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Iacomino E, Fratini C, Sollima L, Eibenstein A, Barbato C, de Vincentiis M, Minni A, Zoccali F. Surgical Resection and Immediate Reconstruction with a Bilayer Wound Collagen Matrix of a Rare Oral Angiosarcoma: A Case Report. Diseases 2024; 12:117. [PMID: 38920549 PMCID: PMC11202842 DOI: 10.3390/diseases12060117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 05/21/2024] [Accepted: 05/23/2024] [Indexed: 06/27/2024] Open
Abstract
Angiosarcomas are malignant vascular tumors that commonly occur on the skin of the head and neck, breast, or scalp. Oral angiosarcoma is a rare tumor (0.0077% of all cancers in Europe), and regarding this atypical localization, no formal treatment trials have been conducted yet. We present a case of a 58-year-old female patient with a diagnosis of oral angiosarcoma. After tumor excision was performed by transoral surgical approach, immediate reconstruction of the intraoral surgical defects was made using Integra® bilayer wound collagen matrix. A skin regeneration technique has previously been reported to provide good healing for defects of buccal resection, preventing postoperative cicatricial fibrosis.
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Affiliation(s)
- Enzo Iacomino
- Department of Life, Health, and Environmental Sciences, Università degli Studi di L’Aquila, 67100 L’Aquila, Italy;
| | - Chiara Fratini
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (C.F.); (M.d.V.); (F.Z.)
| | - Laura Sollima
- Anatomy and Pathological Histology Division, ASL 1 Avezzano-Sulmona-L’Aquila, San Salvatore Hospital, 67100 L’Aquila, Italy;
| | - Alberto Eibenstein
- Department of Applied Clinical and Biotechnological Sciences, University of Aquila, 67100 L’Aquila, Italy;
| | - Christian Barbato
- Institute of Biochemistry and Cell Biology (IBBC-CNR), Department of Sense Organs, Sapienza University Rome, Policlinico Umberto I, 00161 Roma, Italy
| | - Marco de Vincentiis
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (C.F.); (M.d.V.); (F.Z.)
| | - Antonio Minni
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (C.F.); (M.d.V.); (F.Z.)
- Division of Otolaryngology-Head and Neck Surgery, ASL Rieti-Sapienza University, Ospedale San Camillo de Lellis, 02100 Rieti, Italy
| | - Federica Zoccali
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (C.F.); (M.d.V.); (F.Z.)
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Calabrese L, Fazio E, Bassani S, Abousiam M, Dallari V, Albi C, Nucera G, Nebiaj A, Zanghi F, Accorona R, Gazzini L. Systematic review of minimally-invasive reconstructive options for oral cavity defects. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2024; 44:S42-S57. [PMID: 38745516 PMCID: PMC11098536 DOI: 10.14639/0392-100x-suppl.1-44-2024-n2904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 01/20/2024] [Indexed: 05/16/2024]
Abstract
The oral cavity is a primary site for malignant neoplasms of the head and neck region. Surgery, with or without adjuvant therapy, offers the highest probability of cure by focusing on radical tumour removal and organ function restoration. Reconstructive options are represented by local and free flaps, while small defects can be managed without reconstruction. For medium-sized defects without bone involvement, local flaps can be a good alternative to free flaps in selected patients. The purposes of this article are to analyse the main minimally-invasive reconstructive techniques in oral cancer surgery through a systematic review of the literature and develop a reconstructive algorithm based on the site and size of the defect. We defined minimally-invasive reconstruction as any reconstructive option not involving flap dissection from the neck or other distant areas from the oral cavity. Options considered include: local myo-mucosal or mucosal flaps (based on the facial or buccal arteries, and palatal flap), Bichat’s fat pad flap, and nasolabial flap. Use of biological or synthetic materials is also described. In selected patients with small to moderate-sized defects, the possibility of reconstruction with local flaps can be a viable option.
