Maria Siemionow

University of Illinois at Chicago, Chicago, Illinois, United States

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Publications (294)683.5 Total impact

  • Article: LOP05
    M. Bozkurt · F. Ceran · S. Uygur · C. Ozturk · M. Siemionow ·

    Plastic &amp Reconstructive Surgery 08/2015; 136:437. DOI:10.1097/01.prs.0000470697.97739.d0 · 2.99 Impact Factor
  • Article: LOP05
    M. Bozkurt · F. Ceran · S. Uygur · C. Ozturk · M. Siemionow ·

    Plastic &amp Reconstructive Surgery 08/2015; 136(2):437. DOI:10.1097/01.prs.0000470120.95744.5e · 2.99 Impact Factor
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    ABSTRACT: Vapocoolant sprays are commonly used to minimize pain following minor interventions such as venipuncture, shave biopsy or needle insertion. Although these sprays have been widely used in clinical practice, little is known about their effect on microcirculation or cutaneous blood flow. To evaluate the real-time effect of a topical vapocoolant using a well-established, rat cremaster muscle microcirculatory model, allowing direct measurement of changes in vessel diameter, capillary density and leukocyte behaviour. Fifty rats were divided into a control and four experimental groups: group 1: 4 s spray with vapocoolant at 18 cm distance; group 2: 10 s spray at 18 cm distance; group 3: 4 s spray at 8 cm distance; and group 4: 10 s spray at 8 cm distance. Vessel diameters, capillary density and leukocyte behaviour were monitored for 1 h thereafter. Muscle was harvested for immunohistochemistry analysis of proangiogenic markers (vascular endothelial growth factor and von Willebrand factor), leukocyte behaviour markers (E-selectin, vascular cell adhesion molecule, intercellular adhesion molecule), pimonidazole-hypoxia staining and ApopTag (Millipore, USA) staining for apoptosis. Gene expression for inflammatory markers (interleukin [IL]-1β, IL-2, IL-4, IL-6, IL-10, tumour necrosis factor-alpha and interferon-gamma) was evaluated using polymerase chain reaction and myeloperoxidase assay for inflammation was performed. The use of refrigerant spray decreased vessel diameter and capillary density initially, although none of these decreases were statistically significant. Polymerase chain reaction showed no significant changes. The myeloperoxidase assay showed statistically significant increase in myeloperoxidase activity in groups 2, 3 and 4. Immunohistochemistry was negative for angiogenic and proinflammatory markers. The lack of statistically significant changes in vessel diameter and inflammatory markers corroborated the safety on microcirculation.
    05/2015; 23(2).
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    ABSTRACT: Vascularized composite allografts can undergo immune-mediated rejection, and skin biopsies are needed for monitoring of the transplant. However it is an invasive method, and requires processing time and pathological assessment. The purpose of this study is to use a new noninvasive monitoring method of the reflectance confocal microscopy (RCM) to determine severity of the allograft rejection on rats. Five groin flap allotransplantation were performed between 10 male Sprague-Dawley rats. Immunosuppressive therapy with cyclosporine A was given to the recipients during 10 days after surgery and was ended at the 10th postoperative days to allow acute transplant rejection. Following cessation of CsA, concomitant RCM evaluation and skin biopsy was performed every other day from each animal until total rejection of the allograft. Complete rejection of the allograft took nearly about 10 days and 4 or 5 RCM evaluation and skin biopsy was performed from each rat during this period. A total of 17 specimens were evaluated. A scoring system was developed based on the RCM findings. Skin biopsies were evaluated according to the Banff 2007 working classification criteria. RCM evaluation revealed epidermal irregularity and collagen destruction, however mild perivascular inflammation and degeneration of the basal epidermal layer were observed in early and late rejection period respectively with histopathologic evaluation. High correlation was found between the RCM scores and histopathologic grading. The RCM may be the useful tool to reduce the need for skin biopsy for monitoring of the skin containing vascularized composite allograft. © 2015 Wiley Periodicals, Inc. Microsurgery, 2015. © 2015 Wiley Periodicals, Inc.
    Microsurgery 05/2015; DOI:10.1002/micr.22419 · 2.42 Impact Factor
  • Article: Abstract 50
    Joanna Cwykiel · Medhat Askar · Grzegorz Kwiecien · Maria Siemionow ·

    Plastic &amp Reconstructive Surgery 04/2015; 135(4):1203. DOI:10.1097/ · 2.99 Impact Factor
  • maria siemionow · can ozturk ·

