Our evidence-based protocol was associated with a significant decline in infection rates among implant-based breast reconstruction patients and was particularly effective for gram-positive infections. We will continue to use this protocol in our practice and will consider future directions for addressing gram-negative infections as well.

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The course of patient described in this case report is typically: patient reports an intermittent remission of the symptoms, intraoral examination may reveal dental restorations and periodontal diseases, but the clinician should keep in mind that even the tooth involved can appear healthy. Some authors claim that extra-oral fistulas are more common in the children and adolescents because the teeth are not yet fully erupted and the alveolar processes is not fully developed and so roots are more deeply seated. 6-10 However, most case reports available in the literature are predominantly of adults and thus do not support this theory.Odontogenic cutaneous fistula typically arises from periapical infections around the root apices as a result of pulpal necrosis due to penetrant caries or traumatic injury. Routine tests used to locate the involved teeth include pulp sensitivity tests and radiographic analysis. In the clinical case described here, the radiographies clearly revealed pericoronaritis and boneless which the cause of suppuration and fistula. [11][12][13] As far as definitive treatment is concerned, root canal or surgical extraction is the treatment of choice. After surgical treatment of the pathogenic tooth the fistula often heals without furthers intervention by 14 days. Healing occurs by secondary intention and occasionally a residual scar may be persist after a few months. In these cases, surgery may be indicated to improve aesthetics. In this case report we have preferred to have surgical excision in order to speed up the healing process.In conclusion, a dental etiology must always be considered for any cutaneous fistula in the head or in the neck region. 2,3,13 -16 Elimination of the dental source of infection results in resolution of the fistula and the healing of the fistula is expected within 5 to 14 days. In case with of restorable teeth, even just the elimination of the infection through endodontic treatment leads to resolution of the fistula. 2,8,17 The case here described is particular because the fistula was caused by a pericoronaritis and not by a dental necrosis. The pericoronaritis started from the third molar, whose existence was ignored, in an old edentulous woman. This case teaches that clinicians should always look for odontogenic causes of cutaneous fistula, even though they seem unlikely.

Background: This review investigates the use of social media at surgical conferences and possible effects of prepublication data release in surgical fields. Potential risks include patient harm by the preliminary application of research that lacks sufficient peer review, infringements on intellectual property, and loss of “research novelty.” Methods: A literature review of the current use of social media in dispersion of prepublication data was performed. Current submission guidelines for surgical conferences and journals were analyzed for data release embargos and social media use policies. Results: Conference abstract guidelines mentioned data embargos half of the time and the use of social media less than one third of the time. Eighty percentage of journal instructions to authors contained guidelines on both. Conclusions: In nonsurgical fields, the appropriateness of the use of social media to release prepublication data is increasingly being discussed. Little guidance exists on how surgical conference attendees should use social media while at conferences. Given the potential for patient harm and negative impact on intellectual property and attribution, further discussion is warranted. Introducción: Esta crítica investiga el uso de las redes sociales en las conferencias quirúrgicas y los efectos posibles de los datos pre-publicados en cirugía. Los riesgos probables incluyen: daño al paciente causado por la aplicación prematura de las investigaciones sin bastante análisis, violación de la propiedad intelectual, y perdido de “novedad de investigación.” Metodología: Un repaso fue hecho sobre el rol de las redes sociales en la propagación de los datos pre-publicados. Las normas actuales para la entrega de las conferencias y los periódicos quirúrgicos claves fueron analizadas por las reglas gobernando el uso de las redes sociales y los embargos del lanzamiento de datos. Resultados: Las reglas generales sobre la entrega de abstractos para las conferencias mencionaron los embargos de datos la mitad del tiempo mientras que estas mismas reglas mencionaron el uso de las redes sociales menos que un tercio el tiempo. 80% de las instrucciones de los periódicos dirigidas a los autores tuvieron las reglas generales sobre los dos: los embargos de datas y las redes sociales. Conclusiones: En las especialidades non-quirúrgicas, la pertinencia del uso de las redes sociales para lanzar el dato pre-publicado es discutida con más frecuencia. No existen normas sobre cómo se usan las redes sociales durante las conferencias. Dado el daño potencial al paciente y el impacto negativo en la propiedad y la atribución intelectuales, más discusión está obligatoria.

