Fasciocutaneous SMAS Island Flap for Large Facial Defect Reconstruction.

Large cutaneous defects of the face have traditionally been reconstructed with cervicofacial rotation flaps. To measure advancing distance and assess vascular reliability of superficial musculoaponeurotic system (SMAS) island flaps for reconstruction of large cutaneous facial defects. The study design was a retrospective case series of all patients who had undergone reconstruction of facial defects 3 cm or greater with fasciocutaneous SMAS island flaps from 2009 to 2023.

Case Report: Salvation of a congested SCIP flap with a modified "chemical leech" technique.

The superficial circumflex iliac artery perforator (SCIP) flap is a widely accepted workhorse flap for covering defects. Although the success rate of SCIP flaps is currently high, flap failure occurs occasionally due to venous congestion. Venous re-anastomosis is the ideal rescue method but is sometimes limited by poor venule condition.

A minimally invasive modified revolving-door flap for surgical reconstruction of concha and antihelix defects.

Skin cancers affecting the concha and antihelix are quite common, because of anterior auricular projection from the head and subsequent actinic exposure, leading to the need for effective ear reconstruction post-surgery. Various methods such as skin grafts, free tissue transplantation, and local flaps have been used. This study introduces a refined technique for concha-antihelix defect reconstruction, based on a minimally invasive modification of the revolving-door flap procedure.

Free Fasciocutaneous versus Muscle Flaps in Lower Extremity Reconstruction: Implications for Functionality and Quality of Life.

Background:  Free tissue transplantations are commonly used to treat complex lower extremity defects caused by trauma, vascular disease, or malignancy, particularly when vital structures are exposed. This study aimed to expand the knowledge on patient-reported outcomes by comparing fasciocutaneous and muscle flaps, with the goal of facilitating patient counseling. Additionally, patient-level risk factors associated with decreased functioning and health-related quality of life were identified.

Are There Differences in Short-Term Postoperative Outcomes Among Surgical Subspecialists Performing Lower Extremity Flap Procedures? A National Surgical Quality Improvement Project (NSQIP) Analysis of 1324 Patients.

Soft tissue flaps are an integral and versatile tool to help manage soft tissue defects of varying severities. These complex procedures can be done by a variety of specialties and can lead to a variety of postoperative complications. Locoregional flaps are the middle rung of the reconstructive ladder and can be performed by surgeons of various training pathways.

Internal mammary artery perforator-based plug flap.

Introduction: Various oncoplastic techniques have emerged over the years to preserve breast cosmesis and symmetry without compromising the principles of tumor excision. One of the newer techniques for breast volume replacement to achieve symmetry and cosmesis is the use of fascio-cutaneous pedicled chest wall perforator flaps or local perforator flaps (CWPF).

Case Presentation: We present a case of reconstruction with internal mammary artery perforator (IMAP)-based plug flap to fill the infero-medial defect caused by a tumor close to skin, with visible retraction.

[Translated article] Medial tab-type fasciocutaneous flap as an alternative for the management of soft tissue defects of the leg.

Background: Selecting the right technique for lower limb soft tissue reconstruction is a therapeutic challenge. Despite having several reconstruction options, it's important to choose a technique that is effective and with the least possible donor site morbidity.

Objective: Demonstrate the therapeutic efficacy of the medial tab flap in soft tissue reconstruction on the leg, compared to conventional flaps.

Soft tissue flap reconstruction in infected or exposed total knee arthroplasty: A systematic review and network meta-analysis.

Background: Total knee arthroplasty (TKA) infection or exposure associated with soft tissue deficiency represents a challenging scenario for the reconstructive surgeon. The aim of the study is to determine the most successful reconstructive option for infected or exposed TKA comparing local muscle flaps (LMF), local fasciocutaneous flaps (LFF), and free muscle flaps (FMF).

Methods: A systematic review and single-arm network meta-analysis (PRISMA) was conducted to compare outcomes of complicated TKA requiring soft tissue coverage with either LMF, LFF and FMF.

Submental flap: A reconstructive option in head and neck surgery.

