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A place for nerve transfers in your hand surgery service
The author summarises the application of nerve transfers in upper limb trauma. This is a review article and covers the principles of transfer; the indications, preoperative assessment and the whole patient journey, stressing the need for rehabilitation. The technical factors...
Abdominal problems following breast reconstruction using lower abdominal flaps
Abdominal problems following transverse rectus abdominis myocutaneous (TRAM) and deep inferior epigastric perforators (DIEP) flaps are well recognised in these otherwise excellent methods of breast reconstruction. The authors reviewed 399 patients, of whom 57.7% had surgical complications although most of...
Free style facial artery perforator flaps for nasal reconstruction
This is an update from the team of authors that originally described the free style facial artery perforator flap, for one stage nasal reconstruction, in 2009. They now update after 10 years of experience with these freestyle facial artery perforator...
Free flap reconstruction in stage 3 bisphosphonate related osteonecrosis
There is no widely accepted gold standard for the treatments of bisphosphonate-related osteonecrosis (BRONJ). Whereas the lesser stages of this BRONJ seem to respond well to conservative and minimal invasive therapies there is controversy regarding the treatment of the later...
Coupler microvascular anastomoses: how good?
This is a paper written by a group of reconstructive surgeons and school of computing. This study used computational fluid dynamics to model blood flow through ‘idealised sutured and coupled’ vessels. They investigate if the anastomotic technique affects intra vascular...
Subcutaneous botox
The authors of this paper performed a double blind, randomised, prospective trial on 19 patients receiving intramuscular botulinum toxin injections on one side of the forehead and subcutaneous injections on the other. Objective assessment of brow elevation and subjective self-evaluation...
Diagnosis and management of orbital vascular malformations
This is an authoritative review of a controversial and difficult clinical area. The authors have experience of over 350 cases and provide a well-structured review of the classification and management of orbital vascular malformations. They emphasise the need to understand...
Analysis and outcome of explanted hydroxyapatite orbital implants
This is a retrospective case series over 11 years of 25 patients with exposed synthetic hydroxyapatite orbital implants who underwent explantation and simultaneous replacement with a dermis fat graft. All patients had signs of infection and had been treated with...
Case-based illustration and discussion of surgical modalities to manage traumatic hand defects
The authors present four clinical cases of soft tissue defects affecting the hand and discuss various surgical management options available. These cases include a dorsal hand wound, thumb pulp defect, first webspace defect and a volar finger defect. For each...
Comparing the rates of fat necrosis in irradiated muscle-sparing tram versus diep flap breast reconstruction
The authors performed a retrospective cohort study of patients undergoing immediate autologous breast reconstruction with an abdominal free flap. Over a 17-month period, 625 flaps were included in 518 patients, with 40 flaps receiving irradiation. Mean patient age and BMI...
Distal edge necrosis in cervicofacial rotation-advancement flaps
Mohs facial reconstructive surgery can be a difficult process for a patient to undergo. The goal of facial reconstruction is to restore contour, function and aesthetics while minimising morbidity. The authors conducted a review of 88 patients who underwent cervicofacial...
