IMPIANTO PERISUTURALE DI TESSUTO NERVOSO AUTOLOGO DOPO RIPARAZIONE DI UN NERVO PERIFERICO CON AUTOINNESTO DI NERVO A POLARITA’ INVERTITA.

Molti studi scientifici utilizzano cellule di Schwann e fattori di crescita per cercare di migliorare sempre più il processo rigenerativo assonale. Tutt’oggi l’unica fonte autologa di cellule di Schwann deriva dalla processazione del tessuto nervoso e dall’amplificazione di queste così ottenute in coltura. Questo processo richiede molto tempo e notevoli risorse umane ed economiche e per tali motivi non è ancora possibile il loro utilizzo routinario ed immediato durante un intervento di riparazione nervosa. Le cellule di Schwann prodotte mediante differenziazione in coltura da cellule staminali (embrionali o adulte) non possono essere impiegare nella pratica clinica per motivi di ordine etic…

INFLUENCE OF CAROTID AND PERIPHERAL ATHEROSCLEROSIS ON THE OUTCOME OF PATIENTS WITH ACUTE CORONARY SYNDROME

The use of triamcinolone combined with surgery in major ear keloid treatment: a personal two stages approach

Background: Keloid is a fibroproliferative disorder characterized by an abnormal deposition of collagen within a wound. Despite an increased understanding of wound healing and collagen metabolism, the exact cause, the clinical behavior, and gold standard of treatment for keloids remain an enigma. There is no one right way of treatment, the results are variable, and the management of ear keloids can be difficult and frustrating both for patients and physicians. Traditional techniques include intralesional steroids, topical applications of silicone, vitamins, and segmental excision by lasers or surgery. The purposes of this article are to review the literature concerning the current therapies…

Male Breast Cancer: Oncologic Surgery

Many cases of male breast cancer (MBC) have been diagnosed during recent years. The increased incidence of such a mortal disease has pointed out the need for solid and well-defined protocols in order to obtain early diagnosis, effective treatment, as well as a greater long-term survival. Although many similarities with female breast cancer support similar diagnostic and therapeutic paths, recent findings about MBC cell phenotypes and tumor behavior support the need for a more customized ai, t, i, ar. One thing is though sure: nowadays lack of knowledge about MBC needs to stimulate further research and the introduction of more standardized and univocal diagnostic/therapeutic guidelines.

Lembi ALT nella ricostruzione del distretto testa-collo

"Free or Perforator-Pedicled Propeller Flaps in Lower Extremity Reconstruction: Defining the Coverage Failure": Response.

Pulsed radiofrequency energy device (PEAK plasmablade™) and CustomBone® Cranioplasty: an appealing surgical rendez-vous

Background: CustomBone® prosthesis is a widely recognized effective and successful technique for the reconstruction of cranial bone defects. Prior the cranioplasty implant, meticulous dissection wi...

A Rare Case of Giant Basal Cell Carcinoma of the Abdominal Wall: Excision and Immediate Reconstruction with a Pedicled Deep Inferior Epigastric Artery Perforator (DIEP) Flap

Patient: Female, 82 Final Diagnosis: Giant basal cell carcinoma Symptoms: Anemia Medication: — Clinical Procedure: — Specialty: Plastic Surgery Objective: Rare disease Background: Basal cell carcinoma (BCC) greater than 5 cm in diameter is called giant basal cell carcinoma (GBCC), or super giant basal cell carcinoma if it has a diameter larger than 20 cm. Giant BCC only accounts for 0.5% of BCCs and super giant BCC is exceedingly rare. On account of their rarity, there are no established guidelines for GBCC treatment. Case Report: We describe a peculiar case of an 82-year-old woman with a GBCC carcinoma of the lower abdominal wall. The tumor was surgically removed with ipsilateral inguinal …

Microsurgery and external fixation in orthoplastic reconstruction of tibial injuries.

"Orthoplastics" is a relatively new approach to lower limb reconstruction, where an integration of both plastic and orthopedic expertise is required, together with the availability of well-equipped facilities. Acute shortening and long-term frames for lengthening are generally considered alternatives to length preservation and soft tissue microsurgical reconstruction, but an integration of external fixation and reconstructive microsurgery is gaining an increasing role with refinements of joint approaches.Data on sixteen patients who underwent microsurgical lower limb reconstruction and external fixation with an orthoplastic approach, following acute or chronic tibial injury, were retrospect…

The face lift SMAS plication flap for reconstruction of large temporofrontal defects: reconstructive surgery meets cosmetic surgery.

