Pub Date : 2025-12-01DOI: 10.1016/j.cjprs.2025.06.005
Xiaoru Pan , Shaoying Gao , You Yuan , Fuqiang Long , Yang Jian , Zairong Wei
Fournier’s gangrene is a rare urological condition with a poor prognosis and an extremely high mortality rate. Infections caused by pathogenic microorganisms play a critical role in the pathogenesis of Fournier’s gangrene. Rapid assessment and thorough debridement are crucial for survival and prognosis of patients with this disease. The present case involved a 62-year-old male patient with poorly controlled diabetes, who presented with unexplained scrotal swelling for 2 days at a local hospital where scrotal surgical debridement was performed. However, the procedure was unsuccessful. This case was characterized by rapid disease progression, widespread wound involvement, and dual infection with multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa. Our team performed early, extensive surgical debridement and, based on the results of antimicrobial susceptibility testing, initiated combination antibiotic therapy. The patient’s condition improved significantly after these interventions. However, the treatment was ultimately discontinued by the patient’s family for personal reasons, and follow-up care was declined.
{"title":"A case of extensive Fournier’s gangrene induced by dual infection with multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa","authors":"Xiaoru Pan , Shaoying Gao , You Yuan , Fuqiang Long , Yang Jian , Zairong Wei","doi":"10.1016/j.cjprs.2025.06.005","DOIUrl":"10.1016/j.cjprs.2025.06.005","url":null,"abstract":"<div><div>Fournier’s gangrene is a rare urological condition with a poor prognosis and an extremely high mortality rate. Infections caused by pathogenic microorganisms play a critical role in the pathogenesis of Fournier’s gangrene. Rapid assessment and thorough debridement are crucial for survival and prognosis of patients with this disease. The present case involved a 62-year-old male patient with poorly controlled diabetes, who presented with unexplained scrotal swelling for 2 days at a local hospital where scrotal surgical debridement was performed. However, the procedure was unsuccessful. This case was characterized by rapid disease progression, widespread wound involvement, and dual infection with multidrug-resistant <em>Acinetobacter baumannii</em> and <em>Pseudomonas aeruginosa</em>. Our team performed early, extensive surgical debridement and, based on the results of antimicrobial susceptibility testing, initiated combination antibiotic therapy. The patient’s condition improved significantly after these interventions. However, the treatment was ultimately discontinued by the patient’s family for personal reasons, and follow-up care was declined.</div></div>","PeriodicalId":65600,"journal":{"name":"Chinese Journal of Plastic and Reconstructive Surgery","volume":"7 4","pages":"Pages 220-223"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145754080","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}
Flexor tendon injuries in zones II–V are challenging because of the risk of adhesions and rupture. Although early passive mobilization limits rupture, it often compromises the functional recovery. Recent approaches favor early active mobilization with strong, multi-stranded core sutures to enhance outcomes. This study evaluated early active mobilization after eight-strand core repair in a tertiary care setting.
Methods
In this prospective study, 143 tendons from 30 patients who underwent surgery were followed up. The injured tendons were repaired using an eight-strand cross-locked cruciate technique with a double-stranded 4-0 suture, providing the tensile strength of eight strands with the same number of suture passes as in traditional four-core repairs, thereby reducing operative time without increasing bulk. Early active mobilization was initiated on postoperative day 2. The patients underwent digitally supervised physiotherapy and were monitored using a dedicated WhatsApp group, which enabled real-time guidance and compliance monitoring. The outcomes were measured in terms of total active motion, grip strength, pinch strength, time to return to work, postoperative pain, and complications.
Results
Of the 30 patients, 28 (93.3%) had fair-to-excellent outcomes, whereas only 2 (6.7%) had poor outcomes. Most patients (93.3%) returned to work within 12 weeks postoperatively. Four (13.3%) patients had complications, such as wound infection and skin necrosis. The patients showed significant changes in grip strength (45.2%) and pinch strength (70.7%) between weeks 8 and 12. No tendon ruptures were observed.
Conclusion
The eight-core suturing technique used for flexor tendon repair withstood the forces of early active mobilization, which began on the second day after surgery, resulting in fair-to-excellent outcomes. It supports digitally supervised physiotherapy through app-based monitoring, enhancing patient compliance, and reducing reliance on in-person therapy sessions. This combination led to excellent functional recovery with minimal complications.
