Journal of Plastic Reconstructive and Aesthetic Surgery最新文献_第3页

Optimizing the choice between single- and bipedicled DIEP flaps: A strategy guided by 3D volumetrics and indocyanine green angiography 优化单蒂和双蒂DIEP皮瓣的选择：一种由三维体积和吲哚菁绿血管造影指导的策略。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-01-22 DOI: 10.1016/j.bjps.2026.01.018

Boyang Xu, Wenyue Liu, Shangshan Li, Zhaohan Chen, Hao Dong, Siyu Hou, Jie Luan, Chunjun Liu

Background

Determining the need for a bipedicled deep inferior epigastric perforator (DIEP) flap is a critical challenge in delayed breast reconstruction. The traditional, experience-based approach is often subjective and inaccurate. We aimed to evaluate a novel quantitative strategy to optimize this decision-making process.

Methods

Patients undergoing delayed DIEP flap reconstruction managed with a new strategy were prospectively enrolled from January 2022 to December 2024, a historical conventional cohort served as the control. The quantitative strategy combines preoperative three-dimensional measurement to define the breast volume deficit with intraoperative indocyanine green angiography to assess real-time flap perfusion. Primary endpoints were the final volume restoration ratio (VRR), rate of bipedicled flap use, and flap-related complications. Follow-up was a minimum of six months. Multivariable logistic regression was performed to control for confounders and identify independent predictors of optimal volumetric symmetry (VRR 90–110%).

Results

A total of 183 patients were included (Strategy: n = 82; Conventional: n = 101). The Strategy group demonstrated a significantly higher rate of bipedicled flaps (58.5% vs. 40.6%, p = 0.016) and optimal symmetry (45.1% vs. 25.7%, p = 0.010). Multivariable analysis confirmed the quantitative strategy as a significant independent predictor for achieving optimal symmetry (odds ratio 2.53; p = 0.005), after adjusting for demographics and defect size. The incidence of flap-related complications was significantly lower in the Strategy group (2.4% vs. 10.9%, p = 0.040).

Conclusion

This strategy provides objective guidance for selecting single-pedicle versus bipedicled DIEP flaps in delayed breast reconstruction and is associated with significantly improved postoperative symmetry while reducing flap-related complications.

背景：确定是否需要双蒂腹下深穿支皮瓣（DIEP）是延迟乳房重建的关键挑战。传统的、基于经验的方法往往是主观的和不准确的。我们旨在评估一种新的定量策略来优化这一决策过程。方法：前瞻性纳入2022年1月至2024年12月接受新策略延迟DIEP皮瓣重建的患者，以历史常规队列为对照。定量策略将术前三维测量确定乳腺体积缺损与术中吲哚菁绿血管造影评估皮瓣实时灌注相结合。主要终点是最终体积恢复率（VRR）、双蒂皮瓣使用率和皮瓣相关并发症。随访至少为6个月。采用多变量逻辑回归控制混杂因素，并确定最佳体积对称性的独立预测因子（VRR 90-110%）。结果：共纳入183例患者（策略：n = 82；常规：n = 101）。策略组显示出更高的双蒂皮瓣率（58.5%比40.6%,p = 0.016）和最佳对称性（45.1%比25.7%,p = 0.010）。在调整了人口统计和缺陷大小之后，多变量分析证实了定量策略是实现最佳对称性的重要独立预测器（优势比2.53;p = 0.005）。策略组皮瓣相关并发症的发生率明显较低（2.4% vs. 10.9%, p = 0.040）。结论：该策略为延迟乳房重建中选择单蒂或双蒂DIEP皮瓣提供了客观指导，并显著改善了术后对称性，减少了皮瓣相关并发症。

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引用次数: 0

Corrigendum to “Correspondence on: Racial disparities in research productivity among integrated plastic surgery applicants” [J Plast Reconstr Aesthet Surg 113 (2025) 273–274] “通信：种族差异在综合整形手术申请人的研究生产力”的勘误表[J]整形重建美学外科113 (2025)273-274]

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-01-22 DOI: 10.1016/j.bjps.2026.01.017

Lawrence O. Lin , Allyson L. Huttinger , Jeffrey E. Janis

引用次数: 0

Predictors of postoperative complications following staged nipple-sparing mastectomy: A systematic review & meta-analysis 分期保留乳头乳房切除术术后并发症的预测因素：一项系统回顾和荟萃分析。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-01-22 DOI: 10.1016/j.bjps.2026.01.022

