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Good Clinical Practice in Plastic Surgery
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Good Clinical Practice in Plastic Surgery

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Regenerative Medicine and Therapeutics".

Deadline for manuscript submissions: closed (31 August 2023) | Viewed by 18213

Special Issue Editors

Prof. Dr. Hisham Fansa

E-Mail Website
Guest Editor
1. Department of Plastic Surgery and Breast Center, Spital Zollikerberg, Zollikerberg, 8125 Zürich, Switzerland
2. Department of Plastic, Reconstructive and Aesthetic Surgery, Hand Surgery, OWL-University, Klinikum Bielefeld, Teutoburger Str. 50, D-33604 Bielefeld, Germany
Interests: aesthetic facial surgery; aesthetic and reconstructive breast surgery after breast cancer; reconstructive microsurgery; super-microsurgery; peripheral nerve reconstruction
Dr. Onno Frerichs

E-Mail Website
Guest Editor
Department of Plastic, Reconstructive and Aesthetic Surgery, Hand Surgery, OWL-University, Klinikum Bielefeld, Teutoburger Str. 50, D-33604 Bielefeld, Germany
Interests: reconstructive breast surgery; microsurgery; reconstructive surgery

Special Issue Information

Dear Colleagues,

Plastic surgery is a very individualized specialty. More so than in other fields, the quality of the operation depends on the experience and technical skill of the surgeon. While many treatments are standardized, the potential surgical paths a surgeon may choose for an operation, and thus the outcome, vary. Furthermore, prospective randomized studies to improve patient care are hardly possible in the plastic surgery field due to structural, financial and surgical reasons. Therefore, to improve patients’ wellbeing and quality of life, for this Special Issue, we are inviting the submission of papers based on individual’s  experiences and surgical tricks that have proven to be successful. We are particularly interested in experiences of good clinical practice in plastic surgery. Both reconstructive issues as well as aesthetic techniques are welcome.

Prof. Dr. Hisham Fansa
Dr. Onno Frerichs
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • plastic surgery
  • reconstructive surgery
  • microsurgery
  • aesthetic and cosmetic surgery
  • good clinical practice
  • proven surgical techniques

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Published Papers (6 papers)