{"title":"Early active mobilization after eight-strand flexor tendon repair using double-stranded sutures: Outcomes of a digitally supervised rehabilitation protocol in zones II–V","authors":"Chandan Kumar Ramakrishnaiah , Durga Karki , Prashant Bahirani , Sunil Sharma , Shivani Ravish , Itisha Agrawal","doi":"10.1016/j.cjprs.2025.09.001","DOIUrl":"10.1016/j.cjprs.2025.09.001","url":null,"abstract":"<div><h3>Background</h3><div>Flexor tendon injuries in zones II–V are challenging because of the risk of adhesions and rupture. Although early passive mobilization limits rupture, it often compromises the functional recovery. Recent approaches favor early active mobilization with strong, multi-stranded core sutures to enhance outcomes. This study evaluated early active mobilization after eight-strand core repair in a tertiary care setting.</div></div><div><h3>Methods</h3><div>In this prospective study, 143 tendons from 30 patients who underwent surgery were followed up. The injured tendons were repaired using an eight-strand cross-locked cruciate technique with a double-stranded 4-0 suture, providing the tensile strength of eight strands with the same number of suture passes as in traditional four-core repairs, thereby reducing operative time without increasing bulk. Early active mobilization was initiated on postoperative day 2. The patients underwent digitally supervised physiotherapy and were monitored using a dedicated WhatsApp group, which enabled real-time guidance and compliance monitoring. The outcomes were measured in terms of total active motion, grip strength, pinch strength, time to return to work, postoperative pain, and complications.</div></div><div><h3>Results</h3><div>Of the 30 patients, 28 (93.3%) had fair-to-excellent outcomes, whereas only 2 (6.7%) had poor outcomes. Most patients (93.3%) returned to work within 12 weeks postoperatively. Four (13.3%) patients had complications, such as wound infection and skin necrosis. The patients showed significant changes in grip strength (45.2%) and pinch strength (70.7%) between weeks 8 and 12. No tendon ruptures were observed.</div></div><div><h3>Conclusion</h3><div>The eight-core suturing technique used for flexor tendon repair withstood the forces of early active mobilization, which began on the second day after surgery, resulting in fair-to-excellent outcomes. It supports digitally supervised physiotherapy through app-based monitoring, enhancing patient compliance, and reducing reliance on in-person therapy sessions. This combination led to excellent functional recovery with minimal complications.</div></div>","PeriodicalId":65600,"journal":{"name":"Chinese Journal of Plastic and Reconstructive Surgery","volume":"7 4","pages":"Pages 203-208"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145754028","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}
Pub Date : 2025-12-01DOI: 10.1016/j.cjprs.2025.07.003
Mohamed Salama , Bilal Ahmad , Mohamed Amin
Background
Bat ear is a congenital condition that can have psychological effects on patients and is readily correctable, often yielding highly satisfactory outcomes for both patients and surgeons. It is crucial to select appropriate techniques in the surgical plan to ensure optimal outcomes. This study aimed to compare the outcomes of otoplasty using the cartilage scoring technique versus the cartilage excision technique for correcting the antihelix.
Methods
Twenty patients were divided into two groups: group A underwent the cartilage scoring technique, and group B received the cartilage excision technique. Symmetry, satisfaction, and complications were evaluated and compared between the groups. A visual analog score (VAS) was used to assess the perceived symmetry and satisfaction in both groups.
Results
Group A (cartilage scoring technique) demonstrated excellent postoperative symmetry, with a total symmetry score of 96/100 on cartilage grading. In group B, 6 of the 10 individuals reported high satisfaction (score: 10/10 points on VAS), whereas the remaining 4 reported moderate satisfaction (score: 5–9/10 points). The total symmetry score in group B (cartilage excision technique) was 92/100, which was lower than that in group A. No relapses in angle measurements were observed in group A. In contrast, group B showed six average and four slightly overcorrected angle measurements. In group B, the postoperative measures were less satisfactory. Angle measurements were average angles in four cases, and somewhat overcorrected in six. Regarding the helix-to-mastoid distance, three cases were within the average range, whereas seven were slightly overcorrected. No relapses were observed in either group. Concerning complications, we employed minus scoring to measure all complications. Group A had a negative score of −19, whereas group B had −24.
