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Silk-based nerve guidance conduits with macroscopic holes modulate the vascularization of regenerating rat sciatic nerve

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Neural Regeneration Research 2025年第6期20卷 1789-1800页

作者： Carina Hromada Patrick Heimel Markus Kerbl LászlóGál Sylvia Nürnberger Barbara Schaedl James Ferguson Nicole Swiadek Xavier Monforte Johannes C.Heinzel Antal Nógrádi Andreas H.Teuschl-Woller David Hercher Department Life Science Engineering University of Applied Sciences Technikum WienViennaAustria Austrian Cluster for Tissue Regeneration ViennaAustria Ludwig Boltzmann Institute for Traumatology The Research Center in Cooperation with AUVAViennaAustria University Clinic of Dentistry Medical University of ViennaViennaAustria Department of plastic Reconstructive and Aesthetic SurgeryLandesklinikum Wiener Neustadt2700 Wiener NeustadtAustria Department of Anatomy Histology and EmbryologyAlbert Szent-Györgyi Medical SchoolUniversity of SzegedSzegedHungary Medical University of Vienna Department of Orthopedics and Trauma SurgeryDevision of Trauma SurgeryViennaAustria Department of Hand- PlasticReconstructive and Burn SurgeryBG Unfallklinik TuebingenUniversity of TuebingenTuebingenGermany

Peripheral nerve injuries induce a severe motor and sensory deficit. Since the availability of autologous nerve transplants for nerve repair is very limited, alternative treatment strategies are sought, including the use of tubular nerve guidance conduits(tNGCs). However, the use of tNGCs results in poor functional recovery and central necrosis of the regenerating tissue, which limits their application to short nerve lesion defects(typically shorter than 3 cm). Given the importance of vascularization in nerve regeneration, we hypothesized that enabling the growth of blood vessels from the surrounding tissue into the regenerating nerve within the tNGC would help eliminate necrotic processes and lead to improved regeneration. In this study, we reported the application of macroscopic holes into the tubular walls of silk-based tNGCs and compared the various features of these improved silk^(+) tNGCs with the tubes without holes(silk^(–) tNGCs) and autologous nerve transplants in an 8-mm sciatic nerve defect in rats. Using a combination of micro-computed tomography and histological analyses, we were able to prove that the use of silk^(+) tNGCs induced the growth of blood vessels from the adjacent tissue to the intraluminal neovascular formation. A significantly higher number of blood vessels in the silk^(+) group was found compared with autologous nerve transplants and silk^(–), accompanied by improved axon regeneration at the distal coaptation point compared with the silk^(–) tNGCs at 7 weeks postoperatively. In the 15-mm(critical size) sciatic nerve defect model, we again observed a distinct ingrowth of blood vessels through the tubular walls of silk^(+) tNGCs, but without improved functional recovery at 12 weeks postoperatively. Our data proves that macroporous tNGCs increase the vascular supply of regenerating nerves and facilitate improved axonal regeneration in a short-defect model but not in a critical-size defect model. This study suggests that further optimizatio

关键词： axon regeneration blood vessel functional recovery macroporous nerve lesion peripheral nerve repair sciatic nerve silk-based nerve guidance conduit vascularization

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9-Year Clinical Audit on Complications of Cleft Lip and Palate Charity Surgeries in China Shenzhen Area

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International Journal of Otolaryngology and Head & Neck surgery 2025年第1期14卷 19-28页

作者： Yangliu Liao Takkun Chow Sikkuen Chow Wenbo Huang Deheng Chen Huizhi Zeng Division of plastic and reconstructive surgery Department of Surgery The University of Hong Kong-Shenzhen Hospital Shenzhen China Department of surgery The University of Hong Kong Hong Kong China

