The Utility of Flap Coverage for Limb Salvage in Patients With Severe Prosthetic Joint Infections of the Knee Requiring Implant Exchange.

Background: Prosthetic joint infection (PJI) is a challenging complication of knee arthroplasty, which can require amputation in severe cases. This study analyzes the utility of flap reconstruction in PJIs requiring hardware removal and extensive soft tissue debridement.

Methods: This was a retrospective analysis of patients who were treated according to a multistage extremity salvage protocol between 2018 and 2022.

Flap survival and functional outcomes in elbow soft tissue reconstruction: A 25-year systematic review.

Introduction: Different elbow flap reconstructions have been described in the literature. We aim to define the optimal flap technique based on defect size and etiology.

Methods: A systematic review was undertaken using the terms "(Elbow reconstruction) AND ((Soft tissue) OR (flap))".

Vascularized Fibula Epiphysis Transfer for Pediatric Extremity Reconstruction: A Systematic Review and Meta-analysis.

Background: Vascularized fibula epiphysis transfer for pediatric extremity reconstruction intends to preserve growth potential. However, few cases are reported, and outcomes are poorly characterized.

Methods: Systematic review was performed through a MEDLINE search using keywords "pediatric" or "epiphyseal" and "vascularized fibula.

Godina revisited: a systematic review of traumatic lower extremity wound reconstruction timing.

Marko Godina suggested in 1986 that soft tissue coverage of traumatic extremity wounds within 72 h of injury optimizes outcomes. Decades later, these recommendations remain controversial. We performed systematic review of the literature using keywords 'free flap coverage' OR 'soft-tissue reconstruction' AND 'lower extremity trauma' OR 'tibial or fibular fractures'.

Prospective, Randomized, Controlled Comparison of Bupivacaine versus Liposomal Bupivacaine for Pain Management after Unilateral Delayed Deep Inferior Epigastric Perforator Free Flap Reconstruction.

Effective postsurgical analgesia is a critical aspect of patient recovery. The goal of this prospective, randomized, controlled, blinded study was to examine the effect that liposomal bupivacaine delivered by means of a transversus abdominis plane block has on pain control in women undergoing unilateral deep inferior epigastric perforator flap reconstruction. Institutional review board approval was granted for this prospective study.

An analysis of 72% chromated glycerin used for sclerotherapy: sterility, potency, and cost after extended shelf life.

Background: Sclerotherapy is the treatment of reticular veins and telangiectasias of the lower extremities. Sclerosants destroy endothelial tissue and expose subendothelial collagen fibers, which lead to subsequent fibrosis of vessels, thus preventing recanalization. There are several available sclerosants including sodium tetradecyl sulfate (STS), polidocanol (POL), and chromated glycerin (CG) with varying efficacy, potency, side effect profile, and cost.

Recurring pressure ulcers: identifying the definitions. A National Pressure Ulcer Advisory Panel white paper.

Currently, there is a lack of consensus regarding the accepted terminology pertaining to the pressure ulcer healing progression and recidivism. This lack of uniformity can negatively impact initiation of treatment pathways, completion of appropriate interventions, clinical documentation, medical coding, patient education, discharge planning and healthcare revenue through out the healthcare system. The purpose of this paper is to introduce a standard nomenclature as it pertains to pressure ulcer healing progression and any recidivism that may occur.

Continuous bedside pressure mapping and rates of hospital-associated pressure ulcers in a medical intensive care unit.

Background: Critically ill patients are vulnerable to the development of hospital-associated pressure ulcers (HAPUs). Positioning of patients is an essential component of pressure ulcer prevention because it off-loads areas of high pressure. However, the effectiveness of such positioning is debatable.

Silk fibroin conduits: a cellular and functional assessment of peripheral nerve repair.

Silk fibroin conduits were designed with appropriate porosity for peripheral nerve repair. The aim of this work was to use these conduits to examine cell inflammatory responses and functional recovery in a sciatic nerve defect model. A total of 45 randomized Lewis rats were used to create an 8-mm defect bridged by a silk guide, commercial collagen guide, or an autograft.

Incorporation of double-walled microspheres into polymer nerve guides for the sustained delivery of glial cell line-derived neurotrophic factor.

The purpose of this study was to develop a biodegradable polymer nerve guide that locally delivers bioactive neurotrophic factors in physiologically relevant concentrations for the period required by transected peripheral nerves to cross from the proximal to distal nerve stump. Delivery of a neurotrophic factor may enhance nerve regeneration and could potentially be used to overcome the current limitations in nerve repair across large defects. Glial Cell Line-Derived Neurotrophic Factor (GDNF) is a known promoter of axonal elongation and branching and has shown promising pre-clinical results in analysis of nerve regeneration with nerve guides.

Continuous infusion of intraperitoneal bupivacaine after laparoscopic surgery: a randomized controlled trial.

Background: A standard approach for postoperative analgesia in laparoscopic surgery is to infiltrate the incisions with local anesthetic in combination with systemic opioids. The intraperitoneal introduction of local anesthetic in this setting has the potential to provide appropriate analgesia without the side effects of systemic opioids. We performed a randomized clinical trial of the On-Q pump delivery system to determine the safety and efficacy of this device for this novel purpose.