Background: Cervical esophageal reconstruction is vital to improve the quality of life in cancer surgery patients. Microsurgery is crucial in providing vascularized tissue for defect repair, particularly in secondary cases with a higher risk of failure due to larger defects and damage from previous surgery and radiotherapy. The purpose of this study was to describe the clinical characteristics of a series of patients who underwent secondary repair of esophageal defects and provide practical information for the management and treatment of such cases based on the authors’ experience and the literature review. Methods: We retrospectively reviewed the electronic medical records of the Plastic Surgery Clinic at the University of Trieste to identify cases of patients who underwent secondary esophageal microsurgical reconstructions following oncological surgery. Patient demographics, the etiology of esophageal defects, previous surgical history, and preoperative assessments were collected from medical records. Surgical techniques utilized for reconstruction, such as pedicled flaps or free tissue transfers, were documented along with intraoperative information. Postoperative outcomes, including complications, graft viability, and functional outcomes, were evaluated during follow-up. Results: We treated 13 cases of secondary esophageal reconstructions between 2011 and 2022. Most commonly, Antero-Lateral Thigh (ALT) flaps were used in 10 cases, while 2 cases employed a radial forearm flap (RFF), and 1 case employed a chimeric parascapular flap. No flap failures occurred during a median 50-month follow-up. One ALT flap patient experienced postop stricture but maintained swallowing ability. A single tracheoesophageal fistula occurred in an RFF patient with a history of radiotherapy and complete lymph node dissection. Conclusions: Cervical esophageal reconstruction significantly impacts patients’ quality of life by restoring oral feeding and phonation. When local flaps fall short, microsurgical reconstruction with intestinal flaps is valuable but is burdened by limitations. For challenging secondary cases, ALT or RFF flaps emerge as safer options due to their robust pedicles, yielding low complication rates and positive functional outcomes.

Wound complications such as delayed healing and infection remain a challenge in on-coplastic breast surgery, often prolonging recovery and affecting patient comfort. This study explored the use of innovative breast-shaped polyurethane and polyester dressings impregnated with an oxygen-enriched oleic matrix designed to release reactive oxygen species that support natural tissue repair. Sixty patients undergoing unilateral qua-drantectomy with contralateral breast remodeling were included. The advanced dressing was applied to the oncologic breast, while standard premedicated patches were used on the opposite side, allowing each patient to serve as their own control. Over the first po-stoperative month, outcomes such as wound dehiscence, infection, delayed healing, and user experience were assessed. The new dressing provided excellent skin hydration, comfort, and ease of use, with complication rates comparable to traditional treatments. No infections, hematomas, or reoperations were observed. Healthcare personnel reported that the device was simple to handle and replace, while patients appreciated the comfort and absence of adhesive irritation. These preliminary findings suggest that oxygen-enriched oleic matrix breast-shaped dressings offer a safe, practical, and pa-tient-friendly alternative for postoperative care in oncoplastic breast surgery. Larger prospective studies are warranted to confirm their potential in improving healing quality and patient experience.

Wound-related issues such as delayed healing and patient discomfort remain common challenges in oncoplastic breast surgery and may negatively affect early postoperative recovery. This single-centre, retrospective, within-patient study explored the feasibility and safety of a breast-shaped polyurethane and polyester dressing impregnated with an oxygen-enriched oleic matrix, designed to provide a controlled, low-level release of reactive oxygen species involved in physiological tissue repair. Sixty patients undergoing unilateral lumpectomy with contralateral breast remodelling were included. The advanced dressing was applied to the oncologic breast, while standard premedicated patches were used on the contralateral side, allowing each patient to serve as her own control. Early postoperative outcomes, including wound dehiscence, infection, delayed healing, and qualitative user experience, were assessed descriptively over the first postoperative month. The oxygen-enriched oleic matrix dressing was well tolerated and associated with good skin hydration, comfort, and ease of use. No infections, hematomas, or reoperations were observed, and no relevant differences in early complication patterns emerged between the treated and control sides. Both patients and healthcare personnel reported favourable handling characteristics and comfort, with no device-related adverse events. These preliminary, hypothesis-generating findings suggest that oxygen-enriched oleic matrix breast-shaped dressings are a feasible and safe option for early postoperative wound management in oncoplastic breast surgery. Prospective, adequately powered multicentre studies are warranted to further investigate their potential role within standardized postoperative care pathways.

Background. Cervical esophageal reconstruction is vital for improving the quality of life in cancer surgery patients. Microsurgery is crucial, providing vascularized tissue for defect repair, particularly in secondary cases with a higher risk of failure due to larger defects and damage from previous surgery and radiotherapy. The purpose of this study was to describe the clinical characteristics of a series of patients who underwent secondary repair of esophageal defects and provide practical information for the management and treatment of such cases based on the authors' experience and the literature review. Methods. We retrospectively reviewed the electronic medical records of the Plastic Surgery Clinic at the University of Trieste to identify cases of patients who underwent secondary esophageal microsurgical reconstructions following oncological surgery. Patient demographics, etiology of esophageal defects, previous surgical history, and preoperative assessments were collected from medical records. Surgical techniques employed for reconstruction, such as pedicled flaps or free tissue transfers, were documented along with intraoperative details. Postoperative outcomes, including complications, graft viability, and functional outcomes, were evaluated during follow-up. Results. We treated 13 cases of secondary esophageal reconstructions from 2011 to 2022. Most commonly, Antero-Lateral Thigh (ALT) flaps were used in 10 cases, while 2 cases employed Radial Forearm Flap (RFF), and 1 a chimeric parascapular flap. No flap failures occurred during a median 50-month follow-up. One ALT flap patient experienced post-op stricture but maintained swallowing ability. A single tracheoesophageal fistula occurred in a RFF patient with a history of radiotherapy and completion lymph node dissection. Conclusions. Cervical esophageal reconstruction significantly impacts patients' quality of life by restoring oral feeding and phonation. When local flaps fall short, microsurgical reconstruction with intestinal flaps is valuable, but burdened by limitations. For challenging secondary cases, ALT or RFF flaps emerge as safer options due to their robust pedicles, yielding low complication rates and positive functional outcomes.