'Bucket Handle' bipedicled flap for reconstruction of large scalp defects.

Although advances in free flap surgery have allowed the reconstruction of a wide range of complex scalp defects, simpler local options continue to play a role. We describe how bipedicled or 'bucket handle' scalp flap with skin grafting of the donor site can be used to resurface large scalp defects of up to 15 cm x 20 cm. This retrospective case series of 11 patients describes flap outcomes, post-operative complications, pathology and patient-related outcomes collected via a questionnaire.

Radiological evaluation before and after treatment with an osseointegrated bone-anchor following major limb amputation-a guide for radiologists.

Osseointegrated implants have been developed to allow direct skeletal fixation of a prosthesis as an alternative to traditional socket-fitted prostheses for patients who have suffered from a major limb amputation. The implants contribute to improvements in functional outcome and quality of life and radiological evaluation plays a crucial role in pre- and post-operative assessment. This article acts as a guide for radiologists who may be tasked with providing the radiological information required by surgeons and prosthetists.

WAFER trial: a study protocol for a feasibility randomised controlled trial comparing wide-awake local anaesthesia no tourniquet (WALANT) to general and regional anaesthesia with tourniquet for flexor tendon repair.

Introduction: Flexor tendons are traditionally repaired under either general anaesthesia (GA) or regional anaesthesia (RA), allowing for the use of an arm tourniquet to minimise blood loss and establish a bloodless surgical field. However, the use of tourniquets exposes the patient to certain risks, including skin, muscle and nerve injuries. A recent advancement in anaesthesia delivery involves the use of a wide-awake approach where no sedation nor tourniquets are used (wide-awake local anaesthesia no tourniquet (WALANT)).

Management of capitate avascular necrosis in an adult with a free medial femoral condyle flap.

The treatment of the extremely uncommon avascular necrosis of the capitate with a medial femoral condyle corticocancellous free flap has been described previously by one group reporting on outcomes in a paediatric patient. However, no literature to-date has detailed results of this procedure in an adult. We illustrate the case of a 53-year-old man who sustained capitate avascular necrosis and tendon rupture of traumatic aetiology.

Topical Transplantation of Bone Marrow Mesenchymal Stem Cells Made Deeper Skin Wounds Regeneration.

Current wound healing models generally employ full-thickness or irregular split wounds. Consequently, assessing the type of healing at varying wound depths and determining the deepest level at which wounds can regenerate has been a challenge. We describe a wound model that allows assessment of the healing process over a continuous gradient of wound depth, from epidermal to full-thickness dermal loss.

Design and In Vivo Testing of Novel Single-Stage Tendon Graft Using Polyurethane Nanocomposite Polymer for Tendon Reconstruction.

Severe trauma, failure of prior surgical repair, delayed presentation and excessive scarring around the flexor tendon bed often necessitate a two-stage surgical reconstruction, where a silicone spacer is used in the first stage to recreate the fibro-osseous tunnel through which the tendon graft can glide in the second stage. This staged procedure involves great commitment on the part of both patient and surgeon, over the course of several months, involving a prolonged period of rehabilitation that can be quite disruptive to the patient's life and work. Reducing this from a two-stage into a single-stage procedure, therefore, has the potential to reduce rehabilitation time and cost, expedite return to work, and improve outcomes.

A consecutive series of targeted muscle reinnervation (TMR) cases for relief of neuroma and phantom limb pain: UK perspective.

Background: Studies have suggested that targeted muscle reinnervation (TMR) can improve symptoms of neuroma pain (NP) and phantom limb pain (PLP) in patients.

Objectives: Our primary objective was to measure changes in NP and PLP levels following TMR surgery at 4-time points (baseline, 3, 6- and 12-months postoperatively). Secondary aims included identification of the character and rate of any surgical complications and patients' satisfaction with TMR.

Hard-wired Epimysial Recordings from Normal and Reinnervated Muscle Using a Bone-anchored Device.

