BMP-6 promotes type 2 immune response during enhancement of rat mandibular bone defect healing.

Introduction: Bone morphogenetic proteins (BMPs) are used as key therapeutic agents for the treatment of difficult fractures. While their effects on osteoprogenitors are known, little is known about their effects on the immune system.

Methods: We used permutations of BMP-6 (B), vascular endothelial growth factor (V), and Hedgehog signaling pathway activator smoothened agonist (S), to treat a rat mandibular defect and investigated healing outcomes at week 8, in correlation with the cellular landscape of the immune cells in the fracture callus at week 2.

The Clinical Utility and Cost of Routine Staging Exam under Anesthesia for Oral Cavity Squamous Cell Carcinoma.

Introduction: The standard complete evaluation of patients with head and neck squamous cell carcinoma (HNSCC) has included a staging exam under anesthesia (EUA) since the 1970s. The EUA for all sites of HNSCC has historically consisted of panendoscopy for the purpose of diagnostic biopsy, accurate staging of primary disease, and identification of second primary tumors. However, due to the accessibility of the oral cavity, the sole purpose of EUA for tumors of this site is to identify second primary tumors.

Correlating the Bony Facial Trauma Score with Clinical Outcomes.

In 2017, the Bony Facial Trauma Score (BFTS) was developed to quantify and describe bony trauma of the face. To compare BFTSs for the need of hospital admission, intensive care unit (ICU) admission, surgery, tracheostomy tube placement, cervical spine (c-spine) injury, and mortality. A retrospective review of patients sustaining bony facial trauma from January 1, 2017 to November 30, 2019 was done.

Do Postoperative Antibiotics Affect Outcomes in Mohs Reconstructive Surgery?

Objectives/hypothesis: The prescribing of postoperative antibiotics for patients undergoing Mohs reconstructive surgery has increased in the last decade, while antibiotic resistance has been increasing. We hypothesized that routine prescribing of postoperative antibiotics after Mohs reconstruction does not decrease the risk of surgical site infection.

Study Design: Retrospective, single-institution cohort study.

Development of a Patient-Reported Outcome Measure for Mohs Reconstruction.

There are currently no validated patient-reported outcome measures (PROMs) to specifically evaluate quality-of-life (QOL) outcomes for patients undergoing Mohs micrographic surgery (MMS) reconstruction. Therefore, the objective of this report was to develop a short PROM that can be used to evaluate the outcome after MMS reconstruction from the patient's perspective. Following established guidelines for PROM development, a comprehensive literature review, concept elicitation interviews ( = 25), and cognitive debriefing interviews ( = 5) were performed.

Nasal Reconstruction: Defects that Cross Anatomical Subunits.

The nose plays a crucial role in the human experience, both aesthetically and functionally. The biomechanics of covering flaps, the importance of a firm framework, and the anatomical basis for aesthetic subunits are imperative concepts as one proceeds through the algorithm of reparative options. The subunits consist of three paired units-the ala, soft tissue facets (also known as soft tissue triangles), and sidewall, as well as three unpaired units-the dorsum, tip, and columella.

Dog bite injuries to the face: Is there risk with breed ownership? A systematic review with meta-analysis.

Introduction: Dog bite injuries to the face are a serious, yet modifiable public health concern. This study explores the relationship between dog breed and the risk of biting and injury. The objective of this study is to determine the relative risk and severity of dog bite injuries to the face by breed.

Assessment of Hedgehog Signaling Pathway Activation for Craniofacial Bone Regeneration in a Critical-Sized Rat Mandibular Defect.

Importance: Osseous craniofacial defects are currently reconstructed with bone grafting, rigid fixation, free tissue transfer, and/or recombinant human bone morphogenetic protein 2. Although these treatment options often have good outcomes, they are associated with substantial morbidity, and many patients are not candidates for free tissue transfer.

Objective: To assess whether polysaccharide-based scaffold (PS) constructs that are cross-linked with smoothened agonist (SAG), vascular endothelial growth factor (VEGF), and bone morphogenetic protein 6 (BMP-6) would substantially increase bone regeneration.

Comparison of Outcomes of Early vs Delayed Graft Reconstruction of Mohs Micrographic Surgery Defects.

Importance: Reconstructing Mohs defects often requires grafting in the form of full-thickness skin grafts (FTSGs) and composite grafts. These grafts can be complicated by a variable and often indeterminable survival rate. Other researchers have found that delaying FTSG reconstruction improves graft outcomes, but the optimal interval between excision and reconstruction remains unclear, and no study has examined the association between delaying composite graft reconstruction and graft survival.

Evidence-Based Medicine in Facial Trauma.

This article provides the reader with a comprehensive review of high-level evidence-based medicine in facial trauma and highlights areas devoid of high-level evidence. The article is organized in the order one might approach a clinical problem: starting with the workup, followed by treatment considerations, operative decisions, and postoperative treatments. Individual injuries are discussed within each section, with an overview of the available high-level clinical evidence.

Association of Mohs Reconstructive Surgery Timing With Postoperative Complications.

