On March 23,2024,at the 23rd Shanghai International Congress of Plastic and Reconstructive Surgery,a Neurofibromatosis Type 1 and Skin and Soft-Tissue Tumors Forum was unveiled.This forum aimed to foster multidiscipli...On March 23,2024,at the 23rd Shanghai International Congress of Plastic and Reconstructive Surgery,a Neurofibromatosis Type 1 and Skin and Soft-Tissue Tumors Forum was unveiled.This forum aimed to foster multidisciplinary cooperation to standardize the diagnosis and treatment of neurofibromatosis and skin and soft-tissue tumors,attracting leading experts and scholars from across the nation.It served as a pivotal platform for sharing advancements in pathology,clinical practices,and surgical techniques related to these conditions,alongside discussions on standardized care and precision medicine,marking a significant step forward in the field.展开更多
Myofibroblastic sarcoma(MS)is a rare malignant soft tissue tumor characterized by myofibroblasts.It most commonly arises in the head and neck region,especially the tongue,with rare occurrences in the limbs.MS exhibits...Myofibroblastic sarcoma(MS)is a rare malignant soft tissue tumor characterized by myofibroblasts.It most commonly arises in the head and neck region,especially the tongue,with rare occurrences in the limbs.MS exhibits varying histopathology,ranging from low-to high-grade,with diverse subtypes showing different clinical behaviors and prognoses.This article reports the first case of high-grade MS in the hand,adding to the limited documentation of this rare condition.Here,we present the case of a 30-year-old healthy female with a year-long history of progressive shortening,mobility loss,and weakness in the first finger of the left hand.Left-hand imaging revealed a lytic,cottony tumor involving the entire first metacarpal.Following surgical resection,which included metatarsal grafting and joint reconstruction,a diagnosis of high-grade MS was confirmed based on histological manifestations and immunohistochemical staining,which was further classified as grade 2 according to the French Federation of Cancer Centers Sarcoma Group system.Postoperative radiotherapy was administered and the patient experienced a successful recovery without graft osteonecrosis.The patient regained 90%mobility and strength,without shortening,after surgical resection and radiotherapy.Six months post-surgery,the patient reported full hand functionality.MS is a rare tumor that infrequently affects bones and is often misdiagnosed owing to its controversial characteristics.The initial treatment should focus on complete resection with negative margins,followed by reconstructive surgery to preserve function.Further case studies are needed to establish standardized surgical treatment protocols.展开更多
This study aims to develop collagen-based hemostatic materials. The sheet-shaped collagen sponge was manufactured by freeze-vacuum drying the aqueous solution of collagen (Col) and heat-denatured collagen (Col’) at a...This study aims to develop collagen-based hemostatic materials. The sheet-shaped collagen sponge was manufactured by freeze-vacuum drying the aqueous solution of collagen (Col) and heat-denatured collagen (Col’) at a composition ratio of 2/1. The both sides or one side of sponge was treated with ultraviolet (UV) irradiation for 15 minutes to introduce intermolecular crosslinks between collagen molecules. The elution behavior of collagen sponge was investigated by immersing the sponge in water for a predetermined time and then by measuring the weight change. The double-sided UV-irradiated sponge showed very slow elution properties. On the other hand, the single-sided UV-irradiated sponge showed initially fast elution and subsequent very slow elution properties. Such initially fast elution of collagen molecules from the surface without UV-irradiation allows an adhesion of collagen sponge to the wound surface and results in hemostatic effect. In addition, the water absorption and retention properties of sponge were investigated by placing the hydrated sponge on a mesh for a predetermined time and then by measuring the weight change. The double-sided UV-irradiated sponge absorbed 81 times more water than own weight and showed a value of 45 times even after 7 days. The single-sided UV-irradiated sponge absorbed 80 times more water than own weight and showed a value of 39 times even after 7 days. The sponge with high water absorption and retention properties allows a wound healing effect because such sponge can absorb large amounts of blood plasma and exudates containing various cell growth factors. The double-sided UV-irradiated sponge is a good candidate for the wound dressing. On the other hand, the single-sided UV-irradiated sponge is a good candidate for the hemostatic material.展开更多
BACKGROUND The high prevalence of human papillomavirus(HPV)infection in oropharyngeal squamous cell carcinoma(SCC)is well established,and p16 expression is a strong predictor.HPV-related tumors exhibit unique mechanis...BACKGROUND The high prevalence of human papillomavirus(HPV)infection in oropharyngeal squamous cell carcinoma(SCC)is well established,and p16 expression is a strong predictor.HPV-related tumors exhibit unique mechanisms that target p16 and p53 proteins.However,research on HPV prevalence and the combined predictive value of p16 and p53 expression in head and neck cutaneous SCC(HNCSCC),particularly in Asian populations,remains limited.This retrospective study surveyed 62 patients with HNSCC(2011-2020),excluding those with facial warts or other skin cancer.AIM To explore the prevalence of HPV and the predictive value of p16 and p53 expression in HNCSCC in Asian populations.METHODS All patients underwent wide excision and biopsy.Immunohistochemical staining for HPV,p16,and p53 yielded positive and negative results.The relevance of each marker was investigated by categorizing the tumor locations into high-risk and middle-risk zones based on recurrence frequency.RESULTS Of the 62 patients,20(32.26%)were male,with an average age of 82.27 years(range 26-103 years).High-risk included 19 cases(30.65%),with the eyelid and lip being the most common sites(five cases,8.06%).Middle-risk included 43 cases(69.35%),with the cheek being the most common(29 cases,46.77%).The p16 expression was detected in 24 patients(38.71%),p53 expression in 42 patients(72.58%),and HPV in five patients(8.06%).No significant association was found between p16 expression and the presence of HPV(P>0.99),with a positive predictive value of 8.33%.CONCLUSION This study revealed that p16,a surrogate HPV marker in oropharyngeal SCC,is not reliable in HNCSCC,providing valuable insights for further research in Asian populations.展开更多
Large-scale defects of body in the reconstructive surgical practice,and the help-lessness of their repair with autologous tissues,have been an important factor in the development of artificial biological products for ...Large-scale defects of body in the reconstructive surgical practice,and the help-lessness of their repair with autologous tissues,have been an important factor in the development of artificial biological products for the temporary,definitive,or staged repair of these defects.A major advance in the field of plastic and other reconstructive surgery in this regard has been the introduction and successful use of acellular dermal matrices(ADMs).In recent years,not only the type of tissue from which ADMs are produced,product range,diversity and areas of use have increased,but their use in reconstructive fields,especially in post oncologic breast surgery,has become highly regarded and this has favored ADMs to be a potential cornerstone in specific and well-defined surgical fields in future.It is essential that reconstructive surgeons become familiar with some of the ADM’s as well as the advantages and limitations to their use.This review not only provides basic science and clinical evidence of the current use of ADMs in wide range of surgical fields but also targets to keep them as an important backdrop in the arma-mentarium of reconstructive surgeons.Brief considerations of possible future directions for ADMs are also conducted in the end.展开更多
