The efficacy of negative pressure wound therapy on chemotherapeutic extravasation ulcers: An experimental study.

Context: The extravasation of the chemotherapeutic agents is not an unusual phenomenon. Necrosis of the skin and underlying structures has been reported, depending on the cytotoxicity of the extravasating drug. Despite the presence of some antidotes, such wounds tend to enlarge with time and are likely to resist the treatment.

Soft-tissue management with immediate free flap transfer in segmental prosthetic replacement of proximal tibia sarcomas.

Knee reconstruction with endoprosthesis after tumor resection is accepted as superior when compared with the other methods. But sometimes soft tissue reconstruction would be a challenging problem in this way of treatment. Five patients who were operated for tumor resection in this location, followed by reconstruction were presented with their one-year post operative results.

Free groin flap applications in the pediatric population.

The popularity of the groin flap has gradually decreased because of the disadvantages related to its short pedicle and technically demanding harvesting. We have summarized our experience with free groin flap applications in the pediatric population, which were performed by the same surgeon between 2004 and 2007. A total of 10 free groin flap transfers were performed in patients aged 3 to 13 years.

A comparison of various vascularization-perfusion venous nerve grafts with conventional nerve grafts in rats.

Peripheral nerves with defective segments can only be repaired using nerve grafts. Among the various nerve graft options, the outcome of vascularized grafts has been shown to be better, especially when used in the hypovascular and scarred recipient bed. The purpose of this study was to compare the regeneration capacities of various types of venous nerve grafts in a rat model.

Interpositional vein graft suturing over temporary silastic tube.

Interpositional vein grafting is the gold standard for the replacement of vascular defects. Although many microsurgeons have used classical suture anastomosis successfully, it is still technically challenging, especially for the inexperienced surgeon. We present a new technique that facilitates autogenous vein grafting by using a commercially available silastic tube employed temporarily during the suture anastomosis and removed at the end of the procedure.

Gluteus maximus neural-island flap model in the rat.

Flaps that are supplied solely by intrinsic vasculatures of the nerves have been introduced; however, clinical applications of the muscle flaps have not been performed. Our aim in this study was to develop a neural-island muscle flap model. The study was composed of anatomic investigations (part I, n = 8), creation of the neural-island muscle flap model (part II, n = 40), and augmentation of the flap (part III, n = 20).

An unusual variation of deltoid muscle.

An unusual anatomic variation of the deltoid muscle was found in a 45-year-old female cadaver during dissection of the right upper extremity. The posterior fibers of the right deltoid muscle were enclosed in a distinct fascial sheet and the deltoid muscle was seen to arise from the middle 1/3 of the medial border of the scapula. There was no accompanying vascular or neural anomaly of the deltoid muscle.

A modification of the neural-island flap: 'split neural-island flap'.

The purpose of this study was to demonstrate the new concept of a consistent and reliable skin-flap design supplied solely by the intrinsic vasculature of a split cutaneous nerve. A total of 88 Wistar rats were used in this experiment, which was divided into three parts. In Part I (n=20), the vascular anatomy and the fascicular anatomy of the lateral femoral cutaneous nerve were established.

Motor reinnervation of a denervated muscle by using a sensory nerve: an experimental study on gluteus maximus muscle of the rat.

Purpose: This study aimed at developing a new muscle reinnervation technique using a sensory nerve.

Methods: We attempted innervation of the rat gluteus maximus muscle using the lateral femoral cutaneous nerve (LFCN). We placed the gluteus maximus muscle into the fibroadipose tissue in the distribution of the LFCN in 24 rats.

Neuromuscular and neuromusculocutaneous flaps in the rat.

Since the introduction of flaps based on the vascular structures of the cutaneous nerves, these have gained increasing popularity in reconstructive surgery. The purpose of this study is to describe a new concept in which the flap is supplied solely by the intrinsic vasculature of a motor nerve. A total of 94 Wistar rats weighing 200-250 g were used in this experiment, which was divided into three sections.

A new epineural nerve repair technique with external metallic circle.

Background: Despite the existence of various nerve coaptation techniques, functional results of nerve repair are still inadequate. Potential benefits of developing modified coaptation techniques cannot be disregarded.

Methods: The authors report a new coaptation technique in which the epineural sutures were performed with an external metallic circle to increase the coaptation surface.

