Multilayer reconstructions for defects overlying the Achilles tendon with the lateral-arm flap: long-term follow-up of 16 cases.

Unlabelled: Defects of the Achilles tendon and the overlying soft tissue are challenging to reconstruct. The lateral-arm flap has our preference in this region as it provides thin pliable skin, in addition, the fascia and tendon can be included in the flap as well. The aim of this report is to share the experience the authors gained with this type of reconstruction.

A clinical review of 9 years of free perforator flap breast reconstructions: an analysis of 675 flaps and the influence of new techniques on clinical practice.

The aim of this study is to review our 9-year experience with deep inferior epigastric perforator (DIEP) breast reconstructions to help others more easily overcome the pitfalls we experienced. A chart review was conducted for all 543 patients who had 622 DIEP breast reconstructions in our clinic between January 2000 and January 2009. In this time, there were an additional 28 superior gluteal artery perforator and 25 superficial inferior epigastric artery reconstructions, bringing the total free flap reconstructions to 675.

Surgical technique: The intercostal space approach to the internal mammary vessels in 463 microvascular breast reconstructions.

The internal mammary vessels are one of the most frequently used recipient sites for microsurgical free-flap breast reconstruction, and an accepted technique to expose these vessels involves removal of a segment of costal cartilage of the rib. However, in some patients, cartilage removal may result in a visible medial chest-wall depression that requires corrective procedures. We, therefore, use an intercostal space approach to the internal mammary vessels, as there is minimal disturbance of the costal cartilage with this technique.

Bilateral well leg compartment syndrome associated with lithotomy (Lloyd Davies) position during gastrointestinal surgery: a case report and review of literature.

Introduction: Well leg compartment syndrome is a rare complication that can occur after prolonged surgery in lithotomy position. We stress the importance to recognize high-risk patients for this complication and finding ways to reduce this risk. We also emphasize high level of suspicion of at risk patients and early recognition of signs and symptoms to enable early diagnosis and treatment.