The influence of K-wire transfixation on proximalization of the first metacarpal after resection suspension interposition arthroplasty.

Introduction: Osteoarthritis of the first carpometacarpal joint is a common degenerative disease and surgical treatment includes resection suspension interposition arthroplasty (RSIA) with or without temporary transfixation of the first metacarpal. One major drawback includes proximalization of the first metacarpal during the postoperative course. Specific data comparing different transfixation techniques in this context is sparse.

Rare Pseudotumor-like Hematoma at the Latissimus Dorsi Muscle Flap Donor Site: A Treatment Strategy Utilizing Negative Pressure Wound Therapy With Instillation and Dwell Time.

Introduction: In reconstructive surgery, the latissimus dorsi (LD) muscle is known as a workhorse flap and is commonly used as a pedicled or free flap. Postoperative complications of a reconstructive procedure with an LD flap include seroma and hematoma formation at an early stage after LD transfer. Late-onset hematoma at the donor site are considered to be extremely rare postoperative complications; late, expanding pseudotumor-like hematoma can occur months or years after surgery.

Limb salvage procedure in immunocompromised patients with therapy-resistant leg ulcers-The value of ultra-radical debridement and instillation negative-pressure wound therapy.

The purpose of this study was to analyse the outcome of our established triple treatment strategy in therapy-resistant deep-thickness chronic lower leg ulcers. This limb salvage approach consists of ultra-radical surgical debridement, negative-pressure wound therapy (NPWT) with or without instillation, and split-thickness skin grafting. Between March 2003 and December 2019, a total of 16 patients and 24 severe cases of lower leg ulcers were eligible for inclusion in this highly selective population.

Eligibility of Endovascular Repair for Popliteal Artery Aneurysms According the Instructions for Use.

Background: Popliteal artery aneurysms (PAAs) are the most common peripheral aneurysms. Although rare and often asymptomatic, there is a significant risk of thrombosis, embolism, and limb loss. The aim of this study was to evaluate the eligibility for endovascular repair of patients treated for symptomatic and asymptomatic PAAs in accordance with the instructions for use (IFU).

Topical negative-pressure wound therapy: emerging devices and techniques.

: The treatment of chronic wounds constitutes a massive financial burden to society and our health-care system. Therefore, efficient wound care is of great importance to all kinds of medical fields. The implementation and modification of negative-pressure wound therapy can be seen as a major improvement in wound healing.

Wound closure by means of free flap and arteriovenous loop: Development of flap autonomy in the long-term follow-up.

Free flaps in combination with arterial reconstruction by means of arteriovenous loops or bypass have, meanwhile, been established as a therapeutic option in defect reconstruction for areas without recipient vessels. Our aim was to analyse the long-term performance, flap autonomy, and the flap perfusion. Patients receiving this combined reconstruction at a single-centre institution were included.

Body Contouring Surgery Improves Physical Activity in Patients After Massive Weight Loss-a Retrospective Study.

Background: The aim of the study was to compare physical activity (PA) in patients who had undergone massive weight loss (MWL), before and after body contouring procedures.

Methods: All patients undergoing body contouring surgery after MWL between 2007 and 2017 with a minimum follow-up of 6 months after the last procedure were included in this retrospective study. Excluded were those with a body mass index > 35 kg/m and those with comorbidities leading to impaired PA.

Autologous Breast Reconstruction with Transverse Rectus Abdominis Musculocutaneous (TRAM) or Deep Inferior Epigastric Perforator (DIEP) Flaps: An Analysis of the 100 Most Cited Articles.

Post-mastectomy autologous reconstruction with abdominal tissue has evolved over the past 4 decades and is a common reconstructive modality today. To gain more insight into this evolution, we performed an analysis of the 100 most commonly cited articles focusing on autologous breast reconstruction with transverse rectus abdominis musculocutaneous (TRAM) or deep inferior epigastric perforator (DIEP) flaps. A review of the ISI Web of Knowledge database was performed.

Indocyanine green angiography and the old question of vascular autonomy - Long term changes of microcirculation in microsurgically transplanted free flaps.

Background: Free tissue transfer has become a routine procedure with low failure. In case of a compromised vascular pedicle, flap survival is time dependantly possible due to flap autonomization. However it remains unknown at what time and to which degree different factors influence flap autonomization.

Quantitative assessment of microperfusion by indocyanine green angiography in kidney transplantation resembles chronic morphological changes in kidney specimens.

Objective: ICG fluorescence angiography enables a quantitative real-time perfusion assessment in kidney transplantation. The results of intraoperative microperfusion of the kidney allograft were compared to the renal chronicity score in pre-transplantation kidney biopsy specimens. The intrarenal resistance index was calculated by duplex sonography as a method of reference.

Force distribution of a cylindrical grip differs between dominant and nondominant hand in healthy subjects.

Introduction: Grip strength and load distribution of the hand are important parameters for evaluating hand function. The purpose of this study was to analyze and compare grip force and load distribution of dominant and nondominant hands in right-handed healthy subjects.

Methods: Gripping measurements were performed on 40 healthy right-handed subjects using a cylindrical gripping device.

