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J Plast Reconstr Aesthet Surg 2022 May 2. Epub 2022 May 2.

Department of Orthopedic Surgery, Kurashiki Central Hospital, Kurashiki, Japan.

Radial artery superficial palmar branch harvesting is technically challenging, especially for inexperienced hand surgeons. The short pedicle and a damaged recipient digital artery require proximal digital artery dissection and relatively long pedicles. Herein, we describe a facilitated flap elevation technique and its application in various cases. Read More

J Plast Reconstr Aesthet Surg 2022 Apr 25. Epub 2022 Apr 25.

Department of Dermatology, MetroHealth System, Cleveland, OH, United States; Case Western Reserve University, School of Medicine, Cleveland, OH, United States. Electronic address:

Background: While bilobed and trilobed transposition flaps are established workhorses for nasal reconstruction, their utility is often limited to defects less than 1.5 cm, subjecting patients to more involved multistage or cosmetically less favorable repairs. We highlight the use of bilobed and trilobed transposition flaps for intermediate (≥ 1. Read More

Dermatol Surg 2022 May 10. Epub 2022 May 10.

Zitelli & Brodland Skin Cancer Center, University of Pittsburgh Medical Center, Shadyside Hospital, Pittsburgh, Pennsylvania.

J Orthop Surg Res 2022 May 12;17(1):262. Epub 2022 May 12.

Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Hefei, 230022, Anhui, China.

Background: Complex lower limb reconstruction due to severe trauma remains a challenge for reconstructive surgeons. Here, we introduce a modified donor blood flow-preserved cross-leg anterolateral thigh flap procedure and evaluate its clinical efficacy.

Methods: Between January 2013 and December 2019, 22 patients (range 10 to 64 years old) with unilateral lower limb injury underwent modified donor blood flow-preserved cross-leg anterolateral thigh flap procedures. Read More

Ann Chir Plast Esthet 2022 Feb 22;67(1):7-13. Epub 2022 Jan 22.

CHU d'Angers, Angers, France.

Background: The Face is the most frequent localization for cutaneous carcinoma. The nose accounts for about 30% of these tumors. Nose tissue loss repair has to pursue 3 types of objectives: carcinologic, aesthetic and functional. Read More

J Pharm Bioallied Sci 2021 Nov 10;13(Suppl 2):S1291-S1294. Epub 2021 Nov 10.

Ministry of Health, Riyadh, Saudi Arabia.

Background: Cosmetic defects after the major orofacial disease corrections may have an effect on the overall well-being of the patient. Head-and-neck cosmetic surgeries after a major episode of oral cancer impact the functional ability of the individual in several ways. In general, two types of flap are used in reconstructive surgery: microvascular free flaps and regional pedicle flaps. Read More

J Craniofac Surg 2022 May 29;33(3):821-826. Epub 2021 Dec 29.

Department of Plastic Surgery, University of Tennessee Health Science Center.

Abstract: Eyelid reconstruction is a complex topic. This review looks at articles from 1990 to 2018 on eyelid reconstruction that had at least 10 patients and a mean 6 month follow-up. The authors present the results of our findings and propose an algorithm to guide the surgeon in choosing the best technique based on location, size, and lamella. Read More

Dermatol Surg 2022 Feb;48(2):191-194

Cutaneous Oncology Unit, The Skin Centre, Tauranga, New Zealand.

Background: Bilobed transposition flaps are prone to pincushioning (trapdooring), whereby contraction of the flap over the wound bed may produce an unsatisfactory functional and aesthetic outcome. There are several proposed methods to prevent this, but there is currently no clear consensus on the ideal technique.

Objective: To compare primary lobe pexing sutures versus intraoperative triamcinolone (TAC) injection as methods to prevent pincushioning in bilobed transposition flaps. Read More

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021 Nov;56(11):1174-1178

Department of Otorhinolaryngology Head and Neck Surgery, Xuanwu Hospital Capital Medical University, Beijing 100053, China.

To evaluate the application of island flap and combined flap in one-stage reconstruction of nasal alae defects after external nasal tumor resection. Data of 11 patients with perforating or full-thickness defects of the alae after nasal tumor resection in XuanWu Hospital, Capital Medical University between June 2016 and February 2021 were analyzed retrospectively. There were 7 males and 4 females, and the ages ranged from 51 to 89 years. Read More

Plast Reconstr Surg 2021 Nov;148(5):837e-840e

From the Division of Plastic and Reconstructive Surgery, McGill University Health Center; and Faculty of Medicine, McGill University.

Summary: The teaching and assessment of ideal surgical markings for local flaps required for optimal aesthetic and functional outcomes remain a challenge in the present era of competency-based surgical education. The authors utilized the bilobed flap for nasal reconstruction as a proof of concept for the development of an innovative objective assessment tool based on statistical shape analysis, with a focus on providing automated, evidence-based, objective, specific, and practical feedback to the learner. The proposed tool is based on Procrustes statistical shape analysis, previously used for the assessment of facial asymmetry in plastic surgery. Read More

Turk Neurosurg 2021 ;31(6):944-951

Malatya Turgut Ozal University, Malatya Education and Research Hospital, Department of Plastic Surgery, Malatya, Turkey.

