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    The Subunit Principle in Scar Face Revision.
    J Craniofac Surg 2017 Feb 15. Epub 2017 Feb 15.
    Department of Plastic Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
    Facial scaring is considered one of the most difficult cosmetic problems for any plastic surgeon to solve. The condition is more difficult if the direction of the scar is not parallel to relaxed skin tension lines. Attempts to manage this difficult situation included revisions using geometric designs, Z plasties or W plasties to camouflage the straight line visible scaring. Read More

    An Innovative Solution to Complex Inguinal Defect: Deepithelialized SIEA Flap With Mini Abdominoplasty.
    Eplasty 2017 25;17:e2. Epub 2017 Jan 25.
    Introduction: We describe a novel technique of contralateral pedicled deepithelialized superficial inferior epigastric artery flaps, followed by abdominal advancement coverage, as an alternative treatment of radiated complicated inguinal or lower abdominal defects, avoiding the donor-site defect typically seen with other methods of coverage. Methods: Two male patients with histories of liposarcoma after excision and radiation to one side of lower abdomen/inguinal area presented with complicated wounds that were reconstructed with this technique. Results: Successful obliteration of dead space and wound closure were achieved with the combination of a superficial inferior epigastric artery flap with an abdominal advancement flap. Read More

    Simple Skin-Stretching Device in Assisted Tension-Free Wound Closure.
    Ann Plast Surg 2017 Feb 14. Epub 2017 Feb 14.
    From the *Division of Plastic Surgery, Department of Surgery, Buddhist Tzu-Chi General Hospital; †Department of Surgery, Tzu-Chi University, Hualien; and ‡Department of Surgery, Division of Plastic Surgery, Buddhist Tzu-Chi Dalin General Hospital, Chiayi, Taiwan.
    Background: Numerous conventional wound reconstruction methods, such as wound undermining with direct suture, skin graft, and flap surgery, can be used to treat large wounds. The adequate undermining of the skin flaps of a wound is a commonly used technique for achieving the closure of large tension wounds; however, the use of tension to approximate and suture the skin flaps can cause ischemic marginal necrosis. The purpose of this study is to use elastic rubber bands to relieve the tension of direct wound closure for simultaneously minimizing the risks of wound dehiscence and wound edge ischemia that lead to necrosis. Read More

    Super Kutler flap: an alternative technique for reconstruction of fingertip defects.
    J Hand Surg Eur Vol 2017 Feb 1:1753193416686884. Epub 2017 Feb 1.
    4 The Department of Plastic and Reconstructive Surgery, Baskent University Faculty of Medicine, Ankara, Turkey.
    The bilateral V-Y flap concept for fingertip reconstruction was first desribed by Kutler. This method has limitations, such as flap size and advancement, therefore larger flap modifications are described to increase the advancement capacity of the flaps. We described a small direct-flow homodigital island flap method, called the 'super Kutler flap', for recontruction of finger pulp defects. Read More

    Overview of Local Flaps of the Face for Reconstruction of Cutaneous Malignancies: Single Institutional Experience of Seventy Cases.
    J Cutan Aesthet Surg 2016 Oct-Dec;9(4):220-225
    Department of Plastic Surgery, SMS Medical College, Jaipur, Rajasthan, India.
    Context: The most common malignant tumours of the face are basal cell carcinoma, squamous cell carcinoma and melanoma. While the results of skin graft are less than satisfactory for large areas to cover, distant flaps are bulky with a poor colour match. Local fasciocutaneous flaps provide reasonable option for reconstruction of facial defects with good colour and texture match and good success rate. Read More

    A simplified surgical algorithm for flap reconstruction of eyebrow defects.
    J Plast Reconstr Aesthet Surg 2017 Jan 8. Epub 2017 Jan 8.
    Department of Plastic and Reconstructive Surgery, The First Bethune Hospital of JiLin University, No.71, Xin Min Street, Chang Chun 130021, China. Electronic address:
    Background: Partial or total eyebrow defects after trauma or tumor excisions have been repaired by several surgical technique and algorithms. However, these algorithms are often complicated and difficult to apply clinically. We therefore established a simplified surgical algorithm for the treatment of eyebrow defects using flap reconstruction. Read More

