bluuebunny/crossref_metadata_2025_split huggingface dataset:
Supercharge End-to-Side Motor Transfer to a Long Nerve Graft to Enhance Motor Regeneration — An Experimental Rat Study
Authors: Zavala Abraham , Lu Johnny Chuieng-Yi , Chang Tommy Nai-Jen , Daniel Bassem W. , Chuang David Chwei-Chin 
Published: February 2023

BACKGROUND
Long nerve grafts are prone to chronic denervation, often resulting in unsatisfactory clinical outcomes. We aim to investigate if supercharge end-to-side (SETS) motor nerve transfers to a long nerve graft can potentially enhance nerve regeneration and functional outcomes.

METHODS
A reversed long nerve graft was interposed between C6 and musculocutaneous nerve in 48 rats. The motor nerves near the C6 proximally and the musculocutaneous nerve distally were chosen for SETS transfer to the long nerve graft. There were four groups: (A) nerve graft only, (B) proximal SETS transfer, (C) distal SETS transfer, and (D) proximal and distal double SETS transfers. A grooming test was assessed at 4, 8, 12, and 16 weeks postoperatively. Biceps weight, compound action potential amplitude (CMAP), tetanic contraction force, as well as histomorphometric analysis of the musculocutaneous nerve were evaluated at 16 weeks.

RESULTS
Long nerve grafts that received SETS transfers (Groups B, C, and D) showed superior results compared to the control group. Proximal SETS transfer had significantly better outcomes than distal SETS transfer in electrodiagnostic parameters, while double SETS transfer had the highest axonal count and biceps CMAP.

CONCLUSIONS
SETS motor transfers to long nerve grafts can effectively improve functional outcome and optimize nerve graft regeneration to the target nerve.

CLINICAL RELEVANCE STATEMENT:
Long nerve grafts are often necessary in peripheral nerve injuries of the limb, and SETS transfer using motor branches in the vicinity of the nerve graft can enhance the nerve regeneration to achieve better functional outcome.
Intramuscular Nanofat Injection Promotes Inflammation-Induced Gastrocnemius Regeneration in Syngeneic Rat Sciatic Nerve Injury Model
Authors: Schilling Benjamin K. , Baker Jocelyn S. , Komatsu Chiaki , Turer David M. , Bengur Fuat Baris , Nerone W. Vincent , Qin Feng , Cottrill Adam R. , Kokai Lauren E. , Rubin J. Peter , Marra Kacey G. 
Published: February 2023

Background:
Mechanical emulsification of adipose tissue to concentrate protein and stromal cell components (i.e., Nanofat) has gained considerable interest in clinical practice. While the regenerative potential of Nanofat has largely been used in aesthetic applications, these effects have considerable potential in reconstruction as well. Here, we investigated the therapeutic properties of Nanofat injected directly into the denervated gastrocnemius after a sciatic nerve injury in Lewis rats.

Methods:
Muscle denervation was induced by transecting and immediately repairing the sciatic nerve. Inguinal and subcutaneous adipose was harvested from donor rodents, processed into Nanofat, and then injected intramuscularly into the gastrocnemius. Gait analysis was performed weekly. Rodents were sacrificed at 9 and 12 weeks, upon which tetanic contraction force was measured, and gene expression, histology, and cytokine multiplexing were performed.

Results:
Intramuscular injection of Nanofat significantly increased maximum tetanic force generation at 9 and 12 weeks. The forces of the Nanofat-injected gastrocnemii were better correlated to their contralateral gastrocnemii relative to controls. Muscle repair-associated inflammatory gene expressions were significantly upregulated in Nanofat-injected gastrocnemii. Cytokines IL-1β, IL-18, VEGF, GC-MSF, and TIMP-1 were significantly higher in Nanofat-injected gastrocnemii relative to control gastrocnemii, and the tetanic force was linearly and significantly correlated to IL-1β and IL-18, and their interacting effects.

