B. Weyand

Stammzellen aus dem Fettgewebe

While stem cells derived from the bone marrow are well-known in clinical medicine, fatty tissue as a source of mesenchymal stem cells is still the subject of recent research. However, adipose-derived stem cells (ASC) are not only harvested less invasively, i.e. via minimally invasive liposuction, but also yield higher numbers of multipotent stem cells.Due to cell-cell interactions and also because of the very favorable secretion profile of growth factors and cytokines ASCs displayed an extraordinary regenerative potential in recent preclinical and clinical applications and achieved a significantly better healing in ischemic muscle, heart, and brain insults and in impaired wound healing. ASCs enhanced regeneration in skeletal tissues such as cartilage or bone. They also revealed immunomodulatory effects and improved the clinical status in immunological diseases.In conclusion ASCs are comparable to bone marrow-derived stem cells concerning possible applications in clinical medicine.

[Stem cells from fatty tissue : A new resource for regenerative medicine?].

While stem cells derived from the bone marrow are well-known in clinical medicine, fatty tissue as a source of mesenchymal stem cells is still the subject of recent research. However, adipose-derived stem cells (ASC) are not only harvested less invasively, i.e. via minimally invasive liposuction, but also yield higher numbers of multipotent stem cells.Due to cell-cell interactions and also because of the very favorable secretion profile of growth factors and cytokines ASCs displayed an extraordinary regenerative potential in recent preclinical and clinical applications and achieved a significantly better healing in ischemic muscle, heart, and brain insults and in impaired wound healing. ASCs enhanced regeneration in skeletal tissues such as cartilage or bone. They also revealed immunomodulatory effects and improved the clinical status in immunological diseases.In conclusion ASCs are comparable to bone marrow-derived stem cells concerning possible applications in clinical medicine.

[One-stage defect closure of deperiosted bone and exposed tendons with MATRIDERM® and skin transplantation. Possibilities and limitations].

BACKGROUND Full-thickness skin defects over functional structures (tendons, vessels) or deperiosted bones of the extremities usually require extensive soft tissue reconstruction to cover the defect. A new option for coverage of the defect is the application of MATRIDERM®, a bovine matrix consisting of collagen and elastin, as a neodermis underneath skin transplants. Can this combined one-stage surgical intervention successfully cover deperiosted bone or tendon? PATIENTS AND METHODS We performed this one-stage procedure in ten patients instead of soft tissue reconstruction. The success of wound coverage with the one-stage method and in combination with skin transplantation for defects generally associated with considerable loss of transplants (deperiosted bones and tendons without paratenons) was determined. RESULTS In nine of ten patients, complete defect coverage could be achieved. A one-stage wound closure in extensive defects with exposed tendons in four of five locations could be achieved. In deperiosted bone defects the one-stage coverage was only successful in two of six patients. However, complete wound closure could be achieved with a second skin transplantation in a patient with exposed tendon and bone in three of the four locations. CONCLUSION As a one- or two-stage procedure, MATRIDERM® application with skin transplantation resulted in an effective defect closure without the need for a complex plastic reconstructive procedure. With regard to its functionality it cannot be considered as a substitute for skin flaps. In selected cases MATRIDERM® is an interesting and successful method in plastic reconstructive surgery.

Einzeitige Defektdeckung von denudiertem Knochen und freiliegenden Sehnen mittels MATRIDERM® und Spalthaut

BACKGROUND Full-thickness skin defects over functional structures (tendons, vessels) or deperiosted bones of the extremities usually require extensive soft tissue reconstruction to cover the defect. A new option for coverage of the defect is the application of MATRIDERM®, a bovine matrix consisting of collagen and elastin, as a neodermis underneath skin transplants. Can this combined one-stage surgical intervention successfully cover deperiosted bone or tendon? PATIENTS AND METHODS We performed this one-stage procedure in ten patients instead of soft tissue reconstruction. The success of wound coverage with the one-stage method and in combination with skin transplantation for defects generally associated with considerable loss of transplants (deperiosted bones and tendons without paratenons) was determined. RESULTS In nine of ten patients, complete defect coverage could be achieved. A one-stage wound closure in extensive defects with exposed tendons in four of five locations could be achieved. In deperiosted bone defects the one-stage coverage was only successful in two of six patients. However, complete wound closure could be achieved with a second skin transplantation in a patient with exposed tendon and bone in three of the four locations. CONCLUSION As a one- or two-stage procedure, MATRIDERM® application with skin transplantation resulted in an effective defect closure without the need for a complex plastic reconstructive procedure. With regard to its functionality it cannot be considered as a substitute for skin flaps. In selected cases MATRIDERM® is an interesting and successful method in plastic reconstructive surgery.

Lappenplastiken am Skalp

Definition. Als Skalp wird die behaarte Kopfhaut bezeichnet, deren Hautdicke mit 3–8 mm die dickste des ganzen Korpers ist. Der Skalp setzt sich aus mehreren Schichten zusammen: Haut (Epidermis und Kutis), Subkutangewebe, Galea aponeurotica, lockeres Bindegewebe, und das darunter liegende Perikranium und angrenzendes Kranium, bestehend aus Tabula externa und Tabula interna, die wiederum nach innen mit den Hirnhauten (Dura mater, Arachnoidea mater, Pia mater) das Gehirn bedeckt (◘ Abb. 13.1).

