Michele Rosario Colonna

Background: Fingertip injuries frequently involve exposure of bone, tendon, or nail bed and require reconstruction to restore function and appearance. The homodigital adipofascial reverse flap (HDARF) and bilayer dermal substitutes such as Integra are commonly employed, but few comparative studies exist. Methods: A retrospective monocentric study was conducted, including 40 patients treated between 2012 and 2024 for traumatic pulp loss: 20 with HDARF and 20 with dermal substitute plus skin graft. Outcomes were assessed using Semmes-Weinstein monofilament (SWM) test, 2-point discrimination (2PD), Cold Intolerance Symptom Severity, Michigan Hand Outcomes Questionnaire, and return-to-work time. Results: All patients achieved wound healing without major complications. Homodigital adipofascial reverse flap provided superior sensory recovery (85% with normal SWM; mean 2PD < 5 mm), lower incidence of cold intolerance and nail deformities, and shorter return-to-work intervals. Dermal substitutes required longer healing but yielded good aesthetic outcomes and preserved donor sites. Conclusions: Both HDARF and dermal substitutes are safe and effective options for fingertip reconstruction. Homodigital adipofascial reverse flap is preferable for young, active patients requiring rapid functional recovery, whereas dermal substitutes represent a valuable alternative when minimal invasiveness and donor-site preservation are prioritized.

Peripheral nerve injury (PNI) is one of the common life‐altering disabilities resulting in various degrees of impairment in movement and sensation alongside apraxia and long‐lasting pain. The gold standard for restoring the transected nerves is bridging the distal and proximal ends of disrupted autologous nerve using neurosurgical sutures. This approach is helpful, however nerve bridging is valid in pay of consuming healthy nerves and scarring phenomena in damaged site besides difficult donor nerve accessibility and extra surgery is required. Many studies have demonstrated that bFGF plays a pivotal role in the regeneration of PNI and severe spinal cord injury, exerting neuroprotective activity by binding to fibroblast growth factor receptors (FGFRs). Particularly, bFGF exhibits a high affinity for the receptor FGFR1, serving as its specific ligand. The novel synthetic compound SUN11602 exhibited neuroprotective activities like bFGF. Therefore, this study aimed to evaluate the effect of SUN11602 treatment in a rat experimental model of peripheral median nerve transection (MNT) and end‐to‐end suture. MNT was performed on rats, starting from 24 h following the surgical procedure, to orally treat, daily for 7 days, with SUN11602 at the dose of 2.5 mg/kg. The results showed that SUN11602 administration significantly reduced the alteration of PNI, promoting median nerve regeneration, suppressed mast cell accumulation, and resident macrophages. Also, SUN11602 reduced pro‐inflammatory response of M1 macrophages, stimulated Schwann cell proliferation, and slowed down median nerve demyelination and fibrosis. Therefore, SUN11602 could be considered a valuable pharmacological strategy for MNT.

Background: Restoration of sensory feedback has become one of the major goals of modern bidirectional neuroprosthetic rehabilitation, enabling the transition from conventional prosthetic replacement toward bidirectional neuroprosthetic systems capable of restoring physiological sensorimotor communication. This narrative review aims to provide a comprehensive and clinically oriented overview of current neural and related sensorimotor interfaces for upper- and lower-limb prostheses, focusing on their mechanisms of sensory restoration, clinical performance, and translational potential. Methods: A targeted literature search was conducted in PubMed, Scopus, and Web of Science to identify clinical, translational, and landmark studies published between January 2010 and June 30, 2026. Sources were selected according to prespecified relevance criteria consistent with the narrative design of the review. Owing to the heterogeneity of the included technologies, study designs, populations, and outcomes, the evidence was synthesized narratively. Earlier seminal publications were included when relevant to the physiological basis of sensory restoration and the historical evolution of neural interfaces. The selected literature was analyzed thematically according to neural interface technology, sensory restoration strategies, functional outcomes, and clinical translation. Results: Evidence from small pilot studies and experimental evaluations suggests that direct peripheral and central neural interfaces, biological or regenerative interfaces, neuromuscular signal interfaces, non-invasive sensory-feedback systems, and integrated prosthetic platforms may contribute to the restoration or substitution of tactile, proprioceptive, thermal, and multimodal sensory information. Emerging technologies, including regenerative peripheral nerve interfaces, fully implantable wireless systems, biomimetic sensory encoding, adaptive closed-loop control, and artificial intelligence-assisted decoding, may support further clinical translation, although most remain investigational. However, the available evidence remains limited by small patient cohorts, heterogeneous methodologies, and a lack of standardized long-term outcome measures. Conclusions: Neural and related sensorimotor interfaces have shown the feasibility of providing sensory feedback in selected experimental and early clinical settings. Although no single technology currently fulfils all clinical requirements, the integration of complementary biological, neural, and computational approaches appears to represent the most promising pathway toward personalized neuroprosthetic systems with the potential to improve sensorimotor function, although long-term clinical and quality-of-life benefits remain uncertain.

