Exposure pathways (diet, dissolved or particulate substrate) of rare earth elements to aquatic organisms.

The global extraction and use of rare earth elements (REEs) continue to rise as they are implemented in technologies that improve human and environmental livelihoods. However, the general understanding of transfer processes and fates of REEs in aquatic systems remains limited. Here, we aim to determine the REEs' main exposure pathways, e.

Updates in Free Muscle Transfers for Smile Reanimation.

Facial paralysis severely impacts a person's ability to interact with the world. Advances in microsurgery, especially free neurotized muscle transfers, have greatly improved reanimation outcomes. The gracilis free muscle transfer, introduced in 1971, is the most widely used procedure for long-standing flaccid paralysis.

Free functional gracilis transfer for reconstruction of isolated anterior deltoid atrophy following surgical proximal humerus fixation.

Background: Palsy of the clavicular head of the deltoid is a complication after surgical fixation of proximal humerus fractures. Flexion of the shoulder joint may be impaired as a result. Additionally, patients may complain of joint instability, visible atrophy, and pain.

Microsurgery in low- and middle-income countries: Results of 20 years of experience in Cambodia.

Background: Microsurgical free tissue transfer is the gold standard for reconstructing major bone or soft tissue defects but requires complex training, and specific resources. Therefore, some authors have stated that microsurgery is impossible in low- and middle-income countries.

Methods: Patients from Khmer underwent free flap surgery at the Children's Surgical Centre in Phnom Penh between 2004 and 2023.

The PUG Flap: Conjoined Profunda Artery Perforator and Upper Gracilis Flap for Breast Reconstruction.

Abdominal-based free flaps are the mainstay of autologous breast reconstruction; however, the region may not be ideal for patients with inadequate soft tissue or history of abdominal surgery. This case describes the use of a novel conjoined flap based on the profunda artery perforator and upper gracilis pedicles, named the perforator and upper gracilis (PUG) flap. This flap design aims to maximize medial thigh flap volume while ensuring robust tissue perforation.

[Clinical repair strategy for ischial tuberosity pressure ulcers based on the sinus tract condition and range of skin and soft tissue defects].

To investigate the clinical repair strategy for ischial tuberosity pressure ulcers based on the sinus tract condition and range of skin and soft tissue defects. The study was a retrospective observational study. From July 2017 to March 2023, 21 patients with stage Ⅲ or Ⅳ ischial tuberosity pressure ulcers who met the inclusion criteria were admitted to the First Affiliated Hospital of Nanchang University, including 13 males and 8 females, aged 14-84 years.

Dual-Innervated Gracilis Free Functional Muscle Transfers in Facial Palsy Patients: Comparing Long-Term Outcomes between One- versus Two-Stage Procedures.

Background:  In facial reanimation, dual-innervated gracilis free functional muscle transfers (FFMTs) may have amalgamated increases in tone, excursion, synchroneity, and potentially spontaneity when compared with single innervation. The ideal staging of dual-innervated gracilis FFMTs has not been investigated. We aim to compare objective long-term outcomes following one- and two-stage dual-innervated gracilis FFMTs.

Body Mass Index Is Associated With Myocutaneous Free Flap Reliability: Overcoming the Obesity Obstacle With a Proposed Clinical Algorithm to Identify and Manage High-Risk Patients Undergoing Gracilis Free Flap With Skin Paddle Harvest.

Introduction: The purpose of this study was to evaluate the role of body mass index (BMI) in predicting postoperative complications following myocutaneous free flap transfer. In addition, we sought to identify certain body composition variables that may be used to stratify patients into low- versus high-risk for gracilis myocutaneous free flap with skin paddle failure.

Methods: Using the National Surgical Quality Improvement Program database, we collected data for all patients who underwent myocutaneous free flap transfer from 2015 to 2021.

Pediatric Facial Reanimation.

Pediatric facial palsy is rare but severely debilitating and results in profound functional, developmental, psychosocial, and esthetic consequences. Identifying the specific cause of the palsy is important in directing the treatment course. The most common etiologies of pediatric facial palsy are distinct from those of adults.

