Trunk defects can be approached through a multitude of regional flaps that can be harvested from the shoulder girdle, the epigastric axis, the paraspinal region, or the pelvic girdle. The aim of the reconstruction is to provide adequate and tension-free restoration of tissue integrity with minimal functional morbidity, water- and airtight closure of cavities, and coverage of exposed vital structures. Potential donor sites should be estimated for their tissue quality and anticipated donor site morbidity. The prototypical pedicled flap has a constant, reliable anatomy; however, the pedicled flap should have a configuration that is versatile and adequate for coverage and should resist infection. Also, the surgical technique should be uncomplicated.
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http://dx.doi.org/10.1016/j.cps.2010.06.004 | DOI Listing |
Microsurgery
January 2025
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.
Background: The deep inferior epigastric perforator (DIEP) flap is currently the gold standard for autologous breast reconstruction. In cases where the DIEP is contraindicated, the profunda artery perforator (PAP) flap is now the preferred second-line option in our institution. The PAP flap poses unique challenges to the reconstructive surgeon, especially in Asian women with low body mass index (BMI).
View Article and Find Full Text PDFSurg Radiol Anat
January 2025
Maxillo-Facial Surgery Department, Beaujon University Hospital, Clichy, France.
Purpose: The main objective of this study was to conduct a radioanatomical study of the osteo-myo-cutaneous scapulo-dorsal pedicled flap.
Methods: A radiological study was performed to study the anatomical variations of the dorsal scapular pedicle (origin, course of the deep branch of the dorsal scapular artery (DSA) in relation to the medial border of the scapula, perforators from the superficial branch of the DSA). Perforators from the superficial branch of the DSA were also identified on anatomical subjects, and their cutaneous vascular territory was determined.
Eur J Breast Health
January 2025
Department of General Surgery, Gülhane Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey.
Pyoderma gangrenosum (PG) is a rare, chronic, neutrophilic dermatosis characterized by painful ulcers that are often misdiagnosed as wound infections. We report two cases of postsurgical PG following breast surgery: A 46-year-old woman with a non-healing ulcer after a breast biopsy and a 37-year-old woman with wound dehiscence after bilateral reduction mammoplasty. Both cases were initially managed with repeated debridements, antibiotics, and wound care without improvement.
View Article and Find Full Text PDFJ Korean Assoc Oral Maxillofac Surg
December 2024
Department of Oral and Maxillofacial Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
It is crucial to reconstruct extensive soft tissue defects following oral cancer resection to restore both function and aesthetics. Single anterolateral thigh flaps may not suffice for large defects. This report highlights the use of chimeric flaps, which feature multiple paddles with individual perforators, to reconstruct large intraoral and extraoral defects, adapting to wide defects, and covering areas with extensive tissue damage.
View Article and Find Full Text PDFJ Korean Assoc Oral Maxillofac Surg
December 2024
Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
Pedicle ossification is a rare but significant complication following mandibular reconstruction using a fibular free flap (FFF), a technique widely employed in maxillofacial surgery due to its reliable vascularized bone supply and low donor site morbidity. The FFF supports dental implantation and prosthetic rehabilitation, with its vascularized periosteum enhancing osteogenic potential. Despite these advantages, unexpected ossification of the flap's vascular pedicle may occur, potentially mimicking tumor recurrence and causing diagnostic uncertainty.
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