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    1 OF 42

    Reconstructive options for large back free flap donor sites.
    ANZ J Surg 2017 Nov 9. Epub 2017 Nov 9.
    Department of Surgery, St Vincent's Hospital, Melbourne, Victoria, Australia.
    Background: Reconstruction of posterior thoracic and trunk defects can prove challenging even to the most seasoned surgeons. Many commonly used techniques for closing back defects include primary closure and split skin grafts. Often times, however, other techniques are needed in order to give the patient the best aesthetic and functional outcome. Read More

    Vulvo-vaginal reconstruction after radical excision for treatment of vulvar cancer: Evaluation of feasibility and morbidity of different surgical techniques.
    Surg Oncol 2017 Dec 5;26(4):511-521. Epub 2017 Oct 5.
    Department of Gynecologic-Obstetrical and Urologic Sciences, University "Sapienza" of Rome, Policlinico Umberto I Hospital, Rome, Italy. Electronic address:
    Background: Vulvar cancer is a rare disease accounting for approximately 5% of female genital tract tumors worldwide. Currently surgery represents the mainstay alone or sometimes, in combination with chemo-radiotherapy, for locally advanced tumors and recurrent disease. However, significant physical and sexual impairment mostly due to anatomical distortion of external genitalia are a consequence of radical surgical treatment. Read More

    Congenital pharyngeal webs: Treatment of a rare clinical entity by endoscopic CO2 laser approach.
    Int J Pediatr Otorhinolaryngol 2017 Nov 3;102:123-126. Epub 2017 Aug 3.
    Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Lausanne (CHUV), Lausanne, Switzerland.
    Importance: Oesophageal inlet stenosis can promote dysphagia and aspiration. We report the cases of syndromic children with congenital pharyngeal webs successfully treated with endoscopic CO2 laser.

    Observations: Pharyngeal webs were excised with CO2 laser (Ultrapulse mode) and resurfaced using mucosal advancement flaps to avoid restenosis and/or formation of secondary synechia. Read More

    Pedicled posteromedial thigh (pPMT) perforator flap and its application in loco-regional soft tissue reconstructions.
    J Plast Reconstr Aesthet Surg 2017 Oct 16. Epub 2017 Oct 16.
    Department of Plastic and Hand Surgery, University Hospital Zurich, Rämistraße 100, 8091, Zurich, Switzerland.
    Introduction: The posteromedial thigh (PMT) perforator flap is a valuable reconstructive option. In its pedicled form, the experience is currently limited to a few case reports. The purpose of this article is to describe various clinical applications of the pedicled posteromedial thigh (pPMT) flap for reconstruction of loco-regional soft tissue defects. Read More

    Immediate Perineal Reconstruction After Extralevatory Abdominoperineal Excision: Buried Desepidermised Fasciocutaneous V-Y Advancement Flap.
    Ann Plast Surg 2017 Oct 31. Epub 2017 Oct 31.
    From the *Department of Plastic Reconstructive and Aesthetic Surgery, Okmeydani Training and Research Hospital, Istanbul, Turkey; †Department of General Surgery, Okmeydani Training and Research Hospital, Istanbul, Turkey.
    Background: According to National Cancer Institute, there are approximately 39,800 rectal cancer cases per year, 25% of which will need an abdominoperineal resection (APR). The key to avoid most of the complications related to pelvic defect that occurs after APR is choosing an appropriate reconstruction option for perineum. This study aims to introduce an easily applicable flap option for closure to address postoperative pelvic defect in low rectal cancer. Read More

    Materials and techniques in chest wall reconstruction: a review.
    J Vis Surg 2017 26;3:95. Epub 2017 Jul 26.
    Thoracic Surgery Unit, G. B. Morgagni Hospital, Forli, Italy.
    Extensive chest wall resection and reconstruction are a challenging procedure that requires a multidisciplinary approach, including input from thoracic surgeon, plastic surgeon and oncologist. In particular chest wall neoplastic pathology is associated with high surgical morbidity and can result in full thickness defects hard to reconstruct. The goals of a successful chest wall reconstruction are to restore the chest wall rigidity, preserve pulmonary mechanic and protect the intrathoracic organs minimizing the thoracic deformity. Read More

