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Background: Macromastia (breast hypertrophy) has a significant influence on patients' quality of life (QoL), and surgical treatment therefore offers clear medical benefits.Rapid improvements in musculoskeletal complaints are being reported long before final aesthetic results are traditionally evaluated.Objectives: The aim of this study was to use the RAND Health Status Survey, in modified validated Short Form 36 (SF-36), to analyze patient QoL after breast reduction, and examine whether QoL changes as a function of postoperative time.Methods: This cross-sectional study included 50 consecutive selected female patients who underwent breast reduction surgery by the same technique performed by a single surgeon between January 2016 and December 2019. Changes in QoL were reported based on a modified SF-36 survey, with scores standardized according to the mean of the general population. Time intervals between the operations and surveys were recorded.Results: The patients were divided into 3 categories according to time since their operation (<3 months, 3-12 months, and >12 months), and assessed pre- and postoperatively. The mean [standard deviation] weight of breast tissue removed was 479.97 [159.38] g per breast. Mean follow-up time was 15.02 [14.3] months. All patients were satisfied with the shape of their new breasts and none reported to have suffered major complications postoperatively. For all 3 groups, patients' scores in the SF-36 survey post- compared with preoperation indicated improvement unrelated to time elapsed since operation.Conclusions: Breast reduction improves symptoms and well-being, unrelated to amount of tissue removed or to time elapsed postsurgery. This improvement is rapid and may lead to better coverage from medical insurance providers.Level Of Evidence:4: [ABSTRACT FROM AUTHOR]

Burns are a major trauma source in civilian and military settings, with a huge impact on patient's well-being, health system, and operation status of the force in the military setting. The purpose of our study was to summarize characteristics of all burn cases seen by the Israel Defense Forces primary care physicians during the years 2008 to 2016. This can help understand what causes most burns, in what units, at which stages and settings and consequently will allow commanders to make decisions regarding safety rules, protective equipment and uniforms, medical education for soldiers, etc. Data were collected from the military database system. All burn-related visits were analyzed using a designated big data computerized algorithm that used keywords and phrases to retrieve data from the database. 12,799 burn injuries were found presented in 65,536 burn-related visits which were analyzed according to the demographics, burn mechanism, and military unit. It was observed that most of the burns (70.7%) occurred during routine noncombat setting and there was a gradual decrease in burn injuries during the investigated period, from 17.6% of the cases in 2008 to 2.3% in 2016. Most of the burns occurred in the Air Force (19.4%), and the leading etiology was chemical (35%). The average TBSA was 7.5%. Since most of the burns occurred in a routine setting and were occupational-related, investment in education and improving fire protection has proven itself, leading to the decrease in burn prevalence, we recommend that more emphasis should be given on proper handling of chemicals. [ABSTRACT FROM AUTHOR]

Burn injuries have grave consequences for patients and impose a heavy economic burden on healthcare services. Studies on the epidemiology of burn injury in Israel are sparse and outdated, and improved understanding of current trends can help experts plan prevention campaigns and design effective treatment paradigms. This study sought to assess the background, clinical, and treatment characteristics of adult patients admitted with burn injury to a level 1 trauma center in Israel in 2005 to 2017. Data were retrospectively retrieved from the hard copy and electronic files as follows: patient sex and age; burn type, degree, and etiology; percentage total BSA (%TBSA) affected; and type of treatment and length of hospital stay (LOS). The cohort included 734 patients of mean age 41.79 years and a male-to-female ratio of 1.8:1. Thermal factors, particularly hot liquids, were the most common cause; second-degree burns were the most common. Mean %TBSA was 5.39%; mean LOS was 11.81 days; and mean LOS/%TBSA was 4.65. Advanced dressings alone yielded satisfactory outcome in 74.2% of patients. The relatively younger patient age and male predominance of our cohort were in line with published findings. The LOS was similar to previous studies in Israel but lower than in Europe. The LOS/%TBSA was higher than in the literature, with a decrease over time suggesting an increased effectiveness of treatment. There appears to be a decline in the rate of surgery for burn injury and increased expertise in the use of advanced dressings. National prevention campaigns should focus on scalds rather than flame-induced burns. [ABSTRACT FROM AUTHOR]

