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Clin Orthop Relat Res 2020 Jun 1. Epub 2020 Jun 1.

H. Roberts, G. DeSilva, Department of Orthopaedics, University of Arizona-Tucson, Tucson, AZ, USA.

Ann Plast Surg 2020 May 28. Epub 2020 May 28.

Department of Orthopedics, The Second People's Hospital of Lianyungang, Lianyungang, Jiangsu, China.

Background: As a common complication of the long-term bedridden patients, pressure sore is a great challenge for surgeons. The purpose of this study was to explore the surgical method of using a clover-style fasciocutaneous perforator flap raised on the buttocks for the treatment of massive sacral pressure sores and report the clinical outcomes.

Methods: The study included 15 patients from January 2015 to June 2017 with an average age of 52. Read More

Childs Nerv Syst 2020 May 28. Epub 2020 May 28.

Universidad Nacional de Colombia, Hospital Universitario Nacional, Bogotá, D.C., Colombia.

Background: Myelomeningocele (MMC) is the most common and severe pathology of open spina bifida compatible with life. Its early closure is an urgent therapeutic objective to reduce the morbidity and mortality of neonates, being a surgical challenge with two major objectives: (1) achieve closure of the dural cerebrum-spinal fluid fistula and (2) ensure a stable and durable soft tissue coverage. The use of fasciocutaneous flaps in keystone design is shown as a safe and stable surgical option with excellent aesthetic results in patients with MMC and who presented failed primary closures. Read More

Cent European J Urol 2020 31;73(1):74-79. Epub 2019 Dec 31.

Department of Plastic, Reconstructive and Esthetic Surgery and Burn Unit, Centro Hospitalar de São João, Porto, Portugal.

Introduction: Fournier's gangrene is a rapidly progressive necrotizing fasciitis of the genital and perineal tissues with a high mortality rate. Early diagnosis and treatment with fluid resuscitation, surgical debridement and wide-spectrum antibiotics are essential in the management of Fournier's gangrene. After primary treatment, reconstructive surgery is often necessary for coverage of soft-tissue defects. Read More

Sisli Etfal Hastan Tip Bul 2020 24;54(1):98-102. Epub 2020 Mar 24.

Department of Plastic Reconstructive and Aesthetic Surgery, Health Sciences University, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.

Objectives: This study aims to investigate the efficacy of salvage of the mechanically exposed cardiac pacemakers with fasciocutaneous local flaps in elderly patients.

Methods: Between January 2014 and January 2018, ten patients (six females, four males; mean age 66.2 years) who were treated due to pacemaker exposition were retrospectively analyzed in this study. Read More

J Egypt Natl Canc Inst 2020 Jan 14;32(1). Epub 2020 Jan 14.

Department of Surgical Oncology, Dr. BRA-IRCH, All India Institute of Medical Sciences, New Delhi, India.

Background: This study aims to analyze risk factors, clinical profiles, treatment protocols, and disease outcomes in histologically proven resectable vulvar cancer (VC) patients according to tumor stage. This is a retrospective analysis of a prospectively collected database of 20 VC patients from May 2014 to June 2019.

Results: The mean age of VC diagnosis was 55 years, with a range of 38-84 years. Read More

Indian J Plast Surg 2020 Mar 4;53(1):83-89. Epub 2020 Mar 4.

Medical Student, Government Medical College and ESI Hospital, Coimbatore, Tamil Nadu, India.

 The purpose of this study is to present the efficiency of the lateral supramalleolar flap which is a very useful and yet underutilized in the soft tissue reconstruction of the regions extending from the distal leg, ankle, and foot.  Over a period of 3 years, 20 flaps were used in the reconstruction of soft tissue defects in the region extending from the distal leg, ankle, and foot. The location of the defects, the etiology, possible alternative flaps, outcome, and the complications were studied and presented. Read More

J Burn Care Res 2020 Apr 30. Epub 2020 Apr 30.

Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Transplantation of vascularized composite allografts (VCAs) provides a means of restoring complex anatomical and functional units following burns and other disfigurement otherwise not amenable to conventional autologous reconstructive surgery. While short- to intermediate-term VCA survival is largely dependent on patient compliance with medication, the myriad of side effects resulting from lifelong systemic immunosuppression continue to pose a significant challenge. Topical immunosuppression is therefore a logical and attractive alternative for VCA. Read More

Malays Orthop J 2020 Mar;14(1):61-73

Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Introduction: Grade 3B/C open tibial fractures with grossly contaminated degloving injuries have poor outcomes, with or without vascular injuries. Treatment decision oscillates between limb salvage and amputation. The standard protocol of repeated debridement and delayed wound cover is a challenge in developing countries due to overcrowded emergencies and limited operating room availability. Read More

Tech Coloproctol 2020 Jun 13;24(6):593-597. Epub 2020 Apr 13.

Department of plastic and reconstructive surgery, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands.

Background: The aim of this study was to evaluate the efficacy of a combination of flaps for the reconstruction of presacral defects following abdominoperineal resections: a paramedian vertically oriented caudally based lotus petal flap for presacral defects combined with a horizontal V-Y advancement flap for closure of the superficial donor site defect.

Methods: A retrospective study was conducted on patients with a residual defect following an abdominoperineal resection between 2010 and 2017 in the Noordwest Ziekenhuisgroep. The primary endpoint was complications related to the reconstruction. Read More

J Foot Ankle Surg 2020 May - Jun;59(3):462-464. Epub 2020 Apr 3.

Fellowship Director, Amita Health Saint Joseph Hospital Department of Surgery, Chicago, IL.

Medial plantar artery-based flaps have great value in healing full-thickness wounds of the foot and ankle. The goal of this study was to identify a common location for the origin of the medial plantar artery. Recognition of this anatomic marker will help improve incision placement and increase the success of preserving the artery when performing the medial plantar artery fasciocutaneous flap. Read More

Clin Orthop Relat Res 2020 Apr;478(4):739-740

A. Roshan, Department of Plastic & Reconstructive Surgery, Cambridge University Hospitals NHS Trust, Cambridge, UK.

Clin Orthop Relat Res 2020 Apr;478(4):734-738

H. Roberts, G. DeSilva, Department of Orthopaedics, University of Arizona-Tucson, Tucson, AZ, USA.

Background: Many studies have evaluated the reverse sural fasciocutaneous flap for coverage of wounds on the distal lower extremity, and many of these have focused on younger, healthy patients. However, to our knowledge, there has been no dedicated study focusing on older patients. We believe there is a generalized concern about performing these procedures in older patients because of microvascular changes associated with aging. Read More

J Craniofac Surg 2020 Mar 27. Epub 2020 Mar 27.

Department of Plastic and Reconstructive Surgery, Defne Research State Hospital, Hatay, Turkey.

Purpose/object/background: In gunshot injury (GSI), the distance, ballistic properties, and the site of injury of lead or scattering gain importance. The authors investigated alternative methods to local flap applications in large tissue losses on facial regions caused by GSI in the Syrian War at the light of our approaches and outcomes.

Materials And Methods: The study was designed as a cross-sectional retrospective clinical cohort analyze. Read More

J Reconstr Microsurg 2020 Mar 29. Epub 2020 Mar 29.

Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Munich, Germany.

Background:  Whether to perform an end-to-end (ETE) versus end-to-side (ETS) arterial anastomosis is an integral part of preoperative planning and intraoperative decision making in free flap-based reconstructions. This study evaluated the impact of microsurgical anastomotic technique on outcomes of lower extremity reconstructions, with a focus on patients with peripheral arterial disease (PAD).

