JPRAS Open最新文献

英文中文

Letter to the editor: “Analgesia in gender-affirming mastectomy—intraoperative pectoral blocks are equally effective as preoperative, ultrasound-guided PECS I/II blocks” 致编辑的信：“在性别确认乳房切除术中镇痛-术中胸阻滞与术前超声引导的PECS I/II阻滞同样有效”

IF 1.8 Q3 SURGERY

JPRAS Open

Pub Date : 2025-11-04 DOI: 10.1016/j.jpra.2025.10.034

Ergun Gunduz, Seza Apiliogullari

引用次数: 0

Efficacy of high-intensity focused ultrasound for treating upper and lower eyelid sagging 高强度聚焦超声治疗上下眼睑下垂的疗效观察

IF 1.8 Q3 SURGERY

JPRAS Open

Pub Date : 2025-11-03 DOI: 10.1016/j.jpra.2025.10.036

Yousun Hwang , Jin-Hyun Kim , Han Earl Lee , Isaac Wong Kai Jie , Jong Keun Song , Arash Jalali , Isabella Rosellini , Jesper Thulesen , Massimo Vitale , Eun-Jae Kim , Kyu-Ho Yi

Introduction

Eyelid sagging is a frequent concern among aging patients, yet achieving noticeable improvement with noninvasive methods remains challenging.

Objective

This prospective cohort study evaluated the efficacy and safety of high-intensity focused ultrasound (HIFU) for improving upper and lower eyelid sagging.

Methods

Thirty-four Korean women (aged 31–67 years) with mild to moderate eyelid laxity underwent a single session of HIFU (ULTRAFORMER MPT) using a 2.0-mm, 4-MHz probe, delivering 120 shots to the periocular region. Outcomes were assessed at 12 weeks via a four-point scale rated by blinded clinicians and patients. Eyelid length was measured using standardized photography.

Results

Mean eyelid length decreased by 0.94 ± 0.34 mm (p < 0.0001). Clinical improvement was reported by 76 % of patients and recognized by clinicians in 59 % of cases. The mean scores for overall improvement, eyelid tightening, and crow’s feet reduction were 2.25 ± 0.3, 2.10 ± 0.4, and 1.95 ± 0.3, respectively. Mild pain and erythema were the only reported side effects, resolving within 3–4 days.

Conclusion

HIFU is a safe and effective noninvasive option for improving both upper and lower eyelid sagging, with high patient satisfaction and minimal adverse effects.

眼睑下垂是老年患者经常关注的问题，但通过非侵入性方法实现明显改善仍然具有挑战性。目的本前瞻性队列研究评价高强度聚焦超声（HIFU）治疗上、下睑下垂的疗效和安全性。方法34例轻度至中度眼睑松弛的韩国女性（31-67岁）采用2.0 mm， 4 mhz探针进行单次HIFU (ULTRAFORMER MPT)，向眼周区域注射120针。在12周时，通过由盲法临床医生和患者评定的4分制评估结果。眼睑长度采用标准化摄影测量。结果平均眼睑长度减少0.94±0.34 mm （p < 0.0001）。76%的患者报告临床改善，59%的病例得到临床医生的认可。整体改善、眼睑收紧和鱼尾纹减少的平均得分分别为2.25±0.3、2.10±0.4和1.95±0.3。轻度疼痛和红斑是唯一报告的副作用，在3-4天内消退。结论hifu是一种安全有效的无创治疗上、下睑下垂的方法，患者满意度高，不良反应小。

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引用次数: 0

Operative technique: The use of a flexor retinacular flap to cover an osteophytic hook of hamate post repair of a chronic rupture of the flexor digitorum profundus tendon of the little finger 手术技术：小指指深屈肌腱慢性断裂修复后，使用屈肌支持带皮瓣覆盖钩骨赘骨

IF 1.8 Q3 SURGERY

JPRAS Open

Pub Date : 2025-11-03 DOI: 10.1016/j.jpra.2025.10.035

G. Fenn , G. Treacy , S. Ibrahim

Operative Technique: The Use of a Flexor Retinacular Flap to Cover an Osteophytic Hook of Hamate Post repair of a Chronic Rupture of The Flexor Digitorum Profundus Tendon of The Little Finger Closed ruptures of the Flexor Digitorum Profundus (FDP) tendon associated with hook of hamate pathology are rare but have previously been described in the literature. It is mostly associated with fracture non-union of the Hook of Hamate resulting in roughened bone surfaces which over time can erode the flexor tendons. The preferred treatment for a spontaneous flexor tendon rupture in the hand is interposition tendon grafting. Most commonly a resection of the Hook of Hamate is performed however occasionally sharp, or roughened bone surfaces can persist. In our recent case of a closed FDP repair of the little finger we used a flexor retinacular flap to cover the roughened edge of the bone post resection of the Hook of Hamate to create a smooth surface for our tendon repair to glide. This flap should be considered as a beneficial technique in all cases requiring resection of arthritic bone within the carpal tunnel.

