Deciphering the Dysregulating IGF-1-SP1-CD248 Pathway in Fibroblast Functionality during Diabetic Wound Healing.

Reduced fibroblast activity is a critical factor in the progression of diabetic ulcers. CD248, a transmembrane glycoprotein prominently expressed in activated fibroblasts, plays a pivotal role in wound healing. However, the role of CD248 in diabetic wound healing and the CD248 regulatory pathway remains largely unexplored.

A simplified classification and economical application of anterolateral thigh flap.

Background: Anterolateral thigh (ALT) flaps have several anatomical variations and clinical uses. Here, a simplified classification and economical application are introduced.

Methods: A total of 168 ALT flap reconstructions performed between January 2013 and December 2016 were reviewed.

Impact of fibula osteoseptocutaneous flap laterality in mandibular and intraoral reconstruction.

Background: The fibula flap has been the workhorse flap for mandibular reconstruction. However, relationships among the bone, skin, and vessels raise concerns about donor-side selection. This study aimed to clarify its impact on clinical outcomes.

Oral Squamous Cell Carcinoma Metastasis to Anterolateral Thigh Flap Donor Site: A Case Report.

In the realm of oncologic reconstructive surgery, local or distant autologous tissue is frequently used to improve function and appearance. Due to advances in microsurgery and intensive care, reconstructive free flap surgery has become the standard treatment for head and neck cancer. However, the complexity of interdisciplinary intervention and prolonged surgical time inevitably increase the risk of cross-contamination, potentially leading to donor site metastasis.

Functional Chimeric Double-barrel Fibula and Reinnervated Peroneus Brevis Osteomyocutaneous Flap for One-stage Forearm Reconstruction.

Reconstructing a mangled limb is complex and requires expertise in both bone and soft-tissue reconstruction, particularly when there is significant muscle loss. Typically, multistage surgery is necessary, starting with soft-tissue coverage, followed by bone grafting and tendon transfers. Sometimes, microsurgical techniques such as vascularized bone grafts and free functional muscle transfers are necessary, especially when there is a bone defect of over 6 cm; the soft-tissue environment is infected, scarred, or poorly vascularized; or there are extensive musculotendinous injuries.

Comparison of outcomes between circumferential and near-circumferential pharyngoesophageal reconstruction using anterolateral thigh flap.

A leftover narrow strip of the posterior pharyngeal wall may form after laryngopharyngectomy, and whether to retain it during reconstruction remains debated owing to the differing views on the incidence of leakage and strictures. This study aimed to ascertain whether this remnant posterior pharyngeal wall is advantageous or disadvantageous to surgeons performing pharyngoesophageal reconstruction. We reviewed the data of patients with circumferential or near-circumferential pharyngoesophageal defects following oncological laryngopharyngectomy who underwent reconstructive surgery utilizing the anterolateral thigh flap.

Chimeric Anterolateral Thigh Flap for One-stage Reconstruction after Cervical Exenteration with Anterior Mediastinal Tracheostomy.

Cervical exenteration with anterior mediastinal tracheostomy is rarely performed for extensive cervicothoracic malignancies. Although it provides effective palliation and occasional cure, reconstruction remains a formidable challenge owing to its complexity and high mortality. The resultant defects usually require an intestinal flap or tubed skin flap to restore the alimentary tract, soft-tissue interposition to separate the relocated trachea from the innominate artery, and another tubed or fenestrated skin flap to create a tension-free tracheocutaneous anastomosis and provide coverage for the exposed vessels, hopefully in one stage.

Plate-related complication and health-related quality of life after mandibular reconstruction by fibula flap with reconstruction plate or miniplate versus anterolateral thigh flap with reconstruction plate.

Background: Plate-related complications are major long-term complications in mandible reconstruction. There are controversies regarding the use of a reconstruction plate versus miniplates and a bone flap versus a soft tissue flap with a bridging plate. Direct comparisons of a fibula flap and an anterolateral thigh flap, the applicability between a reconstruction plate and miniplate, and the correlation between plate-related complications and quality of life remain unclarified.

Giant Basal Cell Carcinoma of the Axilla: 8-year Follow-up of a Case Treated with Excision, Vismodegib, and Radiotherapy.

Axillary giant basal cell carcinoma is extremely rare and remains challenging for physicians. The few reported cases have a relatively short-term follow-up, and none were treated with an oral hedgehog pathway inhibitor. Herein, we report the case of a 71-year-old man with a giant basal cell carcinoma in the axilla.

Anterolateral Thigh Flap for Low-Voltage Fourth-Degree Electrical Burn Injury With Immediate Radial Nerve Palsy at the Elbow: A Case Report.

While high-voltage electrical injuries usually cause severe burn wounds and axonal polyneuropathy, low-voltage electrical injuries cause limited cutaneous wounds and demyelinating mononeuropathy, of which the median and ulnar nerves are the most commonly involved. We present the case of a 42-year-old man who suffered a 480-voltage electrical injury at his right elbow, resulting in a 24 × 10 cm fourth-degree burn wound and immediate radial nerve palsy. The burn wound was debrided with confirmation and preservation of radial nerve continuity.

Simplifying the Combined Use of Fibula Flap and Anterolateral Thigh Flap for Oromandibular Reconstruction.

Although the preferred technique for reconstruction of extensive composite oromandibular defects involves the use of a fibula flap for the inner mucosal lining and mandibular bone reconstruction and an anterolateral thigh flap for outer skin coverage and soft tissue replenishment, this approach is complicated and manpower-dependent. It also often involves prolonged operations requiring nighttime surgery with insufficient manpower in an era of restricted working hours for residents, which can negatively affect the surgical outcomes. Traditionally, the mucosal defect is first defined and the fibula flap is then dissected to ensure a size-matching skin flap for the inner lining.

