Trials demonstrating the efficacy of biologic therapy for moderate to severe hidradenitis suppurativa (HS) have inspired new multidisciplinary treatment strategies. We present our experience with combined and surgical recalcitrant HS.Between 2011 2014, 21 patients (57 cases) Hurley Stage III HS underwent radical resection delayed primary closure alone, or in combination adjuvant therapy. Demographic data, regimen, outcomes, complications were retrospectively reviewed all cases.Eleven...

Abstract Background Advances in digital imaging, screen technology, and optics have led to the development of extracorporeal telescopes, also known as exoscopes, alternatives surgical loupes (SLs) traditional operating microscopes (OMs) for magnification. Theoretical advantages exoscope over conventional devices include improved surgeon ergonomics; superior three‐dimensional, high‐definition optics; greater ease‐of‐use. The ORBEYE exoscope, particular, has demonstrated early efficacy arena....

BACKGROUND: Postamputation pain is a debilitating condition that affects almost 60% of transfemoral amputees. Recent appreciation for the contribution peripheral nerve derangement to development postamputation has resulted in focus on role reconstruction preventing after amputation. OBJECTIVE: To propose method involving tibial and common peroneal coaptation at time amputation, as means prevent residual limb phantom sequelae resulting from neuroma formation. METHODS: Between May 2014 2015,...

Carpal coalition is a relatively common, yet poorly recognized, anomaly that may present independently or in association with syndromic metabolic disorders. While largely asymptomatic, symptoms manifest secondary to biomechanical stress at the site of fusion. The purpose this report describe 103 cases carpal synostosis and provide review etiology, classification, clinical significance intercarpal fusion.Retrospective medical radiographic records was conducted on all patients identified...

Background No consensus exists regarding the optimal strategy for perioperative thromboprophylaxis in high-risk microsurgical populations. We present our experience with lower extremity free tissue transfer (FTT) thrombophilic patients and compare outcomes between non-stratified risk-stratified anticoagulation protocols. Methods Between January 2013 December 2017, 57 documented thrombophilia underwent FTT non-traumatic, reconstruction by a single surgeon. Patients were divided into two...

Background Recent evidence documenting high success rates following microvascular diabetic foot reconstruction has led to a paradigm shift in favor of more aggressive limb preservation. The primary aim this study was examine reconstructive and functional outcomes patients who underwent free tissue transfer (FTT) for recalcitrant ulcers (DFUs) at our tertiary referral center advanced salvage. Methods Between June 2013 2016, 29 lower extremity FTT by the senior author (K.K.E.). In all cases,...

Background: Limb salvage techniques using free tissue transfer in patients with chronic wounds caused by longstanding osteomyelitis, diabetes, and peripheral vascular disease are technically challenging. The longitudinal slit arteriotomy end-to-side anastomosis is the authors’ preferred technique because it least invasive especially important for diseased recipient arteries. authors reviewed highly comorbid who underwent this to understand success rates, overall outcomes, long-term limb...

<b>Background</b> Undiagnosed thrombophilia is a risk factor for flap failure; however, its prevalence in patients undergoing microsurgical reconstruction unknown. We present our experience with free tissue transfer (FTT) high-risk population of lower extremity documented thrombophilia, identified through preoperative screening. <b>Methods</b> Between January 2012 and April 2014, 41 underwent 43 flaps nontraumatic, by single surgeon. Patients were preoperatively screened using historical...

Sir: Maggot débridement therapy, using larvae of the blowfly Phaenicia sericata, is a proven, cost-effective alternative for treating drug-resistant, chronically infected wounds in patients who are poor operative candidates.1 therapy serves to enhance healing through selective necrotic tissues and reduction bacterial burden that often plagues gangrenous, recalcitrant wounds. A recent meta-analysis evaluating safety effectiveness maggot revealed significant improvements both rate efficiency...

In cases of total knee arthroplasty (TKA) threatened by potential hardware exposure, flap-based reconstruction is indicated to provide durable coverage. Historically, muscle flaps were favored as they vascular tissue an infected wound bed. However, data comparing the performance versus fasciocutaneous are limited and reflect a lack consensus regarding optimal management these wounds. The aim this study was compare outcomes following salvage compromised TKA.A systematic search meta-analysis...

Abstract Background Advancements in three-dimensional (3D) printing have enabled production of patient-specific guides to aid perforator mapping and pedicle dissection during abdominal flap harvest. We present our early experience using this tool navigate deep inferior epigastric artery (DIEA) topography evaluate its impact on operative efficiency clinical outcomes. Patients Methods Between January 2013 December 2018, a total 50 women underwent computed tomographic angiography (CTA)-guided...

Sir: Calcified atherosclerosis, affecting donor and/or recipient vessels, is a known predictor of microvascular complications and flap loss following lower extremity free tissue transfer.1 Among the mechanisms implicated in this association, tendency toward intimal separation during passage transmural sutures relative vascular compliance increase risk anastomotic failure due to thrombosis pedicle kinking, respectively.2 Although operative planning/recipient-vessel selection should facilitate...

Primary intraosseous venous malformations affecting the zygoma are rare vascular lesions, with only 35 cases reported in surgical literature. Despite establishment of binary classification system, which serves to distinguish tumors from malformations, inappropriate use term "hemangioma" describe a variety distinct anomalies remains widespread. The authors present 3 zygomatic and summarize clinical, radiographic, immunohistochemical features these lesions. In each case, an insidious clinical...

<b>Background</b> Functional outcomes and quality-of-life measures following salvage reconstruction of composite Achilles/posterior leg defects are limited. We present our experience with combined Achilles defect utilizing free tissue transfer vascularized neotendon constructs. <b>Methods</b> Between 2011 2012, six patients underwent complex by a single surgeon. Demographic functional data were collected for each patient. Subjective evaluation obtained preoperatively postoperatively using...

Background: Poor health literacy is an epidemic in the United States, associated with higher mortality rates and poor postoperative care. Autologous breast reconstruction highly complex, identification of complications difficult even for non–plastic surgeon practitioners. The authors sought to explore problem this context identify ideal patient education materials. Methods: Available online materials autologous corresponding readability scores were assessed. To derive formula materials,...

The composite anterolateral thigh flap with vascularized fascia lata has emerged as a workhorse at our institution for complex Achilles defects requiring both tendon and soft tissue reconstruction. Safe elevation of this flap, however, is occasionally challenged by absent or inadequate perforators supplying the thigh. When discovered intraoperatively, alternative options derived from same vascular network can be pursued. We present case 74-year-old male who underwent defect reconstruction...