Clinical Data Related to Breast Reconstruction; Looking Back on the 21th Century and Forward to the Next Steps

Breast reconstruction after breast cancer surgery represents a positive step in restoring a women’s idea of self by reestablishing her feminine features and confidence, thus improving essential aesthetic and emotional aspects. Regarded as the cornerstone in breast cancer management, the surgical treatment has come a long way since 1884 when W.S. Halsted performed the first radical mastectomy- a disfiguring procedure which was conducted until the late 70s when owing to contemporary advancements it was surpassed by modified radical mastectomies and other far less invasive approaches. Either performed in an immediate or a delayed fashion breast reconstruction can be achieved not only through alloplastic procedures using expander/ implant prosthesis but also through autologous tissue transfers wisely harvested from different parts of the body or through methods that combine the two. When planning a breast reconstruction, after the oncologist formally rules out any form of residual cancer, one must take into consideration several critical factors that will eventually condition the technique election process for example the possible local or systemic adjuvant therapy. Although a “one size fits all” breast reconstruction procedure has yet to prevail, the extensive volume of published literature regarding this matter enables a well-experienced plastic surgeon to proceed with careful procedural selection allowing for the best possible results

Mucoadhesive and Antimicrobial Allantoin/β Cyclodextrins-Loaded Carbopol Gels as Scaffolds for Regenerative Medicine

Allantoin and its β-cyclodextrin and hydroxypropyl-β-cyclodextrin inclusion complexes 1:1 have been used to prepare carbopol-based mucoadhesive gels. The gelation process occurred by adjustment with glycerol 10% in the presence of triethanolamine. The structural features induced by the presence of allantoin and the corresponding β-cyclodextrins inclusion complexes have been first investigated by infrared spectroscopy highlighting strong interactions within the gels network and ideal crosslinks for the self-healing behavior. The hydrophilicity of the gels was investigated by the determination of the surface tension parameters and the free energy of hydration. The interfacial free energy values indicated prolonged biocompatibility with blood. The gels-water molecule interactions in terms of sorption, permeability, and diffusion coefficients were evaluated by dynamic vapor sorption analysis. The self-assembly process through intermolecular H-bonding, the high hydrophilicity, the mechanical performance, the hydrolytic stability in simulated biological media, the biocompatibility with normal human dermal fibroblast (NHDF) cells, the mucoadhesivity and antimicrobial activity on selected microorganism species (S. Aureus and C. albicans) of the allantoin-based gels recommend them as promising scaffold alternatives in regenerative medicine

PRINCIPLES OF FACE BURNS MANAGEMENT: PERSONAL EXPERIENCE

Aim of the study The aim of this study is to emphasize the principles of face burn management based on our personal experience correlated with published literature data. We aim to illustrate different possible approaches of treatment in order to obtain good functional and aesthetic outcomes. Material and methods The study group included 342 patients (144 females and 198 males), with ages ranging between 18 and 92 years old, hospitalized and treated in the Burn Unit from the “Sf. Spiridon” Emergency County Hospital from Iași, Romania, during december 2020 – october 2023. The inclusion criteria for the study were: patients over 18 years old, isolated burn lesions only of the face or in association with burn lesions distributed on various anatomical regions, burns of all degrees. Results The group included 144 females (42,1%) and 198 males (57,89%). The etiologies of the burns were represented by flame (123 cases) – 35,96%, scald (103 cases) – 30,11%, contact (52) – 15,20%, electrocutions (31) – 9,06% or ultraviolet exposure (33) – 9,64%. 134 patients (39,18%) had isolated lesions of the face and 208 patients (60,81%) associated other localisations as well. Out of the total number of cases, the majority (276 cases) – 69% were treated conservatory, while 31% required different forms of surgical interventions. Conclusions The management of facial burns must be multidisciplinary and early in the face of serious complications that may endanger the vital, functional and aesthetic prognosis. Periodic evaluations must be constant and involve the physical and mental status of the patient. Social, family and professional integration takes a significant place in the overall management of facial burns to limit the difficulty of reintegration of a person affected by burns