Background: In developing countries, charity cleft surgical mission is always operated by sporadic surgical teams without systematic follow up and quality assurance. In the past few decades, many mission projects have been held regularly in China. The purpose of this audit was a retrospective analysis of a 9-year cleft lip and palate charity project operated in a tertiary hospital in China Shenzhen Area to evaluate perioperative and postoperative complications. Nevertheless, understanding the risk profile is essential for establishing a sustainable in-house cleft service in Shenzhen. Methods: A detailed analysis of hospital centralized record in the The University of Hong Kong-Shenzhen Hospital (HKUSZH) was reviewed since the first charity project held in 2015. The parameters of this audit were focused on perioperative complications including anesthesia related problems, early postoperative complications in patients who underwent primary or secondary cleft surgeries. A total of 430 consecutive admitted cases of 311 non-syndromic cleft lip & palate patients were enrolled into the charity project from June 2015 to July 2024. The main anesthesia related complications that occurred during general anesthesia were respiratory tract problems, while intraoperative complication was excessive bleeding, so as wound local infection and reaction were the main early postoperative complications. Results: In our 9-year clinical audit of 430 cleft lip and palate charity surgeries in Shenzhen, we observed no mortalities and a anesthesia-related complication rate of 1.16%. Specific intraoperative complications included excessive bleeding, while early postoperative issues were dominated by wound infections. The fistula rate of 18.7% post palate repair and the average hospital stay of 3.71 days complete the profile of our surgical outcomes. These data underscore the project’s efficacy and offer a reference for international cleft missions aiming for safe and efficient surgical care. Con

关键词： Cleft Lip Cleft Palate Charity surgery Complication

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Enhancing outcomes in severe lymphedema through combined treatment strategies

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World Journal of Clinical Cases 2025年第12期13卷 70-73页

作者： Aidan Shulkin Johnny I Efanov plastic and reconstructive surgery Department of SurgeryCentre hospitalier de l’Universitéde MontréalMontreal H2X3E4QuebecCanada

Lymphedema,particularly in its advanced stages,presents significant challenges in treatment,often necessitating a combination of therapies to manage symptoms effectively and improve patient *** article reviews the findings of Wang et al,regarding the use of lymphovenous anastomosis and complex decongestive therapy in treating severe,deformed stage III lymphedema with recurrent *** case report details the promising results achieved through this combined therapy,highlighting substantial reductions in limb volume and the complete resolution of recurrent *** patient experienced notable improvements in weight loss,physical function,and quality of *** its strengths,the study has several *** lacks specific details on the types of lymphovenous anastomoses performed and complex decongestive therapy protocols,such as frequency and adherence,making reproducibility *** short follow-up period of six months limits understanding of long-term efficacy,and more consistent reporting of key metrics such as weight loss and body mass index would enhance outcome *** article emphasizes the importance of integrating minimally invasive surgical techniques with conservative therapies to address both the symptoms and underlying causes of *** research is essential to standardize protocols and refine combined treatment strategies.

关键词： Lymphedema Lymphangitis Lymphovenous anastomosis Complex decongestive therapy Quality of life Mobility

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Recurrent corneal erosion after buried-suture doubleeyelid blepharoplasty using barbed thread

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International Journal of Ophthalmology(English edition) 2025年第1期18卷 178-180页

作者： Tian-Ze Huang Jiu-Zuo Huang Di Chen Department of Ophthalmology Peking Union Medical College HospitalPeking Union Medical College&Chinese Academy of Medical SciencesBeijing 100730China Department of plastic and reconstructive surgery Peking Union Medical College HospitalPeking Union Medical College&Chinese Academy of Medical SciencesBeijing 100730China

Dear Editor,Recurrent corneal erosion(RCE)is a common clinical condition characterized by repeated episodes of eye redness,pain,foreign-body sensation,photophobia,and tearing[1].The causes of RCE include trauma,chemical and thermal injuries,previous herpetic keratitis,epithelial basement membrane dystrophy,and systemic conditions like epidermolysis bullosa[2-3].

