Diabetic foot ulcers are a severe complication of diabetes, and their management requires a multidisciplinary approach for optimal management. When treating these ulcers, limb salvage remains the ultimate goal. In this article, we present the "hanging" free flap for the reconstruction of chronic lower extremity diabetic ulcers. This two-staged approach involves standard free flap harvest and inset; however, following inset the "hanging" pedicle is covered within a skin graft instead of making extraneous incisions within the undisturbed soft tissues or tunnels that can compress the vessels. After incorporation, a second-stage surgery is performed in 4 to 6 weeks which entails pedicle division, flap inset revision, and end-to-end reconstruction of the recipient vessel. Besides decreasing the number of incisions on diabetic patients, our novel technique utilizing the "hanging" pedicle simplifies flap monitoring and inset and allows reconstruction of recipient vessels to reestablish distal blood flow.
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http://dx.doi.org/10.1055/s-0042-1758635 | DOI Listing |
Am J Otolaryngol
December 2024
University of Florida Cancer Center, 2033 Mowry Rd, Gainesville, FL 32610, United States.
Background: Although the literature supports a shorter course of 24 h of prophylaxis after head and neck free flap reconstruction, studies supporting this duration do not differentiate between flap types. There is a paucity of evidence on the optimal duration of prophylaxis for osteocutaneous free flaps with hardware, which may have higher rates of post-operative complications compared to other free flaps. This study aimed to examine the effect of different lengths of antibiotic prophylaxis on surgical site infection (SSI) rates after head and neck reconstruction with osteocutaneous free flaps and hardware.
View Article and Find Full Text PDFPlast Reconstr Surg
January 2025
Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong.
This novel hybrid single-double-single barrel (1-2-1) design for fibula free flap reconstruction addresses the unique challenges presented by Brown Class III mandibular defects, which involve long-span defects at both bodies of the mandible and the chin. The importance of this design lies in its ability to overcome the limitations of traditional approaches in terms of mandible height and pedicle length, while optimizing both functional and esthetic outcomes.The technique utilizes a combination of single-double-single barrel fibula segments to achieve ideal esthetics and support for dental prosthesis across different areas of the mandible.
View Article and Find Full Text PDFHead Neck
January 2025
Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Background: Flow-through flaps (FTFs) are an advanced technique in which a free flap is anastomosed to the pedicle of another free flap to reconstruct extensive head and neck defects when recipient vessels are scarce.
Methods: A multi-institutional cohort of FTFs used for head and neck reconstruction were reviewed. For comparison, FTF outcomes were compared to free flaps that required vein grafts (VG) to reach distant recipient vessels.
JPRAS Open
March 2025
Department of Plastic and Aesthetic Surgery, Tra Vinh University, Tra Vinh, Vietnam.
The eyebrow plays a crucial role in facial aesthetics and expression. Reconstructing an eyebrow defect remains a challenge due to the unique characteristics of eyebrow hair. While various advanced methods exist, we report the first documented use of a free superficial temporal artery flap for total eyebrow reconstruction.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!