Reconstruction of soft tissue defects around the Achilles region with distally based extended peroneal artery perforator flap.

Introduction: Achilles tendon rupture and soft tissue infections with wound dehiscence and tendon exposure following the tendon repair are not infrequent. Various procedures have been described for the reconstruction of soft tissue defects at the Achilles tendon region, yet there is lack of consensus on the ideal method. In this article we report our experience using the distally based peroneal artery perforator flap in reconstruction of combined defects of the Achilles tendon and overlying soft tissue.

Nipple-Sparing Mastectomy and Immediate Implant-Based Reconstruction with or Without Skin Reduction in Patients with Large Ptotic Breasts: A Case-Matched Analysis.

Background: Nipple-sparing mastectomy (NSM) and implant-based immediate breast reconstruction are becoming preferred options with improved outcomes. However, reconstruction in patients with large and ptotic breasts is challenging. When mastectomy and skin reduction are combined in a single-staged procedure, the vasculature of the skin is disturbed leading to increased complication rates.

Factors Associated With Complications in Immediate Breast Reconstruction in 1 Stage With Completely Submuscular Implants.

Background: Immediate breast reconstruction in 1 stage using permanent implants is gaining popularity and can be performed with or without the use of acellular dermal matrices. This study aimed to investigate the results of breast implants placed submuscularly without acellular dermal matrix and assess the factors affecting surgical complications.

Methods: From November 2009 to March 2018, 138 patients underwent immediate breast reconstruction with permanent submuscular implants after concomitant skin-sparing or nipple-sparing mastectomies in a single institution.

Reconstruction of extensive scalp defects with anterolateral thigh flap.

Background: Extensive scalp defects caused by various etiologies often require free-tissue transfer. We aimed to review our experience in the reconstruction of extensive scalp defects with free anterolateral flaps.

Methods: A retrospective analysis was performed on all patients with extensive scalp defects that were reconstructed with free anterolateral thigh flaps from November 2007 to April 2015.

The satisfaction of patients with breast cancer undergone immediate reconstruction with implant and the effect of radiotherapy.

Aim Of The Study: Postmastectomy reconstructive surgery for cosmetic satisfaction of patients is rapidly increasing. Postoperative complications such as infection, capsular contracture, implant loss are more common in patients who receive adjuvant radiotherapy (RT) than those who do not. Satisfaction levels in patients is still a controversial issue.

Risk Factor Analysis for Survival of Becker-Type Expander in Immediate Breast Reconstruction.

Background: Breast reconstruction with a Becker-type expander is a common technique following mastectomy. However, inconsistency remains in the literature regarding risk factors for the survival of a Becker-type expander following immediate breast reconstruction. This study's purpose is to investigate possible risk factors for the Becker-type expander survival and to evaluate the complications related to expander removal following immediate breast reconstruction.

A Simple Flap Design for the Salvage of Immediate Implant-Based Breast Reconstruction.

Background: Breast reconstruction with implants is a real challenge in patients with large breast volume. Skin-reducing inverted-T mastectomy is the best solution for these patients. Delayed wound healing or necrosis at the T-junction area can be seen in this procedure, although it may also lead to severe conditions such as the exposure and loss of implant.

The repair of complex penile defect with composite anterolateral thigh and vascularized fascia lata flap.

One-stage reconstruction of complex penile defects with functional and cosmetic results is a challenging procedure. The selection of proper technique and materials for reconstruction depends on the type of the deficient tissue components, the size of the wound surface, and the donor site. This article presented a case of a partial penile and urethral defect due to an infection in the previous surgical site.

Selection of recipient vessel in traumatic lower extremity.

The main focus of this paper is the selection of proper vessels for successful free tissue transfer in lower extremities which have suffered extensive trauma. The selection of proper recipient vessels for traumatized lower extremities still presents difficulties for surgeons. This review will provide a general guideline for the selection of proper recipient vessels in traumatic lower extremity reconstruction and describe the possible reasons why some recipient vessels present more problems than others.

Onlay bone grafts in head and neck reconstruction.

BONE GRAFTS ARE USED IN A VARIETY OF CLINICAL SITUATIONS AND CAN BE DIVIDED INTO TWO CATEGORIES: treatment of bone gaps (inlay bone grafting) and bone projection (onlay bone grafting). Cortical grafts are useful in situations requiring immediate mechanical strength. These grafts can survive with or without complete revascularization or resorption and are primarily used by plastic surgeons in the treatment of bone volume deficiency.

Functional reconstruction in large and complex soft tissue defects of forearm and hand with multifunctional anterolateral thigh flap.

Objectives: The aim of this study was to evaluate the results of free anterolateral thigh (ALT) flap reconstruction for large and complex soft tissue defects of forearm and hand.