    Wide local excision of perianal Paget's disease with gluteal flap reconstruction: an interdisciplinary approach.
    J Vis Surg 2016 19;2:159. Epub 2016 Sep 19.
    Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, Park Ridge, Illinois, USA.
    Perianal Paget's disease (PPD) is an extremely rare condition characterized as intraepithelial adenocarcinoma of unclear etiology. It can be either primary or secondary. The disease typically presents as an eczema-like, erythematous, and painful skin lesion that is associated with pruritus. Read More

    Innovation in the Planning of V-Y Rotation Advancement Flaps: A Template for Flap Design.
    Arch Plast Surg 2017 Oct 27. Epub 2017 Oct 27.
    Ankara Training and Research Hospital, Ankara, Turkey.
    Local flaps exhibit excellent color matching that no other type of flap can compete with. Moreover, surgery using a local flap is easier and faster than surgery using a distant or free flap. However, local flaps can be much more difficult to design. Read More

    Endoscopic Endonasal Reconstructive Methods to the Anterior Skull Base.
    Semin Plast Surg 2017 Nov 25;31(4):203-213. Epub 2017 Oct 25.
    Department of Neurosurgery, Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin.
    The success of expanded endoscopic endonasal approaches (EEAs) to the anterior skull base, sellar, and parasellar regions has been greatly aided by the advancement in reconstructive techniques. In particular, the pedicled vascularized flaps have been developed and effectively cover skull base defects of varying sizes with a significant reduction in postoperative CSF leaks. There are two aims to this review: (1) We will provide our current, simplified reconstruction algorithm. Read More

    Combined Gluteus and Pudendal Thigh Flap Reconstruction of Vaginal Defects following Robotic Abdominoperineal Resection.
    Plast Reconstr Surg Glob Open 2017 Sep 19;5(9):e1500. Epub 2017 Sep 19.
    Department of Plastic and Reconstructive Surgery, University of Virginia Health System, Charlottesville, Va.; and Division of Surgical Oncology, Department of General Surgery, University of Virginia Health System, Charlottesville, Va.
    Low-lying rectal cancers are being treated more frequently with robotic-assisted abdominoperineal resection, obviating the need for laparotomy and the ability to raise vertical rectus abdominis musculocutaneous flaps. For female patients, posterior vaginectomy often accompanies the resection. Combined pudendal thigh flaps as an extension of bilateral gluteus advancement flaps allow for posterior vaginal resurfacing with thin pliable fasciocutaneous flaps, which rest on the gluteal flap soft-tissue bulk that obliterates the pelvic dead space. Read More

    [Effects of improved V-Y advancement flap with major artery perforator on repairing skin and soft tissue defects].
    Zhonghua Shao Shang Za Zhi 2017 Oct;33(10):611-615
    Department of Burns and Reconstructive Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.
    Objective: To explore the effect of improved V-Y advancement flap with major artery perforator on repairing several skin and soft tissue defects in whole body. Methods: From March 2015 to June 2017, 4 cases with pressure ulcer in sacrococcygeal region, 4 cases with pressure ulcer at ischial tuberosity, 2 cases with scalp and skull defects at occiput, 1 case with secondary wound after tumor resection in axillary region, and 2 cases with skin and soft tissue defects caused by other trauma were hospitalized, with disease duration ranging from 1 week to 6 months. Bones, blood vessels, or nerves were exposed in wounds of 11 cases. Read More

    V-Y advancement flap reconstruction for anal stricture - video vignette.
    Colorectal Dis 2017 Oct 20. Epub 2017 Oct 20.
    Department of Surgery, Acibadem University, School of Medicine, Maslak Hospital, Istanbul.
    Anal stricture is a rare but serious complication seen after haemorrhoidectomy (1, 2). Extensive removal of the anoderm results in scarring and progressive stricturing. Depending on the severity of stricture, treatment options are usually surgical. Read More