手术技术：使用屈肌支持带瓣覆盖骨赘钩钩修复小指指深屈肌腱慢性断裂后闭合性断裂伴钩钩病理的指深屈肌腱（FDP）是罕见的，但之前在文献中有描述。它主要与钩骨骨折不愈合有关，导致骨表面粗糙，随着时间的推移会侵蚀屈肌腱。手部自发性屈肌腱断裂的首选治疗方法是间位肌腱移植。最常见的是切除钩骨，但偶尔尖锐或粗糙的骨表面会持续存在。在我们最近的小指闭合性FDP修复病例中，我们使用屈肌支持带瓣覆盖钩骨切除术后粗糙的骨边缘，以创造一个光滑的表面，使我们的肌腱修复滑动。在所有需要切除腕管内关节炎骨的病例中，皮瓣应被认为是一种有益的技术。

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引用次数: 0

Sensory and vascular improvement following re-release of amniotic band syndrome and reconstruction with free anterolateral thigh flap in late childhood 儿童晚期羊膜带综合征再释放及游离大腿前外侧皮瓣重建后感觉和血管的改善

IF 1.8 Q3 SURGERY

JPRAS Open

Pub Date : 2025-11-01 DOI: 10.1016/j.jpra.2025.10.023

Mardhiah Jeffrey , Liu Yi , Ahmad Sukari Halim , Abdul Razak Sulaiman , Bazli Md Yusoff

We report a 9-year-old boy with a residual amniotic band over the middle of right leg, with absent pain sensation distal to the constriction.

Patient presented to us at age of 9-year-old with residual amniotic band, with an angiogram showing a dominant peroneal vessel supplying the right leg that gives off a branch to supply the anterior tibial artery distal to the constriction.

He went through a sequential release of constriction band and soft tissue coverage using an anterolateral thigh fasciocutaneous flap harvested from the contralateral leg. No nerve repair was performed A secondary procedure was performed after 17 days to refashion the flap edge with additional multiple Z plasties.

Two years after the procedure, the sensation improved and the posterior tibial artery became the dominant artery supplying the foot, passing through the previous constriction band.

我们报告一个9岁的男孩与残余羊膜带在右腿中部，没有痛感远端收缩。患者于9岁时出现羊膜带残留，血管造影显示支配性腓骨血管供应右腿，并发出分支供应缩窄远端的胫骨前动脉。患者使用从对侧腿取的大腿前外侧筋膜皮瓣进行了连续的收缩带释放和软组织覆盖。没有进行神经修复，17天后进行了第二次手术，用额外的多个Z形成形术重塑皮瓣边缘。手术两年后，感觉得到改善，胫骨后动脉成为供应足部的主要动脉，穿过先前的收缩带。

引用次数: 0

Smiling in the East and the West: Anatomical, cultural and sociological considerations in facial reanimation surgery 东方和西方的微笑：面部再生手术中的解剖学、文化和社会学考虑

IF 1.8 Q3 SURGERY

JPRAS Open

Pub Date : 2025-10-31 DOI: 10.1016/j.jpra.2025.10.033

Stefanos Tsallas , Andres Rodriguez-Lorenzo , Chieh-Han John Tzou

The importance of the smile as a means of communicative and metacommunicative signal in social engagement has been known and highlighted in studies dating back to the early 19th century. It remains a cornerstone of reconstructive surgeries for the paralyzed face. This paper calls attention to the differences between the Eastern and Western smile. Anatomical, cultural, and sociological peculiarities inform the way these populations smile and the way smiling itself is perceived. Reconstructive surgery of today would benefit from considering these aspects and allowing them to individualize the goals of reanimation procedures.

早在19世纪早期的研究中，微笑作为交际和元交际信号的重要性就已经为人所知，并得到了强调。它仍然是瘫痪面部重建手术的基石。这篇文章引起了人们对东西方微笑差异的注意。解剖学、文化和社会学的特点决定了这些人群微笑的方式以及微笑本身被感知的方式。今天的重建手术将受益于考虑这些方面，并允许他们个性化的目标恢复程序。

引用次数: 0

Letter to the editor regarding “Effectiveness of injected versus topically applied platelet-rich plasma in diabetic foot ulcers: A randomized controlled trial with clinical and histopathological assessment” 致编辑关于“注射与局部应用富血小板血浆治疗糖尿病足溃疡的有效性：临床和组织病理学评估的随机对照试验”的信