Osama Darras , Kate Jensen , Diwakar Phuyal , Sarah N. Bishop , Rene Van der Hulst , Raffi Gurunian , Shan Shan Qiu

Introduction

In ptotic breasts, patients can undergo breast reduction or mastopexy before nipple-sparing mastectomy (NSM) to improve the esthetic outcomes. Literature also suggests the benefit of staged nipple-sparing mastectomy (SNSM) on preserving the nipple-areolar complex (NAC). The aim of this study was to identify the predictors of postoperative complications after SNSM and consider whether shorter intervals between the stages are feasible.

Methods

We reviewed MEDLINE and Embase for studies on SNSM outcomes, following the PRISMA guidelines. Key terms included “mastectomy,” “mastopexy,” and “nipple.” Studies detailing surgical timelines and complications were included. Studies utilizing nipple grafting were excluded. Variables of interest included time between surgeries and complications such as NAC necrosis, infection, wound healing problems, seroma, hematoma, fat necrosis, and skin flap necrosis.

Results

Eighteen studies were included for data extraction, encompassing 1085 breasts in 743 patients who received SNMS after breast-reducing mastectomy. The mean age was 46.1 ± 2.3 years, and the mean BMI was 27.8 ± 3.6 kg/m². In studies with fewer than 12 months between surgeries, shorter intervals did not increase the odds of total complications (p = 0.272) or nipple-related complications (p = 0.457). Mastectomy weight positively correlated with complication odds, reaching borderline significant (B = 0.001, p = 0.05). In implant-based reconstructions, implant size significantly positively correlated with the odds of complications (B = 0.002, p = 0.046).

Conclusions

Patient factors such as mastectomy weight and implant size were associated with higher complication rates. In studies of patients who underwent a second surgery within 12 months, no correlation was found between the interval between surgeries and complication likelihood, suggesting that a shorter interval may be safely considered.

简介：对于上睑下垂的乳房，患者可以在保留乳头的乳房切除术（NSM）前进行乳房缩小或乳房固定术，以改善美观效果。文献还表明，分阶段乳头保留乳房切除术（SNSM）对保留乳头-乳晕复合体（NAC）的好处。本研究的目的是确定SNSM术后并发症的预测因素，并考虑缩短两期之间的时间间隔是否可行。方法：我们根据PRISMA指南，回顾MEDLINE和Embase对SNSM结果的研究。关键词包括“乳房切除术”、“乳房切除术”和“乳头”。包括详细的手术时间表和并发症的研究。排除了乳头移植的研究。感兴趣的变量包括手术间隔时间和并发症，如NAC坏死、感染、伤口愈合问题、血肿、血肿、脂肪坏死和皮瓣坏死。结果：18项研究纳入数据提取，包括743例缩乳术后接受SNMS的1085个乳房。平均年龄46.1±2.3岁，平均BMI为27.8±3.6 kg/m2。在手术间隔少于12个月的研究中，较短的间隔并没有增加总并发症（p = 0.272）或乳头相关并发症（p = 0.457）的几率。乳房切除重量与并发症发生率呈正相关，达到临界显著（B = 0.001, p = 0.05）。在种植体重建中，种植体大小与并发症发生率显著正相关（B = 0.002, p = 0.046）。结论：患者因素如乳房切除术重量和种植体大小与较高的并发症发生率相关。在对12个月内接受第二次手术的患者的研究中，没有发现手术间隔与并发症可能性之间的相关性，这表明可以考虑较短的手术间隔。

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引用次数: 0

Lateralisation of basal cell and squamous cell carcinomas: A UK retrospective cross-sectional study 基底细胞癌和鳞状细胞癌的侧化：一项英国回顾性横断面研究

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-01-21 DOI: 10.1016/j.bjps.2026.01.012

