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While fasciotomy is the only urgent treatment option for compartment syndrome, the resulting open wound leaves room for complications. Closure of the wound can be done by different techniques, including split-thickness skin grafts, negative pressure therapy, an absorbable barbed suture system and a cable ties system. The aim of this paper is to demonstrate how a combined application of these methods can reduce their respective individual disadvantages. Our combined method was tried in two patients, one with an open tibial fracture and the other who underwent ulnar nerve reparation. Both patients started exhibiting signs of compartment syndrome within 3 hrs after surgery. Firstly, absorbable barbed suture systems were positioned with the running intradermal technique. Following this the cable ties were inserted and the limb in question was placed in an elevated position. Complete closure of the patient's wounds was achieved within 2 weeks without complications. This result is a testament to the added benefit of a combination of these methods in comparison with the results they produce individually.

Background: Breast carcinoma is the most common malignant disease in women in the majority of developed countries. The development of depression as well as the quality of life (QoL) in these patients depends not only on the result of oncologic treatment, but on the cosmetic outcome as well. The primary aim of this prospective study was to investigate the changes in QoL and depressive symptoms among patients undergoing surgical treatment for breast cancer., Subjects and Methods: We conducted a prospective study that included 100 female patients (mean age 60.26 years) who underwent surgical and oncological treatment for breast carcinoma at the University Hospital Center Zagreb, Croatia. The patients were photographed before and after treatment and were required to fill out a standardized quality of life questionairres QLQ - C30 and QLQ - BR23, Beck Depression Inventory (BDI) and a questionnaire on breast asymmetry., Results: Our results show that patients had significantly higher QoL levels compared with their pre-surgical results. Statistical trend of a lower degree of depression was also observed. A worse cosmetic outcome (i.e., postoperative assymetry) was associated with a lower QoL, but there was no association with depression. Depression was significantly related to the level of pain and lower financial status., Conclusion: QoL improved after surgical treatment of breast cancer and was dependant on postoperative asymmetry, whereas the findings for depressive symptoms remained less clear. Future research should investigate more factors that may contribute to the QoL and degree of depression in this patient population.

Aim: The umbilicus is an essential esthetic landmark on the abdominal wall in women and men. There are only few models published for predicting exact localization of the umbilicus. The aim of our study was to develop a mathematical model for predicting correct umbilical positioning in a sample of young women and men and in a sample of middle-aged women. In addition, we wanted to develop a predictive model applicable to both sexes. We applied our models with distinct anthropometric characteristics such as body mass index (BMI) and waist circumference (WC)/hip circumference (HC) to further expand our findings., Methods: In this study, 98 Croatian women and men randomly selected from the University of Zagreb and 46 female patients awaiting abdominoplasty procedure at our institution were included. Anthropometric data and measurements between the umbilicus and fixed bony points around the anterior abdomen were collected. The data collected were body mass (BM), body height (BH), BMI, WC and HC, and waist-hip ratios (WHR). All collected data were subjected to standard statistical analyses., Results: This study developed 2 different regressive equations for the most accurate prediction of exact umbilical localization. In women, the best prediction of the position of the umbilicus was based on the distance from the interanterior hypochondrium line to the umbilicus using the following regressive equation: u-i-hy = BM × 0.5799 + BH × -0.5051 + BMI × -1.8230 + WHR × -10.6364 + 89.6411. In men, the best prediction of the position of the umbilicus was based on the distance from the umbilicus to the interspinous line using the following regressive equation: u-i-is = age × 0.2033 + BM × 0.6445 + BH × -0.5692 + BMI × -2.2802 + WC × -0.0911 + 101.9408., Methods: We found that age and anthropometric dimensions have a significant influence on the position of the umbilicus on the anterior abdominal wall. The naturally occurring anthropometric variations between women and men made the results of a unique predictive model for umbilical position inaccurate. We found that using 2 distinct predictive models, 1 for both subgroups of women and 1 for men, generated the most accurate predictive results. This quantitative tool should be applied to both women and men for the correct positioning of the umbilicus in reconstructive and esthetic procedures in which the original umbilical location is affected.

Large scalp defects can present as a challenging clinical problem for a reconstructive surgeon. We present a patient with a large scalp defect following an infection after neurosurgical treatment. Reconstruction of a defect was performed using a free latissimus dorsi flap with split-thickness skin graft. For achieving good aesthetic result, we transplanted 1000 minigrafts in 3 sessions on the latissimus dorsi flap. In our opinion, hair transplantation on a free microvascular flap is a viable and easy procedure with good aesthetic outcome for treating residual alopecia after reconstructing large scalp defects.