Chronic wounds present a large burden to our healthcare system and are typically marked by a failure to transition out of the inflammatory phase of wound healing. Venous leg ulcers (VLUs) represent the largest portion of chronic wounds. A pilot study of eleven (11) patients with VLUs seen over a 12-week period was undertaken utilizing RNA sequencing of wound biopsies and plasma cytokine levels to determine if biomarkers could be identified that would distinguish between wounds which heal versus those that do not. Chronic wounds were found to have increased expression of genes relating to epithelial-to-mesenchymal transition (EMT), cartilage and bone formation, and regulation of apical junction. Plasma cytokine levels showed predictive potential for IL-15 and RANTES, which were found to increase over time in patients with healed wounds. Further research is needed to validate these biomarkers as well as additional study of other chronic wound models, such as diabetic foot ulcers (DFUs).

Chronic venous insufficiency with and without ulceration is a common complication of varicose veins. Heinz-Lippmann disease is a potentially underreported complication of chronic venous insufficiency that involves heterotopic ossification of the peri-wound that might contribute to the chronicity of venous leg ulcers. Most commonly, heterotopic ossification is associated with traumatic injury. We report the cases of three patients with chronic venous insufficiency and no history of trauma who were found to have subcutaneous calcifications consistent with Heinz-Lippmann disease. Osteomyelitis was confirmed in two patients. Physical examination and diagnostic imaging can be helpful in determining the diagnosis. Interventions can include biopsy to rule out osteomyelitis, with subsequent treatment, if needed.

Background: Social media has become ubiquitous; its uses reach beyond connecting individuals or organizations. Many biomedical researchers have found social media to be a useful tool in recruiting patients for clinical studies, crowdsourcing for cross-sectional studies, and even as a method of intervention. Social media usefulness in biomedical research has largely been in population health and non-surgical specialties, however, its usefulness in surgical specialties should not be overlooked. Specifically in plastic surgery, social media use to understand patient perceptions, identify populations, and provide care has become an important part of clinical practice. Methods: A scoping review was performed utilizing PubMed and Medline databases, and articles were screened for the use of social media as a method of recruitment to a clinical trial, as crowdsourcing (i.e., recruitment for a cross-sectional or survey-based study), or as a method of intervention. Results: A total of 28 studies were included, which focused on majority females between 18–34 years old. Despite the ability of the internet and social media to connect people worldwide, nearly all the studies focused on the researchers’ home countries. The studies largely focused on social media’s effect on self-esteem and acceptance of cosmetic surgery, but other notable trends were analyses of patient perceptions of a disease, or surgical outcomes as reported in social media posts. Discussion: Overall, social media can be a useful tool for plastic surgeons looking to recruit patients for a survey-based study or crowdsourcing of information.