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Seminars in Plastic Surgery Nov 2020Within the past two decades, vascularized facial composite allotransplantation has evolved into a viable option in the reconstructive surgeons' armamentarium for... (Review)
Review
Within the past two decades, vascularized facial composite allotransplantation has evolved into a viable option in the reconstructive surgeons' armamentarium for patients with extensive facial disfigurements. As it has expanded the frontiers of microsurgical reconstructive techniques, facial transplantation has come to garner widespread interest within both the medical community and the general public. The procedure has established itself as an amalgamation of the forefronts of reconstructive microsurgery, immunology, and transplantation science. Therein too lies its complexity as multifaceted scientific developments are met with ethical and social issues. Both patients and physicians are faced with the everlasting challenges of immunosuppression regimens and their inherent complications, long-term aesthetic and functional considerations, the role of revision procedures, and the inevitable psychosocial implications. This article reflects on the medical and surgical advancements in facial transplantation surgery and highlights anticipated future challenges. It aims to encourage discussion regarding anticipated barriers to current practice and suggest future directions as we transition into the next phase of facial allograft transplantation.
PubMed: 33380909
DOI: 10.1055/s-0040-1721760 -
International Journal of Nanomedicine 2024Hypertrophic scars and keloids are common fibroproliferative diseases following injury. Patients with pathologic scars suffer from impaired quality of life and... (Review)
Review
Hypertrophic scars and keloids are common fibroproliferative diseases following injury. Patients with pathologic scars suffer from impaired quality of life and psychological health due to appearance disfiguration, itch, pain, and movement disorders. Recently, the advancement of hydrogels in biomedical fields has brought a variety of novel materials, methods and therapeutic targets for treating hypertrophic scars and keloids, which exhibit broad prospects. This review has summarized current research on hydrogels and loaded components used in preventing and treating hypertrophic scars and keloids. These hydrogels attenuate keloid and hypertrophic scar formation and progression by loading organic chemicals, drugs, or bioactive molecules (such as growth factors, genes, proteins/peptides, and stem cells/exosomes). Among them, smart hydrogels (a very promising method for loading many types of bioactive components) are currently favoured by researchers. In addition, combining hydrogels and current therapy (such as laser or radiation therapy, etc.) could improve the treatment of hypertrophic scars and keloids. Then, the difficulties and limitations of the current research and possible suggestions for improvement are listed. Moreover, we also propose novel strategies for facilitating the construction of target multifunctional hydrogels in the future.
Topics: Humans; Keloid; Cicatrix, Hypertrophic; Hydrogels; Quality of Life; Pruritus
PubMed: 38293605
DOI: 10.2147/IJN.S448667 -
Pediatric Reports Jul 2012The extravasation of antineoplastic agents is an unwanted and distressing situation that can easily occur. It may cause severe and irreversible local injuries. Left... (Review)
Review
The extravasation of antineoplastic agents is an unwanted and distressing situation that can easily occur. It may cause severe and irreversible local injuries. Left untreated, vesicant chemotherapy extravasation can potentially cause tissue necrosis, functional impairment and permanent disfigurement. This article provides a review of current literature regarding recommendations on the prevention and treatment of extravasation of antineoplastic agents.
PubMed: 25396033
DOI: 10.4081/pr.2012.e28 -
Journal of Cutaneous and Aesthetic... 2023Pyogenic granuloma is a benign vascular tumor, with a tendency to bleed on manipulation. A young female presented to us with a disfiguring facial pyogenic granuloma. We...
Pyogenic granuloma is a benign vascular tumor, with a tendency to bleed on manipulation. A young female presented to us with a disfiguring facial pyogenic granuloma. We adopted a novel approach using pressure therapy to treat the same. The use of an elastic adhesive bandage reduced the size and vascularity of the lesion, following which laser ablation was done with minimal bleeding and scarring. This is a simple, inexpensive method to approach large and disfiguring pyogenic granulomas.
PubMed: 37383971
DOI: 10.4103/JCAS.JCAS_97_21 -
Chinese Journal of Traumatology =... Feb 2021This study aimed at exploring the perceptions and experiences of female burn survivors with facial disfigurement in Pakistan.
