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Background:  Facelift is now the fourth most common aesthetic procedure in men. Facial ageing is very different in men and women. Therefore, individual techniques are used since a uniform concept for the surgical facelift in men does not exist. This study aims to evaluate a gender-specific facelift concept especially developed for men., Material and Methods:  Women and men (n = 10 each) were subjected to a three-dimensional face scan and a subsequent simulation of a V-shaped lift vector (standard lift) and a new facelift concept especially for men in a double T shape (male lift). In an online survey with 262 participants, the simulated as well as the unchanged images were presented and the attributes masculinity, femininity, attractiveness and youthfulness were queried. Statistical models were used to identify attributes of lifting as well as other factors and differences between the simulations., Results:  Facelift changes are generally associated with a significant improvement in the attributes of youthfulness and attractiveness compared with unchanged control faces. As expected, a male lift leads to masculinisation, while a standard lift leads to feminisation, regardless of the sex of the subjects. The male lift led to higher values for the attribute attractiveness in male subjects, as did the standard lift in female subjects. The standard lift developed for women is indeed more suitable for women and is associated with a significantly higher probability for the attribute youthfulness, whereas this is not the case in the newly introduced male lift concept., Conclusion:  The new facelift concept for male patients is significantly associated with masculinity and attractiveness, while the standard lift suitable for women is associated with significantly higher evaluations of femininity and youthfulness. The results of the SIMALIFT study are the first evidence of the need for a more differentiated, gender-specific approach to facelifting., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Introduction: More than half a million patients suffer from minor burns in Germany per year. In 2018, almost 2000 patients needed intensive care for their burn injuries. Despite high standards of burn care, mortality remains high. Burn injuries may lead to long-term sequelae. In order to provide up-to-date burn care, guidelines are available online with public access., Methods and Results: This overview presents a summary of the German AWMF guideline for the treatment of thermal injuries in adults (https://www.awmf.org/leitlinien/detail/ll/044-001.html). Experts of eleven different medical organisations and specialties have contributed to this S2k guideline with their expertise. The focus of the article is on acute burn wound assessment, the indication for specialised care in burn centres, the management of the burn wound at the trauma scene and in hospitals as well as scar management and rehabilitation., Conclusion: This overview reports on the consensus-based treatment of acute burn wounds in adults in Germany. The article is intended to guide doctors and professional caretakers to perform state-of-the-art burn care. The current guideline aims to improve burn outcome., Competing Interests: HOR war beratend tätig für die Firma Birken und hat eine bezahlte Autorentätigkeit für uptodate. UM hat eine Studie für die DIZG durchgeführt. CH war beratend tätig für Acelity und hat Honorar für Vorträge der Firma Integra und Mediwound erhalten. JH war beratend tätig für Mediwound und hat Honorar für Vorträge der Firma Juzo und Thuasne erhalten, sowie eine Studie für die Firma OrionPharma durchgeführt. BH war beratend für die DIZG, die Firmen Polymedics und Mediwound tätig und hat bezahlte Vorträge für die Firmen Juzo und Mediwound gehalten, sowie eine klinische Studie für die Firma Mediwound durchgeführt. ML hat Honorar für Vorträge der Firma Serag Wiesner erhalten. HP hat bezahlte Vorträge für die Berufsfachschule für Orthopädietechnik gehalten, sowie Eigentümerinteressen am Sanitätshaus Pauli und Sanitätshaus Aktuell AG. JLS hat eine Studie für die Firma Prevor durchgeführt. MS hat Honorar für Vorträge der Firma Polymedics erhalten. SW hat bezahle Vorträge für die Firmen Juzo und Thuasne gehalten. SZ hat bezahlte Vorträge für Pfizer, bioMerieux, sifin diagnostics und Aurosan gehalten. HZ hat Honorare für Vorträge für die Firmen Thuasne, Juzo, Albrecht, Smith&Nephew sowie die Bundesfachschule für Orthopädietechnik erhalten. Die übrigen Autoren haben keine Interessenskonflikte., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: Cutaneous microcirculation has shown to play a key role in wound healing. Although healing disorders are still one of the most common complications in hand surgery, there still exists a lack of scientific research on possible age-related changes in cutaneous microcirculation at the dorsum of hand., Hypothesis: Cutaneous microcirculation at the dorsum of the hand differs significantly between different age groups., Methods: 53 healthy subjects were divided into 2 groups by age (Group A:<40 years, n=31 vs. Group B≥40 years, n=22). All subjects underwent measurement of the microcirculation at the dorsum of the hand with combined laser-Doppler and photo spectrometry., Results: Cutaneous oxygen saturation was significantly higher in Group A than in Group B (A: 64.7±9.9% vs. B: 58.3±12.6%; p=0,044). In contrast, blood flow velocity was significantly higher in Group B (A: 43±19.6 AU vs. B: 56.7±21.1 AU; p=0.019)., Conclusion: The hypothesis of this study was confirmed. This is the first study to show significant differences of cutaneous microcirculation at the dorsum of the hand within different age groups. Further clinical trials are needed in order to examine if delayed wound healing can be correlated to impaired cutaneous microcirculation at the dorsum of the hand., (© Georg Thieme Verlag KG Stuttgart · New York.)

Purpose: Soft tissue management is of paramount importance in ankle surgery. As such, full thickness necrosis of the soft tissue envelope represents a severe complication following total ankle joint arthroplasty (TAA) potentially leading to implant exposure, infection and thus, substantially compromised patient outcomes. One of the main factors leading to soft tissue complications is an undetermined arterial perfusion of the lower leg or ankle joint. We report on clinical cases suffering soft tissue complications following TAA with the respective plastic surgical therapy regimen and present a simple algorithm for preoperative perfusion evaluation., Methods: The medical records of 30 consecutive primary TAA patients were retrospectively reviewed after observing a higher than expected rate of severe soft tissue defects which have been referred to our plastic surgery department., Results: 3 patients (10%, all females, age 63 ± 5 years; BMI 27 ± 3 kg/m2) presented with a soft tissue defect leading to angiography revealing one case of severe arterial obstruction. Wound closure could be reached in one case by conservative therapy consisting of regular dressing changes. In the further patients definite soft tissue reconstruction could only be performed by surgical intervention. One could be covered by split-thickness skin grafting and one by a microsurgical transplantation of a free latissimus dorsi flap. On the basis of these complications we established an easy algorithm for the preoperative evaluation of the arterial perfusion in the ankle region. First, (I) the pulses of the dorsal foot artery and posterior tibial artery should be examined. In the case of not palpable pulses (II) the ankle-brachial index should be performed. Values of <0.9 or >1.2 recommend (III) to perform angiography. In the case of stenosis or complete obstruction (IV) the arterial blood flow should be reconstituted by interventional radiological stenting or vascular surgical procedures., Conclusion: The identification of the arterial perfusion status of patients undergoing TAA using a straightforward clinical algorithm might overcome TAA-related soft tissue complications and improve patient-related outcome measures., (© Georg Thieme Verlag KG Stuttgart · New York.)