Patients And Methods: Thirteen patients (11 males, 2 females; mean age 32.5 years; range 18 to 55 years) underwent free ALT flap reconstruction for forearm and hand defects.

Tissue plug technique for management of large chronic empyema defects and bronchopleural fistulas.

After multiple thoracotomies, local muscles are often transected or sacrificed for the treatment of intrathoracic infection. In these conditions, free tissue transfers are described as an alternative. Five anterolateral thigh musculocutaneous free flaps were used for the treatment of complicated large chronic empyema defects and bronchopleural fistulas with a special flap inset and gauze-packing method, the so-called tissue plug technique.

Assessment of fibula osteoseptocutaneous flap donor-site morbidity using balance and gait test.

To assess the functional deficits in gait and balance after fibular osteoseptocutaneous flap harvest, a case-control study in a hospital-based biomechanical laboratory was conducted. Eleven patients receiving fibula osteoseptocutaneous flaps were enrolled as study group and 10 age-matched and healthy subjects as a control group. The average postoperative period at the time of evaluation was 27.

Augmentation of venous drainage by a venous anastomosis for pedicled flaps.

Recently several studies have addressed the venous problem and confirmed that venous ischemia is more injurious to tissue viability than arterial ischemia of equivalent duration. There are different methods of managing venous-compromised pedicled flaps. Between June 1996 and November 2003, our center treated two submental, five Becker, nine posterior interosseous, three distally based sural, and three colon pedicled flaps (22 flaps in total), which had venous congestion either at the time of flap elevation or immediately after inset of the flap.

The use of free flaps in the management of type IIIB open calcaneal fractures.

Background: There have been a limited number of reports regarding calcaneal open fractures so far. Thus, the debate regarding treatment is continuing. Type IIIB open calcaneal fractures are often associated with the possibility of chronic osteomyelitis that may cause severe complications, including amputation.

Safety and reliability of microsurgical free tissue transfers in paediatric head and neck reconstruction--a report of 72 cases.

Although many large series of free tissue transfers for head and neck reconstruction have been reported in adults, there are few studies in paediatric patients. Seventy-three free tissue transfers for reconstruction of various defects of the head and neck were performed in 72 paediatric patients between January 1990 and September 2002, at our centre. The average age at the time of reconstruction was 11.

Demonstration of circulation haemodynamics in random pattern thinned skin flap (an experimental study).

Background: Clinical applications and indications of the thin skin flap have been widely documented but its circulation haemodynamics are still controversial. An experiment was conducted on pigs to show the survival and circulation haemodynamics of random pattern thinned skin flap.

Methods: Group I: Random pattern standard skin flaps; 5 x 5 cm (n=20 flaps), and 5 x 10 cm (n=20 flaps).

Reverse-flow retroauricular island flap in facial reconstruction.

Background: Reconstruction of facial skin defects requires good-quality skin cover to satisfy aesthetic expectations of patient, especially when the skin defect is on the uncovered area of the face. Limitations in the available local tissue and donor-site morbidity restrict the options.

Objective: In an effort to solve these problems, we have begun to use a subcutaneous pedicled retroauricular reverse-flow flap.

Selection of recipient vessels in microsurgical free tissue reconstruction of head and neck defects.

The development of microsurgical techniques has facilitated proper management of extensive head and neck defects and deformities. Bone or soft tissue can be selected to permit reconstruction with functional and aesthetic results. However, for free tissue transfer to be successful, proper selection of recipient vessels is as essential as the many other factors that affect the final result.

Does random pattern skin flap supply adequate circulation to the underlying muscle through musculocutaneous perforators by reverse flow? An experimental study.

An experimental study was designed to examine whether the blood supply of the muscle would be maintained by a reverse flow from the random pattern skin flap through the musculocutaneous perforators. A flap model containing rat rectus abdominis muscle and randomly based overlying abdominal skin was designed. Sixty rats were divided into four experimental groups as follows.

Prefabrication of the free fibula osteocutaneous flap to create a functional human penis using a controlled fistula method.

Neophalloplasty remains one of the most challenging efforts in plastic and reconstructive surgery. The complex functional and aesthetic requirements are difficult to attain with consistency and safety. The current gold standard technique involves the use of a radial forearm tube-in-tube free flap, which also requires the placement of a stiffening prosthetic device for dual function.

Outcome comparison between free muscle and free fasciocutaneous flaps for reconstruction of distal third and ankle traumatic open tibial fractures.

Background: The advantages of free muscle flaps for reconstruction of lower extremity defects have been largely reported to be superior to those of fasciocutaneous flaps.

Methods: One hundred seventy-four patients received 177 microsurgical free tissue transfers for distal third and ankle open tibial fractures. Patients were divided into two groups.