Journal of Plastic Reconstructive and Aesthetic Surgery最新文献_第7页

A single-operator technique for DIEP flap raise in high-BMI patients 高bmi患者DIEP瓣抬高的单操作技术

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-12-23 DOI: 10.1016/j.bjps.2025.12.024

I. Ibrahim, X. Chalhoub, F.P. Henry, J. Hunter

High body mass index (BMI) patients undergoing autologous breast reconstruction with the deep inferior epigastric perforator (DIEP) flap face the increased risk of wound healing complications, fat necrosis, and donor-site morbidity. While postoperative outcomes are well documented, the intraoperative technical challenges of flap harvest in this population are underreported. The heavy abdominal pannus complicates exposure, often necessitating experienced assistance and prolonging operative times. We describe a reproducible, single-operator DIEP flap harvest technique designed to overcome these challenges. The method involves limited incision and dissection to island only the required flap dimensions, sequential exposure down to fascia, and use of a suspension suture to secure the superior abdominal skin. Directional gravity and simple retraction thereby replace continuous assistant involvement. The superficial inferior epigastric vein (SIEV) is identified through a focussed longitudinal incision, eliminating the need for wide inferior pannus retraction. This approach minimises operator strain, reduces dependence on experienced assistance and provides controlled access to the flap perforators, as well as a long length of SIEV. In our experience, this technique has streamlined flap harvest, reduced surgeon energy expenditure, and shortened overall operative times in a technically demanding patient subgroup. By simplifying pannus management and optimising exposure, the technique enhances the safety, efficiency, and reproducibility of DIEP flap elevation in high-BMI patients. Adoption of this approach may broaden access to safe, autologous reconstruction for high-BMI patients and contribute to improved outcomes in this growing and often underserved population.

Lay summary

A new surgical approach makes breast reconstruction using tummy tissue safe and easier for patients with higher BMI. It improves visibility during surgery, reduces operating time and effort, and may help more patients access successful natural-tissue reconstructions.

高体重指数（BMI）的患者采用腹下深穿支（DIEP）皮瓣进行自体乳房重建，面临伤口愈合并发症、脂肪坏死和供体部位发病率增加的风险。虽然术后结果有很好的文献记载，但术中皮瓣切除的技术挑战在这一人群中被低估了。沉重的腹膜使暴露复杂化，往往需要经验丰富的协助和延长手术时间。我们描述了一种可重复的，单操作DIEP皮瓣收获技术，旨在克服这些挑战。该方法包括有限的切口和剥离，只保留所需的皮瓣尺寸，连续暴露至筋膜，并使用悬挂缝线固定上腹部皮肤。定向重力和简单的缩回从而取代了连续的辅助介入。腹下浅静脉（SIEV）是通过集中的纵向切口来识别的，不需要广泛的腹下静脉后收。这种方法最大限度地减少了操作人员的压力，减少了对经验丰富的辅助人员的依赖，并提供了对皮瓣穿孔器的控制通道，以及较长的SIEV。根据我们的经验，该技术简化了皮瓣的收获，减少了外科医生的能量消耗，缩短了对技术要求高的患者亚组的整体手术时间。通过简化输卵管管理和优化暴露，该技术提高了高bmi患者DIEP皮瓣提升的安全性、效率和可重复性。采用这种方法可以为高bmi患者提供安全的自体重建，并有助于改善这一不断增长且往往服务不足的人群的预后。一种新的手术方法使得使用腹部组织进行乳房重建对BMI较高的患者来说更加安全、容易。它提高了手术过程中的可视性，减少了手术时间和工作量，并可能帮助更多的患者获得成功的自然组织重建。

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引用次数: 0

A single center retrospective observational study on 106 consecutive lipedema surgeries: Defining the ideal surgical approach 一项针对106例连续脂肪水肿手术的单中心回顾性观察研究：确定理想的手术入路。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-12-23 DOI: 10.1016/j.bjps.2025.12.018

Maëlle Thiry , Luigi Schiraldi , Martino Guiotto , Marco Fresa , Lucia Mazzolai , Pietro G. di Summa

Introduction

Lipedema causes abnormal fat accumulation in the limbs, leading to pain, functional impairment, and body image disturbance. Nowadays, various liposuction techniques are available. The wet technique is increasingly being considered as the gold standard; however, comparative data between the dry and wet methods remain limited. We evaluated the efficacy of liposuction and compared outcomes between dry and wet approaches. Our analysis focused on surgical characteristics, complication rates, and clinical outcomes including pain relief, functional improvement, and esthetic satisfaction, with comparisons made between preoperative and 12-month postoperative results.

