Special Issue "Recent Advances in Trauma and Reconstructive Surgery of the Extremities"

A special issue of Medicina (ISSN 1010-660X).

Deadline for manuscript submissions: 31 August 2020.

Special Issue Editors

Dr. Francesco De Francesco
E-Mail Website
Guest Editor
Reconstructive Surgery and Hand Surgery, AOU Ospedali Riuniti di Ancona, Italy
Interests: hand surgery; reconstructive surgery; trauma; regenerative medicine
Dr. Nicola Zingaretti
E-Mail Website
Guest Editor
Clinic of Plastic and Reconstructive Surgery, Department of Medical Area (DAME), Academic Hospital of Udine, University of Udine, Udine, Italy
Interests: reconstructive surgery; trauma; regenerative medicine; flaps
Dr. Michele Riccio
E-Mail Website
Guest Editor
Reconstructive Surgery and Hand Surgery, AOU Ospedali Riuniti di Ancona, Italy
Interests: hand surgery; reconstructive surgery; trauma; regenerative medicine; flaps
Prof. Dr. Piercamillo Parodi
E-Mail Website
Guest Editor
Clinic of Plastic and Reconstructive Surgery, Department of Medical Area (DAME), Academic Hospital of Udine, University of Udine, Udine, Italy
Interests: reconstructive surgery; trauma; regenerative medicine; flaps

Special Issue Information

Dear Colleagues,

Extremity injuries are common and can present a significant injury burden for patients, especially if an extremity is mangled. The frequency of injuries in these parts of the body has become more difficult to prevent with the rise in popularity of practices such as riding motorcycles, as well as extreme sports such as skiing, bungee jumping, and mountain-bike. Complex limb injuries due to high kinetic energy crushes are characterized by an extensive loss of soft tissue and bone substance and may be associated with vascular injury. These cases require coordination between the peripheral vascular and microsurgical team and the orthopedist to obtain a rapid and accurate diagnosis of vascularization and to plan adequate wound care and revascularization. Extremity injuries can represent a challenge for surgeons due to several factors, such as the extent of the trauma, wide loss of substance, and a close anatomic relation with vital structures. For these reasons, achieving an optimal outcome in patients with severe upper and lower extremity injury requires a multidisciplinary approach with oversight by the general or trauma surgeon and commitment from other specialists, including orthopedic, vascular, and plastic surgeons and rehabilitation specialists.

The aim of this Special Issue is to provide the readership with current information regarding diagnosis, pathophysiology, techniques, and strategies for the management for upper and lower extremity reconstruction.

This includes the orthopedic management of complex traumas of the extremities, presurgical assessment for the best reconstructive options, orthoplastic reconstruction of the arms and legs (e.g., locoregional flaps, perforator flaps, microsurgical techniques of extremity preservation), the available evidence for choosing individual reconstructive algorithms and practices, wound care treatment and management, the role of adjunctive therapy for wound healing (e.g., hyperbaric oxygen therapy, vacuum-assisted closure therapy), salvage in patients with devastating injuries or severe medical comorbidities, postsurgical complications and their clinical management, and rehabilitation solutions for extremities.

Furthermore, we encourage the publication of original and interesting case reports that contribute significantly to medical knowledge.

Dr. Francesco De Francesco
Dr. Nicola Zingaretti
Dr. Michele Riccio
Prof. Dr. Piercamillo Parodi
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 papers will be 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. Medicina 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 1500 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

  • Extremities trauma
  • Orthoplastic reconstruction
  • Regenerative medicine
  • Flaps
  • Extremity injuries
  • Rehabilitation

Published Papers (2 papers)

