Filippo Boriani

Università degli studi di Cagliari | UNICA · Department of Surgical Science

Background The introduction of non-absorbable barbed sutures in plastic surgery has allowed the achievement of significant results in terms of efficacy and short and long-term outcomes. However, a non-absorbable material with no antibacterial coating could act as a substrate for sub-clinical bacterial colonization and thereby determine recurrent su...

Introduction: Venous congestion burdens up to 15% of deep inferior epigastric artery perforator (DIEP) flap breast reconstructions. For these cases, venous augmentation by superficial outside shunt (SOS) is associated with 100% success in secondary salvage surgeries. Intraoperative venous augmentation using other techniques yields a 0.3% rate of r...

Background With the recent safety communication issued by The Food and Drug Administration, squamous cell carcinoma breast-implant associated (BIA-SCC) has become part of the breast implant capsule related conditions. In the present paper, we review all cases of BIA-SCC currently reported in the literature. Methods From October 2022 to February 20...

Background: Pharyngoesophageal reconstruction with the tubed anterolateral thigh (ALT) flap is burdened by possible strictures and pharyngocutaneous fistulae (PCF). We present our experience with the U-shaped insetting of perforator-based chimeric ALT flap focusing on surgical technique, complications and functional outcomes. Methods: We retrosp...

Background Duration and take of gluteal lipografting are unpredictable. More importantly, unsafety of intramuscular lipofilling has been recently proven. Stromal Enriched Lipograft (SEL) is likely to enhance survival of injected fat. The purpose of this study is to describe the use of SEL for gluteal augmentation through injection into the subcutan...

The profunda femoris artery perforator (PAP) flap has been recently popularized as an alternative option for microsurgical reconstruction. The use of PAP flap has never been reported and described for reconstruction of the upper extremities, in particular the forearm. The purpose of this case report is to describe a case suggesting the PAP flap as...

The aim of this systematic review and meta-analysis was to analyse the literature on the infrahyoid myocutaneous flap (IHMCF) and evaluate its clinical outcomes. The MEDLINE, Embase, Web of Science, Cochrane Library, and Scopus databases were searched (inception to December 31, 2021). Meta-analyses were then conducted to estimate the overall rates...

Defects of the peripheral nervous system are extremely frequent in trauma and surgeries and have high socioeconomic costs. If the direct suture of a lesion is not possible, i.e., nerve gap > 2 cm, it is necessary to use grafts. While the gold standard is the autograft, it has disadvantages related to its harvesting, with an inevitable functional de...

Background In cosmetic pinnaplasty, an underdeveloped or absent antihelical fold and a hypertrophic concha are the most frequent defects requiring surgical consultation. With this study, the authors intend to describe a technique consisting of an anterior para-helical incision to approach the antihelix, with no posterior approach. Advantages of thi...

The authors wish to remove every commercial reference reported in the discussion of the published paper in Processes [...]

Musculoskeletal tumors of the hand are a rare entity and are divided into skeletal and soft tissue tumors. Either category comprises benign and malignant or even intermediate tumors. Basic radiology allows an optimal resolution of bone and related soft tissue areas, ultrasound and more sophisticated radiologic tools such as scintigraphy, CT and MRI...

Background: Face rejuvenation is increasingly challenging because patients request minimally invasive surgery; rapid surgical course and recovery; and fast, tangible, and long-term results. Rejuvenation of face often requires surgery to multiple areas, that is, the lateral face, the midface, the neck, and periorbital areas, in addition to the emer...

This work aims to characterize a new method to recover low-manipulated human adipose tissue, enriched with adipose tissue-derived mesenchymal stem cells (ATD-MSCs) for autologous use in regenerative medicine applications. Lipoaspirated fat collected from patients was processed through Lipocell, a Class II-a medical device for dialysis of adipose ti...

This work aims to characterize a new method to recover low-manipulated human adipose tissue, enriched of adipose tissue-derived mesenchymal stem cells (ATD-MSCs) for autologous use in regenerative medicine applications. Lipoaspirated fat collected from patients was processed through Lipocell, a II-a medical device for dialysis of adipose tissue, by...

