How to Transform a Perforator Propeller Flap into a Keystone Flap in Case of Unsatisfying Perforator Vessel Local Perforator Flap Coverage in Limbs.

Moderate soft-tissue defects need stable coverage, ideally with tissue of similar characteristics and low donor site morbidity. We propose a simple technique for the coverage of moderate skin defects in the limbs. It allows intraoperative transformation of a propeller perforator flap (PPF) into a keystone design perforator flap (KDPF) in cases of unsatisfying perforator vessel or in cases of unpredictable intraoperative events.

[Dermatologic adverse events of the new targeted anticancer therapies used in oncodermatology].

The management of oncology patients has been deeply modified over recent years by the development of new targeted anticancer therapies. Though these new therapies generally have a good safety profile, the skin is probably the organ most affected by their toxicity, in terms of frequency and symptom diversity. This review describes the most frequent cutaneous side effects induced by the new targeted therapies used in oncodermatology, whether they are well-established drugs such as EGF receptor inhibitors (cetuximab, erlotinib) or imatinib, or new treatments for metastatic melanoma such as selective BRAF (vemurafenib) or MEK inhibitors (selumetinib) and CTLA-4 monoclonal antibodies (ipilimumab).

[Dermatologic side effects induced by new angiogenesis inhibitors].

While new anticancer angiogenesis inhibitors present a well-tolerated safety profile, they are not without adverse events. The signaling pathways and/or receptors inhibited by these new drugs are often physiologically expressed in the skin and/or hair follicle and cutaneous toxicity is on the forefront. This article reviews the main dermatologic adverse events induced by these targeted anticancer therapies with a partial or exclusive antiangiogenic activity: sorafenib, sunitinib, pazopanib, vandetanib, everolimus, temsirolimus or bevacizumab.

[Evidence-based medicine and prevention of thrombosis in microsurgery. Critical review].

Prevention of thrombosis in microsurgery was the point of numerous publications without any referenced protocol. The question of this article was to know if it existed, for a patient who needed a microsurgical procedure, any medical treatment used, proved to lower the thrombotic risk. Using principles of evidence-based medicine, we observed that none of the medical treatments proved efficiency on preventing vascular thrombosis, arterial or venous.

[Multicentric study of thrombosis prevention in upper-extremity microsurgery. Survey at the Fesum centers].

Thrombosis is still the first cause of microsurgery failure. Lots of publications have been made but no consensus exists. We first analysed the results of our study in 53 French expert surgeons, then we compared them with the last published datas, most of all, with the similar surveys.