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Burns Trauma 2019 1;7. Epub 2019 Mar 1.

Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, 1-1-5 Sendagi Bunkyo-ku, Tokyo, 113-8603 Japan.

Scars are the final result of the four processes that constitute cutaneous wound healing, namely, coagulation, inflammation, proliferation, and remodeling. Permanent scars are produced if the wounds reach the reticular dermis. The nature of these scars depends on the four wound healing processes. Read More

J Orthop 2019 Mar-Apr;16(2):145-150. Epub 2019 Feb 28.

CARECI, University of Messina, Via consolato del mare 41, 98121, Messina, Italy.

In this paper, an innovative design of prosthesis, conceived to heal the comminuted fractures of long bones has been investigated. The proposed prosthesis consists of two shell valves hinged to each other by a central pin and bearing slits along the surface in such a way as to guarantee the exchange of body fluids and at the same time ensure the structural stability of the bone. Two screws then hold the two valves together. Read More

JBJS Essent Surg Tech 2014 Dec 11;3(4):e23. Epub 2013 Dec 11.

Tulane University Department of Orthopaedic Surgery, 1430 Tulane Avenue SL-32, New Orleans, LA 70112. E-mail address for F.H. Savoie:

Introduction: In the overhead throwing athlete, medial ulnar collateral ligament reconstruction utilizing a hamstring allograft as an alternative to an autograft provides similar results without the donor site morbidity or potential complications of autograft harvest.

Step 1 Mri Or Mra And Preoperative Planning: Obtain an MRI or MRA to determine the location and importance of the tear in the ligament.

Step 2 Medial Elbow Dissection And Identification Of The Medial Ulnar Collateral Ligament: Position the elbow to allow access to the medial side, and expose the medial ulnar collateral ligament via a flexor-pronator split approach. Read More

JBJS Essent Surg Tech 2014 Mar 27;3(1):e6. Epub 2013 Mar 27.

San Diego Center for Spinal Disorders, 4130 La Jolla Village Drive, Suite 300, La Jolla, CA 92037. E-mail address for G.M. Mundis: E-mail address for N. Kabirian: E-mail address for B.A. Akbarnia:

Introduction: The dual growing-rod technique involves implantation of a set of two rods and two anchor groups (upper and lower foundations) to exert frequent distractions to allow for spinal growth.

Step 1 Initial Surgery Positioning: Pay special attention to the effect of positioning on sagittal alignment.

Step 2 Initial Surgery Neuromonitoring: Use multimodality intraoperative neuromonitoring, including SSEPs, MEPs, EMG, and H-Reflexes. Read More

Plast Reconstr Surg Glob Open 2018 Nov 13;6(11):e2001. Epub 2018 Nov 13.

University of Veterinary and Animal Sciences, Lahore.

Background: Cleft palate is a common congenital problem. It is traditionally surgically repaired with interrupted sutures between the ages of 6 and 18 months, with the aim of achieving closure of both nasal and oral layers. In various fields of surgery, continuous, rather than interrupted, sutures are the norm. Read More

World Neurosurg 2019 Mar 14. Epub 2019 Mar 14.

Department of Diagnostic Radiology, University Hospital of Heraklion, Medical School, University of Crete.

Background: Giant Tarlov cysts are always symptomatic, and mimic many serious pathological entities. We present the largest reported Tarlov cyst.

Case Description: A 33-year-old female with Marfan syndrome suffered from right kidney hydronephrosis due to ureter obstruction, for which she was treated with nephrostomy. Read More

J Ethnopharmacol 2019 Mar 14;236:354-365. Epub 2019 Mar 14.

Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan. Electronic address:

Ethnopharmacological Relevance: Oil extracted from Parrotiopsis jacquemontiana stem traditionally used for wound healing, body aches and dermatitis. In this study we have evaluated oil for its phytoconstituents, antioxidant, antimicrobial and wound healing activities.

Methods: Phytochemical characterization of oil was determined by standard qualitative procedures, gas chromatography mass spectrometry technique (GC-MS) and Fourier transform infra-red spectroscopy (FT-IR). Read More

Biomed Pharmacother 2019 Mar 13;113:108724. Epub 2019 Mar 13.