    Operative Microsurgery, Edited by boyd, jones, 01/2015: chapter Face Transplantation; McGrawHill.
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    ABSTRACT: PURPOSE: Peripheral nerve injury (PNI) repair is a challenging task, resulting in unsatisfactory outcomes. Rat epineural sheath conduit supported with rat bone marrow-derived stromal cells demonstrated neuroregenerative potential. To bring this approach closer to clinical applications we developed a new biologic construct for nerve regeneration - human epineural conduit (hEC) consisting of human epineural sheath (hES) filled with human mesenchymal stem cells (hMSC). The aim of this study was to assess the feasibility of hEC on the PNI repair in the nude rat model. METHODS: Sciatic nerve defect (20mm) was created in 24 nude male rats. Animals were divided into four experimental groups: Group 1 - no repair; Group 2 - autograft; Group 3 - hES filled with saline; and Group 4 - hEC (supported with 3-4 x 10^6 hMSC ). hES was created by fascicles removal using pull-out technique. To ensure homogenicity of hMSC, cells were cultured for 14 days and immunostained for hMSC-specific markers prior to injection into the hES. Outcome assessment included: sensory pinprick (PP) and motor toe-spread (TS) tests at 1, 3, 6, 12 weeks. Somatosensory evoked potentials (SSEP), gastrocnemius muscle index (GMI), histomorphometry, fluorescent immunostaining for GFAP, NGF, S-100, HLA I / II, vWF and laminin B2 were performed 12 weeks post-surgery. RESULTS: Cultured hMSC expressed CD105, CD73 and CD90, and lacked expression of CD45, CD34, CD14, CD11b, CD79a, CD19 and HLA-DR surface molecules. No leakage of cells was observed at the time of injection during conduit implantation. hEC maintained its shape and integrity at 12 weeks following repair. No local inflammation or scarring was observed at the end of the follow up. Clinical evaluation and SSEP analysis confirmed sciatic nerve recovery in groups 3 and 4 with outcomes comparable to nerve autograft repair. Immunostaining showed presence of the hMSC in the conduit at 12 weeks post-implantation. Quantitative nerve and muscle histological analysis is currently in progress. CONCLUSION: The feasibility of the application of hEC for restoration of PNI was successfully confirmed in this study. The functional outcomes following the use of hEC were comparable to the golden standard of autograft repair. hEC is a promising new technology for regeneration of long nerve gap defects which combines the effect of neurotropic properties of hES and immunomodulating properties of hMSC.
    Plastic &amp Reconstructive Surgery 10/2014; 134(4S-1 Suppl):67-68. DOI:10.1097/01.prs.0000455413.26992.ce · 2.99 Impact Factor
  • Article: Abstract 28

    Plastic and Reconstructive Surgery 04/2014; 133(4 Suppl):994. DOI:10.1097/01.prs.0000445811.34182.d7 · 2.99 Impact Factor
  • Wojciech Konczalik · Maria Siemionow ·
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    ABSTRACT: Management of soft tissue deficits resulting from congenital abnormalities, trauma, systemic disease, and tumors is a particularly challenging field of plastic and reconstructive surgery. Fat grafting, a technique traditionally used in the correction of facial asymmetry, is commonly seen in aesthetic procedures which use the grafted fat for soft tissue augmentation and recontouring. Despite its widespread use in reconstruction and aesthetic surgery, therapeutic modalities applied in fat grafting are crude and the results of this intervention are unpredictable. The aim of this review was to present the most recent evidence regarding experimental studies and designs which confirmed or disproved fat volume expansion or fat maintenance after autologous fat grafting.
    Annals of plastic surgery 04/2014; 72(4):475-83. DOI:10.1097/SAP.0000000000000117 · 1.49 Impact Factor
  • Safak Uygur · Can Ozturk · Grzegorz Kwiecien · Risal Djohan · Maria Siemionow ·
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    ABSTRACT: Currently, only a few large animal models, including swine, dog, and nonhuman primate, are described for composite face transplantation studies and the literature lacks reports on the large animal model of composite auricular transplantation. Large animal models offer better understanding of the immunological mechanisms and major histocompatibility complex characterization and, for this reason, are preferred to the small animal models for the assessment of new immunosuppressive tolerance induction protocols. Thus, the aim of this study was to demonstrate feasibility of dissection and exploration of vascular territories of the hemifacial and auricle transplantation models in the sheep cadavers. Ten cadaver sheep heads were studied. The vascular territories of the composite hemifacial flap and composite auricle flap were defined by anatomical dissection. Methylene blue staining and laser-assisted indocyanine green angiography using SPY Elite System were used for vascular territories assessment. The dissection of cadaver sheep heads confirmed that the hemifacial flap and auricle flap can be raised on the same pedicle consisting of the common carotid artery and jugular vein. An adequate vascular network was observed in the flaps after injection of methylene blue dye via the arterial pedicle. Laser-assisted indocyanine green angiography identified vascular territories of the hemifacial and auricular vascular network. We described a new hemifacial and an auricular transplantation models in the sheep cadavers and have confirmed presence of the adequate vascular network as demonstrated by the laser-assisted angiography. This study introduces 2 new large animal models into the armamentarium of vascular composite allotransplantation.
    Annals of plastic surgery 04/2014; 72(4):469-74. DOI:10.1097/SAP.0000000000000122 · 1.49 Impact Factor
  • Article: Abstract 90