Conclusion
The outcomes were highly satisfactory for patients and surgeons treated using the cartilage scoring technique, and relatively less satisfactory for patients and surgeons treated using the cartilage excision technique.
{"title":"Bat ear repair using cartilage scoring technique versus cartilage excision technique","authors":"Mohamed Salama , Bilal Ahmad , Mohamed Amin","doi":"10.1016/j.cjprs.2025.07.003","DOIUrl":"10.1016/j.cjprs.2025.07.003","url":null,"abstract":"<div><h3>Background</h3><div>Bat ear is a congenital condition that can have psychological effects on patients and is readily correctable, often yielding highly satisfactory outcomes for both patients and surgeons. It is crucial to select appropriate techniques in the surgical plan to ensure optimal outcomes. This study aimed to compare the outcomes of otoplasty using the cartilage scoring technique versus the cartilage excision technique for correcting the antihelix.</div></div><div><h3>Methods</h3><div>Twenty patients were divided into two groups: group A underwent the cartilage scoring technique, and group B received the cartilage excision technique. Symmetry, satisfaction, and complications were evaluated and compared between the groups. A visual analog score (VAS) was used to assess the perceived symmetry and satisfaction in both groups.</div></div><div><h3>Results</h3><div>Group A (cartilage scoring technique) demonstrated excellent postoperative symmetry, with a total symmetry score of 96/100 on cartilage grading. In group B, 6 of the 10 individuals reported high satisfaction (score: 10/10 points on VAS), whereas the remaining 4 reported moderate satisfaction (score: 5–9/10 points). The total symmetry score in group B (cartilage excision technique) was 92/100, which was lower than that in group A. No relapses in angle measurements were observed in group A. In contrast, group B showed six average and four slightly overcorrected angle measurements. In group B, the postoperative measures were less satisfactory. Angle measurements were average angles in four cases, and somewhat overcorrected in six. Regarding the helix-to-mastoid distance, three cases were within the average range, whereas seven were slightly overcorrected. No relapses were observed in either group. Concerning complications, we employed minus scoring to measure all complications. Group A had a negative score of −19, whereas group B had −24.</div></div><div><h3>Conclusion</h3><div>The outcomes were highly satisfactory for patients and surgeons treated using the cartilage scoring technique, and relatively less satisfactory for patients and surgeons treated using the cartilage excision technique.</div></div>","PeriodicalId":65600,"journal":{"name":"Chinese Journal of Plastic and Reconstructive Surgery","volume":"7 4","pages":"Pages 209-216"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145754029","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}
Pub Date : 2025-12-01DOI: 10.1016/j.cjprs.2025.09.004
Siddig Ibrahim Abdelwahab , Abdullah Farasani , Zenat A. Khired , Abdelkhalig Hussein Elhilu , Ahmad Assiri , Waseem Hassan
Background
There is a notable scarcity of comprehensive bibliometric studies examining plastic surgery research across extended or recent timeframes and diverse regions in relevant journals. The major objective of this study was to comprehensively map historical trends and the global distribution of plastic surgery research efforts.
Methods
We conducted a comprehensive bibliometric analysis (using the Scopus database) of 35 core plastic surgery journals identified in these studies. All the data were extracted from the Scopus database in June 2025. The timeframe was set from 1946 to June 2025, and only original research and review articles were included in the detailed analysis. Countries were grouped into seven regions (Europe, Asia, Latin America, the Middle East, Africa, Australia, and New Zealand, and the United States as standalone categories) to examine regional publication trends.
Results
From 1946 to June 2025, 208 381 documents were published in 35 journals, of which 162 014 were eligible for analysis. The annual publication output has grown steadily, peaking at 8 277 by 2024. The United States led with 66 174 publications, followed by Europe (46 688), and Asia (31 785). Citation analysis of the top 100 regional papers revealed that the United States (70 530 citations) was the most impactful, followed by Europe (43 869), Asia (28 657), and Australia and New Zealand (23 409). The 100 most-cited papers globally accrued 78 833 citations, were dominated by United States-based contributions (71%), and were primarily published in Plastic and Reconstructive Surgery (57 papers). Chung KC, Mulliken JB, and Coleman SR emerged as the top authors (among the 100 most-cited global publications). Authors’ performance is presented as the number of publications, citations, h-index, g-index, m-index, HG composite, and Q2 index.
