Free vascularised tissue transfer and brachytherapy for soft-tissue sarcomas of the extremities.

We reviewed the medical files of nine patients with localised soft-tissue sarcomas of the extremities treated with surgical resection, free vascularised tissue transfer, and computerised after-loading iridium-192 high dose rate brachytherapy over a period of 8 years. All patients had external beam radiation therapy in fractions with a total dose of 48-52 Gy, followed by surgery at approximately 4-5 weeks post-irradiation. Surgical treatment included wide resection of the primary tumour in six patients, and marginal resection in three patients.

Calcium sulphate delivery system with tobramycin for the treatment of chronic calcaneal osteomyelitis.

The case of a 24-year-old woman with Pseudomonas aeruginosa and Proteus mirabilis chronic calcaneal osteomyelitis is presented. Extensive debridement of the necrotic bone and application of tobramycin-loaded polymethylmethacrylate beads was performed and ciprofloxacin was given post-operatively. Three months later, laboratory tests, including complete blood cell count, erythrocyte sedimentation rate and C-reactive protein, were normal.

Facial paralysis.

Detailed knowledge of embryology, anatomy, and function of the facial nerve is essential in treating the devastating functional, aesthetic, and psychological sequelae of facial paralysis. Two basic factors influence the method of repair and the subsequent outcome of the effort to combat facial paralysis. First is the availability of a viable proximal nerve stump which can be used as the source for motor axons, and which is related to the level of the injury.

The conjoint medial circumflex femoral perforator and gracilis muscle free flap: anatomical study and clinical use for complex facial paralysis reconstruction.

Background: [corrected] The aim of this study was to establish the anatomic basis of the conjoint medial circumflex femoral perforator and gracilis muscle flap and to expand the use of this flap in complex facial paralysis reconstruction.

Methods: An anatomic study was initially undertaken to record the existence, consistency, and diameter of musculocutaneous perforators emanating from the proximal third of the gracilis muscle to provide blood supply to the overlying fascia, subcutaneous fat, and skin. In a total of 20 clinical cases of gracilis muscle harvesting, the aforementioned anatomical data were recorded during flap dissection.

The anatomic basis of the gracilis perforator flap.

Another perforator flap, the gracilis perforator flap, has recently been added to the armamentarium of reconstructive surgeons. A detailed study of the anatomy of this flap was undertaken in this study. Forty-seven dissections were performed in cadavers and clinical cases of gracilis muscle harvesting for various reconstructive reasons.