Search Results (49)

Background/Objectives: Surgical debridement and early excision of burned areas followed by skin autograft is the gold standard of treatment for partial and full-thickness pediatric burns. However, skin autografting might be unfeasible or unlikely to succeed due limited availability of skin donor areas or inadequate conditions. In these circumstances, alternative treatment is required, and Skin Substitutes (SS) cold play a role. Recently, Biological Skin Substitutes (BSS) and Tissue Engineered Skin Substitutes (TESS) are emerging as alternative treatment options, but strong evidence is missing. This review investigates the current literature focusing on BSS and TESS, aiming to improve the medical and surgical management of pediatric patients. Methods: A systematic review was performed in accordance with the PRISMA 2020 guidelines and registered in the PROSPERO database (CRD42024627569). A comprehensive search was conducted in PubMed (MEDLINE) from 2000 to 2024 using Boolean logic and PICO-based inclusion criteria. Study quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists according to study design. Results: Twenty-nine articles and 2676 pediatric patients undergoing surgical reconstruction by BSS or TESS for burns were included. The methodological quality was generally moderate, with most studies being observational or case series. Several strategies were critically analyzed and possibly discussed. Conclusions: While BSS and TESS are safe and effective reconstructive options, the overall level of evidence remains low to moderate. A schematic classification of SS for pediatric burns is presented. Further prospective trials are needed to define standardized algorithms for pediatric burn reconstruction. Full article

Background/Objectives: Immortality and anti-aging research is accelerating, with implications across medicine. This narrative review explores the biological principles, translational innovations, and ethical considerations at the intersection of aging and plastic surgery, reframed for a broad clinical audience. Methods: A narrative review of the literature from PubMed, clinical trials, and translational studies was conducted, with emphasis on regenerative medicine, stem cells, tissue engineering, gene editing, and longevity pharmacologics within the field of plastic and reconstructive surgery. Results: Key themes include (1) the biology of aging and epigenetic reprogramming, (2) esthetic and regenerative innovations with broader clinical significance, (3) emerging genetic and pharmacologic longevity strategies, (4) ethical and regulatory challenges, and (5) future directions such as nanotechnology, artificial intelligence, and digital immortality. Conclusions: Immortality remains an aspirational frontier, but innovations in regenerative science and longevity research offer opportunities for improving healthspans. Medicine as a whole must balance innovation with ethics, equity, and safety in translating these discoveries to patient care. Full article

This article presents the report of the First International Congress of Preventive Medicine, organized by the Romanian Society of Preventive Medicine (SRMP) in March 2025, in Bucharest, Romania. The congress featured 11 discussion panels and workshops, bringing together over 85 experts from a wide range of medical disciplines, including oncology, vaccination, cardiology, endocrinology, gynecology, gastroenterology, surgery, family medicine, physical therapy, pulmonology, epidemiology, pediatrics, dentistry, pathology, ENT, genetics, pediatric cardiology, psychiatry, dermatology, plastic surgery, urology, infectious diseases, regenerative medicine, and other key stakeholders in preventive healthcare. The event served as a comprehensive platform for addressing critical public health challenges, with a focus on cancer prevention, anti-aging, oral health, genetics in preventive medicine, preventive cardiology and neurology, the correlation between craniofacial dysfunctions and posture, vaccination strategies, management of congenital malformations, neonatal screening, and the prevention of lifestyle-related diseases such as obesity and tobacco addiction. Furthermore, the congress highlighted the importance of interdisciplinary collaboration and evidence-based interventions in improving population health outcomes. It emphasized the urgent need for coordinated actions to address preventable diseases both at the national and international levels. Full article