Objective:To explore the effectiveness of a chest compression device combined with extended self-care for scar prevention in patients following keloid excision surgery.Methods:Forty patients(36 lesions)who underwent k...Objective:To explore the effectiveness of a chest compression device combined with extended self-care for scar prevention in patients following keloid excision surgery.Methods:Forty patients(36 lesions)who underwent keloid excision surgery at the Department of Plastic and Reconstructive Surgery,First Medical Center,PLA General Hospital from June 2022 to June 2024 were selected.They were randomly divided into an experimental group and a control group,with 20 patients in each group.The control group received traditional elastic garment compression therapy,while the experimental group used a chest compression device designed for scar prevention.Scar width,hypertrophy,and Vancouver Scar Scale(VSS)scores were compared between the two groups at 6 months post-operation.Results:There were no statistically significant differences between the two groups in terms of gender,age,disease duration,lesion area,or location(P>0.05).However,VSS scores(except for pliability)in the experimental group were significantly lower than those in the control group(P<0.05).Conclusion:The chest compression device for scar prevention is more effective than traditional elastic garments in preventing scar hypertrophy after chest wall keloid excision surgery,and it has high clinical value,making it worthy of promotion.展开更多
The treatment of a 40-year-old woman with a giant fibroadenoma in her left breast is presented. The fibroadenoma measured 14 × 5 × 3 cm and weighed 170 g. We demonstrate that the surgical strategy and the re...The treatment of a 40-year-old woman with a giant fibroadenoma in her left breast is presented. The fibroadenoma measured 14 × 5 × 3 cm and weighed 170 g. We demonstrate that the surgical strategy and the reconstructive techniques in oncoplastic breast cancer surgery successfully can be applied to the treatment of these rare benign tumours improving the cosmetic and functional outcome.展开更多
The field of plastic surgery has developed rapidly in the last couple of decades in Hong Kong and Shanghai,China.Both cities have their own educational system for training plastic surgeons.Their training programs diff...The field of plastic surgery has developed rapidly in the last couple of decades in Hong Kong and Shanghai,China.Both cities have their own educational system for training plastic surgeons.Their training programs differ in many ways,including the surgical exposure of undergraduate studies,the structure,curriculum,and operative requirements of residency training.In general,Hong Kong has a single pathway of residency training with more early clinical exposure in an undergraduate study.On the contrary,Shanghai has multiple pathways of residency training that are heavily emphasized in academic research.Both Hong Kong and Shanghai should complement each other to modify their plastic surgery training programs that will eventually benefit the field of plastic surgery education。展开更多
<em>Aloe vera</em> has been used for centuries for medicinal purposes. Clinical and experimental evidence indicates usefulness for skin moisturization, promoting wound healing, thermal skin injury, frostbi...<em>Aloe vera</em> has been used for centuries for medicinal purposes. Clinical and experimental evidence indicates usefulness for skin moisturization, promoting wound healing, thermal skin injury, frostbite, and ischemic skin insults. <em>Aloe vera</em> has anti-inflammatory, vasodilatory, antimicrobial, and proliferative actions, which have been investigated in various experimental models and in various in vitro studies. This extensive literature review of the properties and actions of <em>Aloe vera</em> finds substantial evidence for the reported and also likely clinical usefulness for <em>Aloe vera</em> in Plastic Surgery and in wound care and wound healing. Though further clinical investigation is warranted, Aloe vera use may likely be indicated in situations where its effects could positively influence outcomes, such as wound healing, flap vascularity, and inflammatory skin pathologies.展开更多
BACKGROUND Anxiety and depression are common psychological reactions in teenagers with facial burns and have a significant impact on their rehabilitation and quality of life.AIM To analyze anxiety and depressive sympt...BACKGROUND Anxiety and depression are common psychological reactions in teenagers with facial burns and have a significant impact on their rehabilitation and quality of life.AIM To analyze anxiety and depressive symptoms in teenagers with facial burns.METHODS We selected 50 young patients with facial burns who were treated at our hospital between October 2023 and October 2024.The Hamilton Anxiety Scale and Beck Depression Inventory were used to evaluate anxiety and depressive symptoms.Additionally,we evaluated patients'social support levels and self-esteem.Pearson's correlation analysis was used to evaluate factors related to depression and anxiety.RESULTS The overall average Hamilton Anxiety Scale score was 23.4±6.2,and 16(32%)and 34(68%)patients showed mild to moderate and moderate to severe anxiety,respectively.The overall average Beck Depression Inventory score was 18.7±7.5,and 23(46%)and 27(54%)patients had mild to moderate and moderate to severe depression,respectively.Furthermore,Pearson's correlation analysis showed a significant positive correlation between burn severity and anxiety(r=0.48,P<0.01)and depression(r=0.42,P<0.01)symptoms.Self-esteem scores and social support were significantly negatively correlated with anxiety(r=-0.55 and r=-0.40,respectively;P<0.01)and depression(r=-0.60 and r=-0.38,respectively;P<0.01 for both).CONCLUSION Adolescents with facial burns commonly experience anxiety and depressive symptoms,the severity of which is closely related to burn severity,social support,and self-esteem.展开更多
Current breast reconstruction evaluations mostly focus on static cosmetic analysis as a measure of the clinical outcomes.Moreover,it is essential to consider the dynamic changes in the reconstructed breast alongside a...Current breast reconstruction evaluations mostly focus on static cosmetic analysis as a measure of the clinical outcomes.Moreover,it is essential to consider the dynamic changes in the reconstructed breast alongside assessments of aesthetic symmetry,functional restoration,complication rates,and long-term stability of the reconstruction.This study aimed to assess the mobility of the reconstructed breast following various breast reconstruction techniques,specifically by comparing deep inferior epigastric perforator(DIEP) flaps and pedicled transverse rectus abdominis musculocutaneous(TRAM) flaps.We conducted a longitudinal case study to investigate the changes in breast movement resulting from different surgical interventions.The comparison showed that DIEP flap reconstruction was more likely to achieve superior breast mobility outcomes than TRAM flap reconstruction.For a better breast aesthetic outcome,it is fundamental to improve the awareness of the dynamic evaluation of the reconstructed breast at the surgical strategy level.展开更多
