Vascularized Muscle Flap to Reduce Wound Breakdown During Flexible Electrode-Mediated Functional Electrical Stimulation After Peripheral Nerve Injury

McAvoy, Malia; Doloff, Joshua C.; Khan, Omar F.; Rosen, Joseph M.; Langer, Robert; Anderson, Daniel G.

doi:10.3389/fneur.2020.00644

Cited by 1 publication

(2 citation statements)

References 65 publications

(77 reference statements)

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“…[22][23][24] In addition, the vascularized pectoral muscle brings a rich vascular supply to the wound, potentially demonstrating superior resistance to surgical injury but also leading to a more profound cellular response. 25,26 Previous literature suggests that submuscular over subglandular placement reduces the incidence of CF [27][28][29] though, more recently, numerous long-term studies indicate controversial findings 30,31 or no difference at all. 32 Others suggest that placing breast implants submuscularly limits direct contact with surrounding glandular tissue and therefore minimizes bacterial contamination.…”

Section: Discussionmentioning

confidence: 99%

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MMP9 as a Potential Biomarker in 631 Human Implant-Induced Fibrotic Capsules A Systematic Analysis and Biomarker Study

Kuehlmann

Bonham

Gurtner

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Implants are a staple of modern medicine and are used across a variety of fields to treat conditions that were once untreatable. Today, up to 6% of the population in industrialized countries have received an implantable medical device. 1 Among the most common implantable devices are breast implants, often used in breast reconstruction following mastectomies.Although implants are indisputably beneficial as a contemporary treatment, they bring about their own complications in the foreign body response (FBR). The FBR disrupts the regular cellular environment and leads to an altered physiology in the areas surrounding an implant. This often yields a biological interference with the implanted device and can even lead to device failure, which requires surgical correction. Breast implants, in Background: Capsular fibrosis (CF) often occurs around biomedical devices following implantation causing pain, discomfort, and device failure. Breast implantation remains among the most common medical procedures worldwide. Revealing specific genes that drive fibrotic deposition will help us to garner a better understanding of the pathophysiology of this disease and develop different strategies to combat it. Methods: The authors collected 631 capsules around breast implants and were able to connect clinical baseline characteristics with histopathologic findings. In addition, the authors were able to conduct the first large systematic analysis to identify differentially expressed genes in fibrotic human tissue samples, comparing the lowest form of fibrosis with the most aggravated one. Results: The authors identified 2559 differentially expressed genes on which they performed a knowledge-based network generation and pathway association study to identify putative novel biomarkers for CF. The authors were able to show changes of cellular influx during progression of CF and distinguish several genes as potential clinical biomarkers and drug targets. Among these, matrix metalloproteinase-9 was one of the most up-regulated (P = 0.006) and is attractive because of its wide detectability. Conclusions: Matrix metalloproteinase-9 seems to be a potential biomarker to detect capsular fibrosis. It is a measurable indicator that can easily be detected in blood, sputum, and urine. For the diagnosis of fibrosis, this biomarker might be exceedingly beneficial to developing novel screening methods and prophylaxes. (Plast. Reconstr. Surg. 152: 637e, 2023.) Clinical Relevance Statement: Discovering biomarkers at the earliest and mildest stages for the diagnosis of fibrosis is clinically important. These results bring new hope for biomarker-based diagnosis for capsular fibrosis. CLINICAL QUESTION/LEVEL OF EVIDENCE: Diagnostic, V.

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Section: Discussionmentioning

confidence: 99%

“…22–24 In addition, the vascularized pectoral muscle brings a rich vascular supply to the wound, potentially demonstrating superior resistance to surgical injury but also leading to a more profound cellular response. 25,26…”

Section: Discussionmentioning

confidence: 99%