关键词： injuries sensation corneal

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Nasal Tip-Columella Subunits Infrastructural Reconstruction: 10th Rib Cartilage Graft Operative Technique

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International Journal of Otolaryngology and Head & Neck surgery 2025年第1期14卷 47-56页

作者： Wenbo Huang Takkun Chow Sikkuen Chow Yangliu Liao Division of plastic and reconstructive surgery Department of Surgery The University of Hong Kong-Shenzhen Hospital Shenzhen China Department of surgery The University of Hong Kong Hong Kong China Hong Kong Holistic Cleft Lip & Palate Center Hong Kong China

Background: Reconstruction of Nasal Tip Columella (NTC) subunits is one of the most challenging aspects in functional aesthetic rhinoplasty. Moreover, racial variation for Asian nose rhinoplasty could even demand sophistication of tip and columella strut graft infrastructure enhancement. Various autogenous graft options such as 6th costal cartilage, septal cartilage and conchal cartilage are very commonly considered whilst the 10th costal cartilage is scarcely reported. Objective and Method: The purpose of this manuscript is to illustrate the detailed operative steps to harvest the 10th costal cartilage for infrastructural grafting at NTC subunits by a case illustration. The pros and cons of different cartilage options will be discussed, particularly its application in cleft nose rhinoplasty in Chinese patient. We have adopted the 10th rib as the key option for NTC reconstruction in 11 cases of Chinese cleft secondary rhinoplasty since 2019 and have achieved good and stable results without complications. Conclusion: The 10th costal cartilage is one of the best options in Nasal Tip Columella subunits reconstruction, particularly in complex cleft nose or failure revision aesthetic rhinoplasty cases, due to its safety of harvesting, and the sufficient quality and quantity of grafting materials it provides for simultaneous adjunctive augmentation purpose.

关键词： Nasal Tip Columella Rhinoplasty 10th Rib Cartilage Cleft Chinese

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Revitalizing upper blepharoplasty:Preserving volume

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World Journal of Clinical Cases 2025年第15期13卷 66-68页

作者： Rana Farsakoury Abdulqadir J Nashwan Department of plastic and reconstructive surgery Hamad Medical CorporationDoha 3050Qatar Department of Nursing and Midwifery Research Hamad Medical CorporationDoha 3050Qatar

Blepharoplasty is a frequently performed aesthetic surgery today aimed at enhancing eyelid appearance and correcting age-related *** traditional method of subtraction blepharoplasty,which involved removing fat and excess skin,is now considered *** letter explores Gorgy et al's commentary on Miotti et al's study,highlighting a shift in upper eyelid blepharoplasty towards a more conservative,volume-preserving *** study systematically reviewed 10 publications,including three retrospective studies,five comparative studies,and two clinical *** emphasizes the trend towards preserving the patient's natural anatomy and focusing on enhancement rather than ***,the study's limitations,such as the lack of long-term comparative re-search,a relatively small sample size,and a single-center design,indicate that further research with extended follow-up is necessary to validate the safety and effectiveness of these *** focus is increasingly on preserving and augmenting volume in upper blepharoplasty rather than removing tissue.

关键词： Upper lid blepharoplasty Volume preservation Fat pad Aesthetic longevity Blepharoplasty

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Expression rates of p16,p53 in head and neck cutaneous squamous cell carcinoma based on human-papillomavirus positivity

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World Journal of Clinical Cases 2025年第9期13卷 13-23页

作者： Ha-Jong Nam Heongrae Ryu Da-Woon Lee Je Yeon Byeon Jun Hyuk Kim Ji Hye Lee Soomin Lim Hwan Jun Choi Department of plastic and reconstructive surgery Soonchunhyang University Gumi HospitalGumi-si 39371South Korea Department of plastic and reconstructive surgery College of MedicineSoonchunhyang UniversityCheonan-si 31151South Korea Department of Pathology Soonchunhyang University HospitalCheonan-si 31151South Korea Bachelor of Medicine and Bachelor of surgery University College LondonMedical SchoolLondon WC1E 6DEUnited Kingdom