Background:The first web space not only plays an integral role in hand functionality,but also holds an important aesthetic function for patients with cicatricial contractures,which hinders the ability to move joints,t...Background:The first web space not only plays an integral role in hand functionality,but also holds an important aesthetic function for patients with cicatricial contractures,which hinders the ability to move joints,thereby restricting the performance of everyday activities.Therefore,a wide variety of reconstruction options are available.In this study,our main aim was to have a clear surgical plan prior to surgery according to preoperative findings and the degree of thumb abduction span.Methods:This study was conducted at Kasr Al-Ainy Hospital.This cohort study included 33 patients with cicatricial first web space contractures who underwent reconstructive procedures to restore the first web space.Patients were assessed preoperatively and categorized according to the degree of contracture,and the reconstruction procedure was chosen accordingly.They were assessed using both objective and subjective methods.Results:In this study,33 cases of cicatricial contracture of the first web space due to physical or thermal trauma were included.Measurements of the change in the span of abduction were performed for all patients included in the study preoperatively and postoperatively.Skin grafting and skin substitutes had an average change in abduction span of 32.5°(±14.4°),Z-plasty release had a mean of 30.59°(±8.82°)increase in abduction span,regional flaps had an increase of 40.71°(±12.39°),while distant flaps had an increase of 35°(±3.54°).Conclusion:No single reconstruction method can be used in all cases.When viewing a patient,one must consider that each individual has a unique representation.However,if we follow a systematic method for the initial evaluation,the most efficient flap can be chosen for each case,thus reducing the need for secondary procedures.Categorizing the cases according to the abduction span into mild,moderate,or severe forms is the first building block of this algorithm.Adjacent tissue condition,patient occupation,compliance,and the need to return to work are important factors.展开更多
Tissue expansion is a widely utilized technique in plastic and reconstructive surgery;however,the biological mechanisms underlying the skin response remain poorly understood.We propose that tissue fluidity,the transit...Tissue expansion is a widely utilized technique in plastic and reconstructive surgery;however,the biological mechanisms underlying the skin response remain poorly understood.We propose that tissue fluidity,the transition of tissue from a solid-like state to a fluid-like state,plays a pivotal role in enabling the reorganization of the epidermal structure and cellular spatial order,which is essential for effective tissue expansion.Drawing parallels between fluidity in materials science and biological systems,we suggest that the fluid-like behavior in the skin may be critical for mechanical adaptability.Understanding the influence of tissue fluidity may open pathways for modulating this process,potentially enhancing tissue expansion efficiency,reducing procedural duration,and improving clinical outcomes.This perspective highlights the importance of investigating the biological dynamics of tissue fluidity and exploring the potential for targeted manipulation of fluidity-related pathways to optimize tissue expansion.Such advancements could profoundly affect regenerative and reconstructive surgical practices.展开更多
Adipocyte-secreted extracellular vesicles(EVs)and adipose-derived stem cells(ADSCs)regulate physiological and pathological processes by delivering nucleic acids,proteins,and lipids.Both adipocyte-and ADSC-derived EVs ...Adipocyte-secreted extracellular vesicles(EVs)and adipose-derived stem cells(ADSCs)regulate physiological and pathological processes by delivering nucleic acids,proteins,and lipids.Both adipocyte-and ADSC-derived EVs regulate local inflammatory levels,tumor progression,and insulin sensitivity.These two types of EVs also have significant therapeutic effects on damage repair,including wound healing,angiogenesis,myocardial damage,vessel re-endothelialization,bone and cartilage regeneration,muscle repair,and nerve repair.With regard to wound healing,microRNA-21,microRNA-126,microRNA-31,and long non-coding RNA-H19 accelerate the proliferation and migration of fibroblasts,human immortalized keratinocytes,and endothelial cells via the PI3K/Akt/ERK pathway or fibrillin 1.ADSC-derived EVs contain various growth factors that are beneficial for wound healing.Numerous miRNAs in ADSC-derived EVs and β3-adrenergic receptors on brown adipocytes exhibit protective effects against myocardial infarction.Proteins in adipocyte-and ADSC-derived EVs play a role in promoting vessel re-endothelialization and regulating vasodilation.Angiogenesis is beneficial for the regeneration and repair of injured bone,cartilage,muscle,and nerves.Compared with adipocyte EVs,ADSC-EVs contain a greater variety of miRNAs and proteins that promote tissue regeneration.EV therapy is a promising cell-free therapy,and EV-loaded materials have been used for wound healing and myocardial damage.Future research will focus on identifying the molecules in EVs and the repair mechanisms that contribute to damage repair and regeneration.In addition,we aim to discover materials designed for slow release and specificity to facilitate tissue repair and optimize EV transportation.展开更多
Hypertrophic scars(HS)are fibrotic proliferative diseases that develop after deep skin injuries caused by trauma,burns,and surgery.Traditional treatment methods include both surgical and nonsurgical therapies.Early in...Hypertrophic scars(HS)are fibrotic proliferative diseases that develop after deep skin injuries caused by trauma,burns,and surgery.Traditional treatment methods include both surgical and nonsurgical therapies.Early intervention and combination therapy tailored to the individual needs of the patients are crucial for achieving optimal results.Three-dimensional(3D)printing technology,a rapid prototyping technique,is increasingly being applied in the medical field.The customization and precise functionality of 3D printing technology are particularly important for the rehabilitation of HS.This review provides an overview of HS and the role of 3D printing technology in medical applications,analyses the application of 3D-printed rehabilitation aids for HS,and discusses the use of 3D printing technology to improve HS treatment outcomes,thereby providing clinical guidance for effective HS rehabilitation.展开更多
Background: Scar contractions caused by hand burns seriously impact both the function and appearance of the hand.Consequently,post-burn hand reconstruction is a primary focus of secondary reconstructive surgery perfor...Background: Scar contractions caused by hand burns seriously impact both the function and appearance of the hand.Consequently,post-burn hand reconstruction is a primary focus of secondary reconstructive surgery performed within the first 10 years after a burn injury.This study aimed to identify developmental trends and research hotspots in post-burn hand reconstruction,providing insights and recommendations for researchers.Methods: Bibliometric and visualization analyses were conducted using Cite Space v6.4.R1(64-bit) and VOS viewer.The Web of Science Core Collection served as the data source.A total of 136 articles between 1997 and2025 were included based on the following keywords: “postburn hand reconstruction” or “postburn hand” or“scar contraction hand deformity.”Results: The field of post-burn hand reconstruction is advancing,as indicated by the overall and annual increase in publications.The United States leads in number of published papers.However,major institutions show low centrality,indicating weak collaboration between countries and regions,with research still dominated by singlecenter studies.The top three most prolific authors were Paul P M van Zuijlen,Fatih Uyghur,and Ersin Uyghur.The keywords “double Z-plasty” and the cluster “flap” not only have high emergence intensity but also appear frequently in recent studies,marking them as current research hotspots.Conclusion: The lack of long-term research and consensus limits further advancements in post-burn hand reconstruction.To address this,multi-center and multi-disciplinary collaborations should be encouraged.Additionally,integrating basic medical research with biomedical engineering could enhance the management and outcomes of post-burn hand reconstruction.展开更多