Catharina Tao , Emma Guenther , Animesh Patel

This study aimed to determine whether basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) show asymmetrical distribution in a UK cohort, and to identify further patterns through subgroup analysis. Records of patients with biopsy-confirmed BCC or SCC at Addenbrookes Hospital, UK in 2018–2019, were reviewed retrospectively (5153 BCC, 1728 SCC). Lesions on the face/scalp regions were included; midline or unclear lesions were excluded. Chi-squared or Fisher's Exact Tests assessed distribution differences. 2908 BCCs and 832 SCCs in the non-midline facial/scalp region in 2018–2019 were included. Statistically significantly more right-sided BCCs were observed in 2018 and 2018/19 (in 2018–19: 52% right, 48% left, p=0.01), whilst statistically significantly more right-sided SCCs were observed in 2019 and 2018/19 (in 2018–19: 54% right, 46% left, p=0.032). As right-sided predominance was found for both lesion types and several further subgroups in this UK cohort, these findings could contribute to the emerging literature on skin cancer laterality associated with driving side. Further data collection and adjustment for confounding factors could strengthen these conclusions, emphasising an important public health message on sun protection when driving.

本研究旨在确定基底细胞癌（BCC）和鳞状细胞癌（SCC）在英国队列中是否呈现不对称分布，并通过亚组分析进一步确定模式。回顾性分析了2018-2019年英国阿登布鲁克斯医院活检证实的BCC或SCC患者的记录（5153例BCC， 1728例SCC）。包括面部/头皮区域的病变；排除中线或不明显病变。卡方检验或费雪精确检验评估分布差异。包括2018-2019年非中线面部/头皮区域的2908例bcc和832例SCCs。在2018年和2018/19年，右侧bcc的发生率显著增加（2018 - 19年：52%右侧，48%左侧，p=0.01），而在2019年和2018/19年，右侧SCCs的发生率显著增加（2018 - 19年：54%右侧，46%左侧，p=0.032）。由于在这个英国队列中，两种病变类型和几个进一步的亚组中都发现了右侧优势，这些发现可能有助于新出现的与驾驶侧相关的皮肤癌偏侧的文献。进一步的数据收集和对混杂因素的调整可以加强这些结论，强调驾驶时防晒的重要公共卫生信息。

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引用次数: 0

Outcomes of immediate implant-based vs. autologous breast reconstruction after neoadjuvant therapy 新辅助治疗后即刻植入式乳房重建与自体乳房重建的结果

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-01-21 DOI: 10.1016/j.bjps.2026.01.006

Ziyue Lin , Jian Yin

Background

The choice of modality for immediate breast reconstruction (IBR) following neoadjuvant therapy (NAT) remains controversial. We compared the complications, aesthetic outcomes, and patient satisfaction between two IBR techniques, immediate autologous breast reconstruction (ABR) and implant-based breast reconstruction (IBBR), in patients treated with NAT, with the goal of informing clinical practice.

Methods

Data from patients who underwent unilateral IBR after receiving NAT were retrospectively analyzed. Demographic characteristics, tumour profiles, treatment regimens, complication data, patient-reported outcomes, and aesthetic scores were compared between the groups. Subgroup analyses were also conducted separately for each group.

Results

Of 172 patients who were included in the study, 97 underwent IBBR and 75 underwent ABR. Reconstruction failures (18.6% vs. 1.3%, p<0.001) and infection (13.4% vs. 4.0%, p=0.035) occurred more frequently in the IBBR than in the ABR group. Multivariable regression analysis showed that diabetes significantly increased reconstruction failure risk in the IBBR group (OR=16.14, 95% CI: 1.46–178.51, p=0.023), with infection also emerging as a notable risk factor (OR=5.26, 95% CI: 1.43–19.38, p=0.013). The IBBR group demonstrated significantly lower patient satisfaction scores compared to ABR patients (65.52±19.50 vs. 72.22±18.26, p=0.035). Aesthetic outcomes were analyzed by reconstruction stage, with significantly fewer people reporting “excellent” in the IBBR group than in the ABR group at the tissue expander phase (TEP) (65.6% vs. 89.5%, p=0.002).

Conclusion

Following NAT, fewer complications, higher patient satisfaction, and better aesthetic outcomes were observed with ABR compared to IBBR.

