The use of body mass index(BMI)to determine eligibility for gender-affirming surgery in transgender and nonbinary individuals has been contested.While BMI thresholds are often meant to be protective,restricting patien...The use of body mass index(BMI)to determine eligibility for gender-affirming surgery in transgender and nonbinary individuals has been contested.While BMI thresholds are often meant to be protective,restricting patients from access to surgery can also cause harm.There is a rationale for the continued use of BMI,but the inherent problems with it must also be recognized,including how weight stigma impacts patients’access to gender-affirming surgery and influences clinical care.This article uses a narrative review of current literature to discuss how high BMI affects surgical outcomes in gender-affirming genital surgeries,as well as analogous procedures,existing de facto BMI thresholds,and how to both minimize the harms of proceeding with surgery in patients with a high BMI or the harms of delaying for weight loss.BMI factors into surgical decision-making based on the existing literature,which demonstrates that high BMI is associated with increased surgical risk,including higher incidences of surgical site infections and poor wound healing,as well as the possibility of free flap complications,which are a component of certain genital procedures.This patient population is at higher risk for eating disorders,and it is prudent to find alternatives to requiring patient self-monitored weight management.The impacts of weight stigma should be considered when treating gender-affirming surgery patients,and further data and research are needed to augment shared decision-making and lead to practice change.展开更多
A considerable part of revision rhinoplasty in Asians is associated with problems arising from the use of alloplastic implants. Revising alloplast associated problems of the nose mostly requires the use pf autogenous ...A considerable part of revision rhinoplasty in Asians is associated with problems arising from the use of alloplastic implants. Revising alloplast associated problems of the nose mostly requires the use pf autogenous grafting material to minimize complications and maximize favorable outcomes. Although remnant septal cartilage and/or conchal cartilage can be used, as the deformity becomes more severe, adequate revision requires more volume and strength of grafting materials. Autogenous rib cartilage may be the most practical choice in these circumstances. In this review, common causes of revision rhinoplasty in Asians are discussed together with operative techniques with emphasis on the use of autologous rib cartilage.展开更多
Aim: To evaluate available evidence for the effective management of venous leg ulcers with fibrin matrix with or without growth factors. Methods: A systematic review of the literature was performed to evaluate the use...Aim: To evaluate available evidence for the effective management of venous leg ulcers with fibrin matrix with or without growth factors. Methods: A systematic review of the literature was performed to evaluate the use of fibrin matrices with or without growth factors for the management of chronic venous ulcers in lower limbs. Article searches were performed in MEDLINE, EMBASE, COCHRANE, LILACS and ongoing clinical trials at ClinicalTrial.gov. Results: The search in MEDLINE and EMBASE identified three articles;one was a pilot study evaluating the use of fibrin matrix and autologous growth factors that included patients with chronic ulcers of different etiology. The second article was a description of the product used in the previous study, and the third consisted of a series case reports of patient treated with cultured keratinocytes in a fibrin matrix. A COCHRANE searched resulted in one study assessing the cost effectiveness of using different fibrin matrices. The search in ClinicalTrial.gov and LILACS did not result in any findings. Conclusion: The study did not provide a conclusive evidence for the use of fibrin matrices in patients with venous leg ulcers.展开更多
Aim:Most brachial plexus palsies occur following high-velocity trauma.The shoulder joint is a large proximal joint which influences the motion of the hand.Transfer of the trapezius muscle is an effective alternative f...Aim:Most brachial plexus palsies occur following high-velocity trauma.The shoulder joint is a large proximal joint which influences the motion of the hand.Transfer of the trapezius muscle is an effective alternative for palsy of the deltoid and supraspinatus muscles.Methods:Between 2009 and 2014,32 patients were treated with modified trapezius muscle transfer in which only the descending fibers along with their attachment to the lateral third of clavicle were used.The clavicle was fixed to the anterolateral surface of the humerus by cancellous screws.The arm was immobilized for 6 weeks.Results:All the 32 patients had improved function with stability of the shoulder.The average increase in active abduction was from 7.5°(range:0°-30°)to 85°(range:45°-140°),and the mean forward flexion increased from 5.63°(range:0°-15°)to 55.2°(range:40°-90°)after a mean follow-up of 8.25 months.Twenty-four of the 32 patients rated the result as good to excellent and were satisfied with the improvement in stability and function.Fifty nine point thirty eight percent patients had Medical Research Council Muscle power 4 after the surgery.Conclusion:Transfer of the upper trapezius muscle with a segment of the clavicle segment for a flail shoulder can provide satisfactory function and stability with fewer complications.展开更多