Osteosarcoma,an aggressive bone cancer found most often in children and adolescents,remains difficult to treat,and little improvement in survival rate has been observed over recent decades.The tumor microenvironment(T...Osteosarcoma,an aggressive bone cancer found most often in children and adolescents,remains difficult to treat,and little improvement in survival rate has been observed over recent decades.The tumor microenvironment(TME),especially the extracellular matrix(ECM),is a critical factor determining cancer progression and chemotherapy resistance,yet traditional 2D models generally fail to replicate its properties.Recent development of 3D-bioprinted tumor models has facilitated improved simulation of the complexity of the TME,but specific models involving bioinks tailored to osteosarcoma remain underdeveloped.Gelatin methacryloyl(GelMA)is a common bioink that can rapidly gel and contains Arg-Gly-Asp(RGD)sequences.However,it lacks collagen’s triple-helix structure that is essential for ECM-cell communication.Hyaluronic acid(HA)is a macromolecule that is aberrantly expressed in osteosarcoma by mechanisms that remain largely unexplored.In this study,we developed a composite bioink containing GelMA,collagen,and HA,and applied it to 3D bioprint an in vitro osteosarcoma model.We found that HA significantly enhanced osteosarcoma cell proliferation and chemoresistance,as well as the expression of epithelial-mesenchymal transition and cancer stem cell markers.Furthermore,we found that HA abundance was positively correlated with hypoxia and angiogenesis signaling pathways,and this occurred mainly via upregulation of hypoxia-inducible factor-1α(HIF-1α)and vascular endothelial growth factor A(VEGFA)expression,thereby contributing to increased chemoresistance.Overall,our study provides a protocol for building in vitro realistic 3D-bioprinted models for studying osteosarcoma,highlights the role of HA in osteosarcoma progression,and offers a platform for developing new chemotherapy treatments.展开更多
Background: Plexiform neurofibromas(PNF) are highly vascular tumors with the potential for significant growth.Surgical removal of giant PNF is often challenging because of intraoperative hemorrhage.This study proposed...Background: Plexiform neurofibromas(PNF) are highly vascular tumors with the potential for significant growth.Surgical removal of giant PNF is often challenging because of intraoperative hemorrhage.This study proposed and evaluated an innovative surgical approach involving FENCY ligation and the role of preoperative embolization in the resection of giant PNF.Methods: This was a retrospective,interventional,and sequential case series conducted in a plastic and reconstructive surgery unit.We summarized all patients with PNF who underwent resection at our center between2019 and 2024.Surgical case notes from 11 patients with giant PNF who underwent FENCY ligation were reviewed,including three patients who received preoperative embolization.All patients participated in structured telephone interviews.Patient demographics,surgical safety,postoperative recovery,and patient satisfaction were evaluated.Results: Among 456 patients with 494 PNF who underwent surgical resection,we categorized the procedures into median,large,and giant PNF subgroups.To illustrate comprehensive perioperative and surgical approaches,we analyzed seven female and four male patients with giant PNF.The median maximum tumor diameter at the time of surgery was 30.4 cm(range,11.5–55.6 cm).Most PNF were located on the face(63.6%),followed by the back(18.2%),buttocks(18.2%),upper limbs(9.1%),and neck(9.1%).The median intraoperative hemorrhage volume was 366 m L(range,10–2 034 m L),And the median hospital stay was 17 days(range,14–33 days).The mean follow-up duration was 2.5 years(range,0.4–5.5 years).No severe complications were observed,except for one case of infection.Conclusion: PNF resection,particularly giant PNF resection,is a high-risk treatment option.Comprehensive evaluation,perioperative preparation,and surgical techniques are required to ensure efficacy and safety.FENCY ligation and preoperative embolization can be used to resect giant PNF in multiple complex regions with satisfactory outcomes.展开更多
As the study of vascular anomalies progresses,it is imperative for plastic surgeons to individualize their in-depth research and practice to develop more effective and personalized treatment plans.Recent advancements ...As the study of vascular anomalies progresses,it is imperative for plastic surgeons to individualize their in-depth research and practice to develop more effective and personalized treatment plans.Recent advancements in genome sequencing technology have highlighted the importance of vascular endothelial growth factor(VEGF)and its receptor(VEGFR)in the formation and alteration of vascularity.However,definitive reports regarding mutations associated with this locus and treatment experiences remain scarce.Herein,we report a clinical case of multiple venous malformations with mutations in VEGFR3(FLT4).We implemented a comprehensive approach,including local lesion excision of the left foot and trunk,oral propranolol administration,and local physiotherapy.After two years of follow-up,the patient’s left foot venous malformation did not recur,and he expressed satisfaction with the outcomes of the combined therapy.This case offers valuable insights into the clinical management of this mutant type and similar presentations of multiple venous malformations.展开更多
July 20 and 21,2022,witnessed the highlight of the 21st Shanghai International Conference of Plastic and Aesthetic Surgery,a successful vascular anomalies workshop titled“Advancements in the Management of Vascular An...July 20 and 21,2022,witnessed the highlight of the 21st Shanghai International Conference of Plastic and Aesthetic Surgery,a successful vascular anomalies workshop titled“Advancements in the Management of Vascular Anomalies”at Shanghai Ninth People’s Hospital.The conference was graced by many renowned specialists and scholars from China and abroad who presented lectures and panels on cutting-edge debated concepts and technological progress in the field.Amid the coronavirus disease 2019(COVID-19)pandemic,specialists from numerous fields have delivered rich content in person and virtually to participants across China.Prof.Xiaoxi Lin’s team from Shanghai Ninth People’s Hospital,a leading center in the field of infantile hemangioma and vascular malformation in China,collaborated with colleagues on new developments using teaching and discussion.展开更多
文摘On March 23,2024,at the 23rd Shanghai International Congress of Plastic and Reconstructive Surgery,a Neurofibromatosis Type 1 and Skin and Soft-Tissue Tumors Forum was unveiled.This forum aimed to foster multidisciplinary cooperation to standardize the diagnosis and treatment of neurofibromatosis and skin and soft-tissue tumors,attracting leading experts and scholars from across the nation.It served as a pivotal platform for sharing advancements in pathology,clinical practices,and surgical techniques related to these conditions,alongside discussions on standardized care and precision medicine,marking a significant step forward in the field.
