The Gastroepiploic Vascularized Lymph Node Transfer in the Treatment of Male Genital Lymphedema: A Report of Three Cases.

Male genital lymphedema (MGL) is a debilitating condition that may require surgical intervention. Lymphaticovenous anastomosis (LVA) can be ineffective in primary and advanced cases because of lymphatic disruption, whereas vascularized lymph node transfer (VLNT) can overcome this limitation by promoting neolymphangiogenesis but traditionally carries some risk of donor site complications. Gastroepiploic vascularized lymph node transfer (GEVLNT) has recently emerged as an effective treatment option for upper and lower limb lymphedema, with negligible complications.

Maximizing Aesthetic Outcomes in Delayed Breast Reconstruction: the Be.A.U.T-I.F.U.L. DIEP Step-by-Step Inset Technique.

Introduction: In microvascular breast reconstruction, the focus has shifted to achieving aesthetically pleasing results. Delayed breast reconstruction poses challenges such as ensuring natural ptosis and avoiding a "patch" effect. The Be.

Conventional Versus Regenerative Methods for Wound Healing: A Comparative Experimental Study on a Sheep Model.

: Wound healing is a complex process involving cellular, anatomical, and functional repair, often hindered in chronic wounds associated with diseases like diabetes and vascular disorders. This study investigated the efficacy of conventional and regenerative wound healing approaches in a sheep surgical wound model. : Six female Bergamasca sheep underwent five full-thickness skin lesions treated with various methods: sterile gauze (control), chlorhexidine, sodium hypochlorite, micronized dermis system application, and dermal matrix.

Microsurgical Reconstruction with and without Microvascular Anastomosis of Oncological Defects of the Upper Limb.

Introduction: The choice of the most adequate surgical technique for upper limb defects remains challenging. The aim of this article is to discuss the main microsurgical (pedicled or free) reconstructive options for the post-oncological reconstruction of different anatomical areas of the upper extremity.

Materials And Methods: We reviewed different reconstructive methods reported in the literature needing microsurgical expertise and compared them to our clinical experience, in order to provide further guidance in the choice of different flaps for upper limb soft tissue reconstruction.

Synthetic Simulators for Microsurgery Training: A Systematic Review.

Background: Microsurgery has a steep learning curve. Synthetic simulators have proven to be useful training tools for the initial learning stages, as well as being ethically sound, viable, safe, and cost-effective. The objective of this review was to determine the quality, effectiveness, and validity of these simulators as well as to assess their ability to evaluate microsurgical skills.

Modified Gritti-Stokes amputation: tips and tricks.

Major amputations of the lower extremity may be required after trauma and a variety of underlying diseases such as peripheral vascular disease, diabetes, and malignancies. The goal of any major amputation is an optimal functional result with a maximum limb length in combination with optimal wound healing. The preservation of the knee joint is essential for successful rehabilitation, and this is best achieved by the Burgess below-knee amputation (BKA).

The Promise and Pitfalls of AI-Generated Anatomical Images: Evaluating Midjourney for Aesthetic Surgery Applications.

Backgrounds: The rapid advancement of generative artificial intelligence (AI) systems, such as Midjourney, has paved the way for their use in medical training, producing computer-generated images. However, despite clear disclosures stating that these images are not intended for medical consultations, their accuracy and realism are yet to be thoroughly examined.

Methods: A series of requests were addressed to the Midjourney AI tool, a renowned generative artificial intelligence application, with a focus on depicting appropriate systemic anatomy and representing aesthetic surgery operations.

Role of the Gastrocnemius Musculocutaneous with a Propeller Style Skin Flap in Knee Region Reconstruction: Indications and Pitfalls.

 Soft tissue reconstruction around the knee area is still an open question, particularly in persistent infections and multiple reoperations scenario. Flap coverage should guarantee joint mobility and protection, even when foreign materials are implanted. The chimeric harvesting of the musculocutaneous gastrocnemius flap, based on the sural artery perforators, can extend its applicability in soft tissue reconstruction of the upper leg, overcoming the drawbacks of the alternative pedicled flaps.

Abdominal-Based Microsurgical Breast Reconstruction: How to Inset the Flap to Maximize the Aesthetic Result-A Systematic Review.

Nowadays, the ultimate goal of microsurgical breast reconstruction is not merely the effective transfer of vascularized tissue but the achievement of a natural, symmetric appearance. The aim of this present study was to systematically summarize the published evidence on abdominal-based free flap inset for breast reconstruction in order to provide principles and classification that could guide the surgeon in choosing the most appropriate inset technique based on patient and flap characteristics. A comprehensive review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, looking for articles on the insetting technique for free flap breast reconstruction.

Artistry and Aesthetics in Breast Reconstruction: Raising the Bar.

Breast reconstruction is a critical component of breast cancer treatment for many women who undergo mastectomy [...

Time to return to work after total trapeziometacarpal prosthesis.

Objectives: This study assessed return to work and prosthesis survival after trapeziometacarpal prosthesis surgery.