Conclusions:
Intramuscular injection of emulsified adipose tissue (Nanofat significantly increased gastrocnemii contraction force after sciatic nerve injury, with prolonged reconstructive inflammation via CD68, iNOS, IL-1β, and IL-18 all being potential mechanisms for this recovery. This application could potentially increase the therapeutic breadth of Nanofat to include muscular recovery after nerve injury.
Facial Expansion: A Blueprint for Coverage
Authors: Cohen Joshua M. , Zide Barry M. 
Published: February 2023

The benefits of tissue expansion go unrealized if flap design and coverage concepts do not exist in pre-operative thinking. Without proper analysis, the surgeon will likely burden the patient with more expanders than necessary. Tissue coverage needs can be simplified in forms of triangles and rectangles to determine expanded tissue advancement. Single or double back cuts allow usage of all the expanded tissue. Furthermore, early subtotal excisions, especially in children less than four months old, can reduce the number of expanders required.
With methods presented herein, the face can be resurfaced with better color and less distortion. Eyebrows should be maintained and positioned by keeping the lower frontalis muscles intact. Cheeks can be covered with a large “Schrudde” design and color can be improved by using upper neck skin preferentially over lower neck harvest. Laser hair removal allows larger swaths of forehead to be covered by hair-bearing scalp tissue. Prior incisional delay can expedite success with no tissue loss. The results speak for themselves when surfaces are covered with large, expanded flaps which are expeditiously harvested
“Gender and Ethnic Diversity in Plastic Surgery: Temporal Trends Among Speakers at National and Regional Plastic Surgery Conferences”
Authors: Landford Wilmina , Marquez Jocellie , Ngaage Ledibabari Mildred , Rathi Sourish , Stewart Talia , Hill John , Huston Tara , Broderick Kristen , Aliu Oluseyi 
Published: February 2023

Introduction:
Scientific leadership among women and underrepresented minorities is lacking in plastic surgery. It is unknown whether the underrepresentation of women and ethnic minorities extends into academic conferences. We evaluated the temporal trends of female and ethnic minority representation at plastic surgery conferences in the United States.

Methods:
A retrospective analysis of all presentations from seven national and regional plastic surgery meetings between 2014-2018 was conducted. Gender, ethnicity, and academic rank of the first authors were determined by analyzing pronouns, institutional biographies, and accompanying images identified in online searches.

Results:
A total of 4180 abstracts were presented by 3452 first authors. The majority of first authors were of European descent (53%), male (65%), and most commonly a resident physician (42%). Women were found to have a greater representation at plastic surgery conferences than in the plastic surgery workforce (34% vs 17%, p<0.0001). Similarly, relative to AAMC demographics, individuals of Asian descent were overrepresented as first authors (27% vs 12%, p<0.0001) whereas first authors of European descent were less prevalent (53% vs 64%, p<0.0001). When compared to national plastic surgery conferences, regional conferences had a greater proportion first authors of European descent (51% vs 58%, p<0.0001) but a lower proportion of first authors of East Asian descent (21% vs 16%, p=0.0001). Ethnic representation remained persistently low with first authors of South Asian descent decreasingly represented (2014: 10% to 2018: 6%, p=0.0062).

Conclusion:
Collectively, we present multi-level data that shows a promising trend of increased female representation at national meetings. However, there appears to be a decline in ethnic diversity.
‘Comparison of the Effects of Skin Microneedling with Cupping Therapy and Microneedling Alone: An Experimental Study’’
Authors: Pasinlioğlu Burak , Çenetoğlu İbrahim Seyhan , Karasu Oğuzhan , Özkoçer Süheyla Esra , Elmas Çiğdem 
Published: February 2023

Background
Microneedling promotes percutaneous collagen induction; cupping therapy creates negative pressure and leads to increased blood flow in the applied area. The addition of cupping therapy to microneedling is thought to contribute positively to microneedling’s effects. This study was carried out to investigate the histological effects of adding cupping therapy to microneedling.

Methods:
Thirty Wistar rats were divided into five groups, with six rats in each group. One control group and four experimental groups were formed, which are defined as follows: C group, control; Mi group, single-session microneedling applied to the dorsal trunk; MiCu group, 15-minute cupping therapy added to the single-session microneedling; 3Mi group, microneedling applied over a total of three sessions at 3-week intervals; and 3MiCu group, microneedling with cupping therapy applied over a total of three sessions at 3-week intervals. Each animal was sacrificed at the end of the fourth week following the last treatment, and skin samples were evaluated histologically with hematoxylin-and-eosin stain and type-1 and 3 collagen antibody immunostaining.

Results
The addition of cupping therapy to microneedling increased the thickness of the epidermis and dermis. A significant increase in type-1 collagen immunostaining and the type-1/type-3 collagen ratio was seen only in the Mi group. Cupping therapy did not generate a significant difference in type-1 collagen immunostaining. No treatment was found to produce a significant increase in type-3 collagen immunostaining.