Faculty of Dentistry, Thammasat University, (Rangsit Campus), Paholyothin Road, Klongluang, Pathumthani 12121, Thailand; Center of Excellence in Medicinal Herbs for Treatment of Oral Diseases, Thammasat University. Electronic address:

Aims: Clinacanthus nutans (C. nutans) has demonstrated anti-inflammatory activity, however, the active compound generating this activity remains unknown. The aim of this study was to identify the bioactive compound in C. Read More

J Vis Exp 2019 Feb 23(144). Epub 2019 Feb 23.

Department of Biological Sciences, Northern Arizona University; Department of Mechanical Engineering, Northern Arizona University; Center for Bioengineering Innovation, Northern Arizona University;

Understanding the physiologic mechanisms of wound healing has been the focus of ongoing research for many years. This research directly translates into changes in clinical standards used for treating wounds and decreasing morbidity and mortality for patients. Wound healing is a complex process that requires strategic cell and tissue interaction and function. Read More

Plast Surg (Oakv) 2019 Feb 11;27(1):29-37. Epub 2018 Jan 11.

Department of Plastic, Reconstructive, and Aesthetic Surgery, Erciyes University Medical Faculty, Kayseri, Turkey.

Tension of the wound edges should be overcome with precise surgical planning, which is recognized as one of the major contributors to local complications by compromising circulation of the wound edges. In this article, it was aimed to present the clinical results of a surgical technique, in which the plastic straps and Kirschner wires are used for delayed primary closure of traumatic tension wounds. Depending on the assessment of the wound localization, wound dimension, and mobility of adjacent soft tissue, the technique was performed in 9 patients with a male to female ratio of 8:1. Read More

J Sex Med 2019 Mar 6. Epub 2019 Mar 6.

Mayo Clinic, Department of Urology, Rochester, MN, USA. Electronic address:

Introduction: Scrotoplasty has become a common practice during insertion of penile prosthesis, improving patient perception of penile length. Previous reports on scrotoplasty outcomes have only focused on the perceived benefits. The risk of wound complications after scrotoplasty is unknown. Read More

Anaesth Crit Care Pain Med 2019 Mar 2. Epub 2019 Mar 2.

Anaesthesia and Intensive Care, Hôtel-Dieu, 75181 Paris, France.

Infection is a risk for any intervention. In surgery, for example, pathogenic bacteria are found in more than 90% of operative wounds during closure. This exists whatever the surgical technique and whatever the environment (the laminar flow does not entirely eliminate this risk). Read More

World J Surg 2019 Mar 1. Epub 2019 Mar 1.

Division of General, Oncological and Vascular Surgery, Ospedali Riuniti Marche Nord, Pesaro, Italy.

Although end colostomy closure following Hartmann's procedure is a major surgery that is traditionally performed by conventional celiotomy, over the last decade there has been a growing interest toward the application of different minimally invasive techniques. We aimed at evaluating the relative outcomes of conventional surgery versus minimally invasive surgery by meta-analyzing the available data from the medical literature. The PubMed/MEDLINE, Cochrane Library and EMBASE electronic databases were searched through August 2018. Read More

Am Surg 2019 Feb;85(2):162-166

The ideal incision for specimen extraction during laparoscopic colorectal surgery is controversial. The objective of this study was to compare incision types (Pfannenstiel, periumbilical, lower midline, and right upper quadrant transverse) with regard to postoperative scar appearance, symptoms, preference, and satisfaction. This study is a retrospective survey review performed in an urban teaching hospital. Read More

Medicine (Baltimore) 2019 Mar;98(9):e14488

Department of Obstetric and Gynecologic, West China Second University Hospital, Sichuan University, Sichuan, China.

Placenta previa accreta is an obstetrical complication that severely affects the heath of the fetus and the mother due to massive hemorrhage during pregnancy. This study reported a new suture technique called "cervical internal os plasty" to control obstetrical hemorrhage in cesarean delivery for patients with placenta previa accreta and retrospectively evaluated the safety and effectiveness of the new technique.From January 2012 to May 2018, we collected 56 patients with this new suture technique, which repaired the damaged weak area with bleeding from the placental attachment site in the lower uterine segment, and restored the damaged anatomic internal os of the cervix. Read More

Pharmaceutics 2019 Feb 26;11(3). Epub 2019 Feb 26.

Department of Mechanical Engineering, Yonsei University, Yonsei-ro 50, Seoul 03722, Korea.

Microneedles (MNs) have been extensively developed over the last two decades, and highly efficient drug delivery was demonstrated with their minimal invasiveness via a transdermal route. Recently, MNs have not only been applied to the skin but also to other tissues such as blood vessels, scleral tissue, and corneal tissue. In addition, the objective of the MN application has been diversified, ranging from drug delivery to wound closure and biosensing. Read More

Medicine (Baltimore) 2019 Feb;98(8):e13571

Department of Thoracic Surgery.