The Swords of Iron (SOI) War is an armed conflict between Israel and Hamas, which has been taking place in Gaza from October 2023 until the present time of writing this article. This war is characterized by urban close contact combat. The combat equipment, weaponry, and protective measures employed, differ markedly from those in previously documented major conflicts, significantly impacting the types of injuries sustained by soldiers. This study examines the number of injured soldiers in combat, field mortality rates, incidence of burns and trauma, demographic details of the injured, causes and distribution of injuries, burn characteristics, hemodynamic status, and injury severity. This is a retrospective, registry-based cohort study. Military personnel treated by IDF medical teams with burn injuries from the ground maneuver in Gaza between October 27th, 2023 to April 2024 were included in the analysis. Diagnosis of burn injuries was made in the prehospital setting and recorded in the patient's casualty cards and the IDF trauma registry and/or in the hospitals, and then recorded by the Israel National Trauma Registry. A total of 2,627 documented military personnel were included. Of them, there was a total of 249 burn casualties. They were all male combat soldiers and their mean age was 22 years. Most of the burn injuries were combined with other injuries, only 12% were defined as in shock state, and 14% received whole blood in the field. The burn degree was second and third degree for most cases. A third (34%) of burn injured soldiers had surgery (Table 2), and half of the total were sent to rehabilitation departments following their initial hospitalization. An analysis of total body surface area (TBSA)% affected by burns among SOI War casualties reveals a higher proportion of severe burns exceeding 20% TBSA, compared to previous conflicts. Additionally, a higher proportion of personnel suffered from second and third degree burns. This is likely attributed to the operational mode of the IDF in Gaza, where urban close-contact warfare exposes soldiers to heightened risks of explosive and blast injuries. A significant percentage of live casualties had TBSA percentages that were not life-threatening, which underscores the importance of updating emergency burn treatment protocols and employing rapid evacuation and medical response systems in the field. Most of the wounded that suffer from significant burns had other significant and life-threatening injuries, making the appropriate protective measures and the preparation for rapid evacuation the best way to improve burn casualty survival. The significance of this research lies in the timely analysis of accumulated combat data to derive lessons and conclusions relevant to ongoing and future conflicts, and to understand the clinical implications arising from combat situations. Given the relatively high prevalence of burn injuries, understanding their etiology, severity, and consequences is essential for developing effective prevention and treatment courses., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Introduction: During the last two decades, in parallel to the increased prevalence of bariatric procedures, there has been a marked increase in the prevalence of abdominoplasty surgery in the United States, and in accordance an increase in the scientific and clinical research related to all aspects of this technique. The most common complication of abdominoplasty is the formation of post-operative seroma. Various theories have been raised regarding the pathophysiology of seroma formation, and numerous methods for seroma prevention have been employed and tested. In the early 90's, a new theory argued that post-operative seroma formation is secondary to damage caused to the abdominal wall's lymphatic drainage during flap undermining. In light of this theory, a new surgical technique was suggested to execute the flap undermining in a more superficial plane. This enabled the preservation of the scarpa fascia and the deep adipose compartment, which preserved the integrity of the abdominal wall lymphatic collectors. This method was successful in reducing the rate of postoperative seroma formation. Recent studies have shed new light on the anatomy of the abdominal lymphatic collectors, pathophysiology of seroma formation and methods of its prevention. This new data undermines the foundations of the scarpa fascia preservation theory, and the surgical technique that was derived from it. A new theory that tries to settle the contradiction between the clinical success of the technique in reducing seromas and the new findings regarding abdominal wall's lymphatic collectors anatomy, is the presence of a 'sticky interface' between the deep adipose compartment and the flap.

Introduction: Partial resections of the breast are more than 50% of breast oncological surgery. The resulting defect can be substantial and cause meaningful deformity that leads to reduced body image satisfaction of the patients, affecting their ability to cope with the cancer. Parallel to the development of breast oncology techniques, an evolution of breast reconstruction techniques occurred. During the last decade, by using techniques from cosmetic breast surgery (such as breast reductions, augmentations and mastopexies), we can reconstruct extensive partial defects of the breasts at the immediate and delayed setting and achieve symmetrical aesthetic results. Of the 350 oncological breast surgeries a year performed in our center, 70% undergo partial breast resection and only 10% of those surgeries exhibit a defect necessitating reconstruction. The recovery and post-operative complications, especially in the immediate setting, are significantly reduced in comparison to total breast reconstruction. Our experience shows that by using plastic surgery techniques in those operations, we can overcome the deformity created by large partial resection of the breast and improve the mental recovery from breast cancer.

Objective: To assess the evidence for prophylactic treatment with systemic antibiotics in burns patients., Design: Systematic review and meta-analysis of randomised or quasi-randomised controlled trials recruiting burns inpatients that compared antibiotic prophylaxis (systemic, non-absorbable, or topical) with placebo or no treatment., Data Sources: PubMed, Cochrane Library, LILACS, Embase, conference proceedings, and bibliographies. No language, date, or publication status restrictions were imposed. Review methods Two reviewers independently extracted data. The primary outcome was all cause mortality. Risk or rate ratios with 95% confidence intervals were pooled with a fixed effect model if no heterogeneity was present., Results: 17 trials were included. Trials that assessed systemic antibiotic prophylaxis given for 4-14 days after admission showed a significant reduction in all cause mortality (risk ratio 0.54, 95% confidence interval 0.34 to 0.87, five trials). The corresponding number needed to treat was 8 (5 to 33), with a control event rate of 26%. Perioperative non-absorbable or topical antibiotics alone did not significantly affect mortality. There was a reduction in pneumonia with systemic prophylaxis and a reduction in wound infections with perioperative prophylaxis. Staphylococcus aureus infection or colonisation was reduced with anti-staphylococcal antibiotics. In three trials, resistance to the antibiotic used for prophylaxis significantly increased (rate ratio 2.84, 1.38 to 5.83). The overall methodological quality of the trials was poor., Conclusions: Prophylaxis with systemic antibiotics has a beneficial effect in burns patients, but the methodological quality of the data is weak. As such prophylaxis is currently not recommended for patients with severe burns other than perioperatively, there is a need for randomised controlled trials to assess its use.