An overview of current assessment techniques for evaluating cutaneous perfusion in reconstructive surgery.

This article provides a comprehensive analysis of modern techniques used in the assessment of cutaneous flaps in reconstructive surgery. It emphasizes the importance of preoperative planning and intra- and perioperative assessment of flap perfusion to ensure successful outcomes. Despite technological advancements, direct clinical assessment remains the gold standard. We categorized assessment techniques into non-invasive and invasive modalities, discussing their strengths and weaknesses. Non-invasive methods, such as acoustic Doppler sonography, near-infrared spectroscopy, hyperspectral imaging thermal imaging, and remote-photoplethysmography, offer accessibility and safety but may sacrifice specificity. Invasive techniques, including contrast-enhanced ultrasound, computed tomography angiography, near-infrared fluorescence angiography with indocyanine green, and implantable Doppler probe, provide high accuracy but introduce additional risks. We emphasize the need for a tailored decision-making process based on specific clinical scenarios, patient characteristics, procedural requirements, and surgeon expertise. It also discusses potential future advancements in flap assessment, including the integration of artificial intelligence and emerging technologies.

Effects of Napping on Alertness, Cognitive, and Physical Outcomes of Karate Athletes.

PURPOSE: It has been suggested that napping is the best recovery strategy for athletes. However, researches on the impacts of napping on athletic performances are scarce. The aim of this study was to determine the effects of a 30-min nap after a partial sleep deprivation, or a normal night condition, on alertness, fatigue, and cognitive and physical outcomes. METHODS: Thirteen national-level male karate athletes were randomized to experience nap and no-nap conditions, after either a reference or a partial sleep deprivation night. The nap lasted 30 min at 1:00 PM. The postnap testing session started at 2:00 PM by quantifying subjective alertness and fatigue. Cognitive and physical performances were respectively measured before and after the karate-specific test (KST) by simple reaction time (SRT) test, lower reaction test (LRT), mental rotation test (MRT), squat jump (SJ), and counter movement jump (CMJ) tests. RESULTS: After a reference night, the nap improved alertness and cognitive outcomes (SRT, LRT, and MRT). No effects on subjective fatigue and physical performances were found. After a partial-sleep deprivation, the nap restored subjective alertness and the decrement in performances caused by sleep loss in most of the tests (MRT, LRT, and KST), but no effects were observed in subjective fatigue and CMJ. After the fatigue induced by KST, there was an ergogenic effect of the nap on the physical performances (CMJ and SJ), and a partial psychogenic effect on the cognitive performances (LRT). CONCLUSIONS: A 30-min nap enhances cognitive outcomes. It is also an effective strategy to overcome the cognitive and physical deteriorations in performances caused either by sleep loss or by fatigue induced by exhaustive trainings in the afternoon.