Snowflake Amniotic Membrane in Scalp Reconstruction for Pitbull Bite.

Amniotic membrane, derived from the innermost placenta, is widely employed in surgery to help regenerate soft tissue and promote re-epithelialization. The authors detail a case report of a 59-year-old female who presented with a large, full-thickness scalp avulsion injury (13 × 10 cm) after being attacked by her pet pitbull. Innovative application of "snowflake" or fragmented amniotic membrane to her wound bed was used during both stages of scalp reconstruction: irrigation and debridement with Integra biological membrane placement and later split-thickness skin grafting. The patient had an uncomplicated recovery with a satisfactory cosmetic outcome. The authors believe that the "snowflake" application of amniotic membrane played an important role in forming healthy granulation tissue and optimizing the wound bed for definitive coverage. "Snowflake" amniotic membrane may help maximize its mechanical and biological benefits and holds promise to be an important adjunctive treatment for surgical wound healing.

The Top 100 Most-Cited Publications in Clinical Craniofacial Research.

INTRODUCTION: Craniosynostosis is a birth defect defined as premature closure of sutures leading to possible neurological deficits and cosmetic deformities. Most of the current literature to date focuses on craniosynostosis etiology by analyzing genetics. This paper is a bibliometric analysis of the most influential works related to the clinical management of craniosynostosis to help guide clinicians in their decision-making. METHODS AND MATERIALS: Clarivate Web of Science database was used to identify the top 100 most-cited articles addressing the clinical management of craniosynostosis. A bibliometric review was performed to analyze publication metrics and track research trends. RESULTS: The 100 most-cited publications pertaining to craniosynostosis management were cited a cumulative 12,779 times. The highest cited article was Shillito and colleagues' "Craniosynostosis: A Review Of 519 Surgical Patients" with 352 citations. The oldest clinical craniosynostosis article dates back to 1948, and the most recent was published in 2016. The year with the most clinical-focused publications was 2011. The most prolific author was Renier, D. The United States produced 56 of the 100 articles. Most articles (n=52) were level 3 evidence. DISCUSSION: This bibliometric evaluation of craniosynostosis provides insight into the most impactful literature on this topic. The highest cited articles retrospectively analyze large sample sizes, outline proper evaluation, discuss intervention timelines, and highlight specific treatment plans for this birth defect. By filtering through existing literature, this analysis can guide clinicians on the management of craniosynostosis to maximize patient outcomes.

A clinical study of the local injection of a freshly manufactured 35 kDa hyaluronan fragment for treating chronic wounds.

This study manufactured a 35 kDa hyaluronan fragment (HA35) by enzymatically degrading high-molecular-weight HA using hyaluronidase PH20 derived from bovine testis. The research then examined the therapeutic efficacy of locally administered, tissue-permeable HA35 in alleviating chronic wounds and their associated neuropathic pain. For 20 patients with nonhealing wounds and associated pain lasting over three months, 100 mg of HA35 was injected daily into the healthy skin surrounding the chronic wound for 10 days. Self-assessments before and after treatment indicated that HA35 significantly enhanced wound healing. This was evidenced by the formation of fresh granulation tissue on the wounds (p < 0.0001); reduced darkness, redness, dryness, and damage in the skin surrounding the wounds (p < 0.0001), and a decrease in wound size (p < 0.001). Remarkably, HA35 injections alleviated pain associated with chronic wounds within 24 hours (p < 0.0001). It can be concluded that the low-molecular-weight hyaluronan fragment HA35 potentially enhances the immune response and angiogenesis during wound healing.

Yard Work and Gardening: A Pastime with Potential for Craniofacial Injury.

