Free Bipedicled Radial Forearm and Posterior Interosseous Artery Perforator Flap Phalloplasty.

Introduction: The free radial forearm (FRFA) flap is universally still considered as the gold standard technique in penile reconstruction. Typically, a considerably large flap is required, often involving almost the entire circumference of the forearm. Partial necrosis may occur at the distal-most (dorsoradial) part of the flap as a result of insufficient perfusion.

Free flaps for lower limb soft tissue reconstruction in children: Systematic review.

Background: Since the first reports on microsurgery in children, there has been an evolution in the reconstruction of soft tissue defects as evidenced by a shift to free flaps as the first-line treatment.

Methods: The primary objective of this systematic review was to compare the complication rate of free perforator/fasciocutaneous flaps with free muscular/myocutaneous flaps in pediatric lower limb soft tissue reconstructions. The secondary objective was to evaluate the frequency and severity of complications for both reconstructive options.

Creation of Clitoral Hood and Labia Minora in Penile Inversion Vaginoplasty in Circumcised and Uncircumcised Transwomen.

Gender dysphoria, the incongruence between anatomical sex and gender identity, is estimated to affect 1 percent of the population. Creation of a feminine vulva with labia minora remains a technical challenge for surgeons, especially in circumcised patients. The authors present the technique developed by the senior author (S.

A New Technique for Coronaplasty in Penile Reconstruction.

Background: The coronaplasty is an important step of the phalloplasty procedure as it creates a prominent coronal ridge and a constricted coronal sulcus, resulting in the transformation of a regular skin flap into a flap resembling a circumcised penis.

Aim: The aim of this article is to describe our new coronaplasty technique that exploits opposing contracting forces of 2 different skin grafts to hold the shape of a thick, distally based skin flap, resulting in a natural looking neo-phallus.

Methods: A distally based flap is raised at the junction of the middle and distal thirds of the neo-phallus.

A simple concept for covering pressure sores: wound edge-based propeller perforator flap.

We present a new surgical modification to allow propeller perforator flaps to cover pressure sores at various locations. We used a propeller perforator flap concept based on the detection of newly formed perforator vessels located 1 cm from the wound margin and stimulated by the chronic inflammation process. Between January 2009 and January 2017, 33 wound edge-based propeller perforator flaps were used to cover pressure sores at various locations in 28 patients.

Lumbar artery perforators: an anatomical study based on computed tomographic angiography imaging.

Background: The free lumbar artery perforator flap has recently been introduced as a potentially valuable option for autologous breast reconstruction in a subset of patients. Up to date, few anatomical studies, exploring the lumbar region as a donor site for perforator- based flaps, have been conducted.

Methods: An anatomical study of the position of the dominant lumbar artery perforator was performed, using the preoperative computed tomographic angiography images of 24 autologous breast reconstruction patients.

Composite breast reconstruction: Implant-based breast reconstruction with adjunctive lipofilling.

Introduction: Options for breast reconstructions enclose autologous tissue transfers or implants. Fat grafting is gaining more interest in this specific field of breast surgery. This study concentrates on the technique and aesthetic results of breast reconstruction with fat grafts combined with implants, in women who have undergone total mastectomy.

Intratissular expansion-mediated, serial fat grafting: A step-by-step working algorithm to achieve 3D biological harmony in autologous breast reconstruction.

Background: Breast reconstruction involves the use of autologous tissues or implants. Occasionally, microsurgical reconstruction is not an option because of insufficient donor tissues. Fat grafting has become increasingly popular in breast surgery.

Imaging Features of Hypertrophic Olivary Degeneration.

Hypertrophic olivary degeneration (HOD) is a unique form of transneuronal degeneration caused by a disruption of the dentato-rubro-olivary pathway, also known as the triangle of Guillain-Mollaret. The triangle of Guillain-Mollaret is involved in fine voluntary motor control and consists of both the inferior olivary nucleus and the red nucleus on one side and the contralateral dentate nucleus. Clinically, patients classically present with symptomatic palatal myoclonus.

Central mesh failure after laparoscopic IPOM procedure.

