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Int J Low Extrem Wounds 2021 May 3:15347346211009402. Epub 2021 May 3.

School of the Medicine, 64222Necmettin Erbakan University, Konya, Turkey.

Reconstruction of soft tissue defects in the lower extremity due to different etiologies can be a challenging process for surgeons. Compelling reasons for reconstruction include the anatomy of the lower extremity, limited mobility of soft tissues especially the presence of bone, tendon, and neurovascular structures under the defect, and the exposed fixation materials make these defects more complicated. Local fasciocutaneous and muscle flaps are frequently used for the reconstruction of these defects. Read More

J Plast Reconstr Aesthet Surg 2021 Mar 28. Epub 2021 Mar 28.

Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JAPAN.

Purpose: Although many studies have investigated the optimal anastomotic procedure for the end-to-side (ETS) procedure with a free flap, no study has focused on the size of the arteriotomy. Some surgeons have recently described the effectiveness of ETS with wide arteriotomy, but the postoperative haemodynamics remains unclear for free flaps created using this technique. The aim of this study was to use ultrasonography to evaluate the postoperative blood flow distribution after ETS with a wide arteriotomy in extremity free flap surgery. Read More

BMC Surg 2021 Apr 15;21(1):194. Epub 2021 Apr 15.

Department of Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.

Background: Pelvic sepsis after surgery for rectal cancer is a severe complication, mostly originating from anastomotic leakage. Complex salvage surgery, during which an omentoplasty is often used for filling of the pelvic cavity, is seldomly required. If this fails, a symptomatic recurrent presacral abscess with a risk of progressive inflammation can develop. Read More

Int J Low Extrem Wounds 2021 Apr 15:15347346211002333. Epub 2021 Apr 15.

70566The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.

Distally based sural fasciocutaneous (DBSF) flaps are widely used for reconstructing soft tissue defects of the foot. The purpose of this paper was to compare the clinical efficacy of the use of flaps to repair defects in areas proximal and distal to the level of the tarsometatarsal joints in a relatively large number of patients and to analyze the effects of factors on the risk of developing partial necrosis of the flaps. Between April 2001 and December 2019, a total of 355 DBSF flaps were utilized to cover soft tissue defects in the foot. Read More

J Reconstr Microsurg 2021 Apr 14. Epub 2021 Apr 14.

Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, Missouri.

Background:  Traumatic lower extremity injuries involving the foot and ankle can have devastating consequences and represent a complex reconstructive challenge. To date, there are limited reports on microsurgical reconstruction for foot and ankle defects in children. This study aims to evaluate clinical and functional outcomes of free flaps for pediatric foot and ankle injuries. Read More

Handchir Mikrochir Plast Chir 2021 Apr 13. Epub 2021 Apr 13.

BG Klinik Ludwigshafen, Klinik für Hand-, Plastische und Rekonstruktive Chirurgie, Mikrochirurgie, Schwerbrandverletztenzentrum, Plastische Chirurgie und Handchirurgie der Universität Heidelberg.

Background:  The primary cosmetic and functional outcome following successful upper limb salvage using free tissue transfer can often be unfavourable, which may motivate patients to undergo secondary procedures. In this study, we sought to identify predictors for secondary procedures and to analyse the type and number of these procedures.

Patients And Methods:  Patients who underwent free tissue transfer to the upper extremity between 2010 and 2017 were included in a retrospective cohort study: patients with secondary procedures to optimise the functional and aesthetic flap design (S cohort) vs. Read More

World J Plast Surg 2021 Jan;10(1):114-118

Department of Plastic Surgery - Royal Preston Hospital, Preston, UK.

Extralevator Abdominoperineal Excision (ELAPE) and Abdominoperineal Resection create complex perineal defects made more challenging when combined with additional resection of the posterior vaginal wall. This composite defect requires the restoration of a functional vagina, in addition to the obliteration of the large perineal dead space, a need to reduce donor site, and perineal wound morbidity. Previously described fasciocutaneous and myocutaneous flaps for such defects are associated with long operations requiring intra-operative mobilization and are linked to post-operative complications including herniation, evisceration, flap loss, donor site morbidity and poor cosmetic outcome, amongst other issues. Read More

Indian J Surg Oncol 2021 Mar 6;12(1):172-176. Epub 2021 Jan 6.

Department of Head And Neck Surgery Unit, Mahatma Gandhi Cancer Hospital, Miraj, India.

