Strategies to prevent suppurative chondritis following auricular burns: a systematic review.

Objective: Suppurative chondritis is a potentially devastating complication of burns to the ear. The infection and inflammation can liquify cartilage, leading to significant aesthetic deformities which are difficult to treat. This article reviews published measures for preventing post-burn chondritis.

Staged upper and lower lip reanimation following facial palsy: Peer-reviewed, patient-rated and objective outcomes.

Background: One approach to reanimating both upper and lower lips following facial palsy is through staged surgery: cross-face nerve grafting at stage I, free gracilis muscle transfer to levators at stage II and pedicled anterior belly of digastric muscle transfer (ABDMT) to depressors at stage III. The results of this approach were hitherto unquantified.

Methods: This study retrospectively assessed peer-reviewed, patient-rated and objective outcomes following staged reanimation in adults between 2010 and 2020.

Lower lip depressor reanimation using anterior belly of digastric muscle transfer improves psychological wellbeing in facial palsy patients.

The authors previously published positive peer-reviewed (21 raters using the Terzis scale) and photogrammetric (Emotrics) outcomes in patients who had undergone two-stage lower lip reanimations up to 2018. Other series have published surgeon and peer-rated results, but we know of only two (n=12) that have assessed patients' views using patient satisfaction surveys. This paper presents patient-rated outcomes (PROMS) in an 11-year series of both single and two-stage anterior belly of digastric muscle (ABDM) lower lip reanimations.

Epidemiology And Outcomes Of Radiator Burns At A High Throughput Burns Centre.

Indoor radiator burns can cause significant morbidity and mortality, especially in vulnerable patients. However, the epidemiology and clinical outcomes are poorly characterized. A retrospective study of all radiator burns referred to a tertiary regional burns centre between 2013-2019 was conducted.

Lower Lip Reanimation: Experience Using the Anterior Belly of Digastric Muscle in 2-stage Procedure.

Unlabelled: Lower lip depression was historically regarded a neglected area of facial paralysis, but, with refinement of techniques, has gained increasing attention. We present the first detailed description and evaluation of a 2-stage technique, using first cross facial nerve graft and then the anterior belly of digastric muscle (ABDM), innervated by the cross facial nerve graft, to restore dynamic and spontaneous lower lip depression.

Methods: Retrospective analysis of 2-stage lower lip reanimations between 2010 and 2018 was performed.

A simple computerised technique for estimating resting lip position and symmetry.

The angle between the commisure-commisure and the endocantus-commisure lines (CCE angle) is approximately equal to the contralateral angle. A computerised technique for assessing the gross symmetry and position of the lips by comparing left- and right-sided CCE angles was developed. This study established (1) the repeatability of computerized CCE angle measurement; (2) mean CCE angle magnitudes in healthy controls and suggest a "normal" reference range.

A systematic review of outcomes following hand reconstruction using flaps from the superficial palmar branch of the radial artery (SUPBRA) system.

Background: Flaps based on the superficial branch of the radial artery (SUPBRA) are indicated when homo- or heterodigital flaps are inappropriate, but glabrous or like-for-like reconstruction is required.

Aim: To systematically review the outcomes of hand reconstruction using SUPBRA flaps.

Methods: PubMed was searched for English-language articles studying SUPBRA flaps in November 2019.

The use of moist exposed burn ointment (MEBO) for the treatment of burn wounds: a systematic review.

Moist exposed burn ointment (MEBO) is an oil-based herbal paste, purported to be efficacious in managing burn wounds and more commonly used in Asia and the Middle East. A PRISMA-compliant systematic review was performed to analyse the evidence for the use of MEBO on burn wounds. Wound healing rate was the primary outcome of interest.

The mini-temporalis turnover flap for midface reanimation: Photogrammetric and patient-rated outcomes.

Background: Mini-temporalis transposition (MTT) flaps, modified from Gillies' technique, have become less popular than temporalis tendon transfers for midface reanimation. MTT involves raising the middle third of the temporalis, transposition over the zygomatic arch and lengthening with deep temporalis fascia which is sutured to the orbicularis oris.

Aim: This retrospective study assessed subjective and objective outcomes following MTTs by a single surgeon from 2009 to 2019.

