Reconstruction of Acquired Defects of the External Genitalia: A 24-Patient, Single-Institution Experience.

Purpose: Patients undergoing resection of the external genitalia are often faced with significant deformity and decreased quality of life. Plastic surgeons are tasked with the challenge of reconstructing these defects to minimize morbidity and increase patients' quality of life. The authors have set out to investigate the efficacy of local fasciocutaneous and pedicled perforator flaps in external genital reconstruction.

Transscaphoid Transcapitate Perilunate Fracture-dislocation with Inferior Arc Injury and Acute Ulnar Nerve Compression: A Case Report.

Introduction: Perilunate dislocations and perilunate fracture-dislocations (PLFD) are relatively uncommon injuries, comprising <10% of wrist injuries. Perilunate injuries are often complicated by median neuropathy reported in 23-45% of cases, whereas there are very few reported cases of associated ulnar neuropathy. Combined greater arc and inferior arc injuries are also rare.

Same-Day Mastectomy and Immediate Prosthetic Breast Reconstruction: A 12-Year National Database Analysis and Early Postoperative Outcomes.

Background: Coronavirus disease of 2019 and rising health care costs have incentivized shorter hospital stays after mastectomies with immediate prosthetic reconstruction. The purpose of this study was to compare postoperative outcomes following same-day and non-same-day mastectomy with immediate prosthetic reconstruction.

Methods: A retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program database from 2007 to 2019 was performed.

Standardized Perioperative Protocol and Routine Ketorolac Use for Head and Neck Free Flap Reconstruction.

Unlabelled: No consensus exists on ideal perioperative management or anticoagulation regimen for free flap reconstruction of the head and neck. Perceived benefits from antiplatelet therapy need to be balanced against potential complications. Ketorolac, a platelet aggregation inhibitor and a parenteral analgesic, was introduced as part of a standardized perioperative protocol at our institution.

Outcomes of the Keystone Island Perforator Flap: A Systematic Review.

Background:  The Keystone Design Perforator Island Flap (KDPIF), first described by Behan in 2003, has been demonstrated as a versatile, safe, and straightforward reconstructive option for various soft tissue defects. The purpose of this systematic review is to evaluate the indications, variations, and overall complication profile of the keystone flap in reconstructive surgery.

Methods:  A literature review was conducted in accordance with PRISMA guidelines using MeSH term "surgical flaps" with the keyword "keystone flap.

Wrist Extensor Tendon "Floating Fat" Sign: A Strong Indicator to Recognize Occult Fractures in the Distal Radius: A Case Report.

Case: A 24-year-old woman presented with traumatic left wrist pain. X-rays were negative for fracture. Computed tomography (CT) showed hemorrhagic fatty effusions within the second and third wrist extensor tendon compartments (the "floating fat" sign) and a tiny cortical defect in the Lister's tubercle.

Adipose Tissue-preserved Skin Grafts for Lower Extremity Defects: Recommendations to Optimize Outcomes.

Unlabelled: Adipose tissue-preserved skin grafts (ATPSGs) are full-thickness skin grafts with inclusion of a thin layer of adipose tissue. ATPSGs are recommended for reconstruction of anatomic areas that are cosmetically sensitive and for areas that functionally benefit from additional soft tissue thickness compared to traditional skin grafts. Careful intraoperative technique and postoperative care are mandatory for ATPSG success, given the expected higher metabolic demands compared to traditional grafts.

Primary Cutaneous Peripheral T-Cell Lymphoma of the Hand: Case Report of a Rare Diagnosis and Review of the Literature.

Primary cutaneous T-cell lymphoma (CTCL) is a rare diagnosis, and the subset primary cutaneous peripheral T-cell lymphoma (pcPTL) is even more uncommon. Both CTCLs and pcPTLs typically occur in the head and neck. The authors aim to evaluate the literature for reports of presentation in the hand.

Cranial Erosion Associated With Non-Midline Dermoid Cysts in the Pediatric Population.

Background: While the risk for intracranial extension of midline nasoglabellar dermoid cysts is well-described, the risk in non-midline dermoid cysts and role of preoperative imaging in these lesions is less understood. This study aims to address this gap and provide preoperative recommendations.

Materials And Methods: A retrospective review was performed evaluating patients who underwent excision of craniofacial dermoid cysts by a single surgeon.

Cranial Suture Anchor Temporalis Resuspension: A New Technique to Reconstruct Temporal Hollowing After Craniotomy.

Introduction: Proper temporalis resuspension following craniotomy or craniectomy is necessary to prevent significant temporofacial deformity. Several methods of temporalis reconstruction have been described with varying success; currently there are no reports of suture anchor utilization.

Methods: A patient is presented displaying successful temporalis resuspension using suture anchor fixation.

Endoscopic-Assisted Radial Forearm Free Flap Harvest: A Novel Technique to Reduce Donor Site Morbidity.

Background:  The radial forearm free flap (RFFF) remains a workhorse flap but can have significant donor site morbidity. The authors developed a novel technique for endoscopic-assisted RFFF (ERFFF) harvest and hypothesized improved donor site morbidity.

Methods:  A retrospective cohort study was conducted evaluating patients who underwent ERFFF or RFFF by a single surgeon for head and neck reconstruction between November 2011 and July 2016; outcomes and complications were compared.

Applying the Keystone Design Perforator Island Flap Concept in a Variety of Anatomic Locations: A Review of 60 Consecutive Cases by a Single Surgeon.

Background: The keystone design perforator island flap has been gaining popularity for reconstruction of cutaneous defects. Published experience of this technique in North America is limited predominantly to the trunk and extremities; our study aims to demonstrate expanding applications.

Methods: Retrospective chart review was conducted on all patients who underwent keystone flap reconstruction by a single surgeon.

Improving Functional and Aesthetic Outcomes in Syndromic Patients With Webbed Neck Deformity: Utilizing a Staged Endoscopic-Assisted Approach to Improve the Posterior Hairline and Decrease Scar Burden.

Introduction: Webbed neck deformity (WND) can have significant functional and psychosocial impact on the developing child. Surgical correction can be challenging depending on the extent of the deformity, and patients often also have low posterior hairlines requiring simultaneous correction. Current surgical techniques include various methods of single-stage radical excision that often result in visible scar burden and residual deformity.

Aesthetic and functional satisfaction after monsplasty in the massive weight loss population.

Background: The mons region is often affected by massive weight loss (MWL), with descent of the pubic area and residual adiposity. Thinning and resuspension are often performed concomitantly with abdominal contouring procedures.

Objectives: Assess patient satisfaction, as well as functional and aesthetic results, after monsplasty in the MWL population.

Effects of immunological adjuvants on the mouse complement system--II. Anti-complementary effects of surface-active compounds.

The anti-complementary effects of the surface-active immunological adjuvants dimethyldioctadecylammonium bromide (DDA) and pluronic polyols L101 and L121 were investigated in the mouse system. All three adjuvants showed complement (C)-inactivating effects. DDA caused a time- and dose-dependent reduction of alternative pathway (AP) and overall C activity, which varied with the serum concentration.

Anti-complementary amines are immunological adjuvants in mice.

Complement (C) inactivation by ammonia, ethylenediamine and methylamine in mouse serum was studied in relation to a possible adjuvant effect of the substances in a cell-mediated immune response. The amines caused a dose-dependent depletion of both alternative pathway (AP) and overall C activity in vitro and showed also pronounced adjuvant effects in the delayed type hypersensitivity response of mice to SRBC. A significant correlation between momentary inhibition of AP activity and adjuvanticity was observed (r = 0.