Background: Free flap transfer is a standard practice in reconstruction of oral defects. Fasciocutaneous flaps are commonly used for reconstruction of soft tissue defects. Replacement of oral mucosa with skin often causes discomfort, foreign body sensation, dysgeusia, problems with skin hair and morbidity at the donor site. Read More

Dermatol Surg 2021 Apr;47(4):e106-e110

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

Background: Wide excision (WE) is generally considered to be the most common treatment for recurrent hidradenitis suppurativa. When performed, excision is followed by decisions regarding best options for management of the surgical defect. Different reconstructive strategies (RSs) have been used, with varying rates of recurrence. Read More

J Ayub Med Coll Abbottabad 2020 Oct-Dec;32(Suppl 1)(4):S612-S617

Allama Iqbal Medical College/ Jinnah Burn and Reconstructive Surgery Centre Lahore.

Background: Presence of good size perforators are mandatory to design perforator based pedicelledflaps specially in lower limb as flap failure rate isrelativelyhigh. We have explored the use ofsmartphonebaseddynamic thermal imagingand compared it with doppler to devise a protocol forplanning and executionof pedicled perforator flaps anddescribedits use in deciding delay of flap. We have also compared the time required for detecting dominant perforators. Read More

Eplasty 2021 8;21:e2. Epub 2021 Mar 8.

Department of Plastic and Reconstructive Surgery, Southmead Hospital, Bristol, United Kingdom.

To analyze the recent literature regarding the different types of free tissue transfer used in pediatric lower-limb trauma, trends, flap success rates, and the anatomical location of reconstruction. A search was conducted involving the MEDLINE database using the key words "Paediatric," "Pediatric," "Children," "Lower limb," "Lower extremity," "Leg," "Ankle," "Foot," "Free flap," "Flap," "Microsurgery," and "Free tissue transfer" in a 3-component search applying the Boolean operators "OR" and "AND." The search was condensed to articles published in the last 5 years. Read More

Otolaryngol Head Neck Surg 2021 Mar 16:1945998211000424. Epub 2021 Mar 16.

Department of Otolaryngology, Loyola University Medical Center, Maywood, Illinois, USA.

After a salvage total laryngectomy, one of patients' primary goals is to resume oral intake. This retrospective chart review included all patients who underwent a salvage total laryngectomy with free or pedicled flap reconstruction to compare swallowing outcomes in those with an incorporated flap or primary pharyngeal closure with an onlay flap. There was no significant difference in the ability to achieve complete feeding tube independence or the time that it took to achieve independence. Read More

Cureus 2021 Feb 8;13(2):e13213. Epub 2021 Feb 8.

ENT - Head and Neck Surgery, Hospital Universitario Donostia, San Sebastian, ESP.

Introduction: Radial forearm free flap (RFFF) and supraclavicular artery island flap (SCAIF) are some of the most common fasciocutaneous flaps used for head and neck (H&N) reconstruction.

Material And Methods: A retrospective analysis of clinical data and outcomes of 31 consecutive patients who underwent H&N reconstruction using either SCAIF or RFFF over a three-year period, aiming to compare the surgical outcomes of the SCAIF and the RFFF in H&N reconstruction.

Results: Thirty-two flaps were performed in 31 patients (17 SCAIFs and 15 RFFFs). Read More

J Clin Orthop Trauma 2021 Mar 31;14:113-120. Epub 2020 Jul 31.

SMS Medical College and Hospital, Jaipur, India.

Background: Distal one - third trauma of the lower limb is a complex condition to treat. The reverse sural flap is a time tested procedure for reconstruction of such defects especially in patients where free flaps are ruled out due to comorbidities. The purpose of this study is to compare the two modifications of the classical technique of reverse sural flap (adipofascial and fasciocutaneous) which is lacking in the literature. Read More

J Craniofac Surg 2021 Mar 4. Epub 2021 Mar 4.

Memorial Sloan-Kettering Cancer Center, New York, NY Aga Khan University, Karachi, Pakistan.

Introduction: Partial tongue reconstruction requires a thin pliable flap to restore volume and mobility. The lateral arm flap is well suited to this as it is a thin fasciocutaneous flap that has consistent vascular anatomy, reliable perfusion, short harvest time and low donor site morbidity. The authors report our experience with use of this flap for reconstruction of hemi-glossectomy defects. Read More

Clin Plast Surg 2021 Apr 10;48(2):321-329. Epub 2021 Feb 10.