Background Untreated or undertreated burns are commonly encountered by plastic surgeons on medical trips in India and represent a major cause of disability. We sought to utilize validated patient-reported outcomes instruments to identify the patient population with the greatest burn-related disability in order to appropriately allocate plastic surgery resources to those in greatest need. Methods The Quick Disability of the Arm, Shoulder, and Hand, RAND 36-Item Short Form Health Survey, and Burn-Specific Health Scale–Revised, Brief, and Adapted questionnaires were administered via an interpreter during a plastic surgery trip to Jharkhand, India, in January 2018. Demographics, comorbidities, and burn-specific history were recorded. Results Twenty-eight postburn patients were surveyed (mean age, 17.0 ± 9.2 years; male:female ratio, 1:2.5). Mean time from injury was 4.74 years. No patient had received formal, primary burn care. Mechanism of injury: flame (39%), oil (32%), scalding water (14%), and other (14%). Fifty-four percent were extremity burns; 25%, facial; and 18%, neck burns. The Burn-Specific Health Scale–Revised, Brief, and Adapted demonstrated that the most significantly impacted domains for all patients were body image and skin sensitivity, with more than 80% of patients complaining of issues with skin sensitivity. In addition, children (aged <18 years) had diminished body image domain scores. RAND SF-36 scores were lowest in the energy (73.1 ± 25.0) and general health (76.5 ± 13.8) domains, and females with extremity burns demonstrated statistically significant decreases in their physical limitation domain scores (85.9 ± 17.3, P < 0.05). Females with extremity burns also had statistically significant lower scores in the energy domain (64.09 ± 25.75) as compared with their male counterparts with extremity burns (100 ± 0, P = 0.045). In general, females scored lower than did males in multiple domains, and those results reached statistical significance in the energy (65.9 ± 24.6 vs 93.6 ± 10.9), emotional (77.2 ± 21.5 vs 95.4 ± 11.2), and general health domains (71.1 ± 11.9 vs 90.0 ± 7.5) with P < 0.05. Children demonstrated significantly diminished scores in the emotional (75.5 ± 24.6) and general health (79.1 ± 11.8) domains. Conclusion These data demonstrate the significant impact on quality of life that untreated burns have in this population. Male and female children with extremity burns and adult women with extremity burns were most significantly affected in multiple domains. Consequently, children and adult women with extremity burns appear to be the patient cohort with the greatest opportunity to impact their quality of life. These data may be utilized to improve patient triage and resource allocation for future surgical trips but could also be of significant benefit to internal health agencies and ministries for the same purpose.

Importance: Hidradenitis suppurativa (HS) is a chronic, inflammatory disorder affecting skin of intertriginous areas that is often encountered and treated by nondermatologic specialists.Objective: The purpose of this literature review is to provide a comprehensive, clinical source of information on HS as it relates to incidence of disease, pathophysiology, diagnosis, and overall management of this condition.Evidence Acquisition: Sources were obtained through a comprehensive literature search using PubMed and PMC. Various terms were used to query the database, including "hidradenitis suppurativa," "pathogenesis," "prevalence," "management," "surgery," "perineal," and "vulva."Results: Underreported prevalence and unknown pathogenesis have subsequently led to variable approaches in clinical management, often employing a combination of medical and surgical management.Conclusion: Early diagnosis and treatment of HS may lead to better disease control and minimize patients' associated morbidity related to disease.Relevance: Knowledge of vulvoperineal hidradenitis is necessary for gynecologists and primary care physicians to ensure early diagnosis, management, and referral for optimal patient outcomes.Target Audience: Obstetricians and gynecologists, family physicians.Learning Objectives: After completing this activity, the learner should be better able to describe the presentation and staging of hidradenitis suppurativa; explain possible medical and surgical treatments; and identify options for correction of vulvar deformities.Hidradenitis suppurativa (HS) is a chronic, inflammatory cutaneous disorder that occurs with a predilection for intertriginous locations such as the axilla, buttock, perineum, and groin. [1][2][3] It is a progressive disease characterized by the formation of abscesses, fistulas, and draining sinuses, as well as marked fibrosis leading to irregular, hypertrophic scarring. 1,2,4 Clinical staging is usually denoted using Hurley classification, although there are several additional verified schemata that can be used. Although historically considered rare, the overall prevalence of HS is likely anywhere between 0.1% and 4%. [5][6][7] Pathogenesis was originally felt to center on apocrine glands and follicular occlusion, but in recent years, it has been characterized as a chronic inflammatory disorder primarily centering on hair follicles. 8,9 In addition,

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