Limb loss is disabling and carries significant functional and psychological repercussions to both the individual and society.The numbers of amputees are forecasted to double by 2050 from vascular disease and diabetes ...Limb loss is disabling and carries significant functional and psychological repercussions to both the individual and society.The numbers of amputees are forecasted to double by 2050 from vascular disease and diabetes alone.Europe has 4.66 million amputees(431,000 amputations per year)and the United States 2 million amputees(185,000 amputations per year).Microvascular expertise is now more commonplace,increasing the likelihood of limb salvage and replantation.Further reconstructive input can take advantage of nerve and tendon grafting/transfers,free tissue transfer,and complex bone reconstruction.When this strategy does not satisfy individual needs,such as that seen with unstable soft tissues,amputation may be requested or offered.In part,the decision for salvage,replantation,or amputation in the future is likely to be guided by the sophistication of limb substitutes.This review will introduce the growing domain of bionics and where research in this area may deliver a sought clinical need.展开更多
1.Submission Overview Before you decide to publish with us,please read the following items carefully and make sure that you are well aware of Editorial Policies and the following requirements.1.1 Topic Suitability The...1.Submission Overview Before you decide to publish with us,please read the following items carefully and make sure that you are well aware of Editorial Policies and the following requirements.1.1 Topic Suitability The topic of the manuscript must fit the scope of the journal.Please refer to Aims and Scope for more information.1.2 Open Access and Copyright The journal adopts Gold Open Access publishing model since its establishment and has been distributing contents under Attribution 4.0 International License since October 2017,whereas Attribution NonCommercial ShareAlike 3.0 Unported had been adopted by then.Please make sure that you are well aware of these policies.展开更多
AIM: There are limited reports in the United States demonstrating outcomes of primarily thinned fasciocutaneous flaps in the setting of critical limb ischemia, Charcot collapse and osteomyelitis. We hope to determine ...AIM: There are limited reports in the United States demonstrating outcomes of primarily thinned fasciocutaneous flaps in the setting of critical limb ischemia, Charcot collapse and osteomyelitis. We hope to determine patient and flap related outcomes in advanced lower extremity disease. Methods: The authors conducted a retrospective review of fasciocutaneous free flaps of variable thickness for lower extremity salvage. Osteomyelitis and non-osteomyelitis patients were compared according to our primary outcome measures: functional ambulation, bone healing and complications to flap and patient. Subgroups with critical limb ischemia, Charcot collapse and diabetic foot were analyzed separately. Results: Fifty-nine patients underwent free flap reconstruction: osteomyelitis (n = 20, 34%), Charcot collapse (n = 22, 37%), and/or critical limb ischemia (n = 12, 20%). All patients underwent anterolateral thigh flaps tailored for defect-specific thicknesses: 17 superthin, 25 suprafascial, 17 subfascial. There were no significant differences between groups in terms of partial and complete flap loss (P = 1.000 and P = 0.108). Ninety-one percent of patients were ambulatory at follow up. Eighty-tive percent of individuals with osteomyelitis cleared their infection demonstrating radiographic bone healing. Two patients developed recalcitrant deep space infections ultimately requiring amputation. Subgroup analysis did not show any differences in flap related complications within the diabetic Charcot population. In multivariate regression, preoperative revascularization was independently associated with failure of limb salvage. ;Conclusion: Primarily thinned perforator flaps performed well in the setting of lower extremity limb salvage, critical limbischemia, osteomyelitis, and the Charcot foot - expanding their role in the armamentarium for lower extremity care.展开更多
The word count excludes the abstract,figures,tables,and references.General formats of manuscripts 1.Title Provide a concise and specific title(no more than 12 notional words)that clearly reflects the manuscript’s con...The word count excludes the abstract,figures,tables,and references.General formats of manuscripts 1.Title Provide a concise and specific title(no more than 12 notional words)that clearly reflects the manuscript’s content.And a running title(3-6 words)should also be provided.2.Authors and affiliations?Include all authors’full names.Once accepted,authors cannot be added or deleted,and the order cannot be changed without the written consent of all authors.?Provide full affiliation information(complete name of the department,institution,city,postcode,province/state,and country)for all authors.?Indicate a single corresponding author.The name,title,institution,address,telephone number,and e-mail of the corresponding author should be given,to ensure prompt communication.展开更多
Metoidioplasty consists of lengthening and straightening the hormonally hypertrophied clitoris.The goals of the procedure include masculinizing the external genitalia and enabling standing micturition.Metoidioplasty m...Metoidioplasty consists of lengthening and straightening the hormonally hypertrophied clitoris.The goals of the procedure include masculinizing the external genitalia and enabling standing micturition.Metoidioplasty may be performed as a stand-alone procedure or an interval procedure prior to phalloplasty.While most often performed with urethral lengthening,metoidioplasty may also be performed as a“simple release”(i.e.,without urethral lengthening).Secondary procedures typically include scrotoplasty and placement of testicular implants.While satisfaction with this procedure is high,complications can occur.Complications are commonly categorized as either urologic(i.e.,strictures and fistula)or wound healing(i.e.,wound disruption,infection,bleeding,etc.).This narrative review discusses postoperative outcomes,including both satisfaction and complications.Published data on complications include fistula and stricture rates from 0%-50% and 0%-63%,respectively.Overall satisfaction with appearance ranges from 48%-100%,and patient ability to void while standing ranges from 67%-100%.Metoidioplasty is a safe and effective procedure for transgender men.Further research regarding surgical techniques and outcomes will help reduce complications and improve overall patient satisfaction.展开更多