Aim: To evaluate fasciocutaneous flaps used for reconstruction of meningomyelocele defects in our clinic and to suggest an algorithm for flap selection.

Material And Methods: A retrospective analysis of 45 patients with meningomyelocele, who underwent repair with fasciocutaneous flaps, was carried out. Preoperative and postoperative photos were analyzed. Read More

J Laryngol Otol 2022 Mar 4;136(3):252-255. Epub 2021 Oct 4.

Department of Otolaryngology - Head and Neck Surgery, Chonnam National University Medical School and Hwasun Hospital, Hwasun, South Korea.

Objective: To analyse the treatment results of bilobed flap reconstruction performed for skin defects after parotid carcinoma surgery.

Method: Ten patients who underwent bilobed flap reconstruction for skin defects after parotid carcinoma surgery in our hospital, from 2014 to 2020, were retrospectively enrolled.

Results: All patients underwent bilobed flap reconstruction for skin defects after parotid carcinoma surgery. Read More

J Nippon Med Sch 2021 Sep 14. Epub 2021 Sep 14.

Department of Otorhinolaryngology Head and Neck Surgery Keio University.

Objectives: Reconstruction of medium-sized skin defect after excision of parotid carcinoma is performed using local flaps, pedicled flaps, or free flaps. The bilobed flap is one of the local flaps adopted by plastic surgeons primarily for a small nasal skin defect. We report a case of a patient with parotid carcinoma with skin infiltration who successfully underwent skin reconstruction with the bilobed flap. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 Sep;35(9):1172-1176

Department of Oncology Plastic Surgery, Hunan Province Cancer Hospital, Changsha Hunan, 410008, P.R.China.

Objective: To explore the effectiveness of the modified designed bilobed latissimus dorsi myocutaneous flap in chest wall reconstruction of locally advanced breast cancer (LABC) patients.

Methods: Between January 2016 and June 2019, 64 unilateral LABC patients were admitted. All patients were female with an average age of 41. Read More

Dermatol Surg 2021 09;47(9):1205-1213

Department of Dermatology, University of California Davis, Sacramento, California.

Background: Despite numerous options for nasal ala reconstruction, advantages and disadvantages of each method are unclear.

Objective: To summarize reported outcomes of local flaps without the use of grafts for nasal ala oncologic reconstructive surgery.

Methods: A nasal ala-specific protocol was adapted from a previous head- and neck-specific PROSPERO submission (CRD42017071596). Read More

Dermatol Surg 2021 09;47(9):1293-1294

Department of Dermatology, Royal Victoria Infirmary Hospital, Newcastle Upon Tyne, United Kingdom.

Eur Ann Otorhinolaryngol Head Neck Dis 2021 Nov 17;138 Suppl 4:139-140. Epub 2021 Jun 17.

Stockport NHS Foundation Trust, Stockport SK2 7JE, United Kingdom.

Zhonghua Shao Shang Za Zhi 2021 May;37(5):453-459

Department of Foot and Ankle Surgery, Ruihua Affiliated Hospital of Soochow University, Suzhou 215104, China.

To explore the clinical effects of anterolateral thigh perforator flap with sensory nerves in repairing the plantar skin and soft tissue defects. From January 2016 to March 2019, 13 male patients with plantar skin and soft tissue defects were admitted to the Department of Foot and Ankle Surgery of Ruihua Affiliated Hospital of Soochow University, aged 27 to 73 years. The retrospective cohort study was conducted. Read More

Ann Plast Surg 2021 06;86(6):647-654

Department of Plastic, Reconstructive, and Aesthetic Surgery, Selcuk University Faculty of Medicine, Konya, Turkey.

Background: Reconstruction of auricular defects is a challenging surgical procedure because of its complex 3-dimensional structure. Various surgical techniques have been used for the reconstruction of the auricle. However, most of these techniques are not applicable to the reconstruction of marginal and central defects, and the texture and color harmony of the reconstructed parts were not evaluated in detail. Read More

Indian J Surg Oncol 2021 Mar 8;12(1):39-47. Epub 2020 Oct 8.

Department of Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat India.

The gold standard reconstructive options for full-thickness defect of the oral cavity after resection of malignant lesions are the free flaps. But in developing nations due to resource constraints, it cannot be offered to all. Hence, pectoralis major myocutaneous (PMMC) flap as bilobed flaps is most commonly used. Read More

Facial Plast Surg Aesthet Med 2021 12 1;23(6):476-481. Epub 2021 Mar 1.

Dermatology Division, Memorial Sloan Kettering Cancer Center, New York, New York, USA.

Reconstruction of nasal skin defects can be challenging due to limited skin laxity and underlying cartilage and, therefore, often require a complex repair. The aim of this review is to systematically analyze the literature on nasal skin reconstructions with specific detail to flap reconstructions. A systematic literature review of nasal skin reconstruction was performed and focused on flap reconstructions. Read More

Dermatol Surg 2021 05;47(5):618-622

All authors are affiliated with the Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill, North Carolina.