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Affiliation(s)
- Luca Calabrese
- Department of Otolaryngology-Head and Neck Surgery, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy
| | - Enrico Fazio
- Department of Otolaryngology-Head and Neck Surgery, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy
| | - Sara Bassani
- Department of Otolaryngology-Head and Neck Surgery, University Hospital of Verona, Verona, Italy
| | - Monir Abousiam
- Department of Otolaryngology-Head and Neck Surgery, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy
| | - Virginia Dallari
- Department of Otolaryngology-Head and Neck Surgery, University Hospital of Verona, Verona, Italy
| | - Cecilia Albi
- Department of Otolaryngology-Head and Neck Surgery, University Hospital of Ferrara, Ferrara, Italy
| | - Giuseppe Nucera
- Department of Otolaryngology-Head and Neck Surgery, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy
| | - Aurel Nebiaj
- Department of Otolaryngology-Head and Neck Surgery, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy
| | - Francesca Zanghi
- Department of Otolaryngology-Head and Neck Surgery, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy
| | - Remo Accorona
- Department of Otolaryngology-Head and Neck Surgery, Niguarda Hospital, Milan, Italy
| | - Luca Gazzini
- Department of Otolaryngology-Head and Neck Surgery, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy
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Chernova UV, Varakuta EY, Koniaeva AD, Leyman AE, Sagdullaeva SA, Plotnikov E, Melnik EY, Tran TH, Rutkowski S, Kudryavtseva VL, Buznik VM, Bolbasov E. Piezoelectric and Dielectric Electrospun Fluoropolymer Membranes for Oral Mucosa Regeneration: A Comparative Study. ACS APPLIED MATERIALS & INTERFACES 2024. [PMID: 38607352 DOI: 10.1021/acsami.4c01867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Wound healing of the oral mucosa is an urgent problem in modern dental surgical practice. This research article presents and compares the findings of the investigations of the structural, physicochemical, and biological characteristics of two types of polymeric membranes used for the regeneration of oral mucosa. The membranes were prepared from poly(tetrafluoroethylene) (PTFE) and a copolymer of vinylidene fluoride and tetrafluoroethylene (VDF-TeFE) and analyzed via scanning electron microscopy, atomic force microscopy, X-ray diffraction analysis, and Fourier transform infrared spectroscopy. Investigation results obtained indicate that both types of membranes are composed of thin fibers: (0.57 ± 0.25) μm for PTFE membranes and (0.43 ± 0.14) μm for VDF-TeFE membranes. Moreover, the fibers of VDF-TeFE membranes exhibit distinct piezoelectric properties, which are confirmed by piezoresponse force microscopy and X-ray diffraction. Both types of membranes are hydrophobic: (139.7 ± 2.5)° for PTFE membranes and (133.5 ± 2.0)° for VDF-TeFE membranes. In vitro assays verify that both membrane types did not affect the growth and division of mice fibroblasts of the 3T3-L1 cell line, with a cell viability in the range of 88-101%. Finally, in vivo comparative experiments carried out using Wistar rats demonstrate that the piezoelectric VDF-TeFE membranes have a high ability to regenerate oral mucosa.
