A systematic review (53 studies, 1,822 hand fractures) examined the timing of mobilisation post-ORIF. Immediate mobilisation showed faster healing but higher adverse events. Delayed mobilisation had fewer complications. Heterogeneity and lack of standardised PROMs limit conclusions.
Also: Journal club article, final round of the Sunday quiz, & original Seymour's publication.
Rhomboid (Limberg) flap is a 120° transposition design for closing cutaneous defects with minimal tension. Plan flap along relaxed skin tension lines, preserve subdermal plexus, variations adapt geometry to site. Complications are rare, mostly due to tension or vascular issue.
Scalp reconstruction balances inelastic hair-bearing skin, robust dual blood supply, & curved skull. Small defects use primary closure, VAC, second intention, or skin anchors. Grafts need a vascular bed and no planned radiation. Larger gaps need local, rotation, or advancement flaps.
Also: A book recommendation, the Sunday quiz, & events calendar.
Also: Why flaps beat grafts, punch biopsy pitfalls, & the Sunday quiz.
Also: Foundations update, the Sunday quiz, & events calendar.
Securing a plastic surgery residency is no easy task, and excelling in your Sub-Is is arguably one of the most important steps. This guide offers 10 actionable strategies to prepare for plastic surgery sub-I rotations in the USA.
Toxic Epidermal Necrolysis (TEN) is a severe dermatologic condition affecting >30% TBSA, triggered by drugs like sulfonamides and antiepileptics. Symptoms include painful skin detachment and mucosal erosions. Management prioritizes causative agents, supportive care, and adjunctive therapies.
Chemical peels apply controlled acids to resurface skin and spark collagen repair. Superficial, medium, and deep depths offer escalating gains for photoaging, acne, and pigment issues, yet also rising downtime and risks; deep phenol/TCA peels need strict monitoring.
Prominent ears (>30° tilt or >2 cm from skull) usually lack a defined antihelical fold or have a hypertrophic concha. Otoplasty reshapes cartilage with techniques like Mustardè or Furnas, restoring natural projection; recovery needs headband support and hematoma vigilance.
Also: Opening a second waitlist?, the Sunday quiz, & 3 recommended cleft lip reads.
Systematic review (48 studies, 7,045 patients) found 49 % of breast-implant recipients reported BII symptoms: fatigue, joint pain, brain fog. After explantation, 57 % improved. Autoimmune, psychiatric, and cancer comorbidities were common; diagnosis remains unclear.
Also: BIA-ALCL signs, the Sunday quiz, & 3 recommended reads.
Chest-wall reconstruction restores support, organ protection, ventilation, & contour after tumour resection, trauma, or infection. Defects > 5 cm or ≥ 4 ribs need rigid mesh/PTFE/titanium plus vascular flaps (pectoralis, lat dorsi, rectus). Sepsis or poor lung reserve contraindicate.
Congenital haemangiomas are GLUT-1–negative vascular tumours fully formed at birth. They appear as solitary violaceous plaques and follow RICH (rapid), PICH (partial), or NICH (none) involution. Diagnosis is clinical; observe unless bleeding, ulcer, or cosmetic concern warrants surgery/laser.
Facelift repositions SMAS and skin to restore midface, jawline, and neck contours. Thorough pre-op assessment guides technique choice from skin-only to deep-plane/high-SMAS, balancing durability and risk. Nerve protection plus vigilant post-op care curbs hematoma, necrosis, and asymmetry.
Also: P'Fella's event calendar, the Sunday quiz, & 3 recommended reads.
The nose is a layered unit: thin bony vault, cartilaginous middle/tip, and skin-soft tissue cloak. Key angles guide aesthetics (nasofrontal 115-130°, nasolabial 90-105°, Goode ratio). Septum, valve, & turbinates ensure airflow; rich carotid vessels and trigeminal nerves supply it.
Hartrampf divides lower‑abdominal TRAM/DIEP flaps into four perfusion zones around the dominant perforator: Zone I being best, and Zone IV worst. Later imaging showed ipsilateral lateral tissue (Zone III) may out‑perfuse contralateral medial (Zone II) & that patterns shift with perforator row.
Microsurgery employs magnification, delicate tools, and 8-0–11-0 sutures to join vessels/ nerves ≤2 mm, powering free flaps, replantation, nerve and lymphatic repair. Outcomes rely on ergonomic setup, meticulous vessel prep, apt end-to-end or end-to-side stitches, and vigilant flap monitoring.
Also: New quiz champs, cortical vs cancellous, & a journal review.
Lipomas are common benign tumours of mature adipocytes, presenting as soft, mobile subcutaneous nodules. Most need only observation, but imaging (US, MRI) and excision are advised for pain, rapid growth, deep/large size, or diagnostic doubt to exclude liposarcoma.
Also: Gluteal danger zones, the Sunday quiz, & 3 recommended reads.
