Treatment of Advanced Male Genital Lymphedema With a Complete Functional Lymphatic System Pedicled Transfer.

Objective: To evaluate the functional efficacy of the superficial circumflex iliac artery perforator (SCIP) -lymphatic pedicled flap in the treatment of advanced male genital lymphedema.

Methods: From February 2018 to January 2022, we treated 26 male patients with scrotal and penoscrotal advanced lymphedema using reconstructive lymphatic surgery. Isolated scrotal involvement was seen in 15 patients, and 11 patients had penoscrotal involvement.

The Fate of Sensation in Noninnervated Perforator Free Flaps in the Lower Extremity.

Background: The recovery of sensation for noninnervated perforator flaps is not well understood. This prospective study aims to evaluate the quality, tendency, and related factors for recovery of sensation.

Methods: A total of 187 patients over a 6-year period were evaluated at intervals of 3, 6, 12, and +24 months for demographic data and sensory tests [Semmes-Weinstein (SW) monofilament test, static two-point discrimination, temperature, and pain] on peripheral and central regions of the flap.

The durability of thin superficial circumflex iliac artery perforator flap in sole reconstruction: Clinical experience with 18 cases.

Background: The superficial circumflex iliac artery perforator flap's overall success in the reconstruction of the lower limb has been acceptable, but the sole of the foot remains more challenging. The purpose of this article is to report our experience employing the SCIP flap and evaluate its durability in reconstructing different units of the foot's sole, heel, middle, and forefoot.

Patients And Methods: This retrospective study reviewed 18 patients with sole defect reconstructed with free SCIP flap from 2017 to 2019.

Are Perforators Reliable as Recipient Arteries in Lower Extremity Reconstruction? Analysis of 423 Free Perforator Flaps.

Background: Perforator flaps have revolutionized lower limb reconstruction by offering single-stage thin, pliable coverage with an excellent aesthetic match. Although anastomosis of the flap to a major artery remains the gold standard, perforator-to-perforator anastomosis has several advantages, including expedient recipient dissection and increased recipient options in vessel-depleted extremities. The aim of this study was to compare flap survival when a perforator or major artery was used as a recipient vessel.

Reverse Lymph Node Mapping Using Indocyanine Green Lymphography: A Step Forward in Minimizing Donor-Site Morbidity in Vascularized Lymph Node Transfer.

Background: Reverse lymphatic mapping before harvesting a lymph node flap is crucial to avoid donor-site lymphedema; however, the technique is complex and unavailable in many centers. The authors introduce radioisotope-free reverse lymphatic mapping using indocyanine green and Patent Blue dye.

Methods: The authors conducted a prospective study in patients undergoing free vascularized groin lymph node transfer for postmastectomy upper extremity lymphedema.

Treatment of secondary scrotal and lower extremity lymphedema using combined pedicled lymph node transfer and lymphaticovenous anastomosis: A case report.

Combined secondary scrotal and lower extremity lymphedema is an infrequent complication of radical excision of urogenital cancers associated with pelvic lymphadenectomy. Scrotal lymphedema is usually psychologically distressing, and difficult to treat. We report a case of a 41-years old male who presented with scrotal and left lower extremity lymphedema after radical prostatectomy and pelvic lymphadenectomy successfully treated with pedicled superficial inguinal lymph node (SILN) transfer and lymphaticovenous anastomosis (LVA) restoring the lymphatic drainage.

3D printing guided surgery in the treatment of unicoronal craniosynostosis orbital dysmorphology.

Purpose: The purpose of our study was to improve the minor asymmetries of fronto-orbital advancement (FOA) by introducing a simple model to guide the FOA in unicoronal synostosis which may help saving time and cost.

Methods: A retrospective analysis of 16 consecutive patients with unicoronal synostosis corrected by FOA guided by a guide model. Patients with syndromic craniosynostosis or associated craniofacial anomalies were excluded from the analysis.

Two Abnormal Cell Lines of Trisomy 14 and t(X;14) with Skewed X-Inactivation.

Trisomy 14 is incompatible with live, but there are several patients reported with mosaic trisomy 14. We aimed to study the pattern of X inactivation and its effect on a translocated autosome and to find out an explanation of the involvement of chromosome 14 in 2 different structural chromosomal abnormalities. We report on a girl with frontal bossing, hypertelorism, low-set ears, micrognathia, cleft palate, congenital heart disease, and abnormal skin pigmentations.

Effect of Simvastatin Use in Free Tissue Transfer: An Experimental Study in a Rat Epigastric Free Flap Model.

Background:  Statins are traditionally used in lowering cholesterol and low-density lipoprotein biosynthesis, but recent reports show their beneficial effect on microcirculation. The aim of this study was to investigate the effect of simvastatin on the microcirculation and in conjunction with aspirin in a rat free epigastric flap model.

Methods:  Thirty-six Sprague-Dawley rats were divided into group A (control,  = 12), group B (simvastatin treated,  = 12), and group C (simvastatin and aspirin,  = 12).

Correlation between superficial and deep lymphatic systems using magnetic resonance lymphangiography in breast cancer-related lymphedema: Clinical implications.

Background: Magnetic resonance lymphangiography (MRL) has increased our knowledge of lymphatic anatomy and lymphedema pathophysiology and improved the efficacy of microsurgical procedures to manage peripheral lymphedema. The aim of this study is to investigate the ability of MRL to detect communications between superficial and deep lymphatic systems in breast cancer-related lymphedema (BRCL) and to investigate whether these communications could preserve lymphatic drainage of the hand.

Methods: Between 2008 and 2017 we used MRL imaging in 59 women with BCRL.

Algorithm for Free Perforator Flap Selection in Lower Extremity Reconstruction Based on 563 Cases.

Background: Microsurgical lower extremity reconstruction remains a challenge. The use of perforator flaps in lower extremity reconstruction is expanding. The authors present an algorithm to guide in the selection of the ideal free perforator flap that can be tailored to each lower extremity defect.

Bone Transport Distraction Osteogenesis in the Reconstruction of Pediatric Posttraumatic Calvarial Defects.

Reconstruction of posttraumatic calvarial bone defects in pediatric patients is a challenge due to the growing brain and limited autogenous bone supply. Traditional techniques such as split calvarial and particulate bone grafts are associated with prolonged operative time and significant blood loss, which is a major concern in children under the age of 3 years. Bone transport distraction osteogenesis has proven efficacy and safety in the reconstruction of other craniofacial deformities.

Extended Bifurcated Superficial Temporal Artery Island Flap for the Reconstruction of a Periorbital Burn: A Case Report.

A 47-year-old man with severe thermal burn injury to the face, including bilateral periorbital regions, presented with bilateral upper and lower ectropion with loss of both eyebrows. The periorbital area was reconstructed with the extended bifurcated superficial temporal artery flap with two islands extending out of territory to restore both eyebrows, lower eyelid, and add length to upper eyelid. After 12 months of the operation, the patient showed complete resolution of postburn sequels in addition to a high grade of satisfaction.