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Affiliation(s)
- Ulyana V Chernova
- School of Nuclear Science & Engineering, National Research Tomsk Polytechnic University, I-634050 Tomsk, Russian Federation
| | - Elena Yu Varakuta
- The Human Anatomy Department, Siberian State Medical University, I-634050 Tomsk, Russian Federation
| | - Anastasiia D Koniaeva
- The Human Anatomy Department, Siberian State Medical University, I-634050 Tomsk, Russian Federation
| | - Arina E Leyman
- The Human Anatomy Department, Siberian State Medical University, I-634050 Tomsk, Russian Federation
| | - Sofia A Sagdullaeva
- The Human Anatomy Department, Siberian State Medical University, I-634050 Tomsk, Russian Federation
| | - Evgenii Plotnikov
- Research School of Chemistry and Applied Biomedical Sciences, National Research Tomsk Polytechnic University, I-634050 Tomsk, Russian Federation
| | - Evgeniy Yu Melnik
- Research School of Chemistry and Applied Biomedical Sciences, National Research Tomsk Polytechnic University, I-634050 Tomsk, Russian Federation
| | - Tuan-Hoang Tran
- Research School of Chemistry and Applied Biomedical Sciences, National Research Tomsk Polytechnic University, I-634050 Tomsk, Russian Federation
| | - Sven Rutkowski
- Weinberg Research Center, School of Nuclear Science & Engineering, National Research Tomsk Polytechnic University, I-634050 Tomsk, Russian Federation
| | - Valeriya L Kudryavtseva
- School of Engineering and Materials Science, Queen Mary University of London, E14NS London, United Kingdom
| | - Vyacheslav M Buznik
- Faculty of Chemistry, Tomsk State University, I-634050 Tomsk, Russian Federation
| | - Evgeniy Bolbasov
- School of Nuclear Science & Engineering, National Research Tomsk Polytechnic University, I-634050 Tomsk, Russian Federation
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Kondej K, Zawrzykraj M, Czerwiec K, Deptuła M, Tymińska A, Pikuła M. Bioengineering Skin Substitutes for Wound Management-Perspectives and Challenges. Int J Mol Sci 2024; 25:3702. [PMID: 38612513 PMCID: PMC11011330 DOI: 10.3390/ijms25073702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/14/2024] Open
Abstract
Non-healing wounds and skin losses constitute significant challenges for modern medicine and pharmacology. Conventional methods of wound treatment are effective in basic healthcare; however, they are insufficient in managing chronic wound and large skin defects, so novel, alternative methods of therapy are sought. Among the potentially innovative procedures, the use of skin substitutes may be a promising therapeutic method. Skin substitutes are a heterogeneous group of materials that are used to heal and close wounds and temporarily or permanently fulfill the functions of the skin. Classification can be based on the structure or type (biological and synthetic). Simple constructs (class I) have been widely researched over the years, and can be used in burns and ulcers. More complex substitutes (class II and III) are still studied, but these may be utilized in patients with deep skin defects. In addition, 3D bioprinting is a rapidly developing method used to create advanced skin constructs and their appendages. The aforementioned therapies represent an opportunity for treating patients with diabetic foot ulcers or deep skin burns. Despite these significant developments, further clinical trials are needed to allow the use skin substitutes in the personalized treatment of chronic wounds.
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Affiliation(s)
- Karolina Kondej
- Department of Plastic Surgery, Medical University of Gdansk, 80-214 Gdansk, Poland;
| | - Małgorzata Zawrzykraj
- Department of Clinical Anatomy, Medical University of Gdansk, 80-211 Gdansk, Poland; (M.Z.); (K.C.)
| | - Katarzyna Czerwiec
- Department of Clinical Anatomy, Medical University of Gdansk, 80-211 Gdansk, Poland; (M.Z.); (K.C.)
| | - Milena Deptuła
- Laboratory of Tissue Engineering and Regenerative Medicine, Department of Embryology, Medical University of Gdansk, 80-211 Gdansk, Poland; (M.D.); (A.T.)
| | - Agata Tymińska
- Laboratory of Tissue Engineering and Regenerative Medicine, Department of Embryology, Medical University of Gdansk, 80-211 Gdansk, Poland; (M.D.); (A.T.)
| | - Michał Pikuła
- Laboratory of Tissue Engineering and Regenerative Medicine, Department of Embryology, Medical University of Gdansk, 80-211 Gdansk, Poland; (M.D.); (A.T.)