Conclusions
Cupping therapy can be added to microneedling therapy and used to increase certain desired effects on skin.
Micronized cellular adipose matrix (MCAM) promotes the therapeutic effect of an artificial nerve conduit in peripheral nerve gap injury
Authors: Sawai Seiji , Sowa Yoshihiro , Kishida Tsunao , Inokawa Hitoshi , Inafuku Naoki , Tsuchida Shinji , Oda Ryo , Fujiwara Hiroyoshi , Mazda Osam , Yoshimura Kotaro , Takahashi Kenji 
Published: February 2023

Introduction:The stromal vascular fraction (SVF) isolated from adipose tissue has been shown to be beneficial for treating peripheral nerve injuries. Micronized cellular adipose matrix (MCAM) is a SVF-rich micronized fat tissue obtained by a series of simple mechanical processes. The aim of this study is to assess the therapeutic effect of MCAM for peripheral nerve injury.Methods:Microscopic evaluation of the cell phenotype and functions was performed to determine the adipose-derived stem cell (ADSC) content of the MCAM. An ANC filled with MCAM was implanted into a sciatic nerve defect in immunodeficient mice. Comparisons of this treatment with an autograft, an ANC filled with SVF cells, and an ANC alone were made based on electrophysiologic characteristics, sciatic function index, histological analyses of regenerated nerve fiber and myelination using electron microscopy, and the preventive effect on innervated muscle atrophy.Results:MCAM contained many cells with a phenotype and differentiation potency similar to ADSCs. The implantation experiment indicated that MCAM enhanced the efficiency of functional and structural recovery, while preventing atrophy of the innervated muscle. These effects were significantly improved than in the control group (ANC only) and comparable to those in the SVF group, whereas the improvement did not reach the same level of autograft group.Conclusion:Injection of MCAM into an ANC accelerated nerve regeneration compared with use of an ANC alone and this effect, which indicate that MCAM is a promising transplant material for treatment of peripheral nerve injury and an alternative to use of SVF cells.
E2F1- deficient adipose-derived stem cells improve skin wound closure in mice by upregulating paracrine expression of VEGF and TGF-β1
Authors: Yi Zhen , Wu Yiping , Zhang Qi , Xiao Hui , Yang Changchun , Hou Kai , Zeng Ning , Qin Gangjian , Wu Min 
Published: February 2023

Background:
Wound healing is a widespread health problem that imposes a financial burden on health systems. Cell therapy with genetically modified ADSCs is a promising strategy for dysregulated wound repair. E2F transcription factor 1 is a bidirectional regulator of cytokines. Here, we aimed to investigate the impact and potential mechanism of E2F1–/– ADSCs in promoting the wound healing process.

Methods:
Forty-five C57BL/6 mice (SPF, male) with 10 mm full-thickness wound were randomly treated with subcutaneous injection of 2 x 106 wild type (WT) ADSCs, 2 z 106 E2F1–/– ADSCs or PBS. The wound closure rate was monitored at day 0, 3, 7, 10, and 14 post-treatment. The collagen synthesis, angiogenesis, and wound contraction were calculated by Masson, IHC and IF staining (CD31, KI67), WB (α-SMA, collagen I, VEGF, and TGF-β1) separately at day 14. In vitro, the conditioned media (CM) of WT ADSCs and E2F1–/– ADSCs were collected to evaluate the impact on proliferation, migration, and angiogenesis.

Results:
In vivo, the E2F1–/– ADSCs group exhibited increased healing rate, proliferating vessels, and collagen synthesis compared to control at day 14 (P <0.05). Moreover, E2F1–/– ADSCs showed enhanced VEGF and TGF-β1 expression in the wound site and CM, and the CM from E2F1–/– ADSCs promoted the proliferation, migration, and tube formation of co-cultured cells in vitro (P < 0.05).

