Closed Incision Negative-Pressure Therapy on Free Flap Donor Sites: A Meta-analysis of Postoperative Outcomes.

Background: Closed incision negative-pressure therapy (ciNPT) has become increasingly used on surgical sites to attempt to minimize postoperative complications. The literature describing the benefits of ciNPT in reducing donor site morbidity after free tissue transfer is limited. This review compares the effectiveness of ciNPT and conventional dressings in reducing donor site complications after free tissue transfer.

Preoperative Prophylactic Antibiotics in Mandibular Fractures and Surgical Site Infection.

Background: Compared with other facial fractures, mandibular fractures have the highest rate of postsurgical site infection. There is strong evidence to suggest that postoperative antibiotics do not reduce rates of surgical site infections (SSIs) regardless of duration. However, there are conflicting data in the literature regarding the role of prophylactic preoperative antibiotics in reducing rates of SSIs.

Palmar Creases and Their Implication on Carpal Tunnel Surgery.

Background: A thorough knowledge of normal and variant anatomy of the wrist and hand is fundamental to avoiding complications during carpal tunnel release. The purpose of this study was to document variations of the surface anatomy of the hand to identify a safe zone in which the initial carpal tunnel incision could be placed. The safe zone was identified as the distance between the radial side of hook of hamate and the ulnar edge of the origin of the motor branch of the median nerve (MBMN).

The Role of Maximal Locoregional Block in Autologous Breast Reconstruction.

Background: Enhanced Recovery After Surgery (ERAS) has become the standard of care in microsurgical breast reconstruction. The current literature provides overwhelming evidence of the benefit of ERAS pathways in improving quality of recovery, decreasing length of hospital stay, and minimizing the amount of postoperative narcotic use in these patients. However, there are limited data on the role of using maximal locoregional anesthetic blocks targeting both the abdomen and chest as an integral part of an ERAS protocol in abdominally based autologous breast reconstruction.

Traumatic Abdominal Wall Hernia Repair with Dermal Autograft within a Morel-Lavallée Lesion.

Morel-Lavallée lesions and traumatic abdominal wall hernias seldom present together and have no standardized guidelines for treatment. We present a unique case of a traumatic abdominal wall hernia present within a patient's abdominal Morel-Lavallée lesion, which was reduced and repaired with a dermal autograft. This is a novel approach to repairing a rare and unusual injury.

Modified Carpal Tunnel Release: A New Approach to Minimizing Pillar Pain.

Introduction: Pillar pain is a frequent postoperative complication of carpal tunnel release (CTR). The precise definition of pillar pain is lacking, but most authors describe it as diffuse aching pain and tenderness in the thenar and hypothenar area. The etiology of pillar pain is unclear.

Temporal trends and outcome of splenectomy in adults with immune thrombocytopenia in the USA.

Splenectomy is one of the treatments of immune thrombocytopenia (ITP) with a high response rate. However, it is an irreversible procedure that can be associated with morbidity in this setting. Our aim was to study the trends of splenectomy in adults with ITP, and the factors associated with splenectomy and resource utilization during these hospitalizations.

Innervated Pedicled Gracilis Flap for Dynamic Abdominal Wall Reconstruction.

Abdominal wall reconstruction for full-thickness defects is a challenging procedure that usually requires the use of flaps. The gracilis flap is known to be used in hernia repair in which the abdominal muscles are still intact, but there are no reports in literature describing the use of an innervated gracilis for dynamic abdominal wall reconstruction after tissue loss due to severe trauma. We present a surgical technique in which the gracilis is harvested preserving the neurovascular pedicle, then tunneled underneath the adductor longus to cover the lower abdominal defect and provide it with basal muscle tone without tension on the pedicle.

Anomalous Radial Artery as an Incidental Finding During a Routine Carpal Tunnel Release.

Background: Compression of the median nerve at the wrist, or carpal tunnel syndrome, is the most commonly recognized nerve entrapment syndrome. Carpal tunnel syndrome is usually caused by compression of the median nerve due to synovial swelling, tumor, or anomalous anatomical structure within the carpal tunnel.

Methods: During a routine carpal tunnel decompression, a large vessel was identified within the carpal tunnel.

Regulation of Chlamydomonas flagella and ependymal cell motile cilia by ceramide-mediated translocation of GSK3.

Cilia are important organelles formed by cell membrane protrusions; however, little is known about their regulation by membrane lipids. We characterize a novel activation mechanism for glycogen synthase kinase-3 (GSK3) by the sphingolipids phytoceramide and ceramide that is critical for ciliogenesis in Chlamydomonas and murine ependymal cells, respectively. We show for the first time that Chlamydomonas expresses serine palmitoyl transferase (SPT), the first enzyme in (phyto)ceramide biosynthesis.