Background: Excessive scarring remains a frequent complication in plastic surgery, yet standardized preventive strategies are lacking. Type I collagen-based biomaterials may support regenerative processes and improve scar outcomes. Methods: This case series includes six female patients (ages 24–52) undergoing wound management after trauma and procedures including blepharoplasty, abdominoplasty, and revision mammaplasty. Native collagen type I (7% or 15%) was injected along wound margins or into hypertrophic scars at 3–4 week intervals. Outcomes were assessed through patient-reported symptoms and Antera 3D imaging (vascularity, pigmentation, surface topography). Results: Patients reported reduced tightness, pruritus, and scar stiffness after initial sessions. Antera 3D imaging showed decreased vascular and pigment indices, and a reduction in surface elevation over follow-up (up to 14 months). No adverse effects such as atrophy or infection were observed. Conclusions: Native type I collagen was well tolerated and may be a useful adjunct for wound healing and scar modulation following plastic surgery. Full article

Background: Scar management remains a significant challenge in plastic and reconstructive surgery, particularly when addressing atrophic, retractile, or fibrotic scars. Autologous fat grafting and hybrid fractional laser therapy have independently shown efficacy in improving scar quality. This study aims to evaluate the synergistic effect of their combination on clinical and functional scar outcomes. Methods: A prospective, comparative study was conducted on patients with cutaneous scars of various etiologies. Participants were treated with either hybrid fractional laser therapy alone (CO₂ and 1570 nm Erbium-glass wavelengths) or a combined protocol of laser plus autologous lipofilling. Clinical outcomes were assessed at baseline and at 30, 60, and 90 days post-treatment using the Vancouver Scar Scale (VSS), patient satisfaction scores, and Visual Analog Scale (VAS) for pain and discomfort. Results: Patients receiving the combined treatment demonstrated significantly greater improvement in scar pigmentation, elasticity, pliability, and thickness compared to those treated with laser alone. Subjective symptoms, including pain and itching, were also more effectively alleviated. The volumetric and regenerative properties of adipose tissue, particularly its content of adipose-derived stem cells (ADSCs) and stromal vascular fraction (SVF), likely contributed to the enhanced outcomes observed. Conclusions: The combination of hybrid fractional laser therapy and autologous lipofilling offers a superior therapeutic strategy for scar remodeling compared to laser monotherapy. This integrated regenerative approach addresses both structural and biological aspects of scar tissue, making it a valuable protocol for personalized and effective scar management. Further randomized trials with larger sample sizes and histological validation are warranted to confirm these preliminary findings and refine therapeutic protocols. Full article

As the fields of plastic surgery and dermatology advance, regenerative medicine is positioned to play a transformative role in both aesthetic and reconstructive procedures. This narrative review examines current and emerging applications of biologic therapies, including exosomes, platelet-rich plasma (PRP), and adipose-derived stem cells (ASCs) with an emphasis on their mechanisms of action, clinical efficacy, and regulatory considerations. We also explore synergistic strategies, such as the combined use of biologics with laser-based technologies, which may enhance therapeutic outcomes. Looking forward, we highlight promising developments in mitochondrial-based therapies, microRNA-based therapies, synthetic exosome mimetics, and AI-assisted biologic design, offering a framework for personalized, precision-driven interventions. By synthesizing existing clinical data alongside scientific and ethical challenges, this narrative review provides a comprehensive perspective on how regenerative therapies are transforming the landscape of aesthetics. Ultimately, successful integration of these innovations will require rigorous validation, ethical responsibility, and a patient-centered approach by plastic surgeons and dermatologists to ensure both safety and accessibility in mainstream practice. Full article

