Review Special Issue Series: Recent Advances in Plastic, Reconstructive and Aesthetic Surgery/Aesthetic Medicine

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Plastic, Reconstructive and Aesthetic Surgery/Aesthetic Medicine".

Deadline for manuscript submissions: 25 December 2024 | Viewed by 5155

Special Issue Editor

Special Issue Information

Dear Colleagues,

In recent decades, the field of plastic reconstructive and aesthetic surgery has undergone significant advancements, particularly in the areas of craniofacial surgery, bone biology, wound healing, flap physiology, tissue engineering and nerve repair. Microsurgery has also developed substantially due to a better understanding of flap physiology and perforator arteries anatomy, availability of a larger spectrum of free flaps, new technologies for flap surveillance, and novel biological/prosthetic materials to design the most challenging reconstructions possible. Additionally, the introduction of new imaging techniques such as the ultra-high-frequency ultrasound imaging has transformed  lymphatic surgery.

Novelties in breast reconstructive surgery, achieved through refinement in techniques, new materials (i.e., acellular dermal matrices and new prosthetic materials) and increased communications among breast surgeons, have also helped in ameliorating the effects of breast cancer. The recent developments observed in the domains of nanotechnology, tissue engineering, and regenerative medicine could also help to formulate novel treatments capable of replacing or restoring cell and organ functions. Moreover, the increasing popularity of aesthetic surgery has led to a growing interest in new injectables drugs (i.e., hyaluronic acid, calcium hydroxyapatite, poly L-lactic acid, collagen, botulinum neurotoxin, and polymethyl methacrylate), and adipose tissue is now recognized as a target for antiaging treatments, with new technologies being available for its collection, handling, and reimplantation. Furthermore, as surgical procedures such as the “foxy eye” surgeries, facelift, non-invasive procedures with no pain or complications, centrofacial rejuvenation surgeries, and gluteal augmentation are gaining traction, the search and development of a plethora of materials and techniques in this field are also increasing at a staggering rate.

However, despite several promising findings and growing interest, the prevalence, pathogenesis, and treatment of several diseases requiring reconstructive surgeries, particularly lymphoma,  are yet to be fully understood. It is important to note that social media has been playing a crucial role in the popularity of plastic surgery, and most often, the pressure exerted via social media compels aesthetic surgeons and doctors to find easier and rapid procedures, which are not always corroborated by sufficient evidence in terms of their safety and effectiveness. Thus, there is a dire need for accurate data collection and analysis for a wide range of reconstructive procedures.

Given this context, this Special Issue, titled ‘Recent Advancements in Plastic, Reconstructive and Aesthetic Surgery/Medicine’ invites scholars to submit their original research articles, systematic reviews, meta-analysis as well as overviews that address any of the aforementioned areas.

Dr. Roberto Cuomo
Guest Editor

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Published Papers (3 papers)