Background: Large segmental bone defects remain a major challenge in reconstructive surgery, particularly in the presence of impaired vascularization. Despite advances in scaffold design and biomaterials, insufficient vascular supply continues to represent the primary limitation in bone tissue engineering, often leading to impaired osteogenesis and graft failure. Objective: This review aims to analyze the role of vascularized flaps as “living bioreactors” in bone tissue engineering, focusing on their capacity to enhance scaffold vascularization, support osteogenesis, and facilitate clinical translation. Methods: A narrative review was conducted through a structured search of PubMed, Scopus, and Web of Science using combinations of the following keywords: “bone tissue engineering”, “vascularized flaps”, “arteriovenous loop”, and “in vivo bioreactor”. Relevant preclinical and clinical studies were selected based on their contribution to vascularization strategies in scaffold-based bone regeneration, with the aim of illustrating the evolution and integration of these approaches. Results: Vascularized flaps provide an established vascular network and a biologically active microenvironment that promote scaffold integration and tissue regeneration. Periosteal flaps demonstrate strong osteogenic potential, whereas muscle and omental flaps primarily act as vascular carriers and adaptable regenerative environments. AV loop-based strategies enable intrinsic axial vascularization, ensuring rapid and homogeneous perfusion of large constructs. Hybrid approaches, including regenerative matching axial vascularization (RMAV), integrate vascularized tissues with advanced biomaterials and show promising translational outcomes. Conclusions: Vascularization-driven strategies represent a paradigm shift in bone tissue engineering, moving from passive scaffold implantation to actively engineered, vascularized constructs. The integration of microsurgical techniques with advanced biomaterials offers significant potential for the development of personalized and clinically applicable bone regeneration strategies.

Background/Objectives: Nasal reconstruction after non-melanoma skin cancer excision remains challenging due to the need to restore both nasal form and function while ensuring oncologic safety. Beyond surgical success, patient-reported outcomes are increasingly recognized as essential components of postoperative evaluation. The aim of this study was to retrospectively assess oncologic, surgical, and patient-reported outcomes in a real-world cohort of patients undergoing nasal reconstruction following skin cancer excision. Methods: A retrospective cohort study was conducted on 60 patients treated at the University Hospital “G. Martino” (Messina, Italy) between 2019 and 2022. Reconstructive techniques included direct closure, full-thickness skin grafts, local or regional flaps. Oncologic outcomes and postoperative complications were recorded during routine follow-up. Patient-reported outcomes were evaluated using a semi-structured PROM-derived questionnaire adapted from the FACE-Q Skin Cancer Module, NOSE, and SCaFF domains. Internal consistency of the questionnaire was assessed using Cronbach’s alpha. Results: Basal cell carcinoma was the most frequent diagnosis (55%), and the nasal ala, dorsum, and tip were the most commonly involved subunits. Local flaps were performed in 42% of cases. No histologically confirmed recurrences were observed in the flap-reconstructed subgroup during the available follow-up, whereas recurrences were observed in patients managed with non-flap reconstructive approaches. Postoperative complications were uncommon; however, one fatal infectious event occurred in a high-risk patient undergoing complex reconstruction for recurrent disease. The PROM-derived questionnaire demonstrated good internal consistency (Cronbach’s α = 0.82). Functional symptoms were rare, with 93% of patients reporting no snoring or nasal obstruction and 97% reporting no nasal voice alteration. Aesthetic satisfaction was rated as satisfactory or very satisfactory by 63% of patients, and social relationships were not affected in 85%. Patient-perceived recurrence risk (38%) exceeded histologically confirmed recurrence (15%). Conclusions: In this elderly real-world cohort, flap-based nasal reconstruction was associated with generally favorable patient-centered outcomes and low complication rates. The discrepancy between patient-perceived and confirmed recurrence highlights the role of oncologic anxiety. Prospective studies using fully validated PROMs are warranted to support standardized outcome comparison and guide clinical decision-making.

Natural compounds are increasingly explored for their ability to modulate multiple molecular pathways involved in inflammation and oxidative stress and for their therapeutic potential. Among these, Opuntia ficus-indica (L.) Mill. has attracted growing interest due to its rich phytochemical profile; however, the biological properties of unripe fruits remain largely unexplored. In this study, a hydroalcoholic extract obtained from unripe O. ficus-indica fruits was characterized for its chemical composition, antioxidant capacity, and concentration-dependent embryotoxic profile and subsequently investigated in a zebrafish model of spinal cord injury (SCI). UHPLC-HRMS/MS analysis identified 14 secondary metabolites, mainly flavonoids and phenylpropanoid acids. Antioxidant activity was confirmed by DPPH and ABTS assays. An embryotoxicity assessment conducted according to OECD Test Guideline 236 revealed no mortality at concentrations below 100 µg mL⁻¹ and an LC₅₀ of 323.59 µg mL⁻¹ at 96 h post-fertilization, allowing the identification of non-toxic concentrations for subsequent in vivo experiments. Based on these results, the extract was tested in a larval zebrafish SCI transection model. Treated larvae showed improved locomotor recovery, particularly under continuous exposure, accompanied by modulation of molecular pathways involved in inflammation, neurotrophic support, and neurogenesis, including reduced pro-inflammatory cytokine expression and increased BDNF and Sonic Hedgehog signaling markers. Overall, these findings expand current knowledge on unripe O. ficus-indica and highlight its potential to modulate molecular pathways involved in SCI-induced damage and repair.

