Platelet Rich Plasma Enhancement of Skin Regeneration in an ex-vivo Human Experimental Model

An original ex vivo wounded skin culture protocol using autologous Platelet Rich Plasma (PRP) and enriched Dulbecco's Modified Eagle's Medium demonstrated a favourable modulation of the epithelial cells and fibroblasts proliferation, a relevant antiinflammatory action and a favourable modulation of the re-organization of collagen and elastic fibres. The step by step regenerative effects of PRP on human skin wound repair and regeneration process was observed over a period of 10 days

Experimental assessment of regenerative properties of platelet rich plasma on the human skin - a review

Several studies demonstrated the favorable effects of platelet rich plasma (PRP) on the skin and promoted its wide use in clinical practice. The growth factors stored in platelet alfa-granules allow for the tissue regeneration and the main fields of application of PRP in current clinical practice are the cartilage and musculoskeletal defects, osteoarthritis and other bone disorders, chronic and difficult to heal wounds, and aesthetic procedures. The relevant number of different PRP preparation protocols may explain the inconsistency of the different clinical outcomes reported in the literature. Despite the technological advances in PRP preparation, the objective assessment of the clinical efficacy of PRP from the literature reports still is difficult due to the low homogeneity of the samples in terms of both inclusion criteria and size. Therefore, it might be useful to establish standardized and reproducible experimental models to confirm and objectively measure the effectiveness of the available clinical results. Many experimental investigations have been carried out to objectively assess the effectiveness of PRP and platelet gel on several tissues. As far as the skin is concerned, the studies carried out to date are limited to fibroblasts in in-vitro culture models or to collagen, vascular supply, epithelium, and hair follicle in in-vivo models. The skin, however, is a very complex organ, where different cell lines coexist and feature complex mutual interaction. A model that combines the advantages of both in-vitro and in-vivo cultures is the ex-vivo model. The demonstration of the platelet derived growth factors effects through the ex-vivo human full-thickness skin culture model is a keystone to support the evidence of the PRP effectiveness, as it represents an objective, fast, reproducible, and ethical investigational method

REFINEMENTS IN BROW RECONSTRUCTION. SYNERGY BETWEEN PLASTIC SURGERY AND AESTHETIC MEDICINE

Objective: The purpose of this study was the introduction in clinical practice of the combined application of traditional reconstructive surgery and intense pulsed light (IPL) for the restoration of a post-traumatic eyebrow defect. Case: The authors present a case of surgical eyebrow reconstruction with an axial temporal hair-bearing scalp island flap. A persistent localized erythema and a marked difference in hair density in comparison with the contralateral one harmed the eventual surgical outcome. Results: A combined sequential treatment with IPL achieved both hair density and skin erythema reduction, and eventually allowed for a very satisfactory result. Conclusions: Our experience demonstrated the efficacy of the integrated multidisciplinary approach involving traditional plastic reconstructive surgery and the innovative new technologies in aiming for perfectio

Long term assessment of intralipotherapy in Madelung′s disease

Madelung′s disease is characterised by multiple symmetric abnormal fat masses in the head, neck and upper limbs. Surgical excision or liposuction is the only realistic available option, although palliative in nature. The serial intralipotherapy with phosphatidylcholine/deoxycholate has been proposed as a non-invasive treatment of Madelung′s disease. The authors used serial intralipotherapy with phosphatidylcholine/deoxycholate in two patients affected by Madelung′s disease. Three injections per lesion per patient were performed with 1 month′s interval. Pre- and 6 months′ post-treatment dimensions were assessed with ultrasound scan and patients were observed along a 5 years′ clinical follow-up. A 42.5% average size reduction was reported in all treated lesions. About 33% recurrence rate was observed in the 5 years′ follow-up. We confirm the efficacy of intralipotherapy in the non-invasive palliative treatment of Madelung′s disease, as a valid option to reduce the volume and limit the growth of the pathological adipose masses

The three-bite technique: a novel method of dog ear correction

The closure of any circular or asymmetric wound can result in puckering or an excess of tissue known as a 'dog ear'. Understanding the mechanism of dog ear formation is a fundamental requirement necessary to facilitate an appropriate treatment. Many solutions have been reported in the literature, but in all cases, the correction entails the extension of the scar and the sacrifice of the dermal plexus. Here, we propose a novel technique of dog ear correction by using a three-bite suture that sequentially pierces the deep fascial plane and each dog ear's margin, thus allowing for flattening the dog ear by anchoring the over-projecting tissue to the deep plane. The three-bite technique proved to be a fast, easy, and versatile method of immediate dog ear correction without extending the scar, while maintaining a full and complete local skin blood supply

Malformazioni congenite

Sezione VIII - CHIRURGIA PLASTICA E RICOSTRUTTIVA: 91. Principi generali, 92. Melanoma e altre lesioni cutanee oncologiche di interesse chirurgico, 93. Ustioni, 94. Innesti e impianti, 95. Trapianti di cute, 96. Chirurgia plastica ricostruttiva della mammella, 97. Malformazioni congenite, 98. Chirurgia estetica, 99. Chirurgia craniofaccial