文摘Myofibroblastic sarcoma(MS)is a rare malignant soft tissue tumor characterized by myofibroblasts.It most commonly arises in the head and neck region,especially the tongue,with rare occurrences in the limbs.MS exhibits varying histopathology,ranging from low-to high-grade,with diverse subtypes showing different clinical behaviors and prognoses.This article reports the first case of high-grade MS in the hand,adding to the limited documentation of this rare condition.Here,we present the case of a 30-year-old healthy female with a year-long history of progressive shortening,mobility loss,and weakness in the first finger of the left hand.Left-hand imaging revealed a lytic,cottony tumor involving the entire first metacarpal.Following surgical resection,which included metatarsal grafting and joint reconstruction,a diagnosis of high-grade MS was confirmed based on histological manifestations and immunohistochemical staining,which was further classified as grade 2 according to the French Federation of Cancer Centers Sarcoma Group system.Postoperative radiotherapy was administered and the patient experienced a successful recovery without graft osteonecrosis.The patient regained 90%mobility and strength,without shortening,after surgical resection and radiotherapy.Six months post-surgery,the patient reported full hand functionality.MS is a rare tumor that infrequently affects bones and is often misdiagnosed owing to its controversial characteristics.The initial treatment should focus on complete resection with negative margins,followed by reconstructive surgery to preserve function.Further case studies are needed to establish standardized surgical treatment protocols.
文摘This study aims to develop collagen-based hemostatic materials. The sheet-shaped collagen sponge was manufactured by freeze-vacuum drying the aqueous solution of collagen (Col) and heat-denatured collagen (Col’) at a composition ratio of 2/1. The both sides or one side of sponge was treated with ultraviolet (UV) irradiation for 15 minutes to introduce intermolecular crosslinks between collagen molecules. The elution behavior of collagen sponge was investigated by immersing the sponge in water for a predetermined time and then by measuring the weight change. The double-sided UV-irradiated sponge showed very slow elution properties. On the other hand, the single-sided UV-irradiated sponge showed initially fast elution and subsequent very slow elution properties. Such initially fast elution of collagen molecules from the surface without UV-irradiation allows an adhesion of collagen sponge to the wound surface and results in hemostatic effect. In addition, the water absorption and retention properties of sponge were investigated by placing the hydrated sponge on a mesh for a predetermined time and then by measuring the weight change. The double-sided UV-irradiated sponge absorbed 81 times more water than own weight and showed a value of 45 times even after 7 days. The single-sided UV-irradiated sponge absorbed 80 times more water than own weight and showed a value of 39 times even after 7 days. The sponge with high water absorption and retention properties allows a wound healing effect because such sponge can absorb large amounts of blood plasma and exudates containing various cell growth factors. The double-sided UV-irradiated sponge is a good candidate for the wound dressing. On the other hand, the single-sided UV-irradiated sponge is a good candidate for the hemostatic material.
基金Supported by the National Research Foundation of Korea,No.2020R1A2C1100891Soonchunhyang University Research Fund,No.2024-05-014.
文摘BACKGROUND The high prevalence of human papillomavirus(HPV)infection in oropharyngeal squamous cell carcinoma(SCC)is well established,and p16 expression is a strong predictor.HPV-related tumors exhibit unique mechanisms that target p16 and p53 proteins.However,research on HPV prevalence and the combined predictive value of p16 and p53 expression in head and neck cutaneous SCC(HNCSCC),particularly in Asian populations,remains limited.This retrospective study surveyed 62 patients with HNSCC(2011-2020),excluding those with facial warts or other skin cancer.AIM To explore the prevalence of HPV and the predictive value of p16 and p53 expression in HNCSCC in Asian populations.METHODS All patients underwent wide excision and biopsy.Immunohistochemical staining for HPV,p16,and p53 yielded positive and negative results.The relevance of each marker was investigated by categorizing the tumor locations into high-risk and middle-risk zones based on recurrence frequency.RESULTS Of the 62 patients,20(32.26%)were male,with an average age of 82.27 years(range 26-103 years).High-risk included 19 cases(30.65%),with the eyelid and lip being the most common sites(five cases,8.06%).Middle-risk included 43 cases(69.35%),with the cheek being the most common(29 cases,46.77%).The p16 expression was detected in 24 patients(38.71%),p53 expression in 42 patients(72.58%),and HPV in five patients(8.06%).No significant association was found between p16 expression and the presence of HPV(P>0.99),with a positive predictive value of 8.33%.CONCLUSION This study revealed that p16,a surrogate HPV marker in oropharyngeal SCC,is not reliable in HNCSCC,providing valuable insights for further research in Asian populations.
文摘Large-scale defects of body in the reconstructive surgical practice,and the help-lessness of their repair with autologous tissues,have been an important factor in the development of artificial biological products for the temporary,definitive,or staged repair of these defects.A major advance in the field of plastic and other reconstructive surgery in this regard has been the introduction and successful use of acellular dermal matrices(ADMs).In recent years,not only the type of tissue from which ADMs are produced,product range,diversity and areas of use have increased,but their use in reconstructive fields,especially in post oncologic breast surgery,has become highly regarded and this has favored ADMs to be a potential cornerstone in specific and well-defined surgical fields in future.It is essential that reconstructive surgeons become familiar with some of the ADM’s as well as the advantages and limitations to their use.This review not only provides basic science and clinical evidence of the current use of ADMs in wide range of surgical fields but also targets to keep them as an important backdrop in the arma-mentarium of reconstructive surgeons.Brief considerations of possible future directions for ADMs are also conducted in the end.