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Research

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13 pages, 1616 KiB  
Article
Ilizarov Bone Transfer for Treatment of Large Tibial Bone Defects: Clinical Results and Management of Complications
by Zheming Cao, Yiqian Zhang, Katelyn Lipa, Liming Qing, Panfeng Wu and Juyu Tang
J. Pers. Med. 2022, 12(11), 1774; https://doi.org/10.3390/jpm12111774 - 27 Oct 2022
Cited by 3 | Viewed by 2272
Abstract
Backgrounds: The purpose of this study is to present our clinical experience using the Ilizarov bone transfer technique and free-flap technique in the reconstruction of large tibial bone and soft tissue defects, including an evaluation of both the management of postoperative complications and [...] Read more.
Backgrounds: The purpose of this study is to present our clinical experience using the Ilizarov bone transfer technique and free-flap technique in the reconstruction of large tibial bone and soft tissue defects, including an evaluation of both the management of postoperative complications and long-term outcomes. Methods: From January 2010 to May 2020, 72 patients with tibia bone and soft tissue defects were retrospectively evaluated. Either an anterolateral thigh perforator flaps (ALTP) or latissimus dorsi musculocutaneous flaps (LD), solely or in combination, were used to cover soft tissue defects. Once the flap was stabilized, an Ilizarov external fixator was applied to the limb. Follow-up was postoperatively performed at 1, 3, 6, 9, and 12 months. Results: Postoperatively, there were two cases of total and five of partial flap necrosis, and two cases of subcutaneous ulcers, which were caused by vascular crisis, infection, and hematoma, respectively. All the patients underwent Ilizarov external fixator surgery after flap recovery. A total of 16 complications occurred, including 3 cases of simple needle tract infection (antibiotic treatment) and 13 cases of complications requiring reoperation. A correlation factor analysis revealed that the main factors affecting the healing time were the defect length and operative complications. All patients with complications treated with the vascularized iliac flap eventually healed completely. Conclusions: The Ilizarov method used together with an ALTP, LD, or a combination thereof yields good clinical results for repairing large bone and soft tissue defects of the tibia, thus reducing the incidence of amputations. However, longer treatment times may be involved, and postoperative complications can occur. The vascularized iliac flap may be a suitable choice for the treatment of postoperative complications of this type of Ilizarov bone transport. Full article
(This article belongs to the Special Issue Good Clinical Practice in Plastic Surgery)
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10 pages, 1486 KiB  
Article
Reconstruction of Large Soft Tissue Defects in the Distal Lower Extremity: Free Chain-Linked Bilateral Anterolateral Thigh Perforator Flaps versus Extended Latissimus Dorsi Musculocutaneous Flaps
by Jiqiang He, Gunel Guliyeva, Panfeng Wu, Liming Qing, Fang Yu and Juyu Tang
J. Pers. Med. 2022, 12(9), 1400; https://doi.org/10.3390/jpm12091400 - 29 Aug 2022
Cited by 1 | Viewed by 4037
Abstract
Background: Reconstruction of the large soft-tissue defects in the lower extremity still constitutes a challenge for plastic surgeons. This retrospective study was conducted to compare the surgical and clinical outcomes of the chain-linked bilateral anterolateral thigh perforator flaps and extended latissimus dorsi musculocutaneous [...] Read more.
Background: Reconstruction of the large soft-tissue defects in the lower extremity still constitutes a challenge for plastic surgeons. This retrospective study was conducted to compare the surgical and clinical outcomes of the chain-linked bilateral anterolateral thigh perforator flaps and extended latissimus dorsi musculocutaneous flap in the reconstruction of the large soft tissue defects of the lower extremity. Methods: From January 2012 to December 2021, 34 patients aged between 20 and 66 years received chain-linked bilateral anterolateral thigh perforator flaps (15 cases) or extended latissimus dorsi musculocutaneous flaps (19 cases) for the reconstruction of extensive soft-tissue defects in the lower extremity. The two groups were homogeneous in terms of age, etiology, comorbidities, and flap area. In addition, the intraoperative data, outcomes, complications, and long-term follow-up results were collected and analyzed. Results: The extended latissimus dorsi musculocutaneous flap group had a shorter operation time (271.8 ± 59.5 min vs. 429.6 ± 51.9 min), harvest time (58.9 ± 24.8 min vs. 152.7 ± 41.4 min), and anastomosis time (27.2 ± 10.4 min vs. 53.7 ± 8.1 min) than the chain-linked bilateral anterolateral thigh perforator flaps group (p < 0.05). Based on patient self-assessment, the donor site temporary muscle weakness in the extended latissimus dorsi musculocutaneous flap group was significantly more than that in the chain-linked bilateral anterolateral thigh perforator flaps group (p < 0.05). Conclusion: Both methods can repair large defects and restore the function of the injured limbs at a single stage. However, considering the operation time and flap-harvesting time, the authors recommend the extended latissimus dorsi musculocutaneous flap, especially for those who cannot tolerate a prolonged surgery. Full article
(This article belongs to the Special Issue Good Clinical Practice in Plastic Surgery)
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11 pages, 1761 KiB  
Article
Improvement of Ocular Surface Disease by Lateral Tarsoconjunctival Flap in Thyroid-Associated Orbitopathy Patients with Lid Retraction
by Chih-Kang Hsu, Meng-Wei Hsieh, Hsu-Chieh Chang, Yi-Hao Chen and Ke-Hung Chien
J. Pers. Med. 2022, 12(5), 802; https://doi.org/10.3390/jpm12050802 - 16 May 2022
Cited by 2 | Viewed by 2240
Abstract
There is a high incidence of ocular surface disease (OSD) in thyroid-associated orbitopathy (TAO) patients as a result of incomplete eyelid closure and chronic inflammatory eyelid status. This study was performed to evaluate the efficacy of a lateral tarsoconjunctival flap (LTF) in improving [...] Read more.
There is a high incidence of ocular surface disease (OSD) in thyroid-associated orbitopathy (TAO) patients as a result of incomplete eyelid closure and chronic inflammatory eyelid status. This study was performed to evaluate the efficacy of a lateral tarsoconjunctival flap (LTF) in improving OSD in TAO patients from the perspective of correcting eyelid closures. As a study design, TAO patients were enrolled in this study to evaluate OSD perioperatively before they were scheduled for LTF surgery. Additional lid surgery was also recorded. The outcome was evaluated with perioperative OSD measurements and tear inflammatory mediators at baseline and one month and three months postoperatively. As a result, 42 patients (5 male, 37 female) underwent LTF surgery, and 13 patients received medial pretarsal support with collagen grafts. Eleven patients underwent blepharotomy, and 6 patients received Botox injections for upper lid retraction. The mean age of the participants was 46.4 years old, and the mean follow-up period was 10.6 months. Their clinical activity score (CAS) at the time of the operation was 2.1. Dry eye parameters, such as ocular surface disease index, tear breakup time, Schirmer’s I test score, and meibomian gland dropout were all significantly improved 3 months postoperatively. Tear osmolarity and inflammatory mediators in tear fluid, such as IL-6, IL-8, IL-18 and MCP-1, were also significantly improved after the procedures. After the surgery, all complications were mild and temporary. As a conclusion, LTF could provide TAO patients with both lid retraction correction and improvement of ocular surface disorders. Dry eye parameters significantly improved 3 months postoperatively. This method can serve as an alternative treatment option for lid correction in TAO patients. Full article
(This article belongs to the Special Issue Good Clinical Practice in Plastic Surgery)
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Review

