Aims The purpose of secondary breast reconstruction is to restore patient’s integrity. Autologous breast reconstruction has become the superior method of breast reconstruction, especially in cases with inadequate skin envelope and post-radiotherapy tissue damage. A 3D-template-enhanced secondary autologous breast reconstruction with restoration of innervation was developed at our department. Methods Thirty patients are planned to be included in the prospective double-blinded study. The reconstruction is performed with the deep inferior epigastric perforator (DIEP) free flap using 3D template from the contralateral healthy breast. Additionally, coaptation of the anterior branch of the 3rd intercostal nerve with the dominant lateral intercostal nerve innervating the DIEP flap is performed. Breast-Q questionnaires are collected before and after the reconstruction and the breast sensation is assessed on regular intervals. Results The preliminary results show an improvement in the sensation of the reconstructed breast and higher patient satisfaction score. Prior to abstract submission, no significant complications have been noted, in one patent abnormal sensation of the breast was reported. Conclusions According to previous studies, patients with innervated free flap reconstruction express higher level of satisfaction as the sensation of the reconstructed breast contributes significantly to the level of satisfaction. Furthermore, use of 3D model from the contralateral breast produces results that are superior to traditional methods. Preliminary results showed that the combination of both methods improved patient satisfaction regarding the aesthetic outcome and functional result. With the appropriate patient selection this type of optimised breast reconstruction should be performed.

The purpose of the study was to evaluate the use of sonication in the detection of prosthetic joint infections with the emphasis on patients who received pre-operative antimicrobial therapy. Consecutive patients that required revision surgery of the hip or knee arthroplasty were enrolled in the study. An algorithm for the diagnosis of prosthetic joint failure based on the culture of intraoperative tissue samples and the sonication of explanted orthopaedic material was used. The results of both methods were compared and evaluated. Between November 2010 and December 2013, 103 patients were enrolled, which underwent 136 revision procedures. In 31 cases (22.8 %) the patient received pre-operative antimicrobial therapy. Prosthetic joint infection and aseptic failure was diagnosed in 69 (50.7 %) and 45 (33.1 %) cases. In 22 cases (16.2 %) microbiology was inconclusive. Sonication was a significantly better diagnostic method for the detection of prosthetic joint infection when pre-operative antimicrobial therapy was received (p < 0.05). In recent years sonication has become vital for the diagnosis of prosthetic joint infection. According to our results, it is especially crucial in patients that received pre-operative antimicrobial therapy.