Efficacy of autologous micrografts technology: a promising approach for chronic wound healing and tissue regeneration-a pilot study.

Introduction: This study explores the efficacy of Autologous Micrografts Technology (AMG) in treating chronic wounds refractory to traditional therapies. Methods: AMGs, derived from adipose tissue or dermis using a mechanical fragmentation process, were applied to patients with post-surgical dehiscence. A comprehensive evaluation of wound healing outcomes, including surface area reduction and complete healing, was conducted over a 90-day follow-up period. Additionally, the study investigated the cellular antioxidant activity of AMG solutions and characterized the exosomes obtained through mechanical disaggregation. Results: Results indicate significant improvements (p < 0.05) in wound healing, with 91.66% of patients showing at least a 50% reduction in lesion size and 75% achieving complete healing by day 90. Notably, AMG technology demonstrated immediate efficacy with fat-only application, while combined dermis and fat micrografts showed longer-term benefits, particularly in chronic wounds. The study also elucidated the mechanism of action of AMGs, highlighting their role in enhancing cellular antioxidant activity and exosome-mediated tissue regeneration. Discussion: Overall, these findings underscore the promising potential of AMG technology as a versatile and effective treatment option for chronic wounds, warranting further investigation into its mechanisms and clinical applications.

'J' brachioplasty technique in massive weight loss patients.

Upper extremity body reshaping is a very frequent surgical procedure in massive weight loss patients. Many surgeons have presented different patterns of brachioplasty skin excision and a variety of adjunctive techniques, each of them claiming improvements in scar aesthetic, arm shape or overall safety of the procedure. In this pape,r we want to illustrate our personal brachioplasty technique for massive weight loss patients. Our incision design named 'J' Brachioplasty is described. Between March 2013 and March 2016, a retrospective study of patients with massive weight loss and clinical diagnosis of brachial ptosis undergoing surgical reconstruction with 'J' brachioplasty was performed. All patients were treated according to a standard surgical procedure described in detail in the paper. The presence of axillary and thoracic skin excess was also recorded for every subject, as well as clinical and surgical postoperative complications. A total number of 73 Caucasian underwent J-shaped brachioplasty. Our technique allowed us to treat both arm and thoracic skin excess with a single skin incision. Among our casuistic we had only two cases of postoperative bleeding and four cases of partial wound dehiscence due to tension. Seroma was reported only in one (female) patient. Despite the recent introduction our technique has proven to reach good results in massive weight loss patients.

Reconstruction Approach to a Rare Case of Acquired Scrotal Giant Muscular Hamartoma.

Acquired scrotal giant muscular hamartoma is an uncommon benign lesion with fewer than 10 documented cases all over the world. It is characterized by a proliferation of dermal smooth muscle bundles of scrotum dartos fascia. The authors report a rare case of acquired scrotal giant muscular hamartoma, which occurred in a 70-year-old severely obese and diabetic man presenting with a progressive scrotal enlargement and swelling in the last year, causing marked reduction in quality of life and cosmetic problems. The patient underwent a wide excision of the hamartomatous lesion, and then, a reductive scrotoplasty and autologous skin grafting of penis were performed. Anatomopathological examination showed an acquired scrotal giant muscular hamartoma arising from muscular fascia of dartos. This surgical technique is a valid, safe, effective, and minimally invasive option to treat this pathology, achieving both excellent functional and aesthetic results, with a marked improvement of the patient's quality of life.

Aquacel Surgical Dressing after Thigh Lift: A Case-Control Study.

The postoperative dressing in patients undergoing thigh lift is often difficult, not very resistant to movement, and uncomfortable for the patient, and often exposes surgical site to infection, maceration, or delay in wound healing. METHODS: We included 40 patients in a case-control crossover study with no period effects, who were treated both by Aquacel Surgical and a traditional wound dressing. Surveys with a 10-point scale evaluation were used to assess nontraumatic removal level, ease of application, adhesion, and strength of the 2 treatments. We reported the number of days necessary for wound healing, the number of infection cases, and wound-related complications. Costs of the 2 medications were also considered. Ten days after surgery, patients answered a questionnaire with 6 multiple-choice questions to assess comfort, pain at dressing change, pruritus, strength, and number of dressing changes. RESULTS: Compared with controls, surveys revealed Aquacel Surgical to be less traumatic to remove, easier to apply, and to be more adherent and stronger. Significant acceleration of the wound healing was also evident with Aquacel Surgical compared with the traditional dressing. Nonsignificant differences were reported about the risk of infection and wound-related complications between the 2 treatments. A statistical analysis of costs revealed that Aquacel Surgical is significantly more expensive than the traditional medication. CONCLUSION: We recommend the use of Aquacel Surgical in all the surgery procedures where the risk of wound dehiscence and maceration is high.

Treatment of Oncological Post-surgical Wound Dehiscence with Autologous Skin Micrografts.

BACKGROUND/AIM: The closure of postoperative wounds is essential in order to prevent surgical site infections or wound dehiscence, mainly in oncological patients. We aimed to demonstrate the efficacy of autologous micrografts in the management of wound dehiscence in an oncology patient undergoing decompressive spinal laminectomy. CASE REPORT: A 57-year-old man with IgG multiple myeloma and medullary plasmocytoma C7-T3, was to undergo decompressive spinal laminectomy and vertebral fixation leading to a wound dehiscence with exposed instrumentation. Autologous micrografts were obtained by Rigenera protocol and directly applied to the dehisced wound. After 60 days of negative pressure wound therapy, we observed reduction of the diameter and depth of wound dehiscence, with a coverage of instrumentation, without complete re-epithelialization, that instead was reached by application of autologous micrografts after 70 days. CONCLUSION: The Rigenera protocol may be the solution for complex wounds in oncological and immune-compromised patients where other treatments are contraindicated.

Aesthetic role of the surgically rebuilt inframammary fold for implant-based breast reconstruction after mastectomy.

The inframammary fold (IMF) represents one of the most important anatomic landmarks in defining a woman's breast ptosis and inferior quadrant shape. Therefore it is important to preserve it, if this is oncologically safe, at the time of excisional surgery. If it is sacrificed, dislocated cranially or caudally, or there is a thick panniculus adiposus with a poor definition of the fold, it is necessary to recreate it. We present our experience in the reconstruction of the IMF in patients suffering from post-oncologic mastectomy, reconstructed with silicone implants. From January 2000 to May 2004 at the Plastic Surgery Department of the University of Turin, 74 reconstructions of the IMF were performed through Nava's technique, partially modified by us. We believe that IMF reconstruction, through fixation of cutis, subcutis and fascia superficialis to VI rib, along with capsulectomy of periprotesic pocket inferior quadrants, is a milestone for achieving, in selected cases, a good aesthetic result in terms of shape, ptosis and projection of inferior pole. The comparison between patients' opinions (obtained through questionnaires) and surgeon's, at 1 year after the reconstruction, shows that both are satisfied with the achieved outcome in terms of shape, projection, symmetry, ptosis and IMF definition. Another comparison was made between cases of fold preservation and cases of fold reconstruction, with a remarkable similarity of aesthetic satisfaction. The technique proposed here appears to be the current method of choice for IMF reconstruction in all cases where it is necessary to recreate or redefine it.