Giuseppe Cottone - Academia.edu (original) (raw)

Papers by Giuseppe Cottone

Research paper thumbnail of RIB Plaster: a versatile, moldable derivative from scraping the periphery of the rib

Plastic & Reconstructive Surgery

Research paper thumbnail of Efficacy of Septoplasty in Patients with Nasal Obstruction: A Systematic Review and Meta‐analysis

Laryngoscope, Apr 5, 2023

Research paper thumbnail of Modified dorsal split preservation hybrid rhinoplasty for cartilaginous pushdown and full letdown applications: A PROM-based review of 100 consecutive cases

Facial Plastic Surgery

Splitting the middle vault on an anatomical plane along the “Septal T” allows a new hybrid perspe... more Splitting the middle vault on an anatomical plane along the “Septal T” allows a new hybrid perspective on the many modifications of “surface” preservation techniques. The “dorsal split preservation” concept can be applied both to cartilaginous pushdown as well as to full letdown techniques. The dorsal keystone area (DKA) is maintained, while the middle vault is reshaped. The septum is addressed by conventional L strut septoplasty. Precise direct suture fixation of the high-middle strip is easily accomplished after flexing the osseous-chondral junction at the K area. Specific technical points are described to allow exact and stable configuration of the dorsum. A retrospective analysis on 100 consecutive patients demonstrated aesthetic and functional improvement.

Research paper thumbnail of Endogenous Endophthalmitis Secondary to Infected Cutaneous Basal Cell Carcinoma: A Case Report

Ocular Immunology and Inflammation

Research paper thumbnail of Reconstruction of the Axillary Region after Excision of Hidradenitis Suppurativa: A Systematic Review

Indian Journal of Plastic Surgery

Introduction Hidradenitis suppurativa (HS) is a chronic, debilitating, recurrent, auto-inflammato... more Introduction Hidradenitis suppurativa (HS) is a chronic, debilitating, recurrent, auto-inflammatory disease of the pilosebaceous units of the skin. The axillary region is the most affected anatomical site and its reconstructive options include skin grafts, local random plasties, regional axial flaps, and regional perforator flaps. The main aim of this systematic review is to identify the best surgical technique for axillary reconstruction in the context of HS, in terms of efficacy and safety. Methods We adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) throughout the whole review protocol build-up. The literature search was performed using MEDLINE, Embase, and Cochrane library databases, updated to March 2021. Quality was assessed for each study, through the National Institutes of Health Quality Assessment Tool. Results A total of 23 studies were included in the final analysis. We reviewed a total of 394 axillary reconstructions in 313 patients a...

Research paper thumbnail of The Acute Achilles Tendon Rupture: An Evidence-Based Approach from the Diagnosis to the Treatment

Medicina-lithuania, Sep 1, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of Craniotomy Burr Hole Covers: A Comparative Study of Biomechanical, Radiological, and Aesthetic Outcomes Using 3 Different Plug Materials

Journal of Craniofacial Surgery

Research paper thumbnail of Outcomes in Hybrid Breast Reconstruction: A Systematic Review

Medicina

Background and Objectives: Lipofilling is a commonly performed procedure worldwide for breast aug... more Background and Objectives: Lipofilling is a commonly performed procedure worldwide for breast augmentation and correction of breast contour deformities. In breast reconstruction, fat grafting has been used as a single reconstructive technique, as well as in combination with other procedures. The aim of the present study is to systematically review available studies in the literature describing the combination of implant-based breast reconstruction and fat grafting, focusing on safety, complications rate, surgical sessions needed to reach a satisfying reconstruction, and patient-reported outcomes. Materials and Methods: We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) throughout the whole review protocol. A systematic review of the literature up to April 2022 was performed using Medline, Embase, and Cochrane Library databases. Only studies dealing with implant-based breast reconstruction combined with fat grafting were included. Results: W...

Research paper thumbnail of Reply to “Anxiety and depression in patients with nasal septal deviation: What is the clinical impact?”