Methods:  Over a 6-year period, 425 patients underwent 437 microvascular lower extremity free flap reconstructions with fasciocutaneous anterolateral thigh- or gracilis muscle flaps at a single surgical center. Read More

Plast Reconstr Surg 2020 Apr;145(4):1071-1076

New York, N.Y.; and Charlottesville, Va. From the Hansjörg Wyss Department of Plastic Surgery and the Department of Orthopaedic Surgery, New York University School of Medicine; and the Department of Plastic Surgery, University of Virginia Health System.

Osteocutaneous reconstruction can be challenging because of concomitant injuries and limited donor sites. There is a paucity of data on limb salvage outcomes following combined soft-tissue reconstruction and bone transport or Masquelet procedures. The authors reviewed a consecutive series of open tibia fracture patients undergoing soft-tissue reconstruction with either distraction osteogenesis or Masquelet technique. Read More

Hernia 2020 Mar 26. Epub 2020 Mar 26.

Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.

Purpose: No previous study reported the use of a fasciocutaneous anterolateral thigh (ALT) flap combined with a biological mesh for abdominal wall reconstruction (AWR) after enterocutaneous fistula (ECF) in a single-staged procedure and the use of Indocyanine Green Angiography (ICGA) intraoperatively. The purpose of this study was to determine the feasibility and safety of this procedure and to examine the added value of ICGA in minimizing postoperative complications.

Methods: A single-institution review of a prospectively maintained database was conducted at Maastricht University Medical Center. Read More

J Craniofac Surg 2020 Mar 20. Epub 2020 Mar 20.

Ex-Head Division Plastic Surgery, Argerich Hospital Ciudad Autonoma de Buenos Aires, Educational Plastic Surgery Unity, Medicine Faculty Buenos Aires University, Buenos Aires, Argentina.

The use of fasciocutaneous flaps remain as first election of reconstructive method after remotion of tumors, benign lesions and sequel of traumas.A new designed fasciocutaneous flap according to mechanism V-Y like island flap is described. It has 2 different portions: 1. Read More

World J Plast Surg 2020 Jan;9(1):55-61

Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: Hidradenitis suppurativa is a chronic inflammatory disease with multiple inflammatory nodules and abscesses. We aimed to compare split thickness skin graft (STSG) and flaps in bilateral chronic refractory axillary hidradenitis suppurativa.

Methods: Thirty patients were investigated from March 21, 2010 to March 20, 2015. Read More

Int J Low Extrem Wounds 2020 Feb 23:1534734620905738. Epub 2020 Feb 23.

Ankara Numune Training and Research Hospital, Ankara, Turkey.

Reconstruction of the heel region poses great challenge to plastic surgeons not only due to calcaneal bone lying just deep to the subdermal fat pad but also due to easily exposed Achilles tendon. In order to achieve permanent closure of the heel defect, exposed bone or tendon-or both-should be covered with durable, preferably sensate, well-vascularized, thin skin flaps. Even though fasciocutaneous free flaps remain the gold standard in the reconstruction of heel defects with exposed bone or tendon, a significant number of these patients are older individuals with multiple comorbidities such as diabetes mellitus, hypertension, atherosclerosis, and peripheral vascular disease. Read More

J Oral Maxillofac Surg 2020 May 22;78(5):823-834. Epub 2020 Jan 22.

Assistant Professor of Surgery and Division Chair, Section of Head and Neck Oncologic Surgery and Reconstruction, Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic and Mayo College of Medicine, Rochester, MN.

Subscapular-based flaps have historically maintained an unparalleled ability to provide a multitude of bone and soft tissue components based on a single vascular pedicle. However, these flaps are often not thought of as an ideal choice for composite defects requiring extended lengths of bone for reconstruction. The ability to harvest long segments of bone and reliably perform multiple contouring osteotomies is fundamental to long-span composite mandibular reconstruction, and microvascular surgeons are often met with significant reconstructive challenges when fibular free flaps cannot be used owing to variant vascular anatomy or occlusive atherosclerotic disease in these specific clinical scenarios. Read More

J Maxillofac Oral Surg 2020 Mar 30;19(1):151-156. Epub 2019 Mar 30.

4Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr-Universität Bochum, Bochum, Germany.

Introduction: Perforator dissection can be technically demanding with a steep learning curve. Inadvertent perforator damage during dissection can be minimized with practice and familiarity with tissue-handling techniques unique to perforator dissection. There currently lacks a simulation model that mimics the human perforator in size and course. Read More

Int J Oral Maxillofac Surg 2020 Jan 21. Epub 2020 Jan 21.

Department of Plastic Surgery, VPS Lakeshore Hospital, Cochin, Kerala, India.

The aim of this study was to determine whether the islanded facial artery myomucosal flap (iFAMM) is a good alternative to fasciocutaneous free flaps (FCFF) in the reconstruction of lateral oral tongue defects. This was a retrospective study of 40 patients with oral tongue cancers (lateral lesions not >4 cm) operated on between August 2014 and March 2017, who underwent primary reconstruction with either an iFAMM or FCFF. The two groups were compared with respect to intraoperative time, total intensive care unit (ICU) and hospital stay, complications, speech, swallowing, aesthetics, donor site morbidity, and economic feasibility. Read More

Plast Reconstr Surg Glob Open 2019 Sep 10;7(9):e2434. Epub 2019 Sep 10.

Department of Neurosciences, Clinic of Plastic Surgery, University of Padua, Padua, Italy.

Postbariatric surgery, either by itself or in association with other procedures, tries to correct physical defects and body deformities. Because of the intrinsic complexity of massive weight loss (MWL) patients, more than a single procedure is, most of the time, required. We report a combined surgical method able to improve arms' and breasts' contour that aims to obtain a satisfying functional and aesthetic result by reducing surgical times and costs. Read More

Plast Reconstr Surg Glob Open 2019 Nov 14;7(11):e2508. Epub 2019 Nov 14.

Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, Glasgow, United Kingdom.

The chimera flap is a versatile and exciting tissue composition for the reconstruction of complex tissue defects.

Methods: Here, we present 2 cases of internally fabricated anterolateral thigh (ALT)-amputate chimera flaps for metachronous transfer.

Results: A 22-year-old man (case 1) developed extended soft tissue necrosis in both legs following meningococcal septicemia. Read More

J Surg Res 2020 Apr 7;248:165-170. Epub 2020 Jan 7.

Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine, New York, New York.

Background: Microsurgical free tissue transfer is an important treatment option for nonhealing lower extremity diabetic wounds. The purpose of this study was to identify factors that affect flap survival and wound complications.

Methods: A retrospective review was conducted of 806 lower extremity free-flap reconstructions performed from 1979 to 2016. Read More

Microsurgery 2020 May 8;40(4):473-478. Epub 2020 Jan 8.

Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, New York.

Background: Free flap reconstruction after lower extremity trauma remains challenging with various factors affecting overall success. Increasing defect and flap size have been demonstrated to be a surrogate for overall injury severity and correlated with complications. In addition, larger free flaps that encompass more tissue theoretically possess high metabolic demand, and may be more susceptible to ischemic insult. Read More

Ann Plast Surg 2020 May;84(5):529-534

From the St Andrew's Centre for Plastic Surgery, Broomfield Hospital, Essex.

Introduction: The aim of any reconstruction is to provide a robust and cosmetically pleasing result that does not significantly alter function. We describe our experience of using the V-Y principle in advancement flaps designed around a distinct perforator to reconstruct soft tissue defects of the upper limb. The shortcomings of fasciocutaneous and fascial flaps requiring skin grafting can be eliminated. Read More

Ann Plast Surg 2020 02;84(2):196-200

From the Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.

Background: Colorectal cancer is one of the most common and fatal malignancies in the United States. When localized to the distal gastrointestinal tract, surgical therapy includes abdominoperineal resection (APR) or pelvic exenteration (PEX). Subsequent ablative defects are considerable, impart concerning morbidity, and often necessitate autologous reconstruction. Read More

Br J Neurosurg 2019 Dec 26:1-5. Epub 2019 Dec 26.

