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1.  A Novel Laser-Doppler Flowmetry Assisted Murine Model of Acute Hindlimb Ischemia-Reperfusion for Free Flap Research 
PLoS ONE  2013;8(6):e66498.
Suitable and reproducible experimental models of translational research in reconstructive surgery that allow in-vivo investigation of diverse molecular and cellular mechanisms are still limited. To this end we created a novel murine model of acute hindlimb ischemia-reperfusion to mimic a microsurgical free flap procedure. Thirty-six C57BL6 mice (n = 6/group) were assigned to one control and five experimental groups (subject to 6, 12, 96, 120 hours and 14 days of reperfusion, respectively) following 4 hours of complete hindlimb ischemia. Ischemia and reperfusion were monitored using Laser-Doppler Flowmetry. Hindlimb tissue components (skin and muscle) were investigated using histopathology, quantitative immunohistochemistry and immunofluorescence. Despite massive initial tissue damage induced by ischemia-reperfusion injury, the structure of the skin component was restored after 96 hours. During the same time, muscle cells were replaced by young myotubes. In addition, initial neuromuscular dysfunction, edema and swelling resolved by day 4. After two weeks, no functional or neuromuscular deficits were detectable. Furthermore, upregulation of VEGF and tissue infiltration with CD34-positive stem cells led to new capillary formation, which peaked with significantly higher values after two weeks. These data indicate that our model is suitable to investigate cellular and molecular tissue alterations from ischemia-reperfusion such as occur during free flap procedures.
PMCID: PMC3688775  PMID: 23840492
2.  A Second National Survey of Health-Related Quality of Life Questionnaires in Head and Neck Oncology 
With an increasing number of publications on health-related quality of life (HRQOL) following head and neck cancer, the recognition of a number of well-validated questionnaires and a growing awareness of the potential role of HRQOL in practice, it was our aim to repeat the survey of 2002 reported in the Annals to see how practice changed.
A postal survey of members of the British Association of Head and Neck Oncologists was undertaken in January 2006 with reminders sent in February, March and April.
The response was 50% (106 of 210) of which 53% were using or had used HRQOL questionnaires. The main reasons for not using HRQOL questionnaires were that they were too time-consuming or intrusive in a clinic setting and that there was a lack of resources.
Clinicians still see the use of questionnaires as a research-tool only, rather than an adjunct to giving patient information, promoting choice, and identifying patients with problems. The burden on HRQOL evaluation in routine clinical practice remains a substantial barrier. Advances with IT support in clinic should make it easier to collect and use these data in the future. As surgeons, we still need to be persuaded of the benefits of HRQOL outcomes in our practice.
PMCID: PMC2758445  PMID: 19409153
UW-QOL; Validation; Health-related quality of life; Head and neck cancer; Surgery; Questionnaires
3.  Oral cancer awareness amongst hospital nursing staff: a pilot study 
BMC Oral Health  2009;9:4.
Oral cancer is as prevalent as cervical and testicular cancer in the United Kingdom. Nursing staff provide the oral health care for the patient population in hospital. Admission to hospital provides a 'window of opportunity' for oral cancer 'screening' via an oral health check during nursing clerking. This study aimed to investigate whether nursing staff are aware of risk factors for oral cancer, its clinical signs, and could therefore provide a 'screening' service for oral cancer.
Through the use of a questionnaire we assessed 121 nursing staff on oral health check behaviour and attitudes; their knowledge of risk factors for oral cancer; their understanding of common clinical signs of oral cancer; and their undergraduate and postgraduate training in oral health and oral cancer.
Over 80% thought oral health checks were important although only 49% performed this task regularly; approximately 70% identified smoking as a risk factor but less than 30% identified alcohol. Awareness of the clinical signs of oral cancer was low with 21% identifying white patches, 15% identifying ulceration and only 2% identifying red patches despite their malignant potential. Nurses within 3 years of qualification were significantly better at recognising risk factors for oral cancer than their colleagues, identifying a need for continuing postgraduate education on oral health and oral cancer. Sixty-one percent of nursing staff received oral healthcare as an undergraduate with 34 percent receiving postgraduate training.
An oral health check upon admission to hospital provides an opportunity for nurses to 'screen' for oral diseases including oral cancer and allows nurses a greater role in total patient care. Nurses' awareness of oral cancer risk factors and clinical signs was, however, poor. This study highlights a need for improved education of nurses on oral cancer to make the oral health check on admission viable for oral cancer screening.
PMCID: PMC2640385  PMID: 19175923

Results 1-3 (3)