    Levator alae nasi muscle V-Y island flap for nasal tip reconstruction.
    J Craniomaxillofac Surg 2016 Dec 21. Epub 2016 Dec 21.
    Department of Plastic and Reconstructive Surgery, A.O.U. Federico II, 80131 Naples, Italy.
    Nasal tip reconstruction can be very challenging. It requires close attention to skin texture, colour and thickness matching, with the respect of the nasal aesthetic units and symmetry. Flaps are usually preferred to skin grafts where possible. Read More

    A Prospective Assessment of Surgical Risk Factors in 114 Gluteal Fold Flap Reconstructions After Oncological Vulvoperineal Resection to Establish Clinically Relevant Selection Criteria.
    Ann Plast Surg 2017 Jan 18. Epub 2017 Jan 18.
    From the Departments of *Plastic Reconstructive Surgery and †Gynecologic Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
    Background And Aim: To date, clinically relevant selection criteria have not been established for the use of the gluteal fold flap after oncological vulvoperineal resection. We prospectively assessed the surgical risk factors of this reconstructive technique in a large series.

    Methodology: From April of 2000 through December of 2015, 114 gluteal fold flaps were used for vulvoperineal reconstruction after excision of (pre)malignant skin disorders in 75 women. Read More

    Giant Anterior Chest Wall Basal Cell Carcinoma: An Approach to Palliative Reconstruction.
    Case Rep Oncol Med 2016 19;2016:5067817. Epub 2016 Dec 19.
    Department of Plastic Surgery, University of California, Irvine, CA, USA.
    Anterior chest wall giant basal cell carcinoma (GBCC) is a rare skin malignancy that requires a multidisciplinary treatment approach. This case report demonstrates the challenges of anterior chest wall GBCC reconstruction for the purpose of palliative therapy in a 72-year-old female. Surgical resection of the lesion included the manubrium and upper four ribs. Read More

    Management of human bite injury of the upper and lower eyelids: a rare case report.
    J Korean Assoc Oral Maxillofac Surg 2016 Dec 27;42(6):375-378. Epub 2016 Dec 27.
    Richardsons Dental and Craniofacial Hospital, Nagercoil, Tamil Nadu, India.
    Human bite injury to the eyelid is extremely rare and poses a significant challenge in surgical reconstruction. We report an extremely rare case of human bite injury to the eyelid in a 43-year-old male with approximately 60% full thickness loss of the upper eyelid and 80% to 90% full thickness loss of the lower eyelid and its successful reconstruction using the local advancement cheek flap. Read More

    Omega (Ω) Advancement Flap: A Circular Flap Design for the Aesthetic Closure of Circular Skin Defect.
    Aesthetic Plast Surg 2016 Dec 30. Epub 2016 Dec 30.
    Department of Plastic and Reconstructive Surgery, Ankara Yıldırm Beyazıt Training and Research Hospital, Ankara, Turkey.
    Background: Most skin defects that require reconstruction with a local skin flap have a circular- or oval-shaped pattern. The majority of the skin flaps are planned in an angled shape. Therefore, it may be necessary to modify the shape of the defect or the distal flap border to minimize tissue distortion. Read More

    Horizontally Opposed V-Y Advancement Flaps for Surgical Reconstruction of Central Upper Lip Defects.
    J Craniofac Surg 2016 Dec 23. Epub 2016 Dec 23.
    University of Arizona Cancer Center, Phoenix, AZ Division of Dermatology, University of Arizona, Tucson, AZ Dermatology and Plastic Surgery of Arizona, Tucson, AZ Northwestern University Feinberg School of Medicine, Chicago, IL.

    The Visor Flap: A Novel Design for Scalp Wound Closure.
    J Craniofac Surg 2016 Dec 23. Epub 2016 Dec 23.
    *University of Illinois at Chicago †Feinberg School of Medicine, Northwestern University, Chicago, IL.
    Full-thickness scalp defects pose a reconstructive problem in the setting of infection, radiation, and underlying calvarial defects. Current options include dermal matrices, skin grafts, and local fasciocutaneous flaps. Free tissue transfer is frequently required when scalp-based flaps fail or the wound is significantly large or complex. Read More