Department of Plastic Surgery, King's College Hospital, Denmark Hill, London, UK.

Spinal surgical wound infection can lead to tissue voids between the spine and skin that can be difficult to reconstruct. Previously described techniques include myocutaneous flaps or perforator based fasciocutaneous flaps. However, these procedures can be time-consuming and surgically challenging. Read More

Int Braz J Urol 2020 Jan-Feb;46(1):83-89

Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

Purpose: Obliterative urethral stenosis is a type of urethral lesion that compromises the whole corpus spongiosum's circumference. We present our experience in resolving complex long segment urethral obliteration in a single procedure using a combination of dorsal onlay oral mucosa graft (OMG) and ventral fasciocutaneous penile skin flap.

Materials And Methods: A prospectively maintained database was reviewed, which included data of men presenting long, obliterative strictures. Read More

Diabetes Metab Res Rev 2020 03 16;36 Suppl 1:e3256. Epub 2019 Dec 16.

Kolding Hospital, University Hospitals of Southern Denmark, Department of Regional Health Research, University of Southern Denmark, Kolding, Denmark.

This article summarizes surgical procedures for preservation of the foot in diabetic patients with peripheral artery disease. Distal bypass surgery performed to perigeniculate arteries and to an isolated 'blind' popliteal segment with visible collaterals can be performed with limb salvage rates close to what can be achieved with standard bypass to crural arteries. This is also the case when performing bypass to the dorsalis pedis artery. Read More

Balkan Med J 2020 02 10;37(2):84-90. Epub 2019 Dec 10.

Department of Nuclear Medicine, Cumhuriyet University School of Medicine, Sivas, Turkey

Background: In plastic surgery practice, fasciocutaneous single-perforator-pedicled propeller flap is a preferred procedure; however, its survival rate is below than expected, especially in flaps with a big rotation arc. When botulinum toxin-A is injected into the muscle tissue that the perforator pedicle is arisen, the tonus of pertinent muscle can reduce and the blood flow of its perforator pedicle can increase. Therefore this procedure can improve the survival rate of single-perforator-pedicled propeller flap. Read More

Acta Cir Bras 2019 28;34(9):e201900907. Epub 2019 Nov 28.

Head, Full Professor, Division of Plastic Surgery, UNIFESP, Researcher 1A-CNPq, Director Medicine III-CAPES, Sao Paulo-SP, Brazil. Critical revision.

Purpose: To describe a case report of FG associated with NPWT in the treatment of complex wound on the distal third of the lower limb with bone exposure.

Case Report: A 59-year-old patient with chronic left tibial osteomyelitis since childhood underwent extensive debridement of the distal tibial diaphysis (40% of bone thickness per 10 cm extension) and placement of bioactive glass S53P4. Distal necrosis occurred in the fasciocutaneous flap used as the primary bone coverage. Read More

Burns 2020 02 29;46(1):225-233. Epub 2019 Nov 29.

Department of Orthopaedics Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China. Electronic address:

Background: Distally based peroneal artery perforator-plus fasciocutaneous (DPAPF) flaps and distally based posterior tibial artery perforator-plus fasciocutaneous (DPTAPF) flaps are widely used to reconstruct soft-tissue defects of the distal lower leg, ankle, and foot. However, a comparative study of both flaps in a considerable sample size is lacking. This retrospective study aimed to compare the efficacy of the flaps and provide referential evidence for selection of flaps. Read More

Plast Reconstr Surg Glob Open 2019 Oct 29;7(10):e2444. Epub 2019 Oct 29.

Department of Surgery, Division of Plastic Surgery, Baylor Scott & White, Temple, Tex.

Background: The keystone flap is a popular reconstructive option for closure of cutaneous defects. Traditionally, this is a perforator-based fasciocutaneous advancement flap that uses both skin incision and fascial release. We propose a limited skin incision technique that utilizes percutaneous fasciotomies to accomplish wound closure. Read More

Int J Surg Case Rep 2019 6;65:115-118. Epub 2019 Nov 6.

