Soft Tissue Mandibula and Tongue Reconstruction Using A Suprafascial, Folded, Deepithelialized Antero-Lateral Thigh Perforator Free Flap.

Head and neck squamous cell carcinoma (HNSCC) is the most frequent carcinoma of the head and neck region. For coverage of an entire resected mandible with floor of the mouth, 3/4 of the tongue and soft tissue of cheeks and neck bony reconstruction of the mandible and soft tissue reconstruction of tongue, cheeks and a neck large flap are needed. A patient with a superinfected T4 HNSCC was presented to our outpatient clinic.

Antigen Titer Elevation and Mortality in Burn Patients.

Background: Mortality in burn patients has several contributing factors as sex, age, degree of burns, or inhalation injuries. Usefulness of antigen (CAG) titer is still being under debate to predict mortality. This study assessed correlation between CAG titer and mortality in burn patients.

Degloving Injuries of Upper Extremity: A Strategy with Full Thickness Skin Mesh.

Degloving injuries of the upper extremity during work are rare nowadays, because of effective worker protection devices. However, these devastating injuries still occur today during motor vehicle car accidents and surgeons have to be aware of the possibilities of wound coverage for these large, contaminated wounds. We present two cases of degloving injuries of the hand and entire forearm using degloved skin as meshed full thickness skin graft to cover the entire wound.

Experience of total knee arthroplasty using a novel navigation system within the surgical field.

Background: With the aim of improving component alignment and outcome in total knee arthroplasty (TKA), several computer-assisted devices (CAD) have been developed.

Methods: In February 2014, the present unit started to use a new imageless navigation system with accelerometric pods within the surgical field for all primary TKAs; there was no need for optical trackers or cameras. This paper presents the results of the first 72 TKAs using this iAssist system in 71 prospectively collected and retrospectively analyzed patients.

O2C Laser Doppler and Digital Photo Analysis for Treatment Evaluation of Beta-Glucan versus Provitamin Pantothenic Acid of Facial Burns.

Various creams are available for superficial second-degree burns (SSDB) of the face. We evaluated provitamin pantothenic acid versus β-glucan for SSDB of the face using the O2C laser Doppler system and digital photo analysis. Out of 20 patients (January to December 2012) with facial burns, 7 with SSDB of both cheeks were included to our study.

Optimizing Biomaterials for Tissue Engineering Human Bone Using Mesenchymal Stem Cells.

Background: Adequate biomaterials for tissue engineering bone and replacement of bone in clinical settings are still being developed. Previously, the combination of mesenchymal stem cells in hydrogels and calcium-based biomaterials in both in vitro and in vivo experiments has shown promising results. However, results may be optimized by careful selection of the material combination.

A comparison of complications in 400 patients after native nail versus silicone nail splints for fingernail splinting after injuries.

Background: The fingertip is the most commonly injured part of the hand and is an important aesthetic part of the hand.

Methods: In this retrospective study we analyzed data from 700 patients operated on between 1997 and 2008 for complications after nail splinting with native nail or silicone nail. Inclusion criteria were patients living in Bern/Berner Land, complete documentation, same surgical team, standard antibiotics, acute trauma, no nail bed transplantation, and no systemic diseases.

Deep sternal osteomyelitis: an algorithm for reconstruction based on wound width.

Patients with sternum osteomyelitis are transferred to plastic surgery departments for wound coverage. Several options of flap coverage are known; however, various wound diameters need different flaps. In a retrospective study, 135 patients from 2006-2010 with deep sternal wound infections were evaluated.

A high bifurcation of the dorsal branch with dominant superficial palmar branch of the radial artery: a case report of an aberrant radial artery with traumatic aneurysm.

Anatomical abnormalities such as unusual bifurcations or aberrant arteries of the radial artery are extremely rare and due to malformation or disruption of the vascular net. We present a case of a 64 year old woman with a high bifurcated dorsal branch of the left radial artery, consulting us for a pulsatile mass in the anatomical snuffbox after a fall. The mass measured 3-4 mm in diameter and was located on the dorsal aspect of the wrist over the anatomical snuffbox.

Incidence and treatment of burns: a twenty-year experience from a single center in Germany.

Objective: To analyze trends in incidence and treatment of thermal injuries over the last two decades.

Methods: We retrospectively reviewed our local single center database of patients with thermal injuries admitted to the burn intensive care unit (BICU) of the Cologne-Merheim Medical Center (University Hospital of Witten/Herdecke). The cohort was divided into two groups according to the decade of admission and the epidemiology and clinical course of the patient sample admitted during the period 1991-2000 (n=911) was compared to that of 2001-2010 (n=695).

Technique and indication of distal arterial-to-proximal venous anastomosis at an amputated distal phalanx.

Digital finger amputation with soft tissue injury is a frequent accident in reconstructive surgery. Several techniques about reconstruction of digital finger amputation are described in literature. However replantation is difficult when large segments of the arteries are missing.

Failure of secondary wound closure after sternal wound infection following failed initial operative treatment: causes and treatment.

Background: Patients transferred to Plastic Surgery Departments for sternum osteomyelitis have a high morbidity of about 3%. Despite several known options for sternal wound coverage and salvage operations, wound dehiscence or wound necrosis can occur, increasing patient morbidity.

