Chinese Journal of Plastic and Reconstructive Surgery最新文献

英文中文

Current practice in autologous rib and costal-cartilage harvest for rhinoplasty: A systematic review 自体肋骨和肋软骨采集用于鼻整形术的当前实践：系统回顾

Chinese Journal of Plastic and Reconstructive Surgery

Pub Date : 2024-03-01 DOI: 10.1016/j.cjprs.2024.02.002

Mengyuan Jiang , Haizhong Huo , Lu Zhang

Background

Autologous costal grafts are used universally in clinical practice for rhinoplasty and reconstruction. However, surgeons worldwide have not agreed on the details of graft harvesting, including rib selection, side preference, operation mode, cutting methods, and handling of the periosteum and perichondrium. This study aimed to provide an overview of the novel techniques used for auto-rib harvesting in rhinoplasty within the past 5 years and identify potential avenues for future research.

Methods

We searched for related articles in PubMed, Embase, and Web of Science from 2019 to 2023, summarized crucial but controversial steps in recent practice, and analyzed their theoretical basis and clinical feasibility.

Results

Auto-rib and cartilage open harvest is still mainstream in rhinoplasty and reconstruction, with the 5th to 8th ribs and cartilage being the most used. The laparoscopic harvest is gaining attention, being second only to the open harvest, with the 9th/10th ribs and cartilages being particularly convenient. The clinical applications of full-cut and split-cut methods differ in their advantages. Except for some special reasons, almost all studies tended to preserve the periosteum and perichondrium in situ, and few surgeons chose to harvest the grafts on the left side.

Conclusion

Multiple techniques have emerged, requiring surgeons to balance the benefits and risks of various strategies at each step. New theories and techniques should be fully tested promptly and in clinical practice before wide application. Overall, a professional consensus is needed for better directivity, precision, and stability in clinical practice.

背景自体肋骨移植物被普遍用于鼻整形和鼻重建的临床实践中。然而，世界各地的外科医生对移植物采集的细节，包括肋骨的选择、偏好的一侧、操作模式、切割方法以及骨膜和软骨膜的处理等，尚未达成一致意见。本研究旨在概述过去 5 年中用于鼻整形术中自体肋骨采集的新技术，并确定未来研究的潜在途径。方法我们在 PubMed、Embase 和 Web of Science 中检索了 2019 年至 2023 年的相关文章，总结了近期实践中关键但有争议的步骤，并分析了其理论基础和临床可行性。结果自体肋骨和软骨开放式采集仍是鼻整形和重建的主流，其中第 5 至第 8 根肋骨和软骨使用最多。腹腔镜取材越来越受到重视，仅次于开放式取材，其中第 9/10 肋骨和软骨的取材尤为方便。全切法和分切法的临床应用优势各不相同。除一些特殊原因外，几乎所有的研究都倾向于原位保留骨膜和软骨周围，很少有外科医生选择在左侧采集移植物。新理论和新技术在广泛应用之前，应及时在临床实践中进行充分检验。总之，要想在临床实践中获得更好的指导性、精确性和稳定性，需要达成专业共识。

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引用次数: 0

Revolutionizing diabetic wound healing: The power of microneedles 糖尿病伤口愈合的革命：微针的力量

Chinese Journal of Plastic and Reconstructive Surgery

Pub Date : 2023-12-01 DOI: 10.1016/j.cjprs.2023.12.004

Chun Liang , Ren Wang , Tian He , Dongsheng Chen , Guangliang Zhang , Xiangye Yin , Hongyu Wang , Jiale Xie , Yujing Li , Youbai Chen