INTRODUCTION: Yard and garden tools are increasingly used by Americans. Despite the growing popularity of gardening as a leisure activity, the rate of injury associated with these tools remains remarkedly high. Previous research has highlighted the risks associated with improper handling of tools and associated potential long-term consequences. This retrospective study aims to provide a comprehensive analysis of the craniofacial injuries caused by yard and garden equipment. The investigation will emphasize the need for improved safety measures and regulations. METHODS AND MATERIALS: Publicly available data from the National Electronic Injury Surveillance System (NEISS) database were utilized to identify craniofacial injuries related to yard and garden tool handling during a 10-year period (2013-2022). Study population included patients aged 1 to 85+ years who visited emergency departments secondary to these injuries. Data analysis involved queries for specific products and diagnostic codes related to craniofacial injuries. RESULTS: Over the study period, a total of 588,384 craniofacial injuries associated with yard and garden tools were recorded, averaging 58,838 injuries annually. Men accounted for a significantly higher proportion of injuries (69.2%) compared to women (30.8%). Elderly population, particularly those aged 60 to 64 years, experienced the highest incidence of craniofacial injuries. Cranium was the most commonly affected anatomical location, comprising 34% of all injuries. Lacerations and contusions were the most frequent injury diagnoses. Greenhouse or gardening supplies and lawnmowers are the most common causative agents, respectively. DISCUSSION: Our study highlights the persistent incidence of craniofacial injuries associated with yard and garden tool handling emphasizing the need for standardized safety regulations and guidelines. Sociological and demographic factors, such as differences in gardening habits and behavioral patterns between genders, contribute to the observed disparities in injury rates. Understanding the underlying factors contributing to these craniofacial injuries is crucial to promoting safer practices and reducing the overall burden associated with yard and garden tools.

Epidemiology of Craniofacial Injuries from Exercise and Weightlifting: A 10-Year Analysis.

INTRODUCTION: Exercise is the cornerstone of a healthy lifestyle. It is recognized for enhancing cardiovascular health and bolstering mental well-being. While the fitness industry grows, the incidence of exercise-related injuries continues to rise. This study examines craniofacial injuries resulting from exercise and weightlifting over the past decade. The goal is to uncover trends, demographics, diagnoses, and patient dispositions. METHODS AND MATERIALS: A retrospective review was conducted using the National Electronic Injury Surveillance System database. Emergency department visits for craniofacial injuries associated with exercise and weightlifting between 2013 and 2022 were analyzed. One-sample t-tests and the Mann-Kendall test were used to evaluate injury prevalence and significant trends. RESULTS: Over the past decade, 582,972 craniofacial injuries related to exercise and weightlifting were documented. Men accounted for 55.7% of cases. Annual incidence increased by 32.7% between 2013 and 2022. It was statistically significant. Adolescents aged 15 to 19 displayed the highest injury rate. Head injuries were most common (45%), followed by face (26%), neck (21%), mouth (4%), eye (3%), and ear (1%). Diagnoses included internal injury (25.2%), laceration (24.8%), contusions/abrasions (12.9%), and strain/sprain (11.9%). Hospitalization was required for only 8.5% of patients. DISCUSSION: This study elucidates the need for injury prevention strategies. Vulnerable subgroups such as males, adolescents, and the elderly demand targeted prevention efforts. Future research should explore specific mechanisms of injury to identify high-risk exercise. This study promotes the need for safe exercise practices and increases awareness of craniofacial injury risks associated with physical activity.

Craniofacial Injuries in Swimming and Water Sports: Implications for Prevention.

