Temporary Keratoprosthesis and Primary Corneal Graft for Ocular Trauma: A Systematic Review and Meta-Analysis.

Purpose: When severe retinal and corneal injury occur together, a temporary keratoprosthesis (TKP) is often a last resort to allow posterior segment visualization to enable vitreoretinal surgery, followed by a penetrating keratoplasty (PKP) which can restore corneal clarity in a single operation. We aimed to assess visual outcomes following combined PKP and vitreoretinal surgery with the use of a TKP for cases of ocular trauma.

Design: A systematic literature review was performed following PRISMA guidelines (PROSPERO registration number: CRD42023423518).

The Risk of Sympathetic Ophthalmia Associated with Open-Globe Injury Management Strategies: A Meta-analysis.

Topic: Sympathetic ophthalmia (SO) is a sight-threatening granulomatous panuveitis caused by a sensitizing event. Primary enucleation or primary evisceration, versus primary repair, as a risk management strategy after open-globe injury (OGI) remains controversial.

Clinical Relevance: This systematic review was conducted to report the incidence of SO after primary repair compared with that of after primary enucleation or primary evisceration.

Long-term follow-up of keystone perforator island flap in reconstructed myelomeningocele defects.

Myelomeningocele (a type of spina bifida) is the most common congenital condition that causes lifelong physical disability and requires multi-system surgical procedures. Therefore, it is paramount to reconstruct them using a stable and robust method that heals with minimal wound issues and produces maximum durability. We published a case series on reconstruction of myelomeningocele defects using keystone perforator island flap in the in 2016.

The Use of Preoperative Prophylactic Systemic Antibiotics for the Prevention of Endopthalmitis in Open Globe Injuries: A Meta-Analysis.

Topic: This study reports the effect of systemic prophylactic antibiotics (and their route) on the risk of endophthalmitis after open globe injury (OGI).

Clinical Relevance: Endophthalmitis is a major complication of OGI; it can lead to rapid sight loss in the affected eye. The administration of systemic antibiotic prophylaxis is common practice in some health care systems, although there is no consensus on their use.

Modern Solutions for Ancient Pathogens: Direct Pathogen Sequencing for Diagnosis of Lepromatous Leprosy and Cerebral Coenurosis.

Microbes unculturable in vitro remain diagnostically challenging, dependent historically on clinical findings, histology, or targeted molecular detection. We applied whole-genome sequencing directly from tissue to diagnose infections with mycobacteria (leprosy) and parasites (coenurosis). Direct pathogen DNA sequencing provides flexible solutions to diagnosis of difficult pathogens in diverse contexts.

The arterialised saphenous venous flow-through flap for managing the radial forearm free flap donor site.

Background: The radial forearm fasciocutaneous flap (RFFF) is a workhorse flap, however concerns with donor site morbidity include tendon exposure, delayed wound healing, impaired sensitivity, and poor cosmesis, have seen it fall out of favor. We present a method of using an arterialised saphenous flow through flap to reconstruct the RFFF donor site.

Method: A cohort study of six patients (five male, one female; mean age 59 [range 19-90]) who had their RFFF donor site reconstructed with an arterialised saphenous flow through flap is presented.

Decreasing extents of Archean serpentinization contributed to the rise of an oxidized atmosphere.

At present, molecular hydrogen (H) produced through Fe(II) oxidation during serpentinization of ultramafic rocks represents a small fraction of the global sink for O due to limited exposures of ultramafic rocks. In contrast, ultramafic rocks such as komatiites were much more common in the Early Earth and H production via serpentinization was a likely factor in maintaining an O-free atmosphere throughout most of the Archean. Using thermodynamic simulations, this work quantifies the global O consumption attributed to serpentinization during the past 3.

A novel technique for proximal interphalangeal joint fracture-dislocations: the second toe middle phalanx osteochondral graft.

Many different surgical techniques have been used to treat unstable dorsal proximal interphalangeal joint fracture-dislocations. The authors have used the base of the middle phalanx of the second toe base as an alternative autograft to treat this type of injury. This retrospective study assessed the clinical outcomes of this procedure in 11 patients.

Panuveitis in Sweet syndrome.

Ocular manifestations of Sweet syndrome, or acute febrile neutrophilic dermatosis, are usually limited to the anterior segment. We report the case of a patient with bilateral panuveitis and retinal vasculitis associated with Sweet syndrome. A 45-year-old Asian female with an undiagnosed febrile illness with rash presented with bilateral panuveitis with haemorrhagic occlusive retinal vasculitis.

Collagenase Management of Multicord Dupuytren's Disease under Intravenous Sedation: A Prospective Cohort Study.