背景：新辅助治疗（NAT）后立即乳房重建（IBR）方式的选择仍然存在争议。我们比较了两种IBR技术（即刻自体乳房重建（ABR）和基于植入物的乳房重建（IBBR））在接受NAT治疗的患者中的并发症、美学结果和患者满意度，目的是为临床实践提供信息。方法回顾性分析NAT术后单侧IBR患者的资料。比较两组之间的人口统计学特征、肿瘤概况、治疗方案、并发症数据、患者报告的结果和美学评分。各组的亚组分析也分别进行。结果纳入研究的172例患者中，97例接受了IBBR， 75例接受了ABR。IBBR组的重建失败（18.6%对1.3%,p= 0.001）和感染（13.4%对4.0%,p=0.035）发生率高于ABR组。多变量回归分析显示，糖尿病显著增加了IBBR组重建失败的风险（OR=16.14, 95% CI: 1.46 ~ 178.51, p=0.023），感染也是一个显著的危险因素（OR=5.26, 95% CI: 1.43 ~ 19.38, p=0.013）。IBBR组患者满意度得分明显低于ABR组（65.52±19.50比72.22±18.26,p=0.035）。美学结果按重建阶段进行分析，在组织扩张期（TEP）， IBBR组报告“优秀”的人数明显少于ABR组（65.6%比89.5%,p=0.002）。结论NAT术后ABR比IBBR并发症少，患者满意度高，美观效果好。

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引用次数: 0

A novel umbrella graft approach in nasal reconstruction of patients with frontonasal dysplasia 一种新的伞形移植物入路用于额鼻发育不良患者的鼻部重建。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-01-21 DOI: 10.1016/j.bjps.2026.01.019

Suleyman Yildizdal , Etkin Boynuyogun , Sinan Kadir Altunal , Berkay Kose , Ugur Koçer , Ibrahim Vargel

Background

Frontonasal dysplasia (FND) is a rare craniofacial anomaly characterized by hypertelorism and nasal deformities. Traditional intracranial approaches for correction, such as box osteotomy or facial bipartition, are effective but associated with high morbidity. This study presents an extracranial umbrella graft technique for nasal reconstruction in patients with FND.

Methods

Between 2014 and 2024, 55 patients with FND were retrospectively evaluated, and 14 met the criteria for extracranial nasal reconstruction. Inclusion criteria were interorbital distance (IOD) <40 mm and the presence of inwardly projecting concave nasal cartilage. Through a midline incision, inverted U-shaped osteotomies were performed to medialize nasal bones. Concave cartilage was harvested, inverted, and used as an umbrella graft to restore nasal projection. Septal cartilage grafts supported the lower nasal framework. Outcomes were assessed by complications and Whitaker classification.

Results

This study included 9 females and 5 males (mean age 8.3 years). Mean follow-up was 2.3 years. No major complications, such as cerebrospinal fluid leakage, visual impairment, or infection, were observed. One patient developed pressure sores from splints, and two underwent minor scar revisions. Mean anterior IOD decreased from 34 to 26.9 mm. Three patients reported insufficient projection, whereas all others achieved significant improvement. According to Whitaker classification, 10 patients were category I and 4 were category II.

Conclusion

This technique offers a safe, less invasive alternative for nasal reconstruction in selected patients with FND, providing satisfactory esthetic results with minimal morbidity. Although long-term outcomes remain to be clarified, this approach may serve as a valuable option.

背景：额鼻发育不良（FND）是一种罕见的颅面畸形，其特征是远端畸形和鼻畸形。传统的颅内矫正方法，如盒形截骨或面部双隔，是有效的，但与高发病率相关。本研究提出颅外保护伞移植技术用于FND患者的鼻部重建。方法：回顾性分析2014 - 2024年55例FND患者，其中14例符合颅外鼻部重建术标准。纳入标准为眶间距离（IOD）。结果：本研究纳入女性9例，男性5例，平均年龄8.3岁。平均随访时间为2.3年。未见脑脊液漏、视力损害或感染等重大并发症。一名患者因夹板产生压疮，两名患者进行了轻微的疤痕修复。平均前IOD从34 mm下降到26.9 mm。三名患者报告投射不足，而所有其他患者均有显著改善。根据Whitaker分类，ⅰ类10例，ⅱ类4例。结论：该技术为FND患者提供了一种安全、微创的鼻部重建方法，以最小的发病率提供了令人满意的美观效果。尽管长期结果仍有待澄清，但这种方法可能是一种有价值的选择。