BACKGROUND The high prevalence of human papillomavirus(HPV)infection in oropharyngeal squamous cell carcinoma(SCC)is well established,and p16 expression is a strong ***-related tumors exhibit unique mechanisms that target p16 and p53 ***,research on HPV prevalence and the combined predictive value of p16 and p53 expression in head and neck cutaneous SCC(HNCSCC),particularly in Asian populations,remains *** retrospective study surveyed 62 patients with HNSCC(2011-2020),excluding those with facial warts or other skin *** To explore the prevalence of HPV and the predictive value of p16 and p53 expression in HNCSCC in Asian *** All patients underwent wide excision and *** staining for HPV,p16,and p53 yielded positive and negative *** relevance of each marker was investigated by categorizing the tumor locations into high-risk and middle-risk zones based on recurrence *** Of the 62 patients,20(32.26%)were male,with an average age of 82.27 years(range 26-103 years).High-risk included 19 cases(30.65%),with the eyelid and lip being the most common sites(five cases,8.06%).Middle-risk included 43 cases(69.35%),with the cheek being the most common(29 cases,46.77%).The p16 expression was detected in 24 patients(38.71%),p53 expression in 42 patients(72.58%),and HPV in five patients(8.06%).No significant association was found between p16 expression and the presence of HPV(P>0.99),with a positive predictive value of 8.33%.CONCLUSION This study revealed that p16,a surrogate HPV marker in oropharyngeal SCC,is not reliable in HNCSCC,providing valuable insights for further research in Asian populations.

关键词： Squamous cell carcinoma Oropharyngeal Non-oropharyngeal Human papillomavirus The p16 The p53

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A functional tacrolimus-releasing nerve wrap for enhancing nerve regeneration following surgical nerve repair

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Neural Regeneration Research 2025年第1期20卷 291-304页

作者： Simeon C.Daeschler Katelyn J.W.So Konstantin Feinberg Marina Manoraj Jenny Cheung Jennifer Zhang Kaveh Mirmoeini JPaul Santerre Tessa Gordon Gregory HBorschel SickKids Research Institute Neuroscience and Mental Health ProgramTorontoONCanada Institute of Biomaterials and Biomedical Engineering University of TorontoTorontoONCanada Indiana University School of Medicine IndianapolisINUSA Division of plastic and reconstructive surgery the Hospital for Sick ChildrenTorontoONCanada Translational Biology and Engineering Program Ted Rogers Centre for Heart ResearchInstitute of Biomedical EngineeringFaculty of DentistryUniversity of TorontoTorontoONCanada

Axonal regeneration following surgical nerve repair is slow and often incomplete,resulting in poor functional recovery which sometimes contributes to lifelong ***,there are no FDA-approved therapies available to promote nerve *** accelerates axonal regeneration,but systemic side effects presently outweigh its potential benefits for peripheral nerve *** authors describe herein a biodegradable polyurethane-based drug delivery system for the sustained local release of tacrolimus at the nerve repair site,with suitable properties for scalable production and clinical application,aiming to promote nerve regeneration and functional recovery with minimal systemic drug *** is encapsulated into co-axially electrospun polycarbonate-urethane nanofibers to generate an implantable nerve wrap that releases therapeutic doses of bioactive tacrolimus over 31 *** and drug loading are adjustable for applications in small and large caliber nerves,and the wrap degrades within 120 days into biocompatible *** released from the nerve wrap promotes axon elongation in vitro and accelerates nerve regeneration and functional recovery in preclinical nerve repair models while off-target systemic drug exposure is reduced by 80%compared with systemic *** its surgical suitability and preclinical efficacy and safety,this system may provide a readily translatable approach to support axonal regeneration and recovery in patients undergoing nerve surgery.

