Vitamin D has long been known to be a major regulator for both the endocrine and the immune system. With the advent of COVID-19 pandemic, there has been a growing interest in looking at the feasibility of using vitamin D as a preventative and therapeutic option in the management of the disease. A low serum level of vitamin D is linked to higher incidence of respiratory tract infection and disease progression. Vitamin D supplementation has proven to be effective in enhancing the immune system, strengthen lung epithelial barrier, and prevention of unchecked inflammatory response. Previous studies on the roles of vitamin D in managing influenza and other enveloped virus infection could shed light on the possible roles of vitamin D in the current pandemic. More randomised controlled trials are needed to explore the effects of vitamin D supplementation on COVID-19 infection. Review Criteria: Papers published in the MEDLINE and EMBASE databases were reviewed for evidence relating viral and respiratory tract infections to vitamin D deficiency; the effects of vitamin D supplementation on the immune and inflammatory responses; and ongoing trials on the use of vitamin D in managing COVID-19 illness. The findings were discussed and dose recommendation for vitamin D supplements summarised. Message for the Clinic: Vitamin D could be a readily accessible and cost-effective adjuvant therapy for COVID-19 that deserves further research.

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Serratia marcescens represents an unusual yet potentially deadly cause of lower limb necrotizing fasciitis (NF). Compounding the already high mortality of NF, S. marcescens infections are usually associated with worse outcomes (i.e., amputation). Here we present the case of a 56-year-old immunocompromised man due to lupus nephritis who developed lower limb NF secondary to S. marcescens followed by nosocomial coronavirus disease 2019 (COVID-19) pneumonitis. Successful limb salvage was achieved through a multidisciplinary team approach from various specialties including plastic surgery, orthopedic surgery, anesthesiology, intensive care, respiratory medicine, and nephrology. At 11 months' follow-up, the patient was largely independent with activities of daily living and was able to ambulate. Unfortunately, he suffered a myocardial infarction at 19 months post-operatively and passed away. A review of the literature revealed only a handful of cases of lower limb NF due to S. marcescens and none with subsequent COVID-19. Therefore, this is the first report of such a case which should help with the clinical management of such cases going forward, especially with COVID-19 now becoming endemic in our communities and contributing to delayed presentations and increased mortality in NF.

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Background and Objective: The deep inferior epigastric artery perforator (DIEP) flap was first described by Koshima and Soeda in 1989 and is now well-established as the gold standard in breast reconstruction. Lately, this issue has been explored in the context of head and neck reconstruction, highlighting growing interest in the use of the DIEP flap beyond breast reconstruction, but its usage in other anatomical regions appears elusive. Nevertheless, DIEP flap reconstruction may be a viable choice for complex, three-dimensional head and neck deformities while upholding the criteria of minimal donor site morbidity, according to a recent review. To determine whether the DIEP flap may be used successfully in other types of reconstruction, we conducted a review on the use, applications, and outcomes of the DIEP flap in non-breast reconstruction. This is, as far as we are aware, the first comprehensive analysis of all applications of the DIEP flap other than for breast reconstruction.Methods: A literature review was performed using PubMed to include all relevant articles in English or French published up to February 2022. Keywords included "DIEP flap" and "deep inferior epigastric perforator flap". Key Contents and Findings: A total of 1,299 articles were identified with 105 on the use of the DIEP flap in non-breast reconstruction. This suggests increasing recognition of the DIEP flap as a feasible option for reconstruction of most anatomical regions, especially in lower limb and head and neck reconstruction, followed by gynecological reconstruction. The DIEP flap was also utilized in the reconstruction of upper limb, thigh and hip defects. Less commonly, it has been used for penoscrotal, groin, sternal, buttock and abdomen reconstruction. Conclusions:The scientific body of evidence showed the robustness and versatility of the DIEP flap in non-breast reconstruction, with its relative pros and cons at different anatomical regions.

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