    Plastic &amp Reconstructive Surgery 03/2014; 133:10-99. DOI:10.1097/01.prs.0000445123.00363.31 · 2.99 Impact Factor
  • Article: Abstract 64

    Plastic &amp Reconstructive Surgery 03/2014; 133:10-99. DOI:10.1097/01.prs.0000445097.91845.d5 · 2.99 Impact Factor
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    ABSTRACT: Background: Venous grafting has been widely used in microsurgical training. Different types of vascular grafts have been described in experimental models. In this study we describe for the first time the Y- and X-shaped vein grafts (YVG, XVG) with accompanying drain-out branches as a new tool for the microsurgical training and free flap applications in rats. Methods: Twelve adult male Lewis rats were used in this study. The dissections were performed to determine the average diameter and harvestable length of vein grafts in eight rats. In four rats vein grafts were applied for bridging of the common carotid artery gap, whereas the drain-out branches were used as the arterial source for single and bilateral free groin flap applications. The venous anastomoses of groin flaps were performed in end-to-end fashion to the external jugular vein and its branches. The patency of anastomoses was checked 72 hours after repair. Results: The average length of the harvestable vein branches ranged between 5.2 to 11.8 mm. The average surgery time for repair of the arterial gap with the vein grafts was 40 minutes. The ischemia time for single and bilateral groin flap transfer using YVG and XVG was 30 and 70 minutes, respectively. The patency of the interpositional vein graft was 100%. Flap survival rates were 50%. Conclusions: These vein grafts can be used as an alternative technique for reconstruction of tissue defects that require arterial gap repair with single or multiple free flap applications and also as a new microsurgical training model.
    Journal of Reconstructive Microsurgery 02/2014; 30(6). DOI:10.1055/s-0033-1361930 · 1.31 Impact Factor

  • American Society for Reconstructive Microsurgery 2014; 01/2014
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    ABSTRACT: Vascularized lymph node transfer is of high interest for the treatment of lymphedema. Currently, there are few experimental small animal models of vascularized lymph node transplantation. In this article, our aim was to describe a new vascularized cervical lymph node transplantation model in rats. Ten male Sprague-Dawley rats weighing 200 to 250 g were used in this study. The anatomic features of the neck lymph nodes in rats were explored. Anatomic neck dissections were performed, and lymph node flaps were harvested. The common carotid artery and the jugular vein were used as the vascular pedicles of the lymph node flap. Methylene blue dye was injected into the arterial pedicle. Lymph nodes were identified, and their structure was confirmed by histological evaluation. Laser-assisted indocyanine green angiography was used to confirm perfusion of the lymph node flap. An adequate perfusion was observed in the lymph node flap. The dye disseminated evenly within the lymph nodes, indicating that the flap had a well-established vascular network and an adequate blood supply. Macroscopically, perfusion of 5 to 6 lymph nodes was observed. Histological examination of tissue samples confirmed well-defined lymph nodes. After indocyanine green administration, fluorescence was observed throughout the lymph node flap and within the venous pedicle of the flap. To the best of our knowledge, this is the first report describing vascularized lymph node flap in the head and neck region of a rat. Our lymph node flap preparation technique confirmed the presence of 5 to 6 lymph nodes within the flap. The presented vascularized lymph node flap can be applied to transplantation studies, lymphedema studies, and to studies on immunological mechanism of tolerance and rejection.
    Annals of plastic surgery 12/2013; 71(6):671-674. DOI:10.1097/ · 1.49 Impact Factor
  • Maria Siemionow · Bahar Bassiri Gharb · Antonio Rampazzo ·
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    ABSTRACT: This review aims to present the most recent updates on face and upper-extremity allotransplantation. To date, 27 face and more than 89 upper-extremity allotransplantations have been performed. Both the face and hand transplants restored form, function and patients' social integration. The complications were comparable with solid organs; however, face transplantation, as well as the combination of face and double hand transplantation, presented with significant morbidity and mortality. Evidence of chronic rejection was confirmed in hand transplants, but it has not been reported yet for facial transplantation. Novel immunosuppressive protocols have allowed a decrease in the number and dosages of traditional immunosuppressants. With increased awareness that following face and hand transplantation, the return of function is more important than anatomical restoration of the missing parts, there has been an important shift in the ethical debate weighing the risks and benefits of face and hand allotransplantation. Early results after face and upper extremity transplantation are promising, with 5-year survival rates greater than in solid organ transplants. However, these procedures still need to be closely monitored and the outcome data should be rigorously reported to the central patient registry database to allow continuous surveillance.
    Current opinion in organ transplantation 10/2013; 18(6). DOI:10.1097/MOT.0000000000000021 · 2.88 Impact Factor
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    ABSTRACT: Muscle denervation atrophy is a result of lower motor neuron injury, thus an early restitution of muscle stimulation is essential in prevention of atrophic changes. The aim of the study was to evaluate the new application of naturally occurring epineural sheath conduit in repair of the peripheral nerve gap to prevent development of muscle denervation atrophy. Material and methods. We used the model of 20 mm sciatic nerve gap, resulting in denervation atrophy of the gastrocnemius muscle in the diabetic rats (DM type 2, n=42, Zucker Diabetic Fatty strain). We applied the epineural sheath conduit created from the autologous sciatic nerve for gap repair. Muscle atrophy was assessed with the Gastrocnemius Muscle Index (GMI) and microscopic muscle morphometry (mean fiber area) at 6 and 12 postoperative week. Muscle regeneration in the experimental group was compared to the gold-standard technique of autologous nerve grafting for the repair of created nerve gap. Results. The GMI evaluation revealed comparable muscle mass restoration in groups with nerve repair using both epineural sheath and standard autologous nerve grafting (reaching 28 and 35% of contralateral muscle mass at 12 postoperative week, respectively, p=0.1), and significantly better restoration when compared to the negative control group (no repair, 20%, p<0.01). Micromorphometry confirmed significantly larger area of the regenerated muscle fibers in groups with both nerve grafting and epineural sheath conduit repair (reaching for both ca. 42% of the non-operated side), when compared to severe atrophic outcome when no nerve repair was performed (14% of the control fiber area, p<0.0001). The effectiveness of epineural conduit technique in muscle mass restoration was observed between 6 and 12 weeks after nerve repair - when gastrocnemius muscle mass increased by 12%. Conclusions. Peripheral nerve gap repair with naturally occurring epineural sheath conduit is effective in prevention of muscle denervation atrophy. This method is applicable in diabetic model conditions, showing results of regeneration which are comparable to the autologous nerve graft repair.
    Polish Journal of Surgery 07/2013; 85(7):387-94. DOI:10.2478/pjs-2013-0059
  • Joanna Cwykiel · M Askar · M Siemionow ·

