Diagnostical accuracy of hyperspectral imaging after free flap surgery.

Microsurgical free-tissue transfer has been a safe option for tissue reconstruction. This study aimed to analyze the diagnostic accuracy of hyperspectral imaging (HSI) after free-tissue transfer surgery. From January 2017 to October 2019, 42 consecutive free-flap surgeries were performed, and their outcomes were analyzed via HSI.

A Novel Hair Restoration Technology Counteracts Androgenic Hair Loss and Promotes Hair Growth in A Blinded Clinical Trial.

Androgenic alopecia (AGA) is a genetically predetermined condition that occurs as a result of stepwise miniaturization of the dermal papilla. During this process, the hair follicle suffers from increasing malnutrition and eventually dies, causing progressive hair loss. We recently highlighted that HIF-1α modulation may counteract hair loss.

Tolerable degree of muscle sacrifice when harvesting a vastus lateralis or myocutaneous anterolateral thigh flap.

The myocutaneous anterolateral thigh (ALT) and vastus lateralis (VL) flaps include a large muscle mass and a sufficient vascular pedicle, and they have been used for decades to reconstruct traumatic and acquired defects of the head and neck and extremities. In spite of these benefits, musculoskeletal dysfunction was reported in nearly 1 out of 20 patients at follow-up. It is unclear whether the recently proposed muscle-sparing flap-raising approach could preserve VL muscle function and whether patients at increased risk could benefit from such an approach.

Infections in Burn Patients: A Retrospective View over Seven Years.

Burn patients represent a challenging cohort because the injuries entail a vulnerability to colonisation by microorganisms. The ensuing infections can lead to serious complications and, in many cases, to the death of the burn patient. Surgical intervention and wound dressings, as well as antibiotic treatment, are crucial for optimising the treatment of the patient.

Smoking and microvascular free flap perfusion in head and neck reconstruction: radial free forearm flaps and anterolateral thigh flaps.

Head and neck reconstruction with microvascular free flaps is frequently performed in smokers. Smoking causes various alterations in the cardiovascular system. The aim of this study was to investigate the effects of smoking on flap perfusion as a critical factor for flap survival.

The Use of Intact Fish Skin as a Novel Treatment Method for Deep Dermal Burns Following Enzymatic Debridement: A Retrospective Case-Control Study.

Background: The optimal therapy for deep burn wounds is based on the early debridement of necrotic tissue followed by wound coverage to avoid a systemic inflammatory response and optimize scar-free healing. The outcomes are affected by available resources and underlying patient factors, which represent challenges in burn care and suboptimal outcomes. In this study, we aimed to determine optimal burn-wound management using enzymatic debridement (NexoBrid™, MediWound Germany GmbH, Rüsselsheim, Germany) and intact fish skin (Kerecis Omega3 Wound, Isafjordur, Iceland).

Botulinum Toxins for Esthetic Facial Injections: A Scientific Review to Support Evidence-Based Best Practice.

Botulinum toxins (BoNT) are complex biological products. Each licensed BoNT type A (BoNTA) has its own individual characteristics resulting into different attributes, some of them being of clinical relevance. Besides profound anatomical knowledge and understanding of esthetic principles, the responsible injecting physician should be aware of those pharmaceutical and clinical properties.

Hepatic Functional Pathophysiology and Morphological Damage Following Severe Burns: A Systematic Review and Meta-analysis.

Severe burns are devastating injuries affecting multiple organ systems. Little is known about the influence on the hepatic system and its physiology. This systematic review aimed to assess the current state of research on morphologic liver damage following severe burns.

Stevens-Johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysis.

Objective: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare and severe skin and mucosal reactions that are associated with high mortality. Despite the severity, an evidence-based treatment protocol for SJS/TEN is still lacking.

Method: In this systematic review and meta-analysis, the PubMed database was searched using the following terms: [Stevens-Johnson syndrome] OR [toxic epidermal necrolysis] AND [therapy] OR [treatment] over a 20-year period (1999-2019) in the German and English language.

Automated PD-L1 Scoring Using Artificial Intelligence in Head and Neck Squamous Cell Carcinoma.

Immune checkpoint inhibitors (ICI) represent a new therapeutic approach in recurrent and metastatic head and neck squamous cell carcinoma (HNSCC). The patient selection for the PD-1/PD-L1 inhibitor therapy is based on the degree of PD-L1 expression in immunohistochemistry reflected by manually determined PD-L1 scores. However, manual scoring shows variability between different investigators and is influenced by cognitive and visual traps and could therefore negatively influence treatment decisions.

Stevens-Johnson syndrome and toxic epidermal necrolysis: a 10-year experience in a burns unit.

Objective: Stevens-Johnson syndrome (SJS) and its more severe counterpart, toxic epidermal necrolysis (TEN), are skin hypersensitivity reactions defined by epidermal blistering and necrosis. The exact pathophysiology of SJS/TEN is yet to be deciphered, but a number of risk factors have been identified including adverse drug reactions. The diagnosis of SJS/TEN is made on a clinical basis, and treatment consists of supportive care and occasionally immunosuppressants, such as cyclosporin, high-dose intravenous immunoglobulins and/or corticosteroids.

Fungal Infections in Burn Patients.

Fungal burn wound infections are among the most devastating complications in patients who are severely burned. Increasing incidence of burn wound infections caused by fungi led to new challenges in diagnostic and therapeutic approaches. The wide use of broad-spectrum antibiotic agents, an increased prevalence of molds and non- spp.

Ultrasound Analysis of Lateral Ankle Ligaments in Functional Ankle Instability.

