Shunsuke Mima, Yoshiro Abe, Kazuhide Mineda, Yutaro Yamashita, Shinji Nagasaka, Hiroyuki Yamasaki, Mayu Bando, Makoto Mizuguchi, Kenta Ikushima, Teruyoshi Kageji and Ichiro Hashimoto : Current status and potential of online telemedicine in plastic surgery., Journal of Plastic and Reconstructive Surgery, 4, 3, 121-126, 2025.
(Summary)
Remote medical care is becoming popular worldwide, but not as much has yet been done in plastic surgery. We provided online treatment related to plastic surgery using a 5G system. This study aimed to investigate the usefulness and future of online telemedicine in plastic surgery. A plastic surgeon alternated between face-to-face and telemedicine. The interval between consultations was 1 week. Specifically, local doctors and staff provided medical care to patients at the suburban hospital, and the plastic surgeon remotely observed patients and provided instructions and guidance on procedures to the local doctors and staff. In this study, we evaluated the patients who were treated under telemedicine with respect to their age, use, and effectiveness. The study encompassed the period from August 2021 to October 2022. Thirty-five patients were treated via online telemedicine (mean age, 73.0 years). Twenty-one (60%) of the postoperative procedures were related to surgeries performed by a plastic surgeon. Consultation for simple wound care was performed in 8 (22.9%) patients. Guidance on pocket incision surgery for pressure ulcers was given to one patient. As for the quality of communication, images were clear, no delays were encountered, and no cases interfered with medical care. Our system was primarily useful as a postoperative management tool. The high image quality and low-latency communication allowed for real-time instruction during complex postoperative procedures and surgical techniques. Even in hospitals with infrequent visits from plastic surgeon, telemedicine has the potential to make surgery safer and more proactive.
Yutaro Yamashita, Yoshiro Abe, Mayu Bando, Shunsuke Mima, Hiroyuki Yamasaki, Shinji Nagasaka, Kazuhide Mineda and Ichiro Hashimoto : Total Contact Cast after Sole Free Flap Reconstruction for Early Ambulation, Archives of Plastic Surgery, 52, 2, 104-109, 2025.
Yutaro Yamashita, Yoshiro Abe, Mayu Bando, Shunsuke Mima, Hiroyuki Yamasaki, Shinji Nagasaka, Kazuhide Mineda and Ichiro Hashimoto : Surgical methods for reducing early wound dehiscence after reconstruction surgery for pressure ulcer., Journal of Wound Care, 35, Sup2a, 12-16, Feb. 2026.
(Summary)
Early postoperative wound dehiscence is the most common complication of pressure ulcers (PUs). The authors previously investigated the risk factors for this complication and reported that the main cause of early wound dehiscence was surgical site infection. This study aimed to improve the surgical method to decrease early postoperative wound dehiscence. Patients with PUs between 2005 and 2022 were retrospectively investigated. In the control group, the ulcer surface was stained with methylene blue and debrided using the conventional method (surgical debridement). For comparison purposes, three test groups were established. In group 1, the ulcer surface was covered with hydrofibre with ionic silver, and debridement was performed using the covered debridement method. In group 2, debridement was performed using the conventional method and postoperative incisional negative pressure wound therapy (iNPWT) on the skin flap. Group 3 underwent both the covered debridement method and iNPWT. Patient data on: sex; age; body mass index (BMI); history of diabetes; smoking history; PU site; detection of meticillin-resistant Staphylococcus aureus in wound bacterial culture; serum albumin level; operation time; and ulcer size, were collected. Significant differences from the control group were determined for each factor. A total of 60 patients underwent flap coverage (control group: 39 patients; group 1: six patients; group 2: eight patients; group 3: seven patients). There were no significant differences between the groups for each item except for albumin level and BMI. Rates of early wound dehiscence in the control group and groups 1, 2 and 3 were 15/39 (38.5%); 2/6 (33.3%; p=0.81); 2/8 (25%; p=0.47), and 0/7 (0.0%; p=0.049), respectively. A combination of methods may effectively reduce the incidence of early wound dehiscence.