Diabetic wounds significantly affect patient quality of life. Microneedles are a promising treatment to accelerate wound healing owing to their high drug-loading capacity and efficient drug delivery; however, few studies to date have comprehensively reviewed microneedles for diabetic wound healing. This up-to-date review summarizes the research progress in microneedles for diabetic wound healing, including manufacturing materials and techniques, structures, designs, release mechanisms, delivery substances, and their specific effects. This study showed that most microneedles designed for diabetic wounds are made of synthetic polymers and/or natural materials using polydimethylsiloxane micromolding. The geometric structure and design directly influence penetration ability and drug delivery capacity. Microneedles can deliver antibiotics, hypoglycemic agents, traditional Chinese medicines, metal ions, growth factors, exosomes, stem cells, and microorganisms, thus promoting diabetic wound healing through diverse mechanisms, such as antibacterial, anti-inflammatory, antioxidant, hypoglycemic, and angiogenic activities, at different stages of the healing process. In conclusion, microneedles are promising drug delivery systems for the treatment of diabetic wounds.

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引用次数: 0

A two-step correction of a congenital alar cleft in an adult patient: A case report 对一名成年患者的先天性腭裂进行两步矫正：病例报告

Chinese Journal of Plastic and Reconstructive Surgery

Pub Date : 2023-12-01 DOI: 10.1016/j.cjprs.2023.11.002

Yinmin Wang , Shikun Cao , Jun Yang , Xusong Luo

This report describes a two-step surgical correction of an isolated left-sided congenital alar cleft in a 21-year-old male patient presenting with a 9 × 6.5 mm²-sized cleft. Malformations of the alar structure and displacement of the lower lateral cartilage were observed. All flaps survived, and the patient was completely satisfied with the surgical results. This surgical treatment is simple and reliable, can greatly improve the nasal appearance of patients with alar clefts, and may be an alternative to the current surgical treatment.

引用次数: 0

Nasal implants for drug delivery: Advancements and applications

Chinese Journal of Plastic and Reconstructive Surgery

Pub Date : 2023-12-01 DOI: 10.1016/j.cjprs.2023.09.004

Hiti, Sanshita, Inderbir Singh

Nasal implants have emerged as a pioneering technology for nasal drug delivery systems. These are breakthrough options made of biocompatible materials that are temporarily inserted into the nasal passages for both functional and cosmetic purposes. Drug-eluting nasal implants are beneficial for improving patient compliance, reducing the need for repeated drug administration, and achieving controlled release of therapeutic agents. This article offers a comprehensive insight into nasal implants and their applications, and addresses a patent perspective in the same context. Important considerations for clinically approved implants, such as Propel, Sinuva, Sinu-Foam, and Relieva Stratus, have also been discussed.

引用次数: 0

Errata regarding previously published articles 有关以前发表的文章的勘误

Chinese Journal of Plastic and Reconstructive Surgery

Pub Date : 2023-12-01 DOI: 10.1016/j.cjprs.2023.12.002

引用次数: 0

Advances and established therapies in linear scar prevention 线性疤痕预防方面的进展和成熟疗法

Chinese Journal of Plastic and Reconstructive Surgery

Pub Date : 2023-12-01 DOI: 10.1016/j.cjprs.2023.12.003

Jingjing Sun, Yajing Qiu, Xiaoxi Lin

Linear scars are scars formed after surgery or other trauma-healing procedures that typically exhibit a linear morphology. Optimal linear scars are characterized by narrowness, flatness, and a color closely resembling the adjacent tissue. Failure to meet these criteria can have detrimental effects on the physical and psychological well-being of patients. Thus, early intervention for linear scars can effectively improve functionality and aesthetics. This review aimed to consolidate the prevailing agreement on scar prevention therapies and provide clinical physicians with comprehensive and cutting-edge guidance.