A new flap design: neural-island flap.

This report introduces the "neural-island flap" concept, which represents a consistent and reliable skin flap design supplied only by the intrinsic vasculature of a cutaneous nerve. In this study, the lateral femoral cutaneous nerve was selected as the pedicle of the neural-island flap, and a standard skin flap, which is the territory of the accompanying vessels (i.e.

Microsurgical revascularization of almost totally amputated alar wing of the nose.

A case of nearly complete amputation of the alar wing is presented whereby a successful arterial revascularization was accomplished using an arterial rerouting technique. Venous stasis was overcome by means of stab-wound wiping. An excellent result was obtained following complete survival of the revascularized segment.

Oblique radial forearm reverse-flow flap.

A modifed design for the distally-based radial forearm flap is presented, in an oblique direction rather than longitudinally, based on the existence of skin laxity in the proximal forearm region. The skin paddle of the flap is designed in an oblique fashion pedicled on one of the proximal-row septocutaneous perforators, and elevated in the usual manner supplied by the distal radial artery. The oblique radial forearm flap thus created was successfully utilized for reconstruction of seven dorsal hand defects.

Easy method of capturing microscopical images by using a consumer-type digital camera.

Taking pictures of microstructures is difficult, requiring sophisticated cameras coupled by the microscopes. Furthermore, it may not be feasible to find an operating microscope paired with a camera, especially in laboratory conditions. Considering the difficulty of obtaining microscopic photographs in clinical and laboratory settings, this report describes a practical method of digital photography of microstructures using a consumer-type digital camera.

Technique to re-establish continuity of the recipient artery after end-to-end anastomoses in cross-leg free flap procedure.

In this report, a simple technique is described to restore the continuity of the recipient artery in cross-leg free flap procedure after end-to-end anastomoses. In the first stage, the latissimus dorsi flap was revascularized by end-to-end anastomosis between the posterior tibial artery of the noninjured leg and the thoracodorsal artery of the flap. After 4 weeks of neovascularization period, in the second stage when the pedicle was to be divided, the thoracodorsal artery was dissected until its bifurcation in the muscle, transected, and rerouted to the distal ligated end of the posterior tibial artery, accomplishing a simple end-to-end anastomosis between these two vessel ends.

Dorsal penile vein as a new training model for microvenous anastomosis in rats.

The authors present a new model for microsurgical training of venous anastomosis-namely, the dorsal penile vein of the rat. In 12 male Wistar rats weighing 220 to 290 g, the anatomy of the dorsal penile vein was studied by dissection and histology. Anatomic dissection studies revealed that the dorsal penile vein has an average diameter of 1.

A simplified atraumatic technique for tunneling a nerve graft in a cross-face nerve-grafting procedure.

This report describes a simple and reliable method of tunneling a nerve graft in a cross-face nerve grafting procedure. In this technique, a subcutaneous tunnel is developed in two passes by means of a long hemostat that advances an 18F sterile tube from one side of the face to the other. The nerve graft is then attached to a heavy (1-0) polypropylene suture with a stitch that, by its inherent firmness, is easily threaded through the tube, dragging the nerve graft behind.

Free flap transfer to the dorsum of the rat: a new technique to avoid autocannibalization in free flap studies.

In this report the authors describe a new method that avoids autocannibalization by free transfer of a flap to the dorsum of the rat by means of a simple exposure technique. A total of 22 Wistar rats of both sexes (weight, 200-290 g) were used in this experiment. An anatomic study performed in 12 rats revealed that a wide exposure could be created in the axillary fossa by retracting the inferior tip of the scapular bone superiorly (after severing its attachments with the deep extrinsic back muscles), the latissimus dorsi muscle laterally, and the serratus anterior muscle medially.

Ring avulsion replantation by extended debridement of the avulsed digital artery and interposition with long venous grafts.

Ring avulsion replantation is a technically challenging procedure with a very low success rate. Because the zone of arterial injury is more extensive than what it appears to be in such avulsion amputations, a technique was developed to debride the avulsed digital artery for a long distance, extending well into the digital pulp, thereby creating healthy arterial ends to be bridged by one or two segments of long venous grafts. Using this technical approach, 7 patients with complete amputations of ring avulsion injury (Urbaniak's class III) were operated.