Predicting the Timing and Cause of Microvascular Free Flap Failure: An Australian Study of 1569 Free Flaps.

Background: The aim of the study is to assess the possible predictors of microvascular free flap failure and determine the critical postoperative timing of flap failure, thereby minimizing this adverse outcome.

Methods: This is a retrospective single-institutional review of 1569 free flap operations. All free flaps with outcome status recorded were analyzed for possible predictors in the development of microvascular compromise.

The Effect of Sedation on Diagnostic Lumbar Medial Branch Blocks for Facetogenic Low Back Pain: An Observational Study.

Background: Lumbar medial branch blocks (MBB) are some of the most commonly performed pain procedures in the United States. Diagnostic MBBs are performed to confirm if the generator of low back pain is the facet joint. However, with diagnostic injections, false positive blocks may occur.

The thoracoacromial axis in salvage head and neck reconstructive surgery, a case series.

We present the surgical technique, relevant anatomy and a consecutive case series of salvage head and neck free flap reconstructions utilising the thoracoacromial axis. We demonstrated that the thoracoacromial axis is safe and reliable in salvage head and neck reconstruction with particular use in reconstruction of tracheoespophageal and pharyngolaryngectomy fistulae.

Validation of a risk prediction calculator in Australian patients undergoing head and neck microsurgery reconstruction.

Background: The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) surgical risk calculator (SRC) is an open access calculator predicting patients' risk of postoperative complications. This study aims to assess the validity of the SRC in patients undergoing microsurgical free flap reconstruction at an Australian tertiary referral centre.

Methods: This is a retrospective cohort study of 200 consecutive patients treated up to November 2020.

Validated specialty-specific models for multi-disciplinary microsurgery training laboratories: a systematic review.

Background: Laboratory simulation is increasingly important for teaching microsurgical skills. Training microsurgeons of different specialties within the same simulation laboratory increases efficiency of resource use. For maximal benefit, simulations should be available for trainees to practice specialty-specific, higher-order skills.

Structural Failure Mechanisms of Common Flexor Tendon Repairs.

Background: This study investigated the exact failure mechanisms of the most commonly used conventional tendon repair techniques. A new method, radiographing repair constructs in antero-posterior and lateral projections before and after tensioning was used. This allowed to precisely analyse failure mechanisms in regards to geometrical changes in all three dimensions.

The Interlocking Modification of the Cross Locked Cruciate Tendon Repair (Modified Adelaide Repair): A Static and Dynamic Biomechanical Assessment.

The 4-strand cross-locked cruciate flexor tendon repair technique (Adelaide technique) has been shown to have comparably high resistance to gap formation and ultimate tensile strength. This study aimed to determine whether an interlocking modification to the Adelaide repair would impart improved biomechanical characteristics. Twenty four sheep flexor tendons were harvested, transected and repaired using either standard or modified Adelaide techniques.

Whip stitch versus grasping suture for tendon autograft.

Purpose: During tendon autograft harvest, either a grasping suture or traditional whip stitch can be used to grasp tendon prior to definitive bone fixation. Their grip strength has not, to our knowledge, been compared. This article compares a needle-free suture technique to a standard whip stitch by testing grip strength in vitro.

A highly elastic and adhesive gelatin tissue sealant for gastrointestinal surgery and colon anastomosis.

Background: We describe the development of a highly elastic and adhesive surgical tissue sealant, based on photochemically crosslinked gelatin, for sealing sutured incisions in the gastrointestinal (GI) tract in a rabbit surgical model and in a canine colon anastomosis study.

Methods: The study included in vitro assessment of mechanical parameters of the tissue sealant and in vivo analysis of burst strength and histology at 24 h, 3 days and 7 days post surgery, in a rabbit model, to assess progress of wound healing at the suture sites. Utility of this sealant to repair and seal a lower colonic resection and anastomosis procedure in a canine model was also investigated.

Influence of locking stitch size in a four-strand cross-locked cruciate flexor tendon repair.

Purpose: The 4-strand cross-locked cruciate technique (Adelaide technique) for repairing flexor tendons in zone II is a favorable method in terms of strength and simplicity. The purpose of this study was to investigate the effects of varying the cross-lock stitch size in this repair technique. Outcomes measured were load to failure and gap formation.

The relationship between gap formation and grip-to-grip displacement during cyclic testing of repaired flexor tendons.

The assessment of repair site gap formation during cyclic loading of reconstructed flexor tendons provides important data on the performance of repair techniques in the early postoperative period. This study describes our cyclic testing protocol and evaluates the relationship between changes in optical gap and grip-to-grip displacement. Sixteen sheep hind limb deep flexor tendons were randomized into four repair groups (n=4 per group): a 2-strand repair (modified Kessler) and 4-strand repair (Adelaide), both with and without a simple running peripheral suture.

Cross-sectional area and strength differences of fiberwire, prolene, and ticron sutures.

Purpose: Flexor tendons should be repaired with suture material strong enough to permit early motion and small enough for the resulting knot to allow unimpeded tendon glide and healing. This study sought to define differences in cross-sectional area and knotted tensile strength among Fiberwire, Prolene, and Ticron sutures.

Methods: Five strands, each of 3-0 and 4-0 Prolene, Ticron, and Fiberwire sutures, were embedded in polymethylmethacrylate and sectioned in a linear precision saw to obtain 10 cross-sections of each material and size.

A biomechanical assessment of repair versus nonrepair of sheep flexor tendons lacerated to 75 percent.

Purpose: The benefit of repairing a 75% partial flexor tendon laceration remains controversial. The purpose of this study was to assess the degree of gap formation with and without repair when the 75% lacerated tendon is subjected to cyclic loading. Repair with only a peripheral suture was compared to that using a core and peripheral repair technique.

Effectiveness of a new tunneled catheter in preventing catheter malfunction: a comparative study.

Purpose: To compare infection and malfunction rates of two different types of antimicrobial-eluting tunneled cuffed catheters (TCCs) for hemodialysis.

Materials And Methods: The HemoSplit TCC with BioBloc (silver sulfadiazine) coating (n = 100, control group) and the Tal Palindrome Ruby TCC, which has a novel silver antimicrobial sleeve and a spiral-z tip design (n = 100, study group), were compared in this case-controlled study. The main endpoints were TCC infection and malfunction.

Results of aggressive graft surveillance and endovascular treatment on secondary patency rates of Vectra Vascular Access Grafts.

Objective: The aim of the present study was to determine the effect of an aggressive graft surveillance and endovascular treatment protocol on secondary patency rates of a polyetherurethaneurea vascular access graft, specially designed to provide early access and rapid hemostasis.

Methods: One hundred and ninety Vectra Vascular Access Grafts (C. R.