The Turbocharged Becker Flap: a Simple Variation that Allows Coverage of Most of the Dorsum of the Hand

Cover of medium and large defects of the dorsum of the hand remains a substantial surgical challenge that often requires free tissue transfer. We report the case of a 28-year-old male who presented with necrosis of most of the dorsum of his dominant hand after an iatrogenic injury. A large Becker flap was raised to cover the entire defect. However, venous insufficiency was noted intraoperatively. The flap was turbocharged by performing a venous anastomosis between the flap and the recipient site, resulting in complete survival of the flap. The authors conclude that the turbocharged Becker flap can be a good alternative for expeditiously covering large defects of the dorsum of the hand without having to resort to free tissue transfer.

Osmolality of Elemental and Semi-Elemental Formulas Supplemented with Nonprotein Energy Supplements

Elemental and semi-elemental formulas are used to feed infants with short bowel syndrome, who may not be able to tolerate feeds of more than 310 mOsm kg(-1). The present study aimed to measure the osmolality of elemental and semi-elemental formulas at different concentrations, with and without the addition of nonprotein energy supplements.