Rationale: While performing esophago-ileal anastomosis after esophagectomy with circular staplers, the mucosal folds of the ileum can complicate stapling and lead to obstruction, especially when the diameter of the circular stapler is equal or greater than that of the small bowel lumen.

Patient Concerns: A 53-year-old man, presented with complaints of difficulty in swallowing for 2 weeks. Fifteen years previously, he had undergone partial gastrectomy for gastric ulcers. Read More

Tech Coloproctol 2019 Feb 26. Epub 2019 Feb 26.

Division of Colorectal Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Taylor Pavilion, Suite D-365, 100 Woods Road, Valhalla, NY, 10595, USA.

Background: There is no level 1a evidence regarding the best technique for skin closure at loop ileostomy reversal. The aim of this study was to evaluate whether purse-string skin closure (PSC) is associated with lower surgical site infection (SSI) rates as compared to linear skin closure (LC).

Methods: EMBASE, MEDLINE, Pubmed, Cochrane Library, Web of Science, and CINAHL databases were systematically searched. Read More

Crit Rev Biomed Eng 2019 ;47(1):59-99

Hamilton Health Sciences, Suite 515, 644 Main Street West, Hamilton, Ontario, Canada L8S 1A1.

The topographic anatomy of the sternum is similar in a healthy population. However, in a clinical subset of patients with comorbidities such as diabetes mellitus, chronic obstructive pulmonary disease, high body mass index, chronic renal disease, or age-related osteoporosis, there are significant changes in the normal physiology that may influence overall patient outcome following trans-sternal intrathoracic surgery. These changes can create technical difficulties in reconstructing the bisected sternum and adversely affect the biomechanics of the thoracic wall, forcing difficult surgical choices with regard to implant options and increasing the cost of an otherwise routine cardiac surgery. Read More

Crit Rev Biomed Eng 2019 ;47(1):27-57

Hamilton Health Sciences, Suite 515, 644 Main Street West, Hamilton, Ontario, Canada L8S 1A1.

The intact one-piece sternum is indispensible to the thorax for its normal physiological biomechanics. To overcome tri-planar forces acting on the sternum following midsagittal osteochondrotomy, it must be reconstructed using an optimal technique to withstand distraction loads of normal respiration and violent cough. It should be fixed rigidly to reconstitute the anterior coronal column of the axial skeleton to maintain erect posture and prevent kyphosis. Read More

In Vivo 2019 Mar-Apr;33(2):495-500

Section Upper Extremity, Foot and Rheuma Surgery, Trauma Department, Medical School Hanover (MHH), Hanover, Germany

Background/aim: There is a need for a simple and atraumatic technique for wound closure in soft tissue defects. The aim of this study was to evaluate the technique of skin extension by multiple incisions in the healing of soft tissue defects following trauma.

Patients And Methods: This is a retrospective clinical study on soft tissue defects after trauma. Read More

Heart Surg Forum 2019 01 21;22(1):E008-E010. Epub 2019 Jan 21.

Department of Cardiovascular Surgery, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.

We performed Bentall procedure on a 65-year-old male patient. Cardiopulmonary bypass was initiated via cannulation of the aneurysmatic segment of the aorta. Distal anastomosis was performed with the open technique under deep hypothermic circulatory arrest at 18°C. Read More

J Am Acad Dermatol 2019 Feb 21. Epub 2019 Feb 21.

Department of Dermatology, University of California-Davis, Sacramento, CA. Electronic address:

Background: Absorbable suture material (Fast Absorbing Gut (FG)) is often employed for patient convenience, however, the optimal diameter of FG sutures is debatable.

Objective: To determine whether the use of 6-0 FG during repair of linear cutaneous surgery wounds on the head and neck improves scar cosmesis compared to 5-0 FG.

Methods: This was a prospective, randomized, split-scar intervention in patients undergoing repair of linear cutaneous wounds on the head and neck. Read More

Prague Med Rep 2018 ;119(4):148-155

Department of General Surgery, Okan University Medicine Faculty, Istanbul, Turkey.