Negative pressure wound treatment with computer-controlled irrigation/instillation decreases bacterial load in contaminated wounds and facilitates wound closure.

Microbial wound contamination is known to be a hindrance to wound healing. Negative pressure wound therapy (NPWT) with or without irrigation is known to optimise conditions in problem wounds. The aim of this study was to investigate the influence of computer-controlled wound irrigation with NPWT on the bacterial load in contaminated wounds.

Mechanistic basis of an epistatic interaction reducing age at onset in hereditary spastic paraplegia.

Many genetic neurological disorders exhibit variable expression within affected families, often exemplified by variations in disease age at onset. Epistatic effects (i.e.

Pilot Assessment of the Angiosome Concept by Intra-operative Fluorescence Angiography After Tibial Bypass Surgery.

Objectives: The "angiosome" concept as a model for decision making in revascularisation of patients with critical limb ischaemia (CLI) has been subject to lively discussion in recent years. The aim of this prospective pilot study was to use intra-operative fluorescence angiography to provide further data on the angiosome concept on the level of microcirculation after tibial bypass surgery.

Design, Materials, And Methods: This was a prospective analysis of 40 patients presenting with CLI Rutherford stage IV to VI before and after tibial bypass surgery.

Medical overuse and quaternary prevention in primary care - A qualitative study with general practitioners.

Background: Medical overuse is a topic of growing interest in health care systems and especially in primary care. It comprises both over investigation and overtreatment. Quaternary prevention strategies aim at protecting patients from unnecessary or harmful medicine.

Microcirculation Evaluated by Intraoperative Fluorescence Angiography after Tibial Bypass Surgery.

Background: Intact microperfusion of the foot in the critical ischemic limb remains a crucial condition for ulcer healing. Aim of this clinical study was to evaluate the immediate effect of tibial bypass surgery on the microcirculation by usage of fluorescence angiography.

Methods: Prospective analysis of 33 patients presenting with critical limb ischemia (Rutherford IV-VI) undergoing tibial bypass surgery was performed.

The Potential Role of Telocytes for Tissue Engineering and Regenerative Medicine.

Despite recent advances in surgery, medicine and anaesthesiology as well as the development of microsurgical tissue transplantation, wear out of body parts remains a problem, and organ shortage does not allow to allocate enough donor organs for patients with vital diseases and conditions. The idea to create spare parts or spare organs from the patients own cells by combining engineering approaches to cellular and molecular medicine for th purpose of Tissue Engineering (TE) was fascinating when popularized in the early 1990ies. However clinically success was limited, mainly because of a lack in rapid vascularization of large scale TE replacement constructs useful for clinical purposes.

Management of extremely hard-to-heal extremity wounds with severe life-threatening complications.

The introduction of neoadjuvant radiotherapy has allowed limb-preserving surgical treatment in patients with extremity soft tissue sarcoma, and the overall prognosis of this approach is similar to that of limb amputation. The benefits of this treatment, however, are often accompanied with a higher risk of major complications and blood vessel damage because of radiation-induced inflammation and necrosis of the vessel wall. In particular, it is associated with the rupture of large vessels like the femoral artery and more severe complications of wounds located in the proximal lower extremity.

In vitro cell response to Co-containing 1,393 bioactive glass.

Cobalt ions are known to stimulate angiogenesis via inducing hypoxic conditions and hence are interesting agents to be used in conjunction with bioactive glasses (BGs) in bone tissue engineering approaches. In this work we investigated in vitro cell biocompatibility of Co releasing 1393 BG composition (in wt.%: 53SiO2, 6Na2O, 12K2O, 5MgO, 20CaO, and 4P2O5) derived scaffolds with osteoblast-like cells (MG-63) and human dermal microvascular endothelial cells (hDMECs).

Predictors of Self-Rated Health: Does Education Play a Role Above and Beyond Age?

Objectives: Previous studies have demonstrated that while health factors lose importance for the individual conceptualization of self-rated health (SRH) with advancing age, subjective well-being (SWB) factors gain in importance. The present study examined whether this age-related pattern differs between educational groups.

Method: Longitudinal data of adults aged 40 years and older of the German Ageing Survey was used (N = 6,812).

Incisional negative pressure wound therapy for high-risk wounds.

With an ageing population and a growing number of people with obesity and/or undergoing advanced cancer therapies, there is an increasing risk of surgical site complications including surgical site infections (SSIs). Postoperative shifting of large mobilised tissue flaps, such as in abdominoplasties, remains a dreaded complication, particularly following massive weight loss. Besides negative implications for the patient, surgical site complications result in an economic burden due to prolonged and repeated wound treatments.

Nutrient free flaps with vascular bypasses for extremity salvage in patients with chronic limb ischemia.

Aim: Treatment of severe wounds remains a surgical challenge in patients with critical limb ischemia (CLI). In some patients with end stage disease a combined arterial and venous vascular bypass together with immediate or subsequent free soft tissue transfer can become necessary to salvage the limb. The aim of this paper was to develop an algorithm of differential approaches of interdisciplinary reconstructions with bypasses and free flaps for leg salvage.