18) An easy and cheap way to assemble a tissue expander for laboratory use.
Valdatta L., Mortarino C., Thione A., Buoro M., Tibiletti M.
Plast. Reconstr. Surg. 112: 1179, Sep 2003.

19) Basaliomatosis without a genetical disorder in a young female patient: a case report.
Valdatta L., Mortarino C., Thione A., Buoro M., Fidanza C.
Quaderni di Chirurgia Plastica 2002 (accepted for pubblication).

20) A double pocket for tissue expander implantation in breast reconstruction.
Valdatta L., Mortarino C., Thione A., Buoro M., Fidanza C.
Plast. Reconstr. Surg. (accepted for publication).

21) A rare case of auricular lobule malignant melanoma: a case report
Valdatta L., Mortarino C., Thione A., Buoro M., Barbieri B.
Clinical and experimental plastic surgery (accepted for pubblication).

22) A transposition outer rhomboid flap over an inner deepithelialized one for covering subcutaneous devices.
Valdatta L., Tuinder S., Barbieri B., Thione A., Buoro M.
Plast. Reconstr. Surg. (in press)

23) Opportunity to perform intraoperative histological examinations in suspect lipomas? A case report.
Valdatta L., Buoro M., Thione A., Mortarino C., Fidanza C., Dainese E.
Riv.Ital.Chir.Plast. – Clin. and exp. plastic surgery, 34 (3-4): 139, 2002.

24) "Abstract Idiopathic circumscripta calcinosis cutis of the knee."
Valdatta L, Buoro M, Thione A, Mortarino C, Tuinder S, Fidanza C, Dainese E.
Dermatol Surg. 2003 Dec; 29(12):1222-4.

25) "Abstract Evaluation of the efficacy of polydeoxyribonucleotides in the healing process of autologous skin graft donor sites: a pilot study."
Valdatta L, Thione A, Mortarino C, Buoro M, Tuinder S.
Curr Med Res Opin. 2004 Mar; 20(3):403-8.

26) "A transposition outer rhomboid flap over an inner deepithelialized flap for covering subcutaneous devices."
Valdatta L, Tuinder S, Barbieri B, Thione A, Buoro M.
Plast Reconstr Surg. 2004 Apr 1;113(4):1303-4.

27) "Lichen planus cutis and squamous cell carcinoma."
Valdatta L, Tuinder S, Thione A, Buoro M, Barbieri B, Pozzi B, La Rosa S.
Plast Reconstr Surg. 2004 Mar;113(3):1085-6

28) "The medial sural artery perforators: anatomic basis for a surgical plan."
Thione A, Valdatta L, Buoro M, Tuinder S, Mortarino C, Putz R.
Ann Plast Surg. 2004 Sep;53(3):250-5.

29) "Modified deepithelialized bilateral triangular VY flaps for the correction of posttracheostomy scar."
Valdatta L, Mortarino C, Thione A, Buoro M.
Plast Reconstr Surg. 2005 Jan;115(1):351-3; author reply 353.

30) "Mandibular reconstruction with frozen autologous mandibular bone and radial periosteal fasciocutaneous free flap: preliminary report."
Roselli R, Muscatello L, Valdatta L, Pavan G, Spriano G.
Ann Otol Rhinol Laryngol. 2004 Dec;113(12):956-60.

31) "A modified inverted omega incision for surgical treatment of gynecomastia."
Thione A, Valdatta L, Gottardi A.
Ann Plast Surg. 2005 Oct;55(4):437.

32) "Experimental study in rats: does varying the hardness of a silicone implant affect the type of capsule that surrounds it?"
Valdatta L, Fidanza C, Thione A, Benedetta B, Reguzzoni M, Protasoni M.
Plast Reconstr Surg. 2006 Mar;117(3):1076.

Research activity

Projects of research and interests: the projects of search developed from the Section of Plastic and Reconstructive Surgery focus on five specific guidelines:

Anatomical dissection on corpse for the identification of new microsurgical reconstructive units.
The study consists in the injection of arterial vascular axis of fresh corpses with Biodur substance, used as auto-polymerizing acrylic resin, in order to put in evidence the vascular axis and their fine ramifications.
Then it is performed the dissection of such axis concentrating the attention on the perforating vessels in their relationship with the reconstructive units (FLAPS) perfused by them.
Photographic documentation is collected and the surgical relapses are analyzed.
It is evidenced the number and the characteristics of the perforating vessels subtended to the reconstructive units based on cutaneous and musculocutaneous islands with their study in terms of bore, number, position and possibility of perfusion for a determined anatomical district.
It is a modern study that would make it possible to identify new repairing techniques with a modest surgical cost in the donor zones, since it would numerically reduce the sacrifice of important vascular axis.
Doctors orienting towards a surgical specialistic branch and learning the Macrocospic Anatomy cannot be satisfied simply by bare theoretical information.
This study would enable young surgeons to resume the dissecting practice of the human body for surgical aims.

Studies on test animals aiming at identifying haemodynamic parameters subtended to the vitality of microsurgical edges.
The aim of these experimental studies is to clarify the patency of the vascular micro-anastomosis in basal conditions and under pharmacological treatment, at the same time estimating the thrombogenic role induced by the focal necrosis by the point of suture and by microvascular clamping.
The results coming from such experimental studies on rats can be applied with inductive method to the haemodynamic of human edges.