American Journal of Otolaryngology

Research paper thumbnail of The “3 Points Compartmentalization” Technique in Subperichondrial–Subperiosteal Dissection in Primary Rhinoplasty to Reduce Edema and Define Contour

Aesthetic Plastic Surgery

Research paper thumbnail of Anxiety and depression mood disorder in patients with nasal septal deviation: A systematic review and meta-analysis

American Journal of Otolaryngology

Research paper thumbnail of Reducing Complications in Reconstruction of the Cervical Esophagus with Anterolateral Thigh Flap: The Five Points Protocol

Journal of Plastic, Reconstructive & Aesthetic Surgery

Research paper thumbnail of Comparison of Efficacy among Three Dermal Substitutes in the Management of Critical Lower-Limb Wounds: The Largest Biases-Reduced Single-Center Retrospective Cohort Study in Literature

Medicina, 2021

Background and objectives: The skin recently became the main focus of regenerative medicine and, ... more Background and objectives: The skin recently became the main focus of regenerative medicine and, in this context, skin substitutes are fully entering into the plastic surgeon’s armamentarium. Among the various types of skin substitutes, dermal substitutes (DSs) are the most used. Our study aims to retrospectively compare three renowned and extremely similar DS in the management of critical lower limb wounds in the largest cohort analysis currently present in literature. Materials and Methods: We followed a strict protocol of application and evaluation of the DS for each patient and wound and, after a meticulous bias reduction process, we compared final outcomes in terms of efficacy and speed in achieving the defect coverage. Results: Among patients who did not receive a skin graft after the DS, we registered a wound healed surface of 50% for Pelnac, 52% for Integra, and 19% for Nevelia, after 30 days from the external silicon layer removal; among those who received a skin graft afte...

Research paper thumbnail of Tunnelized superior anterior auricular artery chondrocutaneous flap for tragal zone reconstruction after tumor excision

European Journal of Plastic Surgery, 2020

Despite the constitutional small size, the tragal zone plays an essential functional and morpholo... more Despite the constitutional small size, the tragal zone plays an essential functional and morphological role. Little has been said about the tragal zone reconstruction after tumor excision in the literature. In this paper, we present a novel, smart, and safe idea to reconstruct the abovementioned anatomical region after a radical tumoral excision: the superior anterior auricular artery chondrocutaneous flap. Level of evidence: Level V, therapeutic study.

Research paper thumbnail of Perineural fat grafting in end-neuroma pain treatment: long-term outcomes

Background Peripheral painful end-neuromas decrease quality of life significantly. Drug-resistant... more Background Peripheral painful end-neuromas decrease quality of life significantly. Drug-resistant painful neuromas often require surgical treatment, nevertheless there is no actual gold standard. Methods We retrospectively analyzed 26 patients suffering from painful end-neuromas treated with neuroma excision followed by the perineural fat grafting (PFG). We evaluated the improvement in pain, disability, and quality of life on the long term.All patients were referred to our department between 2009 and 2017. “Visual analogue scale (VAS)”; “disability of the arm, shoulder, and hand (DASH)”; and “World Health Organization Quality of Life (WHOQOL) index” were systematically scored before each surgical intervention and re-evaluated after 24 months. Results The majority of neuromas were traumatic (n. 16; 62%) and involved the upper extremity (n. 21; 81%). Eight patients (31%) had already received a previous neuroma excision. After the neuroma excision followed by the PFG, pain decreased 4 ...

Research paper thumbnail of Esthetic and Functional Improvement of Asymmetric Lower Limb Overgrowth in a Proteus Syndrome Patient: a Combined Surgical Technique

Indian Journal of Surgery

Proteus syndrome is a rare, sporadic, congenital syndrome that causes asymmetric and disproportio... more Proteus syndrome is a rare, sporadic, congenital syndrome that causes asymmetric and disproportionate overgrowth of limbs, connective tissue nevi, epidermal nevi, alteration of adipose tissue, and vascular malformations. Genetic mosaicism, such as activating mutations involving protein kinase AKT1, phosphoinositide 3 kinase (PI3-K), and phosphatase and tensin homolog (PTEN), may be important causes of Proteus syndrome. However, many patients have no evidence of mutations in these genes. Currently, the diagnosis is clinical and based on phenotypic features. This article reports a case of Proteus syndrome in a 14-year-old female patient who presented with linear epidermal nevi, viscera anomalies, and adipose tissue dysregulation. She showed an asymmetric progressive overgrowth of the right lower limb after birth bringing relevant functional and esthetic consequences. Therefore, she asked a plastic surgery consultation and a surgical treatment with a combined technique was planned. Wit...