Conclusion
This study extends prior bibliometric investigations by offering a complete historical and geographical perspective on plastic surgery research. This inclusive, regionalized methodology provides a robust framework for future benchmarking and global equity assessments in surgical scholarship.
{"title":"Global trends and regional dynamics in plastic surgery research: A bibliometric analysis","authors":"Siddig Ibrahim Abdelwahab , Abdullah Farasani , Zenat A. Khired , Abdelkhalig Hussein Elhilu , Ahmad Assiri , Waseem Hassan","doi":"10.1016/j.cjprs.2025.09.004","DOIUrl":"10.1016/j.cjprs.2025.09.004","url":null,"abstract":"<div><h3>Background</h3><div>There is a notable scarcity of comprehensive bibliometric studies examining plastic surgery research across extended or recent timeframes and diverse regions in relevant journals. The major objective of this study was to comprehensively map historical trends and the global distribution of plastic surgery research efforts.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive bibliometric analysis (using the Scopus database) of 35 core plastic surgery journals identified in these studies. All the data were extracted from the Scopus database in June 2025. The timeframe was set from 1946 to June 2025, and only original research and review articles were included in the detailed analysis. Countries were grouped into seven regions (Europe, Asia, Latin America, the Middle East, Africa, Australia, and New Zealand, and the United States as standalone categories) to examine regional publication trends.</div></div><div><h3>Results</h3><div>From 1946 to June 2025, 208 381 documents were published in 35 journals, of which 162 014 were eligible for analysis. The annual publication output has grown steadily, peaking at 8 277 by 2024. The United States led with 66 174 publications, followed by Europe (46 688), and Asia (31 785). Citation analysis of the top 100 regional papers revealed that the United States (70 530 citations) was the most impactful, followed by Europe (43 869), Asia (28 657), and Australia and New Zealand (23 409). The 100 most-cited papers globally accrued 78 833 citations, were dominated by United States-based contributions (71%), and were primarily published in <em>Plastic and Reconstructive Surgery</em> (57 papers). Chung KC, Mulliken JB, and Coleman SR emerged as the top authors (among the 100 most-cited global publications). Authors’ performance is presented as the number of publications, citations, h-index, g-index, m-index, HG composite, and Q2 index.</div></div><div><h3>Conclusion</h3><div>This study extends prior bibliometric investigations by offering a complete historical and geographical perspective on plastic surgery research. This inclusive, regionalized methodology provides a robust framework for future benchmarking and global equity assessments in surgical scholarship.</div></div>","PeriodicalId":65600,"journal":{"name":"Chinese Journal of Plastic and Reconstructive Surgery","volume":"7 4","pages":"Pages 233-242"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145754084","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}
This study explored the value of integrating problem-based learning (PBL) and team-based learning (TBL) methods into plastic and reconstructive surgery clinical practice. By addressing the challenges faced in traditional teachings, this study aimed to enhance educational outcomes and prepare students for real-world surgical scenarios, thereby improving patient care in this specialized field.
Methods
Fifty undergraduate students majoring in clinical medicine at the Shanghai Jiao Tong University School of Medicine were selected as research subjects. They were randomly divided into experimental and control groups. The experimental group received the combined PBL-TBL teaching method, whereas the control group received the traditional teaching. The teaching effect was evaluated based on student satisfaction and academic performance.
Results
The student satisfaction in the experimental group was higher than that of the control group (P<0.05). Subjective scoring for academic performance by instructors was higher in the experimental group than in the control group (P<0.05).
Conclusion
The PBL and TBL combination had a significant effect when applied in plastic and reconstructive surgery clinical practice.
