Publications by authors named "James Kk Chan"

Background: Free tissue transfer (FTT) for reconstruction of diabetic foot disease (DFD) is an emerging field to preserve the lower limb within this patient group. The design of future quantitative research and clinical services in this area must consider the needs, expectations and concerns of patients. This qualitative study explores patient experiences of FTT for reconstruction of DFD.

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Article Synopsis
  • * Patients seek treatment options for early-stage disease, but existing methods like steroid injections lack strong evidence or scientific support.
  • * New research targeting tumor necrosis factor (TNF) has led to promising results, with a clinical trial showing that a specific dosage of adalimumab reduces nodule size and hardness, providing solid evidence for future patient treatments.
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Background: Open fractures of the major long bones are complex limb-threatening injuries that are predisposed to deep infection. Treatment includes antibiotics and surgery to debride the wound, stabilise the fracture and reconstruct any soft tissue defect to enable infection-free bone repair. There is a need to assess the effect of timing and duration of antibiotic administration and timing and staging of surgical interventions to optimise outcomes.

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Background: Functional restoration of upper limb paralysis represents a major reconstructive challenge. Free functional muscle transfer (FFMT) enables reanimation in patients with a lack of local donor tissues or delayed presentation. This systematic review summarises the evidence for FFMT in the reconstruction of upper limb paralysis.

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Article Synopsis
  • * A case study highlights a successful use of a free dorsal toe flap from the opposite toe to repair a dorsal defect on the hallux, marking it as a unique approach in reconstructive surgery.
  • * The surgery involved using the lateral dorsal digital artery for the flap, which provided an aesthetic and functional result, allowing the patient to return to normal activities within three weeks without complications.
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Early vascularized soft-tissue closure has long been recognized to be essential in achieving eventual infection-free union. The question of whether muscle or fasciocutaneous tissue is superior in terms of promoting fracture healing remains unresolved. In this article, the authors review the experimental and clinical evidence for the different tissue types and advocate that the biological role of flaps should be included as a key consideration during flap selection.

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Background: NSAIDs are commonly used analgesic agents in the orthopaedic trauma setting. Evidence-based guidelines recommend that patients with one or more risk factors for NSAID-associated gastrointestinal (GI) ulcer complications should be prescribed gastroprotective agents to minimise the risk of serious ulcer complications, including gastrointestinal haemorrhage. The purpose of the present audit was to evaluate and improve the adherence to these guidelines in new-NSAID users in a trauma unit at a district general hospital.

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