引用次数: 0

Eyelid reconstruction methods: A 10-year review 眼睑重建方法：十年回顾

Chinese Journal of Plastic and Reconstructive Surgery

Pub Date : 2023-12-01 DOI: 10.1016/j.cjprs.2023.11.001

Maria Cervatiuc , Igor Vladimirovich Reshetov , Svetlana Vagovna Saakyan , Eldor Jonnazarov , Larisa Viktorovna Shklyaruk , Nodirbek Ulugbekovich Dzhapiev , Bashirkhon Ahmadkhojaevich Tursunov

In ophthalmological practice, eyelid reconstruction is often needed because of the presence of defects that arise after the excision of a tumor or after injuries. Various methods for reconstructing these defects have been previously described. However, it is important to understand the basic principles underlying these techniques and their advantages and disadvantages to ensure the choice of the optimal technique in a particular case. We have analyzed the recent literature on new methods or modifications of existing ones to provide a brief overview of the reconstructive methods of the century for comparison. We searched PubMed and CyberLeninka for articles on restoring eyelid defects reported in the literature over the past 10 years. Most techniques can be considered modified classical reconstruction methods. Postoperative complications included aesthetic defects, such as scarring of the upper or lower eyelid, trichiasis, entropion, and lagophthalmos. Surgeons continue to search for the best methods for complex reconstructive surgery to achieve good cosmetic and aesthetic outcomes.

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引用次数: 0

Treatment of mild and moderate congenital ptosis via the levator imbrication technique 通过提上睑肌腱膜固定技术治疗轻度和中度先天性上睑下垂

Chinese Journal of Plastic and Reconstructive Surgery

Pub Date : 2023-12-01 DOI: 10.1016/j.cjprs.2023.12.005

Feixue Ding , Xuran Zhu , Li Yang

Background

To correct mild and moderate congenital ptosis, traditional surgical techniques usually include dissection of the Müller’s muscle. Meanwhile, both the levator palpebrae superioris and the Müller’s muscle play a synergistic role to elevate the upper eyelid. Thus, to protect the Müller muscle and minimize injury, we developed and applied a levator imbrication technique in patients with mild and moderate congenital ptosis and followed it up to evaluate its clinical efficacy.

Methods

This retrospective case series included 53 patients with mild and moderate congenital ptosis, all of whom had undergone ptosis correction using the levator imbrication technique at the Plastic and Aesthetic Department of the Second Affiliated Hospital of Zhengzhou University between June 2018 and June 2020. The outcomes of correction, upper eyelid appearance, and operative complications were observed and analyzed. The postoperative follow-up was 3–12 months.

Results

Fifty cases of ptosis were fully corrected, and the bilateral double eyelids were smooth and natural. The eyelids of 20 patients were incompletely closed immediately after the operation but were able to close spontaneously within 2 weeks. No serious complications such as exposure keratitis were reported. Three patients with undercorrection underwent reoperation 3 months after the first operation, and ptosis was corrected.

Conclusion

The levator imbrication technique for mild and moderate congenital ptosis is simple to perform and shortens the operation time with less damage, stable postoperative outcomes, and no long-term complications.

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引用次数: 0

History and prospect of melanocytic nevus treatment: A bibliometric analysis 黑素细胞痣治疗的历史与展望:文献计量学分析

Chinese Journal of Plastic and Reconstructive Surgery

Pub Date : 2023-12-01 DOI: 10.1016/j.cjprs.2023.10.001

Zizhen Guo , Lingling Ge , Yuehua Li , Yihui Gu, Wei Wang, Chengjiang Wei, Bin Gu, Qingfeng Li, Zhichao Wang

Background

Melanocytic nevus is mainly treated by complete or partial removal. However, predicting the risk of malignant transformation of melanocytic nevi and which treatment patients should receive, surgical or non-surgical management, to gain the best results and aesthetic outcomes is controversial.

Methods

Global literature on melanocytic nevus treatment, published between 1997 and 2022, was scanned using the Web of Science Core Collection database. Microsoft Office Excel, CiteSpace V, VOSviewer, Scimago Graphica, Bibliometrix, and Biblioshiny packages in R were used for the bibliometric analysis to summarize the leading countries, institutions, professors, and research trends in this field.