{"title":"Combination of problem-based and team-based learning in clinical teaching of plastic and reconstructive surgery","authors":"Ya Gao, Chiakang Ho, Dongsheng Wen, Yangdan Liu, Qingfeng Li, Danning Zheng, Yifan Zhang","doi":"10.1016/j.cjprs.2024.11.005","DOIUrl":"10.1016/j.cjprs.2024.11.005","url":null,"abstract":"<div><h3>Background</h3><div>This study explored the value of integrating problem-based learning (PBL) and team-based learning (TBL) methods into plastic and reconstructive surgery clinical practice. By addressing the challenges faced in traditional teachings, this study aimed to enhance educational outcomes and prepare students for real-world surgical scenarios, thereby improving patient care in this specialized field.</div></div><div><h3>Methods</h3><div>Fifty undergraduate students majoring in clinical medicine at the Shanghai Jiao Tong University School of Medicine were selected as research subjects. They were randomly divided into experimental and control groups. The experimental group received the combined PBL-TBL teaching method, whereas the control group received the traditional teaching. The teaching effect was evaluated based on student satisfaction and academic performance.</div></div><div><h3>Results</h3><div>The student satisfaction in the experimental group was higher than that of the control group (<em>P</em><0.05). Subjective scoring for academic performance by instructors was higher in the experimental group than in the control group (<em>P</em><0.05).</div></div><div><h3>Conclusion</h3><div>The PBL and TBL combination had a significant effect when applied in plastic and reconstructive surgery clinical practice.</div></div>","PeriodicalId":65600,"journal":{"name":"Chinese Journal of Plastic and Reconstructive Surgery","volume":"7 4","pages":"Pages 217-219"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145754026","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}
Pub Date : 2025-12-01DOI: 10.1016/j.cjprs.2025.11.002
Zhu Zhu , Nan Huang , Feixue Ding , Xusong Luo , Jun Yang , Jun Chen , Di Sun , Zhaoqi Yuan
Background
Dermatofibrosarcoma protuberans (DFSP) is an uncommon cutaneous sarcoma that infrequently involves the head and face. Despite its low incidence, the complex anatomical subunits of this region and frequent misdiagnosis can result in functional impairment and challenging reconstruction. However, the distribution characteristics of DFSP in the head and face have not yet been systematically evaluated. This study aimed to characterize the distribution of DFSP in the head and face to provide guidance for clinical diagnosis.
Methods
We retrospectively reviewed patients who underwent treatment for DFSP involving the head and face at our hospital. The associations between tumor location and patient characteristics—including sex, age, tumor size, history of trauma, and histopathological features—were systematically analyzed.
Results
Among the 161 cases, 26 (16.1%) involved DFSP of the head and face. The highest tumor frequency was observed in the cheek region (65.38%). Patients with DFSP located in the cheek were older than those with DFSP in non-cheek regions (48.82 vs. 37.22 years, P=0.04). Histologically, among the 26 cases, 23 were classic DFSP and 3 were fibrosarcomatous dermatofibrosarcoma protuberans (FS-DFSP), a more aggressive histologic subtype. The proportion of FS-DFSP was lower in the cheek region than in non-cheek areas (0 vs. 3, P=0.032).
Conclusion
DFSP of the head and face demonstrated a predilection for the cheek region. Recognition of this distribution pattern may assist dermatologists in the clinical assessment and management of patients, particularly for lesions involving the cheeks.
