Acta chirurgiae plasticae最新文献

Regenerative medicine has gained significant attention due to its diverse strategies for tissue restoration and restructuring. This therapeutic approach combines knowledge from cellular biology, tissue engineering, and translational medicine, providing new hope for treating conditions that previously lacked definitive therapeutic options. Although natural tissue regeneration occurs in some organs, such as the liver, and in superficial epidermal injuries, this process is limited. Tissue regeneration involves replacing damaged cells with cells of the same type, fully restoring tissue structure and function, while healing often results in scar tissue that may not have the same functional properties. Given this limitation, regenerative medicine aims to enhance the body's regenerative capacity. The manipulation of growth factors, such as platelet-derived growth factor and vascular endothelial growth factor, has been shown to increase vascularization and cell proliferation. Autologous fat grafting has emerged as a vital tool in regenerative medicine, demonstrating efficacy in promoting tissue regeneration due to its rich composition of mesenchymal stem cells and growth factors. Case studies illustrate that lipografting can improve wound healing in patients with chronic ulcers and contribute to aesthetic and functional outcomes in breast reconstruction. This study reports a case of a 27-year-old male who sustained severe trauma to his left hand in a car accident, resulting in complex injuries. Despite the potential for amputation, the decision was made to preserve the limb. A series of surgical interventions, including necrotic tissue debridement and lipografting, were conducted over several weeks, resulting in significant tissue regeneration. By the fifth week, the wound bed exhibited adequate granulation tissue, and a skin graft was applied, demonstrating successful integration and functional recovery. This case underscores the potential of regenerative medicine techniques, specifically lipografting, in limb salvage and tissue repair. Further research is needed to enhance understanding and application of these strategies in treating complex wounds and improving patient outcomes.

Schwannomas are the most common peripheral nerve sheath tumors in adults, originating from Schwann cells of the peripheral nerve sheath. These tumors are benign, solitary, non-invasive, and encapsulated, with no gender preference. They are more commonly observed in individuals in their fourth decade of life. In this case series, we present schwannomas arising from various peripheral nerves across different age groups, with varying clinical presentations, and their management without any postoperative functional deficits.

Objective: External ear reconstructive surgery is often needed due to congenital malformations or acquired traumas, which requires surgeons to comprehend ear norms as morphological variations exist between ethnicities. This study presents the first set of anthropometric data specific to the Vietnamese adult ear.

Materials and methods: A cross-sectional study involving 2,000 Vietnamese participants (1,000 women and 1,000 men) aged 18-25 years without a history of ear malformations, trauma, or surgery was conducted. On the left ear, 14 anatomical landmarks were defined, and 13 ear dimensions were measured using a standardized photographic analysis method.

Results: The 13 ear dimensions measured on both genders are ear length, ear breadth, ear length above tragus, ear length below tragus, tragus length, concha length, concha breadth, lobule height, lobule width, distance from the tragus to antihelix, distance from the tragus to helix, the measurement between the posterior point of the tragus and a point of the helix, width of the intertragic incisura and depth of the intertragic incisura. Most notably, mean values of ear length, ear breadth, concha length, and concha breadth in female subjects were found to be 58.70 ± 4.20, 29.75 ± 2.53, 26.87 ± 2.27, and 15.92 ± 2.39, respectively. In males, the corresponding values were 63.11 ± 4.95, 30.81 ± 2.97, 29.02 ± 2.64, and 15.96 ± 2.63, respectively.

Conclusions: Gender-based differences in left ear morphology were observed, with measurements being higher in males for 10 out of 13 variables. Furthermore, our findings highlight distinctive ear dimensions among Vietnamese individuals compared to other ethnic groups. However, since we only studied the left ear, further research should investigate the dimensions of the right ear and assess symmetry between both sides.

The anatomy and variability of the maxillary artery have been extensively studied through cadaveric dissections and CT angiography, revealing diverse courses of its terminal branches. These studies underscore the importance of understanding regional anatomy, particularly in surgical contexts such as intraoral vertical ramus osteotomy and temporomandibular joint (TMJ) arthroplasty, where proximity to the maxillary artery in the infratemporal fossa poses risks of complications. MRI offers distinct advantages in visualizing soft tissues critical to TMJ function, surpassing conventional imaging modalities like orthopantomography in providing detailed anatomical insights. This study aims to assess the risk of iatrogenic damage to the maxillary artery during arthroscopic procedures using MRI scans. A total of 42 patients, comprising both sexes and varying ages, underwent MRI at the Department of Maxillofacial Surgery, University Hospital Louis Pasteur in Košice. Imaging protocols were standardized on a Toshiba Atlas 1.5 Tesla MRI scanner, ensuring consistent quality with a slice thickness of 6 mm and standardized imaging matrices. Measurements of the maxillary artery's proximity to anatomical landmarks were conducted in axial and parasagittal sections to delineate precise anatomical relationships.

