Publications by authors named "Jonathan I Leckenby"

Peripheral nerve injuries lead to severe functional impairments, with rodent models essential for studying regeneration. This review examines key factors affecting outcomes. Age-related declines, like reduced nerve fiber density and impaired axonal transport of vesicles, hinder recovery.

View Article and Find Full Text PDF

In Eastern nations, interventions like acupuncture and herbal medicine are often first-line for patients presenting with facial paralysis. Despite the rising popularity of Eastern medicine in Western nations, the literature assessing whether Eastern medicine interventions should be recommended for patients with facial paralysis is lacking. This meta-analysis aims to define what Eastern medicine interventions exist for the management of facial paralysis and assess whether current research supports these approaches as safe and effective.

View Article and Find Full Text PDF

Introduction: Surgeons use several quality-of-life instruments to track outcomes following abdominal wall reconstruction (AWR); however, there is no universally agreed upon instrument. We review the instruments used in AWR and report their utilization trends within the literature.

Methods: This scoping review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews guidelines using the PubMed, Embase, Web of Science, ClinicalTrials.

View Article and Find Full Text PDF

Background: Facial palsy patients experience an array of problems ranging from functional to psychological issues. With regard to the eye, lacrimation, lagophthalmos, and the inability to spontaneously blink are the main symptoms and, if left untreated, can compromise the cornea and vision. This article reports the outcomes of 23 free functional vascularized platysma transfers used for reanimation of the eye in unilateral facial paralysis.

View Article and Find Full Text PDF

Murphy Roths Large (MRL/MpJ) mice have demonstrated the ability to heal with minimal or no scar formation in several tissue types. In order to identify a novel animal model, this study sought to evaluate whether this attribute applies to peripheral nerve regeneration. This was a two-phase study.

View Article and Find Full Text PDF

Introduction: Twenty three years after the first successful upper extremity transplantation, the role of vascularized composite allotransplantation (VCA) in the world of transplantation remains controversial. Face and upper extremity reconstruction via transplantation have become successful options for highly selected patients with severe tissue and functional deficit when conventional reconstructive options are no longer available. Despite clear benefit in these situations, VCA has a significant potential for complications that are more frequent when compared to visceral organ transplantation.

View Article and Find Full Text PDF
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.
View Article and Find Full Text PDF

Background: Abdominal wall allotransplantation following intestinal and multivisceral transplant procedures has proven to be successful in achieving adequate closure in patients in whom other techniques have proven inadequate. Thus far, the focus of these abdominal wall allotransplants has been on graft and overall patient survival following surgery and the implementation of immunosuppression. The purpose of this study was to review the outcomes of abdominal wall allotransplantation reported in the literature.

View Article and Find Full Text PDF

Introduction: Two-stage free functional muscle transfers for long-standing facial palsy can yield unpredictable results. Earlier studies have demonstrated incomplete regeneration across neurorrhaphies in native nerve and higher donor axonal counts correlating with improved outcomes but axonal count in nerve grafts have not been as thoroughly reviewed. To investigate the impact of varying axonal counts in autologous grafts on functional outcomes of repair.

View Article and Find Full Text PDF

Background:  Abdominal wall vascularized composite allotransplantation (AW-VCA) is a novel reconstructive technique used for large abdominal wall defects in combination with intestinal transplantation (ITx) or multivisceral abdominal transplantation (MVTx). Since the introduction of this procedure, several studies have been published reporting their experience. This study aims to present a scoping review looking at all available evidence-based medicine information to understand the most current surgical techniques and clinical outcomes.

View Article and Find Full Text PDF

Background:  Uterine transplantation (UTx) is acknowledged to be on the second (2A) of five steps of development in accordance with the staging system for the evaluation of surgical innovations. Accordingly, we aimed to systematically review the available evidence of the surgical techniques and outcomes of UTx in terms of graft survival.

Methods:  A comprehensive search was conducted across PubMed Medline, Cochrane-EBMR, Scopus, Web of Science, and CENTRAL through November 2020.

View Article and Find Full Text PDF
Article Synopsis
  • 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.
View Article and Find Full Text PDF

There exists a dichotomy in regenerative capacity between the PNS and CNS, which poses the question - where do cranial nerves fall? Through the discussion of the various cells and processes involved in axonal regeneration, we will evaluate whether the assumption that cranial nerve regeneration is analogous to peripheral nerve regeneration is valid. It is evident from this review that much remains to be clarified regarding both PNS and CNS regeneration. Furthermore, it is not clear if cranial nerves follow the PNS model, CNS model or possess an alternative novel regenerative process altogether.