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15 pages, 897 KiB  
Review
Lipedema Research—Quo Vadis?
by Anna M. Ernst, Hannelore Bauer, Hans-Christian Bauer, Marianne Steiner, Anna Malfertheiner and Anna-Theresa Lipp
J. Pers. Med. 2023, 13(1), 98; https://doi.org/10.3390/jpm13010098 - 31 Dec 2022
Cited by 4 | Viewed by 4324
Abstract
When studying the current literature, one might get the impression that lipedema is a “modern” disease, with increasing incidence and augmenting prevalence throughout Western countries during the last decade. However, a quick look into older textbooks shows that disproportionate accumulation of fat in [...] Read more.
When studying the current literature, one might get the impression that lipedema is a “modern” disease, with increasing incidence and augmenting prevalence throughout Western countries during the last decade. However, a quick look into older textbooks shows that disproportionate accumulation of fat in female bodies has long been known without being recognized as an independent disease. Nevertheless, it was not until 1940 that Allen and Hines described a “syndrome characterized by fat legs and orthostatic edema” in a seminal publication. The mere awareness that people who have lipedema are not just overweight but suffer from a yet poorly defined pathological condition, may be considered a decisive leap forward in the understanding of lipedema. A number of comprehensive publications have since dealt with the clinical presentation of lipedema and have provided the first clues towards the potential pathological mechanisms underlying its initiation and progression. Nevertheless, despite all effort that has been undertaken to unravel lipedema pathology, many questions have remained unanswered. What can be deduced with certainty from all experimental and medical evidence available so far is that lipedema is neither a cosmetic problem nor is it a problem of lifestyle but should be accepted as a serious disease with yet undetermined genetic background, which makes women’s lives unbearable from both a physical and psychological point of view. To date, results from clinical inspections have led to the categorization of various types and stages of lipedema, describing how the extremities are affected and evaluating its progression, as demonstrated by skin alterations, adipose tissue volume increase and physical and everyday-behavioral impediments. There is accumulating evidence showing that advanced stages of lipedema are usually accompanied by excessive weight or obesity. Thus, it is not unreasonable to assume that the progression of lipedema is largely driven by weight gain and the pathological alterations associated with it. Similarly, secondary lymphedema is frequently found in lipedema patients at advanced stages. Needless to say, both conditions considerably blur the clinical presentation of lipedema, making diagnosis difficult and scientific research challenging. The present literature review will focus on lipedema research, based on evidence fromex vivo and in vitro data, which has accumulated throughout the last few decades. We will also open the discussion as to whether the currently used categorization of lipedema stages is still sufficient and up-to-date for the accurate description of this enigmatic disease, whose name, strangely enough, does not match its pathologic correlate. Full article
(This article belongs to the Special Issue Good Clinical Practice in Plastic Surgery)
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Other