Our study aims to compare the surgical outcome of Limberg transposition flap, Karydakis flap, and primary closure after excision to treat sacrococcygeal pilonidal sinus disease. A total of 634 patients with pilonidal sinus who underwent surgery were evaluated retrospectively from January 2014 to January 2016. The patients were divided into three groups. Read More

J Foot Ankle Surg 2019 Feb 13. Epub 2019 Feb 13.

Professor, Department of Orthopaedics and Traumatology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey.

Distal tibia and fibula fractures are challenging injuries to treat as evidenced by the high rates of wound complications because of vulnerable soft tissue coverage. The aim of this study was to examine the effect on soft tissue complications of the pie-crusting technique when applied between 2 incisions in distal tibia and fibula fractures treated with open reduction and internal fixation. We reviewed 34 patients with distal tibia and fibula fractures treated between September 2014 and March 2017. Read More

VideoGIE 2019 Feb 7;4(2):91-94. Epub 2018 Dec 7.

Division of Gastroenterology and Hepatology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.

Background And Aims: GI tract perforations and anastomotic dehiscence are increasingly effectively being repaired endoscopically; however, well-known and long-held surgical principles must still be honored. One important principle is that significant extraluminal contamination must be washed out, debrided, and drained in conjunction with repair of the defect if the wound is to effectively heal and resolve. Here we describe the use of endoscopic washout and debridement of extraluminal contamination at the time of luminal defect closure in a 7-patient series at our institution, with video demonstration of 2 patients in the series. Read More

Am Surg 2019 Jan;85(1):e31-e33

Am Surg 2019 Jan;85(1):1-7

Surgical site infection (SSI) and incisional hernia are common complications after major pancreatectomy. We investigated the effects of negative pressure wound therapy (NPWT) on short- and long-term wound outcomes in patients undergoing pancreatectomy. A randomized controlled trial comparing the effect of NPWT with standard surgical dressing (SSD) on wounds was performed in 265 patients undergoing open gastrointestinal resections from 2012 to 2016. Read More

J Hand Surg Asian Pac Vol 2019 Mar;24(1):65-71

† Department of Orthopaedic Surgery, Wakamatsu Hospital, University of Occupational and Environmental Health, Kitakyushu, Japan.

Background: Some cases treated with open palm technique need relatively long wound healing time. This study aims to clarify whether the preoperative lifestyle-related diseases or factors are associated with surgical results after the open palm technique for Dupuytren's contracture.

Methods: The study included 122 fingers of 84 hands of 84 consecutive male patients with Dupuytren's contracture who were treated with McCash's open palm technique at our hospital from 1980 to 2016. Read More

Am Surg 2018 Oct;84(10):1665-1669

Department of General Surgery, University of California Los Angeles, Los Angeles, California, USA.

Surgical site infections (SSIs) are considered a quality metric across surgical specialties and are a major cause of increased readmissions and overall costs to surgical patients. Bundled interventions have demonstrated efficacy in reducing SSIs in various surgical fields, yet the ability to sustain and spread interventions while continuing to reduce infection rates is a significant challenge. This study assessed the implementation and sustainability of an SSI bundle, which was initially piloted within the colorectal surgery division and then spread to additional general surgery services. Read More

Am Surg 2018 Nov;84(11):e494-e497

Am Surg 2018 Nov;84(11):1790-1795

Little data exist about management of wounds created by debridement in necrotizing soft tissue infections (NSTIs). Multiple wound coverage techniques exist, including complete primary wound closure, split-thickness skin grafting, secondary intention, and flap creation. We hypothesized that all wound coverage techniques would be associated with high rates of successful wound coverage and low crossover rates to other wound coverage techniques. Read More

Am Surg 2018 Nov;84(11):1756-1761

Internal hernias are one of the most devastating late, postsurgical complications associated with laparoscopic Roux-en-Y gastric bypass (LRYGB). The objective of this study was to determine whether placement of a bioabsorbable tissue matrix in soft tissue defects after gastric bypass resulted in a lower incidence of internal hernia development. Prospective database was used to identify all patients who underwent LRYGB between January 2002 and January 2016. Read More

Am Surg 2018 Nov;84(11):1741-1744

Construction of diverting loop ileostomy has become a common adjunct to low anterior resection for rectal cancer because it substantially reduces the severity of postoperative morbidity. Various trials have compared hand-sewn with stapled anastomotic techniques, but the existing evidence regarding different configurations of hand-sewn anastomoses is scarce. The aim of this study is to compare the early postoperative outcomes of loop ileostomy reversal using the hand-sewn end-to-end or side-to-side configuration. Read More

Am Surg 2018 Nov;84(11):1734-1740

Pancreatic stump leak after distal pancreatectomy (DP) is a major determinant for impaired postoperative recovery. Factors influencing pancreatic fistula (PF) occurrence remain of interest. Prospectively collected data from an academic surgical oncology practice were examined for predictors of PF. Read More

Clin Implant Dent Relat Res 2019 Feb 11. Epub 2019 Feb 11.