Cartilage-derived migratory cells show great potential for autologous use in cartilage repair surgery. However, their collection through arthroscopic biopsy has not been previously reported in individuals without osteoarthritis. This study aimed to characterize migratory cartilage cells isolated from arthroscopic biopsies of volunteers without osteoarthritis and compare them with cells obtained by enzymatic digestion. Cell cultures were successfully established using both methods—enzymatic digestion and cell migration—from cartilage explants, with no significant differences observed in stem cell markers or plasticity between the cell lines. Cells derived from both procedures exhibited characteristics of mesenchymal stem cell, including fibroblast-like morphology, expression of CD29, CD90, and CD105 markers, absence of hematopoietic and endothelial cell markers, and the ability to differentiate into adipocytes, chondrocytes, and osteoblasts under appropriate conditions. Cells obtained by migration showed lower expression of collagen I and II, along with reduce collagen II/collagen I ratio, both positively associated with chondral matrix production, as well as lower RUNX2 expression. However, no differences were found in the levels of SOX9, essential for chondrogenic differentiation, or in the expression of perlecan gene. Syndecan-1 expression was lower in cells obtained by migration. In conclusion, this study demonstrates that cartilage-derived migratory cells can be successfully obtained from arthroscopic biopsies of individuals without osteoarthritis, presenting comparable dedifferentiation and plasticity profiles. Furthermore, these cells express essential chondrogenic markers and proteins. Although further in vivo studies are needed to determine their effective regenerative potential, cartilage-derived migratory cells represent a promising avenue for cartilage repair strategies. Full article

Background: Mesenchymal stem cell-based therapy may be indicated in ischaemic heart disease. The use of autologous adipose-derived mesenchymal stromal cells (AdMSCs) offers regenerative potential due to their paracrine effects. The aim of this study was to expand and characterise adult human thymus-derived MSCs harvested during open heart surgery with respect to their stem cell and paracrine properties. Methods: Enzymatically and non-enzymatically isolated human thymic AdMSCs (ThyAdMSCs) were cultured in xeno-free media containing pooled human platelet lysate (pPL). MSC characterisation was performed. Ex vivo expanded ThyAdMSCs were differentiated into three lineages. Proliferative capacity and immunomodulatory properties were assessed by proliferation assays and mixed lymphocyte reaction, respectively. Gene expression analysis was performed by qPCR. Results: Both isolation methods yielded fibroblast-like cells with plastic adherence and high proliferation. Flow cytometry revealed distinct expression of MSC markers in the absence of haematopoietic cell surface markers. Ex vivo expanded ThyAdMSCs could be differentiated into adipocytes, osteocytes, and chondrocytes. Activated peripheral blood mononuclear cells were significantly reduced when co-cultured with ThyAdMSCs, indicating their ability to inhibit immune cells in vitro. Gene expression analysis showed significantly less IFNγ and TNFα, indicating an alteration of the activated and pro-inflammatory state in the presence of ThyAdMSCs. Conclusions: These results demonstrate an efficient method to generate AdMSCs from human thymus. These MSCs have a strong immunomodulatory capacity and are, therefore, a promising cell source for regenerative medicine. The culture conditions are crucial for cells to proliferate in culture. Further research could explore the use of ThyAdMSCs or their secretome in surgical procedures. Full article

Skin is composed of three layers: the epidermis, dermis, and hypodermis. It is enriched with skin appendages, including hair follicles, sweat glands, and sebaceous glands, which play essential roles in regulating fluid exchange, controlling body temperature, and providing protection against pathogens. Currently, skin regeneration treatments rely on transplantations. However, this approach has several disadvantages, including hemostasis at the recipient site, limitations in donor area closure, increased graft contraction, and hypertrophic scarring. Recent advancements in three-dimensional (3D) bioprinting technologies have enabled the fabrication of structures that closely mimic native tissues, with the aim of enhancing tissue regeneration. Bioprinting offers several advantages, such as high reproducibility, precision, and the ability to create complex geometries. The most promising bioinks combine excellent biocompatibility and biodegradability, with mechanical and rheological stability. This review highlights the most recent and innovative studies on 3D-printed bioinks in the field of skin tissue engineering. In particular, considering the growing interest in the regenerative potential of exosomes, we discuss cutting-edge research involving exosome-loaded bioinks and their potential to support skin regeneration and repair. Full article

