Fat Preservation Research Articles

An Overview of Potential Benefits for General Health and Weight Management by Consuming of Chia Seedsaa

Chia seeds (Salvia hispanica L.) have undoubtedly Attain Approval in current time due to their nourishing advantages. They are Famous for their huge composition of omega-3 fatty acids, which are essential for cardiac and central nervous systems. Also, chia seeds are Affluent in nutritive microfibers, which can help in assimilation and allow an affection of satiety; chia seeds have a huge contentof proteins and derivatives, so considered a good origin of proteins. These proteins and derivatives are necessary for different bodily Concerns, including muscle rebuilding and development, enzyme protraction. A way from the twenty certified proteins, dozen are included in the standardized metabolism techniques of plant corpuscle, and the tarrying 8 are exactly connected to the rendering and preservation of plant fats, indicating that the huge content of fats in chia seeds, which is responsible for thirty percent of their content. Also, chia seeds are Distinctly Loaded in omega-3 fatty acids, hatch twenty percent of their fats content. The residences of these proteins are interrelated to fats generation and preservation enlighten on why chia seeds are an important origin of omega-3 fatty acids and other advantageous fats. Chia seeds are a rich nutrient because of their super content and good effects on the health. Also, Weight controlling, Chia seeds are loaded in natural or artificial substance and nitrogenous matter, which can aid in assist a feeling of satiety and decrease calories consumption.

Complete Preservation of Orbital Fat by Restoration of Attenuated Orbital Septa Using an Acellular Dermal Matrix in Lower Blepharoplasty.

We hypothesized that application of acellular dermal matrix (ADM) over the orbital septum overlying the herniated orbital fat to tighten and strengthen the attenuated orbital septum in lower blepharoplasty would allow successful repositioning of the herniated orbital fat within the bony orbit. The author prospectively compared the cosmetic outcomes of lower blepharoplasty using ADM with standard blepharoplasty. We evaluated recurrence of eyelid bulging and tear trough deformity, volume of the lower periorbital region, and enophthalmos and eyelid droop 1 year after surgery. Twenty-two of the 24 enrolled patients completed the study. There was no significant difference in recurrence of eyelid bulging and tear trough deformity between standard blepharoplasty and blepharoplasty with ADM graft groups. In the standard blepharoplasty group, the volume of the lower periorbital region decreased significantly after surgery. In the blepharoplasty with ADM graft group, there was no significant change in the volume of the lower periorbital region after surgery. In the standard blepharoplasty group, there was no significant change in eyelid droop on either side after surgery. In the blepharoplasty with ADM graft group, the eyelid droop decreased significantly after surgery on the right side but showed no significant change on the left side. There was no significant change in enophthalmos after surgery for either group. This study demonstrated that ADM graft provided effective support for maintaining the replaced orbital fat in lower blepharoplasty. In the long-term, blepharoplasty with ADM graft might be effective in slowing development of age-related enophthalmos. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Commentary on: The Role of Nasal Fat Preservation in Upper Lid Surgery and Assessment With the FACE-Q Questionnaire: Innovations in Upper Blepharoplasty.

Commentary on: The Role of Nasal Fat Preservation in Upper Lid Surgery and Assessment With the FACE-Q Questionnaire: Innovations in Upper Blepharoplasty.

A comparative analysis of traditional meat processing methods

This comparative analysis examines traditional meat preservation techniques, including drying, curing, fermentation, smoking, fat preservation, air drying, fermented fish sauce, pickling and traditional sausage making. Rooted in different cultures, these methods use specific processes and ingredients to preserve meat, enhance flavour and extend shelf life. Some different variations and adaptations showcase techniques such as marinating, braising, and incorporating herbs or probiotics. Studies highlight advances in reducing salt and nitrite levels during pickling, improving brine handling methods, and optimizing smoking techniques for safety. Factors affecting preservation include the microbial community in fermented cured meats, temperature control during smoking and moisture content during air drying. Recent research findings observed that fermentation-enhanced sausage flavour and certain microorganisms declined histamine levels in fish sauce. New technologies and traditional methods combined facilitate conservation, nutrition, and the sensory quality of meat.

