The superior lateral genicular artery flap for soft-tissue reconstruction around the knee: clinical experience and review of the literature.

Soft-tissue reconstruction in the knee area needs thin, pliable, and tough skin. The availability of local soft tissue, which would meet the requirements best, is limited. This study is a retrospective analysis of our clinical experience with the superior lateral genicular artery (SLGA) flap for soft-tissue reconstruction around the knee, and a review of the relevant literature.

Linezolid concentrations in infected soft tissue and bone following repetitive doses in diabetic patients with bacterial foot infections.

The present study aimed at assessing unbound extracellular concentrations of linezolid in inflamed soft tissue and bone of diabetic patients suffering from severe bacterial foot infections. Linezolid was administered intravenously twice daily at a dosage of 600 mg. At steady-state conditions, the microdialysis technique was utilised to sample serially interstitial space fluid from inflamed subcutaneous adipose tissue and metatarsal bone from 0-8h post dose in three representative patients.

Soft tissue and bone penetration abilities of daptomycin in diabetic patients with bacterial foot infections.

Objectives: In the attempt to overcome increasing glycopeptide- and methicillin-resistant soft tissue infections, daptomycin is presently considered as an attractive alternative to the class of glycopeptides. However, daptomycin dosing and its ability to penetrate into inflamed target tissues are still a matter of controversy. Thus, in the present investigation, we set out to evaluate daptomycin's ability to penetrate into inflamed subcutaneous adipose tissue and bone in diabetic patients presenting with severe bacterial foot infection.

Management of an unfortunate triad after breast reconstruction: pyoderma gangrenosum, full-thickness chest wall defect and Acinetobacter Baumannii Infection.

If diagnosed late, post-surgical pyoderma gangrenosum (PSPG) is a rare, tricky and potentially life-threatening complication. Once diagnosed, immunosuppressive agents may provoke further complications. Well-intentioned extensive serial debridement may cause deep skin and soft-tissue defects, requiring skin grafting and possible flap surgery.

High fosfomycin concentrations in bone and peripheral soft tissue in diabetic patients presenting with bacterial foot infection.

Objectives: Appropriate antimicrobial therapy and surgical intervention may be required in diabetic patients presenting with severe bacterial foot infection. Methicillin-resistant Staphylococcus aureus (MRSA) agents such as fosfomycin are increasingly in demand because of recent concern regarding vancomycin and daptomycin efficacy and constant use. Intravenous fosfomycin is approved for the therapy of severe soft tissue infections and is highly active against methicillin-susceptible S.

The vascular anatomy of the tensor fasciae latae perforator flap.

Background: The purpose of this study was to differentiate between musculocutaneous and septocutaneous perforators of the tensor fasciae latae perforator flap; to evaluate their number, size, and location; and to provide landmarks to facilitate flap dissection. An additional injection study estimated the skin area of the flap.

Methods: The anatomical study was performed on 23 fixed and injected cadavers.

[Clinical experiences using the Versajet system in burns: indications and applications].

Early debridement and early skin grafting are the "Gold standard" in the surgical treatment of burns. There are different debridement methods available. Concerning the treatment of burns, surgical-sharp debridement, laser ablation and hydrosurgery system are used.

Extended reverse dorsal metacarpal artery flap: clinical experience and donor site morbidity.

Extended reverse dorsal metacarpal artery (RDMA) flaps use the skin from the dorsum of the hand to cover defects of the long fingers up to the distal phalanx. The authors present a series of 12 patients who underwent closure of defects of the long fingers with these flaps. As relevant literature is scarce, special emphasis was put on donor site morbidity.

Reconstructive potential of the lateral arm flap after tumor resection.

The reconstruction of extended tumor-related defects in different anatomic regions requires a versatile and reliable flap. For many surgeons, the lateral arm flap has become the technique of choice in the reconstruction of small- to medium-sized defects. The aim of this study was to analyze the reconstructive potential of the lateral arm flap after cancer ablation in various indications.

Surgical management of extensive gnathophyma.

Rhinophyma is an uncommon disease of the nose characterized by irregular skin thickening and nodular deformation. The extensive growth causing 'whisky nose' is due to hyperplasia of the sebaceous glands and the surrounding connective tissue. Other facial regions may concomitantly be affected.

[Severing of the tibial nerve with stripping of the lesser saphenous vein--a rare complication of surgery for varicosity].

