Plastic and reconstructive surgery
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Plast. Reconstr. Surg. · Nov 2013
Stimulation of the follicular bulge LGR5+ and LGR6+ stem cells with the gut-derived human alpha defensin 5 results in decreased bacterial presence, enhanced wound healing, and hair growth from tissues devoid of adnexal structures.
Discovery of leucine-rich repeat-containing G-protein-coupled receptors 5 and 6 (LGR5 and LGR6) as markers of adult epithelial stem cells of the skin and intestine permits researchers to draw on the intrinsic cellular fundamentals of wound healing and proliferation dynamics of epithelial surfaces. In this study, the authors use the intestine-derived human alpha defensin 5 to stimulate epithelial proliferation, bacterial reduction, and hair production in burn wound beds to provide the field with initial insight on augmenting wound healing in tissues devoid of adnexal stem cells. ⋯ Application of human alpha defensin 5 increases LGR stem cell migration into wound beds, leading to enhanced healing, bacterial reduction, and hair production through the augmentation of key Wnt and wound healing transcripts. These findings can be used to derive gut protein-based therapeutics in wound healing.
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There is increasing evidence that bacterial biofilm is responsible for the failure of medical devices, leading to device-associated infection. As plastic surgeons, we are among the leading users of prostheses in surgery, and it is important that we are kept informed of this growing problem. This article summarizes the pathogenesis of device-associated infection, outlines the evidence for such infection in a number of medical devices, and outlines operative strategies aimed at reducing the risk of bacterial contamination at the time of device deployment. It also outlines strategies under investigation to combat the development of device-associated infection.
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Plast. Reconstr. Surg. · Nov 2013
Editorial Biography Historical ArticleThe assassination of JFK: a plastic surgery perspective 50 years later.
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Plast. Reconstr. Surg. · Oct 2013
Revisiting the scapular flap: applications in extremity coverage for our U.S. combat casualties.
Combat injuries commonly result in massive bony and soft-tissue destruction within the extremities. These extremity wounds often require large free tissue transfers and/or composite flaps for definitive reconstruction. In U.S. military war trauma experience, the authors' practice has found the scapular flap increasingly useful for reconstruction of complex extremity injuries. The purpose of this study is to report the authors' experience using the scapular flap in extremity reconstruction and evaluate the indications for use in the authors' patient population. ⋯ Therapeutic, IV.
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Plast. Reconstr. Surg. · Oct 2013
Complete horizontal skin cell resurfacing and delayed vertical cell infiltration into porcine reconstructive tissue matrix compared to bovine collagen matrix and human dermis.
Xenogenous dermal matrices are used for hernia repair and breast reconstruction. Full-thickness skin replacement is needed after burn or degloving injuries with exposure of tendons or bones. The authors used a human skin organ culture model to study whether porcine reconstructive tissue matrix (Strattice) is effective as a dermal tissue replacement. ⋯ Matrix texture and surface properties governed cellular performance on tissues. Although dense dermal compaction delayed vertical cellular ingrowth for Strattice, it allowed uncompromised horizontal resurfacing. Dense dermal compaction may slow matrix decomposition and result in prolonged biomechanical stability of the graft. Reconstructive surgeons should choose the adequate matrix substitute depending on biomechanical requirements at the recipient site. Strattice may be suitable as a dermal replacement at recipient sites with high mechanical load requirements.