Analysis and Validation of the 3D Reconstructive Process through the Extended Matrix Framework of the Temple of the Roman Forum of Nora (Sardinia, CA)

In this work, we will describe the application of the Extended Matrix Framework (EMF) to the 3D reconstruction of the temple on the Roman forum of Nora. EMF represents a specific section of the Extended Matrix (EM) method, developed by the VHLab of the CNR ISPC (Rome), dedicated to the development of software solutions for 3D data management in the field of virtual reconstruction. The combination of EM and EMF allows to: map the reconstructive process, validate the entire workflow (from data ingestion to 3D modelling), manage 3D data, and share outcomes online.

Lipotransfer Strategies and Techniques to Achieve Successful Breast Reconstruction in the Radiated Breast

Radiation therapy is frequently a critical component of breast cancer care but carries with it side effects that are particularly damaging to reconstructive efforts. Autologous lipotransfer has the ability to improve radiated skin throughout the body due to the pluripotent stem cells and multiple growth factors transferred therein. The oncologic safety of lipotransfer to the breasts is demonstrated in the literature and is frequently considered an adjunctive procedure for improving the aesthetic outcomes of breast reconstruction. Using lipotransfer as an integral rather than adjunctive step in the reconstructive process for breast cancer patients requiring radiation results in improved complication rates equivalent to those of nonradiated breasts, expanding options in these otherwise complicated cases. Herein, we provide a detailed review of the cellular toxicity conferred by radiotherapy and describe at length our approach to autologous lipotransfer in radiated breasts.

Simplified management of a giant forehead congenital nevus allows for early reconstruction

We report simplified surgical management of giant congenital forehead nevus that customarily requires the use of tissue expander for complete excision. Commencing treatment at the age of 3 months, the TopClosure tension relief system (TRS) was applied as an external tissue expander allowing preoperative skin stretching by mechanical creep. This was followed by partial excision of the nevus. Intraoperative stress-relaxation allowed further expansion of the skin. Postoperative wound closure was secured with the aid of the TRS. Repeated, six simple staged excisions of the forehead lesion and a minor skin graft to the eyelid part, allowed for delayed primary closure of the entire lesion by the age of 2. This simple alternative approach, which allows the early start and early conclusion of the reconstructive process, should be considered as the primary option in the treatment of these patients.

Contemporary reconstruction after complex facial trauma

Complex facial trauma requires complex repair and solutions. This process is challenging for the surgeon who seeks to manage the expectations of the patient and family while achieving the best possible result. Historically, the use of pedicled flaps, and then free tissue transfer, were the primary techniques utilized. Advancements in soft-tissue reconstruction, such as perforator flaps and pre-expanded and prefabricated flaps, allow refinement of the soft-tissue reconstruction process to create the best initial soft-tissue coverage. The advent of contemporary technologies, such as virtual surgical planning, stereolithography and customized implants and plates, facilitates a tailored approach to the patient’s reconstructive needs for precise bony reconstruction. When surgical and technological techniques are combined in complementary multistage reconstructions, better reconstructive and aesthetic outcomes are achievable than ever before. In this review, the authors present a summary of the management of complex facial trauma based on the senior author’s broad experience. Initial management and contemporary reconstructive techniques and technology to provide optimal outcomes are reviewed. A case series of complex facial traumas and their reconstructive process is also presented to demonstrate how complementary staged procedures can yield an optimal result. We believe the reconstructive surgeon managing complex facial trauma should strive to incorporate contemporary technologies and techniques into their armamentarium to provide the best patient care.

Merleau-Ponty e Cézanne

The aim of this article is to demonstrate the intrinsically technical nature of visual perception and pictorial performance through their common anchorage in the corporeity that brings them into existence. As with any other artistic technique, painting reveals itself to be the natural extension of a technological attitude already rooted in the sensorimotor devices of the body in action; painting is led to inhabit a world that is of the same nature as corporeal agents, because the objects that populate it share with it the ontological element of the “flesh”. Through Merleau-Ponty’s analyses of Cezanne’s pictorial works, I demonstrate that the main purpose of painting is, analogically with the descriptive analyses made possible by the phenomenological reduction, to render intersubjectively evident the hidden work of vision before its sedimentation in an accomplished perceptual scene. As the experiments of contemporary neuroscience also demonstrate, perception is by and large a reconstructive process of “image-making” rather than an allegedly accurate reproduction of the spectacle of the world. Painting, on the other hand, both in terms of creation and for the observer, employs the same sensorimotor resources as instruments.