The influence of retropatellar fat preservation on the positioning of the tibial component of total knee arthroplasty

Background: The good clinical-functional outcomes of total knee arthroplasty (TKA) depend on several factors, such as the surgical time and the adequate positioning of the prosthesis components. The present study aims to evaluate whether the preservation of retropatellar fat pad during the surgical act influences the rotational alignment of the tibial component and the surgical time of the procedure. Methods: The study was carried out with 50 patients operated on by the main author, who were randomly divided into two groups, experimental and control. For the evaluation of the positioning of the tibial component, the patients underwent computed tomography (CT) four weeks after the surgery, on average. Casuistry was determined by pilot study with the first five patients of each group. For the sample calculation, the t-student test was used for two independent samples. Results: All patients presented internal rotation of the tibial component, with no statistical difference in mean rotation between the experimental and control groups. When there was complete detachment of the fat in the experimental group, the tibial component showed greater external rotation, with a statistical difference. Surgical time was shorter in the experimental group, varying in this group according to the degree of osteoarthrosis. Conclusions: Maintenance of retropatellar fat pad did not influence the rotational alignment of the tibial component; however, in patients with advanced osteoarthrosis, such maintenance increases the surgical time.

EFFECTS OF CRUSHED AND CUBED ICE STORAGE TOWARDS FAT, ASH AND MOISTURE CONTENT IN RED SNAPPER AND INDIAN MACKEREL

This study evaluates the effect of crushed and cubed ice on the preservation of fat, ash, and moisture content of the Red Snapper and Indian Mackerel stored for seven days. The determination of fat, moisture, and ice storage content was determined at three days (0,4,7) throughout the storage period. Statistical analyses were carried out to indicate the significant difference in the effects of treatment days and physical characteristics of ice on the crude fat, ash, and moisture content. The fat and ash percentage decrease while the moisture content in both ice storage increases throughout the storage period. Red Snapper comprises 1.32% fat, 78.00% moisture, and 1.03% ash content, while Indian Mackerel is composed of 1.30% of fat, 72.50% moisture, and 1.06% ash content during the initial storage period. The fat content in both species starts to decrease during day four in both storages, where the highest deterioration of fat (42-43%) was found for both species kept in cubed ice. The moisture content results show an increase in the moisture content for both species, where the highest percentage (7-8%) was found in both species kept in cubed ice. The ash content decreased in both species kept in cubed ice (22.00 - 42.00%) throughout the storage period. The study suggested that crushed ice is one of the fish preservation options for preserving fish quality.

Contemporary Upper Blepharoplasty: Volumetric Contouring Concept

Upper blepharoplasty has traditionally involved subtractive approaches with excision of different amounts of skin, muscle, and fat. However, this approach often results in iatrogenic acceleration of the normal volume depletion and bone resorption associated with aging, which leads to deepening of the superior sulcus, A-shape deformity and generalized hollowness. In recent years, the concept of periorbital volume restoration and augmentation has shifted the paradigm toward fat preservation and gland repositioning procedures. Herein, we describe the volumetric contouring concept, a contemporary approach for upper blepharoplasty that includes gland repositioning, suspension of the levator aponeurosis, fat transposition or reposition, and adjunctive filling procedures. This concept seeks for long-term restoration of the eyelid-brow complex by addressing every involutional aspect of the aging process, while treating and preventing hollow eyes and A-shaped deformity. In our experience, this approach has enabled us to attain optimal and long-lasting aesthetic results.

Three-Dimensional Analysis of Tear Trough Volume After Lower Blepharoplasty with Midface Lift.

Background: This study aims to evaluate three-dimensional stereophotogrammetry measured volume changes in the tear trough area after lower blepharoplasty with midface lift with or without orbital fat manipulation. Objective: Among patients undergoing midface lift surgery, volume change by three-dimensional photography in the tear trough region was compared between those having no orbital fat manipulation, fat transposition, or fat resection. Methods: This is a prospective study of 260 eyelids of 130 patients who underwent cosmetic midface surgery. All patients had an external skin muscle flap midface lift. During the procedure, medial inferior orbital fat was resected, repositioned to a preperiosteal dissection pocket, or not manipulated. Forty-six patients (35.4%) had no fat manipulation, 42 patients (32.3%) had fat preservation with repositioning to the preperiosteal pockets on the medial inferior orbital rim, and 42 patients (32.3%) had fat resection without repositioning. Results: All patients had volume gain in tear trough volume. The amount was not statistically significantly different between fat treatment groups. Mean follow-up time was 12 months (range 6-20 months). Conclusions: Midface lifting improved tear trough volume irrespective of how fat was manipulated.