    Nasopalatine Island Advancement Flap.
    J Craniofac Surg 2016 Nov;27(8):2190-2191
    *Oral and Maxillofacial Diseases Research Center†Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
    Background: Anterior maxilla is a high esthetic region of the mouth. Some flaps are introduced for bone graft coverage, mainly based on secondary epithelization of connective tissue-periosteal tissues. This article evaluates the versatility of a new mucoperiosteal flap for reproducible coverage in anterior maxilla. Read More

    Jaw in a Day: State of the Art in Maxillary Reconstruction.
    J Craniofac Surg 2016 Nov;27(8):2101-2104
    *Hansjörg Wyss Department of Plastic Surgery, New York University†Department of Prosthodontics, New York University College of Dentistry‡Department of Pediatrics, Memorial Sloan-Kettering Cancer Center§New York Head and Neck Institute, Northwell, Lenox Hill Hospital, New York, NY.
    Background: Reconstruction of maxillary defects following tumor extirpation is challenging because of combined aesthetic and functional roles of the maxilla. One-stage reconstruction combining osseous free flaps with immediate osseointegrated implants are becoming the standard for mandibular defects, and have similar potential for maxillary reconstruction.

    Methods: A woman with maxillary Ewing sarcoma successfully treated at age 9 with neoadjuvant chemotherapy, right hemimaxillectomy, and obturator prosthetic reconstruction presented for definitive reconstruction, complaining of poor obturator fit, and hypernasality. Read More

    Correction of Pterygium Colli in Turner Syndrome: A Clinical Report and Review of the Surgical Management.
    J Craniofac Surg 2016 Nov;27(8):2081-2083
    Department of Plastic Surgery, University of Tennessee Health Science Center, Memphis, TN.
    The aim of surgery for pterygium colli (PC) is to correct the contour deformity, redistribute or remove the horizontal excess of skin, address the abnormal posterior hairline, avoid excessive scarring, and prevent recurrence. The purpose of this study is to review the available methods to correct the deformity and highlight a recent patient performed by the senior author. A modified bilateral Z-plasty technique was used for correcting PC on a 5-year-old African American girl diagnosed with Turner syndrome. Read More

    Chest wall reconstruction after extended resection.
    J Thorac Dis 2016 Nov;8(Suppl 11):S863-S871
    Division of Thoracic Surgery, Department of Thoracic Surgical and Medical Oncology, Istituto Nazionale Tumori, IRCCS, Naples, Italy.
    Extensive chest wall resection and reconstruction is a challenging procedure that requires a multidisciplinary approach, including input from thoracic surgeons, plastic surgeons, neurosurgeons, and radiation oncologists. The primary goals of any chest wall reconstruction is to obliterate dead space, restore chest wall rigidity, preserve pulmonary mechanics, protect intrathoracic organs, provide soft tissue coverage, minimize deformity, and allow patients to receive adjuvant radiotherapy. Successful chest wall reconstruction requires the re-establishment of skeletal stability to prevent chest wall hernias, avoids thoracoplasty-like contraction of the operated side, protects underlying viscera, and maintain a cosmetically-acceptable appearance. Read More

    Hypoperfusion in response to epinephrine in local anaesthetics: Investigation of dependence on epinephrine concentration, spread of hypoperfusion and time to maximal cutaneous vasoconstriction.
    J Plast Reconstr Aesthet Surg 2017 Mar 11;70(3):322-329. Epub 2016 Nov 11.
    Lund University, Skane University Hospital, Department of Clinical Sciences Lund, Ophthalmology, Lund, Sweden. Electronic address:
    Objectives: The present study aimed to examine hypoperfusion in response to epinephrine following the administration of a local anaesthetic. The concentration of epinephrine that causes maximal hypoperfusion, the spread of hypoperfusion in the tissue and the time to the stabilization of hypoperfusion were investigated.