Methods

Besides surgical data extraction, patient-reported outcome measures (PROMs) were obtained through three different standardized questionnaires to assess pain relief, function gain, and esthetic satisfaction.

Results

Both techniques were effective, demonstrating overall improvements in pain, function, and body image, when comparing pre and postoperative outcomes. Lipoaspirate volumes were comparable between the groups. Operative time was significantly shorter in the wet technique group. Short-term complication rates did not differ between dry and wet techniques. While both techniques led to a global improvement, the wet technique showed greater potential in pain reduction and better esthetics satisfaction 12 months post-surgery.

Conclusion

Lipedema is a complex disease that is still poorly understood. Liposuction may offer symptomatic relief regardless of the technique used, but the wet technique demonstrates better postoperative results, with improved PROMs and fewer complications. The treatment of lipedema requires a multidisciplinary approach, while conservative therapy remains the first-line option, surgical treatment by wet liposuction should be considered for its significant potential in improving functional outcomes and as an effective therapeutic option.

简介：脂水肿导致肢体脂肪异常堆积，导致疼痛、功能障碍和身体形象障碍。如今，有各种各样的抽脂技术可供选择。湿法技术越来越被认为是黄金标准；然而，干法和湿法之间的比较数据仍然有限。我们评估了吸脂术的疗效，并比较了干法和湿法的结果。我们的分析侧重于手术特点、并发症发生率和临床结果，包括疼痛缓解、功能改善和审美满意度，并对术前和术后12个月的结果进行比较。方法：除手术数据提取外，通过三种不同的标准化问卷评估疼痛缓解、功能获得和审美满意度，获得患者报告的结果测量（PROMs）。结果：两种技术都是有效的，在比较术前和术后结果时，显示出疼痛、功能和身体形象的总体改善。两组间吸脂量具有可比性。湿法组手术时间明显缩短。短期并发症发生率在干法和湿法之间没有差异。虽然这两种技术都带来了全面的改善，但湿法技术在术后12个月的疼痛减轻和美学满意度方面显示出更大的潜力。结论：脂水肿是一种复杂的疾病，目前仍知之甚少。无论采用何种技术，吸脂术都可以缓解症状，但湿法术后效果更好，PROMs得到改善，并发症更少。脂水肿的治疗需要多学科的方法，保守治疗仍然是一线选择，湿吸脂手术治疗应该被考虑，因为它在改善功能结果方面有很大的潜力，也是一种有效的治疗选择。

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引用次数: 0

Severe cryptotia correction using an adjustable postauricular Z-skin flap combined with autologous conchal cartilage grafting: A retrospective study 应用可调节耳后z型皮瓣联合自体耳甲软骨移植术矫正严重隐隐症：回顾性研究。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-12-19 DOI: 10.1016/j.bjps.2025.12.020

Ning Wang, Jiajun Zhi, Yue Wang, Bingqing Wang, Tun Liu, Jin Qian

Objective

Cryptotia is a common congenital auricular deformity among Asian populations, often involving cartilage malformations in the upper third of the auricle. Existing surgical techniques frequently yield unsatisfactory outcomes due to inadequate skin coverage or insufficient cartilage correction. This study introduces a modified technique combining a postauricular Z-shaped skin flap with autologous conchal cartilage grafting to address these issues.

Methods

A retrospective analysis was conducted on 48 unilateral severe cryptotia cases treated between 2020 and 2023. All patients underwent corrective surgery using a postauricular Z-shaped skin flap with autologous conchal cartilage grafting. During the operation, the concha cartilage was transplanted to stretch the helix and support the antihelix, achieving a thorough and stable correction of the cartilage deformity. Surgical outcomes were evaluated using 3D scanning and visual analog scale (VAS) scores.

Results

The mean follow-up period was 17.67 ± 4.72 months. Significant improvements were observed in auricular perimeter, length, width, and vertical distance “D” between the highest point of the auricle and skull immediately postoperatively (P＜0.05), with no statistical differences compared to the contralateral ear (P＞0.05). These results remained stable and improved further at the final follow-up. VAS scores indicated high satisfaction among patients and their families.

Conclusion

This modified technique effectively restores auricular contour and symmetry in severe cryptotia. Short-term follow-up revealed stability of the operative result with minimal complications and concealed scarring. It represents a safe and efficient option for surgical correction of severe cryptotia.

