Publications by authors named "Ioana Lese"
Article Synopsis
- Researchers aimed to improve a porcine model used for vascularized composite allotransplantation (VCA) by reducing its bulk and including critical vascularized lymph nodes.
- The study involved harvesting and analyzing porcine flaps using both conventional and modified techniques, with results showing a significant reduction in flap weight and muscle/bone ratio in the modified group.
- The findings indicate that the modified model maintains vascularization while providing a more suitable platform for studying immunological responses in transplant research, suggesting its potential for broader experimental applications.
Article Synopsis
- This study explores the immune rejection of cartilage in vascularized composite allotransplantation (VCA), which is vital for restoring motor function in joint transplants.
- Using a swine model, researchers analyzed tissue samples from grafts that experienced severe skin rejection and found evidence of immune attacks on cartilage but with less severity than skin and muscle.
- The findings indicate that cartilage is not immune from rejection in VCA, showing significant immune response activity, including markers of cell death, although it endures milder inflammation compared to other tissues.
The standard of care approach to identify sentinel lymph nodes (SLNs) in clinically non-metastatic cutaneous melanoma patients is technetium (Tc)-based lymphoscintigraphy. This technique is associated with radiation exposure, a long intervention time, high costs, and limited availability. Indocyanine green (ICG)-based near-infrared fluorescence imaging offers a potential alternative if proven to be of comparable diagnostic accuracy.
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- The current standard for preventing rejection in vascularized composite allotransplantation (VCA) uses systemic immunosuppression, which poses significant side effects, leading to interest in local immunosuppression methods.
- Researchers investigated a local drug delivery system for tacrolimus (TGMS-TAC) to reduce toxicity and enhance graft survival, showing promising results in a porcine model, although some rejection signs were noted.
- Results indicated that while systemic immune responses remained stable, local tissue analysis revealed infiltration of immune cells and involvement of neutrophil extracellular traps (NETs) in the rejection process, highlighting the need for better understanding of VCA graft rejection mechanisms.
Background: Color match of a reconstructed breast with the surrounding area is of importance for the overall aesthetic result. The objective of the authors' study was to quantify the degree of color match achieved with different autologous breast reconstructions and to analyze the changes in color over time by analyzing digital photographs.
Methods: A total of 193 patients who underwent a delayed autologous breast reconstruction (deep inferior epigastric perforator [DIEP], profunda artery perforator [PAP], lumbar artery perforator [LAP], latissimus dorsi [LD]) were included.
Article Synopsis
- Vascularized composite allotransplantation (VCA) is a promising technique for restoring limbs or facial features but struggles with high rejection rates due to immune responses.
- Researchers used pig models to study immune rejection by analyzing tissue samples and gene expression, comparing those with moderate and severe rejection to healthy controls.
- Findings showed upregulation of genes linked to innate immunity and immune responses, particularly involving CD8 T cells and macrophages, providing insights for improving VCA outcomes.
Engineering of catalytically active inorganic nanomaterials holds promising prospects for biomedicine. Catalytically active metal oxides show applications in enhancing wound healing but have also been employed to induce cell death in photodynamic or radiation therapy. Upon introduction into a biological system, nanomaterials are exposed to complex fluids, causing interaction and adsorption of ions and proteins.
View Article and Find Full Text PDFSeroma formation is a common postoperative complication. Fibrin-based glues are typically employed in an attempt to seal the cavity. Recently, the first nanoparticle (NP)-based treatment approaches have emerged.
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- Free tissue transfer is the preferred method for reconstructing major defects in head and neck surgery, evaluated through a 15-year study at a university hospital.
- The study analyzed 353 procedures, noting that most defects were due to cancer surgery, with a high prevalence of patient comorbidities like smoking and alcohol use.
- Overall success rates for flaps were 97.7%, but complications occurred in 45.9% of cases; effective management by a multidisciplinary team is crucial for maintaining successful outcomes despite these challenges.
Article Synopsis
- Soft tissue and bone sarcomas require careful management, often involving reconstructive surgeons for limb salvage post-resection.
- Over a 5-year study, 90 patients received flap reconstruction, with 26 using free flaps and 64 using pedicled flaps; complications were common, affecting nearly 38% of patients.
- Factors such as diabetes and preoperative treatments like chemotherapy and radiotherapy increased various postoperative complications, making reconstructive surgery challenging but generally reliable.
Article Synopsis
- The study focuses on the osteocutaneous variants of the superficial circumflex iliac perforator (SCIP) flap, which offer benefits like customizability and low donor site issues, yet haven't been widely adopted.
- A retrospective review of six patients who received osteocutaneous SCIP flaps shows successful surgical, functional, and aesthetic outcomes, despite one case requiring emergency revision.
- The conclusion highlights that these flaps provide effective tissue reconstruction options with minimal complications, emphasizing their potential for broader use in osteoplastic surgeries.
Article Synopsis
- Sentinel lymph node (SLN) biopsy using radiocolloid and blue dye is standard for early-stage melanoma but has drawbacks like radiation exposure and allergic reactions.
- Indocyanine green (ICG) is a promising alternative fluorescent dye that can be detected with near-infrared imaging, showing high sensitivity in identifying SLNs.
- The study involving 93 melanoma patients found ICG's overall SLN detection sensitivity to be 96.1%, and suggests that ICG/NIRFI could replace traditional methods for certain patients, especially considering factors like body mass index.
Article Synopsis
- This study focuses on postoperative seroma, a serious complication, and analyzes patient data from a university hospital to identify factors linked to the need for revisional surgery.
- Among the 156 patients studied, 41% were treated initially with needle aspiration, and 61% eventually required surgical intervention, with specific comorbidities and extended aspiration times significantly impacting the likelihood of needing surgery.
