Chinese Journal of Plastic and Reconstructive Surgery最新文献

In this study, we present a representative case of multiple glomuvenous malformation in a 12-year-old female patient. Approximately five years ago, the patient developed multiple blue-purple papules and plaques on her hypogastrium and right thigh, which progressively enlarged and presented tenderness. Histopathological examination confirmed the diagnosis of glomuvenous malformation. Following two injections of lauromacrogol, a significant improvement was observed in the lesions, including a resolution of tenderness. These findings suggest that sclerotherapy not only exhibits evident therapeutic efficacy but also effectively alleviates pain while addressing both aesthetic and therapeutic concerns.

Background

Prolonged pressure on the skin known as pressure sores, can cause frequent injuries to the skin and underlying tissues. However, several prevention approaches, including non-surgical and surgical management, are available. In flap surgery for pressure sores, a variety of flap types may be used; each offers certain benefits and some incidences of complications and recurrence. This study evaluated the versatility of the perforator-enhanced rhomboid flap technique for ischial sore construction.

Methods

This prospective study was conducted in the Plastic Surgery Department of Fayoum University Hospital. The perforator-enhanced rhomboid flap technique was employed in 20 patients with ischial pressure sores who failed to respond to conservative treatment. A proper history was obtained and a preoperative arterial duplex was performed to determine the site of the prominent perforators for their preservation at the base of the flap. Postoperative follow-ups and evaluations were performed.

Results

The mean age of the study group was 43.7 ​± ​13.1, ranging from 19 to 65 years. Moreover, 80% of the participants were males while 20% were female. The main etiology of the sores was paraplegia in 45% of cases. The mean surface area of sores was 24.8 ​± ​6.3 ​cm². In 75% of cases, the color match of the flap was rated as excellent. Similarly, 70% of the patients rated flap thickness as excellent. In 55% of the cases, the scar appearance was deemed excellent. Overall satisfaction was reported as excellent by 40% of the patients, while only 5% reported poor satisfaction. Approximately, 10% of the cases were identified with seroma, and 30% had wound dehiscence of a mean size of 1.33 ​± ​0.98 ​cm and required around 6.8 ​± ​1.9 weeks to heal.

Conclusion

The perforator-enhanced rhomboid flap technique is a versatile method for reconstructing ischial pressure sores owing to its technical ease, short operative time, reliable vascularity, aesthetic outcome, matching skin color, and short recovery time. The main limitations include large defects with large surface areas, lack of a nearby donor site for a rhomboid flap, and scarring from prior procedures around the sore.

Orbital fractures are a frequent and serious problem for practicing ophthalmologists. The complexity of the pathology is explained by the combined nature of the injuries (often associated with craniofacial injuries), multistage treatments, results that are often unsatisfactory, and a wide range of complaints about functional and cosmetic limitations. Over the years, significant progress has been made in the field of orbital reconstruction, allowing the transition from traditional methods using simple materials to innovative bioengineering solutions. This evolution has been driven by advances in surgical technologies, imaging techniques, and biomaterials aimed at optimizing the restoration of the shape and function of the orbital region. Traditional approaches are based on the use of autologous tissues such as bone grafts and muscle flaps, which provide biocompatibility and natural integration, but have limitations in terms of customization and accessibility. The advent of patient-specific implants and 3D printing technology has revolutionized the reconstruction of the orbit, allowing implants to be precisely adapted to a patient’s anatomy. Biocompatible materials, such as porous polyethylene, titanium, and silicone, have become the basis for orbital reconstruction, ensuring durability and compatibility while minimizing long-term complications. Bioengineered solutions hold promise for further advancements in orbital reconstruction. We searched PubMed, Cyberleninka, and other verified databases for published articles on orbital reconstruction reported in the literature between 1960 and January 2024. In this article, we consider the advantages and disadvantages of each category of reconstruction materials and provide up-to-date information on the methods for modifying their properties using modern processing technologies.

Aging is one of the most significant health challenges worldwide and is a primary cause of chronic diseases and physiological decline. Among the myriad changes that occur with aging, alterations in adipose tissue distribution and function have gained considerable attention because of their profound impact on metabolic health and overall well-being. Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) are the two major depots of white adipose tissue, each with distinct roles in metabolism and health. Understanding the characteristics and underlying mechanisms of SAT and VAT is crucial for elucidating the aging process and developing strategies to promote healthy aging. This review focuses on delineating and analyzing the characteristics and intrinsic mechanisms underlying the aging of subcutaneous and visceral adipose tissue during the aging process, which can contribute to a better understanding of the aging process and enhance healthy aging.