A comparative study of full-thickness skin grafting with and without subcutaneous fat preservation.

Skin grafting is an important method of wound repair and reconstruction. Skin grafting can be classified using multiple classification criteria. We often perform full-thickness skin grafting (FTSG) for small wound areas; however, the traditional FTSG technique frequently causes postoperative scar depression at the donor site, especially in the abdomen. This study aimed to determine whether preserving the subcutaneous fat when performing FTSG can improve donor site prognosis. We reviewed 25 patients who underwent autologous FTSG in the last 3 years. Among them, subcutaneous fat was preserved in 11 patients (experimental group), whereas it was not preserved in 14 patients (control group). Using a 3D camera and the Patient and Observer Scar Assessment Scale (POSAS), we evaluated the donor site postoperatively. According to POSAS, vascularization was significantly more severe in the experimental group. The Antera 3D camera revealed more severe scar depression at the donor site in the control group. The processing time for graft take, subcutaneous fat trimming and donor site closure was less in the experimental group than in the control group. Preserving subcutaneous fat at the donor site improved patient outcomes by reducing donor site depression after FTSG.

Assessment of lipid preservation by carotenoids extracted from Daucus carota (L.) and Beta vulgaris (L.) roots

Fruits and vegetables are good sources of phytochemicals such as carotenoids capable of preventing diseases and maintaining well-being. This study aims to investigate the antioxidant activity of carotenoids obtained from Daucus carota L. (D. carota) and Beta vulgaris L. (B. vulgaris) roots and to determine their impact on the fat preservation. Carotenoids were extracted using a mixture of an equal volume of methanol, ethyl acetate, and petroleum ether. The antioxidant activity of the roots extracts was determined using DPPH scavenging and β-carotene bleaching methods. The oxidative stability of the butter added to the roots extracts was assessed using the Schall test. Results have shown that carotenoid contents of D. carota and B. vulgaris extracts were about 2.47±0.24 and 1.44±0.09 mg β-carotene equivalent per g of roots extract, respectively. DPPH-scavenging activity revealed IC50 values of 0.58 and 0.89 mg /mL, and a percentage of β-carotene bleaching inhibition of 51.25±4.26% and 56.84% in the presence of 1mg/mL of B. vulgaris and D. carota extract, respectively. The oxidation of the butter fats was significantly reduced (P<0.05) in the presence of the two carotenoid extracts compared to the control. The present study clearly showed the protective effect of D. carota and B. vulgaris against oxidative reactions in general and lipid peroxidation in particular. In addition to its use as a natural colorant, the carotenoids roots extract of these two plants could be used as a potential food preservative.

Impact of Hydrothermal Treatments on Nutritional Value and Mineral Bioaccessibility of Brussels Sprouts (Brassica oleracea var. gemmifera).

Hydrothermal treatment of Brussels sprouts (Brassica oleracea var. gemmifera) induces both physical and chemical changes in nutrients and non-nutrients. It also affects the bioaccessibility of individual compounds. The aim of this study was to investigate the influence of hydrothermal treatment (boiling, steaming, and sous vide technique) on the concentration of the selected nutrients and non-nutrients in Brussels sprouts and in vitro bioaccessibility of the mineral components. It has been shown that, in terms of the leaching of nutrients and non-nutrients into the aqueous medium, traditional cooking in water involves the greatest percentage loss (the highest decrease in dry matter (11.8%), ash (13.3%), protein (10.4%), crude fat (43.3%), dietary fiber (9.5%), digestible carbohydrates (12.2%), and most of mineral components (7.6–39.8%)). In contrast, steam cooking and sous vide cooking of Brussels sprouts allow a higher level of preservation of the individual compounds. By using reduced process temperatures and vacuum packaging, sous vide cooking can be an alternative to traditional cooking to preserve the higher nutritional value of Brassica oleracea var. gemmifera (preservation of dry matter, ash, crude fat, and most of the mineral components at the level of the raw sample p ≤ 0.05).

Thirty Years of No-Touch Saphenous Vein Harvesting: A Timely Jubilee Gift

Thirty Years of No-Touch Saphenous Vein Harvesting: A Timely Jubilee Gift

Larger Remaining Stomach Volume Is Associated With Better Nutrition and Muscle Preservation in Patients With Gastric Cancer Receiving Distal Gastrectomy With Gastroduodenostomy.