Background/Objectives: This study comprehensively examines how artificial intelligence (AI) technologies are transforming clinical practice in plastic and reconstructive surgery across the entire patient care continuum, with the specific objective of identifying evidence-based applications, implementation challenges, and emerging opportunities that will shape the future of the specialty. Methods: A comprehensive narrative review was conducted analyzing the integration of AI technologies in plastic surgery, including preoperative planning, intraoperative applications, postoperative monitoring, and quality improvement. Challenges related to implementation, ethics, and regulatory frameworks were also examined, along with emerging technological trends that will shape future practice. Results: AI applications in plastic surgery demonstrate significant potential across multiple domains. In preoperative planning, AI enhances risk assessment, outcome prediction, and surgical simulation. Intraoperatively, AI-assisted robotics enables increased precision and technical capabilities beyond human limitations, particularly in microsurgery. Postoperatively, AI improves complication detection, pain management, and outcomes assessment. Despite these benefits, implementation faces challenges including data privacy concerns, algorithmic bias, liability questions, and the need for appropriate regulatory frameworks. Future directions include multimodal AI systems, federated learning approaches, and integration with extended reality and regenerative medicine technologies. Conclusions: The integration of AI into plastic surgery represents a significant opportunity to enhance surgical precision, improve outcome prediction, and expand the boundaries of what is surgically possible. However, successful implementation requires addressing ethical considerations and maintaining the human elements of surgical care. Plastic surgeons must actively engage with AI development to ensure these technologies address genuine clinical needs while aligning with the specialty’s core values of restoring form and function, alleviating suffering, and enhancing quality of life. Full article

The use of autologous biological preparations (ABPs) and their combinations fills the void in healthcare treatment options that exists between surgical procedures, like plastic reconstructive, cosmetic, and orthopedic surgeries; non-surgical musculoskeletal biological procedures; and current pharmaceutical treatments. ABPs, including high-density platelet-rich plasma (HD-PRP), bone marrow aspirate concentrates (BMACs), and adipose tissue preparations, with their unique stromal vascular fractions (SVFs), can play important roles in tissue regeneration and repair processes. They can be easily and safely prepared at the point of care. Healthcare professionals can employ ABPs to mimic the classical wound healing cascade, initiate the angiogenesis cascade, and induce tissue regenerative pathways, aiming to restore the integrity and function of damaged tissues. In this review, we will address combining autologous HD-PRP with adipose tissue, in particular the tissue stromal vascular fraction (t-SVF), as we believe that this biocellular combination demonstrates a synergistic effect, where the HD-PRP constituents enhance the regenerative potential of t-SVF and its adipose-derived mesenchymal stem cells (AD-MSCs) and pericytes, leading to improved functional tissue repair, tissue regeneration, and wound healing in variety of clinical applications. We will address some relevant platelet bio-physiological aspects, since these properties contribute to the synergistic effects of combining HD-PRP with t-SVF, promoting overall better outcomes in chronic inflammatory conditions, soft tissue repair, and tissue rejuvenation. Full article

This study addresses a significant gap in the clinical validation and standardization of exosome-based applications within the domains of cosmetics and regenerative medicine. Despite offering a thorough overview of the potential therapeutic benefits and underlying mechanisms of exosomes, the manuscript underscores several unresolved challenges, including the paucity of clinical evidence, regulatory barriers, inconsistencies in standardization, and incomplete mechanistic understanding. The primary aim of this research is to conduct a systematic and comprehensive review of existing studies on the applications of exosomes in cosmetics and skincare. To achieve this, a systematic literature review was performed, drawing on the major medical database PubMed. This approach facilitated the collection and meta-analysis of relevant data, ensuring a rigorous assessment of recent advancements in exosome research. The main outcomes of the study highlight the multifaceted roles of exosomes in promoting skin rejuvenation and mitigating signs of aging. Specific applications discussed include pigmentation correction, wound healing, tissue repair, and innovative delivery mechanisms. Moreover, the study examines the emerging potential of exosomes in plastic surgery and regenerative medicine. Challenges and limitations, such as regulatory constraints, standardization hurdles, and the need for further clinical validation, are critically analyzed, providing a framework for future research directions. Full article