{"title":"Dermatofibrosarcoma protuberans of the head and face: A retrospective single-center study highlighting its predilection for the cheek region","authors":"Zhu Zhu , Nan Huang , Feixue Ding , Xusong Luo , Jun Yang , Jun Chen , Di Sun , Zhaoqi Yuan","doi":"10.1016/j.cjprs.2025.11.002","DOIUrl":"10.1016/j.cjprs.2025.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Dermatofibrosarcoma protuberans (DFSP) is an uncommon cutaneous sarcoma that infrequently involves the head and face. Despite its low incidence, the complex anatomical subunits of this region and frequent misdiagnosis can result in functional impairment and challenging reconstruction. However, the distribution characteristics of DFSP in the head and face have not yet been systematically evaluated. This study aimed to characterize the distribution of DFSP in the head and face to provide guidance for clinical diagnosis.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed patients who underwent treatment for DFSP involving the head and face at our hospital. The associations between tumor location and patient characteristics—including sex, age, tumor size, history of trauma, and histopathological features—were systematically analyzed.</div></div><div><h3>Results</h3><div>Among the 161 cases, 26 (16.1%) involved DFSP of the head and face. The highest tumor frequency was observed in the cheek region (65.38%). Patients with DFSP located in the cheek were older than those with DFSP in non-cheek regions (48.82 vs. 37.22 years, <em>P</em>=0.04). Histologically, among the 26 cases, 23 were classic DFSP and 3 were fibrosarcomatous dermatofibrosarcoma protuberans (FS-DFSP), a more aggressive histologic subtype. The proportion of FS-DFSP was lower in the cheek region than in non-cheek areas (0 vs. 3, <em>P</em>=0.032).</div></div><div><h3>Conclusion</h3><div>DFSP of the head and face demonstrated a predilection for the cheek region. Recognition of this distribution pattern may assist dermatologists in the clinical assessment and management of patients, particularly for lesions involving the cheeks.</div></div>","PeriodicalId":65600,"journal":{"name":"Chinese Journal of Plastic and Reconstructive Surgery","volume":"7 4","pages":"Pages 197-202"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145754027","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}
Pub Date : 2025-12-01DOI: 10.1016/j.cjprs.2025.09.003
Phu Man Truong Ho , Nhat Dang Huy Nguyen , Linh Khanh Le , Dat Thanh Tran
Primary congenital lymphedema (PCL) is a rare lymphatic disorder that typically presents in early life and is usually managed conservatively. In severe neonatal cases, however, complications such as skin necrosis and coagulopathy can occur. We report the case of a term male infant with prenatally diagnosed vascular malformations who presented with progressive limb swelling, hemorrhagic skin necrosis, and systemic signs of infection. Laboratory findings revealed severe thrombocytopenia and coagulopathy, consistent with Kasabach-Merritt-like phenomenon. The patient underwent staged surgical management, including limb decompression and debridement, followed by negative pressure wound therapy (NPWT), application of an acellular dermal matrix (ADM), and full-thickness skin grafting. The combined use of ADM and NPWT promoted rapid granulation tissue formation and neovascularization, resulting in stable wound coverage and successful limb preservation. Follow-up at 12 months showed excellent graft take, improved limb function, and no recurrence of necrosis or infection. This case highlights the potential role of integrating NPWT and regenerative scaffolds in managing complex neonatal wounds associated with PCL and Kasabach-Merritt-like phenomenon. To our knowledge, this is the first report describing such an approach in a neonate, offering a viable limb-salvaging strategy in otherwise life-threatening presentations.
{"title":"Limb salvage in a neonate with primary congenital lymphedema and Kasabach-Merritt-like phenomenon using negative pressure wound therapy and acellular dermal matrix: A case report","authors":"Phu Man Truong Ho , Nhat Dang Huy Nguyen , Linh Khanh Le , Dat Thanh Tran","doi":"10.1016/j.cjprs.2025.09.003","DOIUrl":"10.1016/j.cjprs.2025.09.003","url":null,"abstract":"<div><div>Primary congenital lymphedema (PCL) is a rare lymphatic disorder that typically presents in early life and is usually managed conservatively. In severe neonatal cases, however, complications such as skin necrosis and coagulopathy can occur. We report the case of a term male infant with prenatally diagnosed vascular malformations who presented with progressive limb swelling, hemorrhagic skin necrosis, and systemic signs of infection. Laboratory findings revealed severe thrombocytopenia and coagulopathy, consistent with Kasabach-Merritt-like phenomenon. The patient underwent staged surgical management, including limb decompression and debridement, followed by negative pressure wound therapy (NPWT), application of an acellular dermal matrix (ADM), and full-thickness skin grafting. The combined use of ADM and NPWT promoted rapid granulation tissue formation and neovascularization, resulting in stable wound coverage and successful limb preservation. Follow-up at 12 months showed excellent graft take, improved limb function, and no recurrence of necrosis or infection. This case highlights the potential role of integrating NPWT and regenerative scaffolds in managing complex neonatal wounds associated with PCL and Kasabach-Merritt-like phenomenon. To our knowledge, this is the first report describing such an approach in a neonate, offering a viable limb-salvaging strategy in otherwise life-threatening presentations.</div></div>","PeriodicalId":65600,"journal":{"name":"Chinese Journal of Plastic and Reconstructive Surgery","volume":"7 4","pages":"Pages 224-227"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145754081","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}