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Do J, Han JJ, Kwon IJ. Application of double layer with collagen-elastin matrix (Matriderm®) and polyglycolic acid sheet (Neoveil®) for oroantral and oronasal fistula closure after maxillectomy: a retrospective single center experience. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101648. [PMID: 37769966 DOI: 10.1016/j.jormas.2023.101648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/03/2023]
Abstract
PURPOSE This study investigates the effectiveness of a new double-layer approach for closing oroantral and oronasal fistulas (OA/ONFs) using Matriderm® and Neoveil®. Matriderm®, an acellular dermal matrix composed of collagen and elastin fibers, supports tissue regeneration, while Neoveil®, a biodegradable mesh sheet, serves as a barrier to prevent leakage and scarring. MATERIAL AND METHODS A retrospective study of 12 maxillectomy patients with oral cancer between January 2022 and May 2023 was conducted. Patient data, including tumor stage, bone invasion, and defect size, were analyzed. Surgical techniques included sinus mucosa preservation, and either buccal fat grafting combined with the double layer technique or the double layer technique alone, with statistical analysis performed using R software to evaluate outcomes. RESULTS The results indicate a 41.7% incidence rate of fistula formation with lower T stages, absence of bone invasion, smaller defect dimensions, and intact sinus mucosa correlating with reduced fistula risk (p < 0.05). Notably, no patients required fistula-related surgical revisions, validating the efficacy of the approach. CONCLUSION This study introduced a novel double-layer technique using Matriderm® and Neoveil® for closing OA/ONFs after maxillectomy. The technique demonstrated promising outcomes in addressing these post-operative complications. Lower tumor stages, no bone invasion, smaller defects, and intact sinus mucosa correlated with reduced fistula risk. This technique holds potential to enhance maxillectomy outcomes, offering a comprehensive approach to functional concerns, but warrants further investigation.
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Affiliation(s)
- Jiwon Do
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea; Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Korea
| | - Jeong Joon Han
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea; Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Korea
| | - Ik-Jae Kwon
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea; Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Korea.
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Mansour J, Nesbitt B, Khanjae S, Horowitz G, Amit M, Muhanna N, Hofstede TM, Gillenwater A. The Feasibility and Outcome of Integra® Bilayer Matrix in the Reconstruction of Oral Cavity Defects. Otolaryngol Head Neck Surg 2024; 170:373-379. [PMID: 37717219 DOI: 10.1002/ohn.531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/06/2023] [Accepted: 08/12/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVE To evaluate the feasibility, safety, and failure rate of Integra® Bilayer Wound Matrix (Integra) in the reconstruction of oral cavity defects. STUDY DESIGN Retrospective cohort study. SETTING All study information was collected from a single academic tertiary care hospital. METHODS Subjects included adult patients who underwent oral cavity resection and immediate subsequent reconstruction with Integra® Bilayer Wound Matrix at MD Anderson Cancer Center between the years 2015 and 2020. The following variables were collected: patient's demographics, comorbidities, disease stage, treatment and reconstruction modalities, and surgical outcome from the medical records. Statistical analysis included distribution analysis for all collected parameters and Pearson's χ2 tests to find correlation between variables and take rate of Integra. RESULTS Eighty-three patients underwent reconstruction with Integra® Bilayer Wound Matrix dressing. Average age was 66 years old. Thirty-nine patients (47%) had history of previous resections for oral cavity tumors. Fourteen patients (17%) had history of radiation therapy to the Head and Neck region. Most common pathology was invasive squamous cell carcinoma (75%) followed by dysplasia (12%). Complete wound healing with good cellular integration occurred in 83 patients (96%) with only 3 failures requiring additional surgery. Reconstruction of mandibulectomy defects was associated with increased risk of dehiscence and bone exposure (0.66, P = .03). CONCLUSION This study shows promising results with high take rate of Integra® Bilayer Wound Matrix dressing in the reconstruction of various oral cavity defects. We encourage surgeons to adopt this technique as a viable and versatile option into the reconstruction ladder of oral cavity defects.