Importance: Same-day Mohs reconstructive surgery is not always possible; moreover, a delay can offer benefits such as improved surgical planning and increased blood supply to the cauterized wound bed. However, recent work found that delaying reconstruction by more than 2 days increases the postoperative complication rate.

Objective: To review the outcomes of Mohs micrographic surgery (MMS) reconstruction with respect to patient- and surgery-specific variables, especially timing of repair.

A Facial Trauma Simulation Course for Evaluation and Treatment of Facial Fractures.

Importance: Traditional facial trauma laboratories are used for teaching basic concepts of fracture reduction and hardware manipulation. Facial trauma simulation laboratories allow training physicians the opportunity to develop unique treatment plans as they would in real patient encounters.

Objective: To assess the value of a novel facial trauma simulation course requiring residents to practice advanced decision making.

An innovative photographic database for cutaneous facial defects.

Objectives/hypothesis: To construct an easy-to-use server-based database that stores photographs of patients undergoing reconstructive surgery for cutaneous facial defects and organizes them in a manner best suited for rapid search and education.

Study Design: An institutional review board-approved user-modifiable database was designed using OnBase software (Hyland Software Inc., Westlake, OH) to store both the photographs of patients undergoing reconstructive surgery and the pertinent clinical data.

Classifying and Standardizing Panfacial Trauma With a New Bony Facial Trauma Score.

Importance: The practice of facial trauma surgery would benefit from a useful quantitative scale that measures the extent of injury.

Objective: To develop a facial trauma scale that incorporates only reducible fractures and is able to be reliably communicated to health care professionals.

Design And Setting: A cadaveric tissue study was conducted from October 1 to 3, 2014.

Regenerative Medicine in Facial Plastic and Reconstructive Surgery: A Review.

The field of regenerative medicine aims at enhancing tissue healing and regeneration through the exogenous addition of therapeutic growth factors and cells, often in combination with tissue-compatible scaffolds. Perhaps the biggest advances in facial plastic and reconstructive surgery (FPRS) in the coming years will be the result of regenerative medicine techniques. While many articles on regenerative medicine have been published in the FPRS literature, to our knowledge there are no reviews that describe both soft-tissue and bony regeneration strategies, including scaffolds, stem cells, growth factors, and platelet-rich plasma.

Poly(lactic-co-glycolide) polymer constructs cross-linked with human BMP-6 and VEGF protein significantly enhance rat mandible defect repair.

We have previously shown that the combined delivery of mesenchymal stem cells (MSCs), vascular endothelial growth factor (VEGF) and bone morphogenetic protein 6 (BMP-6) induces significantly more bone formation than that induced by the delivery of any single factor or a combination of any two factors. We now determine whether the exogenous addition of VEGF and BMP-6 is sufficient for bone healing when MSCs are not provided. Poly(lactic-co-glycolic acid) (PLAGA) microsphere-based three-dimensional scaffolds (P) were fabricated by thermal sintering of PLAGA microspheres.

Early Practice Focus: Evidence-Based Practice in Facial Plastic Surgery.

The practice of evidence-based medicine combines physician experience, knowledge of current literature, and patient preferences. Different grading systems are used to evaluate current levels of evidence and recommendations. A variety of common instruments are used to measure outcomes in facial plastic surgery.

Update in disease-specific quality-of-life studies in facial plastic surgery.

Purpose Of Review: Improvements in the quality of life (QOL) of patients undergoing facial plastic and reconstructive surgery are readily apparent to any practitioner performing these procedures and interacting with these patients. However, proving these benefits objectively has become ever more important in the current practice environment and there has been a body of literature reported to address this need.

Recent Findings: As techniques for facial reanimation, revision cleft surgery and other procedures are further developed and the tailored treatments of these ailments are honed, the body of literature for QOL improvements is growing.

Histopathologic margin distance in survival in resection of cutaneous melanoma of the head and neck.

Objectives/hypothesis: Treatment of cutaneous melanoma involves surgical excision with wide clinical margins. No guidelines regarding safe histopathologic margin distance exist. This study examines the impact of histopathologic margin, measured from closest cut edge of the specimen, on overall survival in resection of cutaneous melanoma of the head and neck.

Current concepts of bone tissue engineering for craniofacial bone defect repair.

Craniofacial fractures and bony defects are common causes of morbidity and contribute to increasing health care costs. Successful regeneration of bone requires the concomitant processes of osteogenesis and neovascularization. Current methods of repair and reconstruction include rigid fixation, grafting, and free tissue transfer.

PEDF counteracts DL-α-aminoadipate toxicity and rescues gliotoxic damages in RPE-free chicken retinal explants.

Gliotoxic responses complicate human eye diseases, the causes of which often remain obscure. Here, we activated Müller cells (MCs) by the gliotoxin DL-α-aminoadipate (AAA) and assayed possible protective effects by pigment epithelium-derived factor (PEDF) in RPE-free retinal explants of the E6 chick embryo. These models are suited to analyze gliotoxic reactions in vitro, since the avian retina contains only Müller cells (MCs) as glial components, and the RPE-free explants are devoid of a major PEDF source.