The increased peripheral arterial disease (PAD) incidence associated with aging and increased incidence of cardiovascular conditions underscores the significance of assessing lower limb perfusion. This study aims to report on the correlation and utility of two novel non‐invasive instruments: transcutaneous oxygen pressure (TcPO ₂ ) and forward‐looking infrared (FLIR) thermography. A total of 68 patients diagnosed with diabetic foot ulcer and PAD who underwent vascular studies at a single institution between March 2022 and March 2023 were included. Cases with revascularization indications were treated by a cardiologist. Following the procedure, ambient TcPO ₂ and FLIR thermography were recorded on postoperative days 1, 7, 14, 21 and 28. In impaired limbs, TcPO ₂ was 12.3 ± 2 mmHg and FLIR thermography was 28.7 ± 0.9°C. TcPO ₂ ( p = 0.002), FLIR thermography ( p = 0.015) and ankle–brachial index ( p = 0.047) values significantly reduced with greater vascular obstruction severity. Revascularization ( n = 39) significantly improved TcPO ₂ (12.5 ± 1.7 to 19.1 ± 2.2 mmHg, p = 0.011) and FLIR (28.8 ± 1.8 to 32.6 ± 1.6°C; p = 0.018), especially in severe impaired angiosomes. TcPO ₂ significantly increased immediately post‐procedure, then gradually, whereas the FLIR thermography values plateaued from day 1 to 28 post‐procedure. In conclusion, FLIR thermography is a viable non‐invasive tool for evaluating lower limb perfusion based on angiosomes, comparable with TcPO ₂ .

Secondary intention healing offers an alternative when surgical options are infeasible. This study analyzed the effect of micronized acellular dermal matrices (mADMs; CGderm Matrix^®, CG Bio, Seoul, Republic of Korea) on secondary intention healing in patients with complex soft-tissue defects and assessed mADMs’ efficacy in promoting secondary healing and improving clinical outcomes in these challenging cases. This retrospective study included 26 patients treated with sheet-type reprocessed mADMs between August 2022 and December 2022 at Soonchunhyang University Cheonan Hospital. Patients with full-thickness skin defects classified as complex wounds were included. Data on demographics, wound characteristics, and treatment outcomes were collected and analyzed. Wound area was measured using ImageJ software, and statistical analyses were conducted using SPSS. The application of mADMs resulted in a median wound area reduction of 81.35%, demonstrating its significant efficacy in wound healing. Most patients presented with compromised vascular supply, significant tissue loss, or infections that precluded conventional surgical interventions. No significant correlations were observed between patient variables and wound-healing outcomes, indicating the complex nature of wound healing. mADMs effectively promote secondary intention healing by providing a supportive extracellular matrix scaffold that enhances epithelialization and angiogenesis. Their rapid absorption, ease of handling, and ability to improve wound tensile strength make them particularly suitable for complex wounds.

Background: Facial aging is characterized by soft tissue atrophy, subcutaneous fat redistribution, and dermal laxity, most pronounced in the lower face and submental region. High-intensity focused ultrasound (HIFU) is the benchmark noninvasive lifting modality, whereas microwave energy–based devices (MEBDs) have recently emerged, targeting adipose tissue and dermis. Although MEBD has been validated in body contouring, evidence for facial efficacy and safety remains limited. Objectives: This study aimed to compare the efficacy and safety of MEBD and HIFU for facial rejuvenation in an East Asian population, emphasizing temporal improvement patterns, tolerability, and adverse events. Methods: The authors retrospectively analyzed 171 patients (MEBD: n = 89; HIFU: n = 82) treated at a single institution. MEBD used 7 and 3 mm handpieces for subcutaneous lipolysis and dermal tightening, guided by fat-compartment mapping. HIFU applied 600 shots at 3.0 and 4.5 mm depths targeting the dermis and superficial musculoaponeurotic system. Outcomes included blinded evaluator Global Aesthetic Improvement Scale (GAIS), Cutometer elasticity, Facial Aesthetic Surgery Outcome Questionnaire (FACE-Q) satisfaction, pain, and adverse events, assessed at baseline, 1 month, and 3 months. Results: MEBD showed greater early improvements in GAIS, Cutometer parameters (R2, R5), and FACE-Q scores at 1 month, with lower pain (2.3 vs 4.7, P < .001) and fewer adverse events. By 3 months, HIFU surpassed MEBD in sustained GAIS, FACE-Q, and elasticity gains. Both modalities were safe, with only mild, transient effects. Conclusions: MEBD demonstrated rapid onset, superior tolerability, and lower complication rates, whereas HIFU provided stronger long-term lifting and elasticity improvements. These findings support complementary clinical roles and a compartment-based rationale for facial MEBD. Level of Evidence: 3 (Therapeutic):