Unlabelled: A combined approach for prosthetic attachment and control using a transcutaneous bone-anchored device and implanted muscle electrodes can improve function for upper-limb amputees. The bone-anchor provides a transcutaneous feed-through for muscle signal recording. This approach can be combined with targeted muscle reinnervation (TMR) to further improve myoelectric control.

Functional Outcome After Reconstruction of Traumatic Soft Tissue Defects in the Lower Half of the Leg With Distally Based Medial Hemisoleus Muscle Flaps: A Case Series and Literature Review.

Background: Data regarding donor-site morbidity, postoperative clinical course, and functional outcome after hemisoleus muscle flap reconstruction are rare. The aim of this study was to determine the clinical and functional outcome of distally based medial hemisoleus flaps used for the reconstruction of defects in the lower half of the leg.

Methods: Data regarding 31 patients who underwent medial hemisoleus flap reconstruction between 2011 and 2017 were analyzed retrospectively.

Microchannel neural interface manufacture by stacking silicone and metal foil laminae.

Objective: Microchannel neural interfaces (MNIs) overcome problems with recording from peripheral nerves by amplifying signals independent of node of Ranvier position. Selective recording and stimulation using an MNI requires good insulation between microchannels and a high electrode density. We propose that stacking microchannel laminae will improve selectivity over single layer MNI designs due to the increase in electrode number and an improvement in microchannel sealing.

Assessing the augmented breast: a blinded study comparing round and anatomical form-stable implants.

Background: Controversy persists as to whether round or anatomical form-stable breast implants provide the most aesthetically pleasing results, and there is a paucity of evidence comparing cosmetic outcomes of these two implants. A blinded study comparing aesthetic outcomes was conducted in an attempt to address this issue.

Objectives: The authors compare aesthetic outcomes between round and anatomical form-stable breast implants.

Trends in tertiary breast reconstruction: literature review and single centre experience.

Background: Autologous flap reconstruction can improve aesthetic results after failed implant reconstruction and be considered following previous failed autologous flap reconstruction. This study presents a review of the indications, motivation and outcomes of tertiary breast reconstruction.

Methods: A comprehensive literature review was conducted using Pubmed, Embase, Web of Science and Google Scholar.

Obesity in mammaplasty: a study of complications following breast reduction.

Background: Access to effective surgical treatments such as breast reduction is often restricted on the grounds of patient obesity. However, there is a lack of unambiguous data on the surgical risks of obesity in patients undergoing breast reduction. The aim of this study was to assess the relationship between patient obesity, as determined by body mass index (BMI), and surgical outcome following bilateral breast reduction (BBR).

Evidence-based burn care--An assessment of the methodological quality of research published in burn care journals from 1982 to 2008.

Introduction: The quantity and quality of research evidence in peer-reviewed burn care journals have never been evaluated. The aim of this study was to empirically assess the evidence available in this literature.

Methods: All studies published in Burns and Journal of Burn Care and Research between 1st January 1982 and 31st December 2008 were reviewed.

Descriptive and inferential statistical methods used in burns research.

Background: Burns research articles utilise a variety of descriptive and inferential methods to present and analyse data. The aim of this study was to determine the descriptive methods (e.g.

Burns surgery handover study: trainees' assessment of current practice in the British Isles.

Introduction: Effective handover of clinical information between working shifts is essential for patient safety. The aim of this study was to identify current practice and trainees' assessment of handover in the burns units of the British Isles.

Methods: A telephone questionnaire was conducted to trainee burns surgeons (at junior and senior grades) currently working at all 30 burns surgery units in the British Isles.

Superficial fascial system repair: an abdominoplasty technique to reduce local complications after caesarean delivery.

Abdominal incision complications are a major source of morbidity after caesarean delivery. Repair of the superficial fascial system may avert local complications after caesarean delivery by minimising tension to the skin and increasing the initial biomechanical strength of wound which has the potential to decrease early wound dehiscence and as a by-product correct suprapubic bulging.