Conclusions:
The E2F1–/– ADSCs exhibited a strong paracrine ability to improve the vascularization process and collagen deposition, thereby accelerating the wound healing in the rodent model.
Avascular fat grafts show lower volume retention but higher hypoxia, angiogenesis, adipocyte proliferation, and macrophage infiltration than vascularized adipocutaneous flaps in an in vivo pilot mouse study Fat grafting vs. flap transfer in mice
Authors: Thomas Benjamin , Warszawski Jan , Falkner Florian , Bleichert Sonja , Haug Valentin , Bigdeli Amir K. , Schulte Matthias , Hoffmann Sabrina HL. , Garvalov Boyan K. , Schreiber Caroline , Takamiya Masanari , Sleeman Jonathan P. , Schmidt Volker J. , Kneser Ulrich , Pichler Bernd J. , Dimmler Arno , Thiele Wilko 
Published: February 2023

Background:
Over 137,000 breast reconstructions are performed annually by ASPS member surgeons in the US alone. Vascularized flap transfer and avascular fat grafting each account for over 33,000 annual autologous reconstructions, respectively. And although autologous approaches yield superior long-term functional and aesthetic outcomes, clinical and experimental observations of both techniques suggest considerable biologic differences with diverging effects on locoregional tumor control. However, parallel small animal models to compare their inherent proliferative, angiogenic, metabolic, and immunogenic influences in vivo are lacking. Therefore, we standardized existing flap transfer and fat grafting models in immunocompetent mice to reduce experimental bias, guarantee comparability, and lay the methodological foundation for an in vivo model of autologous breast reconstruction combinable with orthotopic mammary tumor implantations.

Methods:
Autologous groin flaps (n=25) and syngeneic fat grafts (n=39) were transferred in 8-week-old female BALB/c-mice. Viable adipocytes were tracked via Hoechst-Calcein-DiI-staining (n=2/group) and postoperative graft versus flap volumes were compared via longitudinal MRI (n=3/group) on days 1, 11, 21, and 31. Proliferation indices, microvessel densities, tissue hypoxia, and macrophage infiltrates (graded 0-3) were compared via Ki67-, CD31-, pimonidazole-, and H&E-staining on days 5, 10, 15, 20, and 30 (n=4/group/timepoint).

Results:
Viable adipocytes were present in both transferred tissue types. Fat graft volume retentions plateaued at 42.7±1.2% versus 81.8±4.0% of flaps on day 31 (p<0.001). Contrary to flaps, fat grafts initially contained more hypoxic cells (D5: 15.192±1.249 vs. 1.157±192, p<0.001), followed by higher proliferation (D15: 25.2±1.0% vs. 0.0±0.0%, p<0.001) and higher microvessel numbers per high-power field (D30: 307.0±13.2 vs. 178.0±10.6, p<0.001), accompanied by higher-graded macrophage infiltrates (3 vs. 2, p<0.01).

Conclusions:
Vascularized flaps and avascular lipofilling were compared in experimental mice in vivo. This comparative pilot study suggests differences in recipient site volume retention, adipocyte proliferation, angiogenesis, hypoxia, and macrophage recruitment.
How Minimally Invasive Treatments Can Render a Subsequent Facelift More Difficult.
Authors: Skouras George , Skouras Athanasios , Skoura Elena 
Published: February 2023

Background:
Minimally invasive antiaging procedures are often misused or overused, creating difficulties when the patient later decides to have a facelift.
The goal of this study was to examine the most common problems that the senior surgeon faces in his facelifts because of these non-invasive interventions and to demonstrate the ways he uses to solve them.

Methods:
A review of rhytidectomy cases from 2012 to 2017 performed by the senior author was conducted. All patients who had had any type of minimally invasive procedure before they had a facelift with the senior author were included in the study.
The aim of our study was to examine the author’s facelifts regarding the problems created by minimally invasive interventions that the patient had undergone in the past.

Results:
During the 5-year study period, the author performed 552 face lifts. By analyzing these patients, we found that 207 of them had previously undergone one or more minimally invasive procedures, in an effort delay or avoid a facelift.
The problems frequently encountered by the senior author in these patients were the following:
1) Cheek fat atrophy because of previous energy-based treatments.
2)Significant scar tissue formation because of previous energy-based treatments or thread lifting
3) Large volume injectables.
In all the abovementioned cases, the surgeon had to modify his basic surgical plan accordingly.

Conclusion:
Plastic surgeons today must be perfectly trained to evaluate and solve any of the problems caused during a facelift by misused or overused minimally-invasive treatments performed in the past.
Immediate post-mastectomy implant-based breast reconstruction: an outpatient procedure?
Authors: Keane Alexandra M. , Keane Grace C. , Skolnick Gary B. , Chi David , Ebersole Trina D. , Myckatyn Terence M. , Tenenbaum Marissa M. 
Published: February 2023

Background:
Coronavirus disease 2019 (COVID-19) poses unique challenges for breast reconstruction. At our institution, COVID-19 postoperative protocols mandated patients undergoing immediate prosthetic breast reconstruction transition from 23-hour postoperative observation to same-day discharge. We sought to compare complications and hospital costs between these groups.