Constricted ear has a prevalence of 5.2 to 10% among ear abnormalities, and various surgical methods are suggested for treatment. We introduce a case of a constricted ear treated with a simple method using a novel concept cartilage graft and transposition flap, along with the well-known Mustardé suture, which is used for pediatric patients with mild to moderate constricted ears of Tanzer classification type IIA. A 10-year-old female patient visited the hospital complaining of an abnormality in the congenital right ear. Surgical approach was planned under the diagnosis of Tanzer classification type IIA constricted right ear. Posterior helix onlay graft and perichondrocutaneous transposition flap using excessive helical cartilage were performed along with the Mustardé suture. In the immediate postoperative period, ear contour was improved, and it was well-maintained without recurrence until 6 months' follow-up. In conclusion, the combination of Mustardé suture, and cartilage onlay graft and perichondrocutaneous transposition flap in the mild to moderate constricted ear would be a useful surgical option, producing aesthetically good results in a simple and effective method.

Rationale: Contrast medium extravasation injury is a rare but potentially limb-threatening complication of intravenous imaging, particularly in anatomically confined regions such as the dorsum of the hand. Thus, adjunctive diagnostic tools are needed to supplement clinical judgment and identify patients who will benefit from early surgical interventions. Patient concerns: A 55-year-old female patient presented with extensive swelling and pain in the left hand following contrast medium extravasation during a computed tomography angiography. The initial physical examination revealed minimal skin changes; however, the patient reported progressive pain and taut swelling. Diagnosis: The examination results were inconclusive of compartment syndrome. Transcutaneous oxygen pressure (TcPO₂) monitoring revealed critically low perfusion values (5 mm Hg in the dorsal wrist and 1 mm Hg in the distal dorsum), suggesting evolving ischemia. Forward-looking infrared thermal imaging confirmed localized hypoperfusion. Interventions: Based on TcPO₂ and thermal imaging findings, a prophylactic fasciotomy was performed. Negative pressure wound therapy was applied, and primary wound closure was performed on postoperative day 3 without the need for skin grafting. Outcomes: The patient recovered without wound-related complications, and no additional procedures were required. Lessons: This may be the first reported case of contrast medium extravasation injury in the hand managed with TcPO₂-guided fasciotomy. TcPO₂ and forward-looking infrared thermography may serve as alternative noninvasive tools to support early decision-making for fasciotomy in cases where traditional clinical signs are absent. Early intervention based on perfusion metrics may prevent irreversible ischemic complications.

Neurofibromas, rare benign tumors of the peripheral nerve sheath, present diagnostic challenges, particularly in diabetic patients with toe ulcers. This case involves a 55-year-old female with type 2 diabetes mellitus who developed an enlarging ulcer on her right second toe. The initial evaluation suggested a diabetic ulcer; however, advanced imaging revealed a mass-like lesion. Partial excision and biopsy confirmed a neurofibroma with spindle cells within the myxoid stroma and S100 protein expression. One month later, total excision and Z-plasty reconstruction were performed under general anesthesia. The patient’s postoperative recovery was uneventful, and the patient was discharged without complications. Follow-up revealed successful healing with no recurrence or functional issues. This case highlights the importance of considering neurofibromas in the differential diagnosis of diabetic toe ulcers to avoid misdiagnosis and ensure appropriate management.