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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...

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...

Oncological and functional outcomes of transoral robotic surgery for oropharyngeal cancer

Due to the fact that conventional surgery is technically demanding and involves significant morbidity, transoral procedures are becoming increasingly popular. In this prospective study the authors analysed the oncological and functional results of transoral robotic surgery (TORS) to find out...

Cosmetic botulinum toxin: minimal invasive facial enhancement

Myriam Loyo and Theda Kontis present a review of indications for minimally invasive facial cosmetic procedures, based on chemodenervation with botulinum toxin A. The authors present the following treatments in a well structured manner: chemical brow lift, treatment of hypertrophic...

Nasal reconstruction – short and sweet

This brief article by Stephen S Park presents his modified technique for nasal reconstruction, based on a single-stage forehead flap. The author presents this method as an alternative to a multiple staged interpolated forehead flap and discusses its advantages and...