Morel-Lavallée lesion.

Morel-Lavallée lesion (MLL) is a closed degloving injury caused by traumatic sheering of subcutaneous tissue from the underlying fascia. MLL can be classified as acute (less-than 3 months) or chronic (greater-than 3 months or if a capsule has formed). Acute lesions are treated with compression, percutaneous aspiration, sclerodesis, suction-curettage or open surgery depending on vitality of the overlying skin, if fractures are present next to the lesion or if infection has occurred. Chronic lesions are treated with sclerodesis, suction-curettage or open surgery. Drain and vacuum-assisted closure placement should be used post-operatively, as argued in this review.

Treatment of postgestational rectus diastasis.

Rectus diastasis is defined by thinning and widening of linea alba and is a part of pregnancy. In some patients, the diastasis persists giving symptoms such as core instability, and cosmetic complaints. Treatment consists of exercise and surgery by either a plastic surgeon or a general surgeon. Lately, rectus diastasis has gained both national and international attention but it is not clear which patients will benefit from surgery or which operative technique has the best outcome. This review describes postgestational rectus diastasis and summarizes treatment possibilities based on the latest literature.

[Newly diagnosed melanoma diagnosed on the basis of cutaneous side effects from COVID-19 vaccine].

While the Danish Health Authority has withdrawn the vaxzevria vaccine from the Danish vaccination programme due to reports of rare cases of severe side effects, this case report presents a potential beneficial side effect of this vaccine. A patient presented, three days after her first jab, with localized itching and bleeding from a pigmented tumour on her lower leg, which was therefore excised, and, unexpectedly, diagnosed as a melanoma. We speculate if the vaccine-induced immune reaction resulted in increased immune activity within the tumour environment, and thus facilitated the early diagnosis of melanoma.

[Breast implant-associated anaplastic large cell lymphoma].

Breast implant-associated anaplastic large cell lymphoma is an uncommon malignancy associated with textured breast implants, and since 2014 13 Danish cases have been identified. Early diagnosis is important to minimise morbidity. Most patients present with swelling of the breast due to seroma within the fibrous capsule, fewer with a tumour. The diagnosis is based on cytology/histology with finding of typical anaplastic large cells, positive for CD30 and negative for anaplastic lymphoma kinase. Staging includes bone marrow examination and PET-CT scan, and a minority need systemic treatment, as argued in this review.

Treatment of osteoarthritis with autologous, micro-fragmented adipose tissue: a study protocol for a randomized controlled trial.

BACKGROUND: Osteoarthritis is a destructive joint disease that leads to degeneration of cartilage and other morphological changes in the joint. No medical treatment currently exists that can reverse these morphological changes. Intra-articular injection with autologous, micro-fragmented adipose tissue has been suggested to relieve symptoms. METHODS/DESIGN: The study is a blinded randomized controlled trial with patients allocated in a 1:1 ratio to 2 parallel groups. Patients suffering from pain and functional impairment due to osteoarthritis Kellgren-Lawrence grades 2-3 in the tibiofemoral joint are eligible for inclusion. The intervention group is treated with an intra-articular injection with autologous, micro-fragmented adipose tissue prepared using the Lipogems® system. The control group receives an intra-articular injection with isotonic saline. In total, 120 patients are to be included. The primary outcome is The Knee injury and Osteoarthritis Outcome Score (KOOS4) evaluated at 6 months. Secondary outcomes are KOOS at 3, 12 and 24 months; the Tegner activity score; treatment failure; and work status of the patient. The analysis will be conducted both as intention-to-treat and per-protocol analysis. DISCUSSION: This trial is the first to investigate the efficacy of autologous, micro-fragmented adipose tissue in a randomized controlled trial. The study uses the patient-reported outcome measure Knee Injury and Osteoarthritis Outcome Score (KOOS4) after 6 months as the primary outcome, as it is believed to be a valid measure to assess the patient's opinion about their knee and associated problems when suffering from osteoarthritis.

[Sentinel node-positive melanoma].

Two recent randomised studies found no survival difference in patients, who had melanoma with metastasis to the sentinel node (SN) and underwent immediate complete lymph node dissection (CLND), compared with patients, who were followed closely with ultrasound scans and only underwent CLND if metastases developed. From 2018, the Danish guidelines concur: SN-positive patients will no longer undergo routine CLND, which has high morbidity, but will be followed with ultrasound scans of the SN-positive region(s) at their follow-up visits every third month for two years, then every six month for three years, except if PET-CT is performed.