Thermographic Assessment of a Vascular Malformation of the Hand: A New Imaging Modality.

Vascular malformations of the hand are rare. Angiography is the current Gold Standard imaging modality. Thermal imaging is an emerging noninvasive, noncontact technology that does not require intravenous contrast agents.

Extended applications of gauze-based negative pressure wound therapy in hand surgery: a review of five cases.

Unlabelled: Negative pressure wound therapy (NPWT) is an established treatment for a wide variety of acute and chronic wounds. Although the exact mechanism of action is still undefined, the proposed benefits of NPWT have been well described in the literature and include improved wound perfusion, granulation and reduction of oedema and bacteria. Here we describe a series of five challenging cases where NPWT dressings were applied for both elective and traumatic wounds of the upper limb.

A systematic review of 2-strand versus multistrand core suture techniques and functional outcome after digital flexor tendon repair.

Purpose: To determine published evidence to evaluate the hypothesis that multistrand techniques result in a poorer outcome than 2-strand techniques for digital flexor tendon repairs.

Methods: A systematic review was undertaken to compare outcomes and rupture rates between 2-strand and multistrand core sutures in digital flexor zones 2 to 5. Outcome was measured by the American Society for Surgery of the Hand criteria, original or modified Strickland criteria, or Buck-Gramcko criteria.

Ligating perforators in abdominoplasty reduces the risk of seroma.

Background: Seroma formation, a common complication of abdominoplasty, can cause patient discomfort and inconvenience. This study aimed to compare seroma rates after ligation and diathermy of large abdominal perforating vessels during abdominoplasty.

Methods: Consecutive patients undergoing abdominoplasty with epigastric undermining between 2004 and 2011 were studied.

A simple technique for protecting exposed k wire ends.

Several techniques have been described for protecting the sharp ends of Kirschner wires intraoperatively. We describe a simple, inexpensive technique, which can be used to protect the ends of the wires both intraoperatively and postoperatively.

Detection of perforators using thermal imaging.

Background: Perforator flaps are commonly used in reconstructive surgery and require accurate vascular anatomy navigation. Several imaging methods help surgeons, including hand-held Doppler, color Doppler ultrasound, computed tomography, and magnetic resonance angiography. A growing literature supports the efficacy of thermal imaging in identifying perforators.

Prosthetic metal implants and airport metal detectors.

Introduction: Metal detectors have been present in airports and points of departure for some time. With the introduction of heightened security measures in response to fears of an increased threat of terrorism, they may become more prevalent in other public locations. The aim of this study was to ascertain which prosthetic devices activated metal detector devices used for security purposes.

Outcomes in the repair of pilonidal sinus disease excision wounds using a parasacral perforator flap.

Introduction: The ideal treatment for pilonidal sinus disease has yet to be defined. There are many approaches described in the literature.

Methods: Thirty-five consecutive patients who underwent wide excision of pilonidal sinus disease had the wound repaired using a parasacral perforator flap.

Fasciotomy: a call for proper placement.

Introduction: It is important that acute compartment syndrome is recognised and treated early. Treatment involves surgical decompression and it is imperative that this is performed in a timely and appropriate manner. The knowledge of plastic and orthopaedic surgery trainees of the safe technique for performing lower leg fasciotomy was examined.

The evolution of a hand day-surgery unit.

Introduction: Following the merger of two major units to form a regional centre for plastic surgery in the West Midlands, acute hand surgery referrals reached overwhelming proportions. This study describes audits performed at three time points. The first highlighted the extent of in-patient delay and was instrumental in the subsequent development of a dedicated hand trauma day-case unit.

A-a type, arterialized, venous, flow-through, free flap for simultaneous digital revascularization and soft tissue reconstruction-revisited.

Significant soft tissue injuries to palmar surfaces are frequently associated with digital vessel damage. Flap coverage might have to be combined with microsurgical revascularization using vein grafts if the digit is to be salvaged. Two cases of simultaneous digital revascularization and soft tissue reconstruction using an arterialized, venous flow-through flap are presented in detail.

Metacarpal descent, definition and normal range.

Metacarpal descent, an indication of carpometacarpal (CMC) joint mobility, was measured in 90 normal subjects by assessing the alignment of the metacarpal heads with the hand in a relaxed posture and when making a tight fist. Metacarpal descent was greater in women. Hand dominance was associated with an increase in positional angles but not metacarpal descent.