The accurate assessment of wound size is a critical step in advanced wound care management. This study aims to introduce and validate a Light Detection and Ranging (LiDAR) technique for measuring wound size. Twenty-eight wounds treated from December 2022 to April 2023 at the Chungnam National University Hospital were analyzed. All the wounds were measured using three techniques: conventional ruler methods, the LiDAR technique, and ImageJ analysis. Correlation analysis, linear regression, and Bland–Altman plot analysis were performed to validate the accuracy of the novel method. The measurement results (mean ± standard deviation) obtained using the ruler method, LiDAR technique, and ImageJ analysis were 112.99 ± 110.07 cm², 73.59 ± 72.97 cm², and 74.29 ± 72.15 cm², respectively. The Pearson correlation coefficient was higher for the LiDAR application (0.995) than for the conventional ruler methods (mean difference, −5.0000 cm²), as was the degree of agreement (mean difference, 38.6933 cm²). Wound size measurement using LiDAR is a simple and reliable method that will enable practitioners to conveniently assess wounds with a flattened and irregular shape with higher accuracy. However, non-flattened wounds cannot be assessed owing to the technical limitations of LiDAR.

Marginal reflex distance1 (MRD1) is a crucial clinical tool used to evaluate the position of the eyelid margin in relation to the cornea. Traditionally, this assessment has been conducted manually by plastic surgeons, ophthalmologists, or trained technicians. However, with the advancements in artificial intelligence (AI) technology, there is a growing interest in the development of automated systems capable of accurately measuring MRD1. In this context, we introduce novel MRD1 measurement methods based on deep learning algorithms that can simultaneously capture images and compute the results. This prospective observational study involved 154 eyes of 77 patients aged over 18 years who visited Chungnam National University Hospital between 1 January 2023 and 29 July 2023. We collected four different MRD1 datasets from patients using three distinct measurement methods, each tailored to the individual patient. The mean MRD1 values, measured through the manual method using a penlight, the deep learning method, ImageJ analysis from RGB eye images, and ImageJ analysis from IR eye images in 56 eyes of 28 patients, were 2.64 ± 1.04 mm, 2.85 ± 1.07 mm, 2.78 ± 1.08 mm, and 3.07 ± 0.95 mm, respectively. Notably, the strongest agreement was observed between MRD1_deep learning (DL) and MRD1_IR (0.822, p < 0.01). In a Bland–Altman plot, the smallest difference was observed between MRD1_DL and MRD1_IR ImageJ, with a mean difference of 0.0611 and ΔLOA (limits of agreement) of 2.5162, which was the smallest among all of the groups. In conclusion, this novel MRD1 measurement method, based on an IR camera and deep learning, demonstrates statistical significance and can be readily applied in clinical settings.

Background. Many different operative options have been used to cover sacral defects. Perforator flap enables wide defect reconstruction with long pedicle and a large arc of rotation while preserving gluteus maximus muscle, but the risk of vessel injury can jeopardize flap survival. Perforator-based flap, the flap transposed without skeletonization of the perforator, requires much experience to be perfect in flap design to achieve tension-free closure. Methods. Fourteen modified parasacral perforator-based flap procedures were carried out on 14 patients. The records of patients at Chungnam National University Hospital from February 2017 to January 2020 were retrospectively reviewed. Results. All 14 flaps survived completely. One patient developed localized hematoma, and another presented with latent seroma. No donor or recipient site dehiscence or recurrence occurred during follow-up. Conclusion. We present our experience of a parasacral perforator-based flap with modified design of bilobed flaps. It could be performed easily and safely with less wound dehiscence and serve as a good practice model for young surgeons to cover small to moderately sized defects.

Background: Despite the increasing popularity of various materials for ischemia-reperfusion (I/R) injury mitigation, research on botulinum toxin type A (BoNTA) remains limited. This study assesses BoNTA’s efficacy in protecting flaps from I/R injury by inhibiting the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase system and reducing reactive oxygen species (ROS) production. Methods: Seventy-six Sprague-Dawley rats were studied. We examined the effects of BoNTA on superoxide production in four rats using a lucigenin-enhanced chemiluminescence assay (LECL). Another group of 60 rats had their superficial inferior epigastric artery (SIEA) flaps treated with either BoNTA or saline and clamped for 0, 1, and 4 hours before reperfusion. Flap survival and histological outcomes were assessed five days post-operation. ROS production in SIEA flaps and femoral vessels was analyzed in 12 additional rats, post-I/R injury. Results: The LECL results showed that the BoNTA group had significantly lower superoxide production compared to controls, with notable reductions at 4 hours. While no significant differences were noted at the 0 and 1-hour marks, the 4-hour mark showed significant protective effects in BoNTA-treated groups. The survival rate was 90% for BoNTA-treated rats versus 60% for controls (P = 0.028). Significant reductions in ROS were also observed in the 4-hour I/R group. Conclusions: BoNTA effectively protects against I/R injury by inhibiting the NADPH oxidase system and reducing ROS levels. These results support further investigation into the specific mechanisms of NADPH oxidase inhibition by BoNTA and its potential clinical applications, given its safety profile Clinical Relevance Statement: The findings from the present study are expected to provide a basis for clinical studies regarding this use of BoNTA.

Background Various materials, commonly called fillers, have been developed and are now used for cosmetic and reconstruction purposes. Indiscriminate injections of illegal and unknown substances have various side effects, among which foreign body granulomas are particularly difficult to treat. Surgical resection can be considered for small and well-defined foreign body granulomas, but complete resection is often impossible for wide facial granulomas, and postoperative deformities may occur. Therefore, this study presents cases where foreign bodies were evaluated using imaging studies and removed through minimally invasive procedures depending on their characteristics.Methods Thirty-five patients with chronic granulomas after illegal filler injections treated from 2012 to 2019 were enrolled. Clinically, these granulomas were classified into cystic and infiltrating groups according to the imaging study patterns. Patients in the cystic group underwent puncture and drainage, and those in the infiltrating group were first treated with intralesional laser treatment and then suctioned. If the results were insufficient, surgical removal combined with a lifting procedure was performed.Results All 35 patients were women, and their average age was 51 years. Surgery was successful in almost all cases, but four cases of insufficient removal and contour deformity were encountered during follow-up. Two patients underwent reoperation and two patients improved naturally.Conclusions In this study, we classified the characteristics of granulomas using preoperative imaging studies. Aesthetically favorable results were obtained using puncture and drainage and tumescent suction, along with, if necessary, surgical removal accompanied by a lifting procedure when removing facial foreign body granulomas.