Particulate bone plays a crucial role in various oral and maxillofacial surgical procedures, including reconstruction, implantation, and craniofacial surgery. Autologous bone and deproteinized bovine bone xenografts are the two primary resources used for such procedures, with the former demonstrating superior cost-effectiveness and reduced comorbidity rates, particularly in cases involving donor zones. However, a significant challenge lies in acquiring uniformly sized autologous particulate bone specimens, with existing tools often yielding coarse particles at a high cost. Consequently, commercial bone xenograft solutions are frequently favored despite lower standards. This technical note introduces a novel technique for swiftly, safely, and efficiently obtaining autologous particulate bone specimens. The procedure involves the use of a motor handpiece fitted with a micro drill and surgical spoon to collect the bone particles. The continuous irrigation with saline maintains a clear surgical field during the milling process. The collected bone particles are then transferred to a metal capsule for further use. This technique offers a promising solution to the challenge of inconsistent particle size associated with harvesting using traditional methods, providing surgeons with a reliable and efficient method of obtaining autologous particulate bone samples.

Neurofibromatosis type 1 (NF1) is one of the most common genetic disorders that predisposes patients to benign and malignant tumors of the peripheral nervous system. Plexiform and cutaneous neurofibromas are NF1-associated benign tumors. Despite their benign nature, they can cause tremendous morbidity in patients with NF1. Therapeutic drug options are limited to the MEK inhibitor, selumetinib, which is the only approved drug for pediatric patients with plexiform neurofibromas. Antifibrotic strategies have substantial therapeutic potential for NF1-associated neurofibromas. This review discusses the fibrotic features of plexiform and cutaneous neurofibromas focusing on the pathological composition of the extracellular matrix. It also highlights the core pathways implicated in the biochemical and biophysical regulation of the extracellular matrix remodeling in tumor imitation and progression. Finally, this review provides a brief outlook on how exploring novel vulnerabilities residing in the aberrant extracellular matrix and their underlying pathways can benefit the treatment of NF1-associated neurofibromas.

Congenital melanocytic nevi (CMN) are common skin tumors. Large and specially located nevi cannot be completely removed by surgery, posing the risks of both cosmetic deformities and potential malignancy. Nonsurgical treatments, such as laser therapy and physical dermabrasion, can overcome the limitations of surgery; however, the high rate of repigmentation remains an unresolved global challenge. We conducted a self-controlled observational study of a patient with a nevus on the chest. Two areas of the lesion were treated with an Er:YAG laser and 5% imiquimod cream was applied to one of these areas. After nearly 7-months of follow-up, we observed a significant difference in color between the two areas, suggesting that topical imiquimod may inhibit repigmentation and significantly enhance the effectiveness of laser treatment.

Cutaneous neurofibroma (cNF) is a prevalent clinical manifestation of neurofibromatosis type 1, significantly affecting the well-being and quality of life of the affected individuals. The adoption of reliable and reproducible volumetric measurement techniques is essential for precisely evaluating tumor burden and plays a critical role in the development of effective treatments for cNF. This study focuses on widely used volumetric measurement techniques, including vernier calipers, ultrasound, computed tomography, magnetic resonance imaging, and three-dimensional scanning imaging. It outlines the merits and drawbacks of each technique in assessing the cNF load, providing an overview of their current applications and ongoing research advancements in this domain.

Background

Keloids are benign skin tumors characterized by fibroblast proliferation, tumor-like biological behavior, and excessive deposition of extracellular matrix in wounded skin. Ferroptosis, a type of programmed cell death, is critical in tumor pathogenesis. We aimed to investigate the role of ferroptosis in keloid formation.

Methods

We downloaded public high-throughput sequencing raw count data (GSE92566), containing three normal skin and four keloid samples, from the Gene Expression Omnibus database. Ferroptosis-related genes were obtained from the Ferroptosis database website. The ferroptosis-related differentially expressed genes (FRDEGs) were obtained by merging differentially expressed genes with ferroptosis-related genes. The FRDEGs were then used for Gene Ontology, Kyoto Encyclopedia of Genes and Genomes, Gene Set Enrichment Analysis, protein-protein interaction (PPI) network, and microRNA (miRNA)-mRNA network analysis. Finally, real-time quantitative polymerase chain reaction (RT-qPCR) was performed to validate our findings.

Results

We found 25 FRDEGs, including 8 up-regulated and 17 down-regulated genes. Pathway enrichment analysis revealed that the Hippo and transforming growth factor β signaling pathways were significantly up-regulated in keloids. In contrast, regulation of the peroxisome proliferator-activated receptor signaling pathway, glutathione metabolism, and unsaturated fatty acid metabolic process were down-regulated. PPI and FRDEGs hub networks were constructed using the STRING database and Cytoscape software. Ten hub genes were identified, including PLA2G6, RARRES2, SNCA, CYP4F8, CDKN2A, ALOX12, FABP4, ALOX12B, NEDD4, and NEDD4L. We constructed a miRNA-mRNA network, which predicted hsa-mir-155-5p, hsa-let-7b-5p, hsa-mir-124-3p, hsa-mir-145-5p, hsa-mir-328-3p, hsa-mir-24-3p, and hsa-mir-10b-5p as the most connected miRNAs regulating ferroptosis in keloids. Finally, we verified the expression levels of the hub genes by RT-qPCR, which confirmed that ALOX12, ALOX12B, and CYP4F8 expression were reduced in keloids.

Conclusions

This study provides novel information on ferroptosis-mediated keloid pathogenesis, underscoring the importance of further research in this area to unlock new therapeutic avenues for keloid treatment.