Real-Time Subcutaneous Arterial Navigation for Thinning of an Anterolateral Thigh Flap Using Photoacoustic Imaging and Projection Mapping: A Case Report.

Thinning of anterolateral thigh flap is challenging. Anatomical studies have shown variations in arterial branching patterns in the subcutaneous layer, which were suspected to be the reason for the high frequency of thinning failures. We attempted to visualize subcutaneous arterial courses preoperatively and perform thinning of perforator flaps using this information appropriately.

Planned Y-shaped Muscle Wrapping for Salvaging Aortic Graft Infection: Latissimus Dorsi and Reverse Serratus Anterior Muscles.

Aorta-related infections are life threatening. Aggressive replacement surgery using artificial aortic grafts should be performed using well-vascularized tissue wrapping to avoid reinfection. An omental flap is the first choice; however, a history of abdominal surgery necessitates other methods.

Noninvasive visualization of the midline-crossing arterial variation in the deep inferior epigastric artery perforator flap using photoacoustic tomography for application in patients with abdominal scars.

Background: The importance of the subcutaneous arterial network crossing the midline in transverse abdominal flaps has been reported. Photoacoustic tomography can be used to noninvasively visualize subcutaneous vascular networks. We applied this novel technology preoperatively in patients undergoing breast reconstruction to detect individual variations in the midline-crossing arteries.

Double-Flap Elevation From the Ipsilateral Lower Extremity: The Anterior Approach to Fibula Osteo-Cutaneous Flap Elevation.

The free fibular flap has been elevated by a "lateral approach" from the posterior edge of the peroneal muscle for more than 40 years. However, in this approach, the surgical view is limited because flap elevation in mandibular reconstruction is performed simultaneously with tumor resection in the supine position, even when using positioning pillows. We herein propose an "anterior approach" as a new surgical method.