文摘Objective:To explore the effectiveness of a chest compression device combined with extended self-care for scar prevention in patients following keloid excision surgery.Methods:Forty patients(36 lesions)who underwent keloid excision surgery at the Department of Plastic and Reconstructive Surgery,First Medical Center,PLA General Hospital from June 2022 to June 2024 were selected.They were randomly divided into an experimental group and a control group,with 20 patients in each group.The control group received traditional elastic garment compression therapy,while the experimental group used a chest compression device designed for scar prevention.Scar width,hypertrophy,and Vancouver Scar Scale(VSS)scores were compared between the two groups at 6 months post-operation.Results:There were no statistically significant differences between the two groups in terms of gender,age,disease duration,lesion area,or location(P>0.05).However,VSS scores(except for pliability)in the experimental group were significantly lower than those in the control group(P<0.05).Conclusion:The chest compression device for scar prevention is more effective than traditional elastic garments in preventing scar hypertrophy after chest wall keloid excision surgery,and it has high clinical value,making it worthy of promotion.
文摘The treatment of a 40-year-old woman with a giant fibroadenoma in her left breast is presented. The fibroadenoma measured 14 × 5 × 3 cm and weighed 170 g. We demonstrate that the surgical strategy and the reconstructive techniques in oncoplastic breast cancer surgery successfully can be applied to the treatment of these rare benign tumours improving the cosmetic and functional outcome.
基金supported by grants from the Youth Doctor Collaborative Innovation Team Project(QC201803)of Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicinethe Project of Biobank(NO.YBKA201901)from Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine+1 种基金the Shanghai Youth Top-Notch Talent Program(201809004)“Chenguang Program”supported by Shanghai Education Development Foundation and Shanghai Municipal Education Commission(19CG18)and Science and Technology Commission of Shanghai Municipality(19JC1413),Shanghai Rising-Star Program(20QA1405600).
文摘The field of plastic surgery has developed rapidly in the last couple of decades in Hong Kong and Shanghai,China.Both cities have their own educational system for training plastic surgeons.Their training programs differ in many ways,including the surgical exposure of undergraduate studies,the structure,curriculum,and operative requirements of residency training.In general,Hong Kong has a single pathway of residency training with more early clinical exposure in an undergraduate study.On the contrary,Shanghai has multiple pathways of residency training that are heavily emphasized in academic research.Both Hong Kong and Shanghai should complement each other to modify their plastic surgery training programs that will eventually benefit the field of plastic surgery education。
文摘<em>Aloe vera</em> has been used for centuries for medicinal purposes. Clinical and experimental evidence indicates usefulness for skin moisturization, promoting wound healing, thermal skin injury, frostbite, and ischemic skin insults. <em>Aloe vera</em> has anti-inflammatory, vasodilatory, antimicrobial, and proliferative actions, which have been investigated in various experimental models and in various in vitro studies. This extensive literature review of the properties and actions of <em>Aloe vera</em> finds substantial evidence for the reported and also likely clinical usefulness for <em>Aloe vera</em> in Plastic Surgery and in wound care and wound healing. Though further clinical investigation is warranted, Aloe vera use may likely be indicated in situations where its effects could positively influence outcomes, such as wound healing, flap vascularity, and inflammatory skin pathologies.
文摘BACKGROUND Anxiety and depression are common psychological reactions in teenagers with facial burns and have a significant impact on their rehabilitation and quality of life.AIM To analyze anxiety and depressive symptoms in teenagers with facial burns.METHODS We selected 50 young patients with facial burns who were treated at our hospital between October 2023 and October 2024.The Hamilton Anxiety Scale and Beck Depression Inventory were used to evaluate anxiety and depressive symptoms.Additionally,we evaluated patients'social support levels and self-esteem.Pearson's correlation analysis was used to evaluate factors related to depression and anxiety.RESULTS The overall average Hamilton Anxiety Scale score was 23.4±6.2,and 16(32%)and 34(68%)patients showed mild to moderate and moderate to severe anxiety,respectively.The overall average Beck Depression Inventory score was 18.7±7.5,and 23(46%)and 27(54%)patients had mild to moderate and moderate to severe depression,respectively.Furthermore,Pearson's correlation analysis showed a significant positive correlation between burn severity and anxiety(r=0.48,P<0.01)and depression(r=0.42,P<0.01)symptoms.Self-esteem scores and social support were significantly negatively correlated with anxiety(r=-0.55 and r=-0.40,respectively;P<0.01)and depression(r=-0.60 and r=-0.38,respectively;P<0.01 for both).CONCLUSION Adolescents with facial burns commonly experience anxiety and depressive symptoms,the severity of which is closely related to burn severity,social support,and self-esteem.
文摘Current breast reconstruction evaluations mostly focus on static cosmetic analysis as a measure of the clinical outcomes.Moreover,it is essential to consider the dynamic changes in the reconstructed breast alongside assessments of aesthetic symmetry,functional restoration,complication rates,and long-term stability of the reconstruction.This study aimed to assess the mobility of the reconstructed breast following various breast reconstruction techniques,specifically by comparing deep inferior epigastric perforator(DIEP) flaps and pedicled transverse rectus abdominis musculocutaneous(TRAM) flaps.We conducted a longitudinal case study to investigate the changes in breast movement resulting from different surgical interventions.The comparison showed that DIEP flap reconstruction was more likely to achieve superior breast mobility outcomes than TRAM flap reconstruction.For a better breast aesthetic outcome,it is fundamental to improve the awareness of the dynamic evaluation of the reconstructed breast at the surgical strategy level.