    Plastic &amp Reconstructive Surgery 05/2013; 131:91. DOI:10.1097/01.prs.0000430061.35471.4e · 2.99 Impact Factor
  • Maria Siemionow · Safak Uygur · Can Ozturk · Kris Siemionow ·
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    ABSTRACT: Peripheral nerve surgery performed under unfavorable conditions results in increased scar formation and suboptimal clinical outcomes. Providing the operated nerve with a protective barrier, reduces fibrosis and adhesion formation and may lead to improved outcomes. The ideal coverage material should prevent scar and adhesion formation, and maintain nerve gliding during motion. Nerve protection using autologous tissues has shown good results, but shortcomings include donor site morbidity and limited availability. Various types of methods and materials have been used to protect nerves. There are both advantages and disadvantages associated with the various materials and techniques. In this report we summarize currently used protective materials applied for nerve coverage under various surgical conditions. © 2013 Wiley Periodicals, Inc. Microsurgery, 2013.
    Microsurgery 05/2013; 33(4). DOI:10.1002/micr.22104 · 2.42 Impact Factor

Publication Stats

4k Citations
683.50 Total Impact Points


  • 2014-2015
    • University of Illinois at Chicago
      Chicago, Illinois, United States
  • 2000-2013
    • Cleveland Clinic
      • • Department of Plastic Surgery
      • • Department of Plastic and Reconstructive Surgery
      Cleveland, Ohio, United States
    • Universität zu Lübeck
      Lübeck Hansestadt, Schleswig-Holstein, Germany
  • 2007-2012
    • Case Western Reserve University
      Cleveland, Ohio, United States
    • American Society of Ophthalmic Plastic and Reconstructive Surgery
      Cleveland, Ohio, United States
    • Lerner Research Institute
      Cleveland, Ohio, United States
  • 2007-2008
    • Poznan University of Medical Sciences
      Posen, Greater Poland Voivodeship, Poland
  • 1994-2002
    • Gazi University
      • Department of Plastic and Reconstructive Surgery
      Engüri, Ankara, Turkey
  • 1999
    • Salt Lake City Community College
      Salt Lake City, Utah, United States
  • 1993-1995
    • University of Utah
      • Division of Plastic Surgery
      Salt Lake City, UT, United States