Microanastomosis in large vessel size discrepancies: A novel training model.

Introduction: Different vessel diameters may challenge the completion of a high-quality anastomosis in microsurgery. In clinical practice, discrepancies in vessel size are commonly encountered. These variations can range from small to moderate, and microsurgeons typically employ established techniques, such as dilating the smaller vessel or creating an oblique cut in its wall, to address these differences.

Posttraumatic Scrotal Reconstruction with a Pedicled "Extended" Superficial Circumflex Iliac Artery Perforator Flap: A Case Report.

The superficial circumflex iliac artery (SCIA) perforator (SCIP) flap has been used for scrotal reconstruction after Fournier's gangrene, skin cancer, or infections. However, there are few publications with regard to penoscrotal reconstruction after a traumatic injury with this flap. In this article, we propose a new SCIP flap variation, the "extended" or "direct" SCIP flap, to effectively reconstruct a wide scrotal defect after a traumatic injury.

Prophylactic lymphedema surgery in lower limb soft tissue sarcomas: A clinical paradigm in a promising field.

Introduction: Oncological treatments, such as radiotherapy and surgery, are high-risk factors for the development of secondary lymphedema in the upper and lower limbs, as well as the genitalia. Prophylactic lymphedema surgery (PLS) has previously demonstrated promising results in reducing secondary lymphedema in breast cancer and urogenital cancer patients. We conducted a study to adapt this principle for patients with lower-extremity sarcomas.

Chimeric SCIP flap with iliac bone for reconstruction of foot first ray in a radiated surgical bed: A case report.

Surgical management of sarcoma has evolved from amputation to limb salvage. Nevertheless, subsequent resections in previously irradiated feet are still challenging to reconstruct. First foot ray functional reconstruction is relevant due to its function in weight-bearing and gait.

The extended SCIP flap: An anatomical and clinical study of a new SCIP flap design.

Purpose: We describe a variation of the superficial circumflex inguinal artery perforator (SCIP) flap, based the superficial branch of the superficial circumflex inguinal artery (SCIA) METHODS: The vascular supply of the SCIP flap was prospectively studied in 91 preoperative CT angiograms in patients undergoing reconstruction with other flaps, and verified randomly with a hand-held doppler in 20% of them. Based on the results, a new SCIP flap was designed medial and cranial to the anterosuperior iliac spine (ASIS) using the superficial branch of the SCIA. This flap was used in 39 patients to reconstruct lower limb and head and neck defects RESULTS: The superficial branch of the SCIA was found in all patients and its exit point through Hesselbach's fascia was located within a 21 mm-radius circumference drawn 18 mm medial and 17 mm distal to the ASIS in 90% of the patients.

Ankle joint salvage surgery with an ipsilateral mid-fibula osteocutaneous free flap and contralateral anterolateral thigh free flap: A case report and literature review.

The tibiofibular joint can be reconstructed after distal fibular sarcoma salvage surgery to maintain ankle stability and achieve early gait. Classical reconstructive options include ligamentoplasties, arthrodesis, prosthetic replacement, bone grafts, and pedicled ipsilateral or free contralateral fibular bone flaps. We present a novel strategy for reconstruction of the ankle in an elderly patient and a literature review.

The Effect of Perioperative Blood Transfusions on Microvascular Anastomoses.

Introduction: Perioperative transfusions are associated with complications of free flaps. The purpose of the present study was to find out whether there is a significant relationship between the risk of developing complications in vascular anastomoses and the history of transfusions.

Methods: We studied 372 patients retrospectively with microsurgical reconstruction between 2009 and 2017 with regards to the number of red blood cell concentrates transfused.

Flow-Through Flaps in the Absence of an Arterial Gap for Extremity Defect Reconstruction: Minimizing the Donor-Site Morbidity.

Background:  The use of flow-through flaps was popularized in the early 1990s by Costa, Soutar and Lamberty in cases where an arterial gap was present or a major artery of the limb was damaged. We hypothesized that flow-through flaps can be used in all extremity reconstruction cases, where there is an indication for a free-flap, irrespective of the existence of arterial defect due to its many advantages while not increasing the flap loss significantly.

Methods:  A retrospective study was performed by examining patient status and surgery reports of all patients who underwent extremity reconstruction with a flow-through flap from January 2011 to January 2016.

Turbocharged bilateral pedicled DIEP flap for reconstruction of thigh defect without recipient vessels: A case report.

Reconstruction of thigh defects is usually straightforward, but in cases of poor soft tissue quality, free flap reconstruction is not possible due to the absence of recipient vessels. The turbocharge technique may increase the viable, vascularized area of a flap. In this report we present a case of the use of a turbocharged bilateral pedicled DIEP flap for reconstruction of thigh defect without recipient vessels.

Chimeric Superficial Circumflex Iliac Perforator Flap Including External Oblique Fascia: A Refinement of Conventional Harvesting.

The superficial circumflex iliac perforator (SCIP) flap is one of the most suitable flaps to cover distal extremity defects due to its lack of bulkiness and donor site concealment. However, it is less popular than other perforator flaps due to its anatomical variations, short pedicle length, and small caliber vessels. We describe a novel design for the SCIP flap, consisting of a chimeric flap with a piece of the external oblique muscle fascia.

Augmentation mammaplasty with anatomic soft, cohesive silicone implant using the transaxillary approach at a subfascial level with endoscopic assistance.

Background: Many augmentation mammaplasty techniques have been developed paying special attention to incision location and pocket plane to achieve more natural-looking breasts.

Methods: The authors' technique of choice in patients with mammary hypoplasia, empty breasts following a diet program, or more than one lactation episode causing skin flaccidity without ptosis is the placement of an anatomical implant using a transaxillary approach in a subfascial plane with endoscopic assistance. Thus, ideal patients are those presenting mammary hypoplasia, empty breasts following two or more lactation episodes, and breast skin flaccidity without ptosis, with the nipple-areola complex placed above the inframammary fold.