PURPOSE
This study aimed at exploring the perceptions and experiences of female burn survivors with facial disfigurement in Pakistan.
METHODS
Two different quantitative and qualitative studies were conducted, of which the data were collected from 100 burn patients. A pilot interview protocol was developed. An indepth interview of five female burn survivors with facial disfigurement was taken in Lahore, Pakistan. The transcripts were analyzed using thematic analysis and four major themes were identified, respectively physical appearance, posttraumatic growth, relationships and coping strategies.
RESULTS
Thematic analysis reflected differences in attributional style, perceptions and individual experiences of female burn survivors with facial disfigurement. The study showed the importance of physical appearance for different burn survivors and how their life had changed after suffering from a burn injury.
CONCLUSION
It could be easy to have a positive outlook towards life and accept visible differences post injury for the burn survivors, who are grateful for life, get a strong family support and have available resources. On the contrary, with low self-esteem, lack of a family support and available resources, patients would be dissatisfied with their life.
Topics: Adaptation, Psychological; Adult; Burns; Face; Facial Injuries; Family; Female; Humans; Life Change Events; Middle Aged; Pakistan; Perception; Physical Appearance, Body; Self Concept; Social Support; Survivors; Young Adult
PubMed: 33308964
DOI: 10.1016/j.cjtee.2020.11.007 -
JAMA Otolaryngology-- Head & Neck... Jul 2022This cross-sectional study assesses the association between observer-rated disfigurement and body image–related distress among survivors of head and neck cancer.
This cross-sectional study assesses the association between observer-rated disfigurement and body image–related distress among survivors of head and neck cancer.
Topics: Body Image; Head and Neck Neoplasms; Humans; Quality of Life; Survivors
PubMed: 35554492
DOI: 10.1001/jamaoto.2022.0822 -
Scientific Reports May 2019Faces are among the most salient and relevant visual and social stimuli that humans encounter. Attractive faces are associated with positive character traits and social...
Faces are among the most salient and relevant visual and social stimuli that humans encounter. Attractive faces are associated with positive character traits and social skills and automatically evoke larger neural responses than faces of average attractiveness in ventral occipito-temporal cortical areas. Little is known about the behavioral and neural responses to disfigured faces. In two experiments, we tested the hypotheses that people harbor a disfigured is bad bias and that ventral visual neural responses, known to be amplified to attractive faces, represent an attentional effect to facial salience rather than to their rewarding properties. In our behavioral study (N = 79), we confirmed the existence of an implicit 'disfigured is bad' bias. In our functional MRI experiment (N = 31), neural responses to photographs of disfigured faces before treatment evoked greater neural responses within ventral occipito-temporal cortex and diminished responses within anterior cingulate cortex. The occipito-temporal activity supports the hypothesis that these areas are sensitive to attentional, rather than reward properties of faces. The relative deactivation in anterior cingulate cortex, informed by our behavioral study, may reflect suppressed empathy and social cognition and indicate evidence of a possible neural mechanism underlying dehumanization.
