Background: Many wound assessment systems including the Wagner classification and University of Texas (UT) grading system have been previously described. The authors of this study applied the DIRECT (Debridement of necrosis, Infection control, Revascularization, Exudate control, Chronicity, and Top surface) wound coding system for initial assessment of diabetic foot ulcers (DFUs) to predict limb salvage and prognosis.<br/>Methods: From January 2016 to February 2020, a total of 169 first-time DFU patients were retrospectively evaluated using the DIRECT wound coding assessment system. DFUs were followed up for at least 6 months, and scores in each component of the coding system according to final limb status were statistically evaluated. The coding assessment’s ability to predict major amputation was compared to those of the Wagner classification and the UT grading system.<br/>Results: Subjects were divided into complete healing (n=80, 47.3%), not healed (n=71, 42%), and amputation (n=18, 10.7%) groups. The mean values of each component of DIRECT assessment for the complete healing/amputation groups were D 0.86/1.56 (P<0.001), I 0.46/0.89 (P=0.001), R 0.65/0.94 (P=0.014), E 1.15/1.56 (P=0.049), C 0.69/0.89 (P=0.086), T 0.53/0.72 (P=0.13) and the sum was 3.140/4.741 (P<0.001). The area under the receiver operating characteristic curve of the DIRECT, Wagner, and UT grading systems was 0.722, 0.603, and 0.663, respectively.<br/>Conclusion: The DIRECT coding system shows a greater association with prediction of amputation or complete healing, compared with the Wagner and UT wound classification systems. This more accurate wound assessment system will be helpful in predicting prognosis and planning treatments.

Ossifying fibroma (OF) is a benign fibro-osseous lesion. It is characterized by the presence of well-demarcated borders and cell-rich fibrosis and contains varying amounts of calcified tissues such as bone or cementum, or both. OF is classified into cemento-OF, juvenile trabecular OF and juvenile psammomatoid OF (JPOF) [1]. JPOF usually occurs before the age of 15 years, but it can also reportedly occur in adults [2-5]. It has a predilection for the paranasal sinuses and can occur in the maxilla, mandible, orbit, fronto-ethmoid complex, and frontal bone [2-8]. The diagnosis of JPOF is based on characteristic clinical manifestations, histological examination, and radiological characteristics. It is usually asymptomatic but short-term rapid growth of the mass can cause facial asymmetry, and when the maxilla, mandible, or both are affected it can also cause dental symptoms [2,7,8]. Histopathological JPOF exhibits dense cellularity with fibrous stroma and psammoma bodies. Radiological examinations have yielded a large spectrum of findings, including locularity, radiodensity, and cortical bone perforation [2,7]. Complete removal is the recommended treatment for JPOF because of its aggressive and locally invasive characteristics, but conservative local excision such as curettage, enucleation, or partial excision can be attempted depending on the patient's individual condition [2,3,9]. CASE REPORT A 20-year-old man was referred to our clinic by the department of otorhinolaryngology. Ten months prior he had noticed a mass on his right cheek, which was initially tender. Three months thereafter the mass had started increasing in size, and Archives of Craniofacial Surgery

Background An electrosurgery unit (ESU) is the mainstay of bleeding control in blepharoplasty. There are two different types of ESUs: monopolar (m‐ESU) and bipolar (b‐ESU). Aims We used m‐ and b‐ESUs in upper, lower, and combined blepharoplasty and compared their outcomes. Patients/Methods In this retrospective file review of 292 blepharoplasty patients, we excluded 14 who were lost to follow‐up or had missing data; among the 278 enrolled patients, we recorded operative time, a surgeon panel's score for edema and ecchymosis on the third postoperative day, patients’ scores of their satisfaction and inconvenience, and postoperative complications. Results One hundred thirty‐nine patients were included in the m‐ESU and b‐ESU group. Overall, 105 patients underwent upper blepharoplasty, 77 underwent lower blepharoplasty, and 96 underwent combined blepharoplasty. The total mean operative time in the m‐ESU and b‐ESU was 67.94 and 62.82 minutes, respectively. This difference was not significant (P > .05). The panel's edema and patient satisfaction and inconvenience scores were significantly better in the b‐ESU group (P < .05). There were no significant differences in the panel's ecchymosis score and frequency as well as nature of complications between the m‐ESU and b‐ESU group (P > .05). Conclusions In this cohort of blepharoplasty patients, minimally invasive b‐ESUs were efficient in obtaining reliable surgical results with higher satisfaction and lower inconvenience rates of patients than m‐ESUs. We would like to recommend the use of b‐ESUs in blepharoplasty, especially for plastic surgeons inexperienced in periorbital esthetic surgery.