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AORN Journal Feb 2022
Topics: Scalp; Skin Transplantation
PubMed: 35084756
DOI: 10.1002/aorn.13620 -
Facial Plastic Surgery Clinics of North... May 2020Most complications associated with hair transplant surgery are usually preventable and most often arise as a consequence of poor planning or faulty surgical technique.... (Review)
Review
Most complications associated with hair transplant surgery are usually preventable and most often arise as a consequence of poor planning or faulty surgical technique. Patients should be evaluated for having realistic goals and a pattern that is amenable to aesthetic restoration. A good treatment plan must consider the potential for future hair loss. Well-informed patients who carefully follow instructions and take an active role in the postoperative recovery process minimize the chance of patient-controlled complications. This article discusses potential complications associated with hair restoration surgery, and the roles of the patient and physician in decreasing the risk of complications.
Topics: Alopecia; Hair; Humans; Postoperative Complications; Skin Transplantation; Tissue and Organ Harvesting; Transplant Donor Site; Transplantation, Autologous
PubMed: 32312509
DOI: 10.1016/j.fsc.2020.01.003 -
Current Opinion in Organ Transplantation Oct 2020To summarize the evolution of skin xenotransplantation and contextualize technological advances and the status of clinically applicable large animal research as well as... (Review)
Review
PURPOSE OF REVIEW
To summarize the evolution of skin xenotransplantation and contextualize technological advances and the status of clinically applicable large animal research as well as prospects for translation of this work as a viable future treatment option.
RECENT FINDINGS
Porcine xenografts at the start of the millennium were merely biologic dressings subject to rapid rejection. Since then, numerous important advances in swine to nonhuman primate models have yielded xenotransplant products at the point of clinical translation. Critical genetic modifications in swine from a designated pathogen-free donor herd have allowed xenograft survival reaching 30 days without preconditioning or maintenance immunosuppression. Further, xenograft coverage appears not to sensitize the recipient to subsequent allograft placement and vice versa, allowing for temporary coverage times to be doubled using both xeno and allografts.
SUMMARY
Studies in large animal models have led to significant progress in the creation of living, functional skin xenotransplants with clinically relevant shelf-lives to improve the management of patients with extensive burns.
Topics: Animals; Models, Animal; Skin Transplantation; Swine; Transplantation, Heterologous
PubMed: 32773504
DOI: 10.1097/MOT.0000000000000798 -
Plastic and Aesthetic Nursing
Topics: Skin Transplantation
PubMed: 36450050
DOI: 10.1097/PSN.0000000000000453 -
The Journal of the American Academy of... Sep 2022Acute compartment syndrome is a surgical emergency in the extremities resulting from increased compartmental pressure, requiring immediate fasciotomy to resolve muscular... (Review)
Review
Acute compartment syndrome is a surgical emergency in the extremities resulting from increased compartmental pressure, requiring immediate fasciotomy to resolve muscular compromise. As the mainstay treatment, fasciotomies involve substantial skin incisions and are thus prone to complications such as skin necrosis, wound infection, and permanent disability. Multidisciplinary care instituted at the time of fasciotomy can facilitate timely closure and minimize the complication profile. Several approaches are available to enhance outcomes of fasciotomy wounds, and a comprehensive knowledge of these options affords the treating surgeon greater flexibility and confidence in optimal management. Common techniques include early primary closure, gradual approximation, skin grafting, and negative pressure therapy. There is currently no consensus on the best method of closure. The purpose of this study was to review fasciotomy wound management from the time of initial release to final closure. Highlights include preparation for closing these wounds; the various techniques for fasciotomy closure, including adjunct options; evaluation of timing and staging; and injury-specific features, such as fracture management, limited subcutaneous tissues, and hand fasciotomies. Combining the perspectives of orthopaedic and plastic surgery, this review evaluates the benefits of multiple closure methods and highlights the importance of planning closure at the time of release.
Topics: Compartment Syndromes; Extremities; Fasciotomy; Humans; Skin Transplantation; Suture Techniques
PubMed: 36001887
DOI: 10.5435/JAAOS-D-21-01046 -
Annals of Anatomy = Anatomischer... May 2020Existing epidermal transplantation procedures applied in burn surgery or wound treatment, such as mesh grafting or the Meek method, do not lead to a restoration of all...