- The findings suggest that patients should be advised to consider surgical options earlier rather than relying on prolonged drainage or repeated aspirations, as this can elevate the risk of complications.
Article Synopsis
- A significant rise in bariatric surgeries has led to more patients needing plastic surgery for body contouring after major weight loss, but insurance coverage for these procedures is inconsistent and lacks standardized criteria.
- A study analyzed data from 116 post-bariatric patients from 2013 to 2018, discovering that only 41% received insurance approval for body contouring surgery, with specific factors influencing these decisions.
- Key findings include that mentioning "medical indication" greatly increased approval chances, while citing "mental suffering" decreased them; also, higher pre-surgery BMI and significant weight loss improved insurance approval odds.
- The results suggest the need for clearer, objective criteria for insurance coverage decisions regarding post-bariatric body contouring surgeries.
Background: The lop ear deformity is defined by a deficient helix and scapha, underdeveloped anthelix, and downfolding of the helix. The terminology used is still confusing, and the treatment is not entirely structured. The aim of this study was to provide a new systematic surgical approach of this deformity based on our center's experience.
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- The lymphatic system is important for controlling inflammation in autoimmune diseases and organ transplants, prompting researchers to explore how transferring donor lymph nodes (LN) might help with transplant acceptance.
- In an experiment involving hindlimb transplants in rats, those receiving grafts with donor LN experienced slower rejection and better lymphangiogenesis compared to those without donor LN, highlighting the benefits of donor lymph nodes.
- Blocking the lymphangiogenic pathway led to quicker graft rejection, indicating that manipulating donor lymph nodes could be a potential strategy to enhance graft acceptance in transplants.
Article Synopsis
- Seroma formation is a common issue after surgeries, but current treatments are not effective.
- A new study tested a nano-bridging technique in rats to see if it could reduce seroma formation after surgical procedures.
- Results showed that the nanoparticle treatment led to complete remission of seromas, while traditional fibrin glue only partially reduced fluid volume, suggesting nanoparticles could be a promising solution for treating seromas without adverse side effects.
Workhorse Free Functional Muscle Transfer Techniques for Smile Reanimation in Children with Congenital Facial Palsy: Case Report and Systematic Review of the Literature.
J Plast Reconstr Aesthet Surg
July 2021
Background: Pediatric facial palsy represents a rare multifactorial entity. Facial reanimation restores smiling, thus boosting self-confidence and social integration of the affected children. The purpose of this paper is to present a systematic review of microsurgical workhorse free functional muscle transfer procedures with emphasis on the long-term functional, aesthetic, and psychosocial outcomes.
View Article and Find Full Text PDFBackground: Arterio-venous malformations (AVMs) of the ear are a rare entity and their management should be decided in a dedicated multidisciplinary team (MDT) setting. The aim of this study is to describe the distinct anatomical patterns of the auricular AVMs in our unit and propose a combined interventional radiological and surgical approach.
Materials And Methods: All consecutive patients presenting with AVMs of the ear and reviewed by the Vascular Anomalies MDT between 2014 and 2019 were included in this study.
Article Synopsis
- The study aimed to identify risk factors leading to flap failure and vascular compromise in free tissue transfers over a 10-year period, creating a predictive index for these complications.
- Data from 2009 to 2018 was analyzed to formulate a risk index categorized into low, moderate, and high risk, which showed significantly increased chances of vascular issues with higher risk groups.
- Identifying high-risk patients preoperatively can enhance patient counseling and allow surgeons to adapt their reconstructive strategies accordingly.
Development of vascularized nerve scaffold using perfusion-decellularization and recellularization.
Mater Sci Eng C Mater Biol Appl
December 2020
Article Synopsis
- Vascularized nerve grafts (VNG) may improve peripheral nerve regeneration by preventing damage caused by ischemia and necrosis, but challenges like surgical complexity and limited nerve availability hinder their clinical use.
- Researchers explored using perfusion-decellularization to bioengineer VNG for better nerve reconstruction.
- The results showed successful preservation of the extracellular matrix and vascular structure in decellularized nerves, along with measurable growth factors, suggesting that these engineered vascularized scaffolds could enhance nerve regeneration in larger defects compared to traditional non-vascularized options.
Article Synopsis
- The study aimed to create a reliable rat model for hindlimb transplantation that incorporates the local lymphatic system to better understand its role in vascularized composite allotransplantation (VCA).
- Thirty transplantations from Brown Norway to Lewis rats were conducted, preserving key lymphatic structures and utilizing a combination of microsurgical and cuff techniques for the surgery.
- Results indicated a high transplant survival rate of 93.3%, confirming the success in including inguinal lymph nodes and vascular integrity through various analyses, paving the way for future research on lymphatic contributions in VCA.
Article Synopsis
- Metal oxide nanoparticles are powerful tools in biomedical applications, but a lack of understanding regarding their interaction with tissues hampers their development as effective nanomedicines.
- This study focuses on complex metal oxide nanoparticle hybrids, specifically cerium oxide and bioglass, using advanced analytical methods to track their distribution in tissues after application.
- The findings reveal that when applied topically, these nanoparticles mainly stay at the application site, are taken up by macrophages, help form apatite, and increase lipid accumulation, highlighting the importance of detailed characterization for designing safer nanomedicine systems.
Article Synopsis
- The study investigates the impact of increasing blood flow in a perforator flap on its survival, aiming to reduce the occurrence of flap necrosis commonly faced in reconstructive surgery.
- In an experiment with 30 male Lewis rats, three groups were tested: a control group, a group with acute inflow, and a group with arterial preconditioning, with results measured on flap survival and blood flow post-surgery.
- The findings revealed that the group with acute inflow had the highest flap survival rate and improved blood flow in specific areas, indicating that optimizing arterial inflow can enhance the survival of perforator flaps.