文摘Background:The first web space not only plays an integral role in hand functionality,but also holds an important aesthetic function for patients with cicatricial contractures,which hinders the ability to move joints,thereby restricting the performance of everyday activities.Therefore,a wide variety of reconstruction options are available.In this study,our main aim was to have a clear surgical plan prior to surgery according to preoperative findings and the degree of thumb abduction span.Methods:This study was conducted at Kasr Al-Ainy Hospital.This cohort study included 33 patients with cicatricial first web space contractures who underwent reconstructive procedures to restore the first web space.Patients were assessed preoperatively and categorized according to the degree of contracture,and the reconstruction procedure was chosen accordingly.They were assessed using both objective and subjective methods.Results:In this study,33 cases of cicatricial contracture of the first web space due to physical or thermal trauma were included.Measurements of the change in the span of abduction were performed for all patients included in the study preoperatively and postoperatively.Skin grafting and skin substitutes had an average change in abduction span of 32.5°(±14.4°),Z-plasty release had a mean of 30.59°(±8.82°)increase in abduction span,regional flaps had an increase of 40.71°(±12.39°),while distant flaps had an increase of 35°(±3.54°).Conclusion:No single reconstruction method can be used in all cases.When viewing a patient,one must consider that each individual has a unique representation.However,if we follow a systematic method for the initial evaluation,the most efficient flap can be chosen for each case,thus reducing the need for secondary procedures.Categorizing the cases according to the abduction span into mild,moderate,or severe forms is the first building block of this algorithm.Adjacent tissue condition,patient occupation,compliance,and the need to return to work are important factors.
基金supported by the National Natural Science Foundation of China(grant nos.82102343 and 82372536)the Shanghai Municipal Health Commission Health Industry Clinical Research Special Program(grant no.20244Y0031)the Shanghai“Rising Stars of Medical Talents”Youth Development Program(Youth Medical Talents-Specialist Program).
文摘Tissue expansion is a widely utilized technique in plastic and reconstructive surgery;however,the biological mechanisms underlying the skin response remain poorly understood.We propose that tissue fluidity,the transition of tissue from a solid-like state to a fluid-like state,plays a pivotal role in enabling the reorganization of the epidermal structure and cellular spatial order,which is essential for effective tissue expansion.Drawing parallels between fluidity in materials science and biological systems,we suggest that the fluid-like behavior in the skin may be critical for mechanical adaptability.Understanding the influence of tissue fluidity may open pathways for modulating this process,potentially enhancing tissue expansion efficiency,reducing procedural duration,and improving clinical outcomes.This perspective highlights the importance of investigating the biological dynamics of tissue fluidity and exploring the potential for targeted manipulation of fluidity-related pathways to optimize tissue expansion.Such advancements could profoundly affect regenerative and reconstructive surgical practices.
基金supported by the National Natural Science Foundation of China(grant no.82272287).
文摘Adipocyte-secreted extracellular vesicles(EVs)and adipose-derived stem cells(ADSCs)regulate physiological and pathological processes by delivering nucleic acids,proteins,and lipids.Both adipocyte-and ADSC-derived EVs regulate local inflammatory levels,tumor progression,and insulin sensitivity.These two types of EVs also have significant therapeutic effects on damage repair,including wound healing,angiogenesis,myocardial damage,vessel re-endothelialization,bone and cartilage regeneration,muscle repair,and nerve repair.With regard to wound healing,microRNA-21,microRNA-126,microRNA-31,and long non-coding RNA-H19 accelerate the proliferation and migration of fibroblasts,human immortalized keratinocytes,and endothelial cells via the PI3K/Akt/ERK pathway or fibrillin 1.ADSC-derived EVs contain various growth factors that are beneficial for wound healing.Numerous miRNAs in ADSC-derived EVs and β3-adrenergic receptors on brown adipocytes exhibit protective effects against myocardial infarction.Proteins in adipocyte-and ADSC-derived EVs play a role in promoting vessel re-endothelialization and regulating vasodilation.Angiogenesis is beneficial for the regeneration and repair of injured bone,cartilage,muscle,and nerves.Compared with adipocyte EVs,ADSC-EVs contain a greater variety of miRNAs and proteins that promote tissue regeneration.EV therapy is a promising cell-free therapy,and EV-loaded materials have been used for wound healing and myocardial damage.Future research will focus on identifying the molecules in EVs and the repair mechanisms that contribute to damage repair and regeneration.In addition,we aim to discover materials designed for slow release and specificity to facilitate tissue repair and optimize EV transportation.
基金supported by the Cross-Disciplinary Research Fund Project of the Shanghai Ninth People’s Hospital of Shanghai Jiao Tong University School of Medicine(grant no.JYJC202236)the Shanghai Plastic Surgery Research Center of Shanghai Priority Research Center(grant no.2023ZZ02023)the Shanghai Healthcare System Key Supporting Disciplines Program(grant no.2023ZDFC0303).
文摘Hypertrophic scars(HS)are fibrotic proliferative diseases that develop after deep skin injuries caused by trauma,burns,and surgery.Traditional treatment methods include both surgical and nonsurgical therapies.Early intervention and combination therapy tailored to the individual needs of the patients are crucial for achieving optimal results.Three-dimensional(3D)printing technology,a rapid prototyping technique,is increasingly being applied in the medical field.The customization and precise functionality of 3D printing technology are particularly important for the rehabilitation of HS.This review provides an overview of HS and the role of 3D printing technology in medical applications,analyses the application of 3D-printed rehabilitation aids for HS,and discusses the use of 3D printing technology to improve HS treatment outcomes,thereby providing clinical guidance for effective HS rehabilitation.
文摘Background: Scar contractions caused by hand burns seriously impact both the function and appearance of the hand.Consequently,post-burn hand reconstruction is a primary focus of secondary reconstructive surgery performed within the first 10 years after a burn injury.This study aimed to identify developmental trends and research hotspots in post-burn hand reconstruction,providing insights and recommendations for researchers.Methods: Bibliometric and visualization analyses were conducted using Cite Space v6.4.R1(64-bit) and VOS viewer.The Web of Science Core Collection served as the data source.A total of 136 articles between 1997 and2025 were included based on the following keywords: “postburn hand reconstruction” or “postburn hand” or“scar contraction hand deformity.”Results: The field of post-burn hand reconstruction is advancing,as indicated by the overall and annual increase in publications.The United States leads in number of published papers.However,major institutions show low centrality,indicating weak collaboration between countries and regions,with research still dominated by singlecenter studies.The top three most prolific authors were Paul P M van Zuijlen,Fatih Uyghur,and Ersin Uyghur.The keywords “double Z-plasty” and the cluster “flap” not only have high emergence intensity but also appear frequently in recent studies,marking them as current research hotspots.Conclusion: The lack of long-term research and consensus limits further advancements in post-burn hand reconstruction.To address this,multi-center and multi-disciplinary collaborations should be encouraged.Additionally,integrating basic medical research with biomedical engineering could enhance the management and outcomes of post-burn hand reconstruction.