It is a great honor for me to be part of this scientific project and now reality after several years of very hard and encouraging work, which is the Plastic and Aesthetic Research, an innovative journal focusing on pl...It is a great honor for me to be part of this scientific project and now reality after several years of very hard and encouraging work, which is the Plastic and Aesthetic Research, an innovative journal focusing on plastic and aesthetic surgery, such as plastic and aesthetic materials, plastic surgery, oral and maxillofacial surgery, head and neck surgery, microsurgery, laser treatment, orthopedic surgery, ophthalmoplasty, dentistry, psychology, social ethics, other medical disciplines associated with the postoperative complications of plastic surgery. After over 248 published articles from 2014, the journal is gaining more and more dissemination among scientific forums and medical databases, so that the ultimate advances in plastic and aesthetic surgery are more prone to be at the disposal of clinicians and researchers, in a fast publication process from the development of knowledge, and in a high scientific reputable peer review system which ensures the reliability of the published material.展开更多
Cherubism is a rare disease characterized by significant loss of medullary bone which is replaced by excessive amounts of fibrous tissue growth within the mandible and maxilla. We present a case of a 4-year-old boy wi...Cherubism is a rare disease characterized by significant loss of medullary bone which is replaced by excessive amounts of fibrous tissue growth within the mandible and maxilla. We present a case of a 4-year-old boy with a rapidly enlarging mandible and maxilla, causing significant change in the facial contour, malocclusion and phonation difficulties. He was treated with aggressive tumor curettage, lateral mandibular cortex osteotomies with medial repositioning. This allowed obliteration of the enlarged medullary space and restoration of the normal mandibular anatomy. At 12 months postoperatively, the patient had significant improvement in facial contour, normal outward appearance, and stable dentition.展开更多
The media has a large influence on what constitutes modern day beauty, as it suggests to susceptible young girls and boys what makes someone beautiful. The term 'beautiful' is portrayed as curvy, thin, tall, w...The media has a large influence on what constitutes modern day beauty, as it suggests to susceptible young girls and boys what makes someone beautiful. The term 'beautiful' is portrayed as curvy, thin, tall, with voluptuous hair, big eyes, large breasts, round buttocks, and full lips. Very few people in society naturally appear like this, and thus many people undergo cosmetic surgery for this desired look. This article will examine the difference of opinions regarding the exact age to consider aesthetic plastic surgery. Adolescence is frequently bullied about any defect. The authors discuss some of these opinions and present three very unusual cases where early surgery has been beneficial.展开更多
Aim:The causative role of human papillomavirus(HPV)has been established into the aetiology of oral squamous cell carcinoma(OSCC).Some authors believe that HPV can determinate the prognosis and module treatment respons...Aim:The causative role of human papillomavirus(HPV)has been established into the aetiology of oral squamous cell carcinoma(OSCC).Some authors believe that HPV can determinate the prognosis and module treatment response from this kind of malignancies.Methods:Articles published in the last 10 years,focusing on the role of HPV in the development,molecular biology,prognosis and treatment of OSCC were reviewed.Results:Thirty-nine articles from 252 were selected,highlighting 4 meta-analysis,3 prospective and 2 retrospective studies.According to its role in the development of cervical cancer,HPV is classified into a high risk for malignant lesions subtype and a low-grade malignant lesions subtype.Epidemiology and prevalence of HPV varies according to the published data:large studies tend to have lower rates of HPV(<50%)than smaller ones(0-100%).Interestingly,HPV+patients are usually diagnosed at a younger age,mainly those with oropharyngeal tumours.There is a predilection for the oropharynx and Waldeyer ring tumours.Regarding prognosis,OSCC HPV+patients tend to have better outcome and treatment response.Conclusion:HPV divides OSCC in two types of tumours with different prognostic and therapeutic implications,with increased survival,better treatment response rates and lower risk of death and recurrences.展开更多
Aim:Surgical treatment of clinically negative neck in maxillary squamous cell carcinoma(SCC)of the upper jaw is controversial.The purpose of this systematic review was to define the incidence of cervical metastasis an...Aim:Surgical treatment of clinically negative neck in maxillary squamous cell carcinoma(SCC)of the upper jaw is controversial.The purpose of this systematic review was to define the incidence of cervical metastasis and to assess if elective neck dissection is justified when the neck is not primarily affected.Methods:An electronic literature search was conducted in several databases,including MEDLINE,EMBASE,and Cochrane Central databases,for articles written in English.Results:Twenty-eight articles were included in the review.The overall cervical metastases rate was 33%and the total initial cervical metastases rate was 16%.Interestingly,the author found that 71%of patients with cervical metastases from maxillary SCC carcinoma were T3/T4 stage.Conclusion:This review shows the need for a change in the management of the N0 neck in SCC arising in the maxillary alveolus and hard palate.Elective neck dissection should be performed in patients with T3/T4 tumours with clinic or radiographic negative necks(N0c).展开更多