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Affiliation(s)
- Jobran Mansour
- Department of Head and Neck Surgery, MD Anderson Cancer Center, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Department of Otolaryngology-Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Blaine Nesbitt
- Department of Otolaryngology, Head and Neck Surgery, Walter Reed National Medical Center, Bethesda, Maryland, USA
| | - Sonam Khanjae
- Department of Head and Neck Surgery, MD Anderson Cancer Center, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Gilad Horowitz
- Department of Otolaryngology-Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Moran Amit
- Department of Head and Neck Surgery, MD Anderson Cancer Center, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Nidal Muhanna
- Department of Otolaryngology-Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Theresa M Hofstede
- Department of Head and Neck Surgery, Section of Oral Oncology and Maxillofacial Prosthodontics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ann Gillenwater
- Department of Head and Neck Surgery, MD Anderson Cancer Center, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Li F, Gao C, Song G, Zhang K, Huang G, Liu H. Human Placenta-Derived Mesenchymal Stem Cells Combined With Artificial Dermal Scaffold Enhance Wound Healing in a Tendon-Exposed Wound of a Rabbit Model. Cell Transplant 2024; 33:9636897241228922. [PMID: 38334047 PMCID: PMC10858670 DOI: 10.1177/09636897241228922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 01/09/2024] [Accepted: 01/12/2024] [Indexed: 02/10/2024] Open
Abstract
To overcome the difficulty of vascular regeneration in exposed tendon wounds, we combined human placenta-derived mesenchymal stem cells (hPMSCs) with an artificial dermal scaffold and assessed their role in promoting vascular regeneration and wound healing in vivo. hPMSCs were isolated from the human placenta and characterized based on their morphology, phenotypic profiles, and pluripotency. New Zealand rabbits were used to establish an exposed tendon wound model, and hPMSCs and artificial dermal scaffolds were transplanted into the wounds. The results of gross wound observations and pathological sections showed that hPMSCs combined with artificial dermal scaffold transplantation increased the vascularization area of the wound, promoted wound healing, and increased the survival rate of autologous skin transplantation. Following artificial dermal scaffold transplantation, hPMSCs accelerated the vascularization of the dermal scaffold, and the number of fibroblasts, collagen fibers, and neovascularization in the dermal scaffold after 1 week were much higher than those in the control group. Immunohistochemical staining further confirmed that the expression of the vascular endothelial cell marker, CD31, was significantly higher in the combined transplantation group than in the dermal scaffold transplantation group. Our findings demonstrated that hPMSCs seeded onto artificial dermal scaffold could facilitate vascularization of the dermal scaffold and improve tendon-exposed wound healing.
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Affiliation(s)
- Fang Li
- Cell Therapy Center, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Cong Gao
- Department of Burns and Plastic Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Guodong Song
- Department of Burns and Plastic Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Kun Zhang
- Cell Therapy Center, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Guobao Huang
- Department of Burns and Plastic Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Hua Liu
- Cell Therapy Center, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
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Singh H, Kumar G, Jain A, Khazanchi RK. Dermal Template for Superficial Defects Related to Intra Oral Malignancy. Indian J Otolaryngol Head Neck Surg 2023; 75:3778-3785. [PMID: 37974864 PMCID: PMC10645704 DOI: 10.1007/s12070-023-04099-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 07/17/2023] [Indexed: 11/19/2023] Open
Abstract
Flaps are the workhorse reconstructive options for management of defects for oral malignancy. Superficial defects are traditionally managed with skin grafting or healing by secondary intention, each of which have its own problems. We would like to share our experience of use of dermal template for superficial intra oral defects related to oral malignancy. Patients with cancerous and pre-cancerous lesions which resulted in defects involving mucosa and superficial muscles were included in the study. All the patients were managed with Matriderm 2 mm dermal template without the use of skin graft/ flap. 7 patients in the period of 6 months with superficial defects were managed with Matriderm alone. Two patients had lesions on the tongue while five had it on Buccal mucosa. None of these patients had post operative pain, contracture or trismus. Speech and swallowing at 6 month average follow up is normal. Dermal Substitutes are effective method of management of superficial intra oral defects with no donor area morbidity.