Weichteilplastische Maßnahmen bei Komplikationen im Schädelbereich

ZusammenfassungAusgedehnte Schädeldefekte entstehen zum einen im Rahmen onkologischer Erkrankungen, posttraumatisch oder postinterventionell. Ein nach der Primär- oder Sekundärversorgung in der Neurochirurgie, Hals-Nasen-Ohren-Heilkunde bzw. Schädelbasischirurgie eintretender komplikationsbehafteter Verlauf mit Weichteilverlusten ergibt die Notwendigkeit eines interdisziplinären plastisch-chirurgischen Komplikationsmanagements. In diesem Übersichtsartikel werden beispielhaft die Möglichkeiten der plastischen Weichteilrekonstruktion anhand repräsentativer Fallbeispiele dargestellt.AbstractTumor resection and trauma may leave devastating defects in the head and neck area complicating and preventing patient rehabilitation; therefore, plastic surgery methods are required which are able to prevent further complications and provide efficient functional and aesthetic reconstruction. In this review article typical cases and the interdisciplinary management of plastic surgery are presented.Tumor resection and trauma may leave devastating defects in the head and neck area complicating and preventing patient rehabilitation; therefore, plastic surgery methods are required which are able to prevent further complications and provide efficient functional and aesthetic reconstruction. In this review article typical cases and the interdisciplinary management of plastic surgery are presented.

Soft tissue plastic surgery for complications in the skull region

ZusammenfassungAusgedehnte Schädeldefekte entstehen zum einen im Rahmen onkologischer Erkrankungen, posttraumatisch oder postinterventionell. Ein nach der Primär- oder Sekundärversorgung in der Neurochirurgie, Hals-Nasen-Ohren-Heilkunde bzw. Schädelbasischirurgie eintretender komplikationsbehafteter Verlauf mit Weichteilverlusten ergibt die Notwendigkeit eines interdisziplinären plastisch-chirurgischen Komplikationsmanagements. In diesem Übersichtsartikel werden beispielhaft die Möglichkeiten der plastischen Weichteilrekonstruktion anhand repräsentativer Fallbeispiele dargestellt.AbstractTumor resection and trauma may leave devastating defects in the head and neck area complicating and preventing patient rehabilitation; therefore, plastic surgery methods are required which are able to prevent further complications and provide efficient functional and aesthetic reconstruction. In this review article typical cases and the interdisciplinary management of plastic surgery are presented.Tumor resection and trauma may leave devastating defects in the head and neck area complicating and preventing patient rehabilitation; therefore, plastic surgery methods are required which are able to prevent further complications and provide efficient functional and aesthetic reconstruction. In this review article typical cases and the interdisciplinary management of plastic surgery are presented.

Weichteilplastische Maßnahmen bei Komplikationen im Schädelbereich@@@Soft tissue plastic surgery for complications in the skull region

ZusammenfassungAusgedehnte Schädeldefekte entstehen zum einen im Rahmen onkologischer Erkrankungen, posttraumatisch oder postinterventionell. Ein nach der Primär- oder Sekundärversorgung in der Neurochirurgie, Hals-Nasen-Ohren-Heilkunde bzw. Schädelbasischirurgie eintretender komplikationsbehafteter Verlauf mit Weichteilverlusten ergibt die Notwendigkeit eines interdisziplinären plastisch-chirurgischen Komplikationsmanagements. In diesem Übersichtsartikel werden beispielhaft die Möglichkeiten der plastischen Weichteilrekonstruktion anhand repräsentativer Fallbeispiele dargestellt.AbstractTumor resection and trauma may leave devastating defects in the head and neck area complicating and preventing patient rehabilitation; therefore, plastic surgery methods are required which are able to prevent further complications and provide efficient functional and aesthetic reconstruction. In this review article typical cases and the interdisciplinary management of plastic surgery are presented.Tumor resection and trauma may leave devastating defects in the head and neck area complicating and preventing patient rehabilitation; therefore, plastic surgery methods are required which are able to prevent further complications and provide efficient functional and aesthetic reconstruction. In this review article typical cases and the interdisciplinary management of plastic surgery are presented.

Einzeitige Defektdeckung von denudiertem Knochen und freiliegenden Sehnen mittels MATRIDERM® und Spalthaut@@@One-stage defect closure of deperiosted bone and exposed tendons with MATRIDERM® and skin transplantation: Möglichkeiten und Grenzen@@@Possibilities and limitations

BACKGROUND Full-thickness skin defects over functional structures (tendons, vessels) or deperiosted bones of the extremities usually require extensive soft tissue reconstruction to cover the defect. A new option for coverage of the defect is the application of MATRIDERM®, a bovine matrix consisting of collagen and elastin, as a neodermis underneath skin transplants. Can this combined one-stage surgical intervention successfully cover deperiosted bone or tendon? PATIENTS AND METHODS We performed this one-stage procedure in ten patients instead of soft tissue reconstruction. The success of wound coverage with the one-stage method and in combination with skin transplantation for defects generally associated with considerable loss of transplants (deperiosted bones and tendons without paratenons) was determined. RESULTS In nine of ten patients, complete defect coverage could be achieved. A one-stage wound closure in extensive defects with exposed tendons in four of five locations could be achieved. In deperiosted bone defects the one-stage coverage was only successful in two of six patients. However, complete wound closure could be achieved with a second skin transplantation in a patient with exposed tendon and bone in three of the four locations. CONCLUSION As a one- or two-stage procedure, MATRIDERM® application with skin transplantation resulted in an effective defect closure without the need for a complex plastic reconstructive procedure. With regard to its functionality it cannot be considered as a substitute for skin flaps. In selected cases MATRIDERM® is an interesting and successful method in plastic reconstructive surgery.

Patientenvorbereitung und -nachbehandlung, inkl. interdisziplinäres postoperatives Schmerztherapiekonzept

Fur die Erkennung von latenten und manifesten Vorschaden sind eine genaue Anamneseerhebung, gezielte Befragung und die allgemeine klinische Untersuchung wichtig.