Actually, autologous fat grafts have many clinical applications in breast surgery, facial rejuvenation, buttock augmentation, and Romberg syndrome as well as a treatment of liposuction sequelae. The aim of this article was to describe the preparation and isolation procedures for stromal vascular fraction (SVF), the preparation of platelet-rich plasma (PRP), and the clinical application in the treatment of the scar on the face. Ten patients with burns sequelae (n = 6) and post-traumatic scars (n = 4) were treated with SVF-enhanced autologous fat grafts obtained by the Celution System. Another 10 patients with burns sequelae (n = 5) and post-traumatic scars (n = 5) were treated with fat grafting based on the Coleman technique mixed with 0.5 mL of PRP.To assess the effects of their treatment, the authors compared their results with those of a control group consisting of 10 patients treated with centrifuged fat. In the patients treated with SVF-enhanced autologous fat grafts, we observed a 63% maintenance of contour restoring after 1 year compared with only 39% of the control group (n = 10) treated with centrifuged fat graft (P < 0.0001). In the patients treated with fat grafting and PRP, we observed a 69% maintenance of contour restoring after 1 year compared with that of the control group (n = 10). Autologous fat grafting is a good method for the correction of scars on the face instead of the traditional scar surgical excision.

Background The vascularization of the distal portions of transferred tissue represents the most critical factor in the success of reconstructive surgery. In recent years, indocyanine green (ICG) fluorescence imaging techniques have been applied during surgery to evaluate flap perfusion. However, this investigation has found that there is little consensus regarding the standard dose of ICG as well as the pre-operative requirements of ICG allergy testing. The aim of this study is to summarize the applications of ICG to tissue transfers and safe dosing practices and to provide insight to the possible adverse effects of ICG on flap surgery with the goal of helping clinicians apply ICG safely and efficiently to tissue transfer procedures. Methods A literature search was performed using, Wiley InterScience, and Springer with the key words, ‘Flap,’ ‘indocyanine green,’ ‘surgery,’ and related mesh words for all publications between 2005 and 2015. Title and abstract screening was performed using predefined in- and exclusion criteria. Results Seventy-three articles were included. These were classified as “application of ICG in flap surgery” and “the security of applying ICG in flap surgery “. Conclusions ICG fluorescence imaging preoperatively facilitates the detection of perforators in tissue flaps with thickness <20 mm, aids in the evaluation of flap microcirculation and perfusion, and allows surgeons to select dominant cutaneous nerves while evaluating the quality of vascular anastomoses and locating thromboses. The literature also concluded that potential allergic reactions to ICG should be taken into consideration. ^* These authors contributed equally to this work.

There is an increased need for evidence-based practices in male-to-female (MtF) transgender vaginoplasty. Although there are a multitude of surgical techniques, there is a paucity of data comparing these procedures. A systematic review of retrospective studies on the outcomes of MtF vaginoplasty was conducted to minimize surgical complications and improve patient outcomes for transgender patients. Applying the Preferred Reporting Items for Systematic Review and Meta-Analysis, a comprehensive search of several databases from 1985 to November 7, 2017, was conducted. The databases included PubMed, Ovid MEDLINE Epub Ahead of Print, Ovid Medline In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, and Web of Science. The resulting publications were screened, and those that met our specified inclusion/exclusion criteria were analyzed. The DerSimonian and Laird random-effects model was used to pool complications and patient-reported outcomes. A total of 471 articles were initially identified, of which 46 met our eligibility criteria. A total of 3716 cases were analyzed. Overall incidence of complications included the following: 2% (1%–6%) fistula, 14% (10%–18%) stenosis and strictures, and 1% (0%–6%) tissue necrosis, and 4% (2%–10%) prolapse (upper and lower limits of the 95% confidence interval). Patient-reported outcomes included a satisfaction rate of 93% (79%–100%) with overall results, 87% (75%–96%) with functional outcomes, and 90% (79%–98%) with esthetic outcomes. Ability to have orgasm was reported in 70% (54%–84%) of patients. The regret rate was 1% (0%–3%). The length of the vaginal cavity was 12.5 cm (6.3–4.4 cm). Multiple surgical techniques have demonstrated safe and reliable means of MtF vaginoplasty with low overall complication rates and with a significant improvement in the patient's quality of life. Studies using different techniques in a similar population and standardized patient-reported outcomes are required to further analyze outcomes among the different procedures and to establish best-practice guidelines.

The aim of this meta-analysis was to collect data from randomized trials in burn patients and to analyze them with a meta-analytic approach to give a clear message of potential advantages of nanocrystalline silver (NC) versus older silver formulations (SS). A review of all-English prospective randomized trials that compared NC versus silver sulfadiazine or silver nitrate was conducted. Primary outcome was the evaluation of differences in the infection rate of burns. Secondary outcomes were the eventual differences in the pain experienced during medications, the length of hospitalization (LOS) and costs. Five articles that met the inclusion criteria were selected (n = 285 patients). The NC group had a significant lower incidence of infections compared with the SS group (9.5% vs. 27.8%, odds ratio: 0.14 [95% CI: 0.06–0.35]; χ2 test, P < 0.001), with a 2.9-fold decrease of the risk. Not all studies investigated the pain during change of dressings, LOS and costs. However, when data were available, these showed lower costs (US $1533 per patient for the SS group and US $946 per patient for the NC group) and decreased pain values in the NC group (Hedges’ G: −1.44 [95% CI: −1.86/−1.01]; P < 0.0001), while contrasting results were obtained for LOS. Nanocrystalline silver is a relatively new product with a significant stronger antimicrobial activity compared with older formulations. Its long lasting properties reduce dressing change frequency and are probably responsible for the decreased pain and the minor costs experienced.