Department of Oral- and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany.

Objectives: The aim of this preclinical study was to analyze and compare different grafting techniques with respect to volume stability after wound closure.

Materials And Methods: Four different grafting techniques were evaluated in vitro for volume stability in a one-wall horizontal defect configuration. Group 1: guided bone regeneration (GBR) with collagen membrane, particulated xenograft; group 2: GBR with collagen membrane, particulated xenograft, pins; group 3: GBR with titanium-reinforced membrane, particulated xenograft, pins; group 4: autogenous block graft, particulated xenograft, collagen membrane. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2019 Feb;33(2):219-222

Department of orthopedics, the Joint Service Support Force 920 th Hospital of Chinese PLA, Kunming Yunnan, 650032, P.R.China.

Objective: To investigate the effectiveness of self-made limb chronic wound closure device in the treatment of scarred lower limbs and complex skin and soft tissue defects.

Methods: Between January 2014 and January 2017, 29 patients with complex fractures of the lower extremities and skin and soft tissue defects were treated. There were 19 males and 10 females with an average age of 31. Read More

Int J Surg Case Rep 2019 29;55:132-135. Epub 2019 Jan 29.

Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.

Introduction: Diffuse plexiform neurofibroma (DPN) in patients with neurofibromatosis type 1 (NF1) causes motility dysfunction in severe cases. Transcatheter arterial embolisation (TAE) is an effective haemorrhage control method in vascular tumour surgery.

Presentation Of Case: We performed debulking surgery for DPN in the buttock and posterior thigh of two NF1 patients. Read More

J Photochem Photobiol B 2019 Mar 30;192:124-130. Epub 2019 Jan 30.

Department of Emergency, Linyi Central Hospital, Linyi 276400, Shandong, China. Electronic address:

Wound dehiscence is a surgical complication and its management is inevitable because 25% to 35% of patients suffered from post laparotomy wound dehiscence. The excellent biodegradability and biocompatibility of chitosan and alginate have provided ample space for future developments in biomedical applications. Hence, the present work is directed towards the synthesis of robust biofilm made up of chitosan (CS), zinc oxide (ZnO) nanoparticles and Alginate (Alg). Read More

Hernia 2019 Feb 8. Epub 2019 Feb 8.

Department of Surgery, New Hanover Regional Medical Center, 2131 South 17th Street, PO Box 9025, Wilmington, NC, 28401, USA.

Purpose: The penetration of hernia prevention techniques into surgical practice remains unknown.

Methods: A survey about knowledge/attitudes on hernia prevention was sent to the members of hernia societies.

Results: The 497 respondents were mostly from the US (47%) or Europe (40%). Read More

Langenbecks Arch Surg 2019 Feb 7. Epub 2019 Feb 7.

Department of Visceral and Transplant Surgery, University Hospital Zurich, Rämistrasse 100, CH-8091, Zürich, Switzerland.

Purpose: Therapeutic approaches for septic open abdomen treatment remain a major challenge with many uncertainties. The most convincing method is vacuum-assisted wound closure with mesh-mediated fascia traction with a protective plastic sheet placed on the viscera. As this plastic sheet and the mesh must be removed before final fascial closure, such a technique only allows temporary abdominal closure. Read More

J Maxillofac Oral Surg 2019 Mar 21;18(1):131-138. Epub 2018 Apr 21.

Mysuru, India.

Introduction: Effective wound closure is critical for minimizing wound complications and preventing wound dehiscence. The various wound closure techniques include staples, traditional nylon and skin sutures, subcuticular sutures, and skin adhesives. Currently topical skin adhesives are frequently being used. Read More

J Maxillofac Oral Surg 2019 Mar 5;18(1):40-45. Epub 2018 Mar 5.

2Department of Surgery, University of Sokoto, Sokoto, Nigeria.

Aim: The aim of the study is to describe the technique and also the outcome of using buccal fat pad (BFP) as an adjunct flap in cleft palate repair and to report the surgical outcome.

