• Non-surgical Correction of Congenital Ear Anomalies: A Review of the Literature

      Ha, Michael; Badiei, Beita; Onyima, Chinenye; Rasko, Yvonne M (Wolters Kluwer Health, 2021-04-23)
    • Rapid identification of 1-positive from patient urine using a novel lipid-based MALDI-TOF-MS assay.

      Smith, Richard D; Izac, Jerilyn R; Ha, Michael; Yang, Hyojik; Johnson, J Kristie; Ernst, Robert K (American Society for Microbiology, 2021-12-17)
      Mobilized colistin resistance (mcr) genes confer resistance to colistin, a last-resort antibiotic for multidrug-resistant Gram-negative infections. In this case report, we describe a novel lipid-based matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) diagnostic used to rapidly identify an mcr-1-positive Escherichia coli directly from a patient with a urinary tract infection without the need for ex vivo growth.
    • Vacuum-Assisted Incisional Closure Therapy After Groin Reconstruction With Muscle Flap

      Taylor, Maryclare E; Ngaage, Ledibabari M; Wasicek, Philip; Ha, Michael; Nagarsheth, Khanjan; Toursavadkohi, Shahab A; Karwowski, John; Rasko, Yvonne M (Cureus, Inc., 2021-05-11)
      Background: Groin reconstruction with muscle flap coverage is associated with high wound complication rates. Incisional vacuum-assisted closure (iVAC) therapy may lower wound complications. We evaluated the impact of iVAC on postoperative outcomes in patients following groin reconstruction with muscle flap coverage. Methods: We conducted a retrospective review of patients who underwent groin reconstruction with muscle flap coverage in 2012-2018. Patients were divided into those who received iVAC therapy and those who received standard sterile dressings (SSD). Results: Of the 57 patients included, most received iVAC therapy (71%, n = 41) and the rest received SSD (28%, n = 16). The iVAC group had higher rates of diabetes, hypertension, coronary artery disease, and peripheral artery disease (p < 0.05). However, iVAC patients had comparable length of hospital stay (12 vs 8.5 days p = 0.0735), reoperations (34% vs 31%, p = 0.8415), and readmissions (32% vs 37%, p = 0.6801) with SSD patients. iVAC placement was less likely in prophylactic flaps (odds ratio 0.08, p = 0.0049). Conclusion: Patients with a prophylactic flap were less likely to receive vacuum therapy, which may highlight a selection bias where surgeons pre-emptively use iVAC therapy in surgical candidates identified as high risk. The pre-emptive use of iVAC may minimize adverse postoperative outcomes in high-risk patients.
    • Wound Closure with Transcutaneous Absorbable Polyglactin Sutures after Hidradenitis Suppurativa Excision

      Drogt, Carolyn; Hanwright, Philip; Ha, Michael; Ngaage, Ledibabari M.; Lin, Mary; Ge, Shealinna; Wu, Yinglun; Silverman, Ronald P.; Rasko, Yvonne M. (Wolters Kluwer Health, 2022-02-01)
      OBJECTIVE: Wide surgical excision is the standard treatment for severe hidradenitis suppurativa (HS). Because of the nature of HS, these wounds are often nonsterile, located in moist intertriginous regions, and closed under tension, increasing the risk for surgical site complications. Although uncommon, absorbable sutures may confer benefits over nonabsorbable material for skin closure. Accordingly, the authors evaluated the use of absorbable, braided, transcutaneous polyglactin sutures after wide surgical excision of HS. METHODS: The authors performed a retrospective chart review for all consecutive patients who underwent wide surgical excision of HS at a tertiary university hospital between January 2009 and March 2020. RESULTS: Sixty consecutive patients with 174 operative sites were included in the study. The surgical site complication rate was 17.8%. Postoperative complications included wound dehiscence (n = 18), surgical site infection (n = 2), and scar contracture (n = 1). Sutures were removed from 12 (6.9%) operative sites. Factors influencing complications were Hurley grade and area of excision. Complications did not differ significantly among disease locations (P = .6417). CONCLUSIONS: The results support the growing evidence that absorbable sutures are an appropriate option after wide surgical excision of HS.