Outcomes of Two-Stage Interpolated Flaps Versus Single-Stage Techniques for Reconstruction of Intermediate Nasal Defects.

Objective: This study compares the results of patients undergoing reconstruction of intermediate nasal defects, measuring 1.5-2.5 cm, with single-staged techniques as opposed to the traditionally recommended staged interpolated flap reconstruction. Design: This is a retrospective review of patients who underwent reconstruction of a nasal defect by a single surgeon between 2010 and 2016. Methods: Postoperative results including revision surgery, treating persistent edema with Kenalog (triamcinolone acetonide), and perioperative complications were analyzed. Aesthetic outcomes were analyzed by a panel of experts and nonexperts, and compared using a 5-point Likert scale. Results: In total, 51 single-stage and 26 two-stage patients underwent evaluation, and of these, 40 single-stage and 15 two-stage patients underwent panel analysis of aesthetic outcomes. The odds of requiring a revision procedure were 6.69 times higher and odds of using Kenalog postoperatively were 29.67 times higher in the two-stage group than in the single-stage group. Aesthetic scores were consistently better for the single-stage group for both panels. Conclusion: Patients undergoing single-stage techniques for reconstruction of intermediate nasal defects showed improved appearance and reduced number of additional procedures relative to patients undergoing two-stage techniques with short-term follow-up.

Use of Dual-Force Aggregation as a Multiplexed, Rapid Point-of-Care Screening Method for White Blood Cell Counting from Whole Blood Samples.

BACKGROUND: Enumeration of blood cells is an integral metric for evaluating patient health and can be used to screen for a wide range of diseases and conditions. Conventional methods rely on large, expensive, and complicated instrumentation that requires trained technicians and is not amenable to point-of-care analysis. This work demonstrates the use of a multiplexed, bead-based assay for both rapid white blood cell (WBC) count screening and accurate, multiplexed WBC counts for point-of-care analysis. METHODS: Blood samples were lysed and diluted before being incubated with silica-coated magnetic particles under chaotropic conditions, a rotating magnetic field, and a source of agitation. The resulting bead aggregation was imaged and correlated to a known WBC count. After establishing standard curves, the WBC count for 18 whole blood samples were determined by this method and compared to values obtained conventionally. RESULTS: When the optimal dilution factor for lysis of whole blood samples was established, 17 of 18 samples (94.4%) were correctly screened and categorized as having high, typical, or low WBC count, while 14 of 18 samples were within 16% of the reported clinical values. The developed system provides analysis of 13 samples in <3 min with a total analysis time of approximately 10 min (including incubation and dilution) and represents comparable throughput to conventional instrumentation, while providing point-of-care capability with reduced size (14 × 21 × 14 cm) and simplicity. CONCLUSIONS: This work demonstrates the potential for a multiplexed, bead-based assay to be used as a rapid, point-of-care screening method for WBC counting from whole blood samples.