View Article and Find Full Text PDF

Recent breakthroughs in our understanding of orthopaedic infections have come from advances in transmission electron microscopy (TEM) imaging of murine models of bone infection, most notably Staphylococcus aureus invasion and colonization of osteocyte-lacuno canalicular networks of live cortical bone during the establishment of chronic osteomyelitis. To further elucidate this microbial pathogenesis and evaluate the mechanism of action of novel interventions, additional advances in TEM imaging are needed. Here we present detailed protocols for fixation, decalcification, and epoxy embedment of bone tissue for standard TEM imaging studies, as well as the application of immunoelectron microscopy to confirm S.

View Article and Find Full Text PDF
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.
View Article and Find Full Text PDF

Introduction: Current microsurgical training courses average 5 consecutive 8-hour days and cost US $1500 to US $2500/individual, making training a challenge for residents who are unable to take leave from clinical duties. This residency-integrated microsurgery course was designed for integration with a residency program, averaging 3 hours/week over 7 weeks. This allows for one-on-one training, beginning with synthetic tissue and concluding with in vivo stimulation.

View Article and Find Full Text PDF

Background: Acellular nerve allografts are a viable treatment modality for bridging nerve gaps. Several small studies have demonstrated results equal to those of autologous grafts; however, there is information lacking with regard to outcomes for wider indications. The authors evaluated the outcomes of patients treated with a nerve allograft in a variety of clinical situations.

View Article and Find Full Text PDF

Introduction: The incidence of malignant melanoma has been rising steadily over the past decades and Merkel cell carcinoma is a highly aggressive neuroendocrine skin tumor with a high mortality rate. Sentinel lymph node (SLN) biopsy is a recommended prognostic tool in primary cutaneous malignant melanomas of intermediate thickness and in all clinically node-negative Merkel cell carcinomas. The gold standard method for identification of SLNs is lymphoscintigraphy, which involves radioactive tracers.

View Article and Find Full Text PDF

Animal models of nerve function have been subject to extensive study in order to understand and investigate methods which may improve axon regeneration and promote functional outcomes following nerve injury and repair. As the facial nerve is a cranial nerve, there is mounting evidence that cranial nerve regeneration differs from peripheral, and outcome models specifically addressing the facial nerve are required. Murine models are the most commonly utilized, with a variety of methods employed to measure the actions of whisking, eye closure, or ear movement as indicators of facial nerve regeneration.

View Article and Find Full Text PDF

Background: Peripheral nerve assessment has traditionally been studied through histological and immunological staining techniques in a limited cross-sectional modality, making detailed analysis difficult. A new application of serial section electron microscopy is presented to overcome these limitations.

Methods: Direct nerve repairs were performed on the posterior auricular nerve of transgenic YFP-H mice.

View Article and Find Full Text PDF

Introduction: Animal models for the study of facial paralysis have been well developed, but concern has arisen regarding the accuracy of eye closure and whisker movement as outcome measures due to new data regarding interconnectivity between facial nerve branches and autonomic innervation. The posterior auricular nerve (PAN) is an isolated branch of the facial nerve which has been confirmed as the sole motor innervat or of the interscutularis muscle. This study was designed to develop a model for facial nerve palsy utilizing the PAN and interscutularis muscle.

View Article and Find Full Text PDF

Background: More than 1000 new patients present to the London Sarcoma Unit each year and between 5% and 10% require plastic surgery intervention. Advancements in radiotherapy and chemotherapy protocols combined with higher expectations for limb preservation has led to increased reconstructive challenges. Frequently, primary closure is achievable; however, larger tumors often require specialist reconstruction.

View Article and Find Full Text PDF

Background: Approximately 160,000 joint replacements are performed each year in the United Kingdom. After multiple revisions, soft tissues become suboptimal and chronic wounds develop, causing infection or metalwork extrusion. The authors present their experience with 155 patients at a tertiary orthopedic hospital.

View Article and Find Full Text PDF

Facial reanimation is the surgical process of attempting to restore dynamic, spontaneous symmetry to the paralysed face. We undertook to review the most frequently used scoring systems and discuss a universal set of assessments which every facial palsy surgeon can use to standardize the outcome of surgical intervention and allow a comparison to be drawn when comparing different operative techniques. A literature review was performed using PubMed and Cochrane databases to identify scoring systems for facial palsy, facial nerve regeneration and facial reanimation.

View Article and Find Full Text PDF