目的：隐耳症是亚洲人群中常见的先天性耳廓畸形，常涉及耳廓上三分之一的软骨畸形。由于皮肤覆盖不足或软骨矫正不足，现有的手术技术经常产生不满意的结果。本研究介绍了一种改良技术，结合耳后z形皮瓣和自体耳甲软骨移植来解决这些问题。方法：回顾性分析2020 ~ 2023年收治的48例单侧严重隐症病例。所有患者都接受了耳后z形皮瓣和自体耳甲软骨移植的矫正手术。术中移植甲骨软骨拉伸螺旋并支撑反螺旋，实现软骨畸形的彻底、稳定矫正。采用三维扫描和视觉模拟评分（VAS）评估手术效果。结果：平均随访时间17.67±4.72个月。术后即刻耳廓周长、长度、宽度及耳廓最高点与颅骨垂直距离“D”均有显著改善（P<0.05），与对侧耳廓比较差异无统计学意义（P<0.05）。这些结果保持稳定，并在最后的随访中进一步改善。VAS评分显示患者及家属满意度较高。结论：该改良术能有效恢复重度隐隐症患者耳廓轮廓及对称性。短期随访显示手术结果稳定，并发症少，瘢痕隐蔽。它是一种安全有效的手术矫正严重隐症的方法。

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引用次数: 0

Functional and psychological benefits of postpartum restoration surgery: A systematic review 产后修复手术的功能和心理益处：系统综述

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-12-19 DOI: 10.1016/j.bjps.2025.12.010

I.S. Whitaker , P. Swarnkar , S.R. Ali , E. Thomson , N. Nugent , M.D. Pacifico

Background

There has been a rise in women seeking surgical help to aesthetically correct postpartum deformities of the breast and abdomen, known as the ’mummy makeover’. The aim of this systematic review was to evaluate the literature and provide a contemporary evidence base for the positive physical and psychological effects of surgical restoration/rejuvenation of the postpartum body.

Methods

A PRISMA compliant systematic review (PROSPERO CRD42023399659) was conducted by searching the PubMed, EMBASE, and Central databases in October 2022 and updated in January 2025. The search was complemented by bibliographic secondary linkage and a narrative synthesis of the literature.

Results

Overall, 1365 articles were screened, and 5 met the inclusion criteria. All studies focused on surgical repair of diastasis recti abdominis and/or abdominoplasty and none of the breast. Overall, 498 women were assessed for physical and 314 for psychological effects of surgical interventions. Analysis reflected a minimum of 85% reduction in back pain and urinary incontinence and statistically significant reduction in trunk dysfunction. Quality of life significantly increased across all the assessed fields, with a 99.5% positive change in self-esteem and 95.2% improvement in sexual life observed post-operatively.

Conclusion

This is the first systematic review to ascertain the functional and psychological value of body contouring surgical procedures specifically in postpartum women. The true extent is likely underestimated, owing to publication titles often being generic and heterogenous in nature. These findings support postpartum surgery being classified as reconstructive and not merely cosmetic. Further studies, with an emphasis on patient-reported outcome measures in the postpartum group, would help facilitate holistic psycho-physical rehabilitation to augment surgery provision.

背景越来越多的女性通过外科手术来矫正产后乳房和腹部的畸形，这被称为“妈咪美容”。本系统综述的目的是评估文献，并为手术修复/产后身体年轻化的积极生理和心理影响提供当代证据基础。方法于2022年10月检索PubMed、EMBASE和Central数据库进行符合PRISMA标准的系统评价（PROSPERO CRD42023399659），并于2025年1月更新。搜索是补充书目二级链接和文献的叙述综合。结果共筛选文献1365篇，其中5篇符合纳入标准。所有的研究都集中在手术修复腹直肌移位和/或腹部成形术，而不是乳房。总的来说，498名女性接受了手术干预的生理影响评估，314名接受了心理影响评估。分析表明，背部疼痛和尿失禁至少减少85%，躯干功能障碍的减少具有统计学意义。所有评估领域的生活质量都显著提高，术后观察到自尊有99.5%的积极变化，性生活有95.2%的改善。结论本文首次系统探讨了塑形手术对产后妇女的功能和心理价值。真正的程度可能被低估了，因为出版物的标题往往是通用的和异质的性质。这些发现支持将产后手术归类为重建手术，而不仅仅是美容手术。进一步的研究，重点是产后组患者报告的结果测量，将有助于促进整体心理-身体康复，以增加手术提供。