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Affiliation(s)
- Hardeep Singh
- Medanta Division of Plastic, Reconstructive and Aesthetic Surgery, Medanta- The Medicity, Sector 38, Gurgaon, NCR 122001 India
| | - Gopal Kumar
- Department of Head and Neck Oncology, Medanta-The Medicity, Sector 38, Gurgaon, NCR 122001 India
| | - Ankit Jain
- Medanta Division of Plastic, Reconstructive and Aesthetic Surgery, Medanta- The Medicity, Sector 38, Gurgaon, NCR 122001 India
| | - Rakesh Kumar Khazanchi
- Medanta Division of Plastic, Reconstructive and Aesthetic Surgery, Medanta- The Medicity, Sector 38, Gurgaon, NCR 122001 India
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Davis M, Hom D. Current and Future Developments in Wound Healing. Facial Plast Surg 2023; 39:477-488. [PMID: 37308128 PMCID: PMC11121504 DOI: 10.1055/s-0043-1769936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
Poor wound healing on the face and neck can lead to significant morbidity and dissatisfaction in facial plastic surgery. With current advances in wound healing management and commercially available biologic and tissue-engineered products, there are several options available to optimize acute wound healing and treat delayed or chronic wounds. This article summarizes some of the key principals and recent developments in wound healing research in addition to potential future advancements in the field of soft tissue wound healing.
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Affiliation(s)
- Morgan Davis
- Department of Otolaryngology, Head and Neck Surgery, University of California, San Diego, La Jolla, California
| | - David Hom
- Department of Otolaryngology, Head and Neck Surgery, University of California, San Diego, La Jolla, California
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Abstract
This summary provides a concise overview of oral cavity reconstruction to optimize functional outcomes in the modern era. Soft tissue and osseous reconstruction options for a wide range of oral cavity sites including lip, oral tongue, floor of mouth, buccal, hard palate, and composite oromandibular resections are reviewed. The appropriate applications of primary closure, secondary intention, skin grafts, and dermal substitute grafts are included. Anatomic considerations, indications, contraindications, and complications of local, regional, and free flaps in oral cavity reconstruction are discussed. Specific defects and the appropriate options for reconstruction of those defects are delineated.
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Affiliation(s)
- Pablo Quadri
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, CSB - 6 Floor, Tampa, FL 33612, USA
| | - Caitlin McMullen
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, CSB - 6 Floor, Tampa, FL 33612, USA.
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Mangini N, Galvano F, Pucci R, Battisti A, Cassoni A, Valentini V. Dermal Regeneration Template: Reconstruction in Oral Cancer Defects. J Maxillofac Oral Surg 2023; 22:151-156. [PMID: 37041955 PMCID: PMC10082868 DOI: 10.1007/s12663-023-01889-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 03/01/2023] [Indexed: 04/13/2023] Open
Abstract
Background Post ablative oral mucosal defect resulting from the removal of tumors can be treated with various techniques. Purpose In this paper, we are showing what, in our experience, are the advantages and disadvantages given using biosynthetic skin substitutes when dealing with this kind of lesions. Materials and methods Patients included in the sample came to our attention with both neoplastic lesions (11 subjects) and important scar retraction after previous oncologic surgery (1 subject). All patients underwent trans-oral resection surgery following the same surgical protocol and post ablative oral mucosal defect were treated using the dermal regeneration template. The surgical defect location, size, and time of removal of the silicone layer varied from one subject to the other. Results Most patients showed good healing with reduced scarring and adequate remucosalisation of the defect. The main complications were shown in a palatal lesion treated with concomitant osteal resection, which developed an oroantral fistula at follow up, and tongue lesions which showed some scarring. Conclusions Given our experience, we would advise using dermal substitutes when reconstructing oral defects only after a cautious evaluation of the area of the lesion, the gap size, the possible adherence of the membrane to the gap, and the presence of tissue supporting the overlying membrane.
