gov were searched. Obesity was defined as a BMI ≥ 30. Comparable data from observational studies SCH772984 order was combined for pooled analysis and quality assessment of observational studies was performed. Fourteen studies met the inclusion criteria (n = 6,043 patients). Pooled data analysis demonstrated significantly higher prevalences of overall complications, recipient site complications overall, donor site complications overall, donors site wound infection, donor site seroma, abdominal bulge/hernia, mastectomy skin flap necrosis, recipient site delayed wound healing, and partial flap failure, in obese (BMI ≥ 30) compared with nonobese (BMI < 30) patients. A BMI

of 40 was identified as a threshold at which the prevalence of complications became prohibitively high. No randomized-controlled trials were found and all studies had methodological weaknesses. Complications in obese patients following free autologous breast reconstruction were higher than in their nonobese counterparts; however the majority of these selleck compound complications were reported in the studies as being minor. Until better evidence is available this information will help when counseling patients. © 2014 Crown Copyright. Microsurgery 34:484–497, 2014. “
“In spinal cord injuries at the C6 level, elbow extension is lost and needs reconstruction. Traditionally, elbow extension

has been reconstructed by muscle transfers, which improve function only moderately. We have hypothesized that outcomes could be ameliorated by nerve transfers rather than muscle transfers. We anatomically investigated nerve branches to the teres minor and posterior deltoid as donors for transfer to triceps motor branches. In eight formalin-fixed cadavers, the axillary

nerve, the teres minor branch, the posterior deltoid branch, the triceps long and upper medial head motor Thiamet G branches, and the thoracodorsal nerve were dissected bilaterally, their diameters measured and their myelinated fibers counted. To simulate surgery, using an axillary approach in two fresh cadavers, we transferred the teres minor or the posterior deltoid branch to the triceps long head and to the thoracodorsal nerve. The posterior division of the axillary nerve gave off the teres minor motor branch and then the branch to the posterior deltoid, terminating as the superior lateral brachial cutaneous nerve. The diameters of the teres minor motor branch, posterior deltoid, triceps long and upper medial head branches, and the thoracodorsal nerve all were ∼2 mm, with minimal variation. The nerves varied little in their numbers of myelinated fibers, being consistently about 1,000. Via an axillary approach, either the teres minor or the posterior deltoid branch could be transferred directly to the thoracodorsal nerve or to triceps branches without any tension. © 2011 Wiley-Liss, Inc. Microsurgery, 2011.