Approach to DIEP Flap Pedicle Dissection via a Midline Fascial Incision.

In this article, our technique for deep inferior epigastric pedicle dissection utilizing a midline fascial incision is described. Approaching these vessels via a midline facial incision provides facile access to the retrorectus space bilaterally, utilizes a dissection plane that facilitates preservation of nerve and muscle fibers, and allows for both efficient and ergonomic pedicle dissection. This method is safe and easily reproducible and may reduce abdominal donor site morbidity in deep inferior epigastric perforator flap breast reconstruction.

Reducing Wound Tension with Undermining or Imbrication-Do They Work?

Background: For the noncolonized wound, achieving tension-free, primary wound closure is ideal. Some surgeons advocate imbrication of deeper tissues rather than undermining, posing that imbrication preserves more dermal perfusion while still reducing tension at the wound edge. We sought to determine which technique most reliably reduced wound tension while preserving dermal wound perfusion.

Examination of the Early Diagnostic Applicability of Active Dynamic Thermography for Burn Wound Depth Assessment and Concept Analysis.

Despite advances in perfusion imaging, burn wound imaging technology continues to lag behind that of other fields. Quantification of blood flow is able to predict time for healing, but clear assessment of burn depth is still questionable. Active dynamic thermography (ADT) is a noncontact imaging modality capable of distinguishing tissue of different thermal conductivities.

Biphasic presence of fibrocytes in a porcine hypertrophic scar model.

The duroc pig has been described as a promising animal model for use in the study of human wound healing and scar formation. However, little is known about the presence and chronology of the fibrocyte cell population in the healing process of these animals. Wounds known to form scar were created on red duroc swine (3" x 3") with a dermatome to a total depth of either 0.

Commercially available topical platelet-derived growth factor as a novel agent to accelerate burn-related wound healing.

The authors investigated whether the application of platelet-derived growth factor (PDGF) to donor site wounds would speed healing in a porcine model. In a red duroc pig model, three wounds that were 3 inches × 3 inches were created with a dermatome (0.06-inch depth) on one side of two different animals.

A prospective evaluation of platelet function in patients on antiplatelet therapy with traumatic intracranial hemorrhage.

Background: Platelet transfusion is increasingly used in patients with traumatic intracranial hemorrhage (ICH) on aspirin therapy to minimize the progression of ICH. We hypothesized (null) that platelet transfusion in this cohort of patients does not improve platelet function.

Methods: We performed a prospective interventional trail on patients with traumatic ICH on daily high-dose (325 mg) aspirin therapy.

Donor site healing dynamics: molecular, histological, and noninvasive imaging assessment in a porcine model.

Understanding the physiology of donor site healing will lead to advances in how these wounds are treated and may ultimately allow faster healing, more frequent autografting, and more effective care of the burn-injured patient. Unfortunately, a paucity of data exists regarding perfusion metrics over the course of donor site healing. Furthermore, there are no studies that interrelate indices of perfusion with the molecular and cellular processes of donor site healing.

Treatment with an oxazolidinone antibiotic inhibits toxic shock syndrome toxin-1 production in MRSA-infected burn wounds.

Mortality rates in burn patients increase if they experience complications of infection. Frequently, the organisms associated with such infections are Staphylococci, including antibiotic-resistant species such as methicillin-resistant Staphylococcus aureus. Virulence factor production can further complicate treatment as a localized toxin presence may derail the healing process and allow a more invasive infection, while a toxin that becomes systemic can induce shock and cause host immune disruption.

Localization of superantigen virulence factors in kidney tissue of animals with Staphylococcus aureus-infected burn wounds.

Gram-positive organisms are often found in association with burn wounds. A paucity of information exists regarding the accumulation and fate of virulence factors from these bacteria. The superantigenic exotoxins produced by Staphylococcus aureus are potent immunomodulating proteins and have also been described to localize in the kidney.

A fitted neoprene garment to cover dressings in swine models.

Domesticated porcine species are commonly used in studies of wound healing, owing to similarities between porcine skin and human skin. Such studies often involve wound dressings, and keeping these dressings intact on the animal can be a challenge. The authors describe a novel and simple technique for constructing a fitted neoprene garment for pigs that covers dressings and maintains their integrity during experiments.