    Methods: Blood perfusion was monitored using laser Doppler velocimetry and laser speckle contrast imaging of random-pattern advancement flaps (1 × 4 cm) or intact skin on the pig flank. Read More

    Skin flap complications after decompressive craniectomy and cranioplasty: Proposal of classification and treatment options.
    Surg Neurol Int 2016 9;7(Suppl 28):S737-S745. Epub 2016 Nov 9.
    Department of Neurosurgery, Polytechnic University, Ancona, Marche, Italy.
    Background: The list of complications reported after decompressive craniectomy (DC) and cranioplasty is progressively increasing. Nonetheless, the exact incidence of these events is still ill-defined. Problems affecting skin flaps after DC and cranioplasty have never been accurately analyzed in papers and their impact on patients' prognosis is largely underestimated. Read More

    Simple Correction of Alar Retraction by Conchal Cartilage Extension Grafts.
    Arch Plast Surg 2016 Nov 18;43(6):564-569. Epub 2016 Nov 18.
    Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea.
    Background: Alar retraction is a challenging condition in rhinoplasty marked by exaggerated nostril exposure and awkwardness. Although various methods for correcting alar retraction have been introduced, none is without drawbacks. Herein, we report a simple procedure that is both effective and safe for correcting alar retraction using only conchal cartilage grafting. Read More

    Flap Designs for Flap Advancement During Implant Therapy: A Systematic Review.
    Implant Dent 2017 Feb;26(1):145-152
    *Resident, Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI. †Professor and Director of Graduate Periodontics, Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI.
    Purpose: Guided bone regeneration (GBR) procedures allow ridge augmentation before or at time of implant placement. GBR outcomes rely on primary passive tension-free wound closure, which may be achieved by a variety of flap designs and surgical procedures. A comprehensive literature review of flap design and management is provided, including material types, incision design, reflection, releasing, and suturing techniques. Read More

    Clinical Effectiveness of Negative Pressure Wound Therapy Following Surgical Resection of Sternoclavicular Joint Infection: A Case Report.
    Cureus 2016 Oct 4;8(10):e815. Epub 2016 Oct 4.
    Department of Surgery, The Ohio State University Medical Center.
    Septic arthritis of the sternoclavicular joint (SCJ) is a rare condition accounting for 0.5% of bone and joint infections. The majority of cases require joint resection and advancement flaps to provide coverage to the resulting wound defect. Read More

    Modified keystone flap for extremity defects after Mohs surgery.
    Int J Dermatol 2016 Dec 15;55(12):1391-1395. Epub 2016 Jul 15.
    Dermatologic Surgery Unit, Department of Dermatology, Hospital de Clínicas, Montevideo, Uruguay.
    Background: When possible, surgery is the treatment of choice for cutaneous carcinomas, as it allows to us perform the anatomopathological study and control the surgical margins. Mohs micrographic surgery (MMS) controls 100% of the margins, maintains a larger amount of healthy tissue, and a fewer number of recurrences are seen. Large limb surgical defects after MMS are a challenge. Read More

    Utility of Superiorly Based Masseter Muscle Flap for Postablative Retromaxillary Reconstruction.
    J Oral Maxillofac Surg 2017 Jan 17;75(1):224.e1-224.e9. Epub 2016 Sep 17.
    Senior Resident, Department of Oral and Maxillofacial Surgery, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Hingana, Nagpur, India.
    Purpose: Resections in the posterior component of the oral cavity usually lead to severe functional compromise and lower quality of life for patients. Notable advances in reconstruction of the posterior part of the mouth and of the oropharynx have occurred in recent decades. The anatomic and physiologic rehabilitation of the defect to a reasonable outcome with low morbidity and mortality remains the founding basis of any surgical reconstruction, which also holds true for oral oropharyngeal and retromaxillary reconstructions. Read More

    Oncoplastic surgery combining abdominal advancement flaps with volume displacement techniques to breast-conserving surgery for small- to medium-sized breasts.
    Breast Cancer 2016 Nov 14;23(6):932-938. Epub 2016 Jan 14.
    Department of Breast Surgery, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan.
    Background: An abdominal advancement flap (AAF) is a flap that pulls the elevated abdominal skin up, creating the shape of the inferior portion of the breast by making a neo-inframammary fold. We used an AAF combined with volume displacement techniques to fill the defect left after breast-conserving surgery (BCS).

    Methods: Forty-one small- to medium-sized breast patients whose resection area included the lower portion of the breast underwent this procedure from October 2010 to December 2014. Read More

    Posterior trunk reconstruction with the dorsal intercostal artery perforator based flap: Clinical experience on 20 consecutive oncological cases.
    Microsurgery 2016 Oct 28;36(7):546-551. Epub 2015 Mar 28.
    Department of Plastic, Reconstructive and Aesthetic Surgery, "Campus Bio-Medico Di Roma" University, Rome, Italy.
    Background: Few studies in the recent literature have investigated the reliability of dorsal intercostal artery perforator (DICAP) flap in posterior trunk reconstruction. The purpose of this report is to describe our clinical experience with the use of DICAP flaps in a cohort of oncological patients.