    "Anterior skull base and pericranial flap ossification after frontofacial monobloc advancement".
    Plast Reconstr Surg 2017 Oct 12. Epub 2017 Oct 12.
    1. Assistance Publique - Hôpitaux de Paris, Hôpital Universitaire Necker - Enfants Malades, Service de chirurgie maxillofaciale et plastique ; Université Paris Descartes, & Centre de références des malformations de la face et de la cavité buccale; Paris, France 2. Assistance Publique - Hôpitaux de Paris, Hôpital Universitaire Necker - Enfants Malades, Unité de chirurgie crâniofaciale, Service de neurochirurgie ; Université Paris Descartes & Centre de référence des malformations crânio-faciales; Paris, France 3. INSERM U1132 & Université Paris-Diderot, Paris, France 4. Clinique Marcel Sembat (Ramsay - Générale de Santé, Boulogne-Billancourt, France).
    Background: Frontofacial monobloc advancement (FFMBA) creates a communication between the anterior cranial fossa and nasal cavities. To tackle this issue, trans-orbital pericranial pedicled flaps (PF) are routinely performed in our center. This study aimed to assess the post-operative ossification of the anterior skull base and PF following FFMBA, and to identify factors influencing this ossification. Read More

    The Keystone Flap-A Case Series Demonstrating Practical Design, Use, and Applications.
    Plast Surg (Oakv) 2017 Aug 25;25(3):184-187. Epub 2017 Jul 25.
    Division of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
    Introduction: The keystone design perforator island flap is a trapezoidal-shaped random perforator island flap with many advantages over primary closure, skin grafting, and other local flaps for soft tissue reconstruction commonly encountered with cancer excisions.

    Methods: This case series of 39 keystone flaps in 37 patients reviews the practical design, use, and applications of the flap while highlighting certain important considerations. Keystone flaps were designed as in the original description, with a minor modification in the lower extremity where a higher flap to defect width ratio was used. Read More

    Microvascular Free Flaps in Oral and Maxillofacial Reconstruction following Cancer Ablation.
    J Nepal Health Res Counc 2017 Sep 8;15(2):88-95. Epub 2017 Sep 8.
    Department of Prosthodontics, College of Medical Sciences-Teaching Hospital, Bharatpur, Chitwan, Nepal.
    Microsurgical free flaps have become the first choice for reconstruction of oral and maxillofacial (OMF) defects after tumor resection. Till recently the pectoralis major myocutaneous flap (PMMC) was considered to be the benchmark for OMF reconstruction. This philosophy is changing fast with rapid advancement in reconstructive microsurgery. Read More

    A Comparative Study of the Aesthetic Outcome of Two Techniques for Unilateral Complete Cleft Lip Repair.
    Plast Reconstr Surg 2017 Oct;140(4):757-764
    Oxford and Salisbury, United Kingdom From Spires Cleft Centre, Oxford University Hospitals NHS Trust, John Radcliffe Hospital; and the Spires Cleft Centre, Salisbury Foundation NHS Trust.
    Background: Cleft lip repair aims to create symmetric nasolabial morphology with minimal scarring. Poor aesthetic outcomes may have damaging psychosocial implications. Determining the optimal method of recreating lip symmetry is a major goal of applied cleft clinical research. Read More

    Bipedicle Flaps for Posterior Elbow Reconstruction.
    Tech Hand Up Extrem Surg 2017 Dec;21(4):161-163
    *MetroHealth Medical Center †Case Western Reserve University School of Medicine, Cleveland, OH.
    Chronic posterior elbow soft tissue defects often require soft tissue reconstruction because of exposure of the underlying triceps tendon and proximal ulna. Current options for soft tissue coverage require sacrifice of a local muscle or microsurgery. The purpose of this study is to evaluate patient and surgical outcomes after reconstruction of small-sized to medium-sized (<50 cm) posterior elbow defects with bipedicle advancement flaps. Read More

    Ilizarov Treatment Protocols in the Management of Infected Nonunion of the Tibia.
    J Orthop Trauma 2017 Oct;31 Suppl 5:S47-S54
    Bone Infection Unit, Nuffield Orthopaedic Center, Oxford, United Kingdom.
    Objectives: We present a treatment algorithm comprising 4 Ilizarov methods in managing infected tibial nonunion, using nonunion mobility and segmental defect size to govern treatment choice.

    Design: Decision protocol analysis study.

    Setting: A university-affiliated teaching hospital. Read More

    Sphincter-Sparing Anal Fistula Repair: Are We Getting Better?
    Dis Colon Rectum 2017 Oct;60(10):1071-1077
    1 Division of Colon and Rectal Surgery, University of Illinois at Chicago, Chicago, Illinois 2 Division of Colon and Rectal Surgery, John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois 3 Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, Park Ridge, Illinois.
    Background: Sphincter-sparing repairs are commonly used to treat anal fistulas with significant muscle involvement.

