整形与美容研究(英文版)最新文献

Craniofacial tissue engineering offers promising solutions for addressing large bone defects caused by congenital abnormalities, trauma, or disease. Traditional approaches, such as autografts and synthetic materials, are widely used but face limitations, including donor site morbidity, immune rejection, and poor graft integration. Recent advancements in biomaterials, including nanoscale scaffold design, bioceramics, cell-laden hydrogels, and bioactive modifications, present promising strategies to replicate the biological, mechanical, and structural properties of native bone. This review explores innovative strategies to enhance osteoconductivity, osteoinductivity, and osteogenicity of engineered grafts, including the use of advanced biomaterials, immunomodulatory scaffolds, and bioprinting technologies. Key biological challenges are discussed alongside translational barriers. Future directions emphasize the integration of bioprinted, vascularized, multi-phasic tissues, alongside personalized therapies and advanced fabrication techniques, to accelerate clinical adoption. By bridging nanoscale innovations with the demands of large-scale clinical application, this review outlines pathways toward scalable, personalized, and clinically effective solutions to restore functionality and aesthetics in craniofacial reconstruction.

Aim: Although vascularized lymph node transplantation (VLNT) has gained recognition as an effective treatment option for lymphedema, no consensus on the timing of transplant with other lymphatic procedures has been established. The aim of this study is to describe our institutional experience with VLNT, including our staged approach and report postoperative outcomes.

Methods: A retrospective review of patients who underwent VLNT for upper extremity lymphedema from May 2017 to April 2022 was conducted. Patients were divided into fat- or fluid-dominant phenotypes based on preoperative workup. Patients with a minimum of 12-month follow-up were included. Records were reviewed for demographic, intraoperative, and surveillance data.

Results: Twenty-three patients underwent VLNT of the upper extremity during the study period, of which eighteen met the study criteria. Nine patients had fluid-dominant disease and nine patients had fat-dominant disease and had undergone prior debulking at our institution. Fluid-dominant patients demonstrated slight reductions in limb volume and hours in compression, and improvement in quality-of-life scores at twelve months. Fat-dominant patients who underwent prior debulking had a slight increase in limb volume without a change in hours of compression, and demonstrated improvements in quality-of-life scores in nearly all subdomains. Overall, 17% of patients discontinued compression therapy entirely. Improvement in extremity edema was present in 83% of postoperative MRIs.

Conclusion: VLNT had varying effects on limb measurements while reliably improving quality-of-life and allowing for the potential of discontinuing compression. Utilizing a staged approach wherein debulking is performed upfront may be particularly beneficial for patients with fat-dominant disease.

Free tissue transfer has become the gold standard for reconstruction within the head and neck. However, there are still many instances where pedicled locoregional flaps are the optimal reconstructive option. When myofascial tissue is needed, several options have been described throughout the literature. Various trapezius flaps have been used, although these have variable vascular anatomy and significant donor site morbidity. The pectoralis major myofascial flap has become a mainstay in head and neck reconstruction for its ease of harvest and reliability but suffers from similar issues with donor site morbidity. The pedicled latissimus dorsi flap (PLDF) is another reliable option that has been used for multiple different ablative sites within the head and neck. The thin, pliable structure of the latissimus dorsi makes it a viable option for many defects, and recent reports also support its feasibility for use in an interdisciplinary two-team approach. Furthermore, the donor site morbidity of the PLDF is minimal compared to other similar myofascial options. In this article, we describe the surgical considerations and operative techniques for PLDF transfer along with a review of its associated donor site morbidity.

Aim: Evaluate the clinical effectiveness of platelet-rich plasma as a treatment for lichen sclerosus.

Methods: A systematic review was performed. The electronic databases PubMed, Ovid MEDLINE^®, Web of Science, Cochrane, clinicaltrials.gov were used to identify case studies, case series, prospective uncontrolled, and randomized controlled studies published between 1946 and April 21, 2021. Six prospective uncontrolled studies, one randomized double-blind prospective study, and one case report were included.

Results: Platelet-rich plasma treatment was subjectively reported to improve quality of life, but objective measures demonstrating treatment efficacy were not observed. In addition, platelet-rich plasma preparation and administration between studies lacked standardization.

Conclusion: Platelet-rich plasma may be used for symptomatic adjuvant treatment of lichen sclerosus, though additional double-blind controlled studies with standardized platelet-rich plasma protocols are needed to better characterize the efficacy of platelet-rich plasma.