Research paper thumbnail of Artificial dermal substitutes for tissue regeneration: comparison of the clinical outcomes and histological findings of two templates

Journal of International Medical Research

Objective Artificial dermal substitutes (DSs) are fundamental in physiological wound healing to e... more Objective Artificial dermal substitutes (DSs) are fundamental in physiological wound healing to ensure consistent and enduring wound closure and provide a suitable scaffold to repair tissue. We compared the clinical and histological features of two DSs, Pelnac and Integra, in the treatment of traumatic and iatrogenic skin defects. Methods This prospective observational study involved 71 randomly selected patients from our hospital. Wound healing was analyzed using the Wound Surface Area Assessment, the Vancouver Scar Scale, and a visual analog scale. Histological and immunohistochemical evaluations were also performed. Results At 2 weeks, greater regeneration with respect to proliferation of the epidermis and renewal of the dermis was observed with Pelnac than with Integra. At 4 weeks, the dermis had regenerated with both DSs. Both templates induced renewed collagen and revascularization. Differences in the Vancouver Scar Scale score were statistically significant at 4 weeks and 1 y...

Research paper thumbnail of Severe A-line infections in COVID-19 patients: A novel management algorithm in an emergency setting

Journal of Plastic, Reconstructive & Aesthetic Surgery

Research paper thumbnail of Levator palpebrae superioris muscle advancement for steinert myotonic dystrophy eyelid ptosis

Journal of Plastic, Reconstructive & Aesthetic Surgery

Research paper thumbnail of The Effect of Muscle Exercise on Perforators Flow: A Prospective Cohort Study

Medicina

Background and objectives: The metabolic response after exercise causes a significant increase in... more Background and objectives: The metabolic response after exercise causes a significant increase in the muscle blood flow. While these effects are demonstrated for intra-muscular vessels, there is no evidence about the inter-muscular vessels, such as the septocutaneous perforators supplying the skin after they branch out from the deep source artery. The aim of our prospective study was to quantify the changes in the anterior tibial artery perforators arterial blood flow after mild isotonic exercise in a young and healthy population. Material and Methods: We performed a prospective analysis of 34 patients who were admitted to the Plastic Surgery Department from December 2019 to April 2020. Flow velocities of two previously identified anterior tibial artery perforators were recorded both before and after 10 complete flexion-extensions of the foot. The time to revert to basal flow was measured. We further classified the overmentioned patients based on their level of physical activity. Re...

Research paper thumbnail of RIB Plaster: a versatile, moldable derivative from scraping the periphery of the rib

Plastic & Reconstructive Surgery

Research paper thumbnail of Efficacy of Septoplasty in Patients with Nasal Obstruction: A Systematic Review and Meta‐analysis

Laryngoscope, Apr 5, 2023

Research paper thumbnail of Modified dorsal split preservation hybrid rhinoplasty for cartilaginous pushdown and full letdown applications: A PROM-based review of 100 consecutive cases

Facial Plastic Surgery

Splitting the middle vault on an anatomical plane along the “Septal T” allows a new hybrid perspe... more Splitting the middle vault on an anatomical plane along the “Septal T” allows a new hybrid perspective on the many modifications of “surface” preservation techniques. The “dorsal split preservation” concept can be applied both to cartilaginous pushdown as well as to full letdown techniques. The dorsal keystone area (DKA) is maintained, while the middle vault is reshaped. The septum is addressed by conventional L strut septoplasty. Precise direct suture fixation of the high-middle strip is easily accomplished after flexing the osseous-chondral junction at the K area. Specific technical points are described to allow exact and stable configuration of the dorsum. A retrospective analysis on 100 consecutive patients demonstrated aesthetic and functional improvement.

Research paper thumbnail of Endogenous Endophthalmitis Secondary to Infected Cutaneous Basal Cell Carcinoma: A Case Report

Ocular Immunology and Inflammation

Research paper thumbnail of Reconstruction of the Axillary Region after Excision of Hidradenitis Suppurativa: A Systematic Review

Indian Journal of Plastic Surgery

Introduction Hidradenitis suppurativa (HS) is a chronic, debilitating, recurrent, auto-inflammato... more Introduction Hidradenitis suppurativa (HS) is a chronic, debilitating, recurrent, auto-inflammatory disease of the pilosebaceous units of the skin. The axillary region is the most affected anatomical site and its reconstructive options include skin grafts, local random plasties, regional axial flaps, and regional perforator flaps. The main aim of this systematic review is to identify the best surgical technique for axillary reconstruction in the context of HS, in terms of efficacy and safety. Methods We adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) throughout the whole review protocol build-up. The literature search was performed using MEDLINE, Embase, and Cochrane library databases, updated to March 2021. Quality was assessed for each study, through the National Institutes of Health Quality Assessment Tool. Results A total of 23 studies were included in the final analysis. We reviewed a total of 394 axillary reconstructions in 313 patients a...

