TFL Perforator Flap Complementing and Completing the ALT-AMT Flap Axis.

 Anterolateral thigh (ALT) flap is the most common soft tissue flap used for microvascular reconstruction of head and neck. Its harvest is associated with some unpredictability due to variability in perforator characteristics, injury or unfavorable configuration for complex defects. Anteromedial thigh (AMT) flap is an option, but the low incidence and thickness restrict its utility.

Division versus de-epithelialization of fibula osteocutaneous flap for composite oromandibular defects: A propensity score-matched analysis.

Background: Different fibula osteocutaneous free flap (FOCFF) configurations have been described with a double-skin paddle (DSP) to address composite through-and-through oromandibular defects: division of the skin paddle using different perforators (div-FOCFF) or a de-epithelialized DSP FOCFF (deEpi-FOCFF). This study aimed to compare the surgical outcomes using these two methods (deEpi-FOCFF/div-FOCFF).

Methods: Patients who underwent segmental mandibulectomy and reconstruction with a DSP FOCFF between 2011 and 2014 were included.

Management of Through-and-Through Oromandibular Defects after Segmental Mandibulectomy with Fibula Osteocutaneous Flap.

Background:  Oromandibular defects involving the external skin are a reconstructive challenge. This study aimed to evaluate the use of the fibula osteocutaneous free flap (FOCFF) for through-and-through oromandibular defects by comparing the surgical outcomes and complications of different techniques to close the external skin defect.

Methods:  A retrospective analysis was conducted of patients who underwent reconstruction of through-and-through oromandibular defects after oncologic segmental mandibulectomy between January 2011 and December 2014.

Utilizing the Retrograde Flow of Internal Mammary Vessels as a Donor Pedicle.

 The aim of this study is to assess the results of retrograde flow of internal mammary artery and vein (IMA/V) as a donor vessel for free flap microvascular anastomosis (MVA). This need arises with bipedicle deep inferior epigastric perforator (DIEP) flaps, when all four zones with extra fat need to be harvested for unilateral breast reconstruction coupled with poor midline crossover of circulation naturally or because of midline scar. Large anterolateral thigh flaps for chest wall cover, with multiple perforators from separate pedicles, also need supercharging.

Total colectomy in a gangrenous large bowel due to a rare double closed loop obstruction.

Introduction: Closed loop obstruction is commonly encountered in sigmoid volvulus. When such obstruction becomes fulminant, it is called acute necrotizing colitis. Gangrene of the entire large bowel from the caecum till the distal end of the sigmoid is a rare entity.