Currently, the gold standard for aesthetic and functional reconstruction of critical mandibular defects is an autologous fibular flap;however, this carries risk of donor site morbidity, and is not a promising option i...Currently, the gold standard for aesthetic and functional reconstruction of critical mandibular defects is an autologous fibular flap;however, this carries risk of donor site morbidity, and is not a promising option in patients with depleted donor sites due to previous surgeries. Tissue engineering presents a potential solution in the design of a biomimetic scaffold that must be osteoconductive, osteoinductive, and support osseointegration. These osteogenesis-inducing scaffolds are most successful when they mimic and interact with the surrounding native macro- and micro-environment of the mandible. This is accomplished via the regeneration triad: (1) a biomimetic, bioactive osteointegrative scaffold, most likely a resorbable composite of collagen or a synthetic polymer with collagen-like properties combined with beta-tri calcium phosphate that is 3D printed according to defect morphology;(2) growth factor, most frequently bone morphogenic protein 2 (BMP-2);and (3) stem cells, most commonly bone marrow mesenchymal stem cells. Novel techniques for scaffold modification include the use of nano-hydroxyapatite, or combining a vector with a biomaterial to create a gene activated matrix that produces proteins of interest (typically BMP-2) to support osteogenesis. Here, we review the current literature in tissue engineering in order to discuss the success of varying use and combinations of scaffolding materials (i.e., ceramics, biological polymers, and synthetic polymers) with stem cells and growth factors, and will examine their success in vitro and in vivo to induce and guide osteogenesis in mandibular defects.展开更多
MANUSCRIPTS PREPARATION Types of manuscripts Types Content Original Article Original Articles include randomized controlled trials,intervention studies,studies of screening and diagnostic testing,outcome studies,cost-...MANUSCRIPTS PREPARATION Types of manuscripts Types Content Original Article Original Articles include randomized controlled trials,intervention studies,studies of screening and diagnostic testing,outcome studies,cost-effectiveness analyses,case-control series,and surveys with high response rate.Review Review articles that summarize the current state of understanding of a topic.Case Report Case Reports should detail new,interesting,or unusual cases.Cases with clinical significance or implications will be given priority.Editorial Editorials are nearly always solicited,although unsolicited editorials may occasionally be considered.Letter to Editor Letters to Editor include the contents and references.Commentary Commentaries are always solicited by the editors.These manuscripts should include relevant background information,comments on the paper,areas that need further investigation,and future directions.The relevant manuscript should be included in the reference list.展开更多
Aim: To explore the characteristics of normal hair distribution in Han Chinese. Methods:A total of 146 healthy Han Chinese and 41 patients with androgenetic alopecia (AGA) were selected as research subjects. Digital p...Aim: To explore the characteristics of normal hair distribution in Han Chinese. Methods:A total of 146 healthy Han Chinese and 41 patients with androgenetic alopecia (AGA) were selected as research subjects. Digital photographs of the vertex, temporal, and occipital regions were taken after their hair was trimmed. An image analysis software was used to compute the number of follicular units (FUs) and hairs. Results: The mean FU density of the 146 healthy Han Chinese was 74.36 ± 13.33 units/cm2 and their mean hair density was 143.33 ± 28.08 hairs/cm2. There was no significant difference between males and females (P >0.05). The mean FU density in the occipital region of AGA patients was 77.78 ± 2.99 units/cm2 and their mean hair count was 148.12 ± 6.98 hairs/cm2. Both were lower than those of healthy Han Chinese, and the differences were statistically significant (P < 0.001). Two-hair FUs (52.62%) were the predominant type found in Han Chinese. Conclusion: The FU and hair densities of healthy Han Chinese are lower than those of whites and Africans. The study provides hair transplantation surgeons with information on hair distribution in Han Chinese. It also provides a quantitative basis for the area of donor site and transplantation density necessary for hair transplantation surgeries. The research findings provide some theoretical data for the hair distribution characteristics of Han Chinese. These data can contribute to the preoperative assessment, surgery planning, and postoperative outcome evaluation by hair transplantation surgeons.展开更多
Aesthetic surgery for the breast is one of the common procedure performed by an aesthetic plastic surgeon today.The surgery is frequently performed for aesthetic as well reconstructive reasons.Breast itself is a uniqu...Aesthetic surgery for the breast is one of the common procedure performed by an aesthetic plastic surgeon today.The surgery is frequently performed for aesthetic as well reconstructive reasons.Breast itself is a uniquely important part of the female body and as such embodies in itself anatomical,physiological and aesthetic role.A proportionately developed breast is an important feminine feature,a sign for fertility and sexuality.It is not surprising that breasts are extremely important for women’s self-confidence especially when their role in society has expanded immensely.展开更多
Facial rejuvenation has changed over the last decade,evolving from the rhytidectomy to an approach that focuses on revolumization,due to a more complete understanding of the changes to bone and soft tissue that occur ...Facial rejuvenation has changed over the last decade,evolving from the rhytidectomy to an approach that focuses on revolumization,due to a more complete understanding of the changes to bone and soft tissue that occur with the aging face.Soft tissue augmentation using various injectable filler agents has gained popularity due to their nonsurgical,non-invasive procedures,instant cosmetic outcomes and limited recovery time.The skin filler market is booming and the variety of available skin fillers is increasing,providing the plastic surgeons many choices.Nonpermenant,biodegradable,resorbable agents may induce little complications,but they will normally disappear soon after injection.Semipermenant,biodegradable,biostimulary,nonresorbable fillers may induce a bit more complications,but they will normally disappear spontaneously in a few months.Permanent,nonresorbable fillers usually give rise to severe complications or reactions which may not disappear spontaneous.They may appear several years after the injection,and treatment is often insufficient.Unfortunately,the ideal filler with lasting effect but without any complication has not been discovered yet.In this review,we give an update on currently available skin filler agents,and what is new in recent 5 years.展开更多
