Full thickness burns caused by cyanoacrylate nail glue: A case series.

Artificial (acrylic) nails are popular cosmetic enhancements that provide the user with the appearance of manicured nails, do not chip or crack, and are generally considered very safe to apply. We report three cases where full thickness thermal burns were sustained from nail glue adhesive (cyanoacrylate) during the application of artificial nails. All three cases underwent surgical debridement and split skin graft reconstruction. We carried out an experiment to characterize the exothermic reaction between nail glue and cotton leggings. The average high temperature produced was 68°C which was sustained for 12.2s which is more than sufficient to cause full thickness burns on skin. We report these cases to increase both professional and public awareness of this serious potential complication associated with the application of artificial nails.

Pedicled distal phalanx fillet flap for finger length preservation in trauma.

Lawnmower injuries to the digits are becoming increasingly common and are often complex in nature with multiple levels of injury. The management of these injuries as with that of other hand injuries is often tailored to the individual patient considering factors such as occupation and hobbies with the ultimate goal of restoration of function and a sensate fingertip. The concept of using amputated, mangled or non-salvageable parts in a form of fillet flap has become more common in the recent years. We report a complex case of a multi-level injury to the dominant index finger of a professional typist from a lawnmower where finger length was maximised using a pedicled distal phalanx fillet flap which ultimately allowed the patient to return to work.

Improving outcomes in microsurgical breast reconstruction: lessons learnt from 406 consecutive DIEP/TRAM flaps performed by a single surgeon.

BACKGROUND: Multiple preoperative, intraoperative and postoperative decisions can influence the outcome of microsurgical breast reconstruction. We have simplified the decision-making process by incorporating a number of algorithms into our microsurgical breast reconstruction practice and critically review our results in this study. METHODS: Prospectively maintained databases for all microsurgical breast reconstructions performed by a single surgeon over a nine-year period were examined to determine: patient demographics; operative details including flap choice, donor and recipient vessel selection; and, details of intraoperative and early postoperative (

Bilateral supraclavicular swelling: an unusual presentation of ruptured Poly Implant Prosthese (PIP) breast implants.

Breast implants manufactured by the French company Poly Implant Prosthese (PIP) have gained notoriety in the International media since the realisation that industrial grade silicone was used in their manufacture with consequent increased risk of implant rupture. At present, it is estimated that there are estimated to be over 40,000 women in the UK with PIP implants. We report an unusual presentation of PIP breast implant rupture as swelling in the supraclavicular fossae. This has not previously been reported in the literature.

Coal ash poultice: an unusual cause of a chemical burn.

Burns from seemingly innocuous substances are rare, probably underrecognized and typically present late. We describe a case of a child who sustained a full-thickness burn after an application of a coal ash poultice for ankle pain. This case report highlights a rare cause of a chemical burn that may become more common with increasing use of traditional remedies worldwide.

Cardiac tissue engineering in an in vivo vascularized chamber.

BACKGROUND: Cardiac tissue engineering offers the prospect of a novel treatment for acquired or congenital heart defects. We have created vascularized pieces of beating cardiac muscle in the rat that are as thick as the adult rat right ventricle wall. METHOD AND RESULTS: Neonatal rat cardiomyocytes in Matrigel were implanted with an arteriovenous blood vessel loop into a 0.5-mL patented tissue-engineering chamber, located subcutaneously in the groin. Chambers were harvested 1, 4, and 10 weeks after insertion. At 4 and 10 weeks, all constructs that grew in the chambers contracted spontaneously. Immunostaining for alpha-sarcomeric actin, troponin, and desmin showed that differentiated cardiomyocytes present in tissue at all time points formed a network of interconnected cells within a collagenous extracellular matrix. Constructs at 4 and 10 weeks were extensively vascularized. The maximum thickness of cardiac tissue generated was 1983 microm. Cardiomyocytes increased in size from 1 to 10 weeks and were positive for the proliferation markers Ki67 and PCNA. Connexin-43 stain indicated that gap junctions were present between cardiomyocytes at 4 and 10 weeks. Echocardiograms performed between 4 and 10 weeks showed that the tissue construct contracted spontaneously in vivo. In vitro organ bath experiments showed a typical cardiac muscle length-tension relationship, the ability to be paced from electrical field pulses up to 3 Hz, positive chronotropy to norepinephrine, and positive inotropy in response to calcium. CONCLUSIONS: In summary, the use of a vascularized tissue-engineering chamber allowed generation of a spontaneously beating 3-dimensional mass of cardiac tissue from neonatal rat cardiomyocytes. Further development of this vascularized model will increase the potential of cardiac tissue engineering to provide suitable replacement tissues for acquired and congenital defects.