Research paper thumbnail of The Acute Achilles Tendon Rupture: An Evidence-Based Approach from the Diagnosis to the Treatment

Medicina-lithuania, Sep 1, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of Craniotomy Burr Hole Covers: A Comparative Study of Biomechanical, Radiological, and Aesthetic Outcomes Using 3 Different Plug Materials

Journal of Craniofacial Surgery

Research paper thumbnail of Outcomes in Hybrid Breast Reconstruction: A Systematic Review

Medicina

Background and Objectives: Lipofilling is a commonly performed procedure worldwide for breast aug... more Background and Objectives: Lipofilling is a commonly performed procedure worldwide for breast augmentation and correction of breast contour deformities. In breast reconstruction, fat grafting has been used as a single reconstructive technique, as well as in combination with other procedures. The aim of the present study is to systematically review available studies in the literature describing the combination of implant-based breast reconstruction and fat grafting, focusing on safety, complications rate, surgical sessions needed to reach a satisfying reconstruction, and patient-reported outcomes. Materials and Methods: We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) throughout the whole review protocol. A systematic review of the literature up to April 2022 was performed using Medline, Embase, and Cochrane Library databases. Only studies dealing with implant-based breast reconstruction combined with fat grafting were included. Results: W...

Research paper thumbnail of Reply to “Anxiety and depression in patients with nasal septal deviation: What is the clinical impact?”

American Journal of Otolaryngology

Research paper thumbnail of The “3 Points Compartmentalization” Technique in Subperichondrial–Subperiosteal Dissection in Primary Rhinoplasty to Reduce Edema and Define Contour

Aesthetic Plastic Surgery

Research paper thumbnail of Anxiety and depression mood disorder in patients with nasal septal deviation: A systematic review and meta-analysis

American Journal of Otolaryngology

Research paper thumbnail of Reducing Complications in Reconstruction of the Cervical Esophagus with Anterolateral Thigh Flap: The Five Points Protocol

Journal of Plastic, Reconstructive & Aesthetic Surgery

Research paper thumbnail of Comparison of Efficacy among Three Dermal Substitutes in the Management of Critical Lower-Limb Wounds: The Largest Biases-Reduced Single-Center Retrospective Cohort Study in Literature

Medicina, 2021

Background and objectives: The skin recently became the main focus of regenerative medicine and, ... more Background and objectives: The skin recently became the main focus of regenerative medicine and, in this context, skin substitutes are fully entering into the plastic surgeon’s armamentarium. Among the various types of skin substitutes, dermal substitutes (DSs) are the most used. Our study aims to retrospectively compare three renowned and extremely similar DS in the management of critical lower limb wounds in the largest cohort analysis currently present in literature. Materials and Methods: We followed a strict protocol of application and evaluation of the DS for each patient and wound and, after a meticulous bias reduction process, we compared final outcomes in terms of efficacy and speed in achieving the defect coverage. Results: Among patients who did not receive a skin graft after the DS, we registered a wound healed surface of 50% for Pelnac, 52% for Integra, and 19% for Nevelia, after 30 days from the external silicon layer removal; among those who received a skin graft afte...

Research paper thumbnail of Tunnelized superior anterior auricular artery chondrocutaneous flap for tragal zone reconstruction after tumor excision

European Journal of Plastic Surgery, 2020

Despite the constitutional small size, the tragal zone plays an essential functional and morpholo... more Despite the constitutional small size, the tragal zone plays an essential functional and morphological role. Little has been said about the tragal zone reconstruction after tumor excision in the literature. In this paper, we present a novel, smart, and safe idea to reconstruct the abovementioned anatomical region after a radical tumoral excision: the superior anterior auricular artery chondrocutaneous flap. Level of evidence: Level V, therapeutic study.