Aim:The bone particles harvested during osteotomy could be used as autogenous bone graft materials to correct a bony defect prior to implant placement.Methods:A simple surgical procedure was described in which autogen...Aim:The bone particles harvested during osteotomy could be used as autogenous bone graft materials to correct a bony defect prior to implant placement.Methods:A simple surgical procedure was described in which autogenous bone was harvested from the drills during the preparation of implant sites.Eleven samples were obtained from bone drilling duringfixture installation in 11 patients(5 men and 6 women)with an average age of 57 years.These samples were subjected to histological preparation,in order to evaluate for the presence of viable osteoblasts.Results:Histological evaluation of the samples suggested that the viability of the bone tissue was maintained.Conclusion:The results show that this method of harvesting autogenous bone may be useful in situations where small amounts of bone are required.展开更多
文摘The use of body mass index(BMI)to determine eligibility for gender-affirming surgery in transgender and nonbinary individuals has been contested.While BMI thresholds are often meant to be protective,restricting patients from access to surgery can also cause harm.There is a rationale for the continued use of BMI,but the inherent problems with it must also be recognized,including how weight stigma impacts patients’access to gender-affirming surgery and influences clinical care.This article uses a narrative review of current literature to discuss how high BMI affects surgical outcomes in gender-affirming genital surgeries,as well as analogous procedures,existing de facto BMI thresholds,and how to both minimize the harms of proceeding with surgery in patients with a high BMI or the harms of delaying for weight loss.BMI factors into surgical decision-making based on the existing literature,which demonstrates that high BMI is associated with increased surgical risk,including higher incidences of surgical site infections and poor wound healing,as well as the possibility of free flap complications,which are a component of certain genital procedures.This patient population is at higher risk for eating disorders,and it is prudent to find alternatives to requiring patient self-monitored weight management.The impacts of weight stigma should be considered when treating gender-affirming surgery patients,and further data and research are needed to augment shared decision-making and lead to practice change.
文摘A considerable part of revision rhinoplasty in Asians is associated with problems arising from the use of alloplastic implants. Revising alloplast associated problems of the nose mostly requires the use pf autogenous grafting material to minimize complications and maximize favorable outcomes. Although remnant septal cartilage and/or conchal cartilage can be used, as the deformity becomes more severe, adequate revision requires more volume and strength of grafting materials. Autogenous rib cartilage may be the most practical choice in these circumstances. In this review, common causes of revision rhinoplasty in Asians are discussed together with operative techniques with emphasis on the use of autologous rib cartilage.
文摘Aim: To evaluate available evidence for the effective management of venous leg ulcers with fibrin matrix with or without growth factors. Methods: A systematic review of the literature was performed to evaluate the use of fibrin matrices with or without growth factors for the management of chronic venous ulcers in lower limbs. Article searches were performed in MEDLINE, EMBASE, COCHRANE, LILACS and ongoing clinical trials at ClinicalTrial.gov. Results: The search in MEDLINE and EMBASE identified three articles;one was a pilot study evaluating the use of fibrin matrix and autologous growth factors that included patients with chronic ulcers of different etiology. The second article was a description of the product used in the previous study, and the third consisted of a series case reports of patient treated with cultured keratinocytes in a fibrin matrix. A COCHRANE searched resulted in one study assessing the cost effectiveness of using different fibrin matrices. The search in ClinicalTrial.gov and LILACS did not result in any findings. Conclusion: The study did not provide a conclusive evidence for the use of fibrin matrices in patients with venous leg ulcers.
文摘Aim:Most brachial plexus palsies occur following high-velocity trauma.The shoulder joint is a large proximal joint which influences the motion of the hand.Transfer of the trapezius muscle is an effective alternative for palsy of the deltoid and supraspinatus muscles.Methods:Between 2009 and 2014,32 patients were treated with modified trapezius muscle transfer in which only the descending fibers along with their attachment to the lateral third of clavicle were used.The clavicle was fixed to the anterolateral surface of the humerus by cancellous screws.The arm was immobilized for 6 weeks.Results:All the 32 patients had improved function with stability of the shoulder.The average increase in active abduction was from 7.5°(range:0°-30°)to 85°(range:45°-140°),and the mean forward flexion increased from 5.63°(range:0°-15°)to 55.2°(range:40°-90°)after a mean follow-up of 8.25 months.Twenty-four of the 32 patients rated the result as good to excellent and were satisfied with the improvement in stability and function.Fifty nine point thirty eight percent patients had Medical Research Council Muscle power 4 after the surgery.Conclusion:Transfer of the upper trapezius muscle with a segment of the clavicle segment for a flail shoulder can provide satisfactory function and stability with fewer complications.