Pub Date : 2025-12-01DOI: 10.1016/j.cjprs.2025.11.001
Rudhra Kannan , Anitha Balaji
Oral and maxillofacial reconstruction represents one of the most complex challenges in plastic and reconstructive surgery, requiring the restoration of both form and function in highly specialized anatomical regions. Traditional strategies, including local flaps and autologous bone grafts, remain fundamental but are limited by donor-site morbidity, tissue availability, and unpredictable outcomes. Recent advances in regenerative medicine have shifted the paradigm from repair to true regeneration, harnessing stem cells, biomaterial scaffolds, and signaling molecules in a synergistic approach. Dental- and craniofacial tissue-derived mesenchymal stem cells, along with adipose-derived stem cells, demonstrate significant potential for alveolar bone repair, periodontal regeneration, and soft tissue augmentation. Innovations in three-dimensional printing and bioactive matrices have enabled precise scaffold design and improved vascularization, thereby enhancing both predictability and esthetic outcomes. This mini review focuses on the synergistic role of stem cells, scaffolds, and signaling molecules in oral and maxillofacial regeneration, with an emphasis on the unique contributions of periodontists. By integrating periodontal biology with reconstructive techniques, a new collaborative framework is emerging to optimize regenerative outcomes. Future research must address clinical translation, large-scale trials, cost-effectiveness, and personalized approaches to fully realize the promise of regenerative surgery.
{"title":"Harnessing stem cells and tissue engineering for oral and maxillofacial reconstruction—A mini review","authors":"Rudhra Kannan , Anitha Balaji","doi":"10.1016/j.cjprs.2025.11.001","DOIUrl":"10.1016/j.cjprs.2025.11.001","url":null,"abstract":"<div><div>Oral and maxillofacial reconstruction represents one of the most complex challenges in plastic and reconstructive surgery, requiring the restoration of both form and function in highly specialized anatomical regions. Traditional strategies, including local flaps and autologous bone grafts, remain fundamental but are limited by donor-site morbidity, tissue availability, and unpredictable outcomes. Recent advances in regenerative medicine have shifted the paradigm from repair to true regeneration, harnessing stem cells, biomaterial scaffolds, and signaling molecules in a synergistic approach. Dental- and craniofacial tissue-derived mesenchymal stem cells, along with adipose-derived stem cells, demonstrate significant potential for alveolar bone repair, periodontal regeneration, and soft tissue augmentation. Innovations in three-dimensional printing and bioactive matrices have enabled precise scaffold design and improved vascularization, thereby enhancing both predictability and esthetic outcomes. This mini review focuses on the synergistic role of stem cells, scaffolds, and signaling molecules in oral and maxillofacial regeneration, with an emphasis on the unique contributions of periodontists. By integrating periodontal biology with reconstructive techniques, a new collaborative framework is emerging to optimize regenerative outcomes. Future research must address clinical translation, large-scale trials, cost-effectiveness, and personalized approaches to fully realize the promise of regenerative surgery.</div></div>","PeriodicalId":65600,"journal":{"name":"Chinese Journal of Plastic and Reconstructive Surgery","volume":"7 4","pages":"Pages 228-232"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145754082","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}
Pub Date : 2025-09-01DOI: 10.1016/j.cjprs.2025.04.001
Fangfang Liu , Nannan Han , Huimin Yuan , Lei Wang , Jinxiu Dong , Yanfen Ding , Min Ruan , Youguo Ying
Background
Free flap transplantation has emerged as a prevalent technique in reconstructive surgery for patients with oral cancer. Postoperative monitoring of flap perfusion is critical for flap survival, necessitating early detection and timely intervention. Developing a monitoring approach that is highly sensitive, specific, non-invasive, continuous, and cost-effective is crucial for accurately assessing flap perfusion and informing clinical decisions.
Methods
From April 2024 to December 2024, 20 patients with oral tumors requiring flap transplantation were enrolled at the Ninth People’s Hospital affiliated to Shanghai Jiao Tong University School of Medicine. Continuous monitoring of various free flaps was performed utilizing a transcutaneous blood gas analyzer, both before and after surgery. This approach allowed for real-time measurement of transcutaneous partial pressure of oxygen (TcPO2) and transcutaneous partial pressure of carbon dioxide (TcPCO2), facilitating the evaluation of perfusion dynamics across various free flap types.