Research paper thumbnail of Perineural fat grafting in end-neuroma pain treatment: long-term outcomes

Background Peripheral painful end-neuromas decrease quality of life significantly. Drug-resistant... more Background Peripheral painful end-neuromas decrease quality of life significantly. Drug-resistant painful neuromas often require surgical treatment, nevertheless there is no actual gold standard. Methods We retrospectively analyzed 26 patients suffering from painful end-neuromas treated with neuroma excision followed by the perineural fat grafting (PFG). We evaluated the improvement in pain, disability, and quality of life on the long term.All patients were referred to our department between 2009 and 2017. “Visual analogue scale (VAS)”; “disability of the arm, shoulder, and hand (DASH)”; and “World Health Organization Quality of Life (WHOQOL) index” were systematically scored before each surgical intervention and re-evaluated after 24 months. Results The majority of neuromas were traumatic (n. 16; 62%) and involved the upper extremity (n. 21; 81%). Eight patients (31%) had already received a previous neuroma excision. After the neuroma excision followed by the PFG, pain decreased 4 ...

Research paper thumbnail of Esthetic and Functional Improvement of Asymmetric Lower Limb Overgrowth in a Proteus Syndrome Patient: a Combined Surgical Technique

Indian Journal of Surgery

Proteus syndrome is a rare, sporadic, congenital syndrome that causes asymmetric and disproportio... more Proteus syndrome is a rare, sporadic, congenital syndrome that causes asymmetric and disproportionate overgrowth of limbs, connective tissue nevi, epidermal nevi, alteration of adipose tissue, and vascular malformations. Genetic mosaicism, such as activating mutations involving protein kinase AKT1, phosphoinositide 3 kinase (PI3-K), and phosphatase and tensin homolog (PTEN), may be important causes of Proteus syndrome. However, many patients have no evidence of mutations in these genes. Currently, the diagnosis is clinical and based on phenotypic features. This article reports a case of Proteus syndrome in a 14-year-old female patient who presented with linear epidermal nevi, viscera anomalies, and adipose tissue dysregulation. She showed an asymmetric progressive overgrowth of the right lower limb after birth bringing relevant functional and esthetic consequences. Therefore, she asked a plastic surgery consultation and a surgical treatment with a combined technique was planned. Wit...

Research paper thumbnail of Artificial dermal substitutes for tissue regeneration: comparison of the clinical outcomes and histological findings of two templates

Journal of International Medical Research

Objective Artificial dermal substitutes (DSs) are fundamental in physiological wound healing to e... more Objective Artificial dermal substitutes (DSs) are fundamental in physiological wound healing to ensure consistent and enduring wound closure and provide a suitable scaffold to repair tissue. We compared the clinical and histological features of two DSs, Pelnac and Integra, in the treatment of traumatic and iatrogenic skin defects. Methods This prospective observational study involved 71 randomly selected patients from our hospital. Wound healing was analyzed using the Wound Surface Area Assessment, the Vancouver Scar Scale, and a visual analog scale. Histological and immunohistochemical evaluations were also performed. Results At 2 weeks, greater regeneration with respect to proliferation of the epidermis and renewal of the dermis was observed with Pelnac than with Integra. At 4 weeks, the dermis had regenerated with both DSs. Both templates induced renewed collagen and revascularization. Differences in the Vancouver Scar Scale score were statistically significant at 4 weeks and 1 y...

Research paper thumbnail of Severe A-line infections in COVID-19 patients: A novel management algorithm in an emergency setting

Journal of Plastic, Reconstructive & Aesthetic Surgery

Research paper thumbnail of Levator palpebrae superioris muscle advancement for steinert myotonic dystrophy eyelid ptosis

Journal of Plastic, Reconstructive & Aesthetic Surgery

Research paper thumbnail of The Effect of Muscle Exercise on Perforators Flow: A Prospective Cohort Study

Medicina

Background and objectives: The metabolic response after exercise causes a significant increase in... more Background and objectives: The metabolic response after exercise causes a significant increase in the muscle blood flow. While these effects are demonstrated for intra-muscular vessels, there is no evidence about the inter-muscular vessels, such as the septocutaneous perforators supplying the skin after they branch out from the deep source artery. The aim of our prospective study was to quantify the changes in the anterior tibial artery perforators arterial blood flow after mild isotonic exercise in a young and healthy population. Material and Methods: We performed a prospective analysis of 34 patients who were admitted to the Plastic Surgery Department from December 2019 to April 2020. Flow velocities of two previously identified anterior tibial artery perforators were recorded both before and after 10 complete flexion-extensions of the foot. The time to revert to basal flow was measured. We further classified the overmentioned patients based on their level of physical activity. Re...