PurposeWeight loss and deterioration in body composition are observed in patients with gastric cancer (GC) following gastrectomy. This study aimed to investigate the impact of residual stomach volume (RSV) on the nutritional status and body composition of patients with GC treated with distal gastrectomy.Materials and MethodsIn total, 227 patients who underwent minimally invasive distal gastrectomy with Billroth 1 anastomosis for stage I GC between February 2015 and May 2018 were enrolled. Clinicodemographic and laboratory data were collected from the GC registry. The RSV, abdominal muscle area, and subcutaneous/visceral fat areas were measured using computed tomography data.ResultsA larger RSV was associated with a lower decrease in the nutritional risk index (P=0.004) and hemoglobin level (P=0.003) during the first 3 months after surgery, and better recovery at 12 months. A larger RSV demonstrated an advantage in the preservation of abdominal muscle area (P=0.02) and visceral fat (P=0.04) after surgery, as well as less reduction in weight (P=0.02) and body mass index (P=0.03).ConclusionsLarger RSV was associated with improved nutritional status and better preservation of muscle and fat after distal gastrectomy.

Body Composition And Bone Mineral Differences According to Lamin A (LMNA) Genotype in Familial Partial Lipodystrophy Type 2

Phenotypic heterogeneity is well known in Familial Partial Lipodystrophy Type 2 (FPLD2), a rare form of adipose tissue disorder caused by pathogenic mutations in LMNA gene. Animal studies from our group have identified an association between adipose tissue loss and an increase in bone mineral density (BMD) in a mouse model with adipose tissue specific knockout of LMNA gene. Aiming to translate this observation to patients with FPLD2, we analyzed body composition data obtained by dual X-ray absorptiometry from 61 patients diagnosed with FPLD2 and 61 individuals with no diagnosis of FPLD (nFPLD) matched for sex, age and body mass index. As expected, we observed lower total fat mass in FPLD2 patients compared to nFPLD (15.8±9.3 kg vs. 28.5±12.4 kg, p=0.001), as well as lower fat mass in regions of arms, legs and trunk. Interestingly, patients with FPLD2 showed lower bone mineral density (BMD) compared to nFPLD 1.0±0.2 g/cm3 vs 1.2±0.1 g/cm3, p=0.01) and lower t-score (0.2±1.8 vs.1.5±1.2). We then aimed to determine if the patients with FPLD2 displayed differences with respect to genotype. For these analyses, the FPLD2 group was divided according to the pathogenic variant; 42 with mutations on the hot spot codon of the LMNA gene (R482: 50.2 ± 164.8 years, 76% women) and 19 with non-hot spot codon mutations (nR482: 44.8 ± 12.8 years, 78% women). Patients in the R482 group were older when they were first diagnosed with lipodystrophy (39.6 ± 18.6 years vs. 36.5 ± 12.3 years, p=0.05). Also, nR482 group presented with more progeroid characteristics. Patients in n-R482 group also had lower weight compared to R482 and nFPLD groups (64.4±14.4 vs. 73.3±18.5 and 77.6±16.6 kg, p=0.01), as well as lower total fat mass (15.3±5.1 vs. 15.8±9.3 and 25.7±11.4 kg, p=0.01) and fat mass ratio (5.8±1.9 vs. 5.9±3.1 and 9.0±4.1, p= 0.01). Control group bone mass was significantly higher in arms, legs and trunk compared to the R482 and nR482 groups. Moreover, the R482 group had lower bone mass in the legs compared to nR482 (690.5±227.2 vs.703.5±95.3 g, p=0.01), while showing higher trunk bone mass (676.4±266.7 vs. 674.1±79.3, p=0.04), in addition to greater fat mass in the legs (3.3±1.6 vs. 2.6±0.7 kg, p=0.05) and trunk areas (10.3±6.1 vs. 10.0±4.2 kg, p=0.03). There were no differences in total bone mass, BMD, and t-scores, according to genotype. Our data showed more fat preservation in LMNA R482 than nR482, presumably leading to a later lipodystrophy diagnosis. Furthermore, bone mass in different regions may be affected by LMNA genotype; however, more studies are needed to define the bone phenotype and fracture risk in FPLD2 population fully.

Scarpa fascia versus rectus sheath plane in Lipoabdominoplasty flap dissection: Comparative study.