Results
After free flap transplantation, a reduction in blood supply resulted in a rapid decline in TcPO2 (to below 10 mmHg), accompanied by a gradual increase in TcPCO2, peaking at 135 mmHg. Following vascular anastomosis and blood flow restoration, TcPO2 and TcPCO2 exhibited opposite trends. Statistical analysis revealed no significant differences in TcPO2 and TcPCO2 measurements among the various flap types (P<0.05), indicating a consistent pattern of change across all flaps.
Conclusion
The transcutaneous blood gas analyzer proves to be a reliable method for monitoring free flap perfusion. Dynamic changes in TcPO2 and TcPCO2 effectively reflect blood supply status, enabling early detection of vascular compromise and potentially enhancing flap preservation outcomes.
Trial registration
ChiCTR, ChiCTR2400086395. Registered March 4, 2024. Prospective registration. https://www.medicalresearch.org.cn/↗ChiCTR2400086395.
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Pub Date : 2025-09-01DOI: 10.1016/j.cjprs.2025.04.002
Lidiya Sorogina , Tatyana Verbakh , Vladimir Malishevsky , Ivan Byrke , Yanis Chakhchakhov , Olesya Startseva , Mark Gabriyanchik
Traumatic peripheral nerve injuries are a major contributor to long-term disability, accounting for nearly half of all peripheral nervous system disorders. Although autologous nerve grafting remains the clinical gold standard, it is limited by donor-site morbidity and often fails to achieve full functional recovery. Biodegradable collagen conduits have emerged as an appealing alternative, providing a scaffold for directed axonal growth without requiring graft harvest. We reported three cases of chronic nerve injuries (6–12 months post-trauma): two involving 2.0–3.5 cm ulnar nerve defects in the forearm and one with a 2.5 cm median nerve defect at the wrist. Under microscopic guidance, each defect was bridged with a tubular type I collagen conduit secured by epineurial sutures, followed by standardized physiotherapy and sensory reeducation. At 12–18 months of follow-up, all patients demonstrated near-complete sensory recovery—two-point discrimination and Semmes-Weinstein thresholds returned to ≤6 mm—and motor function improved to Medical Research Council grades 4–5, restoring fine dexterity and grip strength. Patient-reported measures indicated marked reductions in neuropathic pain and paresthesia. No conduit-related adverse events or neuroma formation were observed. This case series highlights the potential of collagen-based conduits to promote robust axonal regeneration and functional restoration even in delayed presentations. By eliminating donor-site morbidity and simplifying the reconstructive procedure, conduit-assisted repair offers a less invasive, reproducible alternative to autologous grafts for both acute and chronic peripheral nerve injuries.
外伤性周围神经损伤是造成长期残疾的主要原因，占所有周围神经系统疾病的近一半。虽然自体神经移植仍然是临床的金标准，但它受到供体部位发病率的限制，往往无法实现完全的功能恢复。可生物降解的胶原蛋白导管已经成为一种有吸引力的替代方案，它为定向轴突生长提供了一个支架，而不需要移植。我们报告了3例慢性神经损伤（创伤后6-12个月）：2例涉及前臂2.0-3.5 cm尺神经缺损，1例涉及手腕2.5 cm正中神经缺损。在显微镜指导下，每个缺陷用管状I型胶原蛋白导管桥接，并通过神经外缝合线固定，随后进行标准化物理治疗和感觉再教育。在12-18个月的随访中，所有患者表现出几乎完全的感觉恢复- 2点辨别和Semmes-Weinstein阈值恢复到≤6 mm -运动功能改善到医学研究委员会4-5级，恢复了良好的灵活性和握力。患者报告的测量结果显示神经性疼痛和感觉异常明显减少。未观察到导管相关不良事件或神经瘤形成。本病例系列强调了胶原基导管在促进轴突再生和功能恢复方面的潜力，即使在延迟表现中也是如此。通过消除供体部位的发病率和简化重建程序，导管辅助修复为急性和慢性周围神经损伤提供了一种比自体移植物侵入性更小、可复制的替代方法。
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