The New Anatomical Classification System for Orbital Exenteration Defect.

Background: The unique anatomy of the orbita and the different behavior of each malignant tumor cause us to perform the various types of orbital exenteration that yields to varying defect each of which has own specific demands in terms of the reconstruction. Current classification of orbital exenteration defects seems not to be adequate to provide detailed description. This study reviews 50 exenteration defects to offer a more effective anatomical classification system.

Skin Necrosis in a Patient with Factor V Leiden Mutation following Nipple Sparing Mastectomy.

Nipple-sparing mastectomy (NSM) and immediate breast reconstruction have replaced radical surgical interventions for the treatment of selected patients with breast cancer undergoing prophylactic mastectomy. NSM is technically a difficult procedure. After dissection, the remaining breast skin and nipple-areola complex (NAC) must be thin enough to be free of tumor tissue and thick enough to preserve tissue perfusion.

A Novel and Alternative Treatment Method for Diabetic Heel Ulceration Exposing the Calcaneus Which Is Not Suitable for Flap Surgery: Vacuum Assisted Sandwich Dermal Matrix.

Background: Currently, free flaps and pedicled flaps are the first treatment choices for large heel ulcer reconstruction. However, flap reconstruction of heel ulcerations cannot be performed in all diabetics especially with concurrent severe peripheral vascular disease because of higher flap failure rate. In recent years, the use of acellular dermal matrix (ADM) has emerged as an alternative treatment option for extremity ulcers.

Origin, Reality, and Clinical Importance of the Arcade of Struthers: An Anatomic Study.

The literature contains confusing and opposing views about the naming, prevalence, anatomic structure, and clinical significance of the arcade of Struthers. The conflicting rates of arcade (between 0% and 100%) prevalence found in the literature may be due to the varying definition of the arcade among the authors, as well as the dissection method. The present study aims to examine the structure to determine whether or not the arcade of Struthers exists through an anatomic dissection study of a fresh human cadaver and seeks to compare its findings with those in the literature.

The Overlapped Triple Circle Pulse Technique with Nd:YAG Laser for Refractory Hand Warts.

Background And Objective: Inadvertent superficial treatment of hand warts causes recurrence, whereas aggressive treatment can lead to tissue defects resulting in hand dysfunction. This study aimed to determine the effectiveness of a novel laser treatment modality for recalcitrant hand warts.

Materials And Methods: The study included 51 patients who were treated for 146 recalcitrant hand warts using 1064 nm long-pulsed Nd:YAG laser between 2011 and 2014.

Ganglion cyst associated with triangular fibrocartilage complex tear that caused ulnar nerve compression.

Ganglions are the most frequently seen soft-tissue tumors in the hand. Nerve compression due to ganglion cysts at the wrist is rare. We report 2 ganglion cysts arising from triangular fibrocartilage complex, one of which caused ulnar nerve compression proximal to the Guyon's canal, leading to ulnar neuropathy.

Mandibular metastases of papillary thyroid carcinoma treated by hemimandibulectomy and costochondral rib graft.

Papillary thyroid carcinoma (PTC) is the most common and well-differentiated cancer of the thyroid. Unlike most cancers, spread to local lymph node does not worsen the survival rate of PTC, and complete resection of the metastases seems to be important and may have favorable effects on the prognosis. A 33-year-old woman was referred to our clinic with a mass involving the right angulus mandible.

Pachydermoperiostosis: aesthetic treatment of prematurely aging face with facelift and botulinum toxin a.

Pachydermoperiostosis is a rare syndrome that hinders patients' quality of life thru its aesthetics manifestations and functional obstacles. Many techniques for addressing and correcting aesthetic defects associated with pachydermoperiostosis have been introduced, including facelift surgery. This case presentation includes treatment of facial pachydermoperiostosis and restoration of facial aesthetics via treatment with facelift, skin muscle excision, and botulinum toxin A.

Laser lipolysis without suction: reality or myth?

Background And Objective: Liposuction is one of the most frequently performed aesthetic surgical procedures. Laser- and ultrasound-based systems have become especially popular in recent years, including laser lipolysis, which has a number of advantages over classic liposuction. Some researchers contend that the aspiration step is not necessary.

Postradiation sarcoma from a free flap.

Introduction: Postradiation sarcomas constitute approximately 0.5% to 5.5% of all sarcomas.

Subacute and delayed period microsurgical management of traumatic extremity injuries in pediatric population.

The purpose of the present report is to evaluate the outcome of subacute and delayed period microsurgical reconstructions of traumatic extremity defects of the pediatric patients. Eighteen free tissue transfers had been performed in 18 patients. Patients ranged in age from 5 to 17 years of age and had a median age of 12.

The epidemiology of foot wounds in patients with diabetes: a description of 600 consecutive patients in Turkey.