Central mesh failure after laparoscopic repair of a ventral hernia is a rare finding. We present a case of a 42-year-old man with clear umbilical hernia recurrence 4 years after IPOM procedure with an oxidized cellulose composite polypropylene mesh, using the double crown technique. Laparoscopy showed that a segment of small intestine herniated through a central defect in the prosthesis.

Anti-N-methyl-D-aspartate (anti-NMDA) receptor antibody encephalitis in a male adolescent with a large mediastinal teratoma.

We present a case of a 16-year-old boy with Klinefelter syndrome who presented with a syndrome of impaired alertness, orofacial dyskinesias, choreiform movements, epileptic seizures, and autonomic instability, pointing to a diagnosis of anti-N-methyl-Daspartate (anti-NMDA) receptor antibody encephalitis.

[A woman with a swelling in the groin].

A 75-years-old woman presented to the Emergency Department with a painfull swelling in the right groin. Clinical examination was suggestive of an incarcerated hernia. Echography and examination during surgery revealed an Amyand's hernia.

The use of platelet-rich plasma in plastic surgery: a systematic review.

Objective: The study's aim was to evaluate the available evidence regarding the use of platelet-rich plasma in plastic and reconstructive surgery, through implementation of a systematic review of the literature.

Data Sources: PubMed and The Cochrane Library were searched using MeSH terms: 'platelet rich plasma' and 'plastic surgery' for all publications up to July 2011. All English, German, French and Dutch papers were included.

Classification of primary and incisional abdominal wall hernias.

Purpose: A classification for primary and incisional abdominal wall hernias is needed to allow comparison of publications and future studies on these hernias. It is important to know whether the populations described in different studies are comparable.

Methods: Several members of the EHS board and some invitees gathered for 2 days to discuss the development of an EHS classification for primary and incisional abdominal wall hernias.

The preperitoneal memory-ring patch for inguinal hernia: a prospective multicentric feasibility study.

Purpose: To evaluate the feasibility, the reproducibility, the safety and the efficacy of a recently introduced preperitoneal memory-ring patch (Polysoft, Davol Inc., C.R.

Tailgut cysts: rare retrorectal tumours.

Two patients presented with tailgut cysts. The first patient complained of pain and pressure in the sacrococcygeal region. The second patient had developed a cystic mass superficial to the coccyx.

Caecostomy in the management of acute left colonic obstruction.

In the management of acute left colonic obstruction there is a tendency to perform immediate resection with anastomosis. We evaluated 27 consecutive patients (mean age 73.8 years) with acute left colonic obstruction and gross dilatation of the proximal colon treated by the "traditional" staged procedure.

Stenosis development at the distal anastomosis of prosthetic bypasses for aortoiliac occlusive disease. Incidence and accuracy of colour flow duplex in the diagnosis.

When bypasses for aortoiliac occlusive disease fail they often do so because of a stenosis at the distal anastomosis. To assess the incidence of stenotic lesions and to establish the diagnostic reliability of colour-flow Duplex scanning, we investigated 103 aortoiliac and aortofemoral bypasses using intravenous (i.v.

Color-flow duplex criteria for grading stenosis in infrainguinal vein grafts.

Color-flow duplex scanning of infrainguinal vein bypasses was used to identify failing grafts. Several duplex parameters were compared to determine their value in identifying and quantifying the degree of stenosis. Intraarterial digital subtraction angiography was used as the "gold standard" to determine the severity of the stenosis.

[Results of bypass surgery for imperiled leg].

Femoropopliteal and crural bypass operations are performed frequently, but the results of operations for intermittent claudication and severe ischaemia are often reported jointly. However, the importance of the latter category for the quality of life is of a different order, so that its results should be studied separately. In a period of over eight years 199 bypass operation were performed.

Long-term behaviour of modified human umbilical vein grafts; late aneurysmal degeneration established by colour-duplex scanning.

To define long-term results of modified human umbilical vein (MHUV) grafts a retrospective study was undertaken, and in addition the incidence of aneurysmal degeneration was investigated by Colour-Duplex scanning. From July 1979 until December 1986, 227 MHUV grafts were implanted in 181 patients (204 limbs). The operative indication was claudication in 110 limbs and ischaemic rest pain or gangrene in 94 limbs.