The War after War: Volumetric Muscle Loss Incidence, Implication, Current Therapies and Emerging Reconstructive Strategies, a Comprehensive Review

• Main Authors: Stefano Testa, Ersilia Fornetti, Claudia Fuoco, Carles Sanchez-Riera, Francesco Rizzo, Mario Ciccotti, Stefano Cannata, Tommaso Sciarra, Cesare Gargioli
• Format: Article
• Language: English
• Published: MDPI AG 2021-05-01
• Series: Biomedicines
• Subjects: VML; war muscle injuries; permanent disability; prosthesis; reconstructive therapies; muscle loss
• Online Access: https://www.mdpi.com/2227-9059/9/5/564

Volumetric muscle loss (VML) is the massive wasting of skeletal muscle tissue due to traumatic events or surgical ablation. This pathological condition exceeds the physiological healing process carried out by the muscle itself, which owns remarkable capacity to restore damages but only when limited in dimensions. Upon VML occurring, the affected area is severely compromised, heavily influencing the affected a person’s quality of life. Overall, this condition is often associated with chronic disability, which makes the return to duty of highly specialized professional figures (e.g., military personnel or athletes) almost impossible. The actual treatment for VML is based on surgical conservative treatment followed by physical exercise; nevertheless, the results, in terms of either lost mass and/or functionality recovery, are still poor. On the other hand, the efforts of the scientific community are focusing on reconstructive therapy aiming at muscular tissue void volume replenishment by exploiting biomimetic matrix or artificial tissue implantation. Reconstructing strategies represent a valid option to build new muscular tissue not only to recover damaged muscles, but also to better socket prosthesis in terms of anchorage surfaces and reinnervation substrates for reconstructed mass.