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引用次数: 0

The PROMise of patient-reported outcome measures: An ethical minefield? 患者报告结果测量的前景：伦理雷区？

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-12-18 DOI: 10.1016/j.bjps.2025.12.016

Samantha S.Y. Leong, Michael J. Rice, Rachel M. Clancy, Giulia Colavitti

引用次数: 0

Surgical management and outcomes of recurrent palatal fistulae: Insights from CLAPP’s institutional experience 复发性腭瘘的外科治疗和结果：来自CLAPP机构经验的见解。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-12-17 DOI: 10.1016/j.bjps.2025.12.022

Muhammad Daiem , Ghulam Qadir Fayyaz , Sohaib Irfan , Muhammad Mustehsan Bashir , Muneeb Nasir , Marvee Turk , Larry H. Hollier , Marshall G. Miles , Subodh Kumar Singh , Jitske Nolte , Corstiaan Breugem

Background

Recurrent palatal fistulae pose a considerable challenge owing to prior failed repair, substantial scarring, and limited local tissue availability. These defects are particularly challenging to manage in low- and middle-income countries, where expertise and resources for cleft care may be limited. Furthermore, there remains a paucity of data focused specifically on patients presenting with recurrent palatal fistulae.

Methods

A retrospective cohort study was conducted at CLAPP Hospital, Lahore (January 2022-December 2024), by including patients with at least one prior failed palatal fistula repair and ≥9 months of follow-up. Fistulae were classified using the Pakistan Fistula Classification Scheme. Surgical techniques were reviewed, and logistic regression analysis was performed to identify predictors of recurrence.

Results

A total of 282 patients were included (mean age: 16.4 years). Fistula recurrence occurred in 63 patients (22.3%). Larger defects (>10 mm) and older age at the time of surgery were independently associated with increased recurrence risk (adjusted odds ratio [aOR] = 3.28, p = 0.043; aOR = 1.05, p = 0.004). The Bardach re-do palatoplasty was the most commonly used technique (56.0%), but it was associated with higher recurrence, reflecting its frequent use in more complex defects.

Conclusion

Recurrent palatal fistulae demand individualized, patient-centric surgical strategies. Older age and larger defect size significantly increase recurrence risk, underscoring the need for meticulous planning and selection of techniques that address scarring, vascularity, and local tissue limitations. These findings may inform management strategies, particularly in high-volume cleft centers within resource-constrained environments.

背景：由于先前的修复失败，大量疤痕和局部组织可用性有限，复发性腭瘘提出了相当大的挑战。这些缺陷在低收入和中等收入国家尤其具有挑战性，在这些国家，唇裂护理的专业知识和资源可能有限。此外，仍然缺乏专门针对复发性腭瘘患者的数据。方法：在拉合尔CLAPP医院（2022年1月- 2024年12月）进行回顾性队列研究，纳入至少一次腭裂修复失败且随访≥9个月的患者。采用巴基斯坦瘘分类方案对瘘管进行分类。回顾手术技术，并进行逻辑回归分析以确定复发的预测因素。结果：共纳入282例患者，平均年龄16.4岁。瘘管复发63例（22.3%）。缺损较大（bbb10 mm）和手术时年龄较大与复发风险增加独立相关（校正优势比[aOR] = 3.28, p = 0.043; aOR = 1.05, p = 0.004）。Bardach再做腭成形术是最常用的技术（56.0%），但其复发率较高，反映了其经常用于更复杂的缺陷。结论：复发性腭瘘需要个性化的、以患者为中心的手术策略。年龄越大和缺损尺寸越大会显著增加复发风险，强调需要细致的计划和选择解决疤痕、血管和局部组织限制的技术。这些发现可以为管理策略提供信息，特别是在资源受限环境下的高容量裂缝中心。