    Patients And Methods: Twenty patients underwent posterior trunk reconstruction with DICAP based flaps. Read More

    Jaw in a Day: State of the Art in Maxillary Reconstruction.
    J Craniofac Surg 2016 Oct 14. Epub 2016 Oct 14.
    *Hansjörg Wyss Department of Plastic Surgery, New York University †Department of Prosthodontics, New York University College of Dentistry ‡Department of Pediatrics, Memorial Sloan-Kettering Cancer Center §New York Head and Neck Institute, Northwell, Lenox Hill Hospital, New York, NY.
    Background: Reconstruction of maxillary defects following tumor extirpation is challenging because of combined aesthetic and functional roles of the maxilla. One-stage reconstruction combining osseous free flaps with immediate osseointegrated implants are becoming the standard for mandibular defects, and have similar potential for maxillary reconstruction.

    Methods: A woman with maxillary Ewing sarcoma successfully treated at age 9 with neoadjuvant chemotherapy, right hemimaxillectomy, and obturator prosthetic reconstruction presented for definitive reconstruction, complaining of poor obturator fit, and hypernasality. Read More

    Use of Auricular Cartilage for Closure of Oroantral Fistula: A Prospective Clinical Study.
    J Maxillofac Oral Surg 2016 Sep 12;15(3):293-299. Epub 2015 Sep 12.
    Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, India.
    Introduction: The term oro-antral fistula is understood to mean of fistular canal covered with epithelia which may or may not be filled with granulation tissue or polyposis of the sinus mucous membrane. With the presence of a fistula the sinus is permanently open, which enables the passage of microbial flora of the oral cavity into the maxillary sinus and the occurrence of inflammation with all possible consequences. Every now and then various researchers have proposed innumerable techniques to treat this defect. Read More

    Histological and biochemical study of the superficial abdominal fascia and its implication in obesity.
    Anat Cell Biol 2016 Sep 29;49(3):184-188. Epub 2016 Sep 29.
    Department of Anatomy, Kasturba Medical College, Manipal University, Manipal, India.
    The advancement of liposculpturing and fascial flaps in reconstructive surgery has renewed interest in the superficial fascia of abdomen. Its histological and biochemical composition may play a vital role in maintaining strength and elasticity of the fascia. Hence, study of abdominal fascia for the elastic, collagen, and hydroxyproline contents is desirable to understand asymmetrical bulges and skin folds and in improving surgical treatment of obesity. Read More

    Use of suborbicularis oculi fat flap to cover peri-orbital bone exposure.
    Int J Oral Maxillofac Surg 2017 Jan 30;46(1):32-35. Epub 2016 Sep 30.
    Unit of Plastic Surgery, University of Naples "Federico II", Naples, Italy.
    Wide resection of recurrent basal cell carcinoma (BCC) in the peri-orbital-infraorbital-nasal area may include periosteum resection with maxillary or nasal bone exposure. The absence of vascularized periosteum makes the defect ungraftable and local flaps are often required. As an alternative to a large single flap or a combination of flaps, it is possible to turn the ungraftable portion of the defect into a graftable one. Read More

    Three-Directional Reconstruction of a Massive Perineal Defect after Wide Local Excision of Extramammary Paget's Disease.
    Arch Plast Surg 2016 Sep 21;43(5):461-5. Epub 2016 Sep 21.
    Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea.
    Extramammary Paget's disease (EMPD) is a rare, slow-growing intraepithelial malignancy that mainly involves the genital region, including the vulva, penis, scrotum, perianal, and periurethral areas. Although several treatment options exist, wide local excision with a safe margin is considered the treatment of choice. After resection of the lesion, it is often challenging to reconstruct the defect because defects in the perineal region require adequate volume for protection and are susceptible to infections, which is a particularly significant risk for large defects. Read More