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Affiliation(s)
- Nicolò Mangini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Francesca Galvano
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Resi Pucci
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
| | - Andrea Battisti
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
- Oncological and Reconstructive Maxillofacial Surgery Unit, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy
| | - Andrea Cassoni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
- Oncological and Reconstructive Maxillofacial Surgery Unit, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy
| | - Valentino Valentini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
- Oncological and Reconstructive Maxillofacial Surgery Unit, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy
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Deganello A, Bosio P, Giannini L, Parolini F, Berretti G, Sordi A, Rampinelli V, Gualtieri T. Matrix for Mucosal Regeneration in Transoral Glossectomy for Squamous Cell Carcinoma: Objective and Subjective Functional Evaluation. Curr Oncol 2023; 30:1354-1362. [PMID: 36826065 PMCID: PMC9954828 DOI: 10.3390/curroncol30020104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Numerous options to manage local reconstruction following transoral partial glossectomy are possible. In this work, we present our experience using a matrix for mucosal regeneration, Integra®, after transoral resections of squamous cell carcinoma of the oral tongue. METHODS A retrospective analysis of patients treated for tongue carcinoma and reconstruction with Integra®, from September 2017 to September 2022. Functional outcomes were evaluated by measuring swallowing and speech abilities, tongue motility, and subjective quality of life. RESULTS The series accounts for 13 consecutive patients, staged from Tis to T3, no positive resection margins were found, average defect size was 17.8 cm2. The average histologically measured depth of invasion was 4.1 mm (range 2-12 mm), and no recurrences were observed during follow-up. All patients maintained excellent swallowing function, the average number of recognized words by an external listener during a phone call was 70.5 out of 75, the lingual motility test was good (a mean score of 4.5 out of 6 movements correctly executed) and subjective questionnaires results were optimal. Less satisfying functional results were recorded in elderly patients receiving a wider surgical resection. CONCLUSIONS This reconstructive technique for allows obtaining optimal healing and functional outcomes in patients with tumors suitable for transoral glossectomy.
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Affiliation(s)
- Alberto Deganello
- Otolaryngology Head and Neck Surgery Department of IRCCS, National Cancer Institute (INT), 20133 Milan, Italy
- Otolaryngology Head and Neck Surgery Department, Spedali Civili di Brescia, 25123 Brescia, Italy
- Correspondence: ; Tel.: +39-0223902793
| | - Paolo Bosio
- Otolaryngology Head and Neck Surgery Department, Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Lorenzo Giannini
- Otolaryngology Head and Neck Surgery Department of IRCCS, National Cancer Institute (INT), 20133 Milan, Italy
| | - Federico Parolini
- Otolaryngology Head and Neck Surgery Department, Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Giulia Berretti
- Otolaryngology Head and Neck Surgery Department, Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Alessandra Sordi
- Otolaryngology Head and Neck Surgery Department, Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Vittorio Rampinelli
- Otolaryngology Head and Neck Surgery Department, Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Tommaso Gualtieri
- Otolaryngology Head and Neck Surgery Department, Spedali Civili di Brescia, 25123 Brescia, Italy
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Development of an implantable three-dimensional model of a functional pathogenic multispecies biofilm to study infected wounds. Sci Rep 2022; 12:21846. [PMID: 36528648 PMCID: PMC9759537 DOI: 10.1038/s41598-022-25569-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022] Open
Abstract
Chronic wounds cannot heal due to impairment of regeneration, mainly caused by the persistent infection of multispecies biofilms. Still, the effects of biofilm wound infection and its interaction with the host are not fully described. We aimed to study functional biofilms in physiological conditions in vitro, and their potential effects in health and regeneration in vivo. Therefore, Pseudomonas aeruginosa, Staphylococcus aureus and Enterococcus faecalis were seeded in collagen-based scaffolds for dermal regeneration. After 24 h, scaffolds had bacterial loads depending on the initial inoculum, containing viable biofilms with antibiotic tolerance. Afterwards, scaffolds were implanted onto full skin wounds in mice, together with daily supervision and antibiotic treatment. Although all mice survived their health was affected, displaying fever and weight loss. After ten days, histomorphology of scaffolds showed high heterogeneity in samples and within groups. Wounds were strongly, mildly, or not infected according to colony forming units, and P. aeruginosa had higher identification frequency. Biofilm infection induced leucocyte infiltration and elevated interferon-γ and interleukin-10 in scaffolds, increase of size and weight of spleen and high systemic pro-calcitonin concentrations. This functional and implantable 3D biofilm model allows to study host response during infection, providing a useful tool for infected wounds therapy development.