Clinician studies about the effectiveness of antibiotic prophilaxis in a mixed unit of Plastic Surgery and General Surgery and about tissue regeneration with topical application of polideoxyribonucleotides.
The Section of Plastic Surgery of the University of Insubria consists, at the Hospital of Circolo of Varese, in n°4 beds situates in the unit of General Surgery at the 2° floor of the Surgical Pavilion. This particular situation, common to many services of Plastic Surgery in our Country and in Europe, puts our patients at a greater risk of infections by micro-organisms, above all by negative Gram, of enteric origin. Therefore, although the greater part of the international protocols considers unnecessary the antibiotic prophylaxis for the operations of Plastic Surgery except the positioning of implants, in our situation, we have thought it right to protect the patients with a wide ranging antibiotic therapy.
We emphasize the project importance of such a research, as the contraction of the sanitary expense will make such situations of promiscuous allurement among the varied surgical disciplines more and more frequent, the data obtained from this study could be extended to other realities.
Furthermore it is carried out a clinical study on the effectiveness of the polideoxyribonucleotides in accelerating the physiological mechanisms of tissue regeneration in patients subjected to the taking of dermo-epidermal grafts by means of the reparation of DNA damages, neo-syntesis nucleic acids, coenzyme and energetic metabolites, stimulating the renewal of the matrix, increasing the cellular answer to growth factors, and fostering the cellular replication. This would allow a fastened healing and consequently a reduction of the stay in hospital.

The tissue microdialysis for the clinical monitoring of microsurgical and peduncles transplants in the reconstruction of the inferior limbs.
The most common complication of the microsurgical and pedicled transplants is a circulatory one. A hindered blood flow, from a venous or arterial point of view, brings to metabolic alterations in the tissues, which can be monitored through microdialysis, aimimg to identify, as more prematurely as possible, vascular complications in the transplants.
The other techniques available for the clinical monitoring of the tissue vitality are the cutaneous temperature, influenced by the enviromental temperature and by the lighting, by the inner temperature of the patient and by the vasomotor responses; the fotoplethysmography only indicates the presence or absence of the sphygmic wave; the ultrasounds have produced discouraging results and the laser fluximetry is very sensitive to movements.
The microdialysis is an already established method for the study of the metabolic events in the brain and in subcutaneous and muscular tissues, and it has already been described for the metabolic study in the microsurgical and pedicled transplants.
The objective of this study is to compare the peri-operating and post-operating metabolism in pedicled microsurgical transplants with the microdialysis technique.
The study concerns 10 patients to be hospitalized for the reconstruction of the inferior limbs, 5 using pedicled transplants and 5 using the microsurgical ones, on the base of the clinical characteristics of the single case.
Two catheters from microdialysis (catheter model CMA 60 microdialysis) will be positioned in the subcutaneous tissue of the transplant, one distal and one proximal to the vascular source, and a third catheter will be positioned in the same anatomical region of the contralateral limb as a control.
The patients will be monitored between the operations and for three days after the operation, taking samples every 30 minutes during the surgical operation and for the first two post-operative hours; the sampling frequency will progressively diminish: every hour during the first post-operative day, every two hours during the second day and every three during the third day. The catheters will be removed at the end of the third post-operative day. The tissue urea values, the glucose, lactic acid, glycerol and pyruvic acid values, markers of tissue ischaemia, will be registered and analysed by means of statistics analysis.

The role of the Vascular Endothelial Growth Factor (VEGF) in the process of cutaneous expansion.
It is already established, by the present studies in literature on human subjects, that the VEGF has been involved in the biological phenomenon of the angiogenesis and that the cutaneous expansion induces angiogenesis and ischaemia in the overhanging tissues; the ischaemia is the main mechanism of production of the VEGF and in the expanded tissue it has been demonstrated the presence of high levels of VEGF, little expressed in the not expanded tissues.
However this does not demonstrate that the VEGF is the mediator of the angiogenesis.
The aim of the experiment is to estimate the role of the VEGF in the process of angiogenesis by means of an experimental study of the process of cutaneous expansion on the rape. The experiment is subdivided in 2 phases:
PHASE 1
N.5 rapes, weight 350 gr. Sprague-Dawley stock without inhibitor of the receptor for VEGF
Rape's cute and back biopsies in preoperative phase
Insertion of skin-expander in the back of the rape
Rape's cute and back biopsies in post-operative phase at a distance of 6 and 12 weeks
Cute biopsies in proximity of the expanded one in post-operative phase at a distance of 6 and 12 weeks
Estimation of the production of VEGF and the phenomenon of angiogenesis; in case the VEGF production and the presence of angiogenesis is demonstrated , you pass to
PHASE 2
N.5 rapes weight 350 gr. Sprague-Dawley stock dealt with inhibitor of the receptor for VEGF
Rape's cute and back biopsies in preoperative phase
Insertion of skin-expander in the back of the rape
Rape's cute and back biopsies in post-operative phase at a distance of 6 and 12 weeks
Cute biopsies in proximity of the expanded one in post-operative phase at a distance of 6 and 12 weeks
Estimation of the production of VEGF and the phenomenon of angiogenesis; in case it was demonstrated both the production of VEGF and the absence of angiogenesis, it could be asserted that VEGF is the responsible of the angiogenesis; in case there were production of VEGF and the presence of angiogenesis, you could assume the involvement of other GF.
If it were demonstrated that the VEGF is the responsible of the angiogenesis, the clinical fallen back would represent the possibility to use the GF as helper of the angiogenesis, considering that the expansion, from a biological point of view, is an assimilable phenomenon to the autonomization, a technique used in clinic in order to improve the perfusion of the cutaneous edges.