Closure of the osteocutaneous fibula flap donor site with a tonearm (propeller) flap: Anatomic considerations and surgical indications.

Background: Skin graft is frequently used for donor site closure after osteocutaneous fibula free flap (OCFFF) harvest when primary closure is not possible. Partial skin graft loss requiring wound care is a common complication. The purposes of this prospective study were to investigate the perforator anatomy for local propeller or tonearm flap closure and compare the outcomes to those of skin graft closure.

Optimising Control Device Luring Strategies for Invasive Predator Control: A Modelling Approach.

Invasive predators pose a serious threat to native biodiversity, with trapping being one of several methods developed to manage and monitor their populations. Many individuals in these predator populations have been found to display trap-shyness, which hinders eradication and results in inaccurate estimates of population size. Lures are used to help overcome trap-shyness by increasing the probability of interaction with the device, but the extent of trap-shyness in wild populations, and the best timing for the introduction of a new lure or combination of lures, are uncertain.

Increased circulation of GII.17 noroviruses, six European countries and the United States, 2023 to 2024.

We report an increase in GII.17 norovirus outbreaks and sporadic infections of acute gastroenteritis in Austria, Germany, France, Ireland, the Netherlands, England and the United States during the 2023/24 season. A decrease in GII.

Improving recognition of early clinical decline: Determining reliability and validity of the Garvey clinical warning curves.

Background: New graduate nurses have difficulty recognizing and managing the early signs of clinical decline, resulting in a Failure to Rescue (FTR) event and preventable patient death. To address this gap, Garvey developed a series of Clinical Warning Curves as an instructional tool for new graduate nurses in an academic medical center. The Garvey Clinical Warning Curve models depict the progression of clinical changes in six body systems that occur before cardiac arrest.

Free fibula mandible reconstruction for osteoradionecrosis is more challenging than for primary cancer.

Introduction: Osteoradionecrosis (ORN) of the mandible is an unfortunate potential sequela of radiotherapy for head and neck cancer. In advanced cases of ORN, mandibulectomy, and free fibula flap reconstruction are required. We hypothesized that patients undergoing fibula free flap reconstruction and mandibulectomy for ORN pose unique challenges and experience more complications than patients undergoing fibula free flaps after oncologic mandibulectomy.

Outcomes for 160 Consecutive Lateral Arm Free Flaps for Head and Neck Reconstruction.

Objective: Examine outcomes for lateral arm autologous tissue transfer in head and neck reconstruction.

Study Design: Retrospective cohort study.

Setting: Tertiary cancer center.

An ecological study of the spatiotemporal dynamics and drivers of domestically acquired campylobacteriosis in Ireland, 2011-2018.

In 2021, Campylobacteriosis was the main gastrointestinal disease in the European Union since 2007 according to the European Centre for Disease Prevention and Control. In the Republic of Ireland, the incidence of the disease is particularly high with approximately 3,000 cases per annum, raising significant concerns for national health authorities with an expected increase in the number of cases in the light of climate change. The current study sought to assess the spatio-temporal patterns of campylobacteriosis in the Republic of Ireland using 20,391 cases from January 2011 to December 2018.

COVID-19 incidence and outcome by affluence/deprivation across three pandemic waves in Ireland: A retrospective cohort study using routinely collected data.

Background: Since the pandemic onset, deprivation has been seen as a significant determinant of COVID-19 incidence and mortality. This study explores outcomes of COVID-19 in the context of material deprivation across three pandemic waves in Ireland.

Methods: Between 1st March 2020 and 13th May 2021, 252,637 PCR-confirmed COVID-19 cases were notified in Ireland.

The lateral forearm flap versus traditional upper extremity flaps: A comparison of donor site morbidity and flap thickness.

Introduction: The lateral forearm flap (LFF) is a thin fasciocutaneous flap with a donor site that can be closed primarily.

Methods: A retrospective analysis of donor site morbidity and hand function was performed in patients who underwent a radial forearm flap (RFF), ulnar artery perforator flap (UAPF), or LFF. Flap thickness was evaluated radiographically in 50 control patients.

