Surgical management of subungal melanoma

The authors present the findings of a retrospective, single-institution review of all patients with biopsy confirmed subungal melanomas over a period of 96 years in Mayo Clinic. Parameters examined were general demographics, level of digit amputation, disease recurrence, overall survival,...

The original suture suspension necklift before the i-guide

In this excellent issue of the Clinics in Plastic Surgery the topic of neck lifting is discussed. This covers the assessment, non-surgical management, minimally invasive techniques and open techniques. This invited paper looks into the authors’ experience of suture suspension...

Filleting the lobule in otoplasty

The correction of lobular deformities continues to represent a challenge during otoplasty, due to its three major anatomic components: the axial angular protrusion, the coronal angular protrusion and the inherent shape. These aspects make controlled lobule repositioning less predictable. The...

The superficial circumflex iliac artery perforator flap in intraoral reconstruction

There can be little disagreement that a groin flap, or one of its derivatives, can leave behind a scar which is without problems (except, perhaps to a pole dancer). Thus popularisation of such a flap is much to be desired,...

Raised serum lactate as a marker in the diagnosis of necrotising fasciitis

A 10-year prospective study of cases of suspected necrotising fasciitis was made, involving 53 patients. Of these, 28 had histologically proven necrotising fasciitis, 25 did not. Serum lactate measured at presentation of those who had the condition was 4.1+or-1.62 mmol/l...

Beta blockers in the treatment of infantile haemangiomas

Following the work of Léauté-Labrèze et al. in 2008, describing the successful use of beta blockers in the treatment of infantile haemangiomas, the medical treatment of these troublesome malformations has almost completely replaced surgical treatment, which has been relegated to...

VAC therapy and instillation

Vacuum assisted closure (VAC) therapy is now a common sight in plastic surgery departments for the management of difficult wounds, to encourage granulation tissue formation, reduce wound size and facilitate closure or reconstruction. The combined use of VAC dressing with...

Autologous fat graft in scar treatment

A retrospective study was performed of 694 patients with contracted and painful scars over a six year period. A total of 376 patients had burn scars, 54 patients had scars due to road trauma, 92 patients had scars from domestic...

Delayed intraoral wound healing in patients on bisphosphonates

Since Marx first described bisphosphonate related osteonecrosis of the jaw (BRONJ), the literature is now replete with cases of BRONJ. There are no internationally accepted protocols. A three month cessation of drug treatment, a ‘drug holiday’ has been advocated. The...

Anteromedial thigh perforator free flaps

Forty-one consecutive anterior anteromedial thigh (AMT) free flaps are reported, with a success rate of 95%. This flap is being used as an alternative to the preferred anterolateral thigh flap (ALT), which is described as the ‘real workhorse’, when this...

Vascularised composite allotransplantation: an update

Vascularised composite allotransplantation (VCA) includes transplantation of multiple tissues in a single vascularised unit, such as the upper limb, or most dramatically the face. Truly remarkable results have been achieved, such as the one illustrated in this article. More than...

The cost of surgery for bedsores

Many plastic surgeons will have experienced a heart-sinking moment when receiving a request to give an opinion on a patient with a bedsore. The surgery is not technically demanding, but the postoperative care and rehabilitation of the patient can be...