Patients And Methods: One hundred thirty-five patients admitted between January 2007 and December 2010 were evaluated in a retrospective study for wound dehiscence after salvage wound coverage at our institution.

Thoracic radionecrosis following repeated cardiac catheterization.

Radiodermatitis is a known complication in patients having undergone radiotherapy. It usually appears 2 to 5 years after irradiation. We are reporting on a case of radiodermatitis that occurred within months after coronary dilatation and stenting.

Combined latissimus dorsi and serratus anterior flaps for pelvic reconstruction.

In recurrent pressure sores, adjacent tissue has already been consumed by multiple surgeries. Additional problems are several co-morbidities of patients. Especially, severe atherosclerosis would be a contraindication for using free flaps.

Factors of osteogenesis influencing various human stem cells on third-generation gelatin/β-tricalcium phosphate scaffold material.

Human bone marrow-derived stem cells (hBMSCs) and adipose-derived stem cells (hASCs) have been used to regenerate bone. Both sources are claimed to have comparable osteogenic potential, but few comparative studies are available. Third-generation biomaterials have been developed to reduce steps in regenerating tissues.

What's behind the mask? A look at blood flow changes with prolonged facial pressure and expression using laser Doppler imaging.

Clinically, the initial blanching in burn scar seen on transparent plastic face mask application seems to diminish with time and movement requiring mask alteration. To date, studies quantifying perfusion with prolonged mask use do not exist. This study used laser Doppler imaging (LDI) to assess perfusion through the transparent face mask and movement in subjects with and without burn over time.

Conditions affecting cell seeding onto three-dimensional scaffolds for cellular-based biodegradable implants.

Seeding cells efficiently and uniformly onto three-dimensional scaffolds is a key element for engineering tissues, particularly when only a low-number of cells is available for tissue repair and regeneration. The aim of this study was to evaluate three seeding techniques on two biocompatible scaffolds in vitro using chondrocytes as follows: (1) static; (2) modified centrifugal cell immobilization (CCI); and (3) dynamic oscillating motion. Five milliliters of media containing 5, 10, or 25 million articular, auricular, or costal chondrocytes were used to seed porous PLGA scaffolds and sections of devitalized cartilage.

The Vacuum-Assisted Closure (VAC) device for hastened attachment of a superficial inferior-epigastric flap to third-degree burns on hand and fingers.

The vacuum-assisted closure (VAC) device has a wide range of clinical applications, including treatment of infected surgical wounds, traumatic wounds, pressure ulcers, wounds with exposed bone and hardware, diabetic foot ulcers, and venous stasis ulcers. Increased release of growth factors has been described, leading to improved vascularization and thereby formation of new tissue. The system is also used in burn surgery for reconstructive purposes.

Toward regenerating a human thumb in situ.

Regenerative technology promises to alleviate the problem of limited donor supply for bone or organ transplants. Most expensive and time consuming is cell expansion in laboratories. We propose a method of magnetically enriched osteoprogenitor stem cells, dispersed in self-assembling hydrogels and applied onto new ultra-high resolution, jet-based, three-dimensional printing of living human bone in a single-step for in situ bone regeneration.

Human shaped thumb bone tissue engineered by hydrogel-beta-tricalciumphosphate/poly-epsilon-caprolactone scaffolds and magnetically sorted stem cells.

Traumatic amputation of a thumb with bone loss leaves a patient in severe disability. Reconstructive procedures are restricted by limited shape and have the disadvantage of severe donor-site morbidity. To overcome these limitations, we used a tissue engineering approach to create a distal thumb bone phalanx, combining magnetically sorted 133+ human mesenchymal stem cells (hMSCs) suspended in successful tested hydrogels for bone formation and porous 3-dimensionally printed scaffolds (3DP) in the shape of a distal thumb bone phalanx.

Comparison of hydrogels in the in vivo formation of tissue-engineered bone using mesenchymal stem cells and beta-tricalcium phosphate.

Availability of grafts and morbidity at the donor site limit autologous transplantation in patients requiring bone reconstruction. A tissue-engineering approach can overcome these limitations by producing bone-like tissue of custom shape and size from isolated cells. Several hydrogels facilitate osteogenesis on porous scaffolds; however, the relative suitability of various hydrogels has not been rigorously assessed.

An allogenic cell-based implant for meniscal lesions.

Background: Meniscal tears in the avascular zones do not heal. Although tissue-engineering approaches using cells seeded onto scaffolds could expand the indication for meniscal repair, harvesting autologous cells could cause additional trauma to the patient. Allogenic cells, however, could provide an unlimited amount of cells.

Tissue engineering cartilage with aged articular chondrocytes in vivo.

Background: Tissue engineering has the potential to repair cartilage structures in middle-aged and elderly patients using their own "aged" cartilage tissue as a source of reparative chondrocytes. However, most studies on tissue-engineered cartilage have used chondrocytes from postfetal or very young donors. The authors hypothesized that articular chondrocytes isolated from old animals could produce neocartilage in vivo as well as articular chondrocytes from young donors.