查看更多>>摘要：Autologous fat grafting is routinely used in plastic and reconstructive surgery to improve contour deformities and appearance.However,retention of fat over time is inconsistent and unpredictable.Cell-assisted lipostransfer(CAL),the practice of using stem cell-containing portions of adipose to enrich fat grafts,has been found to be a promising area of research to increase not only the retention of volume but also increase collagen production,enhance angiogenesis,and direct the overall repair,remodeling,and regeneration of the recipient site.CAL,therefore,has a multitude of clinical applications,ranging from oncologic reconstruction following radiation to facial rejuvenation,among others.In this paper,we provide a comprehensive review of the current state of cell-supplemented fat transfer and discuss our understanding of cellular interactions in enriched fat grafts,techniques to improve the viability of fat,clinical translation of CAL,regulatory oversight,and future directions.
查看更多>>摘要：Aim:Hyaluronic acid(HA)is extensively used in injectable skin quality products due to its documented role in skin rejuvenation.The rapid in vivo degradation of HA by the enzyme hyaluronidase necessitates the development of advanced formulations to ensure the efficacy and longevity of the treatments.In this context,a novel 2.6%high molecular weight HA(H-HA)/3.2%sorbitol composition has been introduced,featuring stabilization through hydrogen bonds rather than traditional crosslinking.Methods:The stabilized composition was evaluated through two in vitro enzymatic degradation tests.In the first test,the efficiency on the gel degradation was followed by rheology and compared with two crosslinked HA products available on the market.In the second test,the effect on the gel structure of a less diluted hyaluronidase dose was followed by rheological and cohesivity measurements.Results:In vitro study demonstrates that,before its complete degradation into a liquid-like state,the stabilized composition exhibits high elasticity and cohesivity during the enzymatic degradation process,surpassing traditional crosslinked HA products.Conclusion:The stabilization provided by the sorbitol in the stabilized composition effectively enhances product properties and protects them during gel degradation.These attributes indicate significant potential for improved clinical outcomes in skin quality treatments.
Dimitris ReissisCédric ZublerEdel de BuitleirSam Brown...
26-37页
查看更多>>摘要：Aim:Informed consent for paediatric facial reanimation requires effective patient/parent education and involvement in a shared decision-making(SDM)process to help set their expectations and understanding from the outset.No article in the current literature has systematically reviewed the available tools for facilitating effective patient/parent education and the validity of informed consent in the context of paediatric facial reanimation.Methods:A systematic literature review was undertaken,following the Preferred Reporting Items of Systematic Reviews and Meta-analyses(PRISMA)2020 guidelines.MEDLINE via PubMed,Embase and Cochrane Library were searched and the results screened and reviewed in accordance with pre-defined inclusion and exclusion criteria.Results:The initial search yielded 478 articles,of which only 4 fulfilled the study's inclusion criteria.One cohort study evaluated qualitative feedback from patients and their relatives participating in a family education and support day for paediatric facial palsy,while another article from the same group reviewed the readability of online education resources.The remaining two articles represented educational reviews focusing on treatment and patient education based on expert opinion without providing original outcome data.Conclusion:There is a paucity of evidence regarding patient/parent education to support the informed consent process for children undergoing paediatric facial reanimation.There remains a need for further resources and platforms to be developed that may support children and their parents in engaging in a SDM process,setting appropriate expectations,and providing valid informed consent for their surgery.
Elizabeth DominguezAllisa BarberJose Lucas ZepedaGwendolyn Hoben...
38-52页
查看更多>>摘要：Introduction:Targeted muscle reinnervation(TMR)is increasingly common in the care of major limb amputation to limit amputation-related pain.This review aims to elucidate how chronic pain states and length of delay prior to TMR affect its success and outcomes.Methods:Manuscripts were collected from three databases.Articles were first screened and excluded based on exclusion criteria.The remaining manuscripts were independently reviewed to determine inclusion.Article and patient demographics,as well as pain outcomes,were extracted.Data were analyzed based on pain condition,amputation vs.neuroma,and time from amputation/injury to surgery.Results:The literature search yielded 723 articles,with 41 meeting the inclusion criteria.Twenty-one articles included patients with residual limb pain(RLP)and phantom limb pain(PLP),including 14 on amputation and 6 on neuroma excision.Five articles included cancer-related amputation.Complex Regional Pain Syndrome(CRPS)was discussed in 3 articles,ischemia or infection in 2 articles,and neurofibromatosis 1 in 1 article.Twenty-two articles described TMR at the time of amputation.Conclusions:TMR is effective at preventing neuroma formation and limiting pain when performed at the time of amputation.Delayed patients had a greater improvement in RLP but less of an improvement in PLP,when assessed against immediate TMR patients who were compared to non-TMR standard amputees.In the presence of chronic pain states,such as CRPS,there is also improved analgesia.However,current clinical data are limited,indicating a need for further research into the use of TMR for chronic pain management.
Kan NakamotoTsend Ayush BatsaikhanNaiyou LiuW.Samuel Fagg...
53-66页
查看更多>>摘要：Aim:Beta-adrenergic receptor blockers are conventionally used for the treatment of hypertension,tachycardia,and glaucoma.Research has shown that beta-blockers can accelerate wound epithelialization.In this study,we tested the efficacy of the beta-blocker timolol in an ovine model of grafted full-thickness burn wound healing,which closely mimics clinical scenarios.Methods:Six full-thickness burn wounds were created on the sheep's posterior surface.Twenty-four hours later,eschars were excised and meshed skin was grafted(Day0).The wounds in the treatment group received topical application of timolol.Blood flow was measured using a blood perfusion imager.Cardiovascular hemodynamics and blood glucose levels were recorded daily.The epithelialization rate on Day 14 was determined by planimetric assay and analyzed by paired t-test.The days that the epithelialization rate exceeded 85%,90%,and 95%were analyzed by survival analysis.To assess the potential influence of TGFβ,epithelial-mesenchymal transition(EMT),or myofibroblast activation(MFA)on wound healing,the RNA abundance of gene products related to these pathways was measured by reverse transcription and quantitative polymerase chain reaction(RT-qPCR).Results:The epithelialization rate on Day 14 was significantly higher in the treatment group.The days that the epithelialization rate exceeded 85%,90%,and 95%were significantly shorter in the treatment group.There was no significant difference in wound blood flow or RNA abundance related to TGFβ,EMT,or MFA-related pathways among the groups at any time point.Conclusion:The results demonstrate that the beta-blocker timolol accelerates epithelialization of mesh skin grafted full-thickness burn wounds through a mechanism other than improving wound blood flow.
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