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Clinical Advances in Plastic Surgery
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Clinical Advances in Plastic Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Plastic, Reconstructive and Aesthetic Surgery/Aesthetic Medicine".

Deadline for manuscript submissions: 25 May 2024 | Viewed by 2440

Special Issue Editor

Dr. Thomas Holzbach

E-Mail Website
Guest Editor
Department of Hand and Plastic Surgery, Thurgau Hospital Group, Frauenfeld, Switzerland
Interests: reconstructive surgery; skin; aesthetic surgery; hand surgery; plastic surgery

Special Issue Information

Dear Colleagues,

Innovation—the key driver in the field of plastic and hand surgery for the last decades or even centuries—has led to continuous surgical evolution, ensuring the survival of this unique specialty and fostering its interaction with other surgical disciplines.

While major innovations, such as the establishment of microsurgery, tissue allotransplantation, and endoscopic or robotic surgery, enable a completely new direction of this discipline and even define an entire era of a certain specialty, seemingly smaller advancements and refinements of the existing techniques appear to power the engine for continuous development. Additionally, the implementation of novel techniques that are already in use in other medical and non-medical fields, such as 3D imaging, the use of lasers, ICG imaging and other auxiliary techniques, allow to further improve both clinical outcomes and patient care.

The aim of this Special Issue is to collate up-to-date research on new clinical advancements in plastic and hand surgery. We invite submissions of manuscripts that address any of the aforementioned issues.

Dr. Thomas Holzbach
Guest Editor

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 Clinical Medicine is an international peer-reviewed open access semimonthly 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

  • reconstructive surgery
  • plastic surgery
  • microsurgery
  • hand surgery
  • cosmetic surgery
  • 3D
  • surgical innovation
  • ICG fluoroscopy
  • interdisciplinary plastic surgery

Published Papers (3 papers)

