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Background Obtaining optimum breast aesthetics can be challenging in secondary aesthetic breast surgery, particularly with poor quality skin, when downsizing implants and in cases where patients will not accept additional mastopexy scars. Most techniques described in these cases rely on internal suturing and capsulorrhaphy, which can lack precision in tailoring the skin over the internal pocket. Objectives The authors present their experience using the haemostatic net to help address a range of challenging breast cases in their practices. Methods A multi-centre retrospective analysis of patients undergoing aesthetic and reconstructive breast surgery between 2019 and 2021 was conducted. A database was established to record patient demographics, indications for surgery, surgical technique and complications. Following capsulorrhaphy, the haemostatic net was applied in as many rows as required with monofilament sutures and removed 3-7 days post-operatively. Results Twenty-four women (23-67 years) underwent aesthetic or reconstructive breast surgery using the haemostatic net. This approach optimised the stabilisation of the infra-mammary crease and re-draping of lax skin or irregularities in the skin envelope. At follow up review, only one instance of the net failing to successfully redrape the skin was seen. Conclusions The application of the haemostatic net is an option in patients who might otherwise require mastopexy but refuse to accept the scars. The technique has now been extended to primary cases where implant malposition or skin tailoring issues are anticipated, thus securing its place as a part of the surgical armamentarium

Patients that suffer multiple traumatic injuries often present with uncontrollable haemorrhage and rapidly descend into a viscous death triad consisting of hypothermia, coagulopathy and acidosis. Initial surgical intervention does not aim to provide conclusive repair, but instead strives to stop blood loss while priority is given to correct the patient's metabolic state (Duchesne et al., 2010). However in some cases of massive polytrauma, gaining surgical control of bleeding can be incredibly difficult. As a result a number of topical haemostatic agents were developed for use in military and civilian settings. This case details a successful intracavity use of the granular haemostatic agent, Quikclot™ (Z-Medica), in halting massive haemorrhage in a patient who sustained major blast injuries. Although not officially recommended, intracorporeal uses of Quikclot™ can be effective as a last resort in preventing loss of life in cases of severe polytrauma. However, users need to remain wary of complications which may arise due to its application.