Latest Trends in Reconstructive Microsurgery: From Modification to Innovation—Volume II

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Surgery".

Deadline for manuscript submissions: closed (10 March 2024) | Viewed by 4505

Special Issue Editors


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Guest Editor
Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
Interests: lymphedema; reconstructive surgery; perforator flap; superficial circumflex iliac artery perforator flap
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Guest Editor
Department of Hand and Plastic Surgery, Kantonsspital Luzern, Luzern, Switzerland
Interests: plastic and reconstructive surgery; microsurgery; breast surgery, lymphedema surgery
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Special Issue Information

Dear Colleagues,

In the plastic surgery field, there has been a clear trend over the last few years toward the use of microsurgical techniques. Many factors have contributed to this process, ranging from the development of more precise instruments to higher-resolution imaging evaluations and an improved understanding of anatomy and physiology. In certain respects, the advent of perforator-based flaps was revolutionary, overcoming most of the limits of previous autologous reconstructive procedures. They allowed major vessels to be spared, resulting in a much lower donor site morbidity, combined with shortened dissection times and a lower incidence of post-operative complications. Further technical progress resulted in supermicrosurgery, which offers even more opportunities, and we now have the possibility to safely manipulate even the smallest vessels, such as the lymphatic vessels. Nowadays, lymphatic surgery also represents the latest evolution in the reconstructive field, with the purpose of treating and also preventing long-term sequelae.

The purpose of this Special Issue is to present and discuss the latest trends in the reconstructive microsurgery field, including lymphedema surgery and supermicrosurgery, as well as new technologies and tools employed in this setting. The scope of the Special Issue is deliberately broad in order to encourage submissions on a wide range of topics and perspectives related to the many reconstructive procedures, in addition to the new technologies associated with them.

This is a topic for which we are encountering continuous modifications of and innovations applied to well-known procedures. Thus, in this Special Issue, we would like to deeply focus on the great potential of the microsurgical technique in reconstructive settings, which may allow addressing and solving problems that were previously considered unsolvable. In particular, we wish to focus attention not only on structure restoration but also to complete functional preservation.

We are seeking original articles, literature reviews, and case reports/case series dealing with the most modern microsurgical techniques related to defect reconstruction throughout the body. Proposals for clinical treatment, as well as anatomical studies are of interest.

Prof. Dr. Hidehiko Yoshimatsu
Prof. Dr. Mario F. Scaglioni
Guest Editors

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Keywords

  • reconstructive microsurgery
  • supermicrosurgery
  • perforator flap
  • lymphedema surgery
  • propeller flap breast reconstruction
  • lower extremity reconstruction
  • free flap

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Published Papers (2 papers)

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13 pages, 25172 KiB  
Article
Multiple Flap Transfer for Multiple Local Recurrence of Soft Tissue Sarcoma
by Ryo Karakawa, Hidehiko Yoshimatsu, Yuma Fuse and Tomoyuki Yano
Medicina 2023, 59(8), 1489; https://doi.org/10.3390/medicina59081489 - 18 Aug 2023
Cited by 1 | Viewed by 2007
Abstract
Background and Objectives: Surgical management of local recurrence of soft tissue sarcomas (STS) is still challenging. In this article, we report on multiple flap reconstructions for multiple local recurrences of STS. Their feasibility will be validated by examining clinical cases. Materials and [...] Read more.
Background and Objectives: Surgical management of local recurrence of soft tissue sarcomas (STS) is still challenging. In this article, we report on multiple flap reconstructions for multiple local recurrences of STS. Their feasibility will be validated by examining clinical cases. Materials and Methods: Patients who underwent multiple flap reconstructions for multiple local recurrences of STS between April 1997 and October 2021 were included in this retrospective study. Patient demographics, tumor characteristics, surgical characteristics, and postoperative complications were examined. Results: Twenty operations of eight patients were identified. The location of the defects was the back in two, the buttock in two, the groin in two, and the lower extremities in two. The average total number of wide resections was 4.0 and the average total number of flap reconstructions was 2.5. The average follow-up period was 109.4 months. The average size of the defect was 102.4 cm2 and the average flap size was 15.7 × 10.8 cm. The histological diagnoses were malignant fibrous histocytoma (MFH) in eight operations, osteosarcoma in two operations, myxoid liposarcoma in two operations, undifferentiated pleomorphic sarcoma (UPS) in six operations, and myxofibrosarcoma (MFS) in one operation. Of twelve subsequent operations, the resection of the previously transferred flap was performed in six operations (50%). The occurrence of take back, flap complications, and donor-site complications in the primary operation group was 25%, 25%, and 12.5%, respectively. The occurrence of take back, flap complications, and donor-site complications in the second and subsequent operation group was 0%, 0%, and 16.7%, respectively. Conclusions: Multiple operations including wide resections followed by flap reconstructions for multiple local recurrences are feasible. Reconstructive surgeons should choose the options of the flaps considering the future local recurrence for tumors with a high risk of recurrence. Full article
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7 pages, 3679 KiB  
Case Report
Reconstruction Using a Scrotal Flap with Autologous Augmentation for Delayed Infection Caused by Penile Filler Injection: A Case Report
by Hee-Jun Son and Woo-Sik Pae
Medicina 2023, 59(11), 1998; https://doi.org/10.3390/medicina59111998 - 14 Nov 2023
Cited by 1 | Viewed by 1977
Abstract
Penile augmentation using filler injections is gaining popularity; however, complications such as foreign body reactions can arise, leading to issues like penile ulceration and necrosis, subsequently necessitating reconstruction. The existing method of the reconstruction of the penis is primarily aimed at filling the [...] Read more.
Penile augmentation using filler injections is gaining popularity; however, complications such as foreign body reactions can arise, leading to issues like penile ulceration and necrosis, subsequently necessitating reconstruction. The existing method of the reconstruction of the penis is primarily aimed at filling the deficit. In this paper, we describe a case in which a scrotal flap and autologous augmentation were utilized to treat a soft tissue defect caused by a delayed infection following a penile filler injection. The patient, a 41-year-old male, had received an Aquafilling® (Biomedica, Prague, Czech Republic) filler injection seven years earlier and later developed a delayed infection. After debridement, the penile defect spanned the entire shaft, and the circumference of the flaccid penis was 7.5 cm. Using a bilateral scrotal flap technique, the lower margins of both flaps were rolled inward after de-epithelialization to achieve autologous augmentation. Over the three-month post-surgery follow-up, neither infections nor flap necrosis were observed. The penile circumference increased to 12 cm, and the patient reported high satisfaction with the outcome. This new surgical technique can be widely applied as treatment for a variety of penile defects. Full article
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