Mandibular reconstruction with local live vascularised bone transfer.

There are different methods to provide a skeletal support for mandibular reconstruction following the trauma or ablation for tumor in head and neck region. These methods vary from complicated techniques like vascularised free bone grafts to methods like free bone grafts, local vascularised bone grafts, cadaveric irradiated bone grafts and alloplastic material spacers including silastic rubber, polyvinyl plastics, ceramics, hydroxylapatite or metal. The technique employed solely depends upon many factors like expertise available, existing infrastructure, the available time factor and complexity of the defects including the type and extent of tissue loss in the particular patient.

Total oral reconstruction for cancers associated with advanced oral submucous fibrosis.

The progression of submucous fibrosis to oral cancer is well established. This condition in an advanced stage causes progressive trismus. Oral cancers associated with severe submucous fibrosis (interincisor distance [IID] < or = 1.

Free jejunal transfer for pharyngo-esophageal reconstruction.

During the course of head and neck surgery for cancer the reconstructive surgeon is involved in replacement of pharyngeal mucosal defects. Siedenberg (7) first reported free transplantation in 1959 using a segment of jejunum, Roberts (5) using jejunum, Nakayama (3) using colon and Jurkiewicz (4) using ileum and jejunum. Green (2) in 1966 using microsurgical techniques demonstrated 100% survival of free transfers of jejunum and also patches of jejunum in dogs.

The venoneuroadipofascial pedicled distally based sural island myofasciocutaneous flap: case reports.

Complex soft-tissue defects of the lower third of the leg, the heel and the ankle still present a challenge for the reconstructive surgeon. In addition to skin replacement, many of these defects require muscle bulk, which promotes the healing of open bone fractures, effectively fills osteomyelitic cavities and deep three-dimensional defects, and helps to reconstruct the Achilles tendon. In an anatomical study, we developed a new flap based on the 'neuromuscular concept'.

The venoneuroadipofascial pedicled distally based sural island myofasciocutaneous and muscle flaps: anatomical basis of a new concept.

Reconstruction of soft-tissue defects of the lower third of the leg, the heel and the foot remains a challenge. The distally based sural neurocutaneous flap has been used effectively to resurface these defects. However, the paucity of bulk in this flap makes it inadequate for complex post-traumatic or post-ablative soft-tissue reconstruction.

A simple, cost effective, innovative method of securing burns dressing.

An easy, simple way of securing the burns dressing has been described. This is achieved by using an ordinary office stapler and staple pins. The use of long, encircling gauze bandages for fixation of burns wound dressings around the torso and extremities, is eliminated.

Case report: a free arterialized venous flap for intraoral cancer reconstruction.

The free arterialized cephalic venous flap is a good option for intraoral reconstructions. It offers thin, pliable skin as a one-stage transfer without sacrifice of a major artery. The radial dominant hand poses a problem, which can be surmounted by this flap.

Tumor implantation at the flap donor site: a case report.

The genesis of cancer and its variable patterns of spread have been theorized and debated upon for decades. Recurrences, both local and metastatic, are dreaded by both the patient as well as the surgeon. An interesting case of tumor implantation at the flap donor site was noted in a patient who underwent a primary flap reconstruction for cancer of the cheek.

The hemithigh microvascular transfer (combined anterolateral thigh flap and tensor fasciae latae flap) for a full thickness abdominal wall reconstruction: a case report.

In large, full thickness upper abdominal wall defects a free microvascular tissue transfer is the only option which will enable reconstruction of the structural integrity of the abdominal wall as well as give a good aesthetic appearance. We present a case in which such a defect was reconstructed by a 29 x 19 cm hemithigh free flap, combining the adjacent vascular territories of the anterolateral thigh flap and the tensor fasciae latae flap based on the lateral circumflex femoral artery.

The lateral tongue flap: a salvage option for reconstruction of buccal recurrences.

Background: Surgery in an irradiated, previously operated field is fraught with danger. Though microvascular tissue transfers are being gone, they may not be feasible in all circumstances.

Methods: A lateral tongue flap was executed in 11 cases of intraoral buccal recurrence.

Gastrocnemius muscle transfer in limb-sparing surgery for bone tumors around the knee.

Limb-sparing surgery for bony tumors around the knee, resulting in large segmental defects, involves its replacement with an endoprosthesis. The viability of the overlying skin flaps is of utmost importance. Their healing without breakdown is essential or else leads to prosthesis exposure, infection and perhaps prosthesis removal.

The submental island flap for reconstruction of facial defects.

The procedure of facial resurfacing dictates that there should be an excellent colour and texture match between the facial and the transposed skin. Cervical flaps e.g.

Prophylactic antibiotics administration head and neck cancer surgery with major flap reconstruction: 1-day cefoperazone versus 5-day cefotaxime.

Patients who undergo surgery of the head and neck cancer with major flap reconstruction, benefit from perioperative antibiotic prophylaxis. Head and neck surgery, especially ablative cancer surgery with major flap reconstruction is potentially contaminated iatrogenic wound, and the use of preoperative, perioperative and post operative chemoprophylaxis for infection is mandatory. This study is being done to determine if shorter course of antibiotic administration (Cefoperazone) would be more effective than conventional 5-day antibiotic administration (Cefotaxime).

Primary reconstruction of mandible in head and neck cancer with silastic implant--a review of 69 cases.

Different methods of primary mandibular reconstruction carried out at the Tata Memorial Cancer Hospital range from the pectoralis major myocutaneous or osteomyocutaneous composite flap, which is the most frequently performed procedure, to a free vascularised composite tissue transfer with microvascular anastomosis, including, iliac crest free vascularised bone grafts or radial artery forearm flap free vascularised radius bone grafts, free vascularised fibular bone grafts and silastic mandibular implants. The clinical results of immediate mandibular reconstruction with a silastic mandibular implant (SMI) in 69 patients is presented. Out of the 69 cases, 2 patients died in the early post-operative period.

Complications of the pectoralis major myocutaneous flap in the oral cavity: a prospective evaluation of 220 cases.

A prospective study of 220 consecutive pectoralis major myocutaneous flaps used for oral cavity reconstruction from March of 1990 to February of 1991 showed that 89 patients (40.5 percent) developed flap-related complications and 33 patients (15 percent) had complications unrelated to the flap; 92 patients (42 percent) had an uneventful recovery and there were 6 (2.7 percent) postoperative deaths.

Comparative evaluation of function after surgery for cancer of the alveolobuccal complex.

Purpose: The current study was undertaken to assess the functional deficit after hemiresection of the mandible and to determine whether lateral segment resection with reconstruction was a functionally superior alternative in the management of patients suffering from alveolobuccal cancer.

Patients And Methods: Eighty-three patients were assigned to one of two main groups: Group I, hemiresection of the mandible (n = 47), and group II, lateral segment defects (n = 36). Functional assessment of patients included subjective evaluation of overall well-being, feeding, and cosmesis, as well as objective assessment of mastication, speech, and cosmesis.

Caudal trapezius composite island flap for extensive shoulder defects.

The trapezius composite flap was first described by Demergasso in 1979 (2). The caudal trapezius island flap was described by Mathes and Nahai (4), in head and neck cancer reconstruction. Baek and Biller (1) described the descending branch of the transverse cervical artery, as a dominant blood supply.