Pelvic Ring Reconstruction with an Osteocutaneous Fibula Flap for Abdominal Wall Repair in Adults with Bladder Exstrophy.

Abdominal wall repair in adults with bladder exstrophy is challenging. We present a case of a 46-year-old woman with bladder exstrophy presenting with a large midline incisional hernia associated with a 13-cm hypoplasia of both pubic rami that precluded fixation of any abdominal mesh. A two-stage approach was adopted.

Latissimus Dorsi and DIEP Flaps for Pharyngeal Reconstruction: A Novel Indication.

Aims: Complex pharyngeal defects after tumor resection remain a challenging dilemma for reconstructive plastic surgeons. They often benefit from pedicled or free flaps reconstruction to maintain continuity of the aerodigestive tract and protect the great vessels. While pedicle pectoralis major myocutaneous flaps or supraclavicular flaps have been described, microvascular free flaps have largely replaced the use of pedicle flaps.

An Easy and Effective Method for Avoiding Intraoperative Pedicle Vessels Kinking.

Vascular pedicle twisting during a microsurgical anastomosis procedure can jeopardize the viability of the flap. Although the literature describes many maneuvers to prevent vascular pedicle twisting, we present an easy and effective method that can be used when performing microsurgical anastomosis in the operating room.

Reconstruction of a Large Thoracic Radiation-Induced Ulcer Using a Free Extended Vertical Rectus Abdominis Myocutaneous Flap.

Radiation therapy-induced skin ulcers are complex wounds that are unable to heal spontaneously. This affects the patient's quality of life and poses a major health problem. The most reliable curative treatment involves extensive debridement of the affected tissue and covering the wound with well-vascularized tissue.

Anterolateral Thigh Free Flap Donor-Site Morbidity: A Retrospective Cohort Study.

The ability to achieve a good functional outcome, quality of life, and patient satisfaction related to the donor site of free flaps is an important factor in flap selection. One of the main advantages of an anterolateral thigh (ALT) free flap is its minimal donor-site morbidity. We conducted a study to analyze healing of ALT flap donor sites based on the type of closure.

Vram flap transposition in pelviperineal reconstruction. A technical note.

The vertical rectus abdominis myocutaneous flap is a workhorse flap for perineal reconstruction after pelvic exenteration with low rate of complications. When flap viability is compromised, it is principally due to an incorrect inset or inadequate postoperative care. The aim of this article is to specify the technical details that must be taken into account during VRAM flap transposition inside the pelvis.

Extended vertical rectus abdominis myocutaneous flap for reconstruction of large pelviperineal defects following oncologic resection.

Background And Objectives: Extended vertical rectus abdominis myocutaneous (eVRAM) flap has been proposed for reconstruction of large pelviperineal defects where traditional VRAM flap is insufficient. We present our experience with eVRAM flap for pelviperineal reconstruction following oncologic resection.

Methods: A retrospective study was conducted, including all the patients who underwent reconstruction with eVRAM flap after complex pelvic resection, between 2012 and 2020.

Comparison of vertical and extended vertical rectus abdominis myocutaneous flaps. An anatomical study.

The extended vertical rectus abdominis myocutaneous (eVRAM) flap has been proposed for reconstruction of large pelviperineal defects where traditional VRAM flap could be insufficient. To compare the dimensions of VRAM and eVRAM flaps an anatomical study was performed. Ten VRAM and ten eVRAM flaps were dissected in ten fresh adult cadavers.

Free Vacularized Fibula Flap for Septic Bone Defects of the Lower Limb.

Free fibula flap (FFF) is one of the reconstructive techniques to treat bone defects, although in septic conditions there are some limitations that have made it less popular. We present our experience with FFF for the reconstruction of lower limb infectious bone defects. From September 2015 to January 2020, 10 patients underwent reconstruction with FFF without rigid internal fixation of septic bone defects of the lower extremities.

Using Free Arterialized Venous Flaps for Reconstructing Hand Defects.

Hand and digit soft tissue defects are quite common and frequently require specialized reconstruction. When local flaps cannot be used to reconstruct a soft tissue defect, free flaps must be utilized. To overcome tissue volume and discrepancies in vessel diameter, arterialized venous free flaps from the forearm may provide an acceptable alternative.

Therapeutic management of traumatic tension hematoma with potential skin necrosis: a retrospective review of 180 patients.

Introduction: Tension hematoma is a frequent traumatic condition in elderly population under anticoagulation treatments. However, scarce literature exists focused in the management of this condition. In this article, a retrospective study of patients that suffered from traumatic tension hematomas treated at a plastic surgery department is reported.

A Protocol for Performing Reconstructive Microsurgery on Patients With COVID-19.

On March 11, 2020, the World Health Organization declared COVID-19 to be a pandemic, challenging health care systems all over the world. National health care systems have reorganized to cope with the disease. Surgical services departments around the world have been affected and elective surgical procedures have been postponed to conserve medical resources.

Omental free flap for surgical treatment of chronic osteomyelitis of lower limb: A technical note.

Soft tissue reconstruction of chronic lower extremity wounds with bone infection entails an important challenge in reconstructive surgery. We report our experience using the omentum free flap to provide coverage in two patients suffering chronic osteomyelitis of the lower limbs. After extensive soft tissue and bone debridement, an omentum free flap was performed in both cases, providing dead space obliteration and soft tissue coverage in behalf of its large size and pliability.

Simultaneous Opponensplasty and Free Gracilis Muscle Flap for Thenar Reconstruction after Arteriovenous Malformation Resection.

We report the case of a thenar eminence arteriovenous malformation presenting with continuous growth and pain that was treated with surgical excision after embolization. Extracapsular resection compromised thenar muscles which function was reconstructed with extensor indicis proprius transfer for opposition and abduction, and neurotized free gracilis muscle flap for opposition and adduction, as well as thenar eminence reconstruction.

Avoiding Above-the-Knee Amputation with a Free Tibiofibular-Talocalcaneal Fillet Flap and Free Latissimus Dorsi Flap.

Despite the advances achieved in reconstructive surgery, amputation is still the only option after some severe traumas. Preservation of the knee joint is considered a significant functional advantage. We present the case of a 39-year-old man with a comminuted Gustilo type IIIC open tibia fracture with massive bone loss.

Reconstruction of Middle-Third Helical Traumatic Defects With a Two-Stage Approach: Retroauricular Flap and Costal Graft.

In this article, we describe the case of a patient suffering from middle-third helical rim avulsion after a bicycle accident, which was reconstructed with a two-stage procedure: (1) performing a postauricular pedicled flap and (2) reconstruction using a costal graft. The article also includes a brief summary of recommendations in the scientific literature about the reconstruction of middle-third auricular defects.