Use of Muscle Graft Versus Fascia Flap as Interpositional Material in Prevention of Reossification in a Rat Model of Skull Bone Defect.

Aim: To investigate the utility of two different interpositional materials (muscle graft vs. fascia flap) for preventing the osseous reunion of skull bone defect including the coronal suture line in rats.

Material And Methods: A total of 32 male Sprague-Dawley rats were divided into 2 groups (n=16 for each) after the formation of bilateral coronal bone defect, based on the interpositional materials used to prevent re-ossification; the rats were divided into the muscle graft (MG) group and the fascial flap (FF) group.

Intralesional application of epidermal growth factor in limb-threatening ischemic diabetic foot ulcers.

Objective: The intralesional injection of recombinant human epidermal growth factor (EGF-IL), a new therapy, has been claimed to prevent major amputations in advanced diabetic foot lesions. In this study, the efficacy of EGF-IL on advanced diabetic foot ulcers (DFU) was reviewed.

Methods: Intralesional 75 µg EGF application (Heberprot-P® 75, Heber Biotec, Havana, Cuba) to 12 diabetic foot lesions in 11 patients (8 males, 3 females; mean age: 62.

Effects of microarterial anastomosis torsion on survival of oblique groin flap in rats.

A microanastomosis might tolerate a torsion up to 360°, but the effects of arterial microanastomosis torsion on the survival of the flap it supplies are unclear. The aim of this study was to investigate the consequences of microarterial anastomosis torsion on the groin flap in rats. Forty Sprague-Dawley rats were divided into five groups.

Biological reconstruction of the femur using double free vascularized fibular autografts in a vertical array because of a large defect following wide resection of an osteosarcoma: a case report with 7 years of follow-up.

Free vascularized fibular autograft transfer to the defect area after wide resection of bone sarcoma is one of many biological reconstruction methods. We report on an 8-year-old girl with 7 years of follow-up treated for right femur osteosarcoma. A 26 cm long tumor was resected with clear margins.

Midfoot reconstruction with free vascularized fibular graft after wide resection: a case report.

Malignant foot tumours are often treated with amputations due to anatomical difficulties. Limb salvage techniques are difficult to perform, as a stable, sensible and plantigrade foot should be obtained to prevent further problems.In this report, we present a midfoot reconstruction with a vascularized free fibula, osteomized in a V-shape after wide resection of a midfoot synovial sarcoma.

Reconstruction of complex groin defects with inferior epigastric artery-based rectus abdominis muscle flaps: report of two cases.

Because the extremities are dependent on a single vascular supply, namely the brachial and femoral arteries, injuries around the girdles are challenging, and may contribute to high morbidity rates such as extremity loss, or even mortality due to bleeding, sepsis or vascular compromise. The reconstruction or aided closure of these regions may present additional technical difficulties in the presence of a vascular injury that complicates the use of a microvascular-free transfer, which sometimes may be needed to cover the exposed vessels, bones, tendons, and cartilages whenever the neighboring skin and subcutaneous tissue are inadequate or demised. In these circumstances, pedicled regional flaps of muscular or musculocutaneous consistency (especially if a bulk or rich vascular tissue is needed) would be an alternative.

The results of surgical repair of sciatic nerve injuries.

Objectives: The aim of this study was to evaluate surgical treatment and follow-up results of patients who presented to our department with sciatic nerve injuries.

Methods: The study included 13 patients (12 males, 1 female; mean age 23 years; range 11 to 35 years) who underwent surgical treatment for sciatic nerve injuries. The etiologies of sciatic nerve injuries were penetrating trauma in five patients, firearm injuries in four patients, and motor vehicle accidents in four patients.

Hemifacial resurfacing with prefabricated induced expanded supraclavicular skin flap.

Background: Severe facial burn sequelae present a great challenge and maximally test the principles of reconstructive surgery. Three of these basic principles--free tissue transfer, flap prefabrication, and tissue expansion--are combined to achieve superior reconstructive outcomes. This approach evolved into the prefabricated induced expanded flap, which refers to the staged transfer of expanded supraclavicular skin with an antebrachial fascial free flap used as the carrier.

Backup perforator flap derived from a previously transferred musculocutaneous free flap.

Introduction: Reconstruction of the lower leg commonly requires a free tissue transfer after Gustillo grade IIIB-IIIC injuries and severe postoncological resections, where, free musculocutaneous flaps (MCF) are preferred for their size and robust blood supply. The anastomoses are performed at more proximal levels to keep them away from the trauma zone. This reasonable maneuver causes the distal of the flap to cover the most critical part of the defect.

Comparison of primary and secondary lower-extremity lymphedema treated with supermicrosurgical lymphaticovenous anastomosis and lymphaticovenous implantation.