Supernumerary breasts are a rare congenital malformation that can cause physical and psychological problems such as pain, infection, bleeding and aesthetic discomfort. In this article, we present a series of cases with bilateral axillary supernumerary breasts who were treated with liposuction and mastectomy, with satisfactory results. We also discuss the different surgical techniques available for the treatment of supernumerary breasts and their respective advantages and disadvantages.

Background: Advances in the field of facial reanimation surgery have resulted in an increase in the quantity of published research in the international literature. The aim of this work is to provide the reader a synthesized view of the most influential themes, articles and authors in this field.

Material and methods: We searched the Clarivate Analytics Web of Science Citation Index to identify the 50 most cited papers in dynamic facial reanimation in the past 70 years. Data regarding article title, authors, year of publication, total citations and citation index was obtained. Results are presented using descriptive statistics.

Results: The most cited articles were distributed in 16 journals. Plastic and Reconstructive Surgery had the highest number of highly cited works with 27 articles, followed by JPRAS (5 papers) and the Journal of Neurosurgery (4 papers). The United States contributed most (17 papers), followed by Canada and Japan (6 each). Dr. Julia K. Terzis was the most cited author (7 works). Case series and comparative studies were the most prevalent type of article published (96%) from 1953 to 2015. The most cited paper focused on free functional muscle transfer (FFMT). Most articles were level IV research, with a mean citation index of 5.27 ± 2.85.

Conclusion: This collection offers a clear overview of the key milestones and advancements in the field. We expect it serves as a practical resource for clinicians and researchers striving to advance the science and practice of facial reanimation surgery.

Background: Lymphovenous anastomosis (LVA) and vascularized lymph node transfer (VLNT) are both accepted microsurgical treatment options for lymphedema. This article summarises and analyses recent data on outcomes associated with LVA and VLNT for lymphedema treatment at varying degrees of severity.

Methods: Literature research was conducted in the PubMed and Embase Ovid database to extract articles published through March 2024. The included studies report data on objective and subjective improvement in lymphedema after physiological surgical procedures as LVA and VLNT. Extracted data comprised number of patients, affected limbs, staging of the disease, duration of the follow up period, objective and subjective improvement and percentage of discontinuation of compression garments.

Results: A total of 23 articles were included in this article, representing 1,944 patients suffering from either primary or secondary lymphedema. The lymphedema stages were classified by classification of International Society of Lymphedema (ISL stage) or Campisi stage and range from stage I to III, as well as prophylactic indication for surgery. The follow-up duration ranged from 3 months to 8 years. Objective improvement was achieved in 82.76-100% and measured in circumferential reduction rate and reduction of cellulitis episodes. In 80-100% of the patient's subjective improvement was seen, which was measured in quality of life and personal feedback. The percentage of patients able to discontinue the use of compression garments ranges from 0 to 100%, while others were able to reduce the total time of wearing.

Conclusion: LVA and VLNT are both safe and effective techniques for the surgical treatment of lymphedema in several stages. LVA should be preferred if the lymph vessels preserved its patency, otherwise VLNT might be the therapy of choice. Combinations of various procedures with an appropriate postoperative treatment plan might lead to improved patient outcomes.

Background: Malignant melanoma of the head and neck is a highly aggressive tumor with a significant risk of regional and distant metastases. Due to the complex anatomy and rich lymphatic drainage of this area, accurate and timely diagnosis and staging are essential for optimal treatment planning. The sentinel lymph node plays a key role in assessing tumor spread and staging.

Materials and methods: A retrospective study was conducted on 26 patients with head and neck melanoma who underwent sentinel lymph node biopsy at our institution between 2017 and 2023. We evaluated the success rate of sentinel node localization, presence of metastases, and subsequent lymphadenectomy.

Results: Sentinel lymph nodes were successfully identified in 23 patients; 5 had positive findings (3 macrometastases, 1 micrometastasis, 1 isolated tumor cells). Lymphadenectomy was indicated in patients with macrometastases, while follow up monitoring was preferred for micrometastases and isolated tumor cells. One patient experienced a complication after lymphadenectomy. Most patients with negative sentinel nodes remained disease-free during follow-up.

Conclusion: Sentinel lymph node biopsy is a crucial tool for staging and treatment decision-making in head and neck malignant melanoma. The procedure's success depends on surgical expertise. Lymphadenectomy is indicated in cases of macrometastases, whereas micrometastases and isolated tumor cells warrant regular follow up. An individualized, multidisciplinary approach is essential.