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"Giunta, Riccardo"

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Giunta, R. E. (2018). [Focus “Liposuction in Lipedema”]. Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V..., 50(6), 379. https://doi.org/10.1055/a-0806-2397

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Kuhlmann, C., Schenck, T. L., Haas, E. M., Giunta, R., & Wiggenhauser, P. S. (2020). [Current review of factors in the stem cell donor that influence the regenerative potential of adipose tissue-derived stem cells]. Handchirurgie, Mikrochirurgie, Plastische Chirurgie: Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie: Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse: Organ Der V..., 52(6), 521–532. https://doi.org/10.1055/a-1250-7878

BACKGROUND: Regenerative therapies like cell-assisted lipotransfer or preclinical experimental studies use adipose tissue-derived stem cells (ASCs) as the main therapeutic agent. But there are also factors depending on the clinical donor that influence the cell yield and regenerative potential of human ASCs and stromal vascular fraction (SVF). Therefore, the aim of this review was to identify and evaluate these factors according to current literature. METHODS: For this purpose, a systematic literature review was performed with focus on factors affecting the regenerative potential of ASCs and SVF using the National Library of Medicine. RESULTS: Currently, there is an abundance of studies regarding clinical donor factors influencing ASCs properties. But there is some contradiction and need for further investigation. Nevertheless, we identified several recurrent factors: age, sex, weight, diabetes, lipoedema, use of antidepressants, anti-hormonal therapy and chemotherapy. CONCLUSION: We recommend characterisation of the ASC donor cohort in all publications, regardless of whether they are experimental studies or clinical trials. By these means, donor factors that influence experimental or clinical findings can be made transparent and results are more comparable. Moreover, this knowledge can be used for study design to form a homogenous donor cohort by precise clinical history and physical examination.
Koban, K. C., Titze, V., Etzel, L., Frank, K., Schenck, T., & Giunta, R. (2018). [Quantitative volumetric analysis of the lower extremity: validation against established tape measurement and water displacement]. Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V..., 50(6), 393–399. https://doi.org/10.1055/a-0770-3445

BACKGROUND: Tape measures continue to be used for the diagnosis and evaluation of lipoedema and lymphoedema in the clinical routine. Extremity volumes are calculated based on standardised circumferential measurements. Other volume measurements such as water displacement are not applied on a regular basis. This study aimed to evaluate a 3D scanner as an alternative and reproducible tool to objectively measure the volumes of the lower extremity. PATIENTS, MATERIALS AND METHOD: We used a commercially available 3D scanner, the Artec Eva(®), to perform 3D scans of the lower extremities on 20 subjects and calculated the volume using the appropriate software. In addition, limb volume was determined with standardised methods using the circumferential method (cone method and disc method) and the water displacement technique. The results and the time taken to perform the three measurement methods were documented and statistically evaluated. RESULTS: There were no significant deviations between the results from 3D volumetry and water displacement (p > 0.05). The cone method significantly overestimated the volume measured by water displacement and 3D volumetry. The disc method revealed no statistically significant differences, but clinically relevant differences with a high variance in the 95 % confidence interval. All methods demonstrated high positive correlations with each other. Water displacement was the most timeconsuming method. CONCLUSION: Our findings obtained from the examination of 40 lower extremities show that 3D scans and software-based volumetric calculations can achieve objective and reproducible measurements in a relatively short time. The deviation from the gold-standard method of water displacement is small. Compared with the cone and disc method, however, we observed clinically relevant deviations with a high variance. We therefore recommend the 3D scan procedure for the objective documentation of conservative and surgical treatments for lipoedema or lymphoedema and have incorporated it into our clinical routine.

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Funke, S., Kuhlmann, C., Taha, S., Fuchs, B., Wiggenhauser, P. S., & Giunta, R. E. (2023). [Searching for Evidence: A Systematic Review of the Pathology of Lipoedema]. Handchirurgie, Mikrochirurgie, Plastische Chirurgie: Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie: Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse: Organ Der V..., 55(6), 411–426. https://doi.org/10.1055/a-2183-7414

BACKGROUND: Lipoedema is a symmetrically localised, painful hypertrophy of subcutaneous adipose tissue in the extremities with marked disproportion to the trunk, and almost exclusively affects females. Despite being first described over 80 years ago, the aetiology and pathogenesis of the disease are largely unknown and are currently the subject of intensive research efforts. METHODS: To summarise the current evidence-based literature on the cellular pathologies and aetiology of lipoedema, a PRISMA-based systematic review was conducted within the National Library of Medicine and Cochrane databases. RESULTS: A total of 53 studies were identified and included in this review. The results were classified and summarised into categories. CONCLUSION: Although there has been a significant increase in research activity and recent publication of extensive studies with a histological and molecular genetic focus, the fundamental aetiology and pathology of lipoedema remains largely unclear. The current data shows discrepancies across studies, particularly with regard to the "oedematous" component of lipoedema. The frequently present comorbidities "lymphoedema" and "obesity", primarily in advanced stages of lipoedema, complicate the diagnostic differentiation and clear definition of study cohorts in scientific research.
Etzel, L., Schenck, T. L., Giunta, R. E., Li, Z., Xu, Y., & Koban, K. C. (2021). Digital Leg Volume Quantification: Precision Assessment of a Novel Workflow Based on Single Capture Three-dimensional Whole-Body Surface Imaging. Journal of Digital Imaging. https://doi.org/10.1007/s10278-021-00493-8

Whole-body three-dimensional surface imaging (3DSI) offers the ability to monitor morphologic changes in multiple areas without the need to individually scan every anatomical region of interest. One area of application is the digital quantification of leg volume. Certain types of morphology do not permit complete circumferential scan of the leg surface. A workflow capable of precisely estimating the missing data is therefore required. We thus aimed to describe and apply a novel workflow to collect bilateral leg volume measurements from whole-body 3D surface scans regardless of leg morphology and to assess workflow precision. For each study participant, whole-body 3DSI was conducted twice successively in a single session with subject repositioning between scans. Paired samples of bilateral leg volume were calculated from the 3D surface data, with workflow variations for complete and limited leg surface visibility. Workflow precision was assessed by calculating the relative percent differences between repeated leg volumes. A total of 82 subjects were included in this study. The mean relative differences between paired left and right leg volumes were 0.73 ± 0.62% and 0.82 ± 0.65%. The workflow variations for completely and partially visible leg surfaces yielded similarly low values. The workflow examined in this study provides a precise method to digitally monitor leg volume regardless of leg morphology. It could aid in objectively comparing medical treatment options of the leg in a clinical setting. Whole-body scans acquired using the described 3DSI routine may allow simultaneous assessment of other changes in body morphology after further validation.

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