Introduction: Nerve repair poses a significant surgical challenge, and much research on this topic for improvement in reconstruction of segmental defects is ongoing. The aims of the study were to reconfirm the accuracy and safety of a previously described nerve decellularization method on a larger experimental population of rabbits, as well as on...

A multicentre cohort study was conducted on the surgical approach to open tibia fractures. Treatment differences allowed for comparison between orthoplastic and exclusively traditional orthopaedic approach. Out of 160 patients, 70% were cured with an orthoplastic treatment, whereas 30% were treated by an orthopaedic team. All outcome measures were...

Background Acellular nerve allografts (ANAs) have been established as promising alternatives to autologous nerve grafts, which represent the reference standard. Our research group recently performed a systematic review of reported cell-based–enriching methods for recellularization of ANAs. Recellularization results in consistent improvement of peri...

Background: Peripheral nerve reconstruction is a difficult problem to solve. Acellular nerve allografts (ANAs) have been widely tested and are a promising alternative to the autologous gold standard. However, current reconstructive methods still yield unpredictable and unsuccessful results. Consequently, numerous studies have been carried out stud...

Background: The circumferential thigh lift (CTL) with vertical scar is a more extensive and effective procedure compared to the traditional lift, but the scar is not aequally concealed. Negative pressure treatment (NPT) is considered to have a beneficial effect on the physiological process of wound healing and early scar formation. A comparison st...

Introduction: Abdominoplasty is one of the most popular body-contouring procedures. Despite its popularity, classic abdominoplasty is still associated with a significant rate of complaints from patients such as: fullness of flanks and epigastric areas, lack of a posterior lumbar curve, hanging skin over the incision line, and visible scars over th...

Autografts represent the gold standard for peripheral nerve reconstruction but their limited availability, the discrepancy of nerve caliber and long surgical times are drawbacks. Allografts have therefore become a valid alternative option. In particular, acellular nerve allografts (ANAs) rather than fresh allografts do not need immunosuppression an...

Open fractures are severe, complex, limb-threatening and high-energy injuries, often involving lesions of both bone and soft tissues. Traditionally, treatment has been piecemeal by orthopaedic and plastic surgeons. This study aimed to prospectively investigate whether combining orthopaedic and plastic surgery in treating these injuries is more effe...

Purpose: The postoperative course of median nerve decompression in carpal tunnel syndrome may be associated with complications. The aim of this study was to explore the possible effects of alpha-lipoic acid (ALA) in the postoperative period after surgical decompression of the median nerve at the wrist. Methods: We conducted a double-blind prospe...

Background Eumorphic Plastic Surgery aims at improving the severe psychosocial pain caused by a deformity. Dysmorphopathology is an increasingly relevant problem facing the plastic surgeon. Objective The aim of this study is to describe the perioperative questionnaires created by the senior author and to present a cohort of plastic surgery patients...

Background Xiapex (active ingredient: collagenase Clostridium histolyticum), is a novel, innovative and expensive drug under observation from the Italian Medicine Agency (AIFA). Its dispensation is authorised only in highly specialised hospitals, such as this hospital, where it has been given to patients with Dupuytren disease since 4 December 2014...

Mesenchymal stem cells (MSC) have been widely used in orthopedics for several applications. Conventionally, MSC are maintained under 21% O2 which does not reflect the real O2 tension in vivo. Recently, it was reported that different O2 conditions can give different cellular responses. Here, we investigated whether prolonged exposure to hypoxia affe...

Breast ptosis may be caused by several factors, including significant weight loss, pregnancy, long breastfeeding periods, and involution of the postmenopausal breast tissue. The authors performed a prospective study to evaluate patient satisfaction and the rate of complications after modified round block mastopexy versus traditional round block mas...

Background: Obesity is increasingly frequent in our society and is associated closely with metabolic disorders. As some studies have suggested, removal of fat tissue through liposuction and dermolipectomies may be of some benefit in the improvement of metabolic indices. This article aimed to review the published literature on this topic and to eva...