    Objective: The current study evaluates the trends and efficacy of sphincter-sparing repairs and determines risk factors for fistula recurrence.

    Design And Settings: A retrospective review was performed at 3 university-affiliated teaching hospitals. Read More

    Hyperbaric oxygen in the management of wound tissue necrosis after external dacrocystorhinostomy.
    Saudi J Ophthalmol 2017 Jul-Sep;31(3):173-176. Epub 2017 Mar 19.
    King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
    Hyperbaric oxygen is an adjunctive treatment for promoting wound healing and reducing infection. We present an unusual case of wound tissue necrosis occurring after external dacryocystorhinostomy (ExtDCR) that was subsequently treated with hyperbaric oxygen (HBO) and advancement flaps with good outcome. HBO improves vascularization of ischemic tissues after ExtDCR for greater success after reconstructive surgery. Read More

    [Approach of the unilateral cleft lip with Meara's cheiloplasty technique].
    Cir Pediatr 2017 04 20;30(2):111-116. Epub 2017 Apr 20.
    Cirugía Maxilofacial. Hospital Universitari Sant Joan de Déu. Barcelona.
    Introduction: Isolated cleft lip is the mildest form of the cleft lip and palate spectrum; however those patients are often treated with the same surgical techniques that are used for the more severe cases (advancement-rotation flaps, quadrangular flaps). Meara's cheiloplasty technique may be a less aggressive option for lip repair in isolated cleft lip or whenever the gap between labial segments is not wide.

    Material And Methods: All children that had their cleft lip repaired following Meara's cheiloplasty between May 2014 and December 2015 were retrospectively reviewed. Read More

    A comparative study of tissue expansion and free parascapular flaps in extensive facial burn scar reconstruction.
    Int J Burns Trauma 2017 25;7(4):50-55. Epub 2017 Jul 25.
    Department of Burns, Plastic and Reconstructive Surgery, SMS Medical College and HospitalJaipur, Rajasthan, India.
    Background: Large post burn scars are a very difficult problem to treat. Available methods include skin grafts and tissue expansion. The reconstructive method used should be tailored according to individual patient rather than following a textbook approach in each. Read More

    The Modification of Rotation - Advancement Flap Made in 1950.
    Acta Stomatol Croat 2017 Mar;51(1):60-64
    Professor,DM, MSc, PhD at the School of Medicine, University of Zagreb, Department of Oral and Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia.
    The early techniques of cleft lip repair involved the straight-line technique, the triangular flap technique or some kind of geometric line (triangular, quadrangular closure). A turning point in cleft lip surgery was in 1955 when doctor. Millard presented his method: the rotation-advancement technique or flap, at the First International Congress of Plastic Surgery in Stockholm. Read More

    Flap Basics II: Advancement Flaps.
    Facial Plast Surg Clin North Am 2017 Aug;25(3):323-335
    Department of Otolaryngology Head and Neck Surgery, The University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 3010, Kansas City, KS 66160, USA. Electronic address:
    A mastery of advancement flap design, selection, and execution greatly aids the surgeon in solving reconstructive dilemmas. Advancement flaps involve carefully planned incisions to most efficiently close a primary defect in a linear vector. Advancement flaps are subcategorized as unipedicle, bipedicle, V-to-Y, and Y-to-V flaps, each with their own advantages and disadvantages. Read More

    Reconstruction Techniques of Choice for the Facial Cosmetic Units.
    Actas Dermosifiliogr 2017 Oct 27;108(8):729-737. Epub 2017 Jun 27.
    Servicio de Dermatología, Hospital Infanta Sofía, San Sebastián de los Reyes, Madrid, España.
    Background And Objectives: A broad range of skin flaps can be used to repair facial surgical defects after the excision of a tumor. The aim of our study was to develop a practical guideline covering the most useful skin grafts for each of the distinct facial cosmetic units.