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Advances in oral tongue reconstruction: a reconstructive paradigm and review of functional outcomes. Curr Opin Otolaryngol Head Neck Surg 2022; 30:368-374. [PMID: 36004797 DOI: 10.1097/moo.0000000000000828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Glossectomy remains a common treatment of oral tongue malignancies, which has a range of functional impacts depending on the extent of resection. This review aims to categorize and provide context for the approach to reconstructing these defects using recent evidence. RECENT FINDINGS The reconstruction method of choice should be tailored to the size and location of the glossectomy defect with special consideration to replace tongue volume and preserve mobility. There has been an increasing focus on patient-reported outcomes in oral tongue reconstruction. For defects beyond one-third of the tongue, free tissue reconstruction, and more recently, the submental artery island flap yield excellent results. Advances in reconstruction of larger defects have included preoperative soft tissue planning and assessment of outcomes in total glossectomy patients with laryngeal preservation. SUMMARY Depending on the defect, the appropriate reconstruction may range from healing by secondary intention to large volume free tissue transfer. In general, functional outcomes diminish with increasing size and complexity of the defect regardless of the reconstructive technique.
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Vassiliou LV, Sinha D, Dawood A, Kalavrezos N. Vascularized free fibula flap oral rehabilitation using tissue engineered mucosa: Report of 3 cases. J Craniomaxillofac Surg 2022; 50:485-492. [DOI: 10.1016/j.jcms.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 05/16/2022] [Accepted: 05/23/2022] [Indexed: 11/17/2022] Open
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Patel S, Ziai K, Lighthall JG, Walen SG. Biologics and acellular dermal matrices in head and neck reconstruction: A comprehensive review. Am J Otolaryngol 2022; 43:103233. [PMID: 34537508 DOI: 10.1016/j.amjoto.2021.103233] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 09/09/2021] [Indexed: 11/30/2022]
Abstract
Acellular dermal matrices (ADMs) have been studied extensively in the literature and have gained popularity for various reconstructive and aesthetic purposes. ADMs are composed of a basement membrane and acellular dermal layer of collagen and provide a platform for mucosal epithelization and neovascularization. Combining dermal collagen and essential growth factors allows ADMs to support adequate wound healing and bolster soft-tissue repairs. These dermal matrices can be derived from human cadaveric donor skin (allogenic) or mammalian donor sources (xenogeneic). These dermal substitutes provide the benefit of reducing or eliminating the need for autologous tissue grafts and subsequently minimize donor site morbidity. Many ADMs are currently available in the market, each with variations in processing, manufacturing, storage, preparation, and use. The literature validating ADMs in the head and neck for both cosmetic and reconstructive purposes is evolving rapidly. This review aims to provide an up-to-date and comprehensive overview of the principles of acellular dermal matrices (ADMs), the different types of ADMs, and evaluate common indications, techniques, and outcomes pertaining to select anatomic sites in the head and neck reconstruction.
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Affiliation(s)
- Shivam Patel
- Department of Otolaryngology-Head and Neck Surgery, The Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Kasra Ziai
- Department of Otolaryngology-Head and Neck Surgery, The Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Jessyka G Lighthall
- Division of Facial Plastic & Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Scott G Walen
- Division of Facial Plastic & Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, USA.
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