Objectives: Acral lentiginous melanoma (ALM) is a defined histopathological entity with peculiar clinical-pathological features and is the most common subtype of malignant melanoma in acral locations. The 5-year survival rate is lower than that for all cutaneous malignant melanoma overall (80.3% versus 91.3%). Controversy exists in the literature...

The aim of the study was to obtain the highest number of multipotent adipose-derived mesenchymal stem cells (ADMSCs) by using culture conditions which favour cell expansion without loss of mesenchymal stem cells (MSC)-like properties. Based on the assumption that stem cells reside in niches characterized by hypoxic condition, we investigated if the...

The addition of progressive tension sutures to the abdominoplasty technique is advocated to reduce the risk of several complications. High superior tension abdominoplasty is another technique aimed at reducing tension at the prepubic suture line and improving cosmesis of the umbilical area. A cohort of massive weight loss patients undergoing abdomi...

The role of epineurolysis in carpal tunnel release is not clear, and its inclusion or not in the standard practice is a subjective choice of the hand surgeon based on their training and experience rather than being based on evidence. A systematic review with metanalysis of randomized controlled trials comparing median nerve decompression at the car...

Our experience with the treatment of large incisional hernias (IH) was reviewed comparing mesh repair alone vs. mesh repair plus pedicle flaps. A retrospective study was performed on patients treated between 2001 and 2005 that underwent component separation technique (CST) repair with polypropylene mesh alone or with polypropylene mesh and local "...

Initial, variably successful attempts of fat sculpting date back to the beginning of the 20th Century, but Gerard Illouz was the first to introduce the modern, safe, widespread method of liposuction. Preoperative injection of local anaesthesia, saline, distilled water, adrenaline and hyaluronidase, defined wet technique, established as a safe and e...

Cell transplantation for tissue repair has evolved into a widely accepted procedure in a variety of research and clinical fields. Experimental studies and clinical reports have demonstrated the safety, efficacy, and feasibility of adult stem cells autologous transplantation. Over the last decade, the potential advantages of using adult adipose tiss...

Several techniques for lipoinjection have been described in the literature. Recently, the role of adult stem cells in adipose tissue has gained interest. The authors compare autologous fat transplantation to adipose-derived stem cell-enriched lipografts. A group of 20 patients with congenital or acquired facial tissue defects were included in this...

The highly variable anatomic distribution of lower leg perforators is explored, with a standardization based on leg length. The possibility of a correlation between leg length and number of perforators is investigated. Twenty-two lower limbs of cadavers were utilized for an anatomic study on the leg perforators branching from the three major vascul...

The first choice for internal mucosal restoration of the nose is a septal mucosal or vestibular local flap. The forehead flap, raised including the galeal layer, is an alternative option for large nasal defects. It can be used in any difficult situation in which septal or vestibular flaps are not adoptable, such as complete loss of lower one-third....

The importance of residents' training in aesthetic surgery and the need for acquiring confidence in performing cosmetic procedures is an established knowledge. A survey was done in two different training systems to evaluate the experience of junior plastic surgeons in performing four common aesthetic surgery procedures at the end of their residency...

A large and deep oncological defect has been filled up using a very long-pedicled latissimus dorsi myocutaneous flap, together with a trapezius myocutaneous flap, both harvested contralaterally to the lesion. Despite the distance of the defect from the area from which the flaps have been harvested, use of long-pedicled flaps warranted a better flap...

Introduction: The Tripier flap is a bipedicled bridge-shaped flap, originally designed on the upper eyelid. The classically described use was for reconstruction of split-thickness defects of the lower eyelid. In the literature no mention exists of bipedicled flaps from the lower eyelid for reconstructing the upper. Case report and surgical techni...

Aim. Skin ulcers often accompany neuropathy and vascular compromise in what is known as diabetic foot. In the literature no mention of electric stimulation is given in the guidelines for diabetic foot management, usually consisting of wound dressing and, if necessary, reconstructive surgery. The aim of this study was to assess the effectiveness of...

Authors' clinical and surgical experience in correction of the radial polydactyly in its various degrees of severity is presented. Nineteen patients were operated due to thumb duplication in a 10-year period from 1996 to 2006. The cases were classified according to Wassel 7-type classification. The surgical techniques adopted were the Bilhaut-Cloqu...