Dynamic Traction Splint as an Alternative Surgical Treatment for Comminuted Intraarticular Fracture of Metacarpophalangeal Joint.

Background: Comminuted intraarticular fractures of the metacarpophalangeal joint (MPJ) are difficult to treat. We evaluated the clinical outcomes of using a dynamic traction splint to treat comminuted intraarticular fracture of MPJ.

Patients And Methods: We conducted a retrospective chart review on patients with comminuted intraarticular fracture of the MPJ treated with a dynamic traction splint at National Cheng Kung University Hospital between March 2014 and February 2018.

Use of Anterolateral Thigh Flap and Fibula Flap in Oncologic Maxillary Reconstruction: An Algorithm Approach.

Background: Maxillary defects after oncologic resection can lead to not only cosmetic deformity but also functional problem. Reconstruction of maxillary defects remains the most challenging endeavor for plastic surgeons. An algorithm to guide plastic surgeons in selecting either the anterolateral thigh flap or the fibula flap for oncologic maxillary reconstruction has not been well established.

Treatment outcomes for one-stage concurrent surgical resection and reconstruction of synchronous esophageal and head and neck squamous cell carcinoma.

Purpose: It is not uncommon to see the synchronous presentation of esophageal squamous carcinoma (ESCC) and head and neck cancer (HNC), and most patients were treated with staged interventions. This study retrospectively reported the outcomes of patients with synchronous ESCC and HNC treated with one-stage concurrent surgical resection and reconstruction.

Methods: We identified 17 consecutive patients with synchronous ESCC and HNC undergoing primary concurrent surgical resections between 2011 and 2017 at our hospital.

Tumor Endothelial Marker 1 (TEM1/Endosialin/CD248) Enhances Wound Healing by Interacting with Platelet-Derived Growth Factor Receptors.

Tumor endothelial marker 1 (TEM1), also known as endosialin or CD248, is a type I transmembrane glycoprotein containing a C-type lectin-like domain. It is highly expressed in pericytes and fibroblasts. Dermal fibroblasts play a pivotal role during cutaneous wound healing, especially in the proliferative phase.

Surgical Algorithmic Approach to Facilitate Primary Closure of the Anterolateral Thigh Flap Donor Site in Head and Neck Reconstruction.

Background: Use of the anterolateral thigh (ALT) flap has gained popularity in head and neck reconstruction. However, donor sites that cannot achieve primary closure are reported to have poorer functional and aesthetic outcomes. Therefore, we propose an algorithm to facilitate primary closure of the donor site.

Comparison of flap outcomes between single- and multiple-perforator-based free anterolateral thigh flap in head and neck reconstruction.

Introduction: The number of perforators required for safe perfusion remains under debate. This study aimed to determine whether a single- or multiple-perforator-based anterolateral thigh flap yields better flap outcomes in head and neck reconstruction.

Patients And Methods: Between August 2012 and July 2016, 180 men and 4 women with a mean age of 52.

Temporary Ectopic Implantation of an Amputated Leg Using the Distal Runoff Vessel of the Anterolateral Thigh Flap Followed by Subsequent Prefabricated Chimeric Replantation.

Aim: Infrapopliteal replantation is indicated in selected patients. When the patient is hemodynamically unstable or the amputation site is severely contaminated, temporary ectopic implantation of the amputated limb is an option. To the best of our knowledge, this is the first case report using the distal runoff vessel of the anterolateral thigh flap for temporary ectopic implantation of an amputated leg followed by replantation with the prefabricated anterolateral thigh flap.

Esophageal reconstruction after oncological total laryngopharyngoesophagectomy: Algorithmic approach.

Background: Reconstruction for total laryngopharyngoesophagectomy is accomplished mainly by gastrointestinal transposition but can be complicated by anastomotic tension or associated neck-skin defect. Here, we present the results of total esophageal reconstruction by gastrointestinal transposition alone or with additional free tissue transfer and propose an algorithm accordingly.

Methods: We reviewed patients who had oncologic total laryngopharyngoesophagectomy between January 2012 and January 2016.

Intensive Care Unit Versus Ward Management After Anterolateral Thigh Flap Reconstruction After Oral Cancer Ablation.

Background: Whether postoperative care in the intensive care unit (ICU) is a necessity for patients undergoing head and neck free flap reconstruction remains debatable. In August 2012, our institute initiated a policy to care for these patients in the ICU, opposed to the previous policy of care in the ward. Thus, we used this opportunity to compare outcomes between these 2 care approaches.

Investigating the association between diet and risk of head and neck cancer in Taiwan.

Most studies reporting an inverse association between the consumption of vegetables and fruits and head and neck cancer (HNC) risk were conducted in Western populations and only a few included East Asians. The current case-control study investigated the association between diet and HNC risk using data of 838 HNC cases and 998 controls from a case-control study of HNC conducted in Taiwan. Each participant was asked about their consumption of fresh vegetables, pickled vegetables, fresh fruits, citrus fruits, meat, processed meat, fish, egg, and dairy products.

Investigating the Association between Alcohol and Risk of Head and Neck Cancer in Taiwan.

Although alcohol is an established risk factor of head and neck cancer (HNC), insufficiencies exist in the literature in several aspects. We analyzed detailed alcohol consumption data (amount and type of alcoholic beverage) of 811 HNC patients and 940 controls to evaluate the association between alcohol and HNC by HNC sites and by genotypes of ADH1B and ALDH2. Alcohol was associated with an increased HNC risk in a dose-response relationship, with the highest risk observed for hypopharyngeal cancer, followed by oropharyngeal and laryngeal cancers.