Background: With the incidence of breast cancer, breast cancer survival rates, and prophylactic mastectomies all increasing, efforts to optimize breast reconstruction and improve quality of life are becoming increasingly important. Nerve coaptation has been investigated for its potential to remedy the clinical and psychosocial deficits in newly reconstructed breasts. The purpose of this review is to gauge the efficacy of nerve coaptation during breast reconstruction in creating worthwhile benefits in both objective and subjective dimensions of sensation. Methods: A Prospero registered systematic review was conducted. Databases including PubMed, SCOPUS, and ScienceDirect were screened using search terms “innervation," “breast reconstruction," and “neurotization” and relevant inclusion criteria. Results: Twenty-three studies were found that met parameters for inclusion. We identified studies that assessed DIEP-based reconstruction (7), TRAM-based reconstruction (9), implant-based reconstruction (2), and five studies that looked at a variety of reconstructive modalities. Monofilament testing was the most common modality used to assess sensation, while pain, temperature, and pressure thresholds were assessed more infrequently. Various tools were used to measure psychosocial impacts, including the BREAST-Q. While the methods for evaluation of both aspects of sensation were heterogenous, there was a trend towards improved outcomes with neurotization. Conclusions: The results of this review show promising improvements in clinical and psychosocial outcomes in innervated breasts compared to non-innervated breasts. However, the heterogeneity of studies in the literature indicates that more multi-center studies with standardized methodology including the BREAST-Q, sensory testing and complication analysis are needed to adequately demonstrate the value of neurotization in breast reconstruction.

As a government agency focusing on road safety research, MIROS has regularly involved in policy-making exercises which blend together the great understanding of technical, legislative and social framework. This paper recapped the development of a conceptual model of the Malaysian automotive ecosystem with special reference to car maintenance issues, particularly with regard to one of the NAP measures Gradual phase out of imported used parts and components. The methodology of the study was designed into two focus group discussions (FGD) and extensive literature reviews. Internal FGDs were conducted as the study precursor and external discussions involved other ministries and agencies reps. Extensive literature reviews include journals, proceedings, unpublished reports, as well as web-based sources. A conceptual model of the domestic automotive ecosystem is proposed in this paper together with the discussion on NAP measures and relevant future research within the models framework.

A Marjolin ulcer (MU) is a rare type of skin cancer that most commonly occurs in burns and other traumatic scars, and it also may arise in chronic, poorly healing wounds. Typically, MU presents as a squamous cell carcinoma and has a high rate of metastasis resulting in poor prognosis. The mechanism of the aggressive and metastatic potential of MU has not been clearly defined. This malignancy is more common in patients who are elderly or immunocompromised and has also been characterized as a disease of economically developing nations in which health care resources are less abundant and treatment is delayed. Marjolin ulcer is a challenging, although rare, disease. This article presents a case of MU that arose in a chronic sacral pressure ulcer. This was a rare, multifactorial case; the patient’s many comorbidities required coordinated efforts by wound care, oncology, and infectious disease specialists. As seen in this case, MU can be insidious and may not become apparent until considerable progression has occurred. This article discusses the multidisciplinary treatment measures undertaken for this patient, the strategies for prophylaxis and early detection of MU, and ultimately, the poor prognosis of MU in such a scenario where diagnosis is delayed.

Background: Although radiation therapy remains an integral component in cancer treatment, the sequela of tissue damage can result in long-term morbidity and mortality for patients. This article aimed to perform a comprehensive review of the current literature for both nonsurgical and surgical management strategies for radiation-induced injuries. Methods: A literature search was performed on PubMed to review the current described management and treatment options for radiation-induced injuries. Patient demographics, medical diagnoses, complications, strategies of management care, and outcomes were reviewed. Results: The most commonly described management options and reconstructive techniques of radiation wounds were analyzed and reported. Conclusions: Consideration of current techniques and outcomes in the management of radiation-induced wounds demonstrates that impaired wound healing remains a major problem. This literature review provides a detailed overview of the most frequently used therapies with recommendations for surgeons.