1016/j.jpra.2025.11.028","url":null,"abstract":"<div><div>In this study, we defined complete digital survival as the primary outcome and systematically examined preoperative, intraoperative, and postoperative factors influencing this outcome. We enrolled 124 digits replanted and evaluated the correlation between complete survival and preoperative factors such as age, Tamai’s zone classification, injury mechanism, smoking, daily cigarette consumption, diabetes, and complete/incomplete amputation. We considered avulsion to be a factor that could influence intraoperative and postoperative factors. Multiple logistic regression was performed with intraoperative and postoperative variables, such as the number of vessel anastomoses and rescue surgery.</div><div>The characteristics of this study included 29 % avulsions, 39 % crushes, 29 % blunt cuts, and 6 % clean cuts. The total complete survival rate was 80 %. Multiple logistic regression adjusted for avulsion showed that the number of arteries, veins, and number of vein anastomoses ≥ number of artery anastomoses significantly contributed to complete survival in the whole study. However, the success of the replanted digits that needed rescue surgery was significantly poorer than that in the case without rescue surgery. In addition, the vessel transfer, such as vein grafting, was useful for replanting digits in cases with severe vessel damage.</div><div>We should anastomose as many veins and arteries as possible and perform vessel transfer to replace the damaged vessel during the initial surgery. This effort in replantation may reduce reoperation rates and improve the chances of complete survival.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 305-314"},"PeriodicalIF":1.8,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary intention healing with biodegradable temporizing matrix (BTM) in a comorbid patient: A case report","authors":"Ho Yin Kam ,&nbsp;Yuet Ching Wong ,&nbsp;Stephen Goldie","doi":"10.1016/j.jpra.2025.11.020","DOIUrl":"10.1016/j.jpra.2025.11.020","url":null,"abstract":"<div><div>Biodegradable temporizing matrix (BTM) is a synthetic dermal substitute designed for complex wound reconstruction, typically in a two-stage process. We present a case involving BTM-assisted healing by secondary intention of an infected scalp wound in a medically complex patient following failed split-thickness skin grafting. Owing to substantial granulation and neodermis formation, the planned second-stage grafting was ultimately deemed unnecessary. This case highlights BTM’s potential as a definitive reconstructive option in high-risk patients with impaired healing capacity and supports its role in managing complex wounds, particularly when conventional reconstructive strategies are contraindicated or have failed.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 351-355"},"PeriodicalIF":1.8,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined use of rubber bands and patient’s own hair to optimize scalp surgical field exposure and secure wound dressings","authors":"Jin-Yuan Ma,&nbsp;Ya-Di Li,&nbsp;Xi Chen,&nbsp;Yu-Rong Li","doi":"10.1016/j.jpra.2025.11.023","DOIUrl":"10.1016/j.jpra.2025.11.023","url":null,"abstract":"","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"48 ","pages":"Pages 234-237"},"PeriodicalIF":1.8,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}