Injury
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Lymphaticovenular anastomosis (LVA) with supramicrosurgical technique has recently gained popularity as a treatment method for patients with lymphedema. The aim of this study was to prospectively evaluate objective changes in leg volume in patients operated with LVA for lymphedema in the lower extremity, and to find positive predictors for the treatment method to facilitate the location of the venules and lymphatic vessels. ⋯ The current study indicates that supramicrosurgery with LVA may reduce edema volumes, where the most distinctive positive predictor for edema reduction with LVAs was previous lymph node dissection.
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Trauma contributes significantly to the burden of disease and mortality in sub-Saharan Africa (SSA). Like most of SSA, Tanzania lacks prospective trauma registries (TRs), resulting in poor and inconsistent availability of injury data. A model TR was implemented at five representative regional hospitals in Tanzania; the TR incorporates the variables recommended by the World Health Organisation (WHO) Data Set for Injury. This study characterises the burden of trauma seen at five regional hospital Emergency Units (EUs) in Tanzania using data from this new TR. ⋯ TR from these five Tanzanian regional hospitals has provided an opportunity to more accurately describe the country's burden of injury. Having sufficient data for ISS and other key trauma variables allows us to compare the burden and outcomes of trauma in Tanzania with other countries, which will help to quantify an accurate burden of injury, inform quality improvement initiatives, and suggest where to focus preventative measures.
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The recovery of recurrent motor branch of the median nerve might be delayed in high level median nerve injuries due to the long reinnervation distance. The aim of this study is to define a novel nerve transfer to restore the opposition and pinch. ⋯ This new nerve transfer proposal may be an important step in nerve transfer surgery.
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In patients with chronic facial palsy where the treatment by conservative means or only nerve grafting is no longer an option, reconstruction by dynamic procedures such as pedicled and/or free muscle transfer is required. ⋯ All the patients were satisfied with the results. For the fifth patient that the modified technique applied, the healing process was faster, and the aesthetic and functional reanimation achieved easiest, with no donor-site morbidity, comparatively with the rest patients where the standard Gillies-McLaughlin technique was used.
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The lateral circumflex femoral artery one of the most favoured donor-site for a wide array of free flaps including either cutaneous, fascial and muscle components or a combination thereof. Here, we provide evidence on the safe use of the free vastus lateralis muscle flap and its feasibility for optimal soft tissue coverage of the weight-bearing foot. ⋯ The skin-grafted free vastus lateralis muscle flap can safely be used as a "smart" tool for coverage of weight-bearing foot providing optimal cushioning and functional results without fearing donor-side morbidity.