    Material And Methods: This was a multicenter study in which 10 dermatologists with extensive experience in reconstructive surgery chose their preferred technique for each cosmetic unit. Read More

    Semilunar Coronally Advanced Periodontal Flap to Increase Soft Tissue Coverage of a Maxillary Fourth Premolar in a Dog.
    J Vet Dent 2017 Jun;34(2):100-105
    1 Veterinary Dental Specialties & Oral Surgery, San Diego, CA, USA.
    A 7-year-old, 31.3 kg spayed female Golden Retriever dog was presented for the treatment of Miller Class I gingival recession at the right maxillary fourth premolar (108). A semilunar coronally advanced periodontal flap was performed at this tooth and created an increase of approximately 3 mm of soft tissue coverage of the tooth. Read More

    Columella reconstruction with an inferiorly-based philtral advancement flap in a cocaine abuser.
    Indian J Plast Surg 2017 Jan-Apr;50(1):96-99
    Department of Otorhinolaryngology, San Raffaele Hospital and Vita-Salute University, Via Olgettina, Milan, Italy.
    Nasal columella defects can significantly impair aesthetic appearance. Columella reconstruction can be very challenging for surgeons, especially if due to cocaine abuse. The case of a 32-year-old male patient with subtotal columellar necrosis secondary to cocaine abuse is presented. Read More

    Verrucous carcinoma of the vulva: diagnosis and treatment.
    An Bras Dermatol 2017 Mar-Apr;92(2):243-245
    Dermatology Clinic at Irmandade da Santa Casa de Misericórdia de São Paulo - São Paulo (SP), Brazil.
    Vulvar cancer accounts for less than 1% of malignancies in women. Verrucous carcinoma of the vulva is a rare histological variation, comprising less than 1% of vulvar cancer cases. Although it is characterized as being locally invasive, the condition is not associated with metastatic spreading. Read More

    The Split Pectoralis Flap: Combining the Benefits of Pectoralis Major Advancement and Turnover Techniques in One Flap.
    Plast Reconstr Surg 2017 Jun;139(6):1474-1477
    Houston, Texas From the Division of Plastic and Reconstructive Surgery, Baylor College of Medicine.
    Background: The pectoralis major is a versatile flap used as an advancement or turnover flap for sternal wound treatment. The advancement flap provides suboptimal inferior sternal coverage and poorly fills mediastinal dead space. The turnover flap covers the inferior sternum and fills dead space but requires disinsertion of the muscle from the humerus, resulting in functional loss and cosmetic deformity. Read More

    Reconstructing Discontinuous Facial Defects with Simultaneous Ulnar Perforator Free Flaps.
    Plast Reconstr Surg Glob Open 2017 Apr 7;5(4):e1291. Epub 2017 Apr 7.
    Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colo.; and Division of Plastic Surgery, Departments of Surgery and Otolaryngology, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colo.
    Multiple, simultaneous skin cancers of the face are common. This is the first description of reconstructing discontinuous facial defects (i.e. Read More

    Closure of nasal septal perforations with a polydioxanone plate and temporoparietal fascia in a closed approach.
    Am J Rhinol Allergy 2017 May;31(3):190-195
    Background: Septal perforation closure is still often invasive and complex, with relatively low closure rates.

    Objectives: We aimed to provide the first results of a case series of 20 patients with nasal septal perforations who underwent septal perforation repair by both an open and a minimally invasive technique by using a graft that consisted of temporoparietal fascia and a polydioxanone (PDS) plate without mucosal flaps. Between 2014 and 2016, we tested, for the first time, the feasibility of the insertion of this graft via a hemitransfixion incision at our institution. Read More

    Randomized clinical trial comparing collagen plug and advancement flap for trans-sphincteric anal fistula.
    Br J Surg 2017 Aug 10;104(9):1160-1166. Epub 2017 May 10.
    Department of Gastrointestinal Surgery, Akershus University Hospital, Lorenskog, Norway.
    Background: The role of a collagen plug for treating anal fistula is not well established. A randomized prospective multicentre non-inferiority study of surgical treatment of trans-sphincteric cryptogenic fistulas was undertaken, comparing the anal fistula plug with the mucosal advancement flap with regard to fistula recurrence rate and functional outcome.

    Methods: Patients with an anal fistula were evaluated for eligibility in three centres, and randomized to either mucosal advancement flap surgery or collagen plug, with clinical follow-up at 3 and 12 months. Read More

    Sphincter-Sparing Excision and Reconstruction Using Facial Artery Perforator Flaps for Lower Lip Carcinoma.
    J Oral Maxillofac Surg 2017 Aug 8;75(8):1792.e1-1792.e8. Epub 2017 Apr 8.
    Specialist, Pathology Department, Yildirim Beyazit University, Ataturk Training and Research Hospital, Ankara, Turkey.
    Purpose: This article discusses the results of orbicularis oris muscle-sparing surgery and reconstruction of defects through the use of facial artery perforator flaps and mucosal advancement flaps.

