Department of Plastic and Hand Surgery

Inselspital Bern

In its current structure, the Department covers the entire spectrum of plastic, reconstructive and aesthetic surgery, hand surgery, and peripheral nerve surgery. As a so-called tertiary treatment center, the Department receives complicated cases from other hospitals for further treatment.

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Profile

  • Conducting clinical and basic research in the fields of Plastic, Reconstructive and Aesthetic Surgery, under the lead of Prof. Mihai Constantinescu, and Hand Surgery and Surgery of the Peripheral Nerve, under the lead of Prof. Esther Vögelin.
  • Focus of the Plastic Surgery clinical research: implementation of 3D models of aesthetic tissue reconstruction, innovative strategies for the diagnosis and treatment of critical ischemic tissue and malignant skin tumors, innovations and outcome analysis in free tissue transfer
  • Focus of the Hand surgery research: development of mini-invasive treatment modalities using arthroscopy in carpal injuries and evaluation of innovative modalities in repair of peripheral nerve injuries.
  • Focus of the Hand therapy research: prospective and retrospective clinical research to improve hand therapy treatment.
  • Conducting several basic research projects in the field of vascularized composite allotransplantation (VCA) as well as in ischemia and reperfusion injury.
  • Investigating the possibility of innovative nanoparticle-based modalities for the treatment of nerve injuries and surgical complications.
  • Teaching programs for students of Medicine, Biomedical Science and Molecular Life Science, involved in outreach activities for education of young students, such as the Swiss Youth in Science program and the mentoring of Matura Projects of the Swiss Academy of Science

External Partners

Department of Pharmaceutical Technology, Institute of Pharmacy, University of Jena, Germany; Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, University of Zurich, Switzerland; Department of Plastic Surgery and Hand Surgery, University Hospital Basel, University of Basel, Switzerland; Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium; Institute for Stem Cell Biology and Regenerative Medicine (inStem), Bangalore, India; Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, Switzerland; Laboratory for Movement Biomechanics, ETH Zurich; Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, Switzerland; Department of Orthopaedics and Surgery, Université libre de Bruxelles, Brussels, Belgium; Swibrace Ltd, Fribourg, Switzerland; Department of Mechanical Engineering, HES-SO University of Applied Sciences Fribourg, Switzerland; Réseau Hospitalier Neuchâtelois (RHNe), clinique de la main, Neuchâtel, Switzerland

Grants

Grant 1:

  • Site-specific, intra-articular, “on demand” immunosuppression for long-term functional graft survival in joint allotransplantation in a large animal model (US Army DoD RTRP grant nr. HT94252410165: $ 187,821 (09/2024 – 02/2026)
  • PD Dr. med. Radu Olariu has secured a prestigious grant of the United States Department of Defense’s Reconstructive Transplant Research Program.
  • The translational project focuses on joint allotransplantation, an extremely challenging subspecialty of vascularized composite allotransplantation (VCA) which can offer unprecedented reconstructive results in the most severe deformities and amputations. The project aims to establish an orthotopic large-animal (swine) model for long-term follow-up of JA and to evaluate the efficacy and safety of site-specific, intra-articular delivery of local hydrogel-based immunosuppression (TGMS-TAC) therapy. Intra-articular delivery of TGMS-TAC can disassemble and release tacrolimus in response to local proteolytic enzymes in the graft that are over-expressed during inflammation. This inhibits both T-lymphocyte signal transduction and IL-2 transcription, and thus prevents immune rejection directly at the graft site with low systemic tacrolimus levels.
  • We hypothesize that intra-articular administration of TGMS-TAC will maintain long-term joint survival while allowing functional recovery with minimal off-site toxicity in a clinically relevant pig JA model.

Grant 2:

  • Advancing Biomechanical Insights and Surgical Strategies for Scaphoid Fractures
  • Dr. med. Esin Rothenfluh has been awarded two grants to support her innovative research on scaphoid fractures, the most common fractures of the carpal wrist, which primarily affect young individuals. In 10–15% of cases, these fractures fail to heal, leading to non-union, persistent pain, functional impairment, and potential long-term complications such as wrist osteoarthritis.
  • Her project, funded by the competitive Nachwuchsförderungs-Grant for Translational Research from the University of Bern, employs computational modeling to analyze the biomechanics of scaphoid fractures. This work aims to optimize surgical decision-making by providing a detailed understanding of fracture mechanics.
  • Dr. Rothenfluh brings extensive expertise to this research, having pursued advanced training in hand surgery after specializing in trauma and orthopedics, as well as gaining experience in finite element modeling during her tenure at the Laboratory for Orthopaedic Biomechanics at Balgrist, Zurich. Her prior study on the mechanical behavior of scaphoid fractures during healing stages, supported by the Swiss Society for Hand Surgery, was published in the Journal of Hand Surgery (Eur Vol).
  • Additionally, a grant from Medartis AG supports Dr. Rothenfluh’s investigation into optimal fixation methods for scaphoid fractures. This work, conducted in collaboration with the Laboratory of Biomechanics at ETH Zurich, builds on a previously developed finite element model of the scaphoid and is funded with CHF 12,000.
  • Together, these projects aim to enhance the biomechanical understanding and improve treatment outcomes for patients with scaphoid fractures.

Grants 3 and 4:

  • Investigating Motor Neuron Survival and Regeneration in Peripheral Nerve Injuries
  • Dr. med. Remy Liechty has secured two grants to support a cutting-edge basic research project in collaboration with the Leckenby Nerve Lab at the University of Rochester Medical Center, NY. This study addresses the challenges posed by peripheral nerve injuries, which often result in chronic pain, disability, and incomplete recovery despite the nerves' inherent regenerative potential.
  • The project focuses on understanding why motor neurons in brainstem-controlled cranial nerves, such as the facial nerve, exhibit poorer survival and regeneration compared to spinal nerves, like the sciatic nerve, following nerve transection and repair in a rodent model. Central to the research is the role of the p75NTR receptor, which can promote either cell survival or death after traumatic nerve injury. Using the experimental inhibitor LM11A-31, the study investigates whether selectively blocking harmful p75NTR signaling can enhance nerve cell survival and regeneration. This work has the potential to uncover novel therapeutic strategies for improving outcomes in patients suffering from peripheral nerve injuries.
  • The two grants are: BEARS Foundation Basic Science Grant: CHF 50,000 (09/2024-08/2025) and Swiss Universities Medicus Student Exchange Program: USD 10,000 (09/2024-08/2025)