{"title":"Surgical management and outcomes of recurrent palatal fistulae: Insights from CLAPP’s institutional experience","authors":"Muhammad Daiem , Ghulam Qadir Fayyaz , Sohaib Irfan , Muhammad Mustehsan Bashir , Muneeb Nasir , Marvee Turk , Larry H. Hollier , Marshall G. Miles , Subodh Kumar Singh , Jitske Nolte , Corstiaan Breugem","doi":"10.1016/j.bjps.2025.12.022","DOIUrl":"10.1016/j.bjps.2025.12.022","url":null,"abstract":"<div><h3>Background</h3><div>Recurrent palatal fistulae pose a considerable challenge owing to prior failed repair, substantial scarring, and limited local tissue availability. These defects are particularly challenging to manage in low- and middle-income countries, where expertise and resources for cleft care may be limited. Furthermore, there remains a paucity of data focused specifically on patients presenting with recurrent palatal fistulae.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted at CLAPP Hospital, Lahore (January 2022-December 2024), by including patients with at least one prior failed palatal fistula repair and ≥9 months of follow-up. Fistulae were classified using the Pakistan Fistula Classification Scheme. Surgical techniques were reviewed, and logistic regression analysis was performed to identify predictors of recurrence.</div></div><div><h3>Results</h3><div>A total of 282 patients were included (mean age: 16.4 years). Fistula recurrence occurred in 63 patients (22.3%). Larger defects (>10 mm) and older age at the time of surgery were independently associated with increased recurrence risk (adjusted odds ratio [aOR] = 3.28, p = 0.043; aOR = 1.05, p = 0.004). The Bardach re-do palatoplasty was the most commonly used technique (56.0%), but it was associated with higher recurrence, reflecting its frequent use in more complex defects.</div></div><div><h3>Conclusion</h3><div>Recurrent palatal fistulae demand individualized, patient-centric surgical strategies. Older age and larger defect size significantly increase recurrence risk, underscoring the need for meticulous planning and selection of techniques that address scarring, vascularity, and local tissue limitations. These findings may inform management strategies, particularly in high-volume cleft centers within resource-constrained environments.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"113 ","pages":"Pages 629-637"},"PeriodicalIF":2.4,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914536","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

Is cubital tunnel obliteration a safe and effective procedure for cubital tunnel syndrome? A case series 肘管闭塞术是治疗肘管综合征安全有效的方法吗？一个案例系列。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-12-17 DOI: 10.1016/j.bjps.2025.12.019

Ji Sup Hwang, Yongwoo Kim, Jihyeung Kim

Background

Cubital tunnel obliteration aims to eliminate potential drawbacks associated with in situ decompression and anterior transposition of the ulnar nerve for treating cubital tunnel syndrome (CuTS). However, the safety of this technique has not been evaluated further, and no reports have focused specifically on its surgical outcomes. In this study, we evaluated patients who underwent cubital tunnel obliteration for established CuTS at a single institute. We asked: (1) What are the electrophysiological and clinical outcomes of cubital tunnel obliteration? (2) Which demographic and disease-related factors are associated with good electrophysiological outcomes?

Methods

Forty-three patients (mean age, 62 years) treated for CuTS between 2022 and 2023 were studied. We measured motor nerve conduction velocity (mNCV) and the Disabilities of the Arm, Shoulder, and Hand (DASH) scores four months and two years after surgery, respectively. We defined good electrophysiological outcome as normalization of the mNCV, for which we investigated the odds ratio (OR) with age, sex, body mass index, diabetes, etiology of CuTS (idiopathic vs. secondary), and preoperative mNCV as covariates.

Results

The average mNCV improved from 28.9 ± 11.2 to 38.1 ± 15.1 m/s and DASH score from 32.4 ± 18.7 to 11.7 ± 8.6. A good electrophysiological outcome was significantly associated with the absence of diabetes (adjusted OR = 0.04) and idiopathic CuTS (adjusted OR = 18.7), regardless of other factors.

Conclusions

Cubital tunnel obliteration seems to be a safe and reliable surgical option for treating CuTS and its short-term outcome was favorable for both idiopathic and secondary CuTS.

Level of evidence

Level IV (Therapeutic study).

背景：肘管闭塞术旨在消除与尺神经原位减压和前移位治疗肘管综合征（CuTS）相关的潜在缺陷。然而，这项技术的安全性尚未得到进一步的评估，也没有专门针对其手术结果的报道。在这项研究中，我们评估了在单一研究所接受肘管闭塞术治疗的患者。我们的问题是：(1)肘管闭塞术的电生理和临床结果是什么？(2)哪些人口统计学和疾病相关因素与良好的电生理结果相关？方法：对2022年至2023年期间43例（平均年龄62岁）治疗CuTS的患者进行研究。我们分别在手术后4个月和2年测量运动神经传导速度（mNCV）和手臂、肩膀和手的残疾（DASH）评分。我们将良好的电生理结果定义为mNCV的正常化，为此我们研究了年龄、性别、体重指数、糖尿病、CuTS病因（特发性与继发性）和术前mNCV作为协变量的比值比（OR）。结果：平均mNCV由28.9±11.2提高到38.1±15.1 m/s， DASH评分由32.4±18.7提高到11.7±8.6。无论其他因素如何，良好的电生理结果与无糖尿病（校正OR = 0.04）和特发性切口（校正OR = 18.7）显著相关。结论：肘管闭塞术是治疗切口的一种安全可靠的手术选择，其短期疗效对特发性和继发性切口均有利。证据等级：IV级（治疗性研究）。

