Modifying the DIEP flap in autologous breast reconstruction, introducing a fifth ‘Fleur-de-lis’ zone

With current consumer disquiet about silicone implants, more patients may request autologous reconstruction. This can cause difficulties in patients who have undergone massive weight loss. The authors describe an ingenious solution, modifying the deep inferior epigastric perforators (DIEP) flap to...

Superficial lymphatics of the abdominal wall in lymphatic microsurgery

This elegant and beautifully illustrated article requires to be carefully studied in its entirety by any surgeon planning to carry out lymphovenous anastomoses or vascularised lymph node transfer in the groin area. As the authors point out, the most difficult...

Prophylactic postoperative antibiotics for enucleation or evisceration

The authors report on a retrospective, multicentre, comparative case series looking at prophylactic antibiotics and the incidence of orbital cellulitis following enucleation or evisceration. Of the 644 cases included in the analysis, all received a single perioperative intravenous dose of...

Medial conjunctivoplasty for epiphora associated with conjunctivochalasis

The authors describe a retrospective review of 18 patients (25 eyes) who underwent medial conjunctivoplasty for epiphora between 2000 and 2012. In all cases, the epiphora was felt to be predominantly due to the mechanical disruption of normal tear flow...

How long should you wait for your adrenaline to work?

The authors present a prospective, randomised, triple-blind study to see how long it really takes to obtain the lowest cutaneous haemoglobin concentration after lignocaine with adrenaline injection. Twelve healthy volunteers were injected simultaneously in each arm with either plain 1%...

Diced cartilage grafts in rhinoplasty

This article reviews the author’s current techniques and applications of diced cartilage grafts (DCG) in rhinoplasty surgery. Dr Daniel is a renowned rhinoplasty surgeon and he describes the technique that he has been using for more than 30 years. In...

Descending branch peroneal artery perforator flap

Reconstruction of distal third defects in the lower limb is a challenge that often requires microsurgical free tissue transfer. The authors introduce a peroneal artery perforator flap based on the deep descending branch for reconstruction of lateral malleolar defects. They...

How affective is lignocaine in the infiltration for tumescent liposuction?

The authors present a prospective, randomised, double-blind study to assess whether the inclusion of lignocaine in the standard infiltration for tumescent liposuction, reduces postoperative pain. A cohort of women, aged 18-40, BMI 20-27, and receiving abdominal or back liposuction were...

A survey of American plastic surgeons of fat grafting to the breast

The authors present results of a survey of the use of fat grafting by American plastic surgeons in order to benchmark current practices in both aesthetic and reconstructive procedures to the breast. A survey was sent electronically to 2584 members...

Supplement use in cosmetic facial surgery

This objective of this study was to report the incidence of dietary supplement use in facial cosmetic surgery patients in the United States. Dietary supplements are not regulated by the Food & Drug Administration (FDA) and some have been known...

A plea for reconstructive plastic surgery in the routine care of sarcoma patients

The authors from the Mayo Clinic demonstrate the advantage of early intervention by plastic surgeons in the care of patients with sarcoma. A retrospective case study review looks at the wound complication rate of surgery for those patients who have...

Do the benefits of scaphoidectomy and four-corner fusion for SLAC last?

The paper concisely covers the history and definition of scapholunate advanced collapse (SLAC) wrist. The treatments options are described in broad terms and referenced. Forty patients’ records are assessed retrospectively; their data having been collected prospectively in a structured and...