The anterior talofibular ligament and the calcaneofibular ligament were sonographically investigated in 16 patients with functional ankle instability (FAI) and 16 controls under neutral and standardized stress conditions of 15 kp with a TELOS device. Clinical investigation revealed a significantly higher rate of a positive anterior drawer and talar tilt (p <0.001, respectively), significantly increased supination (p = 0.

[Hyperspectral imaging for postoperative flap monitoring of pedicled flaps].

Background: Since pedicle flaps were first described by the Indian physician Sushruta Samhita in the 6th century B. C., they have become an integral part of reconstructive surgery.

Evaluation of the Online-Presence of ABA-Verified Burn Centers.

Currently, patients seek healthcare information online. An up-to-date online presence is vital for success among the competition amid hospitals. Hospital websites have become an important medium to communicate with patients, provide information about certain diseases/conditions, and advertise healthcare services.

Structural topography of the interosseous membrane of the human forearm.

The aim of this study was to evaluate the morphology of the six different parts of the interosseous membrane (IOM) in 11 human cadaver forearms, including the distal oblique bundle (DOB), the distal accessory band (DAB), the central band (CB), the proximal accessory band (PAB), the dorsal oblique accessory cord (DOAC), and the proximal oblique cord (POC). Hematoxylin-eosin and Elastica van Gieson stained slices were used to investigate the tissue morphology. The DOB and DOAC were absent in one IOM and the POB in two IOMs, respectively.

Registration of digital dental models and cone-beam computed tomography images using 3-dimensional planning software: Comparison of the accuracy according to scanning methods and software.

Introduction: The registration of cone-beam computed tomography (CBCT) images and digital dental models is required for the design and manufacturing of dental devices such as implant guides and surgical wafers. This study aims to register intraoral scan (IS) models and cast scan (CS) models onto CBCT images using 3-dimensional (3D) planning software and evaluate the registration accuracy according to scanning methods and 3D planning software.

Methods: The CBCT image of an artificial skull model with reference markers was taken.

Molecular Mechanisms of Hair Growth and Regeneration: Current Understanding and Novel Paradigms.

Hair is a defining feature of mammals and has critical functions, including protection, production of sebum, apocrine sweat and pheromones, social and sexual interactions, thermoregulation, and provision of stem cells for skin homeostasis, regeneration, and repair. The hair follicle (HF) is considered a "mini-organ," consisting of intricate and well-organized structures which originate from HF stem and progenitor cells. Dermal papilla cells are the main components of the mesenchymal compartments in the hair bulb and are instrumental in generating signals to regulate the behavior of neighboring epithelial cells during the hair cycle.

Burns: modified metabolism and the nuances of nutrition therapy.

Objective: To review the effects of burn injury on nutritional requirements and how this can best be supported in a healthcare setting.

Method: A literature search for articles discussing nutrition and/or metabolism following burn injury was carried out. PubMed, Embase and Web of Science databases were searched using the key search terms 'nutrition' OR 'metabolism' AND 'burn injury' OR 'burns'.

[Elevation of Myostatin as a Potential Marker for Compartment Syndrome in Electrical Injuries].

Introduction: Electrical accidents and particularly subsequent compartment syndromes are challenging injuries for clinical treatment. Creatinine kinase (CK) and myoglobin are known lab parameters to detect a compartment syndrome.

Methods: We followed up patients with electrical injuries between the years 2006 and 2016 at our burn unit.

The Influence of Obesity on Treatment and Outcome of Severely Burned Patients.

Obesity and the related medical, social, and economic impacts are relevant multifactorial and chronic conditions that also have a meaningful impact on outcomes following a severe injury, including burns. In addition to burn-specific difficulties, such as adequate hypermetabolic response, fluid resuscitation, and early wound coverage, obese patients also present with common comorbidities, such as arterial hypertension, diabetes mellitus, or nonalcoholic fatty liver disease. In addition, the pathophysiologic response to severe burns can be enhanced.

Optimising management of self-inflicted burns: a retrospective review.

Objective: Self-inflicted burns typically result in extensive injuries requiring intensive care and attention in a specialised burn unit. Burn units should be familiar with the optimal management of self-inflicted burns, including the psychological and psychiatric treatment. This paper describes the experiences of managing these challenging injuries in a German burn centre.

Five Years Experience With Meek Grafting in the Management of Extensive Burns in an Adult Burn Center.

Background: In extensive burn injuries with lack of donor sites for skin grafting, the Meek technique of skin expansion can be an efficient and effective method in covering extensive wounds. The aim of this retrospective study was to present our experience with the Meek technique of grafting.

Methods: We performed a retrospective analysis of patients from our burn center who underwent Meek grafting between 2012 and 2016.

Wnt Pathway in Bone Repair and Regeneration - What Do We Know So Far.

Wnt signaling plays a central regulatory role across a remarkably diverse range of functions during embryonic development, including those involved in the formation of bone and cartilage. Wnt signaling continues to play a critical role in adult osteogenic differentiation of mesenchymal stem cells. Disruptions in this highly-conserved and complex system leads to various pathological conditions, including impaired bone healing, autoimmune diseases and malignant degeneration.

Single-Cell Gene Expression Analysis and Evaluation of the Therapeutic Function of Murine Adipose-Derived Stromal Cells (ASCs) from the Subcutaneous and Visceral Compartment.

Introduction: Adipose-derived stromal cells (ASCs) are a promising resource for wound healing and tissue regeneration because of their multipotent properties and cytokine secretion. ASCs are typically isolated from the subcutaneous fat compartment, but can also be obtained from visceral adipose tissue. The data on their equivalence diverges.