Department of Orthopaedics and Traumatology, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia.

Introduction: Fibroma is a benign tumor. More than 99% fibroma arises from tendon sheaths or tendons. Aggressive Fibroma at posterior compartment knee is a rare case. Read More

Pol Przegl Chir 2019 Jun;91(5):41-50

Dept. of General, Abdominal and Vascular Surgery, University Hospital at Magdeburg, Magdeburg (Germany).

Background: Plastic surgery was first introduced as a sub-specialty of general surgery in Germany in 1978. Since then, this surgical subspecialty/discipline has evolved enormous potential, e.g. Read More

Ulus Travma Acil Cerrahi Derg 2019 Oct;25(6):597-602

Department of Plastic Reconstructive and Aesthetic Surgery, Ataturk University, Faculty of Medicine, Yakutiye, Erzurum-Turkey.

Background: Reconstruction of the complex upper extremity defects is a challenging procedure for reconstructive surgeons because of the complex anatomical and functional structure of this region. In reconstruction, local and regional flap options involving the composite tissues are restricted. The posterior interosseous flap (PIO) has been presented 'in a single study' with a wide variety of uses, and in this study, the versatility of PIO has been tried to be emphasized by its multitude uses as well as its chance at adaptability to each case. Read More

Pan Afr Med J 2019 23;33:243. Epub 2019 Jul 23.

Service de Chirurgie Ostéo-articulaire B4, CHU Hassan II, Université Sidi Mohammed Ben Abdellah, 3000, Fèz, Maroc.

Coverage of loss of skin substances on the lower third of the leg is a challenging problem. This is due to adjacent soft tissues impairment, shortage of local vascularization and bone exposure. We conducted a retrospective study of a series of 9 cases of skin coverage of the lower third of the leg treated at the University Hospital Hassan II of Fez from 2016 to 2018. Read More

Gynecol Oncol Rep 2019 Nov 18;30:100505. Epub 2019 Oct 18.

Department of Surgical Sciences, Division of Gynecology and Obstetrics, University of Cagliari, Italy.

Objective: This study aimed to evaluate the application of the Keystone flap technique and the long-term results of vulvovaginal reconstruction after vulvar surgery

Methods: This is the first case series describing the application of the Keystone perforator island flaps (KPIF) technique to close a wide defect after radical vulvectomy. We prospectively collected patient demographics, operative times, complications, pathologic results, and length of stay on all patients. The benefits, cosmetic results and satisfaction of patients were analyzed in the follow up. Read More

Ann Plast Surg 2020 May;84(5):580-587

From the Department of Orthopedic Surgery, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, People's Republic of China.

Backgrounds: Distally based perforator propeller flap from the lower leg region is a versatile local reconstructive technique for the foot and ankle defects. However, flap venous congestion remains a tough nut to crack. We hypothesize that raising an adipofascial flap with turnover mode of transposition can improve venous drainage and enhance flap safety. Read More

J Maxillofac Oral Surg 2019 Dec 19;18(4):648-650. Epub 2019 Mar 19.

1St Andrew's Centre for Burns and Plastic Surgery, Broomfield Hospital, Court Road, Chelmsford, Essex CM1 7ET UK.

Introduction: The most accepted pathogenesis for Poland syndrome is the subclavian artery supply disruption sequence during embryonic growth. The result is associated with a constellation of abnormalities of structures supplied by the subclavian artery. We present a case of a neck defect reconstructed with a fasciocutaneous supraclavicular flap in a patient with Poland syndrome with the absence of a pectoralis major muscle. Read More

World J Plast Surg 2019 Sep;8(3):316-323

Department of Plastic Surgery and Orthopedics, National Institute of Rehabilitation Medicine (NIRM), Islamabad, Pakistan.

