The roles of gaze and head orientation in face categorization during rapid serial visual presentation.

Little is known about how perceived gaze direction and head orientation may influence human categorization of visual stimuli as faces. To address this question, a sequence of unsegmented natural images, each containing a random face or a non-face object, was presented in rapid succession (stimulus duration: 91.7 ms per image) during which human observers were instructed to respond immediately to every face presentation. Faces differed in gaze and head orientation in 7 combinations - full-front views with perceived gaze (1) directed to the observer, (2) averted to the left, or (3) averted to the right, left ¾ side views with (4) direct gaze or (5) averted gaze, and right ¾ side views with (6) direct gaze or (7) averted gaze - were presented randomly throughout the sequence. We found highly accurate and rapid behavioural responses to all kinds of faces. Crucially, both perceived gaze direction and head orientation had comparable, non-interactive effects on response times, where direct gaze was responded faster than averted gaze by 48 ms and full-front view faster than ¾ side view also by 48 ms on average. Presentations of full-front faces with direct gaze led to an additive speed advantage of 96 ms to ¾ faces with averted gaze. The results reveal that the effects of perceived gaze direction and head orientation on the speed of face categorization probably depend on the degree of social relevance of the face to the viewer.

Combination therapy of oxidised regenerated cellulose/collagen/silver dressings with negative pressure wound therapy for coverage of exposed critical structures in complex lower-extremity wounds.

Complex wounds with exposed critical structures such as tendon and bone are a conundrum in wound management, especially in the setting where the patient is not a suitable candidate for flap surgery. While the individual use of negative pressure wound therapy (NPWT) and oxidised regenerated cellulose (ORC)/collagen/silver (PROMOGRAN PRISMA) dressing has been described in the literature, there are little data on the efficacy of their combined use. In this study, we describe a novel technique of combining the use of NPWT and ORC/collagen/silver dressings to manage complex wound beds as an alternative management option for patients not suitable for reconstructive flap surgery. This technique was performed in a series of 37 patients with complex lower-extremity wounds that were not healing with conventional NPWT alone. All patients had open wounds with exposed critical structures that were difficult to manage, such as exposed tendon, bone, deep crevices, and joint. Successful coverage of exposed critical structures was achieved in 89% of patients, and coverage was achieved within 28 days of combination therapy in 82% of these patients, without any complications. The novel technique of combining ORC/collagen/silver dressing and NPWT provides a useful option in the armamentarium of a reconstructive surgeon dealing with difficult complex lower-extremity wounds.

The Use of Acellular Dermal Matrix in Combination With Pedicled Buccal Fat Pad in Wide Cleft Palate Repair: A Case Report and Literature Review.

We describe a case of the combined use of acellular dermal matrix and pedicled buccal fat pad (BFP) in a wide U-shaped cleft palate repair. Acellular dermal matrix was used as a "patch" repair for the nasal mucosa defect as opposed to the conventional inlay graft. The advantages include reduced cost and a smaller avascular graft load. Lateral relaxing incisions were made to ensure tension-free closure of oromucosa at midline. Lateral oromucosa defect closure with well-vascularized pedicled BFP ensures enhanced healing, less palatal contracture and shortening, and reduced infection. The palate healed with mucosalization at 2 weeks, and no complications were noted at 6 months follow-up.

An Overview of the Use of Bromelain-Based Enzymatic Debridement (Nexobrid®) in Deep Partial and Full Thickness Burns: Appraising the Evidence.

Recent introduction of rapid bromelain-based enzymatic debridement has been increasingly popular in its use in nonsurgical debridement in deep partial and full thickness burns. We designed this study to evaluate the evidence suggested by current studies on the perceived benefits of using Nexobrid® compared with traditional surgical standard of care in burns wound debridement. A comprehensive search on electronic databases Pubmed, Embase, and Web of Science was done to identify studies published between 1986 and 2017 involving the use of Nexobrid® in deep partial and full thickness burns. Studies were evaluated for proposed benefits and categorized under supporting evidence, contradicting evidence, and anecdotal opinions. Seven well-designed prospective studies met the inclusion comprising four randomized controlled trials. Six proposed benefits associated with the use of Nexobrid® were extracted including reduced time to complete debridement, need for surgery, area of burns excised, need for autograft, time to wound closure, and improved scar quality. Most proposed benefits have strong supporting evidences with minimal anecdotal opinions from controlled trials except the proposed improvement in scar quality and reduced time to wound healing that had at least three refuting evidence and one anecdotal evidence. Incidence of pain was also evaluated and was mainly anecdotal lacking formal objective assessment or cohort study. Despite the lack of literatures available, the benefits of Nexobrid® are evident in published randomized and single arm studies. Large number of studies is needed to aid further evaluating the proposed benefits of Nexobrid®.