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Fat grafting as therapy for Raynaud’s
The authors have adapted the technique of lipo-filling, previously described for rejuvenation of the hand, to achieve symptom reduction in patients with primary and secondary Raynaud’s that had previously failed to respond to medical treatments. The majority of the subjects...
Superiorly based nasolabial flaps
This interesting paper takes the common or garden nasolabial flap to new extremes. The flap is based on the contralateral superior orbital artery and behaves as an axial patterned flap as far as the alar rim, becoming a random patterned...
Additional venous anastomoses to safeguard DIEP flaps
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...
Electrochemotherapy for BCCs
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...
Oestrogen receptors in breast capsules – experimental findings
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...
Raised serum lactate as a marker in the diagnosis of necrotising fasciitis
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...
Pose in imaging the breast
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...
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...
Classification of contour deformities after massive weight loss, using the Pittsburgh Rating Scale
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...
A review of treatment options for acute flexor tendon injuries in zone one
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...
Platysma muscle use for oral sphincter substitution or countering excessive pull of a free muscle, following facial palsy
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...