Topics: Adolescent; Adult; Beauty; Brain Mapping; Cerebral Cortex; Dehumanization; Empathy; Face; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Physical Appearance, Body; Prejudice; Social Discrimination; Social Stigma; Visual Perception; Young Adult
PubMed: 31142792
DOI: 10.1038/s41598-019-44408-8 -
Frontiers in Bioengineering and... 2020Each year, congenital defects, trauma or cancer often results in considerable physical disfigurement for many people worldwide. This adversely impacts their... (Review)
Review
Each year, congenital defects, trauma or cancer often results in considerable physical disfigurement for many people worldwide. This adversely impacts their psychological, social and economic outlook, leading to poor life experiences and negative health outcomes. In many cases of soft tissue disfigurement, highly personalized prostheses are available to restore both aesthetics and function. As discussed in part A of this review, key to the success of any soft tissue prosthetic is the fundamental properties of the materials. This determines the maximum attainable level of aesthetics, attachment mechanisms, fabrication complexity, cost, and robustness. Since the early-mid 20th century, polymers have completely replaced natural materials in prosthetics, with advances in both material properties and fabrication techniques leading to significantly improved capabilities. In part A, we discussed the history of polymers in prosthetics, their ideal properties, and the application of polymers in prostheses for the ear, nose, eye, breast and finger. We also reviewed the latest developments in advanced manufacturing and 3D printing, including different fabrication technologies and new and upcoming materials. In this review, Part B, we detail the chemistry of the most commonly used synthetic polymers in soft tissue prosthetics; silicone, acrylic resin, vinyl polymer, and polyurethane elastomer. For each polymer, we briefly discuss their history before detailing their chemistry and fabrication processes. We also discuss degradation of the polymer in the context of their application in prosthetics, including time and weathering, the impact of skin secretions, microbial growth and cleaning and disinfecting. Although advanced manufacturing promises new fabrication capabilities using exotic synthetic polymers with programmable material properties, silicones and acrylics remain the most commonly used materials in prosthetics today. As research in this field progresses, development of new variations and fabrication techniques based on these synthetic polymers will lead to even better and more robust soft tissue prosthetics, with improved life-like aesthetics and lower cost manufacturing.
PubMed: 32391336
DOI: 10.3389/fbioe.2020.00147 -
The Journal of Investigative Dermatology Nov 2023Skin injury and several diseases elicit fibrosis and induce hair follicle (HF) growth arrest and loss. The resulting alopecia and disfiguration represent a severe burden...
Skin injury and several diseases elicit fibrosis and induce hair follicle (HF) growth arrest and loss. The resulting alopecia and disfiguration represent a severe burden for patients, both physically and psychologically. Reduction of profibrotic factors such as dipeptidyl peptidase 4 (DPP4) might be a strategy to tackle this issue. We show DPP4 overrepresentation in settings with HF growth arrest (telogen), HF loss, and nonregenerative wound areas in mouse skin and human scalp. Topical DPP4 inhibition with Food and Drug Administration/European Medicines Agency-approved sitagliptin on preclinical models of murine HF activation/regeneration results in accelerated anagen progress, whereas treatment of wounds with sitagliptin results in reduced expression of fibrosis markers, increased induction of anagen around wounds, and HF regeneration in the wound center. These effects are associated with higher expression of Wnt target Lef1, known to be required for HF anagen/HF-activation and regeneration. Sitagliptin treatment decreases profibrotic signaling in the skin, induces a differentiation trajectory of HF cells, and activates Wnt targets related to HF activation/growth but not those supporting fibrosis. Taken together, our study shows a role for DPP4 in HF biology and shows how DPP4 inhibition, currently used as oral medication to treat diabetes, could be repurposed into a topical treatment agent to potentially reverse HF loss in alopecia and after injury.
PubMed: 37236597
DOI: 10.1016/j.jid.2023.04.027 -
BioMed Research International 2018This review examines the role of interventional radiotherapy (IRT otherwise known as brachytherapy) in cancer treatment for elderly patients. Despite their advanced age... (Review)
Review
This review examines the role of interventional radiotherapy (IRT otherwise known as brachytherapy) in cancer treatment for elderly patients. Despite their advanced age and associated comorbidities, elderly patients should receive definitive cancer therapies, including surgery and radiotherapy (RT). In fact, RT becomes first-line option for patients who are not eligible for surgery (due to comorbidities, anticoagulant drugs, and risk of disfigurement) or those who refuse it. It emerged from this review of the literature as effective, simple, safe, and comfortable and was associated with good local control, low toxicity rates, and excellent cosmesis and provided a cost benefit. IRT may be used as sole treatment for small cancers or as a useful adjunct to surgery or external beam radiotherapy (EBRT) in more advanced (or lymph node positive) cases, especially when the aim is local control with adequate preservation of normal tissue function. As palliative treatment, IRT preserves quality of life and/or improves survival. It is to be hoped that this review will serve as a helpful guide for members of multidisciplinary teams that are involved in treating elderly patients with cancer.
Topics: Age Factors; Aging; Brachytherapy; Humans; Neoplasms
PubMed: 29581964
DOI: 10.1155/2018/2178469