The VAC therapy may help to reduce the flap size and need for a flap transfer for type IIIB open tibial fractures. However, prolonged periods of VAC usage, greater than 7 days, should be avoided to reduce higher infection and amputation risks.

Hidradenitis suppurativa (HS) is a chronic inflammatory condition affecting the apocrine glands of the axilla, groin, and perianal region. Although it is a common condition, it is rarely associated with squamous cell carcinoma (SCC). There have been only 41 reports of this uncommon complication of HS in the literature. This study includes two uncommon presentations of HS associated with SCC along with a literature review. The first patient developed diffuse abdominal carcinomatosis from SCC in the anogenital region arising from HS. This is a rare event in patients with perianal SCC, with only one case previously described in the literature. The second patient developed malignant hypercalcemia, an uncommon complication of cutaneous SCC. The current report represents the largest review of the literature of patients with SCC secondary to longstanding HS. A recurrence rate of 48 per cent was observed after “curative” resection. Approximately half of the patients succumbed to their disease, and the grade of carcinoma was the only predictor of mortality. These two new cases underline the importance of close follow-up and aggressive management of patients with HS. Although the development of carcinoma is an uncommon event in HS, the consequences can be devastating with mortality approaching 50 per cent.

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Background: Immediate breast reconstruction (IBR) is offered as part of the standard-of-care to females undergoing mastectomy. Racial disparity in IBR has been previously reported with a longstanding call for its elimination, though unknown if this goal is achieved. The aim of this study was to examine the current association between race and IBR and to investigate whether racial disparity is diminishing. Methods: Data was extracted from the National Cancer Database (NCDB) from 2004 to 2016. All variables in the database were controlled so that the comparison would be made solely between Black and White females. We also analyzed the trend in racial disparity to see if there has been a change from 2004 to 2016 after several calls for healthcare equality. Results: After propensity score matching, 69,084 White females were compared to 69,084 Black females. There was a statistically significant difference between the rate of IBR and race (23,386 [33.9%] in White females vs 20,850 [30.2%] in Black females, P-value  < .001). Despite a twofold increase in the rate of IBR in both White and Black females, a persistent gap of about 4% was observed over the study period, which translates to more than 2,500 Black females not receiving IBR. Conclusions: Using the NCDB database, a racial disparity was identified for IBR between White and Black females from 2004 and 2016. Unfortunately, the gap between the groups remained constant over this 13-year period.