    [The gluteus maximus inferior split-muscle flap for the cover of ischiatic pressure ulcers: Study of 61 cases].
    Ann Chir Plast Esthet 2016 Dec 22;61(6):845-852. Epub 2016 Sep 22.
    20, quai Claude-Bernard, 69008 Lyon, France. Electronic address:
    Aim Of The Study: The coverage of ischiatic pressure ulcers is characterized by a significant recurrence rate (8-64% depending on the series). It therefore seems necessary to introduce the concept of saving in the use of muscle flaps available to avoid being in a situation of therapeutic impasse. The gluteus maximus inferior split-muscle flap allows a tailored coverage to the ischiatic pressure ulcers grade IV with skin defect less than 8cm after surgical debridement. Read More

    Nasopalatine Island Advancement Flap.
    J Craniofac Surg 2016 Sep 9. Epub 2016 Sep 9.
    *Oral and Maxillofacial Diseases Research Center †Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
    Background: Anterior maxilla is a high esthetic region of the mouth. Some flaps are introduced for bone graft coverage, mainly based on secondary epithelization of connective tissue-periosteal tissues. This article evaluates the versatility of a new mucoperiosteal flap for reproducible coverage in anterior maxilla. Read More

    A Novel Single-Staged Technique for the Treatment of Soft Tissue in an Oblique Facial Cleft.
    J Craniofac Surg 2016 Sep;27(6):1517-20
    *Case Western Reserve University School of Medicine†Department of Plastic Surgery, University Hospital Case Medical Center, Cleveland, OH‡Guwahati Comprehensive Cleft Care Center, Guwahati, India.
    Introduction: Oblique facial clefts are extremely rare and cause significant morbidity. Treatment of these clefts is complex and requires a fundamental understanding of cleft classification and techniques used for treatment of clefts.

    Methods: We describe a novel single-staged technique to repair the Tessier no. Read More

    Surgical correction of lambdoid synostosis - New technique and first results.
    J Craniomaxillofac Surg 2016 Oct 6;44(10):1531-1535. Epub 2016 Aug 6.
    University Hospital Giessen, Dept. for Neurosurgery (Head: Prof. Dr. E. Uhl), Klinikstr. 33, 35385 Giessen, Germany.
    Objective: Premature craniosynostosis of the lambdoid suture is rare. The use of differential diagnosis to rule out positional occipital plagiocephaly is crucial. Nevertheless, once diagnosed, lambdoid craniosynostosis requires corrective surgery to prevent intracranial harm and aesthetic stigma by significant dyscrania. Read More

    Malar Reconstruction Using Y-V Advancement Flaps after Tissue Expansion in Treacher Collins Syndrome.
    Plast Reconstr Surg Glob Open 2016 May 24;4(5):e715. Epub 2016 May 24.
    Department of Plastic and Reconstructive Surgery, Osaka Medical College, Takatsuki, Osaka, Japan.
    The Treacher Collins syndrome is characterized by both soft and hard tissue deficiencies. To reconstruct malar hypoplasia with both soft and hard tissues, we designed a new method using cartilage grafts, Y-V advancement flaps, and Z plasty with tissue expansion. Read More

    Extended V-Y Advancement Flap Reconstruction of a Large Posterior Upper Midline Trunk Defect.
    Plast Reconstr Surg Glob Open 2016 May 20;4(5):e713. Epub 2016 May 20.
    Division of Plastic Surgery, Brigham and Women's Hospital, Boston, Mass.
    Large posterior upper trunk defects can be challenging to reconstruct. Trapezius or latissimus dorsi myocutaneous flaps are principally utilized for reconstruction; however, some defects may not be amenable to this standard approach. Here, we describe a patient with a full-thickness skin and subcutaneous tissue loss of the upper back and inferior cervical region after dermatofibrosarcoma protuberans resection. Read More

    V-Y advancement flaps for extensive perianal defect repair.
    Cir Esp 2016 Nov 21;94(9):525-530. Epub 2016 Aug 21.
    Departamento de Cirugía General y Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
    Objectives: Some perianal pathologies require aggressive surgery that will need techniques to allow to re-establish the integrity of the perianal region. The purpose is to analyze short and long term results after perineal reconstruction with V-Y flaps.

