Lymphaticovenular anastomosis improves quality of life and limb volume in patients with secondary lymphedema after breast cancer treatment.

Secondary lymphedema is a common side effect of breast cancer treatment, with significant impact on patients' physical and psychological well-being. Conservative therapies are the gold standard treatment, however surgical options are becoming more popular. Lymphaticovenular anastomosis (LVA) is a supermicrosurgical procedure that aims to restore lymphatic flow by anastomosing damaged lymphatics to subcutaneous venules.

Lymphaticovenular anastomosis in the treatment of secondary lymphoedema of the legs after cancer treatment.

Objective: As survival from cancer continues to improve, greater importance is placed on quality of life after surgery. Lymphoedema is a common and disabling complication of cancer treatment. Lymphaticovenular anastomosis (LVA) is a supermicrosurgical treatment option for lower limb lymphoedema.

Supraclavicular flap repair in the free flap era.

Background: Supraclavicular flap (SCF) repair is widely reported in head and neck surgery in select patients and defects. The authors' objective is to present our series of 30 patients who underwent SCF repair for varying defects and to review the scope and outcome of SCF repair in the literature.

Methods: The authors contributed primary evidence of 30 cases of SCF repair.

Postoperative washing of sutured wounds.

A best evidence topic was written according to the structured protocol. The three part question addressed was: [In patients undergoing closure of surgical wounds with sutures] does [keeping the wound dry for the first 48 h after closure] [reduce the incidence of surgical site infections (SSIs)]? 4 relevant papers were culled from the literature and appraised. The authors, date, country, population, study type, main outcomes, key results and study weaknesses were tabulated.

Social perception of morbidity in facial nerve paralysis.

Background: There are many patient-based and clinician-based scales measuring the severity of facial nerve paralysis and the impact on quality of life, however, the social perception of facial palsy has received little attention. The purpose of this pilot study was to measure the consequences of facial paralysis on selected domains of social perception and compare the social impact of paralysis of the different components.

Method: Four patients with typical facial palsies (global, marginal mandibular, zygomatic/buccal, and frontal) and 1 control were photographed.

Prospective study of sentinel node biopsy for high-risk cutaneous squamous cell carcinoma of the head and neck.

Background: Nodal metastasis from cutaneous squamous cell carcinoma (SCC) is poorly predicted clinically and is associated with a high mortality rate.

Methods: From 2010 to 2013, patients with high-risk cutaneous SCC were assessed with sentinel node biopsy (SNB) either at the time of primary cutaneous tumor resection or at secondary wide local excision.

Results: Of 57 patients, 8 (14%) had nodal metastasis.

Head and neck multidisciplinary team meetings: Effect on patient management.

Background: The purpose of this study was for us to present our findings on the prospectively audited impact of head and neck multidisciplinary team meetings on patient management.

Methods: We collected clinical data, the pre-multidisciplinary team meeting treatment plan, the post-multidisciplinary team meeting treatment plans, and follow-up data from all patients discussed at a weekly multidisciplinary team meeting and we recorded the changes in management.

Results: One hundred seventy-two patients were discussed in 39 meetings.

Concurrent chemoradiotherapy compared with surgery and adjuvant radiotherapy for oral cavity squamous cell carcinoma.

Background: The purpose of this study was to compare survival and functional outcomes in patients with advanced oral cavity squamous cell carcinoma (SCC) treated with either surgery + adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CRT).

Methods: Patients treated with curative intent by either surgery + RT or concurrent CRT were identified over a 6-year period (2001-2007). Disease and functional outcomes were analyzed on an intention-to-treat basis.

Use of the nasal sidewall island inversion flap for single-stage ala nasi reconstruction: a report of 103 consecutive cases.

Background: Alar reconstruction can be challenging, and numerous solutions for reconstructing this potentially difficult area have been proposed. The authors' preferred solution is an island inversion flap based on the superior alar artery.

Methods: The authors performed a retrospective review of the medical notes and photographs of 103 consecutive patients who underwent alar reconstruction with the nasal sidewall island inversion flap.

Options for configuring the scapular free flap in maxillary, mandibular, and calvarial reconstruction.

Background: A number of microvascular free-flap tissue transfer techniques exist for reconstruction of head and neck defects. The scapular free flap is a versatile option that can be used for a wide variety of defects in this complex region.

Methods: A series of 42 free flaps from 41 patients was retrospectively identified from the senior author's (J.

Central breast excision with immediate autologous reconstruction for recurrent periductal sepsis: an application of oncoplastic surgical techniques.

Objective: The aim of this procedure was to definitively treat periductal mastitis and periareolar sepsis which was previously resistant to multiple surgical procedures and nonoperative treatment of chronic nipple sepsis.

Methods: We employed a multidisciplinary approach to the treatment of end-stage periductal mastitis using a combination of central breast excision and immediate autologous latissimus dorsi flap reconstruction.

Results: Clearance of periductal mastitis and infection has been achieved with no recurrence at 3 years.

PERTHESE implant-identical cohesive-gel sizers in breast augmentation: a prospective report on 200 consecutive cases and implications for treatment of breast asymmetry.

Background: The insertion of sizers in breast augmentation surgery is a common method of predicting the final volume of prosthesis required. However, saline-filled sizers may not accurately represent the shape of the cohesive-gel-augmented breast. PERTHESE cohesive-gel breast implants are produced with matching sets of reusable (sterilizable) cohesive-gel-filled sizers that accurately predict the form of the augmented breast.

Bilateral trigger finger in a 7-year-old after a viral infection: case report.

Triggering in young children is rare. In this report, we describe spontaneous bilateral ring finger triggering in a 7-year-old boy after a viral infection. The pathology completely resolved without intervention.

Neuronal differentiation in basal cell carcinoma: possible relationship to Hedgehog pathway activation?

Although deregulated Hedgehog signalling and elevated Gli transcription factor expression are known to promote the development of basal cell carcinoma (BCC), little is known about molecular mechanisms driving the development of specific growth pattern subtypes. Using gene array analysis, we have previously observed that over-expression of GLI1 in human keratinocytes promotes increased expression of the neuronal differentiation markers ARC and ULK1. We asked whether neuronal differentiation is a characteristic of BCC and whether there is any correlation with BCC subtype.

Chest wall reconstruction using a turbocharged chimaeric anterolateral thigh flap.

Extremely large chest wall defects may result following salvage oncological surgery. Typically these defects involve a large skin defect combined with a variable resected area of underlying muscle and ribs. In situations where the skin defect is very large the use of a large latissimus dorsi flap may require skin grafting to the donor site if a myocutaneous flap is used or to the recipient defect if a muscle-only flap is used.

Mirror ear: a reconstructive technique for substantial tragal anomalies or polyotia.

Polyotia (mirror ear) is an extremely rarely reported congenital anomaly of the external ear. The aetiology of this condition is unclear, and there are few descriptions of surgical techniques used. We aimed to review our experience with this condition by performing a retrospective review of the cases treated in our unit.

Acinetobacter infection is associated with acquired glucose intolerance in burn patients.

Infection with antibiotic-resistant Acinetobacter spp. is an increasing problem in critical care environments worldwide. Acinetobacter spp.