Material And Methods: A multicenter retrospective study was carried out on patients operated on between 2002 and 2020. All working patients who had undergone trapeziometacarpal prosthesis surgery were included.

Isolation and Culture of Human Adipose-Derived Stem Cells With an Innovative Xenogeneic-Free Method for Human Therapy.

Considering the increasing impact of stem cell therapy, biosafety concerns have been raised regarding potential contamination or infection transmission due to the introduction of animal-derived products during in vitro manipulation. The xenogeneic components, such as collagenase or fetal bovine serum, commonly used during the cell isolation and expansion steps could be associated with the potential risks of immune reactivity or viral, bacterial, and prion infection in the receiving patients. Following good manufacturing practice guidelines, chemical tissue dissociation should be avoided, while fetal bovine serum (FBS) can be substituted with xenogeneic-free supplements.

Quality of life and sexual health after perineal reconstruction in Fournier gangrene using pedicled anterolateral thigh flaps.

Objectives: To assess long-term sexual outcome and quality of life after perineal reconstruction by pedicled anterolateral thigh (ALT) flaps after Fournier's gangrene. Postoperative surgical outcomes were assessed; quality of life and sexual function were assessed at long term follow-up (>12 months) with 2 scientifically validated questionnaires.

Methods: We conducted a retrospective analysis of a prospectively maintained database.

Hand gangrene after repetitive IV midazolam injections.

In the IV drug user (IVDU) population injection may inadvertently be intra-arterial or in the subcutaneous tissue causing a various range of complication ranging from simple cellulitis to artero-venous embolization. We present here a case of a full hand mummification and necrosis following repeated injection of chopped midazolam at the elbow, forearm and hand. A 36 year-old man presented to the emergency department with a 24 months history of slowly progressive necrosis to his right.

Total Urethra and Penile Shaft Reconstruction with Combined Pedicled Anterolateral Thigh Flap and Radial Forearm Free Flap after Total Penectomy.

Total reconstruction of the penis (TPR) represents a challenge for urologists and plastic surgeons, especially when urethral length is severely reduced. We here describe, for the first time in an oncologic scenario, a double flap phalloplasty using a pedicled anterolateral thigh (ALT) flap for penile reconstruction and a radial forearm free flap (RFFF) for complete neourethra and glans reconstruction following penile amputation. A 48-year-old patient came to our department following a total penectomy with inferior urethral derivation.

Evaluation of long-term breast shape in inferior versus superomedial pedicle reduction mammoplasty: a comparative study.

Background: Among breast reduction mammoplasty, the inferior pedicle-based (IFP) technique is considered the most performed by plastic surgeons. A growing interest for the supero-medial based pedicle (SMP) mammoplasty technique has been documented in literature and clinical practice. However, no real evidence exists on the superiority of one technique over another.

The proximal ulnar perforator flap (PUPF) for hand digital reconstruction: an anatomical study.

Degloving injuries of the fingers represent a reconstructive challenge. Even if poorly described in literature, the proximal ulnar perforator flap (PUPF), based on perforator of the anterior ulnar recurrent artery or directly on a perforator branch of the ulnar artery, meets the requested criteria for the ideal coverage. We performed a cadaveric study in order to clarify the anatomical basis and vascularization of the PUPF flap.

The value of 18F-FDG-PET-CT in the management of infective native aortic aneurysms.

Objective: The objective of this systematic literature review was to explore the value of positron emission tomography combined with low-dose computed tomography (18F-FDG-PET-CT) in the diagnostics of infective native aortic aneurysm (INAA).

Methods: A systematic literature review was performed using the search terms mycotic- and infected aortic aneurysms in Medline and Sciencedirect databases, published between 1 January 2000 and 1 January 2020. Using the PRISMA statement, articles were scrutinized according to a predefined protocol including: timing of 18F-FDG-PET-CT examination, the maximum standardized uptake value (SUVmax), additional findings on examination, and findings on repeated scanning of 18F-FDG-PET-CT.

Anterolateral Thigh Flap With Vascularized Fascia Lata Associated With Thigh Flaps: A Case Report of an All-in-One Reconstruction of the Suspensory Ligament and Penoscrotal District After Fournier Gangrene.

Radical surgical debridement after Fournier gangrene (FG) can totally change anatomical balance between structures and compromise urogenital function. This is particularly true when the suspensory ligament and the lower abdominal wall are involved, leading to erection and sexual intercourse dysfunction.We present the case of a 48-year-old man, who underwent emergency debridement and split-thickness skin graft (STSG) of inferior abdominal wall, pubis, scrotal bag and penile shaft after Fournier gangrene.

Lymphatic Leaks of the Thigh and Inguinal Region: Combined Plastic Surgery Approaches for an Effective Treatment Algorithm.

Background: Surgical procedures interfering with the draining nodes in the inguinal region carry the intrinsic risk of lymphatic complications. Lesions of the inguinal lymphatic network can lead to lymphocele or lymphocutaneous fistulas and can eventually be associated to limb lymphedema with consequent high morbidity.

Objectives: This article describes a new surgical algorithm based on wound properties to properly address lymphatic complications of the inguinal area.