文摘Limb loss is disabling and carries significant functional and psychological repercussions to both the individual and society.The numbers of amputees are forecasted to double by 2050 from vascular disease and diabetes alone.Europe has 4.66 million amputees(431,000 amputations per year)and the United States 2 million amputees(185,000 amputations per year).Microvascular expertise is now more commonplace,increasing the likelihood of limb salvage and replantation.Further reconstructive input can take advantage of nerve and tendon grafting/transfers,free tissue transfer,and complex bone reconstruction.When this strategy does not satisfy individual needs,such as that seen with unstable soft tissues,amputation may be requested or offered.In part,the decision for salvage,replantation,or amputation in the future is likely to be guided by the sophistication of limb substitutes.This review will introduce the growing domain of bionics and where research in this area may deliver a sought clinical need.
文摘1.Submission Overview Before you decide to publish with us,please read the following items carefully and make sure that you are well aware of Editorial Policies and the following requirements.1.1 Topic Suitability The topic of the manuscript must fit the scope of the journal.Please refer to Aims and Scope for more information.1.2 Open Access and Copyright The journal adopts Gold Open Access publishing model since its establishment and has been distributing contents under Attribution 4.0 International License since October 2017,whereas Attribution NonCommercial ShareAlike 3.0 Unported had been adopted by then.Please make sure that you are well aware of these policies.
文摘AIM: There are limited reports in the United States demonstrating outcomes of primarily thinned fasciocutaneous flaps in the setting of critical limb ischemia, Charcot collapse and osteomyelitis. We hope to determine patient and flap related outcomes in advanced lower extremity disease. Methods: The authors conducted a retrospective review of fasciocutaneous free flaps of variable thickness for lower extremity salvage. Osteomyelitis and non-osteomyelitis patients were compared according to our primary outcome measures: functional ambulation, bone healing and complications to flap and patient. Subgroups with critical limb ischemia, Charcot collapse and diabetic foot were analyzed separately. Results: Fifty-nine patients underwent free flap reconstruction: osteomyelitis (n = 20, 34%), Charcot collapse (n = 22, 37%), and/or critical limb ischemia (n = 12, 20%). All patients underwent anterolateral thigh flaps tailored for defect-specific thicknesses: 17 superthin, 25 suprafascial, 17 subfascial. There were no significant differences between groups in terms of partial and complete flap loss (P = 1.000 and P = 0.108). Ninety-one percent of patients were ambulatory at follow up. Eighty-tive percent of individuals with osteomyelitis cleared their infection demonstrating radiographic bone healing. Two patients developed recalcitrant deep space infections ultimately requiring amputation. Subgroup analysis did not show any differences in flap related complications within the diabetic Charcot population. In multivariate regression, preoperative revascularization was independently associated with failure of limb salvage. ;Conclusion: Primarily thinned perforator flaps performed well in the setting of lower extremity limb salvage, critical limbischemia, osteomyelitis, and the Charcot foot - expanding their role in the armamentarium for lower extremity care.
文摘The word count excludes the abstract,figures,tables,and references.General formats of manuscripts 1.Title Provide a concise and specific title(no more than 12 notional words)that clearly reflects the manuscript’s content.And a running title(3-6 words)should also be provided.2.Authors and affiliations?Include all authors’full names.Once accepted,authors cannot be added or deleted,and the order cannot be changed without the written consent of all authors.?Provide full affiliation information(complete name of the department,institution,city,postcode,province/state,and country)for all authors.?Indicate a single corresponding author.The name,title,institution,address,telephone number,and e-mail of the corresponding author should be given,to ensure prompt communication.
文摘Metoidioplasty consists of lengthening and straightening the hormonally hypertrophied clitoris.The goals of the procedure include masculinizing the external genitalia and enabling standing micturition.Metoidioplasty may be performed as a stand-alone procedure or an interval procedure prior to phalloplasty.While most often performed with urethral lengthening,metoidioplasty may also be performed as a“simple release”(i.e.,without urethral lengthening).Secondary procedures typically include scrotoplasty and placement of testicular implants.While satisfaction with this procedure is high,complications can occur.Complications are commonly categorized as either urologic(i.e.,strictures and fistula)or wound healing(i.e.,wound disruption,infection,bleeding,etc.).This narrative review discusses postoperative outcomes,including both satisfaction and complications.Published data on complications include fistula and stricture rates from 0%-50% and 0%-63%,respectively.Overall satisfaction with appearance ranges from 48%-100%,and patient ability to void while standing ranges from 67%-100%.Metoidioplasty is a safe and effective procedure for transgender men.Further research regarding surgical techniques and outcomes will help reduce complications and improve overall patient satisfaction.