Background: Abdominoplasty and lipoabdominoplasty are frequently performed aesthetic procedures to improve the contour of abdomen and flanks. The improvement obtained would positively impact patient’s self-image and life quality. A lot of potential complications would compromise surgeon/patient satisfaction, the most frequent being seroma formation. A lot of measures/techniques were advocated to reduce seroma incidence including the use of suction drain, dead space obliteration by quilting sutures, and preservation of infraumbilical Scarpa fascia/deep fat layer. The latter is the focus of the current comparative study. Patients and Methods: 40 full lipoabdominoplasty cases were randomized into 2 equal groups based on infraumbilical dissection plane. Group A with traditional rectus sheath dissection plane and group B with supra Scarpa dissection plane. Post-operative drainage volume, time of drain removal and incidence of symptomatic seromas were documented. Results: Drainage volume and duration of drainage were significantly lower in supra Scarpa dissection group (B) than those of rectus plane group (A) (p < 0.001). Clinically evident seroma was detected in 3 cases of group (A) and in one case of group (B). All resolved after 2-3 aspirations in outpatient settings. Both groups were homogenous regarding BMI, age, volume of lipoaspirate, weight of excised dermofat and mean operative time. Conclusion: Scarpa fascia/deep fat preservation significantly reduced the drainage volume and duration. A lower seroma incidence was also observed.Key Words: Scarpa fascia, Lipoabdominoplasty, Seroma.

Proteomics analysis of adipose depots after intermittent fasting reveals visceral fat preservation mechanisms

Intermittent fasting is a beneficial dietary treatment for obesity. But the response of each distinct adipose depot is currently poorly defined. Here we explore the response of key adipose depots to every-other-day fasting (EODF) in mice using proteomics. A key change in subcutaneous white adipose tissue (scWAT) and visceral WAT (vWAT) depots is an increase in mitochondrial protein content after EODF. This effect is correlated with increased fatty acid synthesis enzymes in both WAT depots but not in brown adipose tissue. Strikingly, EODF treatment downregulates lipolysis specifically in vWAT, mediated by a large decrease in the abundance of the catecholamine receptor (ADRB3). Together, these changes are important for preservation of the visceral lipid store during EODF. Enrichment analysis highlights downregulation of inflammatory collagen IV specifically in vWAT, allowing improved insulin sensitivity. This resource for adipose-depot-specific fasting adaptations in mice is available using a web-based interactive visualization.

Abdominoplasty without Drains or Progressive Tension Suturing.

Over the years, the techniques of performing abdominoplasty have been modified and altered. Some of these modifications include progressive tension suturing and preservation of sub-Scarpa fat. These alterations have been done to decrease the risk of postoperative seroma and hematoma formation. Abdominoplasty, without the use of drains, is well documented in the literature. Here, the authors describe that raising superficial flaps (in the sub-Scarpa fat plane) will reduce seroma formation risk. As a result, the use of drains and tension suturing can be avoided altogether. A retrospective study was conducted from January 2015 to January 2018. The data of patients were extracted from admission files and operative notes. All the procedures were done under general anesthesia using the same operative technique by a single surgeon at the same institute. This article describes the operative technique used, observations, and result in comparison to the literature. A total of 100 patients were included in the study for over three years; 89% were females, and the average age was 40 years, with a mean BMI of 25.1 kg/m2. Liposuction was performed concomitantly in 56 patients, and rectus plication was done in 47. The overall complication rate was 14%, with the incidence of seroma and hematoma formation being 6% and 2%, respectively. This is comparable to the incidence found in the literature. The average hospital stay was 1.7 days, and the patients were followed for up to 6 months. Abdominoplasty, when performed in superficial planes with preservation of sub-Scarpa fat, is safe in terms of improved flap vascularity and beneficial in reducing the risk of seroma and hematoma formation. It can be safely performed without drains or progressive tension suturing and reduces the operative time required, patient discomfort, and hospital-stay period. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

SAT-622 Heterogeneity of Familial Partial Lipodystrophy Type 2 from a Genotype-Phenotype Perspective