Profunda Artery Perforator Flap Tongue Reconstruction: An Effective and Safe Alternative to the Anterolateral Thigh Flap.

Background: The anterolateral thigh (ALT) perforator flap is a workhorse flap for tongue reconstruction. The authors present an alternative option using the profunda artery perforator (PAP) flap for glossectomy reconstruction compared with the ALT flap.

Methods: A retrospective review was conducted of 65 patients who underwent subtotal or total glossectomy reconstruction between 2016 and 2020 (46 ALT versus 19 PAP flaps).

Component Separation Decreases Hernia Recurrence Rates in Abdominal Wall Reconstruction with Biologic Mesh.

Background: It is not clear whether mesh-reinforced anterior component separation (CS) for abdominal wall reconstruction (AWR) results in better outcomes than mesh-reinforced primary fascial closure (PFC) without CS, particularly when acellular dermal matrix is used. The authors compared outcomes of CS versus PFC repair in AWR procedures aiming to determine whether CS results in better outcomes.

Methods: This retrospective study of prospectively collected data included 461 patients who underwent AWR with acellular dermal matrix during a 10-year period at an academic cancer center.

Long-term Surgical and Patient-Reported Outcomes Comparing Skin-Preserving, Staged Versus Delayed Microvascular Breast Reconstruction.

Background: Skin-preserving, staged, microvascular, breast reconstruction often is preferred in patients requiring postmastectomy radiotherapy (PMRT) but may lead to complications. We compared the long-term surgical and patient-reported outcomes between skin-preserving and delayed microvascular breast reconstruction with and without PMRT.

Methods: We conducted a retrospective, cohort study of consecutive patients who underwent mastectomy and microvascular breast reconstruction between January 2016 and April 2022.

Collaborative and Interprofessional Educational Program to Maintain Trauma-Focused Education During the COVID-19 Pandemic.

Failure to rescue is prevalent among patients with traumatic injury who are admitted to medical-surgical units. These units are traditionally staffed by new graduate nurses who require mentorship and ongoing continuing education. The coronavirus disease 2019 (COVID-19) pandemic prompted nurse educators to develop and implement new methods of providing routine and just-in-time education in the hospital setting.

Ensuring Safety While Achieving Beauty: An Evidence-Based Approach to Optimizing Mastectomy and Autologous Breast Reconstruction Outcomes in Patients with Obesity.

Background: Although obesity has previously been associated with poor outcomes after mastectomy and breast reconstruction, its impact across the WHO obesity classification spectrum and the differential effects of various optimization strategies on patient outcomes have yet to be delineated. We sought to examine the impact of WHO obesity classification on intraoperative surgical and medical complications, postoperative surgical and patient-reported outcomes of mastectomy and autologous breast reconstruction, and delineate outcomes optimization strategies for obese patients.

Study Design: This is a review of consecutive patients who underwent mastectomy and autologous breast reconstruction from 2016 to 2022.

Rising to the COVID-19 Challenge: Creating a Remote Experiential Simulation.

This article will describe the creation and implementation of a remote learning failure to rescue (FTR) class with remote experiential simulation technology into a nurse residency program. The COVID-19 pandemic impacted traditional delivery methods for education within nurse residency programs. Following is the background of this hospital's nurse residency program and FTR curriculum and a description of the creation and implementation of a remote FTR class using internally developed remote experiential simulation technology.

Sensory Outcomes for Inferior Alveolar Nerve Reconstruction with Allograft following Free Fibula Mandible Reconstruction.

Background: As patient survival with head and neck cancer has improved, treatment goals have had to evolve to focus on improving quality of life. Traditionally, patients who have undergone mandibulectomy are left with an insensate chin and lower lip secondary to resection of the inferior alveolar nerve (IAN). The purpose of this study was to critically evaluate the authors' initial experience using processed nerve allografts (PNA) for IAN reconstruction following oncologic mandibulectomy and reconstruction with free fibula osteocutaneous flaps and to assess their patients' sensory outcomes.