Background: Reconstructing defects on the nose can be challenging. The bilobed transposition flap and the nasalis-based V to Y (NBVY) flaps can be excellent repair options, each with their own advantages and disadvantages.

Objective: To compare bilobed and NBVY flap scar appearances, postoperative complications, scar revision rates, flap sizes, and relative costs. Read More

Zhonghua Shao Shang Za Zhi 2020 Dec;36(12):1199-1203

Department of Plastic and Reconstructive Surgery, the First Medical Center of Chinese PLA General Hospital, Beijing 100039, China.

To explore the methods of repairing large soft tissue defect with latissimus dorsi myocutaneous flap and the management of secondary wound in donor site. From June 2015 to June 2019, 30 patients with soft tissue defect caused by various reasons or hyperplastic scar were hospitalized in the First Medical Center of Chinese PLA General Hospital, including 10 males and 20 females, aged 25-64 years, with 18 cases of head soft tissue defects caused by the growth and rupture of tumor, 7 cases of hypertrophic scar in trunk and limbs, and 5 cases of facial and neck soft tissue defects caused by trauma. The area of primary wound after debridement or enlarged lesion resection was 14 cm×10 cm-18 cm×16 cm. Read More

Acta Dermatovenerol Alp Pannonica Adriat 2020 Dec;29(4):209-214

Department of Dermatology and Allergology, Skin Cancer Center, Dresden Municipal Clinic, Dresden, Germany.

Introduction: Malignant keratinocyte tumors-that is, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)-are commonly found on sun-exposed body areas such as the nose. The primary aim of tumor surgery is complete excision. Due to anatomical, functional, and aesthetic issues, reconstruction of such defects remains a challenge. Read More

Burns Trauma 2020 12;8:tkaa012. Epub 2020 Dec 12.

Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai 200011, China.

Background: Sacral pressure ulcers are associated with high morbidity and, in some cases, result in mortality from severe sepsis. Local flaps are frequently used for reconstruction of stage III and IV pressure ulcers. An ideal flap should be simple to design, have a reliable vascular supply and minimal donor site morbidity. Read More

Medicina (Kaunas) 2020 Nov 25;56(12). Epub 2020 Nov 25.

Department of Translational Research and New Technologies in Medicine and Surgery, Plastic Surgery Unit, University of Pisa, 56125 Pisa, Italy.

The nose represents the most common site for the presentation of cutaneous cancer, especially in sun-exposed areas: ala, dorsum, and tip. Even the smallest loss of substance can create aesthetic and psychosocial concerns for patients; therefore, surgeons who perform nasal reconstruction should be strictly confident with the pertinent surgical anatomy in order to tailor the procedure to the patient's condition and needs. Radical tumor excision and satisfactory aesthetic and functional results are primary targets. Read More

J Plast Reconstr Aesthet Surg 2021 Apr 24;74(4):740-746. Epub 2020 Oct 24.

Department of Oral, Maxillofacial and Facial Plastic Surgery, School of Medicine, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.

The incidence of skin cancer, which often affects the facial skin, has risen worldwide. After resecting such facial lesions, plastic reconstruction is necessary in most cases. The paramedian forehead flap (PFF) and the bilobed flap (BF) are commonly used for nasal reconstruction, but whether patients and physicians are satisfied with the esthetics is undetermined? In this study, scar questionnaires (Manchester Scar Scale, Vancouver Scar Scale, and Patient and Observer Scar Assessment Scale) and optical three-dimensional (3D) imaging were used for subjective and objective evaluation of esthetical outcomes after plastic reconstruction of the nose in 30 patients. Read More

Indian J Ophthalmol 2020 Nov;68(11):2520-2521

Department of Otorhinolaryngology, University of Health Sciences, Okmeydani Education and Research Hospital, Istanbul, Turkey.

Plast Reconstr Surg Glob Open 2020 Aug 11;8(8):e3040. Epub 2020 Aug 11.

Division of Plastic & Reconstructive Surgery, University of Miami, Miami, Fla.

The nasal tip is a complex zone for reconstruction. Numerous flap reconstructions have been proposed. In addition to the technique presented here, only the Gillies-Millard bishop's miter flap and the paramedian forehead flap should be considered. Read More

Aesthetic Plast Surg 2021 06 25;45(3):866-874. Epub 2020 Sep 25.

O.U. Breast Surgical Unit, Morgagni-Pierantoni Hospital, Ausl Romagna, Via Carlo Forlanini 34, 47100, Forli, FC, Italy.

Introduction: The aim of this work was to describe our technique, the "Bifidus pedicle", which is a modification of the superomedial pedicle, for managing large breast cancers (BCs) in the upper outer quadrant (UOQ) in patients with medium/large breasts and associated ptosis. Observed complications, cosmetic outcome and oncologic safety were also reported.

Materials And Methods: Thirty patients underwent our modification of the superomedial pedicle combined with a Wise skin resection pattern for large BCs in the UOQ. Read More