Preoperative perforator mapping of anterolateral thigh perforators via Projected Augmented Reality and Dynamic Infrared Thermography.

Background: The anterolateral thigh (ALT) flap is a reliable and versatile flap with the ideal characteristics for soft-tissue reconstruction. However, as it is known for its highly variable anatomy, it requires preoperative perforator localization to optimize flap design and dissection of the flap. Dynamic Infrared Thermography (DIRT) is a non-invasive and quick imaging method that provides real-time information.

Sleep quality after autologous breast reconstruction.

Background: Sleep is a fundamental aspect of human health and well-being, but is often interrupted in a hospital setting. Especially after surgery, poor sleep quality can negatively affect postoperative recovery and quality of life. Therefore, the aim of this study was to gain insights into the quality of sleep in patients after autologous breast reconstruction and evaluate factors associated with the quality of sleep.

Added Value of Histological Evaluation of Muscle Biopsies in Porcine Vascularized Composite Allografts.

: Machine perfusion (MP) offers extended preservation of vascularized complex allografts (VCA), but the diagnostic value of histology using hematoxylin and eosin (H&E) in detecting ischemia-reperfusion injury (IRI) in muscle cells remains unclear. This study aims to document the application of the Histology Injury Severity Score (HISS) and to assess whether additional staining for nicotinamide adenine dinucleotide (NADH) and membrane attack complex (MAC) improves IRI detection in a porcine limb replantation model. : The forelimbs of 16 Dutch Landrace pigs were amputated and preserved for 24 h using hypothermic MP ( = 8) with Histidine-Tryptophan-Ketoglutarate (HTK) or for 4 h with SCS ( = 8) before heterotopic replantation and 7 days of follow-up.

Inter-rater reliability among healthcare professionals in assessing postoperative wound photos for the presence or absence of surgical wound dehiscence: A Pretest - Posttest study.

Background: Surgical wound dehiscence (SWD) has various definitions, which complicates accurate and uniform diagnosis. To address this, the World Union Wound Healing Societies (WUWHS) presented a consensus based definition and classification for SWD (2018).

Aim: This quasi-experimental pretest-posttest study investigates the inter-rater reliability among healthcare professionals (HCP) and wound care professionals (WCP) when assessing wound photos on the presence or absence of SWD before and after training on the WUWHS-definition.

Automatic analysis of the scapholunate distance using 4DCT imaging: normal values in the healthy wrist.

Aim: Early diagnosis of scapholunate ligament (SLL) injuries is crucial to prevent progression to debilitating osteoarthritis. Four-Dimensional Computed Tomography (4DCT) is a promising dynamic imaging modality for assessing such injuries. Capitalizing on the known correlation between SLL injuries and an increased scapholunate distance (SLD), this study aims to develop a fully automatic approach to evaluate the SLD continuously during wrist motion and to apply it to a dataset of healthy wrists to establish reference values.

Projected augmented reality in DIEP flap breast reconstruction: Projecting perforators on the skin using dynamic infrared thermography.

Background: Dynamic infrared thermography (DIRT) is a quick and non-invasive technique for perforator mapping in free flaps that provides real-time information. After a cold challenge, areas best supplied with blood become visible hotspots on color-coded maps, indicating perforators. This study presents a proof of principle for a new and innovative feature of DIRT, where projected augmented reality is used to directly display thermal images on the patient's abdomen prior to the deep inferior epigastric artery perforator (DIEP) flap breast reconstruction.

The N-LVA Study: effectiveness and cost-effectiveness of lymphaticovenous anastomosis (LVA) for patients with cancer who suffer from chronic peripheral lymphoedema - study protocol of a multicentre, randomised sham-controlled trial.

Introduction: Cancer-related lymphoedema is one of the most debilitating side-effects of cancer treatment with an overall incidence of 15.5%. Patients may suffer from a variety of symptoms, possibly resulting in a diminished health-related quality of life (HRQoL).

24-Hour Ex Vivo Hypothermic Acellular Perfusion of Porcine Forelimb: A 7-Day Follow-up Study.

Background: One of the limiting factors for vascularized composite allograft storage is the short viable ischemic time (4 to 6 hours). Hypothermic machine perfusion enables near-physiologic preservation, avoiding the deleterious effects of hypoxia and static cooling. This study aims to compare muscle injury after 24-hour acellular perfusion with static cold storage (SCS) in a porcine limb replantation model, examining outcomes for up to 7 days after reperfusion.

Changes in patient-reported satisfaction and quality-of-life 6 months after rhinoplasty.

Background: Rhinoplasty is a challenging and demanding procedure in plastic surgery. Surgical success, patient satisfaction, and improved quality-of-life are important outcomes.

Objectives: This study aimed to evaluate patient-reported satisfaction with appearance, treatment, and decision outcomes as well as quality-of-life after rhinoplasty using validated questionnaires.

The 6 month interim analysis of a randomized controlled trial assessing the quality of life in patients with breast cancer related lymphedema undergoing lymphaticovenous anastomosis vs. conservative therapy.

Breast cancer related lymphedema (BCRL) is a chronic condition with a detrimental impact on psychosocial and physical well-being. Lymphaticovenous anastomosis has shown promising results in alleviating physical symptoms and increasing quality of life in patients with BCRL. The aim of the study is to evaluate the effect on health related quality of life (HrQol) after LVA surgery versus conservative treatment in patients with BCRL.