基金supported by the Natural Science Foundation of Zhejiang Province(No.TGY24E050004)the Ningbo Major Research and Development Plan Project(No.2024Z208)+2 种基金the National Natural Science Foundation of China(No.12202387)the Ningbo Health Technology Project(No.2023Y16)the Natural Science Foundation of Ningbo(No.2022J212).
文摘Osteosarcoma,an aggressive bone cancer found most often in children and adolescents,remains difficult to treat,and little improvement in survival rate has been observed over recent decades.The tumor microenvironment(TME),especially the extracellular matrix(ECM),is a critical factor determining cancer progression and chemotherapy resistance,yet traditional 2D models generally fail to replicate its properties.Recent development of 3D-bioprinted tumor models has facilitated improved simulation of the complexity of the TME,but specific models involving bioinks tailored to osteosarcoma remain underdeveloped.Gelatin methacryloyl(GelMA)is a common bioink that can rapidly gel and contains Arg-Gly-Asp(RGD)sequences.However,it lacks collagen’s triple-helix structure that is essential for ECM-cell communication.Hyaluronic acid(HA)is a macromolecule that is aberrantly expressed in osteosarcoma by mechanisms that remain largely unexplored.In this study,we developed a composite bioink containing GelMA,collagen,and HA,and applied it to 3D bioprint an in vitro osteosarcoma model.We found that HA significantly enhanced osteosarcoma cell proliferation and chemoresistance,as well as the expression of epithelial-mesenchymal transition and cancer stem cell markers.Furthermore,we found that HA abundance was positively correlated with hypoxia and angiogenesis signaling pathways,and this occurred mainly via upregulation of hypoxia-inducible factor-1α(HIF-1α)and vascular endothelial growth factor A(VEGFA)expression,thereby contributing to increased chemoresistance.Overall,our study provides a protocol for building in vitro realistic 3D-bioprinted models for studying osteosarcoma,highlights the role of HA in osteosarcoma progression,and offers a platform for developing new chemotherapy treatments.
基金supported by grants from the National Natural Science Foundation of China (grant nos.82472579,82172228,and 82202470)Shanghai Plastic Surgery Research Center of Shanghai Priority Research Center (grant no.2023ZZ02023)+2 种基金Shanghai Clinical Research Center of Plastic and Reconstructive Surgery supported by the Science and Technology Commission of Shanghai Municipality (grant no.22MC1940300)Project of Biobank (grant no.YBKA202204) from Shanghai Ninth People’s Hospital of Shanghai Jiao Tong University School of MedicineCross-Disciplinary Research Fund of Shanghai Ninth People’s Hospital of Shanghai Jiao Tong University School of Medicine (grant no.JYJC202407)。
文摘Background: Plexiform neurofibromas(PNF) are highly vascular tumors with the potential for significant growth.Surgical removal of giant PNF is often challenging because of intraoperative hemorrhage.This study proposed and evaluated an innovative surgical approach involving FENCY ligation and the role of preoperative embolization in the resection of giant PNF.Methods: This was a retrospective,interventional,and sequential case series conducted in a plastic and reconstructive surgery unit.We summarized all patients with PNF who underwent resection at our center between2019 and 2024.Surgical case notes from 11 patients with giant PNF who underwent FENCY ligation were reviewed,including three patients who received preoperative embolization.All patients participated in structured telephone interviews.Patient demographics,surgical safety,postoperative recovery,and patient satisfaction were evaluated.Results: Among 456 patients with 494 PNF who underwent surgical resection,we categorized the procedures into median,large,and giant PNF subgroups.To illustrate comprehensive perioperative and surgical approaches,we analyzed seven female and four male patients with giant PNF.The median maximum tumor diameter at the time of surgery was 30.4 cm(range,11.5–55.6 cm).Most PNF were located on the face(63.6%),followed by the back(18.2%),buttocks(18.2%),upper limbs(9.1%),and neck(9.1%).The median intraoperative hemorrhage volume was 366 m L(range,10–2 034 m L),And the median hospital stay was 17 days(range,14–33 days).The mean follow-up duration was 2.5 years(range,0.4–5.5 years).No severe complications were observed,except for one case of infection.Conclusion: PNF resection,particularly giant PNF resection,is a high-risk treatment option.Comprehensive evaluation,perioperative preparation,and surgical techniques are required to ensure efficacy and safety.FENCY ligation and preoperative embolization can be used to resect giant PNF in multiple complex regions with satisfactory outcomes.
基金supported by the National Natural Science Foundation of China(grant no.82272891).
文摘As the study of vascular anomalies progresses,it is imperative for plastic surgeons to individualize their in-depth research and practice to develop more effective and personalized treatment plans.Recent advancements in genome sequencing technology have highlighted the importance of vascular endothelial growth factor(VEGF)and its receptor(VEGFR)in the formation and alteration of vascularity.However,definitive reports regarding mutations associated with this locus and treatment experiences remain scarce.Herein,we report a clinical case of multiple venous malformations with mutations in VEGFR3(FLT4).We implemented a comprehensive approach,including local lesion excision of the left foot and trunk,oral propranolol administration,and local physiotherapy.After two years of follow-up,the patient’s left foot venous malformation did not recur,and he expressed satisfaction with the outcomes of the combined therapy.This case offers valuable insights into the clinical management of this mutant type and similar presentations of multiple venous malformations.
文摘July 20 and 21,2022,witnessed the highlight of the 21st Shanghai International Conference of Plastic and Aesthetic Surgery,a successful vascular anomalies workshop titled“Advancements in the Management of Vascular Anomalies”at Shanghai Ninth People’s Hospital.The conference was graced by many renowned specialists and scholars from China and abroad who presented lectures and panels on cutting-edge debated concepts and technological progress in the field.Amid the coronavirus disease 2019(COVID-19)pandemic,specialists from numerous fields have delivered rich content in person and virtually to participants across China.Prof.Xiaoxi Lin’s team from Shanghai Ninth People’s Hospital,a leading center in the field of infantile hemangioma and vascular malformation in China,collaborated with colleagues on new developments using teaching and discussion.