Introduction: Spheroids are spherical aggregates of cells that mimic the three-dimensional (3D) architecture of tissues more closely than traditional two dimensional (2D) cultures. Spheroids of adipose stem cells (SASCs) show special features such as high multilineage differentiation potential and immunomodulatory activity. These properties have been attributed to their secreted factors, such as cytokines and growth factors. Moreover, a key role is played by the extracellular vesicles (EVs), which lead a heterogeneous cargo of proteins, mRNAs, and small RNAs that interfere with the pathways of the recipient cells. Purpose: The aim of this work was to characterize the composition of the secretome and exosome from SASCs and evaluate their regenerative potential. Materials and Methods: SASCs were extracted from adipose samples of healthy individuals after signing informed consent. The exosomes were isolated and characterized by Dinamic Light Scattering (DLS), Scanning Electron Microscopy (SEM), and Western blotting analyses. The expression of mRNAs and miRNAs were evaluated through real-time PCR. Lastly, a wound-healing assay was performed to investigate their regenerative potential on different cell cultures. Results: The SASCs’ exosomes showed an up-regulation of NANOG and SOX2 mRNAs, typical of stemness maintenance, as well as miR126 and miR146a, related to angiogenic and osteogenic processes. Moreover, the exosomes showed a regenerative effect. Conclusions: The SASCs’ secretome carried paracrine signals involved in stemness maintenance, pro-angiogenic and pro-osteogenic differentiation, immune system regulation, and regeneration. Full article

Background: The upper respiratory mucosa plays a crucial role in both the physical integrity and immunological function of the respiratory tract. However, in certain situations such as infections, trauma, or surgery, it might sustain damage. Tissue engineering, a field of regenerative medicine, has found applications in various medical fields including but not limited to plastic surgery, ophthalmology, and urology. However, its application to the respiratory system remains somewhat difficult due to the complex morphology and histology of the upper respiratory tract. To date, a culture protocol for producing a handleable, well-differentiated nasal mucosa has yet to be developed. The objective of this review is to describe the current state of research pertaining to cell culture techniques used for producing autologous healthy human upper respiratory cells and mucosal tissues, as well as describe its clinical applications. Methods: A search of the relevant literature was carried out with no time restriction across Embase, Cochrane, PubMed, and Medline Ovid databases. Keywords related to “respiratory mucosa” and “culture techniques of the human airway” were the focus of the search strategy for this review. The risk of bias in retained studies was assessed using the Joanna Briggs Institute’s (JBI) critical appraisal tools for qualitative research. A narrative synthesis of our results was then conducted. Results: A total of 33 studies were included in this review, and thirteen of these focused solely on developing a cell culture protocol without further use. The rest of the studies used their own developed protocol for various applications such as cystic fibrosis, pharmacological, and viral research. One study was able to develop a promising model for nasal mucosa that could be employed as a replacement in nasotracheal reconstructive surgery. Conclusions: This systematic review extensively explored the current state of research regarding cell culture techniques for producing tissue-engineered nasal mucosa. Bioengineering the nasal mucosa holds great potential for clinical use. However, further research on mechanical properties is essential, as the comparison of engineered tissues is currently focused on morphology rather than comprehensive mechanical assessments. Full article

Since three-dimensional (3D) bioprinting has emerged, it has continuously to evolved as a revolutionary technology in surgery, offering new paradigms for reconstructive and regenerative medical applications. This review highlights the integration of 3D printing, specifically bioprinting, across several surgical disciplines over the last five years. The methods employed encompass a review of recent literature focusing on innovations and applications of 3D-bioprinted tissues and/or organs. The findings reveal significant advances in the creation of complex, customized, multi-tissue constructs that mimic natural tissue characteristics, which are crucial for surgical interventions and patient-specific treatments. Despite the technological advances, the paper introduces and discusses several challenges that remain, such as the vascularization of bioprinted tissues, integration with the host tissue, and the long-term viability of bioprinted organs. The review concludes that while 3D bioprinting holds substantial promise for transforming surgical practices and enhancing patient outcomes, ongoing research, development, and a clear regulatory framework are essential to fully realize potential future clinical applications. Full article