Cold intolerance following microsurgical replantation of finger amputations: A retrospective cohort study.

Purpose: Cold intolerance following finger amputation is a major postoperative complication. Although current evidence suggests decreased blood flow to digital peripheral vessels may be associated with cold intolerance, the underlying mechanism remains controversial. This study aimed to investigate the relationship between skin perfusion in affected fingers and the presence of cold intolerance.

Double-Pedicled Vertical Rectus Abdominis Myocutaneous Flap for Sternal Dehiscence Due to Deep Sternal Wound Infection: The Twelfth Intercostal Artery Perforator as an Additional Pedicle.

A 50-year-old male with diabetes mellitus, who experienced recurrent sternal dehiscence secondary to a deep sternal wound infection, failed to respond to treatment with both pectoralis major muscle and greater omental flaps. Consequently, we performed a vertical rectus abdominis muscle flap in a double-pedicle fashion, utilizing the internal mammary artery and the 12th intercostal artery perforator. This intervention successfully addressed the condition.

Natural progression and early recurrence of venous malformations following surgical and endovascular treatments: A 15-year retrospective cohort study.

BackgroundVenous malformations (VMs) are the most common type of vascular malformation. Recurrence after treatment remains a significant challenge in clinical management.MethodsA multi-center retrospective cohort study was conducted on consecutive patients who received surgical or endovascular VM treatment from 2005 to 2020.

The Evolution of the Specialist Surgeon Workforce in East, Central and Southern Africa.

Background: Access to surgery across sub-Saharan Africa faces persistent challenges with substantial disparity between disease burden and the surgical workforce. This updated situational analysis of specialist surgeons was undertaken to monitor progress toward global surgery development goals and address workforce deficits.

Methods: A cross-sectional analysis of the surgeon workforce across 12 of the 14 member countries of The College of Surgeons of East, Central and Southern Africa (COSECSA) was conducted between 2021 and 2022.

Diagnosis and Management of Tuberous Sclerosis Complex in a Resource-Limited Setting-A Case Report of a 14-Year-Old Female Zambian Adolescent.

Tuberous sclerosis complex (TSC) is a rare multisystemic neurocutaneous syndrome with a wide spectrum of clinical manifestations. We present a case of a 14-year-old adolescent female who presented with a history of facial angiofibromas since the age of 8 months. Physical examination was remarkable for multiple angiofibromas on the face, and other multiple cutaneous manifestations of TSC.

Gender and racial diversity Assumed by text-to-image generators in microsurgery and plastic surgery-related subspecialities.

Background: Since the release of ChatGPT by OpenAI in November 2022, generative artificial intelligence (AI) models have attracted significant attention in various fields, including surgery. These advancements have been particularly notable for creating highly detailed and contextually accurate images from textual prompts. A notable area of clinical application is the representation of surgeon demographics in various specialties, particularly in the context of microsurgery and plastic surgery-related subspecialties.

Massive facial keloid precipitated by chronic suppuration and mechanical skin traction: A case report.

Keloids are benign fibroproliferative tumours with a high recurrence rate of 20%-100%, therefore, multimodal treatment is recommended. We report the case of an exceptionally large facial keloid precipitated by a vicious cycle of chronic inflammation and mechanical skin traction and discuss the management challenges in a low resource setting. A 67-year-old man presented with a 10-year history of a facial keloid that rapidly enlarged to 2,800 g in 2 years causing difficulties eating, speaking, dressing, head movements and breathing.

Immediate foot reconstruction and revascularization of toes using an interposition superficial circumflex iliac artery perforator flow-through flap: A case report.

Foot injuries, particularly degloving injuries, can lead to segmental loss of neurovascular structures in the toes, making simultaneous reconstruction of both the foot and toes challenging. This case report presents a technique using the superficial circumflex iliac artery perforator (SCIP) flap for immediate reconstruction of the dorsal foot and revascularization of multiple toes. A 28-year-old man suffered a degloving injury on the dorsum of his foot resulting in a 9 × 6cm skin defect, open fracture dislocations, exposure of tendons, and neurovascular injury, which included a 6-7.

Treatment Effectiveness and Recurrence of Extracranial Arteriovenous Malformations Following Surgical Operations: A 15-Year Retrospective Cohort Study.

Background: At present, there is no golden standard for treatment of extracranial arteriovenous malformations (AVMs) and recurrence remains a major challenge with limited available evidence on the associated factors. This study aimed to evaluate the effectiveness of surgical treatment options, in terms of size reduction, symptoms, and early recurrence in patients treated surgically for AVMs.

Methods: A retrospective cohort study was conducted to evaluate patients with AVMs following surgical treatment in 2 centers from 2005 to 2020.

Microsurgical Treatment for Arteriovenous Malformations in the Hand.

Vascular malformations in the extremities are a common site of occurrence; arteriovenous malformations (AVMs) are the least frequent of all vascular malformations, estimated at 5% to 20%. The first step in management is to perform a thorough clinical examination. Symptoms are assessed, and staging is performed using the Schobinger classification.

Anatomical external auricular muscle transposition with mini flap transfer for mild cryptotia: A case report.

