Of These, Faith, Hope, and Love: Assessing and Providing for the Psychosocial and Spiritual Needs of Burn Patients.

Burn treatment has grown increasingly advanced and technologically capable. Clinicians must take into account, however, multidimensional patient needs that factor into long-term burn recovery. Important psychosocial factors associated with burn care include psychiatric comorbidities, such as anxiety and depression, healthy family relationships, social support, and community involvement.

Pressure ulcers and perineal reconstruction.

Learning Objectives: After reading this article, the participant should be able to: 1. Discuss the approach and rationale of pressure sore management, including specific techniques of bone biopsy and postoperative care resulting in a significant reduction in recurrence rates. 2.

Vastus lateralis flap reconstruction after girdlestone arthroplasty: thirteen consecutive cases and outcomes.

Background: Pressure ulcers are found in approximately 4.7% of hospitalized populations. Up to 12.

Does systemic isotretinoin inhibit healing in a porcine wound model?

Background: Within the plastic surgery community, it is widely believed that waiting a minimum of 6 to 12 months after patient cessation of systemic retinoid therapy is necessary before proceeding with elective surgery.

Objective: The authors investigate partial- and full-thickness wound healing after treatment with systemic isotretinoin in a porcine model.

Methods: Following institutional approval, 2 Hanford miniature pigs were obtained.

Protocol management of late-stage pressure ulcers: a 5-year retrospective study of 101 consecutive patients with 179 ulcers.

Background: Despite a 12 to 82 percent pressure ulcer recurrence rate, no standard protocol exists for postoperative management. The authors reviewed a single surgeon's experience using a standard protocol: surgery and immediate reconstruction regardless of nutrition, intraoperative bone culture guiding postoperative antibiotic use, and hospital admission for 3 weeks of flat bedrest before graduated sitting.

Methods: A 5-year retrospective chart review was performed on consecutive surgically treated pressure ulcers.

Definitive diagnosis and management of axillary hyperhidrosis: the VapoMeter and suction-assisted arthroscopic shaving.

Background: Axillary hyperhidrosis is a benign, yet significant, disability that not only impairs social interaction but also affects occupational activities.

Objectives: The author provides a detailed description of axillary shaving, a procedure with proven results. He also describes the use of the VapoMeter (Delfin Technologies, Stamford, Connecticut), which accurately and easily measures sweating in g/m(2)/h.

Is there a simple, definitive, and cost-effective way to diagnose osteomyelitis in the pressure ulcer patient?

Background: Despite advances in managing pressure ulcers, there is still no definitive way to diagnose bone infection (osteomyelitis) short of open biopsy. An effective, less invasive diagnostic method might result in cost savings and improved care; however, needle aspiration, computed tomography scan, magnetic resonance imaging, ultrasound, and bone scans have proven unsatisfactory in predicting osteomyelitis. The authors reviewed preoperative radiologic studies of stage IV pressure ulcer patients and their bone biopsy results to determine which radiologic studies are most diagnostic for osteomyelitis.

Is oncologic safety compatible with a predictably viable mastectomy skin flap?

Background: Necrosis with partial loss of mastectomy flaps is an all-too-common complication of otherwise advantageous skin-sparing mastectomies. Central to the problem of predictable flap viability is the thickness of the skin flaps. Seeking a balance between the preservation of adequate flap thickness and maintenance of oncologic principles, the authors sought guidelines to help the oncologic surgeon identify the non-breast-bearing subcutaneous layer of tissue between the epithelial/dermal tissue of the breast and its parenchyma.

Head and neck melanoma.

Nearly 20% of malignant melanoma in the human body occurs in the head and neck. Most studies divide the sites of origin of malignant melanoma in the head and neck into the following areas: the face, the scalp and neck, the external ear, and the eyelid or medial or lateral canthal area. Sixty-five percent of malignant melanomas occur in the facial region.

Integrated plastic surgery residency applicant survey: characteristics of successful applicants and feedback about the interview process.

Background: Integrated plastic surgery residency training is growing in popularity, bringing new challenges to program directors and applicants. The purpose of this study was to identify characteristics of successful applicants and to obtain feedback from applicants to improve the integrated plastic surgery residency training application and interview process.

Methods: An anonymous survey assessing applicant academic qualifications, number of interviews offered and attended, and opinions about the application and interview process was distributed electronically to the 2006 integrated plastic surgery residency training applicant class.

Phenol-croton oil peel: establishing an animal model for scientific investigation.

Background: Phenol-croton oil formulas for facial peeling contain a mixture of phenol, croton oil, hexachlorophene foam (Septisol; Steris Corp., Mentor, OH), and water. For years, it was felt that the active ingredient of the solution was phenol, with the view that croton oil was little more than an irritant.

Survival in stage III colon cancer is independent of the total number of lymph nodes retrieved.

Background: Retrieval of >/= 12 lymph nodes has been set as a marker of quality for surgical resection for colon cancer. The aim of our study was to determine if increasing the number of lymph nodes recovered in stage III colon cancer results in improved survival and if it does represent a reasonable quality metric.

Study Design: Data from patients with stage III colon cancer from 1996 to 2001 were analyzed.

A pathogenic role for IgE in autoimmunity: bullous pemphigoid IgE reproduces the early phase of lesion development in human skin grafted to nu/nu mice.

Bullous pemphigoid (BP) is an autoimmune disease characterized by subepidermal blistering. Based on previous work, IgG autoantibodies directed against BP180 are thought to be the primary pathogenic agent in BP. In addition to these IgG autoantibodies, however, most BP patients produce IgE class autoantibodies that also react with BP180, and total IgE levels are often elevated in this disease.

Acceleration of Full-thickness Wound Healing in Porcine Model by Autologous Platelet Gel.

Controversy over efficacy of many wound treatments, particularly autologous platelet gel (APG), is common. The objective of this study was to determine if autologous platelet gel would accelerate the healing process of full-thickness cutaneous wounds in a porcine model. Autologous platelet gel with a ratio of 10:4 was created using 10 cc platelet-rich plasma and 4 cc autologous thrombin rich plasma.