Latissimus dorsi flap salvage of the partially failed TRAM flap breast reconstruction.

Background: The transverse rectus abdominis musculocutaneous (TRAM) flap is an excellent option for patients desiring autogenous breast reconstruction. However, partial flap ischemia can result in isolated areas of skin and fat necrosis, which, when removed, can create irregular and sharply defined defects that distort the aesthetic appearance of the reconstructed breast. Such defects can be difficult to reconstruct with local-tissue rearrangement or with breast implants.

The use of negative-pressure therapy and skin grafting in the treatment of soft-tissue defects over the Achilles tendon.

Management of soft-tissue defects over the Achilles tendon presents specific challenges to the plastic surgeon. Primary closure or local flaps are often not feasible repair options for such wounds, and many of these patients may be poor candidates for free-tissue transfer secondary to their comorbidity. In this case series, the use of negative-pressure therapy in the preoperative period to prepare the wound bed for placement of a split-thickness skin graft and in the immediate postoperative period as a dressing for the graft was successfully used in 3 patients with soft-tissue defects over the Achilles tendon with exposed tendon.

Medication-induced esophagitis: diagnosis by double-contrast esophagography.

Although medication-induced esophagitis is recognized more frequently nowadays, reports of associated radiographic findings are limited. Nine cases of esophagitis associated with various medications were evaluated by using double-contrast esophagography. The usual features were several discrete focal ulcerations localized to a short segment of the proximal half of the esophagus.