Microneedling in Abdominal Scarring after DIEP-flap Breast Reconstruction to Improve Scar Quality: A Randomized Controlled Split Scar Trial.

Background: Deep inferior epigastric perforator (DIEP) flap breast reconstruction leads to large scars in the breast and abdominal region. Common symptoms related to abdominal scarring include changes in color, stiffness, thickness, and irregularity of the skin. The aim of this study was to examine whether microneedling improves the abdominal scar quality after DIEP-flap breast reconstruction.

Automatic segmentation and labelling of wrist bones in four-dimensional computed tomography datasets via deep learning.

This study developed a deep learning model for fully automatic segmentation and labelling of wrist bones from four-dimensional computed tomography (4DCT) scans. This is a crucial step towards implementing 4DCT for diagnosing wrist ligament lesions, reducing time-consuming analysis of extensive data.

Factors Associated with Treatment Outcome Satisfaction Six Months after Upper Blepharoplasty: A Large Cohort Study.

Background: Upper blepharoplasty is the most popular facial cosmetic surgery. Although there are a variety of reasons to undergo this procedure, all patients expect an optimal cosmetic result. However, little is known about the factors that influence satisfaction with treatment outcome.

Patient-Reported Satisfaction and Health-Related Quality of Life in Patients with Breast Augmentation: A Follow-Up of 6 Months.

Background: To evaluate the success of a breast augmentation, it is essential to measure outcomes from the patient perspective, because a successful aesthetic result is, in particular, determined by the patient. This study aimed to evaluate patient-reported satisfaction with their breasts, and psychosocial, physical, and sexual well-being in patients undergoing breast augmentation using validated questionnaires.

Methods: This is a multicenter cohort study based on ongoing routinely collected data.

Hyperbaric oxygen therapy for local late radiation toxicity in breast cancer patients: A systematic review.

Purpose: This systematic review aims to provide an overview of the literature on the effect of hyperbaric oxygen therapy (HBOT) on symptoms of local late radiation toxicity (LRT) in patients treated for breast cancer.

Methods: A systematic search was performed in September 2021. All studies with a sample size of ≥10 patients reporting the effect of HBOT for symptoms of LRT after radiotherapy of the breast and/or chest wall were included.

Superior preservation of capillaries, myofibrils and mitochondria after long-term extracorporeal perfusion of free muscle flaps - A descriptive electron microscopy study.

Background: Extracorporeal perfusion (ECP) is a promising technique for prolonged tissue preservation, but might have side effects. For instance, increased radical oxygen species or capillary endothelial damage.

Objective: To assess ultra-morphological muscle damage during 36-hour ECP of porcine musculocutaneous flaps, hypothesizing that it would delay the onset of damage compared to static cold storage (SCS).

Alternative imaging technologies for perforator mapping in free flap breast reconstructive surgery - A comprehensive overview of the current literature.

Background: The use of perforator mapping has become routine for many microsurgeons in the planning and performing of free flaps in breast reconstructions. Within this field, the number of available technologies and their quality has rapidly evolved over time. This study presents an up-to-date review on the spectrum of alternative perforator mapping modalities and the efficiency and utilization in the practice of free flap breast reconstructive surgery.

Closed-Incision Negative-Pressure Therapy Reduces Donor-Site Surgical Wound Dehiscence in DIEP Flap Breast Reconstructions: A Randomized Clinical Trial.

Background: In breast reconstruction operations, surgical wound dehiscence is a serious complication that generates a significant burden on patients and health care systems. There are indications that postoperative treatment with closed-incision negative-pressure therapy has been associated with reduced wound dehiscence rates. This randomized clinical trial examines the effect of closed-incision negative-pressure application on abdominal donor-site surgical wound dehiscence in low- and high-risk patients undergoing breast reconstruction with a deep inferior epigastric perforator flap.

Past, present and future in plastic flap surgery: From surgeon to bioengineer driven progress. A personal view.

By tracking the evolution of flaps in plastic surgery most progress in the beginning has to be credited first by medical professionals during the last centuries by introducing new personal ideas or procedural techniques and second by technical innovations based on bioscientific engineering coupled with public needs and changes in social life as part of the human society. From simply primary wound closure in the very early stages to procedures with donor site morbidity without complete function restoring to most probably sophisticated complete onsite reconstruction without almost any surgeon's help by functional 3D-tissue bioprinting in a large scale bioreactor in the future. By following these major developments from the past to present we will try to get a glimpse of what's maybe next in plastic flap surgery over the following decenniums.

DIEP flap breast reconstruction combined with vascularized lymph node transfer for patients with breast cancer-related lymphedema.

Introduction: Lymphedema is a condition which heavily impacts patients QoL. For patients who desire autologous breast reconstruction, lymph nodes can be included in the Deep Inferior Epigastric Artery (DIEP) flap combining vascularized lymph node transfer and autologous breast reconstruction.

Material And Methods: Patients who received autologous breast reconstruction with a DIEP flap in combination with vascularized lymph nodes were included in this study.

Ex Vivo Thrombolysis to Salvage Free Flaps Using Machine Perfusion: A Pilot Study in a Porcine Model.

Background:  Mechanical evacuation of capillary thrombi in free flaps is difficult, and often requires thrombolytic therapy. Utilizing machine perfusion systems, the possibility rises to salvage free flaps ex vivo by administering high doses of thrombolytic agents. The primary aim of this pilot study in a porcine model is to investigate the feasibility of ex vivo thrombolysis using an extracorporeal perfusion machine.