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Research

Open AccessArticle
Reconstruction for Defects of Total Nail Bed and Germinal Matrix Loss with Acellular Dermal Matrix Coverage and Subsequently Skin Graft
Medicina 2020, 56(1), 17; https://doi.org/10.3390/medicina56010017 - 03 Jan 2020
Abstract
Background and Objectives: Nail bed and germinal matrix loss due to wide excision for fingertip tumors or malignancy are occasionally encountered complications. These defects also result from severely comminuted fingertip crush injuries. Large-area dorsal finger or toenail bed defects, which usually present with [...] Read more.
Background and Objectives: Nail bed and germinal matrix loss due to wide excision for fingertip tumors or malignancy are occasionally encountered complications. These defects also result from severely comminuted fingertip crush injuries. Large-area dorsal finger or toenail bed defects, which usually present with phalangeal bone exposure, remain challenging regardless of the usage of different reconstruction strategies. This study aimed to evaluate the clinical outcome of a staged operation with an acellular dermal matrix coverage and subsequent skin graft as reconstruction for defects of total nail bed, germinal matrix loss, and bone exposure. Materials and Methods: From April 2018 to October 2019, four patients with total nail bed, germinal matrix, and bone exposure loss after surgery were enrolled in our series. A staged operation of the acellular dermal matrix coverage with subsequent skin graft was performed on these patients. Skin graft take rate, oncological prognosis, and cosmetic outcome were evaluated. Patients were followed up for 5–13 months. An excellent skin graft take rate with a satisfying aesthetic result without local malignancy recurrence was noted. Minimal functional deficit and donor site morbidity were reported. Results: A staged operation with acellular dermal matrix coverage and subsequent skin graft proves to serve as a feasible strategy for patients who experience total nail bed, germinal matrix loss, and bone exposure after surgery. Conclusions: This reconstruction method provides a reliable repair result, satisfying aesthetic outcomes, as well as having minimal functional deficits and donor site morbidity. Full article
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Open AccessArticle
Retrospective Study on the Clinical Superiority of the Vacuum-Assisted Closure System with a Silicon-Based Dressing over the Conventional Tie-over Bolster Technique in Skin Graft Fixation
Medicina 2019, 55(12), 781; https://doi.org/10.3390/medicina55120781 - 12 Dec 2019
Abstract
Background and Objectives: The tie-over bolster technique has been conventionally used for skin graft fixation; however, long operative times and postoperative pain are the main disadvantages of this method. In this study, we introduce a new method using vacuum-assisted closure (VAC) with [...] Read more.
Background and Objectives: The tie-over bolster technique has been conventionally used for skin graft fixation; however, long operative times and postoperative pain are the main disadvantages of this method. In this study, we introduce a new method using vacuum-assisted closure (VAC) with a silicon-based dressing as an alternative for skin graft fixation. This retrospective study aimed to evaluate the clinical effect of the VAC plus silicon-based dressing method and the conventional tie-over bolster technique for skin graft fixation in terms of pain, operative time, and skin graft take rate. Materials and Methods: Sixty patients who underwent skin graft surgery performed by a single surgeon from January 2017 to October 2018 were included in this clinical study. They were divided into two groups based on the type of treatment: tie-over bolster technique and vacuum-assisted closure (VAC), or silicon-based dressing groups. The operative times were recorded twice (during suturing or stapling of the graft and during removal of the dressing) in the two groups; similarly, pain was assessed using a numeric rating scale (NRS) after surgery and during dressing removal. Skin graft take rate was evaluated two weeks after dressing removal. Results: Twenty-six patients who met the eligibility criteria were enrolled into the study and assigned to one of the two groups (n = 13 each). No significant differences in age, gender, and graft area were noted between the two groups of patients. The VAC plus silicon-based dressing group demonstrated higher skin graft take rates (p < 0.05), shorter operation times (p < 0.05), and lower levels of pain (postoperative pain and pain during dressing removal) compared with the tie-over bolster technique group (p < 0.05). Conclusions: These findings indicate that VAC with silicon-based dressing can be used for skin graft fixation due to its superior properties when compared with the conventional method, and can improve the quality of life of patients undergoing skin graft fixation. Full article
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