文摘It is a great honor for me to be part of this scientific project and now reality after several years of very hard and encouraging work, which is the Plastic and Aesthetic Research, an innovative journal focusing on plastic and aesthetic surgery, such as plastic and aesthetic materials, plastic surgery, oral and maxillofacial surgery, head and neck surgery, microsurgery, laser treatment, orthopedic surgery, ophthalmoplasty, dentistry, psychology, social ethics, other medical disciplines associated with the postoperative complications of plastic surgery. After over 248 published articles from 2014, the journal is gaining more and more dissemination among scientific forums and medical databases, so that the ultimate advances in plastic and aesthetic surgery are more prone to be at the disposal of clinicians and researchers, in a fast publication process from the development of knowledge, and in a high scientific reputable peer review system which ensures the reliability of the published material.
文摘Cherubism is a rare disease characterized by significant loss of medullary bone which is replaced by excessive amounts of fibrous tissue growth within the mandible and maxilla. We present a case of a 4-year-old boy with a rapidly enlarging mandible and maxilla, causing significant change in the facial contour, malocclusion and phonation difficulties. He was treated with aggressive tumor curettage, lateral mandibular cortex osteotomies with medial repositioning. This allowed obliteration of the enlarged medullary space and restoration of the normal mandibular anatomy. At 12 months postoperatively, the patient had significant improvement in facial contour, normal outward appearance, and stable dentition.
文摘The media has a large influence on what constitutes modern day beauty, as it suggests to susceptible young girls and boys what makes someone beautiful. The term 'beautiful' is portrayed as curvy, thin, tall, with voluptuous hair, big eyes, large breasts, round buttocks, and full lips. Very few people in society naturally appear like this, and thus many people undergo cosmetic surgery for this desired look. This article will examine the difference of opinions regarding the exact age to consider aesthetic plastic surgery. Adolescence is frequently bullied about any defect. The authors discuss some of these opinions and present three very unusual cases where early surgery has been beneficial.
文摘Aim:The causative role of human papillomavirus(HPV)has been established into the aetiology of oral squamous cell carcinoma(OSCC).Some authors believe that HPV can determinate the prognosis and module treatment response from this kind of malignancies.Methods:Articles published in the last 10 years,focusing on the role of HPV in the development,molecular biology,prognosis and treatment of OSCC were reviewed.Results:Thirty-nine articles from 252 were selected,highlighting 4 meta-analysis,3 prospective and 2 retrospective studies.According to its role in the development of cervical cancer,HPV is classified into a high risk for malignant lesions subtype and a low-grade malignant lesions subtype.Epidemiology and prevalence of HPV varies according to the published data:large studies tend to have lower rates of HPV(<50%)than smaller ones(0-100%).Interestingly,HPV+patients are usually diagnosed at a younger age,mainly those with oropharyngeal tumours.There is a predilection for the oropharynx and Waldeyer ring tumours.Regarding prognosis,OSCC HPV+patients tend to have better outcome and treatment response.Conclusion:HPV divides OSCC in two types of tumours with different prognostic and therapeutic implications,with increased survival,better treatment response rates and lower risk of death and recurrences.
文摘Aim:Surgical treatment of clinically negative neck in maxillary squamous cell carcinoma(SCC)of the upper jaw is controversial.The purpose of this systematic review was to define the incidence of cervical metastasis and to assess if elective neck dissection is justified when the neck is not primarily affected.Methods:An electronic literature search was conducted in several databases,including MEDLINE,EMBASE,and Cochrane Central databases,for articles written in English.Results:Twenty-eight articles were included in the review.The overall cervical metastases rate was 33%and the total initial cervical metastases rate was 16%.Interestingly,the author found that 71%of patients with cervical metastases from maxillary SCC carcinoma were T3/T4 stage.Conclusion:This review shows the need for a change in the management of the N0 neck in SCC arising in the maxillary alveolus and hard palate.Elective neck dissection should be performed in patients with T3/T4 tumours with clinic or radiographic negative necks(N0c).
文摘Currently, the gold standard for aesthetic and functional reconstruction of critical mandibular defects is an autologous fibular flap;however, this carries risk of donor site morbidity, and is not a promising option in patients with depleted donor sites due to previous surgeries. Tissue engineering presents a potential solution in the design of a biomimetic scaffold that must be osteoconductive, osteoinductive, and support osseointegration. These osteogenesis-inducing scaffolds are most successful when they mimic and interact with the surrounding native macro- and micro-environment of the mandible. This is accomplished via the regeneration triad: (1) a biomimetic, bioactive osteointegrative scaffold, most likely a resorbable composite of collagen or a synthetic polymer with collagen-like properties combined with beta-tri calcium phosphate that is 3D printed according to defect morphology;(2) growth factor, most frequently bone morphogenic protein 2 (BMP-2);and (3) stem cells, most commonly bone marrow mesenchymal stem cells. Novel techniques for scaffold modification include the use of nano-hydroxyapatite, or combining a vector with a biomaterial to create a gene activated matrix that produces proteins of interest (typically BMP-2) to support osteogenesis. Here, we review the current literature in tissue engineering in order to discuss the success of varying use and combinations of scaffolding materials (i.e., ceramics, biological polymers, and synthetic polymers) with stem cells and growth factors, and will examine their success in vitro and in vivo to induce and guide osteogenesis in mandibular defects.