Management of intraarticular proximal interphalangeal joint fracture-dislocations and pilon fractures with the Ligamentotaxor® device.

Introduction: Fracture-dislocation and pilon injuries of the proximal interphalangeal joints (PIPJ) continue to pose significant management challenges. Stable fracture configurations can be treated with extension block splinting or pinning. Unstable fractures usually require open or closed reduction and fixation either directly/internally onto the fracture using Kirschner wires, cerclage wires, screws or miniplates or indirectly/externally by ligamentotaxis using external fixators which can be dynamic or static.

An audit of best evidence topic reviews in the International Journal of Surgery.

Introduction: IJS launched best evidence topic reviews (BETs) in 2011, when the guidelines for conducting and reporting these reviews were published in the journal.

Aims: (1) Audit the adherence of all published BETs in IJS to these guidelines. (2) Assess the reach and impact of BETs published in IJS.

Minimal important changes and differences in elective hand surgery.

Unlabelled: Minimal important changes and differences describe the smallest changes and differences between individuals that are relevant to patients following treatment. Minimal important differences may vary between conditions, treatments and lengths of follow-up, and can be calculated in different ways. Minimal important differences for elective hand surgery were reviewed.

Recurrent respiratory distress and cardiopulmonary arrest caused by megaoesophagus secondary to achalasia.

Introduction: Respiratory distress and arrest from tracheal compression secondary to megaoesophagus are rare complications of achalasia. We present the case of a man with end-stage achalasia who required oesophagectomy to prevent recurrent life-threatening tracheal compression and respiratory arrest. A literature review is also presented.

State of the art regarding the management of multiligamentous injuries of the knee.

Multiligamentous knee injuries are rare but serious injuries that can threaten limb viability. As such, they require careful management to give patients the best chance of immediate and ultimate functional recovery. However, as these injuries are rare, there is paucity in prospective comparative studies large enough to provide high level evidence for best practice.

Cytomegalovirus pouchitis in a patient with Crohn's disease.

Colectomy with ileoanal pouch formation is usually contraindicated in patients with Crohn's disease (CD) due to the risk of recurrent disease and pouch failure. We report the case of a patient, initially thought to have ulcerative colitis (UC), who underwent such surgery but subsequently developed perianal CD. She presented with diarrhoea and weight loss.

External cardiac compression during cardiopulmonary resuscitation of patients with left ventricular assist devices.

A best evidence topic was written according to a structured protocol to determine whether there is evidence that cardiopulmonary resuscitation (CPR) by compressing the chest is safe and effective in patients with left ventricular assist devices (LVADs). Manufacturers warn of a possible risk of device dislodgement if the chest is compressed. AMED, EMBASE, MEDLINE, BNI and CINAHL were searched from inception to March 2014.

A cross-sectional study of the presence of United Kingdom (UK) plastic surgeons on social media.

Introduction And Aims: To determine the uptake and usage of websites and social media (SM) by UK consultant (attending) plastic surgeons.

Methods: Professional profiles of full BAPRAS members were searched on Facebook, Twitter, LinkedIn, RealSelf, YouTube, ResearchGate in May 2013. Additional surgeons were identified from the follower lists of @BAPRASvoice and @BAAPSMedia.

The surgically induced stress response.

The stress response to surgery, critical illness, trauma, and burns encompasses derangements of metabolic and physiological processes that induce perturbations in the inflammatory, acute phase, hormonal, and genomic responses. Hypermetabolism and hypercatabolism result, leading to muscle wasting, impaired immune function and wound healing, organ failure, and death. The surgery-induced stress response is largely similar to that triggered by traumatic injuries; the duration of the stress response, however, varies according to the severity of injury (surgical or traumatic).

Validation of a new photogrammetric technique to monitor the treatment effect of Botulinum toxin in synkinesis.

Aims: To validate a new photogrammetric technique for quantifying eye surface area and using this to quantify the degree of improvement in symmetry in patients with oral-ocular synkinesis following Botulinum toxin injection.

Study Design: Feasibility study and retrospective outcomes analysis

Methods: Ten patients' photographs were chosen from a photographic database. Their eye surface areas were measured independently by two raters using a graphics tablet.