Thalidomide-related vessel thrombosis in microsurgical free tissue transfer.

This article describes a 49-year-old man with lower gum cancer who received tumor ablation by an otolaryngologist and immediate reconstruction with microsurgical free tissue transfer. The thrombosis occurred at the arterial anastomotic site at least twice during operation by an experienced microsurgeon and progressed to skin paddle necrosis following surgery. The thalidomide-induced recipient vessel thrombosis is highly suspected after excluding other hypercoagulation problems and technique errors.

Anterolateral thigh perforator flap: varying perforator anatomy.

The anterolateral thigh (ALT) perforator flap is based on the septocutaneous or musculocutaneous perforators from the lateral circumflex femoral vessels. Each perforator artery should be accompanied by 2 veins. Anomalies of the perforator anatomy in the subfascia and intramuscular layer are rarely reported.

Epistaxis as the only initial symptom in pediatric naso-orbital-ethmoid fracture complicated with meningitis.

Epistaxis is a frequent finding in patients with facial trauma. Herein, we report an unusual presentation of pediatric naso-orbital-ethmoid (NOE) fracture with epistaxis as the only initial symptom. The course of the patient's condition was later complicated by meningitis, related in part to the delay in diagnosis.

Long-term management of craniofacial osteosarcoma.

Primary osteosarcoma of the calvarium is rare. A 22-year-old female patient was admitted for a progressively enlarging, indurated mass under her scalp for 6 months. A computed tomographic scan revealed a 4 x 3 x 2-cm3 osteolytic lesion over the right parietal cortex with a sunburst appearance.

Simple and reliable way in sternum wound coverage--tripedicle pectoralis major musculocutaneous flap.

Objective: Sternotomy wound infection requires radically debridements and need secondary reconstruction of the resulting defect. Pectoralis major muscular or musculocutaneous flap is quite common in sternal wound closure. We modified the pectoralis major musculocutaneous flap design: bipedicle advancement cutaneous flap combined with thoracoacromial myocutaneous perforators, as a "tripedicle" fashion.

Penile replantation, complication management, and technique refinement.

We describe a case of complete guillotine-type penile amputation at the proximal penile shaft. The blood flow was established 10 h after trauma. Circulation in the replanted penis was quite good but there was progressive prepuce necrosis after the hematoma.

Using the descending branch of the lateral femoral circumflex vessel as a source of two independent flaps.

Background: Simultaneous reconstruction of two separate defects by two free flaps is time consuming and often requires two donor sites. The anterior and lateral aspect of the thigh is an ideal donor site for free tissue harvest without incurring significant morbidity. In this article, the authors describe their recently developed technique that allows for harvesting two independent fasciocutaneous free flaps from the same descending branch of lateral circumflex femoral vessel as a new clinical application of the versatile anterolateral thigh flap.