Background: Complex soft-tissue defects of the distal third of the leg, proximal third of foot and similar wounds around the ankle represent formidable foes for plastic surgeons. This study compared the outcome of 2-staged interpolated flap design versus single stage islanded flap design of reverse flow superficial sural artery flap.

Methods: Thirty-four patients were enrolled, while half randomly underwent interpolated flap design (group A) and for half, islanded flap design (group B). Read More

Ann Ital Chir 2019 Oct 9;8. Epub 2019 Oct 9.

A heterogeneous range of malignant pathologies affects vulvar and perineal regions. Today standard radical mutilating surgery for the treatment of invasive vulvar carcinoma is being replaced by a conservative and individualized approach. Defects of the external pelvis and perineal lining are usually reconstructed with local or regional fasciocutaneous flaps. Read More

Plast Reconstr Surg 2020 01;145(1):235-240

Charlottesville, Va.; Philadelphia, Pa.; and New York, N.Y. From the Department of Plastic Surgery, University of Virginia Health System; the Department of Surgery, Division of Plastic Surgery, and the Department of Orthopedic Surgery, University of Pennsylvania Health System; and the Department of Plastic Surgery, New York University Langone Health.

Background: Although the surgical microscope remains the most common tool used for visual magnification for microsurgical anastomoses in free tissue transfer, loupe-only magnification for free flap breast reconstruction has been demonstrated to be safe and effective. To evaluate the loupe-only technique in lower extremity free flap reconstruction, the authors compared perioperative outcomes between microsurgical anastomoses performed with loupe magnification versus a surgical microscope.

Methods: The authors conducted a two-institution retrospective study of soft-tissue free flaps for traumatic below-knee reconstruction. Read More

Plast Reconstr Surg Glob Open 2019 Aug 5;7(8):e2361. Epub 2019 Aug 5.

Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centre (Amsterdam UMC), University of Amsterdam, Amsterdam, The Netherlands.

An appropriate reconstruction strategy after wide excision for severe cases of axillary hidradenitis suppurativa (HS) is important to optimize outcomes, but no consensus exists on which reconstruction strategy should be preferred.

Objective: Evaluate which reconstruction strategy after wide excision in patients with severe axillary HS is associated with improved outcomes in terms of recurrence rate, complications, post-reconstruction limb function, aesthetics, and patient satisfaction.

Methods: Retrospective analysis between 2008 and 2018 of wide excision and reconstruction by primary closure (PC), secondary intention healing (SIH), split thickness skin grafts (STSG), or fasciocutaneous flaps (FCF). Read More

J Reconstr Microsurg 2020 Mar 7;36(3):197-203. Epub 2019 Oct 7.

Division of Plastic and Reconstructive Surgery, Anschutz Medical Center, University of Colorado, Aurora, Colorado.

Background:  Limb salvage in the setting of extremity osteomyelitis, though previously dependent on amputation, has been markedly improved through the application of free tissue flaps. Concern exists as to the utility of the fasciocutaneous flap to combat infection verses the traditional muscle flap. Prior studies have shown success with fasciocutaneous flaps in these patients, but given the small series, the choice remains controversial. Read More

Arch Plast Surg 2019 Sep 15;46(5):455-461. Epub 2019 Sep 15.

Department of Plastic Surgery, SMG-SNU Boramae Medical Center, Seoul, Korea.

Background: Various surgical management methods have been proposed for ischial sore reconstruction, yet it has the highest recurrence rate of all pressure ulcer types. A novel approach combining the advantages of a perforator-based fasciocutaneous flap and a muscle flap is expected to resolve the disadvantages of previously introduced surgical methods.

Methods: Fifteen patients with ischial pressure ulcers with chronic osteomyelitis or bursitis, who underwent reconstructive procedures with an inferior gluteal artery perforator (IGAP) fasciocutaneous flap and a split inferior gluteus maximus muscle flap from January 2011 to June 2016, were analyzed retrospectively. Read More