Outcomes of Complex Abdominal Wall Reconstruction After Oncologic Resection: 14-Year Experience at an NCI-Designated Cancer Center.

Background: Outcomes studies for abdominal wall reconstruction (AWR) in the setting of previous oncologic extirpation are lacking. We sought to evaluate long-term outcomes of AWR using acellular dermal matrix (ADM) after extirpative resection, compare them to primary herniorrhaphy, and report the rates and predictors of postoperative complications.

Methods: We conducted a retrospective cohort study of patients who underwent AWR after oncologic resection from March 2005 to June 2019 at a tertiary cancer center.

Vascularized Condyle Reconstruction with Free Medial Femoral Trochlea and Fibular Flow-through Flaps.

The free fibula flap is the gold standard in reconstruction of oncologic mandibular defects. When the mandibular condyle is resected, reconstruction of the temporomandibular joint (TMJ) continues to pose a unique challenge to the reconstructive surgeon. Several conventional methods have been described, including costochondral grafts, bone grafts, and alloplastic prostheses.

Grandparenting as the resolution of kinship as experience.

This article argues that a population of relatively affluent retired people in a small Irish town have employed the possibilities of grandparenting to resolve many of the tensions of contemporary kinship. This includes the tension between the obligations of prescriptive relationships as against the voluntarism of friendship. This is considered against a background shift in kinship studies towards a distinction between kinship as a category and kinship as experience.

Outcomes for recurrent oral cavity squamous cell carcinoma.

Objectives: We sought to determine overall survival (OS), prognostic factors, cost, and functional outcomes after surgery for locally recurrent oral cavity squamous cell carcinoma (OCSCC).

Materials And Methods: We retrospectively reviewed 399 cases of locally recurrent OCSCC from 1997 to 2011, of which 259 patients were treated with salvage surgery. Survival and prognostic factors were evaluated using univariable and multivariable Cox regression, the Kaplan-Meier method, and the log-rank test.

A Prospective, Randomized Comparison of Clinical Outcomes with Different Processing Techniques in Autologous Fat Grafting.

Background: Autologous fat grafting is a useful tool in breast reconstruction. The authors have previously demonstrated a difference in the rate of processing adipose grafts in a randomized time and motion clinical trial. The purpose of this study was to compare clinical outcomes in commonly used grafting systems.

The Cost Utility of Virtual Surgical Planning and Computer-Assisted Design/Computer-Assisted Manufacturing in Mandible Reconstruction Using the Free Fibula Osteocutaneous Flap.

Background:  The use of virtual surgical planning and computer-assisted design and computer-assisted manufacturing (CAD/CAM) has become widespread for mandible reconstruction with the free fibula flap. However, the cost utility of this technology remains unknown.

Methods:  The authors used a decision tree model to evaluate the cost utility, from the perspective of a hospital or insurer, of mandible reconstruction using CAD/CAM relative to the conventional (non-CAD/CAM) technique for the free fibula flap.

Investigation of an international outbreak of multidrug-resistant monophasic Typhimurium associated with chocolate products, EU/EEA and United Kingdom, February to April 2022.

An extensive multi-country outbreak of multidrug-resistant monophasic Typhimurium infection in 10 countries with 150 reported cases, predominantly affecting young children, has been linked to chocolate products produced by a large multinational company. Extensive withdrawals and recalls of multiple product lines have been undertaken. With Easter approaching, widespread product distribution and the vulnerability of the affected population, early and effective real-time sharing of microbiological and epidemiological information has been of critical importance in effectively managing this serious food-borne incident.

Niche partitioning in a guild of invasive mammalian predators.

Predators compete aggressively for resources, establishing trophic hierarchies that influence ecosystem structure. Competitive interactions are particularly important in invaded ecosystems where introduced predators can suppress native prey species. We investigated whether niche partitioning exists within a guild of invasive mammalian predators and determined the consequences for native species.