Materials And Methods: All the surgical repairs with BFP were done under general anaesthesia. The use of BFP was indicated in patients who needed a secondary palatal cleft repair, those with wide palatal clefts or patients whose primary palatal cleft repair was complicated intraoperatively by inadvertent tearing of the nasal mucosa. Read More

Heart Lung Circ 2019 Mar;28(3):358-359

Waikato Cardiothoracic Unit, Waikato Hospital, Hamilton, New Zealand; Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand; University of Waikato Medical Research Centre, The University of Waikato, New Zealand. Electronic address:

Anticancer Res 2019 Feb;39(2):1013-1018

First Department of Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan.

Background/aim: Although perioperative management and operative techniques for pancreatic surgery have improved, postoperative pancreatic fistula (POPF) remains the major cause of morbidity and mortality following distal pancreatectomy (DP). The purpose of this study was to evaluate the superiority of the reinforced stapler compared to the bare triple row stapler.

Patients And Methods: A total of 93 patients who underwent DP at the First Department of Surgery at Yamanashi University were examined. Read More

J Clin Orthop Trauma 2019 Jan-Feb;10(1):111-116. Epub 2017 Nov 13.

Department of Orthopedics, P.D Hinduja Hospital and Medical Research Centre, Mumbai, India.

Objective: With the trend towards accelerated rehabilitation, the method of skin closure has become increasingly important in orthopedic surgery. It is imperative to evaluate a technique that provides superior clinical and cosmetic results specifically for TKA, due to relatively thin skin anterior to the knee making poor wound healing an issue of concern. We conducted a prospective, single-arm audit evaluating the patient assessments of incision cosmesis for a novel technique in TKA wound closure called Concealed Cosmetic Closure (CCC). Read More

Hernia 2019 Feb 30;23(1):157-165. Epub 2019 Jan 30.

Hernia Center, Hospital Alemão Oswaldo Cruz, R. Treze de Maio, 1815, 01327-001, São Paulo, SP, Brazil.

Purpose: A residual bulge in the lateral abdominal wall is a reason for patient dissatisfaction after flank hernia repair (FHR). We hypothesized that combining a laparoscopically-placed intraperitoneal mesh (IPOM) with onlay hernia repair performed through a small open incision would increase repair durability and decrease such residual bulges. We aim to report our medium-term outcomes with this technique. Read More

Ann Plast Surg 2019 Jan 28. Epub 2019 Jan 28.

From the Department of Plastic Surgery, University of Virginia Health System, Charlottesville, VA.

Introduction: The obese or ptotic breast demonstrates significant difficulty in breast reconstruction after mastectomy with increased rates of perioperative complications compared with the general population, regardless of reconstruction type. Implant-based reconstruction in this patient population with the traditional horizontal elliptical skin-sparing mastectomy tends to have aesthetically displeasing qualities secondary to skin flap redundancy and blunting of the breast contour. Wise-pattern closures have been described with submuscular direct-to-implant and 2-stage reconstructions, with more favorable complication profile when staged. Read More

Wounds 2019 Jan;31(1):E1-E4

Christus Trinity Mother Frances Hospitals, Tyler, TX.

Introduction: Negative pressure wound therapy with instillation and dwell time (NPWTi-d) cleanses wounds with cyclic delivery, dwell, and removal of topical solutions to solubilize infectious materials and wound debris.

Objective: In this 2-patient case study, the authors report their experiences using NPWTi-d on 2 critically ill patients requiring management of large, complex wounds.

Materials And Methods: In both cases, normal saline was instilled with 10- to 20-minute dwell times, followed by 2 hours of negative pressure wound therapy (NPWT) at -125 mm Hg. Read More

J Cardiothorac Surg 2019 Jan 28;14(1):25. Epub 2019 Jan 28.

Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Background: Morbidly obese patients (body mass index [BMI] ≥ 35 kg/m) who undergo cardiac surgery involving median sternotomy have a higher-than-normal risk of sternal dehiscence. To explore a potential solution to this problem, we examined the utility of transverse sternal plating for primary sternal closure in morbidly obese cardiac surgical patients.

Methods: We retrospectively reviewed data from cardiac surgical patients who underwent single primary xiphoid transverse titanium plate reinforcement for primary sternal closure from August 2009 to July 2010 (n = 8), and we compared their outcomes with those of patients with BMI ≥35 kg/m who underwent cardiac surgery without sternal plate reinforcement from April 2008 to July 2009 (n = 14). Read More