Methods:
A retrospective study of consecutive patients who underwent immediate prosthetic breast reconstruction from March 2019 - April 2021 at an academic hospital was performed. Before mid-March 2020, patients were admitted postoperatively for observation; after mid-March 2020, patients were discharged same day. Postoperative complications at 48 hours, 30 days, and 90 days and hospital costs were compared.

Results:
There were 238 patients included (119 outpatient, 119 observation). Across all time points, total complications, major complications, categorical complications (wound healing, seroma, hematoma, infection, implant exposure), and reconstructive failures were low and not statistically different between groups. There were no differences in 30-day hospital readmission/reoperation rates (7.6% outpatient vs 9.2% observation, p=0.640). No patient or surgical factors predicted major complication or hematoma by 48 hours or infection by 90 days. At 90 days, radiation history (p=0.002) and smoking (p<0.001) were significant predictors of major complications. Average patient-care costs outside of surgery-specific costs were significantly lower for outpatients ($1,509 vs $4,045, p<0.001).

Conclusions:
Complications after immediate prosthetic breast reconstruction are low. Outpatient surgery is safe, harboring no increased risk of complications. Furthermore, outpatient care is more cost-effective. Therefore, surgeons should consider outpatient management of these patients to minimize COVID-19 exposures and reduce resource consumption, all while maintaining excellent surgical care.
Mid Cheek Lift via the Facial Soft Tissue Spaces
Authors: Wong Chin-Ho , Hsieh Michael Ku Hung , Mendelson Bryan 
Published: February 2023

Summary:
The mid cheek lift is one of the most effective procedures to rejuvenate the aging mid face. However, it is a technically demanding procedure with the risk of complications, such as scleral show and ectropion. In 2015, we published our mid-cheek lift technique and outcomes. In this Video+ article, we present refinements and nuances of our surgical technique, emphasizing technical aspects of this procedure that has enabled us to perform the surgery safely and effectively. The key concept of our approach is to minimize the trauma associated with surgical access, by dissection through the facial soft tissue spaces that are the gliding planes of the mid cheek. This minimizes post-operative bleeding and scarring that are the main contributor to the dreaded post-operative contracture related complications. To effectively mobilize the mid cheek, precise sharp release of specific mid cheek retaining ligaments separating these facial soft tissue spaces is performed. Conservative skin excision is emphasized along with routine canthopexy for lower lid support
Assessment of facial and cranial symmetry after one-piece fronto-orbital advancement with distraction for isolated unilateral coronal synostosis
Authors: Park Hojin , Min Jaechung , Choi Jong Woo , Ra Young Shin 
Published: February 2023

Background:
The surgical correction of unilateral coronal synostosis (UCS) aims to achieve a long-standing facial and cranial symmetry. We hypothesized that endocranial morphology correction achieved by one-piece fronto-orbital advancement with distraction osteogenesis (FODO) could alleviate facial asymmetry because endocranial morphology is thought to be its major determinant. Thus, this study aimed to quantitatively analyze the changes in supraorbital and midfacial symmetry after FODO.

Methods:
We included 27 UCS patients who underwent FODO between May 2008 and November 2019. The supraorbital, midfacial, and orbital symmetry ratios and the endocranial and midface angles were measured using computed tomography images.

Results:
The mean follow-up period was 3.7±1.9 years. The supraorbital shape became symmetric after FODO, as the supraorbital distance ratio changed from 0.88±0.04 to 0.98±0.03 (p<0.001). The endocranial angulation improved from 167.5±5.0° to 174.4±3.4° (p<0.001), and the midface angulation decreased from 6.6±2.2° to 2.6±1.9° (p<0.001). In the long-term follow-up period (5.9 years) analysis, the endocranial angle experienced a slight relapse (- 1.4± 0.9 %) and the supraorbital symmetry noticed a -2.0±3.9 % relapse. The midface angle continued to improve over the follow-up periods, but it was not statistically significant (p=0.121).

Conclusions:
Our observations indicate that FODO produced satisfactory outcomes in correcting supraorbital retrusion and midface asymmetry. In addition, FODO may allow anterior cranial base remodeling and help relieve the midface and skull base angulation. Therefore, FODO can be a good therapeutic strategy for correcting supraorbital and facial asymmetry in patients with UCS.