    Patients And Methods: Patients with lower lip carcinoma were evaluated retrospectively. Patients who underwent reconstruction with facial artery perforator flaps and mucosal advancement flaps with clear surgical margins and no muscle invasion were included in this study. Read More

    The rectus abdominis muscle advancement flap as a salvage option for chest wall reconstruction.
    Ann R Coll Surg Engl 2017 May;99(5):e142-e144
    Department of Plastic and Reconstructive Surgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Preston , UK.
    We describe a previously unreported technique of advancing the rectus abdominis muscle superiorly, based on the deep inferior epigastric artery, to cover a lower anterior chest wall defect. This technique represents an important salvage option for chest wall reconstruction and affords a great deal of intra-operative flexibility. Read More

    Right Ventricular Perforation From a Floating Rib Following Deep Sternal Wound Infection Debridement and Application of a Vacuum-Assisted Closure Device: A Case Report and Literature Review.
    Eplasty 2017 6;17:e15. Epub 2017 Apr 6.
    Institute for Plastic and Reconstructive Surgery, Southern Illinois University School of Medicine, Springfield.
    Introduction: Deep sternal wound infection following major cardiac surgery is a deleterious complication with sequelae that can be life threatening. The use of vacuum-assisted closure therapy in management of sternal wounds with resultant right ventricular rupture has been documented in the cardiothoracic and to a lesser extent in the reconstructive literature. Methods/Case Report: We present a case of a 67-year-old male patient who suffered from right ventricular perforation from a floating rib following debridement of a deep sternal wound infection and placement of a vacuum-assisted closure device. Read More

    Eyelid reconstruction using the "Hughes" tarsoconjunctival advancement flap: Long-term outcomes in 122 consecutive cases over a 13-year period.
    Orbit 2017 Aug 24;36(4):228-233. Epub 2017 Apr 24.
    a Department of Ophthalmology , Waikato District Health Board , Hamilton , New Zealand.
    This article evaluates the complications and long term functional and cosmetic outcomes of tarsoconjunctival advancement flaps for repairing a range of lower eyelid defects in a large cohort of consecutive cases. A retrospective series of 122 consecutive cases of eyelid reconstruction using tarsoconjunctival-advancement flaps was conducted at Waikato Hospital, or Hamilton Eye Clinic, New Zealand. All cases of lid reconstruction using tarsoconjunctival-advancement flaps between January 1, 2001 until April 3, 2014 were included for analysis. Read More

    Single-Stage Separation of 3- and 4-Finger Incomplete Simple Syndactyly With Contiguous Gull Wing Flaps: A Technique to Minimize or Avoid Skin Grafting.
    J Hand Surg Am 2017 Apr;42(4):257-264
    Division of Plastic and Reconstructive Surgery, University of Florida College of Medicine, Gainesville, FL. Electronic address:
    Purpose: Staged separation of 3- and 4-finger syndactyly is commonly performed owing to concerns about vascular supply to the central digit and availability of flap skin. We performed single-stage separation of patients with incomplete syndactyly of multiple digits with adjacent contiguous dorsal gullwing flaps and avoided skin grafts in the majority of cases.

    Methods: Seventy-four webs of 31 patients with more than 2-finger incomplete syndactyly were included. Read More

    The Double Thenar Flap: A Technique to Reconstruct 2 Fingertip Amputations Simultaneously.
    J Hand Surg Am 2017 May 30;42(5):396.e1-396.e5. Epub 2017 Mar 30.
    New York Hand and Wrist Center of Lenox Hill, New York, NY.
    Fingertip injuries are a common problem. There may be pulp loss and exposed bone. Various techniques have been described to reconstruct function as well as aesthetics; yet it is still unclear which treatment options should be chosen for each specific injury. Read More

