Breast mound reconstruction can be a particularly difficult procedure in patients who have delayed reconstruction. A technique in which two flaps are used is described. The lateral thoracodorsal flap is used to create a breast pocket, and the latissimus dorsi flap is used to fill this breast pocket. The advantages of the technique are one-stage autologous reconstruction with a skin envelope similar in color and texture to the opposite breast. The disadvantages include a larger scar.

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Optimal levels of functional recovery in peripheral nerve injuries remain elusive due to the architectural complexity of the neuronal environment. Commercial nerve repair conduits lack essential guidance cues for the regenerating axons. In this study, the regenerative potential of a biosimulated nerve repair system providing three types of regenerative cues was evaluated in a 10 mm sciatic nerve-gap model over 4 weeks. A thermo-ionically crosslinked gellan-xanthan hydrogel conduit loaded with electrospun PHBV-magnesium oleate-N-acetyl-cysteine (PHBV-MgOl-NAC) nanofibers was assessed for mechanical properties, nerve growth factor (NGF) release kinetics and PC12 viability. In vivo functional recovery was based on walking track analysis, gastrocnemius muscle mass and histological analysis. As an intraluminal filler, PHBV-MgOl-NAC nanofibers improved matrix resilience, deformation and fracture of the hydrogel conduit. NGF release was sustained over 4 weeks, governed by Fickian diffusion and Case-II relaxational release for the hollow conduit and the nanofiber-loaded conduit, respectively. The intraluminal fibers supported PC12 proliferation by 49% compared to the control, preserved up to 43% muscle mass and gradually improved functional recovery. The combined elements of physical guidance (nanofibrous scaffolding), chemical cues (N-acetyl-cysteine and magnesium oleate) and therapeutic cues (NGF and diclofenac sodium) offers a promising strategy for the regeneration of severed peripheral nerves.

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Background: Patients with hand masses present for consultation either for pain, loss of function, or cosmetic embarrassment caused by the mass. The majority of hand masses are benign soft tissue tumors. The aim was to review the histology results of hand masses operated on at the Chris Hani Baragwanath Academic Hospital Hand Unit in Johannesburg, South Africa, to explore the relationship of the types of masses according to age, sex, side, and compare the findings with what is in the current literature. Methods: Patients operated on in the hand unit, for hand masses between April 2016 and April 2019 with histology results were included in the study for statistical  analysis. Results: There were 64 males and 105 females with a mean age of 41.03 ± 18.81 years. The most frequent masses were ganglion cysts.  Females appeared to be more affected than males by the different hand masses, but there were no statistically significant differences. Of the 21 giant cell tumors, 15 occurred on the right hand (p-value = 0.021). Conclusion: The profile of hand masses at a high-volume hand unit in Johannesburg, were comparable to the reported literature. There  were no significant differences between sex and diagnosis, however, there was a relationship between diagnosis and side for giant cell tumors of tendon sheaths, requiring further exploration.