Addition of ffPRP improves initial ASC adherence while a single administration of either fresh or flash frozen PRP without additional cell manipulation significantly augments subsequent ASC proliferation. The potential for spontaneous osteogenic differentiation upon PRP exposure invokes the need for additional molecular studies of PRP activity prior to further expansion to clinical applications.

Visualization and quantification of the skin microvasculature are important for studying the health of the human microcirculation. We correlated structural and pathophysiological changes of the dermal capillary-level microvasculature with age and blood pressure by using the reactive hyperemia optical coherence tomography angiography (RH-OCT-A) technique and evaluated both conventional OCT-A and the RH-OCT-A method as non-invasive imaging alternatives to histopathology. This observational pilot study acquired OCT-A and RH-OCT-A images of the dermal microvasculature of 13 young and 12 old healthy Caucasian female subjects. Two skin biopsies were collected per subject for histological analysis. The dermal microvasculature in OCT-A, RH-OCT-A, and histological images were automatically quantified and significant indications of vessel rarefaction in both old subjects and subjects with high blood pressure were observed by RH-OCT-A and histopathology. We showed that an increase in dermal microvasculature perfusion in response to reactive hyperemia was significantly lower in high blood pressure subjects compared to normal blood pressure subjects (117% vs. 229%). These results demonstrate that RH-OCT-A imaging holds functional information of the microvasculature with respect to physiological factors such as age and blood pressure that may help to monitor early disease progression and assess overall vascular health. Additionally, our results suggest that RH-OCT-A images may serve as a non-invasive alternative to histopathology for vascular analysis.

Topical corticosteroid delivery following fractional laser treatment is an effective means of treating hypertrophic scars. However, the relative efficacy of adjuvant corticosteroid treatment vs fractional laser monotherapy alone is unclear. The aim of this study was to compare the efficacy and safety of fractional laser-assisted topical corticosteroid delivery with fractional laser monotherapy in the treatment of hypertrophic scars. In this randomized, comparative, split-scar trial of 19 subjects, a borderline significant reduction in scar thickness was observed at 3-month follow-up in the laser+steroid group compared with laser+petrolatum (p = 0.049). However, no significant long-term difference in scar flattening was observed between the 2 groups. Patient and Observer Scar Assessment Scale scores showed significant improvement in scar appearance from baseline without significant differences between treatment groups. In conclusion, fractional laser monotherapy is an effective treatment for hypertrophic scars, and the application of topical corticosteroid provides no long-term synergistic effect to fractional laser monotherapy.

Background/Objectives Standard optical coherence tomography angiography (OCTA) has been limited to imaging blood vessels actively undergoing perfusion, providing a temporary picture of surface microvasculature. Capillary perfusion in the skin is dynamic and changes in response to the surrounding tissue's respiratory, nutritional, and thermoregulatory needs. Hence, OCTA often represents a given perfusion state without depicting the actual extent of the vascular network. Here we present a method for obtaining a more accurate anatomic representation of the surface capillary network in human skin using OCTA, along with proposing a new parameter, the Relative Capillary Capacity (RCC), a quantifiable proxy for assessing capillary dilation potential and permeability. Methods OCTA images were captured at baseline and after compression of the skin. Baseline images display ambient capillary perfusion, while images taken upon capillary refill display the network of existing capillaries at full capacity. An optimization‐based automated vessel segmentation method was used to automatically analyze and compare OCTA image sequences obtained from two volunteers. RCC was then compared with visual impressions of capillary viability. Results Our OCTA imaging sequence provides a method for mapping cutaneous capillary networks independent of ambient perfusion. Differences between baseline and refill images clearly demonstrate the shortcomings of standard OCTA imaging and produce the RCC biometric as a quantifiable proxy for assessing capillary dilation potential and permeability. Conclusion Future dermatological OCTA diagnostic studies should implement the Capillary Refill Methods over standard imaging techniques and further explore the relevance of RCC to differential diagnosis and dermatopathology. Lasers Surg. Med. © The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals, Inc.

Summary: Recently, there has been heightened interest in the history of Black American plastic surgeons and their contributions to the field of plastic and reconstructive surgery (PRS). Despite the increased awareness and attention toward the lack of racial and ethnic diversity of the PRS workforce, the history of how PRS became one of the most ethnically segregated surgical specialties remains unexplored. Here, we outline the various political and cultural factors that contributed to the exclusion of Black practitioners from American PRS professional societies. This work contextualizes the rise of American PRS within the Jim Crow era and highlights the cultural significance of reconstructive procedures performed in the treatment of disfigured soldiers. Through this lens, we identify circumstances where Black surgeons were systematically denied opportunities to participate in the emerging specialty. Despite these barriers, we demonstrate how Black physicians established informal networks for professional advancement and shed light on several previously unrecognized contributions to PRS from Black surgeons. In addition, we explore how the inclusion of Black voices in PRS sparked a paradigm shift in the treatment of non-White patients that expanded the cosmetic marketplace in ways that remain significant today. Finally, we situate the ongoing disparities in Black representation in PRS within a broader historical narrative and illustrate how the stories we tell about our past continue to shape the future of our field.

Summary: Breast implant surgery remains one of the most common surgical procedures performed in the United States. Implant exchange can be complicated by unavailability of medical records or implant identification cards. Using chest imaging of 154 breast implants, an algorithm for estimating breast implant volume was generated. Based on four simple measurements and patient body mass index, a free, online calculator was created with a mean error of volume estimate of less than 1 cm3 and a SD of 44 cm3. In instances where a surgeon does not have implant records available but has chest imaging, this online tool can be used to obtain a relatively accurate estimate of implant volume.

training during residency. This study aims to review the current state of gender transition education in US plastic surgery residency programs. METHODS:We performed a cross-sectional study on all accredited independent and integrated plastic surgery residency programs. Information on program curricula was collected from official program websites, and email to or telephone interview with the program coordinator. Programs were also categorized on whether they were affiliated with a "Leaders in LGBT Healthcare" center. Exposure to surgical transition was deemed to be either incidental or structured. RESULTS:One hundred and thirty programs were included in this study. Most programs provided exposure to genderaffirming surgery (n = 96, 74%), significantly fewer provided structured training (n = 37, 28% vs 74%, p <0.001). Of those who provided formal training, all provided didactic training, 86% provided clinical training (n = 32) and less than half (n = 14, 43%) provided a dedicated rotation. Programs affiliated with "Leaders in LGBT Healthcare" centers were significantly more likely to provide dedicated rotations than their non-affiliated counterparts (p=0.028). CONCLUSION:Despite the growing demand for gender transition surgery, only one in four plastic surgery residency programs have structured training in their curriculum. To better serve the transgender population, a universal structured curriculum on gender transition surgery should be created.

No abstract