Flavonoids are a diverse group of natural polyphenolic compounds, recognized for their ability to modulate cellular pathways and mitigate the pathological processes of many neurodegenerative diseases. This study investigates the neurotrophic potential of a polyphenolic-rich lemon peel extract (Lpe) in a Zebrafish larvae spinal cord injury (SCI) model. To evaluate its potential effects, embryos were divided into six experimental groups: a baseline control group in which larvae were neither subjected to spinal cord injury nor treated (Ctrl Group); a group with larvae subjected to spinal cord injury at 3 dpf without treatment (SCI Group); a group treated continuously with Lpe (25 µg/mL) from 0 to 5 dpf without injury (Continuous Group); a group treated continuously with Lpe and injured at 3 dpf (Continuous SCI Group); a group treated with Lpe starting at 3 dpf without injury (Curative Group); and finally, a group injured at 3 dpf and treated simultaneously with Lpe (Curative SCI Group). Lpe treatment significantly downregulated proinflammatory cytokines (tnfa, il1b, and xcl8), and modulated the neuroregenerative pathways Wnt/β catenin, and neurotrophic factor Bdnf. Immunohistochemical analysis further revealed Sox2-positive cells localized around the central canal, consistent with activation of ependymal progenitor populations involved in injury-induced repair processes. These findings support the exploration of Lpe for mitigating SCI-induced damage.

Background/Objectives: Investigating how placement of a contralateral breast implant in the context of unilateral implant-based breast reconstruction influences aesthetic and patient-reported outcomes. Methods: A retrospective analysis was performed on a single-center prospectively maintained database (January 2021–March 2025) including patients who underwent unilateral implant-based breast reconstruction in association with a contralateral implant placement or not. Exclusion criteria were bilateral implant-based reconstruction or autologous reconstruction, follow-up of less than 6 months and missing data. Demographics and complications were analyzed. Aesthetic outcomes were evaluated by independent blinded surgeons using the Kroll Scale, patient satisfaction was investigated with the BREAST-Q Reconstruction Module v2.0. Statistical analysis used the Student’s t-test, Multivariate regression analysis and Mann–Whitney U test with significance set at p < 0.05. Results: The study group included 21 patients (40.4%) who received a contralateral implant, while the control group included 31 patients (59.6%) who did not receive a contralateral implant. Patients who received contralateral implants showed a significant improvement in cosmetic outcomes evaluated with the Kroll Scale and a raw increment, without statistical significance, in BREAST-Q scores in all subsections investigated (Psychosocial well-being, Sexual well-being and Satisfaction with breasts). Conclusions: Placing a contralateral breast implant in the context of unilateral implant-based breast reconstruction significantly improves aesthetic outcomes and correlates with higher patient satisfaction scores for the reconstructed breast, compared to placing no contralateral implant, without increasing the overall complication rate.

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disorder characterized by recurrent nodules, abscesses, and sinus tracts in apocrine gland-bearing areas. Surgery plays a key role in moderate-to-severe disease. As patients increasingly rely on the internet for decision-making, the quality of online information on HS surgery requires critical evaluation. Previous studies have shown poor quality and limited coverage of surgical aspects. This study systematically assesses publicly available websites on the surgical and reconstructive management of HS, quantifies their quality using the modified Ensuring Quality Information for Patients (mEQIP) tool, and identifies areas needing improvement to support informed decisions. Methods: Google, Bing, and Yahoo were searched using five HS surgery-related keywords. The first 50 results per keyword and engine were collected (n = 750), and 214 websites met the inclusion criteria. Sites were categorized by provenance (practitioners, hospitals, healthcare portals, professional societies, encyclopedias) and assessed using the 36-item mEQIP checklist. High quality was defined as ≥23/36 (75th percentile). Comparisons were made by publication era (pre-/post-COVID-19) and source type. Results: The mean mEQIP score was 21.7; only 51 websites (23.8%) met the high-quality threshold. No significant difference emerged between pre- and post-COVID publications. Healthcare portals scored highest (22.8), followed by practitioners (21.5) and hospital sites (21.2); professional societies (19.7) and encyclopedias (17.3) performed worst. Major deficiencies included limited discussion of surgical risks, quality-of-life outcomes, and postoperative care. Conclusions: Online resources on HS surgery are frequently incomplete and omit essential details on risks, recurrence, and reconstructive options. Surgeons should direct patients toward vetted sources, and professional societies should develop accessible, evidence-based patient guidelines.