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  • Antonopoulos, Constantine N.; Lazaris, Andreas; Venermo, Maarit; Geroulakos, George (2019)
    Objectives: After surgical or endovascular revascularization, some ischemic lesions will not heal, while some others will heal at a variable period of time from the intervention, indicating a multifactorial interaction between local and systematic "wound healing-promoting" factors. Our objective was to identify predictors of wound healing following revascularization for chronic limb-threatening ischemia (CLTI). Methods: A literature review was performed to identify published research concerning clinical, biochemical, and noninvasive methods as predictors of wound healing time and wound-free period after surgical and endovascular revascularization for CLTI. Results: Our review indicated that potential predictors included local wound factors, wound depth, patient's comorbidities, medications, smoking and alcohol abuse, poor vessel runoff, and direct versus indirect revascularization. Among the clinical biomarkers, platelet-derived growth factor, transforming growth factor beta, basic fibroblast growth factor, tumor necrosis factor alpha, interleukin (IL) 1, and IL-6 have been proposed as potential predictors. Furthermore, the potential of noninvasive microcirculation assessment to predict proper wound healing has been the topic of extensive investigation. Among the novel methods, transcutaneous measurement of oxygen partial pressure, skin perfusion pressure, oxygen-to-see method, indocyanine green fluorescence imaging, and multispectral optoacoustic tomography have shown promising results. Conclusions: The risk factor profile of an ischemic lesion in the lower extremities with a delayed/failed healing response, following a successful revascularization, is not fully clarified. Although many predictors have been assessed so far, further research needs to be done to identify the optimal clinical and biochemical indices and the noninvasive technique assessing the microcirculation that is associated with complete wound healing.
  • Piazza, Cesare; Paderno, Alberto; Sjogren, Elisabeth; Bradley, Patrick J.; Eckel, Hans E.; Mäkitie, Antti; Matar, Nayla; Paleri, Vinidh; Peretti, Giorgio; Puxeddu, Roberto; Quer, Miquel; Remacle, Marc; Vander Poorten, Vincent; Vilaseca, Isabel; Simo, Ricard (2021)
    Purpose To provide expert opinion and consensus on salvage carbon dioxide transoral laser microsurgery (CO2 TOLMS) for recurrent laryngeal squamous cell carcinoma (LSCC) after (chemo)radiotherapy [(C)RT]. Methods Expert members of the European Laryngological Society (ELS) Cancer and Dysplasia Committee were selected to create a dedicated panel on salvage CO2 TOLMS for LSCC. A series of statements regarding the critical aspects of decision-making were drafted, circulated, and modified or excluded in accordance with the Delphi process. Results The expert panel reached full consensus on 19 statements through a total of three sequential evaluation rounds. These statements were focused on different aspects of salvage CO2 TOLMS, with particular attention on preoperative diagnostic work-up, treatment indications, postoperative management, complications, functional outcomes, and follow-up. Conclusion Management of recurrent LSCC after (C)RT is challenging and is based on the need to find a balance between oncologic and functional outcomes. Salvage CO2 TOLMS is a minimally invasive approach that can be applied to selected patients with strict and careful indications. Herein, a series of statements based on an ELS expert consensus aimed at guiding the main aspects of CO2 TOLMS for LSCC in the salvage setting is presented.
  • Sartelli, Massimo; Malangoni, Mark A.; May, Addison K.; Viale, Pierluigi; Kao, Lillian S.; Catena, Fausto; Ansaloni, Luca; Moore, Ernest E.; Moore, Fred A.; Peitzman, Andrew B.; Coimbra, Raul; Leppaniemi, Ari; Kluger, Yoram; Biffl, Walter; Koike, Kaoru; Girardis, Massimo; Ordonez, Carlos A.; Tavola, Mario; Cainzos, Miguel; Di Saverio, Salomone; Fraga, Gustavo P.; Gerych, Igor; Kelly, Michael D.; Taviloglu, Korhan; Wani, Imtiaz; Marwah, Sanjay; Bala, Miklosh; Ghnnam, Wagih; Shaikh, Nissar; Chiara, Osvaldo; Faro, Mario Paulo; Pereira, Gerson Alves; Gomes, Carlos Augusto; Coccolini, Federico; Trana, Cristian; Corbella, Davide; Brambillasca, Pietro; Cui, Yunfeng; Lohse, Helmut A. Segovia; Khokha, Vladimir; Kok, Kenneth Y. Y.; Hong, Suk-Kyung; Yuan, Kuo-Ching (2014)