Background: Reconstruction of large defects in the temporal region can be performed with skin grafts or pedicled or free flaps. Results are often not optimal because of the patch of a skin graft, lack of availability of local flaps, and distant skin from free flaps. A technique for reconstruction of these defects with local tissue is presented in this article that uses superficial musculoaponeurotic system (SMAS) plication to allow wide advancement of a cervicofacial flap. Methods: Once the defect is outlined, a face-lift–like skin incision is used to raise the flap. The SMAS is plicated with two purse-string sutures that relieve tension on the flap and allow maximal advancement. Thirteen f…

THe role of autologous nerve fragments implantation in enhancing peripheral nerve regeneration

ntroduction: The aim of this study was to assess the effect of seeding a nerve suture with autologous nerve fragments. Our hypothesis is that the fragments could improve axonal regeneration. Back to Top | Article Outline Material and Methods: On 20 Sprague-Dawley rats a 15mm sciatic nerve defect was created and grafted. In the study group (n=10) a 1mm nerve segment was minced and seeded around the distal suture. In the control group (n=10) no fragments were seeded. Rats were sacrificed at 4 (n= 10) and 12 weeks (n= 10) and number of regenerated fibers, fiber area and density, Soleus and Gastrocnemius muscles mass indexes, and walking track analysis in the 12 weeks group were evaluated. The …

Seeding nerve sutures with minced nerve-graft (MINE-G): a simple method to improve nerve regeneration in rats

Background: The aim of this study was to assess the effect of seeding the distal nerve suture with nerve fragments in rats. Methods: On 20 rats, a 15 mm sciatic nerve defect was reconstructed with a nerve autograft. In the Study Group (10 rats), a minced 1 mm nerve segment was seeded around the nerve suture. In the Control Group (10 rats), a nerve graft alone was used. At 4 and 12 weeks, a walking track analysis with open field test (WTA), hystomorphometry (number of myelinated fibers (n), fiber density (FD) and fiber area (FA) and soleus and gastrocnemius muscle weight ratios (MWR) were evaluated. The Student t-test was used for statistical analysis. Results: At 4 and 12 weeks the Study Gr…

The Boundless World of Cranioplasty: A Multicenter Retrospective Study and Therapeutic Flow-Chart Patient-Specific Based.

Background Cranioplasty is both a functional and aesthetical therapeutic option. In the clinical scenario every cranioplasty's material is potentially qualified to achieve the goal of calvarian reconstruction but there is a lack of agreement about the optimum choice, especially between the heterologous ones. The choice of cranioplasty widely depends on surgeon's personal preferences. In this retrospective multicentric study a comparative analysis of hydroxyapatite or titanium cranioplasties was carried on analyzing the main factors considered by the surgeon to choose a material rather than another one. Our results and data were compared with those reported in the scientific literature and a…

Retrospective Analysis in Lower Limb Reconstruction: Propeller Perforator Flaps versus Free Flaps.

Background Technical advancements and increasing experience in the management of soft tissue defects in lower extremities have led to the evolution of decisional reconstructive algorithms. Both propeller perforator flaps (PPFs) and free flaps (FFs) proved to be useful methods of reconstruction for lower extremities defects, offering alternative reconstructive tools. We present a case series of PPFs and FFs for reconstruction of lower limbs defects, analyzing and comparing treatment and outcomes. Methods Through a retrospective analysis, we report our experience in performing PPFs or FFs for reconstruction of soft tissue defects of the lower extremities, in patients admitted between 2010 an…

Vascular Grafts and Flow-through Flaps for Microsurgical Lower Extremity Reconstruction

Background The use of vascular grafts is indicated in case of insufficient pedicle length or for complex defects involving both soft tissues and vessels. Venous grafts (for both venous and arterial reconstructions) and arterial grafts (arterial reconstruction) can be used. This study retrospectively evaluated the needs for vascular reconstruction and its results in a clinical series of lower limb reconstructions with microsurgical free flaps. Materials and Methods From 2010 to 2015, a total of 16 vascular grafts or flow-through flaps were used in 12 patients out of a total of 150 patients undergoing microsurgical reconstruction (8%). Arterial reconstruction was performed in seven cases (si…

Novel Application of Pulsed Radiofrequency Energy Device (PEAK Plasmablade) in Neurosurgical Reconstructive Surgery.

Blood Congestion Can Be Rescued by Hemodilution in a Random-Pattern Skin Flap