Current chemical peels and other resurfacing techniques

The currently available methods for resurfacing will be addressed in this article, which has been divided into three areas of focus: chemical peels, lasers, and dermabrasion. Emphasis will be placed on chemical peels, a technique with a long history that provides a very reliable method of resurfacing and that every facial plastic surgeon should be familiar with.     

A biomechanical analysis of distraction force in modified hynes-Giddins dynamic external fixator

Hynes and Giddins modified the rubber band traction device advocated by Suzuki for management of phalangeal pilon fractures and fracture-dislocations. We present here a modification of the Hynes-Giddins version of this dynamic external fixator, which allows alteration of the distracting force by a simple adjustment of the construct.     

Late‐emigrating trunk neural crest cells in turtle embryos generate an osteogenic ectomesenchyme in the plastron

Background : The turtle plastron is composed of a keratinized epidermis overlying nine dermal bones. Its developmental origin has been controversial; recent evidence suggests that the plastral bones derive from trunk neural crest cells (NCCs). Results: This study extends the observations that there is a turtle‐specific, second wave of trunk NCC delamination and migration, after the original NCCs have reached their destination and differentiated. This second wave was confirmed by immunohistochemistry in whole‐mounts and serial sections, by injecting DiI (1,1′, di‐octadecyl‐3,3,3′,3′,‐tetramethylindo‐carbocyanine perchlorate) into the lumen of the neural tube and tracing labeled cells into the plastron, and by isolating neural tubes from older turtle embryos and observing delaminating NCCs. This later migration gives rise to a plastral ectomesenchyme that expresses NCC markers and can be induced to initiate bone formation. Conclusions: The NCCs of this second migration have properties similar to those of the earlier NCCs, but also express markers characteristic of cranial NCCs. The majority of the cells of the plastron mesenchyme express neural crest markers, and have osteogenic differentiation capabilities that are similar or identical to craniofacial ectomesenchyme. Our evidence supports the contention that turtle plastron bones are derived from a late emigrating population of cells derived from the trunk neural crest. Developmental Dynamics 242:1223–1235, 2013. © 2013 Wiley Periodicals, Inc.     

An enhanced recovery after surgery pathway in pediatric colorectal surgery improves patient outcomes

IntroductionEnhanced recovery after surgery (ERAS) pathways in adult colorectal surgery are known to reduce complications, readmissions, and length of stay (LOS). However, there is a paucity of ERAS data for pediatric colorectal surgery.MethodsA 2014–2018 single-institution, retrospective cohort study was performed on pediatric colorectal surgery patients (2–18 years) pre- and post-ERAS pathway implementation. Bivariate analysis and linear regression were used to determine if ERAS pathway implementation reduced total morphine milligram equivalents per kilogram (MME/kg), LOS, and time to oral intake.Results98 (70.5%) and 41 (29.5%) patients were managed with ERAS and non-ERAS pathways, respectively. There was no statistical difference in age, sex, diagnosis, or use of laparoscopic technique between cohorts. The ERAS cohort experienced a significant reduction in total MME/kg, Foley duration, time to oral intake, and LOS with no increase in complications. The presence of an ERAS pathway reduced the total MME/kg (? 0.071, 95% CI ? 0.10, ? 0.043) when controlling for covariates.ConclusionThe use of an ERAS pathway reduces opioid utilization, which is associated with a reduction in LOS and expedites the initiation of oral intake, in colorectal pediatric surgery patients. Pediatric ERAS pathways should be incorporated into the care of pediatric patients undergoing colorectal surgery.Level of evidenceLevel III evidence.Type of studyRetrospective cohort study.