Unique Idea: Using the KliniTray "Breast Board" for Immobilization of Digital Amputates During Replantation.

The KliniTray "breast board" used by many oncological breast surgeons is an innovative idea to succor microsurgical digital replantation. This piece of sterile equipment is readily available and provides excellent immobilization and retraction of the skin of digital amputates with minimal trauma. The fine metal pins are the key to its efficacy.

Microsurgical Salvage of Neonatal Upper Limb Ischaemia Following Intrauterine Brachial Vessel Constriction.

Neonatal limb ischaemia is a rare disease entity with devastating morbidity, including compartment syndrome, tissue loss, limb loss, reduced limb growth, irreparable neuropathies and Volkmann's syndrome.  We report a case of limb revascularisation and salvage due to intrauterine brachial artery thrombosis. Published literature is limited to case reports and case series, with various treatment modalities discussed.

Necrotising Myofasciitis of the Lower Limb Secondary to Extra-Peritoneal Rectal Perforation.

Necrotising fasciitis (NF) is a severe and life-threatening soft tissue infection that often requires extensive debridement and reconstruction. Isolated extra-peritoneal rectal perforations due to trauma, cancer, inflammatory bowel pathology or iatrogenically induced can rarely cause necrotising fasciitis beyond the perineum. Given its rarity, there is a high threshold of suspicion which often leads to late recognition and poor outcome.

pneumonia: beware of the dog!

We report the case of a 35-year-old quadriplegic male with confirmed pneumonia, manifesting with acute hypoxic respiratory failure on a background of chronic hypercarbia requiring mechanical ventilation in intensive care. are known to colonise the upper respiratory tracts of many mammals but are very rarely responsible for acute respiratory tract infections in humans.A review of the literature suggests preponderance for immunocompromised or immunoincompetent patients who have experienced environmental exposure to colonised animals.