Neurological complications are rare with surgery for varicosities and usually involve the saphenous, peroneal, or sural nerve. When the saphenous vein is stripped in the popliteal region, there is danger of tibial nerve injury due to the topographic situation. We report a serious complication involving an iatrogenic extended lesion of the tibial nerve in the popliteal fossa that occurred in the course of a crossectomy and exeresis of the lesser saphenous vein.

Donor site morbidity in cross-finger flaps.

As relevant literature is scarce, this study was undertaken to assess the donor site morbidity of cross-finger flaps. It included 23 patients who had undergone reconstruction of a finger defect with a cross-finger flap. Any additional trauma to the donor finger was an exclusion criterion.

The posterior interosseous artery in the distal part of the forearm. Is the term "recurrent branch of the anterior interosseous artery" justified?

In 1993 Angrigiani raised the question as to whether the distal part of the posterior interosseous artery (AIP) is a recurrent branch of the anterior interosseous artery (AIA) and forms a "choke"--anastomosis with the AIP in the middle of the forearm. A dissection study was conducted on 66 upper extremities to evaluate the diameters of the dorsal branch of the anterior interosseous artery, the anastomotic branch, the diameter of the posterior interosseous artery at the point of origin of the septocutaneous perforators in the middle of the forearm and the diameter of the posterior interosseous artery at the point of emergence in the dorsal compartment. We further tried to identify different forms and types of the "distal" anastomosis and the connections to the dorsal carpal arch and the ulnar artery.

The treatment of painful neuroma on the lower extremity by resection and nerve stump transplantation into a vein.

Lower extremity neuroma resection with nerve stump transposition into a vein was employed in eight patients (five male, three female). The neuromas resulted from amputations (four patients), vein stripping procedures (two patients), tumor resection, and toe-harvest for thumb reconstruction. Follow-up averaged 17 months (range, 8-37).

Verrucous carcinoma of the skin: long-term follow-up results following surgical therapy.

Background: Owing to the benign appearance and slow growth of verrucous carcinoma of the skin, its diagnosis and therapeutic management still pose problems.

Objective: This study was undertaken to point out clinical and histopathologic features of verrucous carcinoma of the skin and to provide diagnostic and therapeutic guidelines on the basis of the long-term results from 20 patients.

Methods: A retrospective study of the long-term results of 20 patients treated surgically for verrucous carcinoma of the skin is presented.

[The impact of the VAC-treatment for locally advanced malignancy of the scalp].

Locally advanced cutaneous malignancy of the scalp is a disease that requires an aggressive approach to resection and reconstruction. In cases where the pericranium is intact a split-thickness skin graft is a simple treatment, since direct closure often fails because due to the lack of elasticity of the scalp. If there is a loss of periosteum or a skull defect local or free flaps are necessary for sufficient coverage.

The lower trapezius musculocutaneous flap from pedicled to free flap: anatomical basis and clinical applications based on the dorsal scapular artery.

The pedicled lower trapezius musculocutaneous flap is a standard flap in head and neck reconstruction. A review of the literature showed that there is no uniform nomenclature for the branches of the subclavian artery and the vessels supplying the trapezius muscle and that the different opinions on the vessels supplying this flap lead to confusion and technical problems when this flap is harvested. This article attempts to clarify the anatomical nomenclature, to describe exactly how the flap is planned and harvested, and to discuss the clinical relevance of this flap as an island or free flap.

Clinical application of the retrograde arterialized venous flap.

Retrograde arterialized venous flaps were applied to skin and soft-tissue defects in 13 patients with an average age of 34.4 years. Ten defects were located on the hand, and three on the lower leg.

Defects on the dorsum of the hand--the posterior interosseous flap and its alternatives.

There are conditions that preclude the use of the posterior interosseous flap for reconstruction of the dorsum of the hand. Based on a series of 34 cases, these conditions are outlined and alternative solutions discussed. The posterior interosseous flap was employed for closure in 30 cases.

Necrotizing fasciitis after ambulatory phlebectomy performed with use of tumescent anesthesia.

The high cost of treatment of varicose veins has an important role in public health care. The search for a less expensive and office-based procedure led to introduction of tumescent local anesthesia for use in ambulatory phlebectomy. Although the overall infection rate is low, severe infection has been reported after liposuction with tumescent anesthesia.