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Review

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16 pages, 839 KiB  
Review
Bioactive Dressing: A New Algorithm in Wound Healing
by Gianmarco Polverino, Francesca Russo and Francesco D’Andrea
J. Clin. Med. 2024, 13(9), 2488; https://doi.org/10.3390/jcm13092488 - 24 Apr 2024
Cited by 2 | Viewed by 2203
Abstract
Wound management presents a significant global challenge, necessitating a comprehensive understanding of wound care products and clinical expertise in selecting dressings. Bioactive dressings (BD) represent a diverse category of dressings, capable of influencing wound healing through various mechanisms. These dressings, including honey, hyaluronic [...] Read more.
Wound management presents a significant global challenge, necessitating a comprehensive understanding of wound care products and clinical expertise in selecting dressings. Bioactive dressings (BD) represent a diverse category of dressings, capable of influencing wound healing through various mechanisms. These dressings, including honey, hyaluronic acid, collagen, alginates, and polymers enriched with polyhexamethylene biguanide, chitin, and chitosan derivatives, create a conducive environment for healing, promoting moisture balance, pH regulation, oxygen permeability, and fluid management. Interactive dressings further enhance targeted action by serving as substrates for bioactive agents. The continuous evolution of BDs, with new products introduced annually, underscores the need for updated knowledge in wound care. To facilitate dressing selection, a practical algorithm considers wound exudate, infection probability, and bleeding, guiding clinicians through the process. This algorithm aims to optimize wound care by ensuring the appropriate selection of BDs tailored to individual patient needs, ultimately improving outcomes in wound management. Full article
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14 pages, 3425 KiB  
Systematic Review
Autologous Fat Grafting (AFG): A Systematic Review to Evaluate Oncological Safety in Breast Cancer Patients
by Federico Lo Torto, Luca Patanè, Donato Abbaticchio, Alessia Pagnotta and Diego Ribuffo
J. Clin. Med. 2024, 13(15), 4369; https://doi.org/10.3390/jcm13154369 - 26 Jul 2024
Viewed by 1100
Abstract
Background: Autologous fat grafting (AFG) has emerged as a useful technique in breast reconstruction. Utilizing a patient’s own fat from areas like the abdomen or thighs, AFG serves various reconstruction needs. Nevertheless, the oncological safety of AFG in breast cancer patients has become [...] Read more.
Background: Autologous fat grafting (AFG) has emerged as a useful technique in breast reconstruction. Utilizing a patient’s own fat from areas like the abdomen or thighs, AFG serves various reconstruction needs. Nevertheless, the oncological safety of AFG in breast cancer patients has become a contentious issue. Concerns about its influence on cancer recurrence and detention have led to significant clinical debate and the need for thorough investigation. Methods: To determine the impact of autologous fat grafting (AFG) on loco-regional recurrence (LRR) in breast cancer survivors undergoing reconstruction, a comprehensive search of databases including PubMed, Medline, Web of Science, and Cochrane libraries was conducted from November 2023 through March 2024. This search adhered to the PRISMA guidelines and aimed to identify all the relevant studies on AFG in the context of breast reconstruction post cancer treatment. A meta-analysis was performed. Results: Out of the studies reviewed, 40 met the inclusion criteria, with a total patient cohort of 14,078. The analysis revealed that AFG had no significant association with increased rates of LRR. Conclusions: According to the available literature, AFG is a safe reconstructive option for breast cancer patients and does not increase the risk of loco-regional recurrence. Nevertheless, further well-structured long-term prospective studies are required, since heterogeneity of available studies is high and requires standardization. Full article
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22 pages, 2076 KiB  
Systematic Review
Fournier’s Gangrene Surgical Reconstruction: A Systematic Review
by Pietro Susini, Gianluca Marcaccini, Jessica Efica, Maria Teresa Giuffrè, Ruggero Mazzotta, Corso Caneschi, Roberto Cuomo, Giuseppe Nisi and Luca Grimaldi
J. Clin. Med. 2024, 13(14), 4085; https://doi.org/10.3390/jcm13144085 - 12 Jul 2024
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Abstract
Fournier’s gangrene (FG) is a rare form of necrotizing fasciitis of the perineal, genital, or perianal region. It is characterized by an aggressive course and high mortality rate, over 20%. FG demands immediate treatment including resuscitation maneuvers, intravenous antibiotic therapy and early surgical [...] Read more.
Fournier’s gangrene (FG) is a rare form of necrotizing fasciitis of the perineal, genital, or perianal region. It is characterized by an aggressive course and high mortality rate, over 20%. FG demands immediate treatment including resuscitation maneuvers, intravenous antibiotic therapy and early surgical debridement. Background/Objectives: The gold-standard treatment for FG is surgical reconstruction. However, up to date, no precise guidelines exist. Thus, we decided to systematically review the literature, focusing on FG contemporary approaches to reconstructive surgery, aiming to analyze the various reconstructive strategies and their specific indications. Methods: A systematic review was carried out according to the PRISMA statement by searching various databases from April 2014 to April 2024, using the terms ‘‘Fournier Gangrene OR Fournier Gangrene Reconstruction OR Fournier Gangrene Treatment OR Fournier Gangrene Plastic Surgery OR Necrotizing Fasciitis OR Necrotizing Fasciitis AND Reconstruction”. The eligibility criteria included original studies aimed at discussing FG reconstruction with at least three clinical cases. Results: The final synthesis included 38 articles, and 576 reconstructions were described. Of these, 77.6% were minimally invasive strategies (direct closure, secondary healing, grafts, and local random flaps), while more invasive reconstructions (loco-regional flaps based on known vascular anatomy) were adopted in 22.4%. No free flaps were reported. Conclusions: FG requires immediate medical interventions including broad-spectrum antibiotic therapy, surgical debridement, adjuvant therapies, and reconstructive surgeries. Taking into account the anatomical characteristics of the inguinal-crural region, skin grafts and local random flaps could offer versatile and effective reconstructions for most FG cases, while the more invasive strategies should be reserved for very few cases. Future research is warranted to define an FG dedicated reconstruction protocol. Full article
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