Surgical Use of Supraclavicular Artery Flap for Head and Neck Cancer Defects Repair: Personal Experience

Abstract Introduction For a long time, major surgical defects after oncological surgery have always been challenging cases for surgeons in terms of wound healing and covering technique. Objectives To demonstrate the feasibility of supraclavicular artery flap (SCAF) in the reconstruction of surgical defects in those "fragile" patients undergoing oncological surgery who could not possibly have endured the timeframes involved in using microvascular free flaps. Methods Between January 2018 and January 2019, at the Azienda Socio Sanitaria Territoriale (ASST) Bergamo Est Hospital (Bergamo, Italy), we reported the cases of 11 patients in whom the SCAF was used for surgical reconstruction after oncological surgery in our Otolaryngology Department. The median age of the 11 patients was 68.7 years old. Results The SCAF has proved, in almost all 11 cases in which it was used, to be very reliable and, above all, easy and quick to make in those "fragile" patients without the need for further intervention. There was only one case in which the resection involved the auricle entirely and a small area of perimeatal bone exposure occurred, which, anyway, healed by secondary intention. Conclusion The SCAF is an extremely versatile flap for head and neck surgery to be considered especially for fragile and vulnerable patients who cannot undergo prolonged surgical time. Moreover, this technique has also shown high feasibility in small hospitals where there is not a plastic surgery department and the surgeon may face the difficulty of practicing surgical reconstruction after enlarged resection.

Surgical Use of Supraclavicular Artery Flap for Head and Neck Cancer Defects Repair: Personal Experience.

Introduction For a long time, major surgical defects after oncological surgery have always been challenging cases for surgeons in terms of wound healing and covering technique. Objectives To demonstrate the feasibility of supraclavicular artery flap (SCAF) in the reconstruction of surgical defects in those "fragile" patients undergoing oncological surgery who could not possibly have endured the timeframes involved in using microvascular free flaps. Methods Between January 2018 and January 2019, at the Azienda Socio Sanitaria Territoriale (ASST) Bergamo Est Hospital (Bergamo, Italy), we reported the cases of 11 patients in whom the SCAF was used for surgical reconstruction after oncological surgery in our Otolaryngology Department. The median age of the 11 patients was 68.7 years old. Results The SCAF has proved, in almost all 11 cases in which it was used, to be very reliable and, above all, easy and quick to make in those "fragile" patients without the need for further intervention. There was only one case in which the resection involved the auricle entirely and a small area of perimeatal bone exposure occurred, which, anyway, healed by secondary intention. Conclusion The SCAF is an extremely versatile flap for head and neck surgery to be considered especially for fragile and vulnerable patients who cannot undergo prolonged surgical time. Moreover, this technique has also shown high feasibility in small hospitals where there is not a plastic surgery department and the surgeon may face the difficulty of practicing surgical reconstruction after enlarged resection.

Investigation on the use of fused deposition modeling for the production of IR dosage forms containing Timapiprant.

The present work focused on evaluating the feasibility of fused deposition modeling (FDM) in the development of a dosage form containing Timapiprant (TMP), also known as CHF6532, which is a novel active molecule indicated in the potential treatment of eosinophilic asthma upon oral administration. The resulting product could be an alternative, with potential towards personalization, of immediate release (IR) tablets used in the clinical studies. Formulations based on different polymeric carriers were screened, leading to the identification of a polyvinyl alcohol-based one, which turned out acceptable for versatility in terms of active ingredient content, printability and dissolution performance (i.e. capability to meet the dissolution specification set, envisaging >80% of the drug dissolved within 30 min). Following an in-depth evaluation on the influence of TMP solid state and of the voids volume resulting from printing on dissolution, few prototypes with shapes especially devised for therapy customization were successfully printed and were compliant with the dissolution specification set.

Raman spectroscopy as a PAT for pharmaceutical blending: Advantages and disadvantages.

Raman spectroscopy has been positively evaluated as a tool for the in-line and real-time monitoring of powder blending processes and it has been proved to be effective in the determination of the endpoint of the mixing, showing its potential role as process analytical technology (PAT). The aim of this study is to show advantages and disadvantages of Raman spectroscopy with respect to the most traditional HPLC analysis. The spectroscopic results, obtained directly on raw powders, sampled from a two-axis blender in real case conditions, were compared with the chromatographic data obtained on the same samples. The formulation blend used for the experiment consists of active pharmaceutical ingredient (API, concentrations 6.0% and 0.5%), lactose and magnesium stearate (as excipients). The first step of the monitoring process was selecting the appropriate wavenumber region where the Raman signal of API is maximal and interference from the spectral features of excipients is minimal. Blend profiles were created by plotting the area ratios of the Raman peak of API (AAPI) at 1598cm-1 and the Raman bands of excipients (AEXC), in the spectral range between 1560 and 1630cm-1, as a function of mixing time: the API content can be considered homogeneous when the time-dependent dispersion of the area ratio is minimized. In order to achieve a representative sampling with Raman spectroscopy, each sample was mapped in a motorized XY stage by a defocused laser beam of a micro-Raman apparatus. Good correlation between the two techniques has been found only for the composition at 6.0% (w/w). However, standard deviation analysis, applied to both HPLC and Raman data, showed that Raman results are more substantial than HPLC ones, since Raman spectroscopy enables generating data rich blend profiles. In addition, the relative standard deviation calculated from a single map (30 points) turned out to be representative of the degree of homogeneity for that blend time.