{"title":"A novel umbrella graft approach in nasal reconstruction of patients with frontonasal dysplasia","authors":"Suleyman Yildizdal , Etkin Boynuyogun , Sinan Kadir Altunal , Berkay Kose , Ugur Koçer , Ibrahim Vargel","doi":"10.1016/j.bjps.2026.01.019","DOIUrl":"10.1016/j.bjps.2026.01.019","url":null,"abstract":"<div><h3>Background</h3><div>Frontonasal dysplasia (FND) is a rare craniofacial anomaly characterized by hypertelorism and nasal deformities. Traditional intracranial approaches for correction, such as box osteotomy or facial bipartition, are effective but associated with high morbidity. This study presents an extracranial umbrella graft technique for nasal reconstruction in patients with FND.</div></div><div><h3>Methods</h3><div>Between 2014 and 2024, 55 patients with FND were retrospectively evaluated, and 14 met the criteria for extracranial nasal reconstruction. Inclusion criteria were interorbital distance (IOD) <40 mm and the presence of inwardly projecting concave nasal cartilage. Through a midline incision, inverted U-shaped osteotomies were performed to medialize nasal bones. Concave cartilage was harvested, inverted, and used as an umbrella graft to restore nasal projection. Septal cartilage grafts supported the lower nasal framework. Outcomes were assessed by complications and Whitaker classification.</div></div><div><h3>Results</h3><div>This study included 9 females and 5 males (mean age 8.3 years). Mean follow-up was 2.3 years. No major complications, such as cerebrospinal fluid leakage, visual impairment, or infection, were observed. One patient developed pressure sores from splints, and two underwent minor scar revisions. Mean anterior IOD decreased from 34 to 26.9 mm. Three patients reported insufficient projection, whereas all others achieved significant improvement. According to Whitaker classification, 10 patients were category I and 4 were category II.</div></div><div><h3>Conclusion</h3><div>This technique offers a safe, less invasive alternative for nasal reconstruction in selected patients with FND, providing satisfactory esthetic results with minimal morbidity. Although long-term outcomes remain to be clarified, this approach may serve as a valuable option.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"114 ","pages":"Pages 205-211"},"PeriodicalIF":2.4,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146128076","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}

引用次数: 0

Meta-analysis of platelet-rich plasma for venous ulcers: Clinical efficacy and complications 富血小板血浆治疗静脉溃疡的meta分析：临床疗效和并发症。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-01-21 DOI: 10.1016/j.bjps.2026.01.020

Tiago Rodrigues-Guimarães , Ricardo Horta , Mário Marques-Vieira , José Andrade , João Rocha-Neves

Background

Venous leg ulcers (VLUs) are a consequence of chronic venous insufficiency, resulting in prolonged healing, high recurrence rates, and substantial economic burden. Traditional treatments, including compression therapy and wound care management, often lead to slow and incomplete healing. Platelet-rich plasma (PRP) is a potential therapy for enhancing wound healing, though its effectiveness remains debated. This systematic review and meta-analysis assessed PRP’s impact on wound healing in VLUs compared to conventional treatments.

Methods

A systematic search was conducted in the PubMed and Web of Science databases and 13 studies with a total of 554 patients were included. Healing outcomes, including complete and partial ulcer healing rates, were analyzed using binary random-effects models. Heterogeneity across studies was assessed using tau², Q-tests, and I² statistics.

Results

Meta-analysis demonstrated that PRP treatment was associated with a 1.5-fold higher odds of complete wound healing compared with conventional treatments (95% CI 1.09–2.07) (I² = 58%). Ulcer area reduction was higher in the PRP group (OR: 16.37 [95% CI 6.45–26.28], I² = 97%). Complete healing at the fourth week showed a meta-analytical OR 3.65 [1.08–12.32] with substantial heterogeneity (I² = 61%, p < 0.001). Meta-regression revealed a significant positive association between age and treatment effect, whereas diabetes mellitus was a significant negative predictor. PRP reduced ulcer recurrence (OR: 0.25 [95% CI 0.06–0.99], p < 0.001) with low heterogeneity.

Conclusion

PRP was associated with improved healing outcomes in VLUs and significantly enhanced wound healing. These findings suggest that PRP may enhance wound healing in venous leg ulcers and warrant further high-quality, large-scale randomized controlled trials to confirm its clinical applicability.