Epidemiological studies describing demographic, clinical, and surgical characteristics of diabetic foot wounds are lacking in Turkey. To further describe the epidemiology of diabetic foot wounds in Turkey, we developed an evaluation form and performed a retrospective cohort study that entailed 600 diabetic patients who were admitted to the hospital for treatment of their foot wound(s). The mean age of the cohort was 62.

A reliable surgical approach for the two-staged amputation in unsalvageable limb and life threatening acute progressive diabetic foot infections: tibiotalar disarticulation with vertical crural incisions and secondary transtibial amputation.

Background: If all efforts to treat acute progressive diabetic foot infection remain insufficient, the decision of major amputation should be undertaken. For this purpose, guillotine amputation is usually performed first. However, guillotine amputation below the knee level may cause the corresponding infection to spread to preserved anatomical spaces.

The effect of epidural anesthesia on muscle flap tolerance to venous ischemia.

Background: Venous ischemia is a major cause of failure after free tissue transfers and replantations. The combination of general and epidural anesthesia leads to vasodilatation and improves tissue perfusion. Postoperative pain relief and sympathetic blockage are additional benefits of epidural anesthesia.

Conversion of the monocortical iliac bone graft to the three-dimensional prism bone graft.

Introduction: The iliac crest is the most common bone graft donor site. However, harvesting of tri or bi-cortical iliac bone graft is associated with some potentially serious complications and cosmetic deformity. We would like to present a case in which we used a new technique converting the mono-cortical iliac graft to the three-dimensional prism bone graft in order to reconstruct an acquired first metatarsal defect and to avoid the potentially serious complication of the iliac crest bone harvest.

Combined cremaster muscle and inner thigh skin composite flap: a novel experimental flap model in the rat.

Unlike the composite musculocutaneous flap models, the combined composite muscle-skin flap model allows evaluating muscle and skin viability independently, because it has an independent blood supply to the muscle and skin component. However, to our knowledge, only two combined muscle-skin flaps have been reported to date. During our cremaster dissection in our laboratory, we perceived a new vessel as a terminal continuation of the pudic-epigastric artery (PEA) on which the cremaster muscle flap is raised.

A new composite flap model in the rat: combined cremaster muscle and pubic bone flap.

Background: We introduce a new model of combined cremaster muscle and pubic bone flap based on a single pedicle consisting of the osseous branch of pubic bone and external spermatic vessels of cremaster muscle in continuity with the pudic-epigastric artery (PEA).

Method: Thirty male Sprague-Dawley rats weighing 200 to 250 g were used in this study. In 10 rats PEA, a branch of the iliac artery was dissected throughout its entire course for the anatomic study.

Reverse-flow retroauricular island flap in facial reconstruction.

Background: Reconstruction of facial skin defects requires good-quality skin cover to satisfy aesthetic expectations of patient, especially when the skin defect is on the uncovered area of the face. Limitations in the available local tissue and donor-site morbidity restrict the options.

Objective: In an effort to solve these problems, we have begun to use a subcutaneous pedicled retroauricular reverse-flow flap.

The effect of hematoma in muscle flap microcirculation.

Free radicals were first mentioned by Healey about the hematoma under skin flaps, trying to explain the blood itself has different effect beyond its space-occupying effect or infection. The aim of this study was to determine whether hematoma would have any effect on neutrophil behavior in muscle flap microcirculation. Rat cremaster muscle flap model was used for measuring intravital different parameters.

Crossover replantation of the foot after bilateral traumatic lower extremity amputation.

Background: Bilateral traumatic amputation and limb-threatening injury of the lower extremities is more challenging than the unilateral amputation. Successful replantation of both lower extremities has been reported previously. However, orthotopic implantations may not be possible when amputation of both lower limbs with different levels of section and degrees of damage to surrounding tissues occurs.

Reconstruction of massive lower lip defect with the composite radial forearm-palmaris longus free flap: empowered static and partial dynamic reconstruction.

Sakai et al described a composite radial forearm plamaris longus flap (CRFPL) for total lower lip reconstruction. However, this technique is not fully capable of preserving satisfactory oral competence, especially when the patients are speaking or eating. Valuable modifications and refinement of the technique of using a composite radial forearm-palmaris longus flap have been described to improve the functional outcomes of this technique.

Adding versatility to the reconstruction of intraoral lining: opened pocket method.

Reconstruction of a full-thickness cheek defect, especially one associated with a large lip and oral commissure defect, remains a challenge. After tumor excision, replacement of the oral mucosa is often necessary. The oral mucosa is a thin, pliable lining.

Free rectus abdominis myocutaneous flap with anterior rectus sheath to provide the orbital support in globe-sparing total maxillectomy.

Reconstruction after total maxillectomy with preservation of the orbital contents is technically more challenging than when the maxillectomy is combined with orbital exenteration. It results in severe complications if the orbital content is not supported. We would like to introduce a new technique using free rectus abdominis myocutaneous (RAM) flap with anterior rectus sheath to support the orbital content in a patient who underwent globe-sparing total maxillectomy.