Use of New Technologies in Implant-Based Breast Reconstruction

Outcomes after mastectomy and prosthetic-based breast reconstruction have improved immensely since the development of the first tissue expander and breast implant in the 1960s. One major factor contributing to our improved outcomes over the past two decades is the increasing availability and improvement of perfusion assessment technology. Instrumental methods now exist which allow surgeons to assess tissue viability intraoperatively, and provide actionable, objective data that augments clinical assessment. In this article, the authors detail two commercially available, state-of-the-art technologies that surgeons may use to assist in mastectomy flap assessment and facilitate the reconstructive process.

Sarcoma of the Lower Limb: Reconstructive Surgeon's Perspective

Management of sarcomas in the lower extremities have evolved from amputations to limb-preserving surgeries with evidence to support that they have equal overall survival, albeit with better functional outcome. The challenge of reconstruction lies in providing a durable, functional, and aesthetically pleasing limb. However, limb-preserving intention should not delay interventions that provide a survival benefit such as chemotherapy and radiotherapy. The advent of radiotherapy and chemotherapy also has implications on wound healing and should be considered during the reconstructive process. This article reviews the methodical approach, reconstructive strategies, and considerations for the reconstructive surgeon with respect to the lower extremity after sarcoma excision.

Reconstructing Vindonissa as a living document – A case-study of digital reconstruction for output to pre-rendered and real-time applications

The legion camp “Vindonissa” in Switzerland is considered one of the most important roman sites north of the alps. Research there has been going on for over a century and reconstructive drawings have always been a way to showcase scientific findings of the site, the earliest of them dating back as far as 1909.In 2015, it was decided to produce a new series of illustrations. The whole camp and its surrounding settlements had to be constructed as hand-generated 3D models, allowing for quick changes during the reconstructive process and flexibility in future adaptations. Topographical data, archaeological plans as well as building profiles provided by experts were the basis for the model.The main focus was on a general impression of the camp and not on individual buildings but some landmarks as the newly postulated circus were crafted with a higher level of detail as they are the topic of scientific discourse and it helps the discussion if they have a certain fidelity. The circus also serves as a good example for the value of the imaging process in research: Only after trying to fit it into the topography it was noted that it would overlap with a street that was previously thought to run through this area. In the discussion between archaeologists and illustrators a new path for the street was chosen that fits into the landscape and is scientifically acceptable.The new series of illustrations was originally published in the annual report of the archaeological society Vindonissa. The resulting model represents the current state of research but mainly serves as a starting point for future discussion: All buildings are constructed so that they can easily be adapted for real-time use and a Virtual Reality application is the logical next step for its use.

The reconstruction of drawn architecture

Among the many cases concerning the process of digital hypothetical 3D reconstruction a particular case is constituted by never realized projects and plans. They constitute projects designed and remained on paper that, albeit documented by technical drawings, they pose the typical problems that are common to all other cases. From 3D reconstructions of transformed architectures, to destroyed/lost buildings and part of towns.This case studies start from original old drawings which has to be implemented by different kind of documentary sources, able to provide - by means evidence, induction, deduction, analogy - information characterized by different level of uncertainty and related to different level of accuracy.All methods adopted in a digital hypothetical 3D reconstruction process show us that the goal of all researchers is to be able to make explicit, or at least intelligible, through a graphical system a synthetic/communicative level representative or the value of the reconstructive process that is behind a particular result.The result of a reconstructive process acts in the definition of three areas intimately related one each other which concur to define the digital consistency of the artifact object of study: Shape (geometry, size, spatial position); Appearance (surface features); Constitutive elements (physical form, stratification of building/manufacturing systems)The paper, within a general framework aimed to use 3D models as a means to document and communicate the shape and appearance of never built architecture, as well as to depict temporal correspondence and allow the traceability of uncertainty and accuracy that characterizes each reconstructed element.