    Methods: A retrospective review of prospectively collected database was conducted at Virgen de la Arrixaca's Hospital in Murcia (España) between January 2000 and December 2013. Read More

    Reconstruction following abdominoperineal resection (APR): Indications and complications from a single institution experience.
    J Plast Reconstr Aesthet Surg 2016 Nov 2;69(11):1506-1512. Epub 2016 Jul 2.
    Division of Plastic Surgery, Stanford University, 770 Welch Road Suite #400, Palo Alto, CA 94304, USA. Electronic address:
    Background: Abdominoperineal resection (APR) is the surgical treatment of low-lying rectal cancers and other pelvic malignancies. Plastic surgery offers a means to close these complicated defects through obliterating dead space, providing tension-free closure, and introducing vascularized tissue into a radiated field. The indications for reconstructive surgery and choice of reconstruction are debatable. Read More

    Superficial Keratectomy and Conjunctival Advancement Hood Flap (SKCAHF) for the Management of Bullous Keratopathy: Validation in Dogs With Spontaneous Disease.
    Cornea 2016 Oct;35(10):1295-304
    *Animal Eye Center, Rocklin, CA; †Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA; and ‡Department of Ophthalmology and Vision Science, School of Medicine, University of California-Davis, Davis, CA.
    Purpose: To evaluate the efficacy of superficial keratectomy and conjunctival advancement hood flap (SKCAHF) for the treatment of bullous keratopathy in canine patients.

    Methods: Nine dogs (12 eyes) diagnosed with progressive corneal edema underwent superficial keratectomy followed by placement of conjunctival advancement hood flaps. The canine patients were examined pre- and postoperatively using in vivo confocal microscopy, ultrasonic pachymetry (USP), and Fourier-domain optical coherence tomography (FD-OCT). Read More

    Reconstruction of the lower lip using bilateral commissurotomy and advancement of skin, muscle, and mucosal flaps.
    Br J Oral Maxillofac Surg 2016 Nov 10;54(9):1012-1015. Epub 2016 Aug 10.
    Poole Hospital NHS Foundation Trust.
    Reconstruction of a composite defect of the lower lip after oncological resection is challenging, and it is essential to consider both functional and aesthetic components when repairing lips. We report a technique that can be used to repair anything ranging from 30% to the whole of the lower lip with a bilateral commissurotomy and advancement of skin, muscle, and mucosal flaps. This technique helps to achieve good oral function, excellent lip function, and a pleasant aesthetic appearance. Read More

    Modified Gluteal Fold V-Y Advancement Flap for Reconstruction After Radical Vulvectomy.
    Int J Gynecol Cancer 2016 Sep;26(7):1300-6
    *Department of Gynecology, University Hospital Pellegrin; †Department of Plastic Surgery, University Hospital Pellegrin, Bordeaux; and ‡Department of Radiotherapy, University Hospital Haut-Leveque, Pessac, France.
    Objective: To describe the surgical technique of the V-Y cutaneous supra-fascial (modified) gluteal advancement flaps for reconstruction after radical vulvectomy and to assess the outcome of patients according to their clinical characteristics.

    Methods: Between January 2006 and July 2012, 36 V-Y flaps were performed in 21 patients to cover the defect after radical surgery of primary vulvar cancers. Surgery duration, blood loss, hospital stay, and wound healing were assessed according to patient age, body mass index (BMI), American Society of Anesthesiologists (ASA) score, and the initial defect size. Read More

    Gluteal Fascial Advancement for Pilonidal Cyst Disease: A 10-year Review.
    Am Surg 2016 Jul;82(7):622-5
    Department of Surgery, Greenville Health System, Greenville, South Carolina, USA.
    Elective excision of noninfected pilonidal cysts has historically been plagued by a high rate of complications, such as wound breakdown and recurrence. Debate remains regarding the most effective method of wound closure. We previously reported a small group of patients (n = 17 out of 83 patients) in which a novel technique decreased wound complications and recurrence. Read More

    Double V-Y Flap to Cover the Fingertip Injury: New Technique and Cases.
    Tech Hand Up Extrem Surg 2016 Dec;20(4):133-136
    *Asotrauma Clinic, Ibagué †Orthopedics and Traumatology Unit, Faculty of Medicine, National University of Colombia, Bogotá, Colombia.
    The volar V-Y flap is used in transverse or dorsal oblique amputations in fingertip injuries; however, its use is contraindicated in patients with volar oblique amputations and cannot advance distally enough to cover the defect. The aim of this report is to describe a technique of double V-Y flap to cover fingertip defects in which a simple V-Y flap is not enough. This technique allows advancement between 30% and 50% farther than the original, simple V-Y flap. Read More