关键词： biodegradable local drug delivery nerve injury nerve regeneration nerve wrap tacrolimus

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Contemporary approach to soft-tissue reconstruction of the lower extremity after trauma

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Burns & Trauma 2021年第1期9卷 351-363页

作者： Matthew R.Zeiderman Lee L.Q.Pu Division of plastic&reconstructive surgery Department of SurgeryUniversity of CaliforniaDavisSacramentoCAUSA

The complex lower extremity wound is frequently encountered by orthopedic and plastic *** in wound care,soft tissue coverage and surgical fixation techniques allow for improved functional outcomes in this patient population with highly morbid *** this review,the principles of reconstruction of complex lower extremity traumatic wounds are *** principles include appropriate initial evaluation of the patient and mangled extremity,as well as appropriate patient selection for limb *** authors emphasize proper planning for reconstruction,timing of reconstruction and the importance of an understanding of the most appropriate reconstructive *** role of different reconstructive and wound care modalities is discussed,notably negative pressure wound therapy and dermal *** role of pedicled flaps and microvascular free-tissue transfer are discussed,as are innovations in understanding of perforator anatomy and perforator flap surgery that have broadened the reconstruction surgeon’s ***,the importance of a multidisciplinary team is highlighted via the principle of the orthoplastic approach to management of complex lower extremity *** completion of this review,the reader should have a thorough understanding of the principles of contemporary lower extremity reconstruction.

关键词： Lower extremity Soft tissue Reconstruction Trauma Surgical approach

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Spatial transcriptomic analysis deciphers adipocyte-to-fibroblast transformation in bleomycin-induced murine skin fibrosis

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Chinese Medical Journal 2024年第22期137卷 2745-2757页

作者： Yixiang Zhang Jiahao He Fangzhou Xie Shengzhou Shan Jiaqi Qin Chuandong Wang Qingfeng Li Yun Xie Bin Fang Department of plastic&reconstructive surgery Shanghai Ninth People’s HospitalShanghai Jiao Tong University School of MedicineShanghai 200011China Shanghai Institute for plastic and reconstructive surgery ShanghaiChina.Department of Plastic&Reconstructive SurgeryShanghai Ninth People’s HospitalShanghai Jiao Tong University School of MedicineShanghai 200011China Department of Orthopedic surgery Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine(SJTUSM)Shanghai 200092China

Background:Scleroderma is characterized by inflammation and fibrosis,predominantly occurring in the skin and extending to various parts of the *** pathophysiology of scleroderma is multifaceted,with the current understanding including endothelial damage,inflammatory cell infiltration,and fibroblast activation in its ***,the mechanism of cellular interactions and the precise spatial distribution of these cellular events within the fibrotic tissues remain elusive,highlighting a critical gap in our comprehensive understanding of scleroderma’s ***:In this study,we administered bleomycin intradermally to the dorsal skin of four individual murine ***,skin tissues were harvested at predetermined intervals for comprehensive spatial transcriptomic analysis to determine the spatial dynamics influencing scleroderma *** validate the possible results from bioinformatic analysis,further in vitro and in vivo experiments were ***:Analysis of the spatial transcriptome revealed significant alterations in cell clusters during the progression of *** Ontology analysis identified disruptions in lipid metabolism as the disease *** analysis provided evidence for a phenotypic transition from adipocytes to *** vitro studies demonstrated increased expression of Col1a1 andα-SMA as the disease *** fibroblasts have been identified as key contributors to the increasing ***-culturing TGF-βinduced adipocytes with RAW264.7 cells resulted in overexpression of pro-inflammatory cytokines in the RAW264.7 *** in vitro and in vivo experiments confirmed adipocyte loss and fibroblast formation,with transformed fibroblasts showing pronounced pro-inflammatory characteristics,highlighting their crucial role in the disease ***:Our study showed the spatial distribution and dynamic alterations of various cell types during scleroderma progress

关键词： Spatial transcriptome Scleroderma Adipocytes Fibroblasts

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