IF 1.8 Q3 SURGERY

JPRAS Open

Pub Date : 2025-10-30 DOI: 10.1016/j.jpra.2025.10.032

Xiuli Li, Yanwei Sun

引用次数: 0

Innovative septum suspension technique with a cantilever graft for effective keystone region reconstruction 创新的中隔悬吊技术与悬臂植骨有效重建拱心区

IF 1.8 Q3 SURGERY

JPRAS Open

Pub Date : 2025-10-26 DOI: 10.1016/j.jpra.2025.10.031

Saori Yamazumi , Naoko Takeuchi , So Moriyama , Nobuyoshi Otori , Takeshi Miyawaki

Background

Saddle nose deformity caused by disruption of the keystone area remains surgically challenging. We developed a septum suspension technique using a rib bone cantilever graft to restore keystone continuity and improve airflow.

Methods

We retrospectively reviewed 41 consecutive cases (2016–2024) undergoing the suspension technique. Deformity type, etiology, concomitant procedures, complications, and CT findings were recorded. Outcomes included visual analogue scale (VAS) scores for nasal ventilation and appearance, and radiological evaluation of graft integrity. Paired analyses were conducted at 12 months using Wilcoxon tests, Hodges–Lehmann estimates, effect sizes, and sensitivity analysis (≥6 months).

Results

The cohort comprised 31 men and 10 women (mean age 38.5 years). Ventilation VAS improved from 2.0 to 9.0 (HL +7.0; p < 0.01) in nine paired cases, with very large effect sizes (Hedges’ g = 3.01). All patients achieved the minimal clinically important difference (MCID). Appearance VAS improved from 3.0 to 10.0 in four paired cases (HL +7.0), with all reaching MCID, though underpowered for significance. Sensitivity analyses confirmed consistent improvements. Complications occurred in five patients (trauma, n = 1; screw loosening, n = 3; hypertrophic donor-site scarring, n = 1). No pneumothorax or infection was observed.

Conclusions

Septum suspension with a rib-bone cantilever graft provided substantial and robust improvement in nasal ventilation, with aesthetic gains also observed. The technique was particularly useful in post-septoplasty saddle nose. Despite limitations of sample size and incomplete follow-up, findings suggest this method is a safe and effective option warranting validation in larger prospective studies.

鞍鼻畸形由拱心区破坏引起的手术仍然具有挑战性。我们开发了一种中隔悬吊技术，使用肋骨悬臂骨移植物来恢复基石的连续性并改善气流。方法回顾性分析2016-2024年连续41例行悬吊术的病例。记录畸形类型、病因、伴随手术、并发症和CT表现。结果包括鼻通气和外观的视觉模拟评分（VAS），以及移植物完整性的影像学评估。在12个月时使用Wilcoxon检验、Hodges-Lehmann估计、效应量和敏感性分析（≥6个月）进行配对分析。结果男性31例，女性10例，平均年龄38.5岁。在9个配对病例中，通气VAS从2.0提高到9.0 (HL +7.0; p < 0.01)，效应量非常大（Hedges ' g = 3.01）。所有患者均达到最小临床重要差异（MCID）。四个配对病例（HL +7.0）的外观VAS从3.0提高到10.0，所有病例都达到了MCID，尽管显著性不足。敏感性分析证实了持续的改善。5例患者出现并发症（创伤，n = 1；螺钉松动，n = 3；供体增生性瘢痕形成，n = 1）。无气胸及感染。结论中隔悬吊与肋骨悬臂移植物可显著改善鼻通气，美观性也有显著提高。该技术对鼻中隔成形术后的鞍鼻特别有用。尽管样本量有限且随访不完整，但研究结果表明，该方法是一种安全有效的选择，值得在更大规模的前瞻性研究中验证。

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引用次数: 0

Perceptions and utilization of telemedicine for hair loss treatment: A survey-based analysis of Korean consumers 认知和利用远程医疗脱发治疗：韩国消费者的调查为基础的分析

IF 1.8 Q3 SURGERY

JPRAS Open

Pub Date : 2025-10-25 DOI: 10.1016/j.jpra.2025.10.003

Jino Kim , Olena Sydorchuk , Kyuho Yi

引用次数: 0

Yin–Yang NAC sharing: Full-thickness split graft from a single NAC for bilateral immediate reconstruction after skin-reducing mastectomy 阴阳共用NAC：单侧NAC全层分裂移植物用于双侧减肤乳切除术后即刻重建

IF 1.8 Q3 SURGERY

JPRAS Open

Pub Date : 2025-10-25 DOI: 10.1016/j.jpra.2025.10.029

Gian Piero Mantovani, Claudio Gio Francesco Blessent, Gianmarco Paolo Federici, Filippo Taccioli, Massimo Pinelli

