St Andrew's ambulatory care strategy for animal & human bite injuries & localised infections.

Background: Infected animal bites and localised infections are traditionally managed by inpatient admission, intravenous antibiotics, and localised washout +/- debridement. Our hand trauma protocol was modified to accommodate the challenges faced in delivering this pathway during the COVID-19 pandemic.

Objective: To evaluate the outcomes of two management pathways, ambulatory (2020) vs inpatient (2019), at a single tertiary referral centre.

A novel technique in flexor pulley reconstruction using an A1 pulley as a donor.

We describe a novel technique for the reconstruction of an essential flexor pulley over a bowstrung flexor tendon using the A1 pulley of the same or another digit. Replacing 'like for like' ensures restoration of pulley-tendon interface and biomechanics.

Reverse Superficial Palmar branch of Radial artery pedicled flap for Palmar and Digital reconstruction: A systematic review of literature with a retrospective case review.

Background: Most studies on the superficial palmar branch of radial artery (SUPBRA) flap involve its use as a free flap with only few reports in literature regarding its use as a reverse pedicled flap. This systematic review presents a summary of the available literature on the indications, anatomy, technique, complications and outcomes of the reverse SUPBRA flap and also describes our experience.

Methods: A computer search was performed on the Embase, Medline and Pubmed databases for clinical studies describing the reverse SUPBRA flap in accordance with the standard principles for systematic review and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.