That DIEP flaps can be troublesome is not news and many descriptions exist trying to circumvent these problems. The most common problem is venous congestion in the flap and this paper presents an ingenious method of anticipating and forestalling such...
A remarkable account of an effective non-surgical treatment for basal cell carcinomas (BCCs). Electrochemotherapy (ECT) consists of making the area surrounding the lesion temporarily permeable using electric pulses (under local anaesthesia), then bleomycin is administered to the area. The treatment...
This study from Rome, on humans, is stated by the authors to be not definitive and further work is required before any treatment can be recommended. But careful analysis of oestrogen receptors in breast capsules and the number of fibroblasts...
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...
Inconsistency in breast imaging is remarkably frequent. Even a simple photograph can mislead, depending upon whether or not the arms are held by the sides, are raised above the head or are akimbo. However, the real gold standard in three...
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...
While the treatment of patients by skin reduction following massive weight loss is increasing, the conclusions of this study from the Netherlands finds that the Pittsburgh Rating Scale is not entirely suitable for this classification purpose and another system must...
This review reports the techniques that have been and are still used to repair acute injuries in this difficult area. The review does not end with a ‘best buy’ in the tradition of a consumer magazine, concluding that there is...
The use of the platysma muscle as a pedicled ‘apron’ flap in order to minimise the overactivity of a free muscle transfer, used in the treatment of facial palsy, is described in admirable detail. The successful results are carefully assessed...
Classification systems come and go, some more memorable than others. Without such systems it is not possible to compare like with like and so it must be conceded that they are necessary, although I personally find them difficult to commit...
James Partridge died on 16 August 2020. He was a truly remarkable person and I would like to share my sadness at his passing and why I held him in such high personal esteem. We started life just a few...
Although I am retired, I still receive the British Medical Journal every week and feel slightly guilty if I do not at least tear off the plastic cover before I throw it into the recycle bin... By taking off the...