Explore the vast range of titles available.

The emergence of xylazine-associated wounds, highlighted by case reports from Philadelphia in 2022, has been linked to the use of this veterinary sedative as an adulterant in the unregulated drug supply and has brought renewed attention to the challenges of complex wound management, particularly in vulnerable populations. Among these challenges are unusual infectious complications, including cases of larva-associated infections such as   bacteremia in maggot-colonized wounds, raising critical questions about the role of environmental exposure, wound neglect, and the presence of maggots. Clinicians must recognize that rare infections often arise not from the drug itself but from environmental exposure and delayed wound care. Furthermore, it is essential to distinguish between uncontrolled myiasis (spontaneous, unsanitary maggot infestation) and the therapeutic application of sterile   larvae through medically supervised larval therapy. Building on historical observations and contemporary wound care literature, we explore how larval therapy offers a precise, cost-effective method for wound debridement, particularly valuable in situations in which definitive surgical care is delayed or unfeasible. As clinicians confront the rising burden of xylazine-related wounds, a nuanced understanding of environmental infectious risks and biosurgical interventions can expand the surgeon's wound care armamentarium and improve outcomes not only for patients with drug-induced wounds but also for individuals with chronic wounds.

Robert H. Ivy significantly influenced the field of plastic surgery through his innovative techniques, leadership, and dedication to the science and art of surgery. His dentistry background and military experience shaped his approach to maxillofacial and reconstructive surgery. Ivy's pioneering work in cleft lip and palate surgery, along with his use of local flaps, advanced the field of plastic surgery. Ivy was a key figure in the professionalization of plastic surgery; he played a crucial role in establishing the field as a distinct medical specialty, becoming the first-ever professor of plastic surgery. He was instrumental in founding major professional organizations and helped set the rigorous standards that govern plastic surgery today. His legacy lives on in the Robert H. Ivy Pennsylvania Plastic Surgery Society, a testament to his exceptional dedication to plastic surgery. Ivy's career exemplifies the power of innovation, leadership, and humility in advancing the practice of plastic surgery; his contributions continue to inspire and guide future generations of surgeons and surgical researchers.

Complex ventral hernias are a surgical challenge associated with high morbidity and healthcare costs. Component separation techniques have improved throughout the years with better outcomes, although the optimal approach remains debated. Robotic surgery has shown promising outcomes as an alternative to open repair, although data in large multicenter studies is still limited. A retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Adult patients undergoing component separation for ventral hernia repair were identified using CPT and ICD codes. Outcomes included 30-day surgical, wound, medical, and overall complications, as well as length of stay and readmission. Multivariable logistic regression and propensity score matching were applied to adjust for baseline differences. A total of 6,207 patients were included, from those 4,443 (71.6%) underwent open technique and 1,764 (28.4%) robotic. After propensity matching (n = 5,259), robotic repair was independently associated with significantly lower overall complication rates (4.8% vs. 19.6%, aOR 0.193, 95% CI 0.140-0.265, p < 0.001), including wound (2.2% vs. 10.2%, aOR 0.164, p < 0.001), surgical (2.9% vs. 10.0%, aOR 0.271, p < 0.001), and medical complications (2.0% vs. 7.0%, aOR 0.229, p < 0.001). Robotic surgery was also associated with shorter length of stay (1.34 vs. 3.86 days, p < 0.001) and lower readmission rates (4.4% vs. 9.1%, p < 0.001). Robotic component separation for ventral hernia repair is associated with lower postoperative complication rates, shorter length of stay, and fewer readmissions compared to the open approach. These benefits remained significant after multivariate analysis and propensity score matching, supporting the robotic technique as an effective strategy. Prospective studies are warranted to evaluate long-term outcomes, including recurrence, and to assess cost-effectiveness to optimize evidence-based surgical decision-making.