The Effect of Regional Anaesthesia on Free Flap Survival in Lower Extremity Reconstructions.

Background: The effect of different modalities of anaesthesia in microvascular free flap surgery has been a topic of ongoing debate. Comparative data to study the effect of general anaesthesia and regional anaesthesia in the form of peripheral nerve blocks (PNBs) on lower extremity free flap survival is lacking to date. This study aims to elucidate the effect of regional anaesthesia on flap survival in lower extremity free flap reconstructions.

Adjunctive hyperbaric oxygen therapy in the management of severe lower limb soft tissue injuries: a systematic review.

Purpose: Traumatic crush injuries of the lower limb often accompany severe complications. The incorporation of hyperbaric oxygen therapy to standard trauma care may have the potential to diminish injury-related complications and improve outcome in such cases. This systematic review aims to evaluate the effectiveness of hyperbaric oxygen therapy in the management of severe lower limb soft tissue injuries.

Access to Burn Care in Low- and Middle-Income Countries: An Assessment of Timeliness, Surgical Capacity, and Affordability in a Regional Referral Hospital in Tanzania.

This study investigates patients' access to surgical care for burns in a low- and middle-income setting by studying timeliness, surgical capacity, and affordability. A survey was conducted in a regional referral hospital in Manyara, Tanzania. In total, 67 patients were included.

Combined massive allograft and intramedullary vascularized fibula transfer: the Capanna technique for treatment of congenital pseudarthrosis of the tibia.

Background and purpose - Congenital pseudarthrosis of the tibia (CPT) is caused by local periosteal disease that can lead to bowing, fracturing, and pseudarthrosis. Current most successful treatment methods are segmental bone transport and vascularized and non-vascularized bone grafting. These methods are commonly hampered by discomfort, reoperations, and long-term complications.

PCR Characterization of Microbiota on Contracted and Non-Contracted Breast Capsules.

Background: The aetiology of capsular contracture around breast implants remains unclear. The leading theory is that a subclinical infection around the implant plays a role in the development of capsular contractions. Several studies found associations between the presence of bacteria and the occurrence of capsular contraction.

The Influence of Radiotherapy on the Mechanical Properties of Silicone Breast Implants.

Background: Silicone breast implants have been used for decades for cosmetic breast augmentation or reconstruction after mastectomy. In selected cases, postmastectomy adjuvant radiotherapy is given with the breast implants in situ. Previous clinical studies have shown that radiotherapy may lead to complications such as capsular contracture and infection and that removal of the implant may be required.

Intraoperative evaluation of perfusion in free flap surgery: A systematic review and meta-analysis.

Background: Free flap survival relies on adequate tissue perfusion. We aim to give an overview of the available literature of all objective methods to intraoperatively assess free flap tissue perfusion, and the effects on (partial) flap loss.

Methods: A systematic review and meta-analysis according to the PRISMA guidelines was performed (PubMed, Cochrane Library, Embase) regarding English language articles.

Breast-conserving therapy for breast cancer: Cosmetic results and options for delayed reconstruction.

Objectives: Optimisation of the cosmetic outcome after breast-conserving therapy (BCT) is important. We aimed to determine the cosmetic outcome following BCT and factors influencing this cosmesis and identify the most favourable options for delayed breast reconstruction.

Materials And Methods: Four reconstructive surgeons evaluated the cosmetic outcome of 109 patients after BCT.

The Aesthetic Items Scale: A Tool for the Evaluation of Aesthetic Outcome after Breast Reconstruction.

Background: Valid tools to assess aesthetic outcomes after breast reconstructive surgery are scarce. Previously a professional aesthetic assessment scale was introduced, the Aesthetic Items Scale (AIS). We aim to determine if this method is a valid and reliable tool to assess aesthetic outcome after breast reconstructive surgery.

Two-stage implant-based breast reconstruction compared with immediate one-stage implant-based breast reconstruction augmented with an acellular dermal matrix: an open-label, phase 4, multicentre, randomised, controlled trial.

Background: The evidence justifying the use of acellular dermal matrices (ADMs) in implant-based breast reconstruction (IBBR) is limited. We did a prospective randomised trial to compare the safety of IBBR with an ADM immediately after mastectomy with that of two-stage IBBR.

Methods: We did an open-label, randomised, controlled trial in eight hospitals in the Netherlands.

Does Increased Experience with Tissue Oximetry Monitoring in Microsurgical Breast Reconstruction Lead to Decreased Flap Loss? The Learning Effect.

Background: Early studies have shown that near-infrared monitoring with tissue oximetry shows promise in providing earlier detection of free flap vascular compromise. However, large-scale clinical evaluation of this technology on flap outcome has not previously been established. This study examines the effect of tissue oximetry on flap reexploration rates and salvage over a 10-year period.

Pelvic reconstruction with a free vascularized distal femur for revision total hip arthroplasty.

The reconstruction of massive structural acetabular defects after revision arthroplasty presents a unique challenge to the orthopedic surgeon. This report describes such a salvage procedure where an autologous vascularized distal femur was used to reconstruct acetabular bone stock with subsequent implantation of a total femoral endoprosthetic replacement that uses a constrained cup and a hinged total knee system. At 2 years of follow-up, there is a good functional result with full incorporation of the graft.

En bloc resection of 3 vertebra in a pancoast patient: long-term stability using a free vascularized fibular graft.

Vertebral involvement is no longer a contraindication for resection in superior sulcus tumors. We describe the reconstruction of thoracic vertebras 2 to 4 using a free vascularized fibular graft combined with dorsal and ventral stabilization using rods, screws, and hooks after resection of a superior sulcus tumor that invaded the thoracic spine. No complications have occurred after 7 years of follow-up, and the reconstruction has been durable and stable.

Results of latissimus dorsi transfer in obstetrical brachial plexus injury.

This study reports on 9 patients with obstetrical brachial plexus injury who underwent a latissimus dorsi (LD) transfer to reconstruct external rotation of the upper extremity. Transfer of the LD to the rotator cuff is widely used for restoring shoulder abduction and external rotation in patients with obstetrical brachial plexus injury. Patients were classified according to type of paralysis, age of surgery, and shoulder function.

Pronating radius osteotomy for supination deformity in children with obstetric brachial plexus palsy.

Purpose: In obstetric brachial plexus lesions, muscle imbalance caused by active supinator muscles and paralyzed pronator muscles can result in a supination position of the wrist, which, apart from cosmesis, may interfere with function.

Methods: In this retrospective study, we describe the results of a pronating radius osteotomy for supination deformity of the hand in children with an obstetric brachial plexus lesion.

Results: After a mean follow-up of 23 months, all 8 patients (mean age, 9.

Lobulitis is a frequent finding in prophylactically removed breast tissue from women at hereditary high risk of breast cancer.

The aim of this study was to investigate closely the nature of premalignant lesions that occur in prophylactically removed breast tissue from patients at hereditary high risk of breast cancer. Breast tissues obtained from 41 patients who underwent prophylactic mastectomy (pM) because of a hereditary high risk of breast cancer and control tissues from 82 age-matched healthy controls who underwent breast reduction surgery were screened for premalignant lesions. Premalignant and malignant lesions were more frequent (p = 0.

Treatment of internal rotation contracture of the shoulder in obstetric brachial plexus lesions by subscapular tendon lengthening and open reduction: early results and complications.

In this prospective study of 19 consecutive children, the operative treatment of internal rotation contracture of the shoulder in obstetric brachial plexus lesions by subscapular tendon lengthening and open reduction of the humeral head is evaluated. The average age of the children was 3.7 years and average follow-up was 20 months.