背景：下肢静脉性溃疡（VLUs）是慢性静脉功能不全的结果，导致愈合时间长，复发率高，经济负担沉重。传统的治疗方法，包括压迫疗法和伤口护理管理，往往导致缓慢和不完全愈合。富血小板血浆（PRP）是一种促进伤口愈合的潜在疗法，尽管其有效性仍存在争议。本系统综述和荟萃分析评估了与常规治疗相比，PRP对vlu伤口愈合的影响。方法：系统检索PubMed和Web of Science数据库，纳入13项研究，共554例患者。愈合结果，包括溃疡完全和部分愈合率，使用二元随机效应模型进行分析。采用tau2、q检验和I2统计量评估各研究的异质性。结果：荟萃分析显示，PRP治疗与常规治疗相比，伤口完全愈合的几率高1.5倍（95% CI 1.09-2.07）（I2 = 58%）。PRP组溃疡面积减少更高（OR: 16.37 [95% CI 6.45-26.28], I2 = 97%）。第四周完全愈合的meta分析OR为3.65[1.08-12.32]，具有很大的异质性（I2 = 61%, p < 0.001）。meta回归显示年龄与治疗效果呈正相关，而糖尿病是显著的负相关预测因子。PRP减少溃疡复发（OR: 0.25 [95% CI 0.06-0.99], p < 0.001），异质性低。结论：PRP可改善vlu的愈合结果并显著促进伤口愈合。这些发现表明，PRP可能会促进静脉性腿部溃疡的伤口愈合，需要进一步进行高质量、大规模的随机对照试验来证实其临床适用性。

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引用次数: 0

Erratum to “Early detection of viable microorganisms in “sterile” periprosthetic fluids in implant-based breast reconstruction: A bioelectrochemical approach using screen-printed electrodes” [J Plast Reconstr Aesthet Surg 113 (2026) 353–361] “在假体乳房再造术中早期检测假体周围液体中的活菌：基于丝网印刷电极的生物电化学方法”[J].中国整形外科杂志，2013(6):353-361。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-01-20 DOI: 10.1016/j.bjps.2026.01.009

Marta Monari , Stefano Vaccari , Alessandro Marco Lupacchini , Anna Parisi , Nicki Zolesi , Sara Beltrame , Paola Petrillo , Fabio Grizzi , Mohamed Ahmed Ahmed Abdelaziz Hegazi , Riccardo Di Giuli , Francesco Klinger , Roberto Rusconi , Valeriano Vinci

引用次数: 0

The “Hourglass” umbilicoplasty: An original four-flap design for aesthetic umbilical reconstruction “沙漏”脐带成形术：一种原始的四瓣设计，用于美观的脐带重建

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-01-20 DOI: 10.1016/j.bjps.2026.01.003

Pavlo O. Badiul , Sergii V. Sliesarenko

Background

The aesthetic outcome of abdominoplasty is largely defined by the appearance of the umbilicus. Existing neoumbilicoplasty techniques may result in suboptimal contour, asymmetry, or visible scarring. This study presents a novel four-flap “Hourglass” technique designed to replicate natural umbilical anatomy with high aesthetic precision.

Methods

A retrospective comparative analysis was performed in 49 female patients who underwent abdominoplasty with neoumbilicoplasty between 2020 and 2025. Patients were allocated into three groups according to the surgical technique: Hourglass (n = 19), vertical oval incision (n = 15), and inverted-U incision (n = 15). Aesthetic outcomes were independently assessed by two plastic surgeons using a five-parameter Likert scale (shape, size, depth, natural appearance, and scar quality; maximum score = 25). Postoperative complications were recorded.

Results

The Hourglass technique achieved the highest mean aesthetic scores across all parameters, with statistically significant superiority in shape (p = 0.0009), natural appearance (p < 0.0001), and scar quality (p = 0.00002). No statistically significant differences were observed for size (p = 0.068), depth (p = 0.347), or overall complication rate (p = 0.27).

Conclusions

The Hourglass neoumbilicoplasty offers a simple, reproducible, and anatomically accurate method for reconstructing a natural-appearing umbilicus. It provides symmetrical, stable, and aesthetically superior results without increasing complication rates, supporting its routine application in abdominoplasty.

Evidence rating scale for therapeutic studies

Level of Evidence – III.