Although some authors previously stated that microlymphatic surgery does not have application to primary lymphedema, opposite views are reported based on the observations that the lymphatics were not hypoplastic in majority of these patients and microlymphatic surgery yielded significant improvement. The aim of this study was to compare the intraoperative findings and outcomes of primary and secondary lower-extremity lymphedema cases treated with lymphaticovenous shunts. Between December 2006 and April 2009, microlymphatic surgery was performed in 80 lower extremities with primary and 21 with secondary lymphedema.

Supermicrosurgical lymphaticovenular anastomosis and lymphaticovenous implantation for treatment of unilateral lower extremity lymphedema.

Recent supermicrosurgical techniques have developed the possibility for vascular anastomosis of smaller vessels and it is now safe and sound to perform precise anastomoses between lymphatics and venules. Reported here is the 2 years experience on supermicrosurgical lymphaticovenular anastomosis and/or lymphaticovenous implantation combined with a nonoperative physical therapy for treatment of lower extremity lymphedema. Microlymphatic surgery was performed in 42 patients with unilateral lower extremity lymphedema.

Fat embolism syndrome after lower extremity replantation associated with tibia fracture: case report.

We report a patient who was diagnosed as fat embolism syndrome after replantation surgery of left amputated foot. This diagnosis was based on the presence of a long bone fracture with an amputation of a major extremity, supported by the signs of pulmonary and cerebral dysfunction and confirmed by the demonstration of arterial hypoxemia in the absence of other disorders.

Association of vascular injury with the proximal side branch and assessment of thrombosis rates in a new microarterial traction model.

The higher rate of anastomotic failure in avulsion injuries has been attributed mostly to the uncertainty in determining the uninjured vessel segment suitable for anastomosis and resection past a proximal branch that has been proposed to achieve good arterial flow. A graded, longitudinal, microarterial traction model in rats has been used to examine the histopathologic aspects of the extent of vascular injury and its association with the proximal side branch. Additionally, anastomoses were performed following traction, and thromboses rates were determined.

Use of free serratus anterior muscle slips for the reconstruction of dorsal-side defects of the hand resulting from hot press injury.

Mutilation of the hand as a result of hot press injury, the common characteristics of which are extensive soft tissue and extensor tendon loss, metacarpal and phalangeal necrosis, exposition of multiple joints, and infection, presents a serious challenge to the hand surgeon. Free transfer of the inferior three slips of the serratus anterior muscle is a useful surgical option for the reconstruction of dorsal-side defects in the hand. The versatility of the three separate slips, which are easily divisible for contouring, enables individual reconstruction of the different digits.

[Single-stage flexor tendoplasty in the treatment of flexor tendon injuries].

Objectives: We evaluated tendon reconstruction with one-stage tendon grafting in flexor tendon injuries in which primary repair was not considered because of delay in treatment or of inappropriate circumstances on the part of the wound and the patient.

Methods: Thirty-seven patients (29 males, 8 females; mean age 20.5 years; range 4 to 52 years) underwent single-stage flexor tendoplasty involving 41 fingers.

[Flexor tendoplasty with a tendon prosthesis for zone II flexor tendon injuries].

Objectives: We evaluated two-staged flexor tendoplasty with tendon prosthesis in patients with flexor tendon injuries in which conventional tendon grafting would fail to yield an acceptable result.

Methods: We performed flexor tendoplasty with tendon prosthesis in 37 hands of 31 patients (24 males, 7 females; mean age 23 years; range 4-46 years). Twenty-six patients had penetrating injuries, four had occupational injuries, and one patient had an electric burn.

Effect of torsion on microvenous anastomotic patency in a rat model and early thrombolytic phenomenon.

Torsion at the microanastomosis site is a basic fault and should be avoided. In this study, we investigate the effects of different degrees of microvenous torsion on patency and its physical changes on anastomoses in a rat model. One hundred anastomoses were performed at different degrees of torsion, using femoral veins of Sprague-Dawley rats.

Effect of torsion on microarterial anastomosis patency.

All kinds of technical faults must be prevented in microvascular anastomosis for successful reconstructive microsurgery. Torsion at the anastomosis site is one of the most basic technical errors. In this study, we investigate the effect of different degrees of microarterial torsion on patency and its physical changes on anastomosis in a rat model.

"Extracorporeal loop" (blind loop): an alternative microsurgical technique for prelaminated flap transfer.

Free tissue transfer is frequently used for reconstruction in the head and neck region. In patients who suffer tissue loss due to a high-energy trauma, the reconstructive surgeon is often faced with a large gap between the defect and the site of anastomosis outside the zone of injury. Utilization of long vein grafts for reestablishment of blood flow to the transferred tissue vessels is a common procedure.