Does controlled, gradually increased venous pressure exposure (dangling) of the lower extremity after free flap reconstructions reduce partial flap loss? A multicenter randomized controlled trial.

Introduction: Controlled, gradually increased venous pressure exposure of lower extremity free flaps (dangling) is common, based on the assumption that this reduces (partial) flap loss. Dangling protocols potentially increase length of hospital stay and resource utilization. We investigated whether: (1) the proportion of partial flap loss 6 weeks after lower extremity free flap reconstruction is non-inferior after uncontrolled exposure compared to gradually increased venous pressure exposure; (2) there is a difference in length of hospital stay and major or minor adverse events 3 months after surgery.

Mental health is strongly associated with capability after lower extremity injury treated with free flap limb salvage or amputation.

Background: Knowledge about factors associated with long-term outcomes, after severe traumatic injury to the lower extremity, can aid with the difficult decision whether to salvage or amputate the leg and improve outcome. We therefore studied factors independently associated with capability at a minimum of 1 year after amputation or free flap limb salvage.

Methods: We included 135 subjects with a free flap lower extremity reconstruction and 41 subjects with amputation, between 1991 and 2021 at two urban-level 1 trauma centers with a mean follow-up of 11 ± 7 years.

Is dangling of the lower leg after a free flap reconstruction necessary? Study protocol for a large multicenter randomized controlled study.

Background: Within the field of plastic surgery, free tissue transfer is common practice for knee and lower leg defects. Usually, after such free flap reconstruction, patients undergo a dangling protocol in the postoperative phase. A dangling protocol is designed to gradually subject the free flap to increased venous pressure resulting from gravitational forces.

Subphenotyping and Classification of Cleft Lip and Alveolus in Adult Unoperated Patients: A New Embryological Approach.

Objective: Previously, a new embryological classification was introduced subdividing oral clefts into fusion and/or differentiation defects. This subdivision was used to classify all subphenotypes of cleft lip with or without alveolus (CL±A). Subsequently, it was investigated whether further morphological grading of incomplete CLs is clinically relevant, and which alveolar part is deficient in fusion/differentiation defects.

Long-Term Patient-Reported Outcomes following Free Flap Lower Extremity Reconstruction for Traumatic Injuries.

Background: Reconstruction of severe lower extremity injuries using free flaps has become a reliable approach. Knowledge of long-term surgical outcomes, limb function, and quality of life is limited.

Methods: Two hundred thirty-nine patients undergoing a free flap reconstruction of an open lower extremity fracture between 1993 and 2014 were divided into three groups and studied, as follows: group 1, early free flap reconstruction within 6 weeks; group 2, delayed reconstruction after 6 weeks; and group 3, delayed reconstruction with osteomyelitis.

Classifying common oral clefts: a new approach after descriptive registration.

Objective: Using the Dutch Oral Cleft Registration, which records the morphology and topography of common oral clefts, a new classification based on the (patho)embryology of the primary and secondary palates was tested.

Design: Prospective observational study.

Setting: The fifteen cleft palate teams in the Netherlands register patients to the national registry.

Validation of the Dutch registry of common oral clefts: quality of recording specific oral cleft features.

Objective: Since 1997, common oral clefts in the Netherlands have been recorded in the national oral cleft registry using a unique descriptive recording system. This study validates data on the topographic-anatomical structure, morphology, and side of individual anomalies of the primary palate and secondary palate that form the oral cleft.

Design: Validation study.

Decreasing prevalence of oral cleft live births in the Netherlands, 1997-2006.

Objectives: The number of new oral cleft patients has fallen in the Netherlands. This may be explained by two hypotheses: (1) greater prenatal detection of congenital anomalies has led to more pregnancy terminations and (2) increased folic acid use has reduced the oral cleft risk. Both hypotheses would mainly apply to the category cleft lip/alveolus ± cleft palate (CL±P), since, unlike cleft palate only (CP), CL±P can be detected prenatally by two-dimensional (2D) ultrasound and develops during the period recommended for folic acid use.

Ten years recording common oral clefts with a new descriptive system.

Objective: After introducing a new descriptive recording system for congenital craniofacial abnormalities in The Netherlands, common oral clefts are highlighted.

Design: Prospective observational study.

Setting: Fifteen cleft palate teams, united in the Dutch Association for Cleft Palate and Craniofacial Anomalies, registered patients from 1997 to 2006.

Validation of the NVSCA registry for common oral clefts: study design and first results.

Objective: Since 1997 the Dutch Association for Cleft Palate and Craniofacial Anomalies (NVSCA) has maintained a national registry of congenital craniofacial anomalies. This study validates data on three common oral cleft categories (cleft lip/alveolus = CL/A; cleft lip/alveolus and palate = CL/AP; and cleft palate = CP) and general items.

Design: Retrospective observational study.