This large-scale comparative real-life study shows that the silver foam dressing supports faster healing of delayed healing wounds.

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1 We have examined the role of nitric oxide (NO) in a model of functional angiogenesis in which survival of a skin¯ap depends entirely on angiogenesis to provide an arterial blood supply to maintain tissue viability. 2 The dierent eects of nitric oxide synthase (NOS) inhibitors on rat skin¯ap survival appeared to be explained on the basis of their NOS isoform selectivity. Skin¯ap survival was decreased by iNOS-selective (inducible NOS) inhibitors, S-methyl-isothiourea, aminoguanidine and aminoethylthiorea; unaected by the non-selective inhibitor nitro-imino-L-ornithine; and enhanced by the cNOS (constitutive NOS, that is endothelial NOS (eNOS) and neuronal NOS (nNOS)) inhibitor, nitro-L-arginine methyl ester. 3 Skin¯ap survival was reduced in mice with targeted disruption of the iNOS gene (iNOS knockout mice), and the administration of nitro-L-arginine methyl ester signi®cantly increased¯ap survival in iNOS knockout mice (P50.05). 4 iNOS immunoreactivity was identi®ed in mast cells in the angiogenic region. Immunoreactive vascular endothelial growth factor (VEGF) and basic ®broblast growth factor were also localized to mast cells. 5 The combination of interferon-g and tumour necrosis factor-a induced NO production and increased VEGF levels in mast cells cultured from bone marrow of wild-type, but not iNOS KO mice. 6 The increased tissue survival associated with the capacity for iNOS expression may be related to iNOS-dependent enhancement of VEGF levels and an ensuing angiogenic response. Our results provide both pharmacological and genetic evidence that iNOS activity promotes survival of ischaemic tissue.

Smart phones are commonly used to obtain clinical photographs in plastic surgery. There are issues around consent process, storage of photos and privacy that need to be addressed.