Cryptotia is a congenital ear deformity characterized by the upper helix buried under the skin of the temporal region. Recurrence and inadequate correction of ear position are major complications following auricle reconstruction. Abnormalities of the auricular muscles are closely associated with cryptotia and considered to be the main cause.

Safety of SARS-CoV-2 Vaccination in Patients with Vascular Malformations: Patient-Reported Adverse Vaccine Reactions.

Concerns among susceptible individuals, especially those with vascular malformations, have been raised by reports of thromboembolism following the administration of the SARS-CoV-2 vaccination against coronavirus disease 2019 (COVID-19). This study's goal was to assess any negative side effects that patients with vascular malformations who received the SARS-CoV-2 vaccine reported after receiving it. Through the three patient groups for vascular malformations in Japan in November 2021, a questionnaire was distributed to patients with vascular malformations who were 12 years of age or older.

Structural and functional analysis of the newt lymphatic system.

Regeneration competent vertebrates such as newts and salamanders possess a weakened adaptive immune system characterized by multiple connections between the lymphatic system and the blood vascular system called lymphatic hearts. The role of lymphatic vasculature and these lymphaticovenous connections in regeneration is unknown. We used in-vivo near-infrared lymphangiography, ultra-high frequency ultrasonography, micro-CT lymphangiography, and histological serial section 3-dimentional computer reconstruction to evaluate the lymphatic territories of Cynops pyrrhogaster.

Tsugishige Kondo, The Father of Japanese Surgery: Exploring the History of Hideyo Noguchi's Hand Reconstruction With a Forearm Flap Before the Establishment of Plastic Surgery in Japan.

Hideyo Noguchi is one of the most famous scientists in Japan's history, and his portrait has adorned the ¥1,000 banknotes since 2004. He had a childhood burn injury resulting in severe hand scarring and contracture that plagued his early life and education.The resulting hand deformity required 3 separate reconstructions with the third and most complex surgery performed by Professor Tsugishige Kondo just before Noguchi's final medical doctor license examination in 1897.

Intra-lymphocele microsurgical identification of causative afferent vessels for effective lymphaticovenular anastomosis in lymphocele treatment: A case report.

Lymphoceles are an important complication of pelvic and abdominal surgery with a reported incidence of 11%-88%. Conventional treatment includes compression, puncture aspiration, sclerotherapy, and ligation but recurrence is not uncommon and is difficult to treat. Recently, microsurgical lymphaticolymphatic anastomosis, lymphaticovenular anastomosis (LVA) and reconstruction of lymphatic circulation with flaps are increasingly being utilized for lymphocele treatment.

Lymphaticovenular anastomoses training model for multiple stages of lymphedema by using efferent lymphatic plexus of the mesenteric lymph node of rats.

Introduction: Lymphaticovenular anastomosis (LVA) has transformed lymphedema treatment and has become an important part of the surgical therapy. LVA requires supermicrosurgical skills and unique nontraumatic techniques as the lymphatic vessel diameter of varies with the progression of lymphedema from 0.3 to 0.

Clinical application and outcomes of reconstructive microsurgery in Africa: A systematic review and meta-analysis.

Background: Reconstructive microsurgical free flap techniques are often the treatment of choice for a variety of complex tissue defects across multiple surgical specialties. However, the practice is underdeveloped in low- and middle-income countries. The aim of this systematic review was to evaluate the clinical application and outcomes of reconstructive microsurgery performed in Africa.

Accelerated Cranioplasty with Perforator-preserved Split Flap Sandwiched Plate for Treatment of Infected Cranial Defects.

Large cranial vault defects are challenging to manage due to the need to balance infection control, skin coverage, and restoration of the protective mechanical rigidity of the skull while also ensuring good head and neck aesthetic results. Conventional-staged treatment requires a long time period that includes debridement and scalp skin defect coverage with flaps as a first step, followed by definitive plate reconstruction 3-9 months later after infection control and flap atrophy resolution. We report a case of successful early cranioplasty in a factory worker who developed a large full-thickness cranial skull defect following artificial dura infection.

Dual imaging lymphangiography guided treatment of infantile chylothorax.

Chylothorax is a potentially fatal postoperative complication of neck, thoracic, and abdominal surgery in children. We report the case of a 3-month-old infant who developed persistent chylothorax with respiratory insufficiency successfully managed using a microsurgical technique and intraoperative embolotherapy. This was achieved using a combination of intermittent digital X rays and live near-infrared fluorescence imaging we have termed "dual imaging lymphangiography" to guide therapy in real time.

Laparoscopic repair of segmental obturator nerve injury defect using an artificial nerve conduit: A case report.

Obturator nerve injury is an uncommon complication frequently associated with pelvic gynecologic or urologic cancer surgery. It can lead to disability or adversely affect quality of life. Large segmental defects are particularly difficult to manage as the limited mobility of the nerve prevents tension-free direct end-to-end anastomosis.

Posterior auricular artery free flap reconstruction of the retroauricular sulcus in microtia repair.

Background: Autologous repair using costal cartilage grafts remains the most widely accepted method of microtia reconstruction. A major complication of current techniques is loss of ear shape caused by scarring, contracture and cartilage absorption. We present a new surgical technique utilizing the posterior auricular artery free flap in microsurgical reconstruction of the retroauricular sulcus in microtia.