Barriers to Remote Burn Care Delivery: An Analysis of Burn Center Proximity and Access to Critical Telehealth Infrastructure.

Mounting evidence supports the use of telehealth to improve burn care access and efficiency. However, barriers to telehealth use remain throughout the United States and may disproportionately affect specific populations, such as rural and non-English-speaking patients. This study analyzes the association between physical proximity to burn care and determinants of telehealth access.

Access to Certified Burn Centers in the United States: The Geospatial and Transport Cost of Transfer.

Specialized burn centers are critical to minimizing burn-associated morbidity and mortality. However, American Burn Association-verified burn centers are unequally distributed across the United States, and fewer centers are available for pediatric patients relative to adults. The economic burden of transporting patients to these centers contributes significantly to the high cost of burn care.

Subdermal Plexus Density as It Relates to Obesity and Wound Complications in Patients Undergoing Reduction Mammaplasty.

Background: Reduction mammaplasty is one of the most common reconstructive procedures performed in plastic surgery. Multiple comorbidities play a role in postoperative wound healing complications; however, there are insufficient data on the subdermal plexus (SDP) as it relates to these comorbidities. The purpose of this study is to evaluate the relationship between body mass index (BMI) and SDP of the superficial breast tissues and examine the association between SDP and postoperative complications.

Comparison of inferior gluteal artery perforator flaps versus vertical rectus abdominis musculocutaneous flaps in the reconstruction of perineal wounds.

Background: Achieving a healed perineal wound following chemoradiotherapy and abdominoperineal resection (APR) is challenging for surgeons and patients. Prior studies have shown trunk-based flaps, including vertical rectus abdominis myocutaneous (VRAM) flaps, are superior to both primary closure and thigh-based flaps; however, there has been no direct comparison with gluteal fasciocutaneous flaps. This study evaluates postoperative complications after various methods of perineal flap closure of APR and pelvic exenteration defects.

Closed Incisional Negative Pressure Wound Therapy Sponge Width and Tension Off-Loading: A Laboratory Model.

Closed incisional negative pressure wound therapy (ciNPWT) has become commonplace in surgery. One mechanism ciNPWT may prevent incision site complications is by off-loading tension. This study aimed to find what width sponge using ciNPWT provides the most tension off-loading.

Microcirculatory Effects of Botulinum Toxin A in the Rat: Acute and Chronic Vasodilation.

Background: Botulinum toxin-A (BTX) has numerous cosmetic and therapeutic applications. Our previous studies have found that BTX augments pedicled flap survival through both vasodilatory effects and attenuation of the inflammatory response to ischemia in the rat. This study examines the effect of chronic BTX on microcirculatory vascular tone and its response to acute topical vasodilators in muscle flaps.

The Effect of Activated Protein C on Attenuation of Ischemia-Reperfusion Injury in a Rat Muscle Flap Model.

Ischemia-reperfusion injury is often the final and irreversible factor causing flap failure in microsurgery. The salvage of a microsurgical flap with an ischemia-reperfusion injury contributes to the success of microsurgical flap transfers. Activated protein C (APC), a serine protease with anticoagulant and anti-inflammatory activities, has been shown to improve ischemic flap survival.

Inflammatory response and survival of pedicled abdominal flaps in a rat model after perivascular application of botulinum toxin type A.

Background: In addition to the numerous applications of botulinum toxin type A, the authors have documented improvements in surgical flap survival through vasoactive effects. This study aimed to investigate its effect on the expression of inflammatory mediators.

Methods: In 54 male Sprague-Dawley rats, cutaneous flaps based on the superficial epigastric vessels were elevated.

Predictable closure of the abdominoperineal resection defect: a novel two-team approach.

Background: Primary closure of the perineum at the time of abdominoperineal resection (APR) is seldom successful. Several factors are known to adversely affect healing, including neoadjuvant chemoradiation, tension, contamination, and fluid collection. This study evaluates a 2-team approach for resection and routine perineal closure in a single stage.

Comparisons of outcomes from repair of median nerve and ulnar nerve defect with nerve graft and tubulization: a meta-analysis.

In this study, an updated meta-analysis of all published human studies was presented to evaluate the recovery of the median and the ulnar nerves in the forearm after defect repair by nerve conduit and autologous nerve graft. Up to June of 2010, search for English language articles was conducted to collect publications on the outcome of median or ulnar nerve defect repair. A total of 33 studies and 1531 cases were included in this study.

Effects of perivascular Botulinum Toxin-A application on vascular smooth muscle and flap viability in the rat.

Botulinum toxin-A (BTX) has become a widely used pharmacologic agent for esthetic surgeons and those who treat neuromuscular and gastrointestinal conditions. Until recently, there has been very little basic science research related to how this powerful agent may be useful when applied to vessels. The mechanism of action of this agent suggests that it may be useful in treating vasospastic conditions and ischemic tissues.

Modification of blood vessel diameter following perivascular application of botulinum toxin-A.

The purpose of this study was to demonstrate that perivascularly applied botulinum toxin-A (BTX) increases the diameter of treated blood vessels in a rat femoral vessel exposure model. Six adult Sprague-Dawley rats were used and bilateral femoral artery and vein exposures were performed. Five units of BTX were applied to the experimental side and an equal volume of sterile saline was applied to the control side.