Stephanie Paola Feijóo Tapia

Lymphedema is a chronic and progressive disorder resulting from impaired lymphatic transport, leading to fluid accumulation, chronic inflammation, fibrosis, and progressive functional impairment. Recent advances in reconstructive surgery have shifted therapeutic strategies from symptom control toward physiological restoration of lymphatic drainage through supermicrosurgical techniques. This review analyzes the current scientific evidence regarding supermicrosurgery and lymphatic reconstruction, emphasizing lymphaticovenous anastomosis, vascularized lymph node transfer, immediate lymphatic reconstruction, advanced diagnostic imaging, and emerging regenerative medicine approaches. Contemporary literature demonstrates that individualized patient selection, supported by indocyanine green lymphography and other imaging modalities, is fundamental for optimizing surgical outcomes. Physiological reconstruction has been associated with reductions in limb volume, lower incidence of cellulitis, improved functional recovery, decreased dependence on compression therapy, and better quality of life when integrated into multidisciplinary care. Emerging technologies, including tissue engineering, therapeutic lymphangiogenesis, artificial intelligence, and image-guided surgery, are expanding future therapeutic possibilities while promoting increasingly personalized treatment strategies. Although current evidence supports the effectiveness of physiological lymphatic reconstruction, further multicenter prospective studies with standardized methodologies are required to strengthen clinical recommendations and improve the global implementation of these techniques. Overall, supermicrosurgery represents a major milestone in modern reconstructive surgery and continues to redefine the management of primary and secondary lymphedema through innovation, technological development, and international multidisciplinary collaboration.

Muscle and tendon injuries remain among the most common causes of functional impairment and time-loss in elite athletes, representing a significant challenge for reconstructive surgery, sports medicine, and rehabilitation. Conventional treatment approaches frequently restore anatomical continuity but may not completely reproduce the biological and biomechanical properties of healthy tissue, increasing the risk of delayed recovery and recurrent injury. In recent years, biological augmentation has emerged as a promising strategy to enhance tissue regeneration through modulation of inflammation, stimulation of angiogenesis, promotion of extracellular matrix remodeling, and improvement of collagen organization. This narrative review critically examined current scientific evidence regarding the biological basis, clinical applications, and therapeutic potential of platelet-rich plasma, bone marrow aspirate concentrate, mesenchymal stromal cells, extracellular vesicles, exosomes, biomaterials, and tissue-engineered constructs for the management of muscle and tendon injuries in elite athletes. Current evidence suggests that platelet-rich plasma remains the most extensively investigated biological intervention, whereas cell-based therapies, biomaterials, and exosome-derived approaches continue to demonstrate considerable regenerative potential despite requiring further clinical validation. The findings also emphasize that successful recovery depends not only on biological augmentation but also on accurate diagnosis, individualized patient selection, technically sound reconstructive procedures, structured rehabilitation, progressive mechanical loading, and multidisciplinary clinical management. Although regenerative medicine continues to evolve rapidly, methodological heterogeneity among available studies highlights the need for standardized treatment protocols and large multicenter clinical investigations. Overall, biological augmentation represents a valuable adjunct to contemporary reconstructive strategies, offering new opportunities to improve tissue healing, functional recovery, and safe return to competitive sport in elite athletes.

Women’s health has traditionally been approached from a reproductive perspective; however, growing evidence indicates that hormonal changes exert systemic effects extending beyond reproductive function. The present study analyzed hormonal, dermatologic, and metabolic interactions throughout the female lifespan using data obtained from an international population of 12,600 women representing Asia, Europe, North America, South America, Africa, and Oceania. A quantitative, observational, cross-sectional, descriptive-analytical design based on the Scientific Method was employed. Data were collected through anonymous standardized questionnaires that evaluated dermatologic manifestations, metabolic alterations, hormonal changes, and the perceived impact of these conditions on overall health and well-being. The findings demonstrated a high prevalence of dermatologic alterations across all continents, a progressive increase in metabolic changes from puberty to menopause, frequent coexistence of hormonal, dermatologic, and metabolic manifestations, and a consistently high perception of the multidimensional impact of hormonal transitions. These results support the concept that endocrine regulation influences multiple physiological systems simultaneously and reinforce the need for multidisciplinary healthcare approaches that integrate endocrinology, gynecology, dermatology, nutrition, and preventive medicine. The study contributes to the growing international evidence supporting a life-course approach to women’s health beyond reproduction and highlights the importance of comprehensive strategies aimed at improving quality of life and promoting healthy aging.

Complex traumatic injuries remain a major cause of long-term disability worldwide, frequently affecting multiple tissues and anatomical systems simultaneously. Conventional reconstructive approaches have improved survival and anatomical restoration; however, complete functional recovery remains a significant clinical challenge. This review examines the current role of regenerative reconstruction in the management of complex trauma, with particular emphasis on stem cell-based therapies, bioengineered scaffolds, biomaterials, tissue engineering, and emerging biofabrication technologies. Scientific evidence from preclinical and clinical studies demonstrates that regenerative strategies can enhance tissue repair through mechanisms including paracrine signaling, angiogenesis, immunomodulation, extracellular matrix remodeling, and cellular differentiation. Bone regeneration emerged as the most extensively investigated application, followed by soft tissue, cartilage, peripheral nerve, skeletal muscle, and spinal cord reconstruction. Bioengineered scaffolds have shown considerable potential to support cellular survival, tissue integration, and functional recovery by recreating biologically active microenvironments. Furthermore, advances in three-dimensional bioprinting have facilitated the development of patient-specific constructs designed to improve regenerative outcomes in complex anatomical defects. Comparative analysis suggests that regenerative reconstruction offers advantages over conventional approaches in biological integration, functional restoration, and long-term adaptation, while maintaining comparable structural outcomes. Despite promising advances, challenges related to clinical translation, standardization, regulatory approval, and large-scale implementation remain significant. Overall, regenerative reconstruction represents a rapidly evolving multidisciplinary field with the potential to transform trauma care by promoting biological restoration and improving functional outcomes for patients with severe injuries.