INTRODUCTION: Water-related recreational activities, including swimming and diving, are widespread. However, they carry a significant risk of craniofacial injuries. Despite the popularity of these activities, comprehensive data on injuries beyond drowning remain scant. This study addresses this gap by providing valuable epidemiological insight into the nature, prevalence, and demographic patterns of craniofacial injuries related to water sports activities. METHODS: The authors queried the NEISS database for craniofacial injuries related to swimming, diving, and water sports from 2013 to 2022. Data were analyzed for demographics, anatomic locations of injuries, and the activities leading to these injuries. RESULTS: Between 2013 and 2022, a total of 952,111 craniofacial injuries were associated with swimming and water sports. Of these, 510,706 (53.6%) were male patients, and 441,405 (46.4%) were female. This indicates that males were 1.16 times more likely to sustain such injuries. The age groups most affected were 0 to 9 and 10 to 19 years. Anatomic locations impacted were as follows: ears (58.1%), head (16.8%), face (13.9%), neck (4.8%), eyeballs (4.4%), and mouth (2%). Leading causes were identified as swimming and water sports activities (66.5%), swimming pools and equipment (28.2%), diving or diving boards (4.7%), and scuba diving (0.5%). Notably, 89.2% of patients with diving-related injuries and 99.1% with swimming-related injuries were not admitted to the hospital. CONCLUSIONS: This study offers critical epidemiological data to supplement targeted prevention strategies and resource allocation in managing craniofacial injuries associated with water activities. The findings highlight the urgent need for specialized care and serve as a foundation for future preventive initiatives.

Jumping Trends In Trampoline-Related Craniofacial Injuries.

INTRODUCTION: In 1990, the American Academy of Pediatrics recommended the sale of trampolines cease in the United States. The risk of traumatic injury is well-documented, yet trampolines remain a growing source of recreation. Trampoline parks, in particular, are becoming a common entertainment attraction that can result in serious injury. There is currently a paucity of literature characterizing craniofacial injuries from trampoline use and plans to prevent these injuries. METHODS AND MATERIALS: A retrospective review of the National Electronic Injury Surveillance System was conducted to analyze emergency department visits for trampoline-related craniofacial injuries in 1 to 20 year olds between 2013 and 2022. RESULTS: An estimated 206,866 trampoline-related craniofacial injuries occurred. Males suffered injuries 1.67 times more frequently than females. Injured sites included the head (41.0%), face (23.2%), neck (20.4%), mouth (11.9%), eyeball (2.0%), and ear (1.4%). The most common diagnoses were lacerations (28.9%), internal injuries (23.2%), strain/sprains (14.8%), contusions/abrasions (13.0%), and concussions (8.7%). Head internal injuries and facial lacerations significantly increased over the observed time period. DISCUSSION: Trampolines are a rising source of craniofacial trauma for America's youth. Children between 3 and 11 years old were disproportionately affected. Regulation over trampoline safety features remains limited in the United States. Future studies should aim to characterize the mechanisms of these injuries for the development of targeted safety measures.

A Characterization of Pediatric Craniofacial Injuries from Children's Toys.

INTRODUCTION: Playing with toys contributes significantly to the cognitive, physical, and social development of children. Certain toys, unfortunately, carry the potential for serious craniofacial injury. There is a gap in the literature regarding the comprehensive assessment of toy-related craniofacial injuries. By studying mechanisms of injury and ensuing trauma, our goal is to encourage innovative design and educate caregivers, health care workers, and the Consumer Product Safety Commission on risk mitigation and prevention. METHODS AND MATERIALS: The National Electronic Injury Surveillance System Database was queried to analyze toy-related craniofacial injuries that occurred in children (ages 0-10) between 2011 and 2020. RESULTS: Approximately 881,000 injuries occurred over a 10-year span. Children ages 1 to 5 sustained most injuries, peaking at age 2 (16.3%). Males were injured 1.95 times more frequently than females. Injured sites included the face (43.7%), head (29.7%), mouth (13.5%), ears (6.9%), and eyes (6.2%). The top diagnoses were lacerations (40.4%), foreign bodies (16.2%), internal injuries (15.8%), and contusions (15.8%). The most common causes were scooters (13%), balls (6.9%), toy vehicles excluding riding toys (6.3%), building sets (4.4%), and tricycles (3%). DISCUSSION: This study identifies toys that most frequently cause craniofacial injuries in children. These results provide new information about types of play that should be supervised, and this data helps anticipate injury profiles seen in emergency settings. Future research should study why the products identified are strongly associated with injuries, so safety features can be optimized and designs appropriately altered.