Existing epidermal transplantation procedures applied in burn surgery or wound treatment, such as mesh grafting or the Meek method, do not lead to a restoration of all the skin layers. Dermal skin layers are indispensable in ensuring the quality and function of the transplanted skin as a frictional surface and a carrier of skin appendages such as hair, sweat glands, and sebaceous glands, as well as nerve receptors for detecting pressure, vibration, and temperature. Because of the restricted skin surface area that can be provided by the donor, full-skin transplants cannot be transplanted over a large area. Cultured skin procedures, based on skin cells cultivated in a laboratory, have not yet reached a stage of development where a complex full epidermal transplantation is possible. In particular, the introduction of skin appendages with a functional cell-to-cell communication has not been observed thus far in cultivated skin. Based on the Reverdin transplantation method, in which concave skin islands with epidermal and dermal parts are transplanted, Davis in 1910 described the transplantation of multiple 2-5 mm sized full-skin islands as a new method for the treatment of skin lesions. Further modifying this 100-year-old procedure, we developed a miniaturization and automation of the Davis transplantation method that started in 2011 and called it "SkinDot". In the following article we describe the effectiveness of the full-skin island transplant procedure in two patients. The transplantation of single 2-3 mm full-skin islands results in a full-skin equivalent without any limits on donor area and with a reduced donor morbidity.
Topics: Biopsy, Needle; Burns; Humans; Skin Transplantation; Transplantation, Autologous
PubMed: 31899297
DOI: 10.1016/j.aanat.2019.151454 -
Acta Chirurgica Belgica Aug 2022Early surgical debridement of the deep second and third-degree burns is still the standard of care (SOC) to prepare the wound bed for skin grafting. However, this... (Review)
Review
INTRODUCTION
Early surgical debridement of the deep second and third-degree burns is still the standard of care (SOC) to prepare the wound bed for skin grafting. However, this technique has some drawbacks that explain the growing interest in enzymatic debridement as an alternative. In this article, we provide a historic overview as well as the current state-of-the-art and future prospective of this type of non-surgical debridement.
MATERIALS AND METHODS
A narrative review of the available literature was conducted using a systematic search.
RESULTS
A total of 32 articles were included. The only enzyme mixture still used nowadays for burn eschar removal is bromelain-based. There is increasing evidence that this type of enzymatic debridement is a powerful tool to selectively remove the eschar in deep burns, thereby reducing the need for autologous skin grafting compared to surgical SOC. Moreover, off-label use of enzymatic debridement with NexoBrid (facial, pediatric, and >15%TBSA burns) has proven to be effective and safe.
CONCLUSION
There is increasing evidence that bedside administered NexoBrid, preferably under regional anesthesia, is a powerful tool for selective burn eschar removal. However, the clinical wound bed evaluation post-NexoBrid procedure in relation to the optimal treatment decision-conservative treatment surgery-is not yet completely elucidated. More high-quality prospective clinical trials are necessary to compare enzymatic debridement of objectively confirmed deep burns with the current standard treatment and assess the effectiveness of the eschar removal, the need for surgery, the healing time of such wounds, and the long-term scar quality.
Topics: Burns; Child; Debridement; Humans; Skin; Skin Transplantation; Wound Healing
PubMed: 35440290
DOI: 10.1080/00015458.2022.2068746 -
Clinics in Plastic Surgery Jul 2024Acute burn reconstruction involves intricate strategies such as skin grafting and innovative technologies, addressing challenges in coverage and minimizing donor site... (Review)
Review
Acute burn reconstruction involves intricate strategies such as skin grafting and innovative technologies, addressing challenges in coverage and minimizing donor site morbidity. Despite being rarely used, flap reconstruction becomes necessary when critical structures are exposed, offering robust coverage and reducing complications. However, free flaps in acute burns face challenges, including a higher failure rate attributed to hyperinflammatory states and hypercoagulability. Surgical optimization strategies involve careful timing, patient preparation, and meticulous postoperative care. In delayed burn reconstruction, free flaps proved effective in functional and aesthetic restoration, with low flap loss rates and minimal contracture recurrence. Prefabricated and prelaminated flaps emerged as a solution for complex cases, ensuring the best functional and aesthetic possible outcomes in challenging facial burn reconstructions.
Topics: Humans; Burns; Microsurgery; Plastic Surgery Procedures; Free Tissue Flaps; Skin Transplantation
PubMed: 38789149
DOI: 10.1016/j.cps.2024.02.005 -
Facial Plastic Surgery Clinics of North... May 2020
Topics: Alopecia; Cosmetic Techniques; Hair; Humans; Plastic Surgery Procedures; Skin Transplantation
PubMed: 32312512
DOI: 10.1016/j.fsc.2020.02.001 -
Medicina (Kaunas, Lithuania) Apr 2021Autologous skin grafting was developed more than 3500 years ago. Several approaches and techniques have been discovered and established in burn care since then. Great... (Review)
Review
Autologous skin grafting was developed more than 3500 years ago. Several approaches and techniques have been discovered and established in burn care since then. Great achievements were made during the 19th and 20th century. Many of these techniques are still part of the surgical burn care. Today, autologous skin grafting is still considered to be the gold standard for burn wound coverage. The present paper gives an overview about the evolution of skin grafting and its usage in burn care nowadays.
Topics: Burns; Humans; Skin; Skin Transplantation; Wound Healing
PubMed: 33916337
DOI: 10.3390/medicina57040348