Objective: The submental flap is a fasciocutaneous flap used in head and neck reconstruction. The aim of this study was to share the indications and outcomes of submental flap reconstruction based on our experience.

Methods: A retrospective descriptive study was conducted on a group of 14 patients who underwent reconstructive surgery of the orofacial region with the submental flap.

Closed-incision negative pressure wound therapy (NPWT) in elderly patients following sacral pressure sore reconstruction.

Background: Pressure sores significantly affect elderly patients, with the sacrum being especially vulnerable, often due to its proximity to the anus and potential for fecal contamination. Despite preventive measures such as frequent repositioning and specialized cushions, some sores still necessitate surgical intervention. Postoperative care focuses on monitoring, hygiene, and pressure alleviation.

Incidence and Risk Factors for Secondary Surgery and Amputation After Lower Extremity Limb Salvage.

Background: Traumatic defects of the lower extremity (LE) require robust soft tissue to cover critical structures and facilitate healing. Free tissue transfer (FTT) is often necessary when local tissue is inadequate. While much of the literature emphasizes free flap viability in successful limb salvage, there is limited understanding regarding the need for additional surgeries or eventual amputation.

Free fillet flap: Outcomes in emergency microsurgical reconstruction of upper and lower limb.

Introduction: Despite its infrequency, 'spare-part surgery' represents a reconstructive strategy that uses segments of amputated limbs as donor tissue to preserve function in other injured anatomical regions. The purpose of this study was to review our 14-year experience in emergency microsurgical reconstruction of traumatised limbs using free fillet flaps obtained from non-salvageable amputated parts.

Materials And Methods: A retrospective observational study was conducted on patients who underwent urgent free fillet flap transfer for upper or lower limb reconstruction between 2007 and 2021.

Deltopectoral Flap in Head and Neck Reconstruction.

: The deltopectoral (DP) flap represents a reconstructive option for the head and neck. It is a fasciocutaneous flap raised from the anterior chest wall below the clavicle. Its role partially declined with the arise of free flaps.

Gracilis muscle flap for reconstruction of extensive soft tissue damage to the palm.

Objective: The reconstruction of a large palmar soft tissue defect is a challenge to restore both aesthetics and functionality. Reconstruction with fascio-cutaneous and fascial flaps are the most widely used in the literature, few cases are reported using muscular free flap. We report our experience with the use of the free gracilis muscle flap for palmar soft tissue reconstruction in patients with complex hand traumas.

Guidance for Circumflex Scapular Artery Flap Utilization in Pediatric Reconstruction.

Background: The circumflex scapular artery (CSA) flap system, consisting of scapular, parascapular, and chimeric flaps, is useful for pediatric reconstruction in many anatomical locations. The objectives of this case series are to offer insights into our decision-making process for selecting the CSA flap in particular pediatric reconstructive cases and to establish a framework for choosing a scapular or parascapular skin paddle. We also aim to emphasize important technical considerations of CSA flap utilization in pediatric patients.

Edge De-epithelialization for Reducing Pharyngocutaneous Fistula in Patch Free Flap Reconstructions for Salvage Total Laryngectomy Defects: A Case-Control Study.

Background: The leakage of saliva through the deep neck region from a pharyngocutaneous fistula could cause devastating complications, including vascular ruptures leading to mortality. While a partial pharyngoesophageal defect is created after total laryngectomy, a patch pattern of hypopharyngeal reconstruction is required, for which a fasciocutaneous free flap is usually applied. If radiotherapy fails to cure pharyngeal cancer, salvage total laryngectomy (STL) is needed.

The Impact of Increased Body Mass Index on Patient Outcomes and Complications in Microsurgical Lower Extremity Reconstruction.

Background: Elevated body mass index (BMI) is a known perioperative risk factor for complications such as delayed wound healing and infection. However, there is a gap in understanding how elevated BMI impacts outcomes after posttraumatic lower extremity (LE) microvascular reconstruction.

Methods: A retrospective review was performed at a level 1 trauma center between 2007 and 2022 of patients who underwent posttraumatic microvascular LE reconstruction.