    Innovations and Future Directions in Head and Neck Microsurgical Reconstruction.
    Clin Plast Surg 2017 Apr;44(2):325-344
    Division of Plastic and Reconstructive Surgery, Mayo Clinic, MA1244W, 200 First Street Southwest, Rochester, MN 55905, USA. Electronic address:
    Head and neck reconstructive microsurgery is constantly innovating because of a combination of multidisciplinary advances. This article examines recent innovations that have affected the field as well as presenting research leading to future advancement. Innovations include the use of virtual surgical planning and three-dimensional printing in craniofacial reconstruction, advances in intraoperative navigation and imaging, as well as postoperative monitoring, development of minimally invasive reconstructive microsurgery techniques, integration of regenerative medicine and stem cell biology with reconstruction, and the dramatic advancement of face transplant. Read More

    Continuing the Original Stanford Sleep Surgery Protocol From Upper Airway Reconstruction to Upper Airway Stimulation: Our First Successful Case.
    J Oral Maxillofac Surg 2017 Jul 20;75(7):1514-1518. Epub 2017 Feb 20.
    Clinical Professor of Stanford Sleep Surgery, Division of Sleep Surgery, Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA.
    In 1993, a surgical protocol for dynamic upper airway reconstruction in patients with obstructive sleep apnea (OSA) was published, and it became commonly known as the Stanford phase 1 and 2 sleep surgery protocol. It served as a platform on which research and clinical studies have continued to perfect the surgical care of patients with OSA. However, relapse is inevitable in a chronic condition such as OSA, and a subset of previously cured surgical patients return with complaints of excessive daytime sleepiness. Read More

    Two-stage treatment of ischial pressure ulcers in spinal cord injury patients: Technique and outcomes over 8 years.
    J Plast Reconstr Aesthet Surg 2017 Jul 23;70(7):959-966. Epub 2017 Jan 23.
    Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. Electronic address:
    Background: Despite newly introduced techniques, reconstruction of ischial pressure ulcers remains a difficult problem with high-reported failure rates.

    Methods: A retrospective chart review was performed on all spinal cord injury patients who underwent ischial pressure ulcer reconstruction by the senior author (V.L. Read More

    [Perineal reconstruction: Salvage surgery with 2flaps technique].
    Cir Cir 2017 Mar 6. Epub 2017 Mar 6.
    Departamento de Cirugía General y del Aparato Digestivo, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España.
    Background: The principles of perineal reconstructive surgery comprise adequate filling of the defect along with stable and durable skin coverage, with a low morbidity rate. Two-flap perineal reconstruction is a simple, fast and reliable technique that uses a single donor site. This improves scar position with low morbidity. Read More

    Transvaginal Repair of Complex Rectovaginal Fistulas Using the Porcine Urinary Bladder Matrix as an Augmenting Graft.
    Female Pelvic Med Reconstr Surg 2017 May/Jun;23(3):e25-e28
    From the Section of Urogynecology and Reconstructive Pelvic Surgery, Department of Gynecology, Cleveland Clinic Florida, Weston, FL.
    Background: After the US Food and Drug Administration issued a safety warning concerning vaginal mesh implants in 2008, their use in correction of pelvic floor defects have decreased in the United States (http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm479732. Read More

    Aesthetic Reconstruction of the Frontotemporal Region: The Extended A-T Plasty, A Workhorse Revisited.
    Ann Plast Surg 2017 Jul;79(1):34-38
    From the Unit of Plastic Surgery and Dermatology, "Campus Bio-Medico di Roma" University, Rome, Italy.
    Background: A-T plasty has long been a workhorse for defects located around the eyebrow or in the upper and lower lip. It allows like-with-like reconstruction with placement of the scars in natural creases or subunit junctions. In this article, the authors describe their refined technique to specifically address moderate to large size defects of the frontotemporal, preauricular, and zygomatic regions. Read More

    Follicular thyroid cancer with sternal metastasis - challenges and outcomes.
    Med J Malaysia 2017 Feb;72(1):80-82
    Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Department of Surgery, Plastics and Reconstructive Unit, 56000 Cheras, Kuala Lumpur, Malaysia.
    Sternal metastasis from differentiated thyroid carcinoma (DTC) is rare and presents a conundrum for surgeons. We present a lady diagnosed with follicular thyroid carcinoma and sternal metastasis who underwent thyroidectomy, sternectomy and sternoplasty with titanium mesh and acrylic plate. She developed a surgical site infection, of which multiple conservative approaches were attempted. Read More

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