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引用次数: 0

Comparison of therapeutic efficacy between second-toe tibial free flaps with plantar and dorsal veins of toe in fingertip defect reconstruction 带足底静脉与趾背静脉的第二趾胫游离皮瓣修复指端缺损的疗效比较。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-12-17 DOI: 10.1016/j.bjps.2025.12.021

Teng-Xie , Liu-Cao , Jing Hui-Hua , Zhuo Heng-Shao , You-Li , Wei Wei-Du , Hai Liang-Liu , Wen Xuan-Yan , Ruixing-Hou , Jihui-Ju , Linfeng-Tang

Objective

To retrospectively compare the clinical efficacy of the second-toe tibial free flap with plantar veins of the toe (modified group) versus dorsal veins of the toe (traditional group) in repairing emergency fingertip defects.

Methods

From March 2022 to December 2024, 60 patients (60 fingers) who underwent second-toe tibial free flap repair for digital defects were included in this study. The patients were categorised into the modified group that received second-toe tibial free flaps with plantar vein of the toe drainage and traditional group that underwent reconstruction using flaps with dorsal vein of toe drainage. Each group comprised 30 patients. Demographic data (sex and age), defect area and flap size were recorded. Postoperative outcomes included static 2-point discrimination (2-PD), total active motion (TAM), modified Vancouver Scar Scale (mVSS) for recipient and donor sites, scar on the dorsum of the foot (SDF), Michigan Hand Outcome Questionnaire (MHOQ) and flap harvesting time.

Results

No significant differences in sex, age, defect area, flap size, 2-PD, TAM, or mVSS for recipient and donor site scores were observed between the groups. Significant differences were observed in SDF, MHOQ and flap harvesting time. No complications were observed at the recipient sites in either the modified or traditional groups. However, 10 patients in the traditional group reported discomfort owing to scarring at the dorsal toe region, whereas no such discomfort occurred in the modified group.

Conclusion

In emergency surgery, the second-toe tibial free flap with plantar vein of the toe demonstrated superior outcomes compared to traditional dorsal vein of the toe drainage, including minimal dorsal toe scarring, lower MHOQ scores and shorter operative time for flap harvesting.

目的：回顾性比较带足底静脉的第二趾胫游离皮瓣（改良组）与带足背静脉的第二趾胫游离皮瓣（传统组）修复急症指端缺损的临床疗效。方法：选取2022年3月至2024年12月行第二趾胫骨游离皮瓣修复指趾缺损的患者60例（60指）为研究对象。将患者分为改良组和传统组，改良组采用带足底静脉引流的第二趾胫骨游离皮瓣，传统组采用带足底静脉引流的皮瓣重建。每组30例。统计资料（性别和年龄）、缺损面积和皮瓣大小记录。术后结果包括静态2点识别（2-PD）、总主动运动（TAM）、改良的温哥华疤痕量表（mVSS）、足背疤痕（SDF）、密歇根手部结果问卷（MHOQ）和皮瓣收获时间。结果：两组患者在性别、年龄、缺损面积、皮瓣大小、2-PD、TAM、mVSS等方面均无显著差异。SDF、MHOQ、皮瓣收获时间差异均有统计学意义。改良组和传统组均未观察到受体部位的并发症。然而，传统组中有10例患者由于趾背区瘢痕而出现不适，而改良组中没有出现这种不适。结论：在急诊手术中，结合足底静脉的第二趾胫游离皮瓣与传统的足背静脉引流相比，具有较好的效果，包括最小的足背瘢痕，较低的MHOQ评分和较短的皮瓣收获手术时间。

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引用次数: 0

Correspondence: Publication counts and research productivity: Contrasting scientific and surgical publishing cultures 通信：出版计数和研究生产力：对比科学和外科出版文化。

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-12-16 DOI: 10.1016/j.bjps.2025.12.012

Joshua McKenna

引用次数: 0

Correspondence on: “Structural barriers and pathways to artificial intelligence integration in plastic surgery” 关于“整形外科中人工智能整合的结构性障碍和途径”的通信

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-12-16 DOI: 10.1016/j.bjps.2025.12.013

Berk B. Ozmen, Graham S. Schwarz

引用次数: 0