Phenotypic heterogeneity is a well-known feature of Familial Partial Lipodystrophy Type 2 (FPLD2) which is caused by pathogenic variants in the LMNA gene. Clinical diagnosis can be challenging in some cases. Likewise, trained physicians can report differences in body composition and clinical manifestation of FPLD2, highlighting the importance of accurate phenotyping. In this study, we aimed to identify phenotype-genotype correlations in a cohort of systematically evaluated patients with FPLD2. We retrospectively evaluated 43 patients diagnosed with FPLD2 (age 50.3±16.1 years, 79.1% women). Per pathogenic variants, patients were divided into two groups; 24 with R482Q (RQ: 55 ± 3.2 years, 70.8% women) and 19 with non-R482Q (Non-RQ: 46 ± 3.2 years, 84.2% women). Non-RQ group consisted of several pathogenic LMNA variants in exons 1, and 5 through 11. Also, DEXA parameters were studied in a subgroup of 19 patients with available assessments (in 11 RQ and 8 non-RQ patients) that were matched for age, sex and BMI. Patients in the RQ group were older when they were first diagnosed with lipodystrophy (48.6 ± 3.2 years and 37.4 ± 3.1 years, p = 0.03). Although the prevalence of diabetes, hepatic steatosis and other co-morbidities associated with metabolic control were similar in both groups at the time of the study, patients with RQ pathogenic variants were diagnosed later in life with diabetes (46.0 ± 4.2 years vs. 35 ± 3.5 years, p = 0.03) and hepatic steatosis (45.3 ± 6.9 years vs. 30.1 ± 3.7 years, p < 0.01. Although more pancreatitis episodes were reported in the RQ group (13 ± 3 vs. 2 ± 1, p = 0.02), the number of patients with a history of pancreatitis was similar across the groups suggesting the occurrence of recurrent pancreatitis episodes in selected patients with RQ pathogenic variant. Pain was a common complaint among the patients, but it was less severe in the RQ group (4.2±2.1 vs 2.3±2.0, p=0.05). In terms of body composition, patients with RQ pathogenic variants had greater bone mass (legs: 879 ± 59.3 g vs. 703.5 ± 33.7 g, p= 0.01; trunk 914.2 ± 65.5 g vs. 674.1 ± 28.0 g, p = 0.005, total body: 2643.7 ± 158.9 g vs. 2140.6 ± 78.4 g, p = 0.005) and higher fat mass in the legs (19 vs. 14%, p = 0.02). Similarly, patients with RQ pathogenic variants had less lean percentage (76 vs. 81%, p = 0.009), and accordingly, less fat-free mass percentage (80 vs. 85%, p = 0.02) in the legs. Total fat-free mass of the RQ group was also lower (66 vs. 76%, p = 0.0009). Genotype-phenotype characterization is important not only for understanding the natural history and clinical manifestation of the disease but also for establishing more accurate and precise diagnostic criteria or therapeutic approaches. Our data suggest more fat preservation in LMNA R482Q carriers, presumably leading to a later diagnosis of lipodystrophy and metabolic abnormalities. More studies are needed to confirm the differences observed in body composition.

Meta-analysis on the comparative efficacy of drains, progressive tension sutures and subscarpal fat preservation in reducing complications of abdominoplasty

Abdominoplasty is a popular aesthetic operation. Complication rates vary from 4-80%. To date, there is a lack of evidence for complication-reducing techniques. The aim of this meta-analysis was to summarise and quantify the effects of these techniques on complication rates and determine the safest combination. A literature search was undertaken from MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases. Two authors assessed the abstracts and evaluated their suitability for inclusion in the review. For each complication (including overall), a random effects meta-analysis was conducted to investigate the average number of complications. The log rate and associated variance is calculated in R using the "escalc" function from the metafor R package. For the forest plots the model output is back-transformed to the original scale. 4295 patients were included in the meta-analysis. Overall complication rates ranged from 9.3-33.8%. Revision rates were 3-21.9%. Forest plots of data extracted from observational studies demonstrated summary measures favouring the sub-scarpal fat preservation and drains, and drains only groups for overall complications. There were no significant differences between groups for seroma, haematoma, infection/abscess, skin/fat necrosis, dehiscence, surgical revision rate and VTE rate. The rates of individual complications are no different with or without the use of PTS, drain or sub-Scarpal fat preservation in different combinations.

Protein energy wasting; what is it and what can we do to prevent it?

Some children with declining height and BMI SDS fail to respond to optimisation of nutritional intake. As well as poor growth, they have muscle wasting and relative preservation of body fat. This is termed protein energy wasting (PEW). The process results from an interaction of chronic inflammation alongside poor nutritional intake. This review discusses the causes and potential preventative therapies for PEW.