After massive weight loss, both upper and lower limbs show a similar deformity which consists of redundancy and ptosis of the cutaneous mantle. Many disturbances are associated with this abnormality, which can be treated surgically. A retrospective review of limb-contouring procedures after massive weight loss is presented. Thigh lift and arm lift...

Launois-Bensaude syndrome is a rare pathology consisting of adipose masses symmetrically distributed mainly in the superior part of the body. Men are especially affected between age of 30 and 60 as well as chronic alcohol abusers. Etiopathogenesis is attributable to mutations or deletions of mitochondrial DNA, and alcohol is a possible cofactor. Th...

Aim. Spinocellular carcinoma is a malignant tumour of the epidermis which reproduces the appearance of keratinising cells. In frequency terms it is the second most common tumour among malignant cutaneous neoplasias. Predisposing factors include a clear phototype, exposure to UV rays, ionising radiation and various chemical substances, burns, scarri...

Aim. Pressure sore treatment in patients suffering from spinal cord injuries is a continous challenge for plastic surgeons. Preventive measures frequently fail and the only treatment is surgery. Authors analyze the surgical treatment of the ulcers in sacral region comparing myocutaneous VY advancement flaps versus fasciocutaneous flaps (perforator...

Morbid obesity is associated with various co-morbidities. With the significant weight loss, new dysfunctions arise, and prior body contour disorders start to severely affect the patient's quality of life. The abdominal apron is generally the greater and the first disturbance faced by the post-bariatric patient. The authors retrospectively reviewed...

Aim. Acute and chronic wounds of the foot often present challenging features. Vacuum Assisted Closure (VAC Therapy System®, KCI USA, San Antonio, TX, USA) is a method for treatment of skin lesions utilizing a negative pressure applied within the wound. This negative pressure wound therapy promotes granulation and reduces the time necessary for woun...

The Authors intend to guide the choice of surgical treatment for mammary asymmetry, according to specific form of asymmetry. Possible types of symmetryzation surgery are listed. First Author's personal technique is described and some clinical cases are presented. Regardless to specific surgical needs for the single case, a generally valid concept i...

The inframammary fold (IMF) represents one of the most important anatomic landmarks in defining a woman's breast ptosis and inferior quadrant shape. Therefore it is important to preserve it, if this is oncologically safe, at the time of excisional surgery. If it is sacrificed, dislocated cranially or caudally, or there is a thick panniculus adiposu...

Traumatic defects of the vermilion are often associated with defects of the adjacent skin. We present a case in which we reconstructed a combined labial defect, both mucosal and cutaneous, by means of a composite advancement flap consisting of orbicularis oris muscle, oral mucosa and underlying skin.

Obesity is an increasingly common disease, whose complex treatment often terminates with the patient's discontinuation of therapies. The authors suggest how to improve a multidisciplinary approach to the obese, to increase compliance with therapy. A characterization of obesity is a helpful initial step. It consists of an accurate anatomic definitio...

"En Cyrano angioma" is a congenital angioma localized to the nose tip. It is commonly treated with a steroid-based approach followed (at 3 years of age) by surgical treatment of fibrolipomatosis and cartilages compromised by the expanding angioma. With this case report the authors present the very early surgical-sclerosis therapy of "en Cyrano" imm...

The prevalence of obesity continues to increase, and presents a growing health and social problem. Cardiovascular, respiratory, musculoskeletal and metabolic disorders associated with obesity compromise quality of life and shorten the lifespan of those affected. Health education and measures to effect lifestyle change and weight loss have had littl...

The size of labia minora is highly variable. Their hypertrophy can be congenital or acquired and surgery is indicated when either psycological or functional discomforts are reported. The traditional female circumcision is a forerunning method of labial reduction that dates back to ancient Egypt and is still practiced in Arabian countries. Based on...

Pharyngostomes are communications from pharynx to the outside, deriving from oncological surgery of the neck. We report our ten years' experience on reconstruction of neck wall. Among the several techniques that are available the choice is mainly based on Bosio's classification of pharyngostomes and patient's conditions. Pectoral major myocutaneous...