A Unique Advantage of a 24-hour Surgical Delay in Autologous Breast Reconstruction.

The surgical delay technique can be used effectively in autologous breast reconstruction when there is unfavorable flap vascular anatomy or when the reconstruction necessitates a larger volume of donor tissue to obtain optimal results. The length of time between surgically delaying the flap to pedicle division and inset of the flap often varies based on surgeon preference but is typically approximately a week or longer. The authors present a case in which a 24-hour surgical delay was successfully used to augment deep inferior epigastric perforator flaps for autologous reconstruction.

The Effect of Venous Augmentation on Complication Rates in Deep Inferior Epigastric Perforator Breast Reconstruction.

Background: With the rising popularity of the deep inferior epigastric perforator (DIEP) flap in breast reconstruction, use of the superficial inferior epigastric vein (SIEV) to augment venous outflow has been proposed as a strategy to prevent venous congestion, a complication positively associated with flap volume. This study evaluated the impact of routine SIEV venous augmentation on the risk of vascular complications or operative fat necrosis in the context of flap size and operating time.

Methods: A retrospective cohort study compared complication rates of patients with SIEV-augmented DIEP flaps to controls over a 3-year period.

The Relationship Between Obesity and Lateral Condyle Fracture Healing: A Pilot Study.

Objective: Childhood obesity is a growing public health concern in the United States. Obesity has been shown to lead to increased complications with regards to orthopaedic injuries, such as more severe fracture patterns, notably observed in injuries like lateral condyle fractures of the humerus. However, there is currently a gap in the literature regarding the relationship between obesity and the healing potential of these fractures.

Complex Deformation in Soft Cylindrical Structures via Programmable Sequential Instabilities.

The substantial deformation exhibited by hyperelastic cylindrical shells under pressurization makes them an ideal platform for programmable inflatable structures. If negative pressure is applied, the cylindrical shell will buckle, leading to a sequence of rich deformation modes, all of which are fully recoverable due to the hyperelastic material choice. While the initial buckling event under vacuum is well understood, here, the post-buckling regime is explored and a region in the design space is identified in which a coupled twisting-contraction deformation mode occurs; by carefully controlling the geometry of our homogeneous shells, the proportion of contraction versus twist can be controlled.

Thigh Perforator Exchange: Intraflap Perforator Augmentation of Anterolateral Thigh Free Flaps.

Peripheral perfusion in large anterolateral thigh flaps may be inadequate if perforator zones are not properly planned during flap design and harvest, and variations in vascular anatomy can contribute to operative difficulty and morbidity. Intraflap anastomosis of extrinsic perforators may allow for augmentation of perfusion while avoiding significant intramuscular dissection. Adaptation of the perforator exchange technique, previously described in autologous breast reconstruction, optimizes vascular flow in anterolateral thigh flaps.