Nipple–areola complex (NAC) reconstruction significantly contributes to postmastectomy body image and patient satisfaction. While nipple sharing has been described in delayed settings, its application in immediate reconstruction after skin-reducing mastectomy (SRM) is limited. We report the case of a 32-year-old BRCA1+ patient undergoing bilateral SRM with immediate implant-based reconstruction, in which a novel Yin–Yang nipple grafting technique was performed using the hypertrophic contralateral nipple. The donor nipple was harvested as a full-thickness non-vascularized graft, divided along a curved Yin–Yang fashion, and both halves were reshaped and grafted bilaterally to create two circular, natural-looking NACs. At the 6-month follow-up, the grafts showed complete take, satisfactory projection, and pigmentation. This report illustrates the feasibility and limitations of one-stage NAC reconstruction using a non-vascularized nipple graft technique in a selected patient undergoing SRM.

乳头乳晕复合体（NAC）重建有助于乳房切除术后的身体形象和患者满意度。虽然乳头共享已被描述为延迟设置，其在皮肤减少乳房切除术（SRM）后立即重建的应用是有限的。我们报告一例32岁的BRCA1+患者接受双侧SRM并立即以移植物为基础的重建，其中一种新的阴阳乳头移植技术使用肥厚的对侧乳头。供体乳头作为全层无血管移植物，沿着弯曲的阴阳时尚分开，两半都被重塑并两侧移植，以创建两个圆形，自然外观的NACs。在6个月的随访中，移植物表现出完全的生长，令人满意的突出和色素沉着。本报告说明了可行性和局限性，一期NAC重建使用无血管化乳头移植物技术在一个选定的病人接受SRM。

引用次数: 0

Novel technique for the repair of recurrent oronasal fistula using autologous auricular composite graft: Clinical outcomes from a case series 自体耳廓复合移植物修复复发性口鼻瘘的新技术：来自一系列病例的临床结果

IF 1.8 Q3 SURGERY

JPRAS Open

Pub Date : 2025-10-25 DOI: 10.1016/j.jpra.2025.10.030

Masanobu Yamashita, Miyuki Kishibe, Mikio Yagishita, Takayoshi Kaneko, Toru Miyanaga, Kenichi Shimada

Background

Oronasal fistulas are common complications of cleft palate surgery. The treatment of recurrent oronasal fistulas is challenging. Several techniques have been reported for the closure of oronasal fistulas. The fistula closure rate varies according to the method used. This study introduces a novel technique using autologous auricular skin-cartilage composite grafts for the treatment of recurrent oronasal fistulas and evaluates the clinical outcomes.

Methods

Thirteen patients with recurrent oronasal fistulas who had previously undergone unsuccessful fistula repair were treated using composite grafts harvested from the auricular concha. Surgical outcomes, complications, and donor site morbidity rates were retrospectively reviewed.

Results

Complete closure was achieved in nine of the 13 cases (69 %) using a single procedure. Three patients underwent repeat surgery, resulting in closure in two additional cases. The overall fistula closure rate was 85 %. No significant donor-site morbidity or postoperative palatal deformities were observed. Minor residual fistulas in two patients were successfully closed during subsequent alveolar bone grafting.

Conclusion

Auricular skin-cartilage composite grafting is a promising option for the management of recurrent oronasal fistulas. This technique provides reliable structural support and mucosal integration with minimal donor site complications. It may be considered as a first-line approach in selected refractory cases, although further studies are needed to confirm its long-term outcomes.

背景：鼻瘘是腭裂手术的常见并发症。复发性口鼻瘘的治疗具有挑战性。已经报道了几种治疗口鼻瘘的方法。瘘管闭合率因使用的方法而异。本文介绍了自体耳廓皮肤-软骨复合移植治疗复发性口鼻瘘的新技术，并对其临床效果进行了评价。方法对13例既往行口鼻瘘修复失败的复发性口鼻瘘患者，采用耳甲复合移植物进行治疗。回顾性分析手术结果、并发症和供区发病率。结果13例患者中有9例（69%）采用单次手术完全闭合。三名患者接受了重复手术，导致另外两例闭合。总瘘管闭合率为85%。未观察到明显的供区发病率或术后腭畸形。在随后的牙槽骨移植中，2例患者成功地关闭了少量残留的瘘管。结论耳廓皮肤-软骨复合移植术是治疗复发性口鼻瘘的理想术式。该技术提供了可靠的结构支持和粘膜整合，并减少了供区并发症。在一些难治性病例中，它可以作为一线治疗方法，尽管需要进一步的研究来证实其长期疗效。

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