Fournier's gangrene secondary to intra-abdominal processes.

We report 2 cases of necrotizing fasciitis of the perineum, perianal area, and male genitalia (Fournier's gangrene) that arose secondary to intra-abdominal infectious processes (ruptured appendicitis and diverticulitis). Management consisted of immediate debridement of necrotic tissue, exploratory laparotomy, and diverting colostomy. The presence of an acute abdominal process was not immediately evident on initial evaluation of either patient.

Rigid internal fixation of the sternum in postoperative mediastinitis.

Objective: The current standard treatment of mediastinitis following median sternotomy is radical sternal débridement and obliteration of anterior mediastinal dead space with muscle or omental flaps. This report describes and reviews our experiences with a new technique of sternal salvage based on osseous quantitative bacteriologic assessment and rigid fixation in patients with postoperative mediastinitis.

Design: A retrospective review of 29 patients treated with sternal rigid internal fixation.

Improved venous drainage of the radial artery forearm free flap: use of the profundus cubitalis vein.

The radial artery forearm free flap (RAFFF) is a versatile and popular flap used in various reconstructive procedures. This flap contains two venous drainage systems: a superficial (cephalic) route, and a deep (venae comitantes) route. Most surgeons use either the deep venous system alone or in combination with a superficial vessel, hence requiring two venous anastomoses.

Measurement of impotence by laser Doppler flowmetry and conventional methodology.

The problem of vasculogenic impotence was evaluated by laser Doppler flowmetry with the LD5000 capillary perfusion monitor to determine cutaneous penile blood flow in 25 men defined previously as impotent by Doppler ultrasound with penile brachial ratios of 0.63 +/- 0.14.