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Research

10 pages, 1004 KiB  
Article
Microvascular Muscle vs. Fascio-Cutaneous Free Flaps for Reconstruction of Plantar Load-Bearing Foot Defects—An International Survey
by Sinan Mert, Paul I. Heidekrueger, Benedikt Fuchs, Tim Nuernberger, Elisabeth M. Haas-Lützenberger, Riccardo E. Giunta, Denis Ehrl and Wolfram Demmer
J. Clin. Med. 2024, 13(5), 1287; https://doi.org/10.3390/jcm13051287 - 24 Feb 2024
Viewed by 452
Abstract
Background: The reconstruction of plantar load-bearing foot defects faces many plastic surgeons with a major challenge. The optimal patient- and defect-oriented reconstructive strategy must be selected. Methods: To analyze the current trends and recommendations in reconstruction of plantar load-bearing foot defects, [...] Read more.
Background: The reconstruction of plantar load-bearing foot defects faces many plastic surgeons with a major challenge. The optimal patient- and defect-oriented reconstructive strategy must be selected. Methods: To analyze the current trends and recommendations in reconstruction of plantar load-bearing foot defects, we conducted an international survey among plastic surgeons querying them about their recommendations and experiences. Results: The survey revealed that the most common strategies for reconstruction of the foot sole are locoregional and microvascular free flaps, emphasizing the relevance of plastic surgery. Among microvascular free flaps, muscle and fascio-cutaneous free flaps are by far the most frequently used. The target qualities of the reconstructed tissue to be considered are manifold, with adherence being the most frequently mentioned. We observed a noteworthy correlation between the utilization of muscle flaps and a preference for adherence. In addition, we identified a substantial correlation between the usage of fascio-cutaneous free flaps and further target qualities, such as good skin quality and sensitivity. Conclusions: Our findings provide insights into the clinical reality and highlight important aspects that must be considered in reconstruction of the weight-bearing areas of the foot providing support in the selection of the appropriate therapy. Full article
(This article belongs to the Special Issue Clinical Advances in Plastic Surgery)
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10 pages, 19376 KiB  
Article
How Reliable Is Breast Volume Assessment When the Patient Is Lying Flat?—Volumetric Assessment of Breast Volume Using a Vectra H2 Handheld Device in Different Positions
by Aljosa Macek, Sebastian Leitsch, Konstantin Christoph Koban, Julius Michael Mayer, Rafael Loucas and Thomas Holzbach
J. Clin. Med. 2024, 13(3), 709; https://doi.org/10.3390/jcm13030709 - 25 Jan 2024
Viewed by 632
Abstract
(1) Background: Three-dimensional (3D) volumetric assessment is receiving increased recognition in breast surgery. It is commonly used for preoperative planning and postoperative control with the patient standing in an upright position. Recently, intraoperative use was evaluated with patients in the supine position. [...] Read more.
(1) Background: Three-dimensional (3D) volumetric assessment is receiving increased recognition in breast surgery. It is commonly used for preoperative planning and postoperative control with the patient standing in an upright position. Recently, intraoperative use was evaluated with patients in the supine position. The aim of this prospective study was to evaluate the volumetric changes in 3D surface imaging depending on the patient’s position. (2) Methods: 3D volumetric analysis was performed using a Vectra-H2 device with patients in standing, sitting, and supine positions. A total of 100 complete datasets of female breasts were included in the study. The measured volumes of each evaluated breast (n = 200) were compared between the three positions. (3) Results: The mean difference between the 3D volumetric assessments of the sitting and standing positions per breast was 7.15 cc and, thus, statistically insignificant (p = 0.28). However, the difference between supine and standing positions, at 120.31 cc, was significant (p < 0.01). (4) Conclusions: The 3D volumetric assessment of breasts in the supine position did not statistically correlate with the validated assessment of breast volume in the standing position while breast volume in the sitting position is reliable and correlates with the assessment of a standing patient. We conclude that intraoperative volumetric assessment should be performed with patients in an upright sitting position. Full article
(This article belongs to the Special Issue Clinical Advances in Plastic Surgery)
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15 pages, 2693 KiB  
Article
Intraoperative Blood Flow Analysis of Free Flaps with Arteriovenous Loops for Autologous Microsurgical Reconstruction
by Alexander Geierlehner, Raymund E. Horch, Ingo Ludolph, Werner Lang, Ulrich Rother, Alexander Meyer and Andreas Arkudas
J. Clin. Med. 2023, 12(23), 7477; https://doi.org/10.3390/jcm12237477 - 2 Dec 2023
Viewed by 1012
Abstract
Background: Arteriovenous (AV) loops help to overcome absent or poor-quality recipient vessels in highly complex microvascular free flap reconstruction cases. There are no studies on blood flow and perfusion patterns. The purpose of this study was to evaluate and compare intraoperative hemodynamic characteristics [...] Read more.
Background: Arteriovenous (AV) loops help to overcome absent or poor-quality recipient vessels in highly complex microvascular free flap reconstruction cases. There are no studies on blood flow and perfusion patterns. The purpose of this study was to evaluate and compare intraoperative hemodynamic characteristics of AV loops followed by free tissue transfer for thoracic wall and lower extremity reconstruction. Methods: this prospective clinical study combined Transit-Time Flowmetry and microvascular Indocyanine Green Angiography for the assessment of blood flow volume, arterial vascular resistance and intrinsic transit time at the time of AV loop construction and on the day of free flap transfer. Results: A total of 11 patients underwent AV loop creation, of whom five required chest wall reconstruction and six required reconstruction of the lower extremities. In seven of these cases, the latissimus dorsi flap and in four cases the vertical rectus abdominis myocutaneous (VRAM) flap was used as a free flap. At the time of loop construction, the blood flow volume of AV loops was 466 ± 180 mL/min, which increased to 698 ± 464 mL/min on the day of free tissue transfer (p > 0.1). After free flap anastomosis, the blood flow volume significantly decreased to 18.5 ± 8.3 mL/min (p < 0.001). There was no significant difference in blood flow volume or arterial vascular resistance between latissimus dorsi and VRAM flaps, nor between thoracic wall and lower extremity reconstruction. However, a significant correlation between the flap weight and the blood flow volume, as well as to the arterial vascular resistance, was found (p < 0.05). Conclusion: This is the first study to perform intraoperative blood flow and hemodynamic measurements of AV loops followed by free tissue transfer. Our results show hemodynamic differences and contribute to deeper understanding of the properties of AV loops for free flap reconstruction. Full article
(This article belongs to the Special Issue Clinical Advances in Plastic Surgery)
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