The accurate assessment of burn wounds is challenging but crucial for correct diagnosis and following therapy. The most frequent technique to evaluate burn wounds remains the clinical assessment, often subjective depending on the experience of the physician. Hyperspectral imaging (HIS) is intended to improve on this subjective diagnosis by accurate and objective analyses of perfusion parameters. The purpose of this study was to analyze the ability of technical burn depth assessment and to investigate a link between a certain value to burn depth versus the value of healthy skin references. One hundred and eighteen HSI analyses were included in this study between July 2017 and July 2019. We analyzed 74 recordings with dorsal hand burns and 44 recordings of healthy skin on the dorsal hand as control group. HSI recordings’ investigation was performed with special interest to wound center, intermediate zone, and wound margin. The results indicate that a differentiation between burned tissue and healthy skin was feasible and also significant in almost all HSI analysis parameters (P < .05). No significant distinction between superficial and deep partial thickness burns could be determined. However, in the wound center, we recorded smaller values with a more pronounced tissue damage. Our preliminary results demonstrate that HSI can distinguish between normal and burned hands. However, as currently used, HSI could not accurately determine the depth of indeterminate burns.

Background: The aim of this study was to examine the potential benefit that may be achieved through the introduction of technical innovations and the incorporation of mesh for fascial donor site closure in uni- and bilateral autologous breast reconstruction with abdominal tissue. Methods: A retrospective single-center review of all breast reconstructions with a DIEP or MS-TRAM flap between January 2004 and December 2019 was performed. Donor and recipient site complications and operation times were evaluated before and after the implementation of coupler anastomoses, preoperative computed tomography angiography (CTA), indocyanine green (ICG) angiography, and the inclusion of mesh in donor site repair. Results: A total of 396 patients were included, accounting for 447 flaps. Operation time was significantly shorter in unilateral reconstructions after the implementation of CTA (p < 0.0001). ICG angiography significantly reduced the rates of partial flap loss (p = 0.02) and wound healing disorders (p = 0.02). For unilateral reconstructions, abdominal bulging or hernia was observed more often in MS1-TRAM flaps without synthetic mesh repair (p = 0.001), whereas conservatively treated seroma developed more frequently after mesh implantation (p = 0.03). Conclusions: Recent technological advancements developed over the past few decades have made a substantial impact on decreasing surgical duration and enhancing procedure safety.

Background: Obesity is frequently present in patients suffering from end-stage renal disease (ESRD). However, overweight kidney transplant candidates are a challenge for the transplant surgeon. Obese patients tend to develop a large abdominal panniculus after weight loss creating an area predisposed to wound-healing disorders. Due to concerns about graft survival and postoperative complications after kidney transplantation, obese patients are often refused in this selective patient cohort. The study aimed to analyze the effect of panniculectomies on postoperative complications and transplant candidacy in an interdisciplinary setting. Methods: A retrospective database review of 10 cases of abdominal panniculectomies performed in patients with ESRD prior to kidney transplantation was conducted. Results: The median body mass index was 35.2 kg/m² (range 28.5–53.0 kg/m²) at first transplant-assessment versus 31.0 kg/m² (range 28.0–34.4 kg/m²) at panniculectomy, and 31.6 kg/m² (range 30.3–32.4 kg/m²) at kidney transplantation. We observed no major postoperative complications following panniculectomy and minor wound-healing complications in 2 patients. All aside from 1 patient became active transplant candidates 6 weeks after panniculectomy. No posttransplant wound complications occurred in the transplanted patients. Conclusion: Abdominal panniculectomy is feasible in patients suffering ESRD with no major postoperative complications, thus converting previously ineligible patients into kidney transplant candidates. An interdisciplinary approach is advisable in this selective patient cohort.

The injury of the scapholunate (SL) ligament is common in wrist traumas leading to pain and reduced wrist function. The wrist's unique joint design and possible underlying theories as the carpal row theory were subject to earlier investigations studying wrist kinematics. Nevertheless, a comprehensive understanding of how SL ligament injuries affect wrist biomechanics is still lacking. Through a quantitative analysis of carpal bone motion patterns, we evaluated the impact on wrist kinematics occurring after SL ligament injury. We conducted a study using computer tomography imaging to analyse wrist kinematics after SL ligament transection in 21 fresh‐frozen anatomical specimens. The collected data were then transformed into 3D models, employing both standardized global and object coordinate systems. The study encompassed the evaluation of rotation and translation for each individual carpal bone, as well as the ulna, and all metacarpal bones in reference to the radius. The study showed a significant increase in rotation towards palmar (p < 0.01), particularly notable for the scaphoid, following transection of the SL ligament during palmar flexion. Ulnar deviation did not significantly affect rotation or translation, and radial deviation also showed no significant changes in rotation or translation. The study highlights the significance of the SL ligament in wrist kinematics, revealing that SL ligament tears lead to changes in wrist motion. While we observed significant rotational changes for the scaphoid, other carpal bones showed less pronounced alterations, emphasizing the complexity of wrist biomechanics.

Aufgrund der Fähigkeit, die komplexe Anatomie der Hand und des Handgelenks detailliert abzubilden, ist die Magnetresonanztomografie (MRT) ein ideales bildgebendes Verfahren für die Analyse vieler unterschiedlicher Traumata und Pathologien. Die MRT wird häufig nach initialer Röntgen- und Ultraschalldiagnostik ergänzend durchgeführt. Zuletzt erfolgten pro Jahr ca. 10 Millionen MRT-Untersuchungen in Deutschland [1]. Zu den häufigsten Indikationen für die Durchführung einer MRT-Untersuchung der Hand zählen: Beurteilung der intrinsischen Bänder des Handgelenks und des triangulären fibrokartilaginären Komplexes (TFCC), Charakterisierung von Raumforderungen (z. B. Ganglien oder Weichteiltumore), Detektion von Beuge- und Strecksehnenverletzungen und Kapsel-/Bandläsionen an den Fingern sowie Nachweis okkulter Knochenverletzungen [2], [3], [4]. Damit die Anatomie der einzelnen Strukturen der Hand bestmöglich abgebildet wird und Bewegungsartefakte möglichst gering gehalten werden können, erfordert dies eine Optimierung der Platzierung der Hand in der gewählten Spule sowie der Bildgebungsparameter (u. a. Schichtdicke, Sichtfeld und Repetitionszeit/Echozeit). Regulär werden Patienten in Bauchlage mit über dem Kopf ausgestrecktem Arm in der „Superman“-Position gelagert, sodass die Hand für eine bestmögliche, homogene Bildqualität im Isozentrum des Magnetfelds positioniert wird. Dies ist jedoch für manche Patienten unangenehm, und einige Patienten sind nicht im Stande, die MRT-Untersuchung in dieser Lagerung zu vollenden [5]. Im Folgenden berichten wir über einen außergewöhnlichen Fall, bei dem es im Rahmen einer MRT-Untersuchung der rechten Hand zu einer relevanten Veränderung der Perfusionsverhältnisse an der linken Hand gekommen war, bei vorausgegangener „Superman“-Lagerung während der MRT-Untersuchung. Publication Date: 14 February 2022 (online) © 2022. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany