Spectral diffuse reflectance and autofluorescence imaging can perform early prediction of blood vessel occlusion in skin flaps.

Flap transfer has become a common technique in reconstructive surgery. However, a significant number of compromised skin flaps are not successfully salvaged because the current clinical method for flap assessment relies heavily on the clinician's experience. Vascular occlusion is the major reason for flap failure, thus the accurate and objective early prediction of blood vessel occlusion is vitally important.

Two-Stage Latissimus Dorsi Flap with Implant for Unilateral Breast Reconstruction: Getting the Size Right.

Background: The aim of unilateral breast reconstruction after mastectomy is to craft a natural-looking breast with symmetry. The latissimus dorsi (LD) flap with implant is an established technique for this purpose. However, it is challenging to obtain adequate volume and satisfactory aesthetic results using a one-stage operation when considering factors such as muscle atrophy, wound dehiscence and excessive scarring.

Early detection and differentiation of venous and arterial occlusion in skin flaps using visible diffuse reflectance spectroscopy and autofluorescence spectroscopy.

Our previous preclinical study demonstrated that both visible diffuse reflectance and autofluorescence spectroscopy, each of which yields a different set of physiological information, can predict skin flap viability with high accuracy in a MacFarlane rat dorsal skin flap model. In this report, we further evaluated our technique for the early detection and differentiation of venous occlusion and arterial occlusion in a rat groin flap model. We performed both diffuse reflectance and autofluorescence measurements on the skin flap model and statistically differentiated between flaps with and without occlusions as well as between flaps with venous occlusion and those with arterial occlusion based on these non-invasive optical measurements.

Early prediction of skin viability using visible diffuse reflectance spectroscopy and autofluorescence spectroscopy.

Background: Accurate and early prediction of skin flap viability is vitally important in reconstructive surgery. To the best of the authors' knowledge, this is the first pilot study to evaluate the simultaneous use of both visible diffuse reflectance and autofluorescence spectroscopy on a reverse MacFarlane rat dorsal skin flap model in the early prediction of skin viability.

Methods: A total of 62 flap measurement sites from 11 Sprague-Dawley rats were monitored for 72 hours.

The chicken aorta as a simulation-training model for microvascular surgery training.

As a technically demanding skill, microsurgery is taught in the lab, in the form of a course of variable length (depending on the centre). Microsurgical training courses usually use a mixture of non-living and live animal simulation models. In the literature, a plethora of microsurgical training models have been described, ranging from low to high fidelity models.

Use of the fix and flap approach to complex open elbow injury: the role of the free anterolateral thigh flap.

Background: Complex elbow injuries with associated nerve, muscle, or joint injury commonly develop post-inury stiffness. In order to preserve function, joint congruency, elbow stability and durable wound coverage must be achieved in a timely manner.

Methods: A retrospective review of patients who underwent orthopaedic fixation followed by free anterolateral thigh (ALT) flap soft tissue coverage was performed.

Correction of nipple inversion using a micro-knife and transverse to longitudinal skin closure.

Through a series of 7 patients (8 nipples), we present a technique for the correction of nipple inversion. We use a micro-knife to divide the shortened ducts and fibrous tissues, as well as an internal cerclage suture and reverse strictureplasty skin closure to effectively correct and maintain the position of the inverted nipple. The advantages of the proposed technique include its simplicity, effectiveness in severe cases, and long-lasting results.

Carbon dioxide laser vaporization of facial siliconomas: flash in the pan or way of the future?

In 1988, Becker first described the "laser silicone flash" encountered while using the CO2 laser to remove breast siliconosis, but no subsequent use of the CO2 laser to remove siliconomas has been reported since. To our knowledge, lasers have not been described to treat facial silicone granulomas. Three cases of facial silicone granuloma (cheek, upper eyelids, and chin) were treated using the technique of CO2 laser vaporization.

Diagnostic dilemmas in unusual presentations of gout.

Background: Gout is known to mimic conditions as diverse as joint and soft tissue infections, skin malignancies, nerve compression syndromes and soft tissue tumours. Upper limb involvement is unusual.

Objective: We discuss four cases of gout in the hand and wrist masquerading as a soft tissue tumour, nodular extensor tenosynovitis, septic arthritis of the wrist and acute and chronic median nerve compression.