    [Locoregional solutions for groin defects : Coverage after vascular surgery].
    Chirurg 2017 Jan;88(1):43-49
    Abteilung für Handchirurgie, Plastische Chirurgie und Ästhetische Chirurgie, Ludwig-Maximilians-Universität München, München, Deutschland.
    Introduction: Vascular surgery through a groin incision may be associated with severe wound healing disorders in this sensitive area. There are many options to reconstruct the defect surgically. The choice of surgical reconstruction depends mainly on the individual status of vasculature, which is most often compromised in these patients. Read More

    Predictable Pattern Digital Artery Perforator Flap: An Alternative Concept in Digital Reconstruction.
    Hand (N Y) 2016 Mar 14;11(1):88-96. Epub 2016 Jan 14.
    Bordeaux 2 University, Bordeaux, France.
    Background: The proper digital arteries as any other axial vessel give rise to multiple cutaneous perforators either volar or dorsal along their course. Their identification is performed with Doppler flowmetry. The vasculo-cutano-tendino-osseous complex (VCTOC), which was described by the senior authors, was responsible for the vascularization of all digital anatomic structures (extensor apparatus, skin, periosteum). Read More

    Expanded Cheek-Shaped Flap for Aesthetic Cheek Reconstruction in the Cervicoperiauricular Area.
    Ann Plast Surg 2016 Feb;77 Suppl 1:S43-8
    From the Ninth Department of Plastic Surgery, Plastic Surgery Hospital of Chinese Academy of Medical Sciences, Beijing, China.
    Background: The cervical area is well acknowledged as an ideal donor site for aesthetic reconstruction of the cheek, and tissue expansion may play an important role for maximally achieving such a purpose. However, the conventional design of the expanded cervical flap generally results in unsightly morbidity of the donor site. The aim of this study is to evaluate the results of using an improvised cervical expanded flap in aesthetic reconstruction of the cheek. Read More

    Surgical Management of the Constricted or Obliterated Vagina.
    Obstet Gynecol 2016 Aug;128(2):284-91
    Division of Gynecologic Surgery, Mayo Clinic, Rochester, Minnesota.
    Management of the constricted or obliterated vagina demands an understanding and recognition of the potential etiologies leading to this presentation. A thorough and comprehensive medical and surgical review is required to arrive at an accurate diagnosis, which then will guide medical or surgical intervention. It is paramount to recognize when underlying medical conditions are contributing to these conditions and to begin medical therapy; failure to do so will often yield suboptimal results. Read More

    Color Doppler Ultrasonography-Targeted Perforator Mapping and Angiosome-Based Flap Reconstruction.
    Ann Plast Surg 2016 Oct;77(4):464-8
    From the *Department of Plastic Surgery, Telemark Hospital, Skien, Norway; †Department of Plastic Surgery, Southwest Hospital, Esbjerg; and ‡Department of Plastic Surgery, Lllebaelt Hospital, Vejle and Odense University Hospital, Denmark.
    Knowledge about perforators and angiosomes has inspired new and innovative flap designs for reconstruction of defects throughout the body. The purpose of this article is to share our experience using color Doppler ultrasonography (CDU)-targeted perforator mapping and angiosome-based flap reconstruction throughout the body. The CDU was used to identify the largest and best-located perforator adjacent to the defect to target the reconstruction. Read More

    Predictors of Complications After Pectoralis Major Transposition for Sternum Dehiscence.
    Ann Plast Surg 2017 Feb;78(2):208-212
    From the *Department of Plastic Surgery, and †Department of Cardio-Thoracic Surgery, University of Groningen and University Medical Center Groningen (UMCG), Groningen, The Netherlands.
    Objectives: Mediastinitis and sternum dehiscence are serious complications after open heart surgery, causing an increase in hospital stay, utilization of health care resources, and mortality. The defect that results after sternal wound debridement frequently necessitates tissue-flap coverage, for which pectoralis major transposition currently is the preferred method. In this study, the postoperative outcome and individual characteristics of patients undergoing pectoralis major transposition were analyzed to identify predictors of complications after wound closure. Read More

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