There was summarized the experience of surgical treatment of 9 patients with the soft tissues defects of various etiology, localization and size, in whom microsurgical autotransplantation of the perforant flaps was performed on thoracospinal and medial gastrocnemial arteries. Peculiarities of preparation and mobilization of perforating vessels, securing the motor nerves branches, were presented. The perforant flaps advantages are: their small thickness, plasticity, mobility and minimal complications in the donor's zone. The perforant flaps advantages secure the wider diapason of their usage comparing with conventional composed complexes of tissues.
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Laryngoscope Investig Otolaryngol
February 2025
Background: The main technique for identification of free flap perforator vessels is Doppler sonography, which is not always accurate, user dependent and affected by the patient's body habitus.
Methods: Adult patients undergoing head and neck resection and free flap reconstruction at two academic institutions were enrolled. Doppler sonography was used to identify perforators, and were marked using a skin marker.
Plast Reconstr Surg Glob Open
January 2025
Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan.
The free fibula flap is a common technique for mandibular bone defects. However, its limited skin paddle is disadvantageous in cases with significant soft-tissue defects. A free fibula dual-skin paddle flap is used for medium-sized soft-tissue defects.
View Article and Find Full Text PDFMicrosurgery
January 2025
Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.
Background: Pressure ulcers are a prevalent and debilitating condition, often necessitating surgical reconstruction. Various flap techniques, such as Advancement Flaps (AF) and Perforator-based Propeller Flaps (PBPF), are commonly used for pressure sore reconstruction. While both techniques have proven effective, there is limited research comparing their outcomes in different clinical scenarios.
View Article and Find Full Text PDFBMJ Open
January 2025
Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
Introduction: Despite its therapeutic advantages, postmastectomy radiotherapy (PMRT) increases the risk of complications and often leads to poor cosmesis in women undergoing breast reconstruction. Preoperative radiotherapy followed by skin-sparing mastectomy and deep inferior epigastric perforator (DIEP) flap reconstruction is technically feasible, with low rates of surgical complications and good short-term oncological outcomes. Further evaluation in a randomised trial comparing preoperative radiotherapy versus conventional PMRT in breast reconstruction is required to assess both oncological and patient-reported outcomes (PROs).
View Article and Find Full Text PDFMicrosurgery
January 2025
Service de Chirurgie Plastique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris Descartes, Paris, France.
Background: Venous congestion due to superficial venous system dominance (SVD) in deep inferior epigastric perforator (DIEP) flap surgery occurs in approximately 2% of cases, with attendant sequelae and increased cost to healthcare systems. This study aimed to describe the predictive factors for SVD in DIEP flap breast reconstruction based on preoperative computed tomography angiography (CTA) findings.
Methods: All women who required takebacks for additional venous anastomosis to the cephalic vein because of SVD after DIEP flap breast reconstruction between 2015 and 2022 were included.
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