Background: Surgery has been the standard of care in managing Dupuytren's disease (DD). Recently collagenase of (CCH) has provided a less invasive alternative. The purpose of the current study is to present the early outcomes of a protocol for CCH involving treatment of multi-cord disease, and large patient cohorts.

Does Delay to Theater Lead to Increased Infection Rates in Hand Trauma? A Retrospective Cohort Study.

Background: In an ideal health system, traumatic wounds would be surgically managed within 24 hours; however, resource constraints result in patients with open wounds commonly waiting much longer for surgery. Does this result in increased morbidity? This study compares infection rates over time for patients who received operative management of traumatic hand injuries.

Methods: A retrospective analysis was undertaken of patients admitted between July 2014 and June 2015 who presented within 24 hours of sustaining a hand injury and subsequently underwent operative repair.

The Benefit-Risk Assessment of Medicines: Experience of a Consortium of Medium-Sized Regulatory Authorities.

Background: In 2008, a consortium of 4 regulatory authorities, the Australian Therapeutic Goods Administration (TGA), Health Canada, Swissmedic, and Singapore Health Sciences Authority (HSA) approached the Centre for Innovation in Regulatory Science (CIRS) to support the development of a benefit-risk framework and template that could be used by all 4 authorities and that would enable joint and shared reviews to maximize resources. CIRS facilitated this collaboration, the Consortium on Benefit-Risk Assessment (COBRA), between 2008 and 2013.

Methods: COBRA developed a benefit-risk assessment template based on the EMA reflection paper of 2008, which was constructed and then evaluated in 3 phases: a feasibility study, a retrospective pilot study, and a prospective study.

Distraction ligamentotaxis for complex proximal interphalangeal joint fracture dislocations: a clinical study and the modified pins rubber band traction system revisited.

Background: The purpose of this study is to present our experience with the modified pins and rubber band traction system, discuss problems encountered, and make recommendations to optimize outcomes.

Methods: Data was collected prospectively from November 2013 to March 2017 at a tertiary referral hospital in Melbourne, Australia. Patients with closed complex proximal interphalangeal joint fracture dislocations that were considered unsuitable for other surgical options were included in the study.

Hibernoma: a rare benign soft tissue tumour resembling liposarcoma.

Hibernoma is a rare benign soft tissue tumour that can mimic a liposarcoma on radiographic imaging. Our case series review illustrates the clinical presentation and radiographic appearances of four patients with histologically confirmed hibernoma. Hibernoma is usually hypointense relative to subcutaneous fat on weighted MRI and demonstrates partial fat suppression on fat-saturated sequences.

End-to-End versus End-to-Side Microvascular Anastomosis: A Meta-analysis of Free Flap Outcomes.

 Optimal outcomes in microsurgery have been attributed to a range of factors, with performing of end-to-end (ETE) versus end-to-side (ETS) influencing anastomotic complications and flap outcomes.  A systematic review of the literature and meta-analysis was undertaken to evaluate the relative risks of anastomotic complications with ETE versus ETS approaches, for arterial and venous anastomoses looking at risk ratios (RRs) for thrombosis and overall flap failure.  RRs of thrombosis and flap failure in ETS versus ETE venous anastomosis groups were 1.

3D Printed Models of Cleft Palate Pathology for Surgical Education.

Unlabelled: To explore the potential viability and limitations of 3D printed models of children with cleft palate deformity.

Background: The advantages of 3D printed replicas of normal anatomical specimens have previously been described. The creation of 3D prints displaying patient-specific anatomical pathology for surgical planning and interventions is an emerging field.

An Application of Keystone Perforator Island Flap for Closure of Lumbosacral Myelomeningocele Defects.

Myelomeningocele, also known as spina bifida, is the commonest form of neural tube defect in which both meninges and spinal cord herniate through a large vertebral defect. It may be located at any spinal level; however; lumbosacral involvement is most common. After birth, the closure of spinal lesion is preferably undertaken in the first 48 hours to minimize the risk of injury and central nervous system infection.

A practical approach to communicating benefit-risk decisions of medicines to stakeholders.

Purpose: The importance of a framework for a systematic structured assessment of the benefits and risks has been established, but in addition, it is necessary that the benefit-risk decisions and the processes to derive those decisions are documented and communicated to various stakeholders for accountability. Hence there is now a need to find appropriate tools to enhance communication between regulators and other stakeholders, in a manner that would uphold transparency, consistency and standards.

Methods: A retrospective, non-comparative study was conducted to determine the applicability and practicality of a summary template in documenting benefit-risk assessment and communicating benefit-risk balance and conclusions for reviewers to other stakeholders.