The Impact of Transfer-Related Ischemia on Free Flap Metabolism and Electrolyte Homeostasis-A New In Vivo Experimental Approach in Pigs.

Free flap tissue transfer represents the gold standard for extensive defect reconstruction, although malperfusion due to thrombosis remains the leading risk factor for flap failure. Recent studies indicate an increased immune response and platelet activation in connection with pathologic coagulation. The underlying cellular and molecular mechanisms remain poorly understood, however.

[Effects of free gracilis muscle flap combined with sural nerve transfer for reconstruction of digital flexion and sensory function of hand in patient with wrist electric burn].

To explore the effects of free gracilis muscle flap combined with sural nerve transfer for reconstruction of digital flexion and sensory function of hand in patient with severe wrist electric burn. A retrospective observational study was conducted. From January 2017 to December 2020, 4 patients with wrist high-voltage electric burn admitted to the Department of Burns of the First People's Hospital of Zhengzhou and 4 patients with wrist high-voltage electric burn admitted to the Department of Hand Surgery of Beijing Jishuitan Hospital met the inclusion criteria, including 6 males and 2 females, aged 12 to 52 years.

Thigh reconstruction between form and function: An algorithm for flap selection based on a series of 70 oncological patients.

Introduction: Thigh reconstruction after oncological resection represents a challenge in terms of ideal morphological and functional outcomes to aim for. Very few papers presented a comprehensive approach to this topic, most of them being only small cases series. The purpose of this article was to review our institutional experience in the field of thigh soft-tissue reconstruction, proposing an algorithm to choose the most convenient pedicled or free flap approach according to the different clinical scenarios and the specific morpho-functional requirements of the case.

Gracilis Free Flap in a Patient with Sickle Cell Disease.

Introduction: Free tissue transfer in the sickle cell population presents many challenges to the reconstructive surgeon. There are few reported cases of successful free tissue transfers within the sickle cell population. The majority of successful cases involve fasciocutaneous free flaps with few successful muscle flaps.

Dual versus Single Innervation of Gracilis Free Functional Muscle Transfer in Facial Paralysis: Long-Term Resting and Dynamic Outcomes.

Background: The purpose of this study was to compare long-term tone and excursion in single- versus dual-innervated free functional muscle transfer (FFMT) in patients with longstanding facial paralysis.

Methods: Patients with longstanding facial palsy treated with an FFMT innervated either by a nerve-to-masseter graft (single-innervation group) or nerve-to-masseter and cross-facial-nerve grafts (dual-innervation group) were included. One-year minimum follow-up was required.

Single slice thigh CT muscle group segmentation with domain adaptation and self-training.

Purpose: Thigh muscle group segmentation is important for assessing muscle anatomy, metabolic disease, and aging. Many efforts have been put into quantifying muscle tissues with magnetic resonance (MR) imaging, including manual annotation of individual muscles. However, leveraging publicly available annotations in MR images to achieve muscle group segmentation on single-slice computed tomography (CT) thigh images is challenging.

Functional reconstruction of the masseter muscle by microvascular free gracilis muscle transfer: technique and outcome.

Microvascular reconstruction of the cheek is most often performed using fasciocutaneous flaps and without functional reconstruction of the masseter muscle. This article reports a technique of masseter muscle resection, dissection of the masseteric nerve, and masseter muscle reconstruction with a functional gracilis muscle flap. The technique was applied in a 38-year-old man with recurrent intramuscular lipoma of the right masseter muscle.

Negative Pressure Wound Therapy in Free Muscle Flaps-Risk or Benefit?

Background:  Application of negative pressure wound therapy (NPWT) on free flaps not only reduces edema but also increases the pressure from outside. The impact of these opposite effects on flap perfusion remains elusive. This study evaluates the NPWT system's influence on macro- and microcirculation of free flaps and edema reduction to better assess the clinical value of this therapy in microsurgical reconstructions.