Jump to: Research, Review

5 pages, 17717 KiB  
Case Report
Buerger’s Disease as a Cause of Post-Operative Skin Necrosis: A Case Report
by Jong Hyup Kim, Hoon Kim, In Chang Koh and Soo Yeon Lim
J. Pers. Med. 2023, 13(1), 108; https://doi.org/10.3390/jpm13010108 - 3 Jan 2023
Viewed by 2201
Abstract
Postoperative skin necrosis occurs due to various causes, including infections, lack of oxygenation, underlying diseases, and lack of nutrition. Therefore, a thorough evaluation of the cause of skin necrosis should be conducted. In the present case, the patient underwent disarticulation of the interphalangeal [...] Read more.
Postoperative skin necrosis occurs due to various causes, including infections, lack of oxygenation, underlying diseases, and lack of nutrition. Therefore, a thorough evaluation of the cause of skin necrosis should be conducted. In the present case, the patient underwent disarticulation of the interphalangeal joint of the right first toe by an orthopedic surgeon and developed postoperative skin necrosis. Through physical examination, imaging studies, and detailed medical history evaluation, the patient was diagnosed with thromboangiitis obliterans, also known as Buerger’s disease. After 4 months of medication for Buerger’s disease and smoking cessation, the wound healed without complications or recurrence. Therefore, in cases of untreatable chronic wounds in young and heavy smoking patients, Buerger’s disease should be suspected as a potential cause. Full article
(This article belongs to the Special Issue Good Clinical Practice in Plastic Surgery)
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9 pages, 1444 KiB  
Case Report
Atraumatic Acromioclavicular Joint Dislocation: A Case Report Treated with Excision of the Distal Clavicle Margin and Button Slide System with Allograft Tendon Reinforcement at Coracoclavicular and Acromioclavicular Joint
by Alejandro León, Sergio Chavez, Belén Garcia-Medrano, Rubén García-Fraile, Pablo Beltrán de Heredia, Jesús Palencia, Alberto Caballero-García, Alfredo Córdova and David Noriega Gonzalez
J. Pers. Med. 2022, 12(12), 2043; https://doi.org/10.3390/jpm12122043 - 10 Dec 2022
Viewed by 2094
Abstract
Although acromioclavicular joint (ACJ) dislocation is a common injury following trauma involving the shoulder, it is rare in the absence of trauma. In this manuscript, we describe a case of ACJ in a 15-year-old girl who presented a painful dislocation with spontaneous shortening [...] Read more.
Although acromioclavicular joint (ACJ) dislocation is a common injury following trauma involving the shoulder, it is rare in the absence of trauma. In this manuscript, we describe a case of ACJ in a 15-year-old girl who presented a painful dislocation with spontaneous shortening of the right acromioclavicular joint that forced her to temporarily abandon her sports career. After failure of conservative physiotherapy treatment, surgical intervention was proposed by performing an arthroscopic-assisted button slide combined with augmented hamstring allograft reconstruction. After the intervention and the subsequent recovery period, the athlete was able to return to her semi-professional training. The follow-up of the patient is 5.5 years post-surgery. The result obtained could help in planning the treatment of future cases. Full article
(This article belongs to the Special Issue Good Clinical Practice in Plastic Surgery)
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