背景：腹部成形术的美学效果很大程度上取决于脐的外观。现有的新胆管成形术可能导致不理想的轮廓、不对称或可见的疤痕。本研究提出了一种新颖的四瓣“沙漏”技术，旨在以高美学精度复制自然脐带解剖。方法对2020 ~ 2025年间49例女性腹部成形术合并新胆管成形术患者进行回顾性比较分析。根据手术方式将患者分为三组：沙漏切口（n = 19）、垂直椭圆形切口（n = 15）、倒u形切口（n = 15）。美学结果由两名整形外科医生使用五参数李克特量表（形状、大小、深度、自然外观和疤痕质量；最高得分= 25）独立评估。记录术后并发症。结果沙漏技术在所有参数中获得了最高的平均美学评分，在形状（p = 0.0009）、自然外观（p < 0.0001）和疤痕质量（p = 0.00002）方面具有统计学上显著的优势。在大小（p = 0.068）、深度（p = 0.347）和总并发症发生率（p = 0.27）方面均无统计学差异。结论沙漏式新脐成形术提供了一种简单、可重复、解剖准确的方法来重建自然呈现的脐部。它提供对称，稳定，美观优越的结果，而不增加并发症的发生率，支持其在腹部成形术的常规应用。治疗性研究证据评定量表证据等级- III。

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引用次数: 0

Fragile vessel simulation for microsurgical training: The microwaved chicken-wing model 用于显微外科训练的脆弱血管模拟：微波鸡翼模型

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2026-01-19 DOI: 10.1016/j.bjps.2026.01.016

Akatsuki Kondo, Hiroki Umezawa, Saya Odaka, Kenko Aoki, Rei Ogawa

Background

Microvascular surgeons often encounter fragile vessels; however, simple microsurgical anastomosis training models for such vessels are lacking. We sought to develop such a model by microwave heating chicken wings. We investigated whether this approach reduced the vascular strength of the ulnar artery in the chicken-wing training model.

Methods

Thirty fresh chicken wings were untreated (control) or microwaved at 500 W for 30 or 60 s (n=10/group) and weighed. The ulnar artery was dissected and its external diameter and breaking force were measured. The groups were compared in terms of breaking force using the Kruskal-Wallis test and post-hoc Bonferroni-adjusted pairwise comparisons. The correlation between heating time and breaking force was determined using the Spearman’s rank test. Multiple linear regression was used to examine the influence of heating time, vessel diameter, and tissue weight on breaking force.

Results

Kruskal-Wallis testing and pairwise comparisons showed that 60-s heating significantly reduced vessel-breaking force compared to the control (p=0.000) and 30-s heating (p=0.029). The control and 30-s heating conditions did not differ (p=0.281). Heating time correlated strongly and negatively with breaking force (ρ=−0.793, p<0.001). Multiple linear regression analysis showed that breaking force was associated positively with vessel diameter (β=0.465, p=0.023) and tended to associate negatively with heating time (β=−0.369, p=0.064). Tissue weight had no influence.

Conclusions

Microwave heating for 60 s markedly reduced chicken-wing arterial-vessel strength, creating fragile vessels that may simulate diseased human arteries. This model could be incorporated into the microsurgical training curriculum to promote the acquisition of fine tissue-handling skills.

微血管外科医生经常遇到脆弱的血管；然而，缺乏简单的显微外科吻合训练模型。我们试图通过微波加热鸡翅来开发这样一个模型。我们研究了这种方法是否会降低鸡翼训练模型中尺动脉的血管强度。方法新鲜鸡翅30只（对照）或500 W微波处理30、60 s （n=10/组）称重。解剖尺动脉，测量尺动脉外径和破断力。使用Kruskal-Wallis检验和事后bonferroni调整两两比较比较各组的断裂力。加热时间与断裂力之间的相关性采用斯皮尔曼秩检验。采用多元线性回归研究加热时间、血管直径、组织重量对断裂力的影响。结果skruskal - wallis检验和两两比较显示，与对照组相比，60s加热组的破血管力显著降低（p=0.000）， 30s加热组的破血管力显著降低（p=0.029）。对照组和30 s加热条件无显著差异（p=0.281）。加热时间与断裂力呈显著负相关（ρ= - 0.793, p<0.001）。多元线性回归分析表明，断裂力与血管直径呈正相关（β=0.465, p=0.023），与加热时间呈负相关（β= - 0.369, p=0.064）。组织重量没有影响。结论微波加热60 s可明显降低鸡翼动脉血管强度，形成脆弱血管，可模拟人体病变动脉。该模型可纳入显微外科训练课程，促进精细组织处理技能的习得。

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引用次数: 0