1,720,975 research outputs found
Decellularized Human Diaphragm Muscle as a Biologic Scaffold for Reconstructive Surgery
No full textTherapeutic options available in the clinical practice to restore severe loss of muscle mass after trauma or tumor excision offer limited functional and aesthetic results and they are limited by several drawbacks, such as donor site morbidities and increased risk of complication.
Thus, tissue engineering is focusing on the development of different strategies to induce and favor tissue regeneration limiting scar formation and fibrosis. Among those, the creation of 3-D scaffold has shown favorable results thanks to its tissue-specificity and ability to stimulate cell differentiation toward the tissue of origin.
In this project, we aimed to create a decellularized human-derived scaffold from diaphragm muscle. Four different detergent-enzymatic protocols were compared to identify the ideal treatment to remove immunogenic signals maintaining structural and functional properties to allow scaffold implantation and cell seeding. Together with DNase I and Trypsin, four different detergents (sodium dodecyl sulfate, SDS + TergitolTM, sodium deoxycholate and TergitolTM) were compared.
All protocols were able to remove nuclei, DNA and muscle fibers preserving collagen, elastin and glycosaminoglycans. In addition while HLA-DR was no more detectable, Collagen I and IV, Laminin (key components of the ECM) were expressed. Macroscopic evaluation and tensile strength confirmed the preservation of functionality and structure without differences among protocols.
Adipose-derived mesenchymal stem cells co-culture and seeding showed absence of cytotoxicity and ability of the graft to support cell proliferation after all decellularization.
Protocol n. 2 (SDS + TergitolTM) exhibited the higher preservation of collagen structure and fibers orientation. For this reason scaffolds treated with this protocol were implanted in mice for 14 days during the in vivo biocompatibility test, which demonstrated favorable integration with VEGF positivity and without signs of severe immunological response from the host.Therapeutic options available in the clinical practice to restore severe loss of muscle mass after trauma or tumor excision offer limited functional and aesthetic results and they are limited by several drawbacks, such as donor site morbidities and increased risk of complication.
Thus, tissue engineering is focusing on the development of different strategies to induce and favor tissue regeneration limiting scar formation and fibrosis. Among those, the creation of 3-D scaffold has shown favorable results thanks to its tissue-specificity and ability to stimulate cell differentiation toward the tissue of origin.
In this project, we aimed to create a decellularized human-derived scaffold from diaphragm muscle. Four different detergent-enzymatic protocols were compared to identify the ideal treatment to remove immunogenic signals maintaining structural and functional properties to allow scaffold implantation and cell seeding. Together with DNase I and Trypsin, four different detergents (sodium dodecyl sulfate, SDS + TergitolTM, sodium deoxycholate and TergitolTM) were compared.
All protocols were able to remove nuclei, DNA and muscle fibers preserving collagen, elastin and glycosaminoglycans. In addition while HLA-DR was no more detectable, Collagen I and IV, Laminin (key components of the ECM) were expressed. Macroscopic evaluation and tensile strength confirmed the preservation of functionality and structure without differences among protocols.
Adipose-derived mesenchymal stem cells co-culture and seeding showed absence of cytotoxicity and ability of the graft to support cell proliferation after all decellularization.
Protocol n. 2 (SDS + TergitolTM) exhibited the higher preservation of collagen structure and fibers orientation. For this reason scaffolds treated with this protocol were implanted in mice for 14 days during the in vivo biocompatibility test, which demonstrated favorable integration with VEGF positivity and without signs of severe immunological response from the host
Invited Response on: Comment on "The Role of Portable Incisional Negative Pressure Wound Therapy (piNPWT) in Reducing Local Complications of Post-bariatric Brachioplasty: A Case-Control Study"
No full text
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
MANAGEMENT OF COMPLEX PEDIATRIC BURN SCARS IN A HUMANITARIAN COLLABORATION La Prise en charge des cicatrices complexes suite aux Brûlures Pédiatriques dans une collaboration humanitaire
No full textLitigation Cases After Post-Bariatric Surgery: Lesson from the Past
Full text linkBackground Due to the high demand of post-bariatric surgeries, the number of litigation cases is rapidly growing. Even if surgical mistakes still represent one of the main causes of medico-legal issues, many disputes depend on what happens in the post-operative course. In this article we analyzed the litigation cases that occurred in our Plastic Surgery Department, the current literature about medico-legal disputes and the importance of the doctor-patient relationship. Patients and methods The medical records of 788 post-bariatric surgeries, the post-operative complications and the related litigation cases from January 2015 to December 2019 were collected, analyzed and compared. Results We performed 380 abdominoplasties, 28 torsoplasties, 65 breast reductions, 99 mastopexies, 94 brachioplasties, 52 thighplasties, 65 liposuctions and 5 facelifts between 2015 and 2019. Eight patients complained of medical issues and claimed for litigation. Despite in all cases the judges highlighted the risk of consent misinterpretation, the payout was granted only in one case. Conclusion Post-bariatric patients often mistake their preoperative condition and consider body contouring procedures as an aesthetic surgery treatment. Patients should be therefore clearly informed about the complexity of body contouring procedures after massive weight loss, which should never be compared to aesthetic surgery. Surgeons should always promote the communication with their patients and build a strong and trustworthy relationship. This attitude will allow to deal more easily with complications and, in the worst situations, with medico-legal litigations
Cutaneous syncytial myoepithelioma:: Clinico-pathological features and differential diagnosis
No full textBraxon(®)-assisted prepectoral breast reconstruction: A decade later
Full text linkWe are sitting on the cusp of the bioengineered breast era, in which implant-based breast reconstruction is seeing a growing trend and biotechnology research progressively empowers clinical practice. As never before, the choice of biomaterials has acquired great importance for achieving reconstructive outcomes, and the increase in the use of acellular dermal matrices (ADMs) in the field of senology tells us a story of profound upheaval and progress. With the advent of prepectoral breast reconstruction (PPBR), plenty of devices have been proposed to wrap the silicone prosthesis, either completely or partially. However, this has caused a great deal of confusion and dissent with regard to the adoption of feasible reconstructive strategies as well as the original scientific rationale underlying the prepectoral approach. Braxon(®) is the very first device that made prepectoral implant positioning possible, wrapping around the prosthesis and exerting the proven ADM regenerative potential at the implant–tissue interface, taking advantage of the body's physiological healing mechanisms. To date, the Braxon(®) method is among the most studied and practiced worldwide, and more than 50 publications confirm the superior performance of the device in the most varied clinical scenarios. However, a comprehensive record of the working of this pioneering device is still missing. Therefore, our aim with this review is to lay a structured knowledge of surgery with BRAXON(®) and to provide a decision-making tool in the field of PPBR through a complete understanding on the very first device for prepectoral, one decade after its introduction
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