文摘MANUSCRIPTS PREPARATION Types of manuscripts Types Content Original Article Original Articles include randomized controlled trials,intervention studies,studies of screening and diagnostic testing,outcome studies,cost-effectiveness analyses,case-control series,and surveys with high response rate.Review Review articles that summarize the current state of understanding of a topic.Case Report Case Reports should detail new,interesting,or unusual cases.Cases with clinical significance or implications will be given priority.Editorial Editorials are nearly always solicited,although unsolicited editorials may occasionally be considered.Letter to Editor Letters to Editor include the contents and references.Commentary Commentaries are always solicited by the editors.These manuscripts should include relevant background information,comments on the paper,areas that need further investigation,and future directions.The relevant manuscript should be included in the reference list.
基金the Natural Science Foundation of China(81471900)the Natural Science Foundation of China(81772104)+2 种基金Natural Science Foundation of China(81701929)Natural Science Foundation of Guangdong Province(2015A030311001)Science and Technology Program of Guangzhou(201508020262).
文摘Aim: To explore the characteristics of normal hair distribution in Han Chinese. Methods:A total of 146 healthy Han Chinese and 41 patients with androgenetic alopecia (AGA) were selected as research subjects. Digital photographs of the vertex, temporal, and occipital regions were taken after their hair was trimmed. An image analysis software was used to compute the number of follicular units (FUs) and hairs. Results: The mean FU density of the 146 healthy Han Chinese was 74.36 ± 13.33 units/cm2 and their mean hair density was 143.33 ± 28.08 hairs/cm2. There was no significant difference between males and females (P >0.05). The mean FU density in the occipital region of AGA patients was 77.78 ± 2.99 units/cm2 and their mean hair count was 148.12 ± 6.98 hairs/cm2. Both were lower than those of healthy Han Chinese, and the differences were statistically significant (P < 0.001). Two-hair FUs (52.62%) were the predominant type found in Han Chinese. Conclusion: The FU and hair densities of healthy Han Chinese are lower than those of whites and Africans. The study provides hair transplantation surgeons with information on hair distribution in Han Chinese. It also provides a quantitative basis for the area of donor site and transplantation density necessary for hair transplantation surgeries. The research findings provide some theoretical data for the hair distribution characteristics of Han Chinese. These data can contribute to the preoperative assessment, surgery planning, and postoperative outcome evaluation by hair transplantation surgeons.
文摘Aesthetic surgery for the breast is one of the common procedure performed by an aesthetic plastic surgeon today.The surgery is frequently performed for aesthetic as well reconstructive reasons.Breast itself is a uniquely important part of the female body and as such embodies in itself anatomical,physiological and aesthetic role.A proportionately developed breast is an important feminine feature,a sign for fertility and sexuality.It is not surprising that breasts are extremely important for women’s self-confidence especially when their role in society has expanded immensely.
文摘Facial rejuvenation has changed over the last decade,evolving from the rhytidectomy to an approach that focuses on revolumization,due to a more complete understanding of the changes to bone and soft tissue that occur with the aging face.Soft tissue augmentation using various injectable filler agents has gained popularity due to their nonsurgical,non-invasive procedures,instant cosmetic outcomes and limited recovery time.The skin filler market is booming and the variety of available skin fillers is increasing,providing the plastic surgeons many choices.Nonpermenant,biodegradable,resorbable agents may induce little complications,but they will normally disappear soon after injection.Semipermenant,biodegradable,biostimulary,nonresorbable fillers may induce a bit more complications,but they will normally disappear spontaneously in a few months.Permanent,nonresorbable fillers usually give rise to severe complications or reactions which may not disappear spontaneous.They may appear several years after the injection,and treatment is often insufficient.Unfortunately,the ideal filler with lasting effect but without any complication has not been discovered yet.In this review,we give an update on currently available skin filler agents,and what is new in recent 5 years.
文摘Aim:The bone particles harvested during osteotomy could be used as autogenous bone graft materials to correct a bony defect prior to implant placement.Methods:A simple surgical procedure was described in which autogenous bone was harvested from the drills during the preparation of implant sites.Eleven samples were obtained from bone drilling duringfixture installation in 11 patients(5 men and 6 women)with an average age of 57 years.These samples were subjected to histological preparation,in order to evaluate for the presence of viable osteoblasts.Results:Histological evaluation of the samples suggested that the viability of the bone tissue was maintained.Conclusion:The results show that this method of harvesting autogenous bone may be useful in situations where small amounts of bone are required.