Results

This study included 1 723 articles. Publications and citations exhibited positive trends over the past 20 years. The United States had the most productive organizations and publications in the comprehensive worldwide cooperation network, and China was recently one of the most active major participants. Professor Giovanni Pellacani, whose H-index, G-index, and M-index ranked first in this field, founded a virtual biopsy using reflectance confocal microscopy. In addition, Krengel and Kinsler contributed significantly to diagnosing and treating melanocytic nevi. The top 25 keywords in recent years were mostly about the mechanisms and risk factors for the malignant transformation of nevi.

Conclusion

The future trend for melanocytic nevi treatment is to specify genotype-phenotype and genotype-outcome correlations, choose proper therapy to reduce the risk of malignant transformation, and simultaneously achieve the best aesthetic outcomes.

黑素细胞痣主要通过完全或部分切除来治疗。然而，预测黑素细胞痣恶性转化的风险以及患者应该接受哪种治疗，手术或非手术治疗，以获得最佳效果和美观效果是有争议的。使用Web of Science Core Collection数据库对1997年至2022年间发表的关于黑素细胞痣治疗的全球文献进行了扫描。使用Microsoft Office Excel、CiteSpace V、VOSviewer、Scimago Graphica、Bibliometrix、Biblioshiny等软件包进行文献计量学分析，总结该领域的主要国家、机构、教授和研究趋势。本研究共纳入1 723篇文献。在过去的20年里，出版物和引用呈现出积极的趋势。在这一全面的全球合作网络中，美国拥有最富有成效的组织和出版物，而中国最近是最活跃的主要参与者之一。h指数、g指数和m指数在该领域排名第一的Giovanni Pellacani教授发明了利用反射共聚焦显微镜的虚拟活检。此外，Krengel和Kinsler对黑素细胞痣的诊断和治疗也做出了重要贡献。近年来排名前25位的关键词多为痣恶性转化的机制及危险因素。未来黑素细胞痣治疗的趋势是明确基因型-表型和基因型-结局的相关性，选择合适的治疗方法来降低恶性转化的风险，同时达到最佳的美学效果。

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引用次数: 0

Salvage anastomosis in free PAP-flap breast reconstruction: What about free flap neovascularization? 游离 PAP 瓣乳房重建中的挽救性吻合：游离皮瓣新生血管怎么办？

Chinese Journal of Plastic and Reconstructive Surgery

Pub Date : 2023-12-01 DOI: 10.1016/j.cjprs.2023.12.001

Michaël Hepp, Aline Berners, Christine Deconinck, Genevieve Pirson, Maxime Servaes, Philippe Fosseprez

Since the emergence of microsurgery in reconstructive surgery, free flaps have become a key tool in the management of patients with breast cancer. One such flap is the profunda artery perforator (PAP) flap. To date, there is no scientific consensus on whether voluminous free flaps remain dependent on their vascular pedicle throughout their lifespan. Therefore, the pedicle should always be carefully protected during revision surgery. In this article, we review the case of a middle-aged woman who suffered a pedicle transection needing re-anastomosis during revision surgery six months after free-flap breast reconstruction. A 52-year-old woman who noticed a firm nodule in her right breast and armpit was referred to our department for surgical management. The Caucasian woman presented with no significant medical history or symptoms at the first consultation. Ultrasound-guided biopsy confirmed an invasive grade III lobular carcinoma. Following staging, the patient underwent neoadjuvant chemotherapy before a right mastectomy with a complete homolateral axillary lymph node dissection and postoperative radiotherapy. One year after completing radiotherapy, free flap reconstruction with a PAP flap was performed, and six months later, revision surgery was required to enhance the volume of the reconstructed breast with a tissue expander and later an implant. Unfortunately, pedicle transection occurred during revision surgery, causing complete devascularization of the flap, which was confirmed by intraoperative Indocyanine Green imaging. The authors elected to perform salvage re-anastomosis during the surgery. In keeping with the author’s 23-year experience with free flaps, the vascular pedicle should always be preserved in voluminous free flaps, as neovascularization alone may not ensure whole flap survival. The authors suggest always attempting re-anastomosis if vessels are compromised during revision surgery.

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