Department of Plastic Surgery, MedStar Georgetown University Hospital, 3800 Reservoir Road Northwest, First Floor PHC Plastic Surgery, Washington, DC 20007, USA. Electronic address:

Chronic lower extremity wounds are defined as wounds that fail to heal within 3 months of defect onset. Free tissue transfer offers an opportunity for limb salvage and length preservation. Preoperative optimization includes a medical and nutritional consult, complete work-up by vascular surgery, and an analysis of bony stability and gait biomechanics by podiatric surgery. Read More

Injury 2021 Feb 11. Epub 2021 Feb 11.

Southmead Hospital, North Bristol NHS Trust, City of Bristol, UK. Electronic address:

Introduction: Open lower extremity fractures pose a challenge for treating surgeons. All surgical strategies have the common aim to facilitate fracture healing. Fracture union, however, should be critically considered in the context of functional recovery and not in isolation. Read More

Eur J Trauma Emerg Surg 2021 Feb 21. Epub 2021 Feb 21.

Department of Orthopedics, Henan Provincial People` Hospital, Zhengzhou, 450003, Henan, People's Republic of China.

Purpose And Background: The posterior tibial artery perforator-plus fasciocutaneous (PTAPF) flap is commonly used for defects over the distal lower extremity. However, the causes of partial necrosis of the PTAPF flap are unknown. This paper aimed to explore the factors related to the partial necrosis of the PTAPF flap. Read More

Ann Plast Surg 2021 03;86(3):308-316

From the Department of Plastic and Reconstructive Surgery, University of Ulsan, College of Medicine, Seoul Asan Medical Center, Seoul, Korea.

Background: Because the tongue consists of 26 intrinsic and extrinsic muscles, even hemiglossectomy, which preserves some of the tongue and its muscles, leads to functional morbidity in speech and swallowing. Subsequent reconstruction using a conventional fasciocutaneous flap results in limited functional recovery. This study compared the functional recovery of patients who underwent hemiglossectomy based on the fasciocutaneous free flap with or without dynamic gracilis muscle flap reconstruction. Read More

Ann Med Surg (Lond) 2021 Feb 26;62:369-372. Epub 2021 Jan 26.

Geisel Dartmouth Medical School, Hanover, NH, 03755, USA.

Introduction: and importance: Large cutaneous defects may result from excision of skin malignancies. Typically, skin grafting is used to manage such defects, but the final result may be compromised by inadequate take and poor cosmesis. Accordingly, transposition flaps may be indicated. Read More

Cureus 2021 Jan 30;13(1):e13024. Epub 2021 Jan 30.

Plastic and Reconstructive Surgery, Baskent University Faculty of Medicine, Ankara, TUR.

Background Elderly patients with multiple comorbidities may not be candidates for cardiac implanted electronic device (CIED) explantation in cases of exposition. Excision of all unhealthy and inflamed scar tissue results in a skin defect that must be covered. Small- to moderate-sized local skin flaps and subpectoral placement of CIEDs have been described in the literature. Read More

J Plast Surg Hand Surg 2021 Feb 3:1-9. Epub 2021 Feb 3.

Department of Plastic and Reconstructive Surgery, National Defense Medical College, Tokorozawa, Japan.

The local flap method is a minimally invasive, quick, and common technique of closing skin defects. Several methods using multiple local flaps are employed for the purpose of closing relatively large defects, and minimizing the resultant scar and deformity. We present a combined local flap method using a banner flap with an adjacent rotation flap (B-R flap) with the potential for closing circular defects. Read More

Chin J Dent Res 2020 ;23(4):257-264

Objective: To evaluate the advantages and disadvantages of the transmandibular approach to the posterior area of the maxilla, oropharyngeal region and the hypopharynx in head and neck surgery. Methods: A series of 42 patients who underwent a lip-split mandibulotomy procedure to access malignant tumours affecting deep areas of the head and neck region between 2008 and 2018 in the Department of Oral and Maxillofacial Surgery at the Ramón y Cajal University Hospital (Madrid, Spain) were retrospectively reviewed. The diagnosis and operations data of the patients were collected and analysed. Read More

Ann Plast Surg 2021 02;86(2):193-200

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

Background: An appropriate reconstruction strategy after wide excision for severe cases of anogenital hidradenitis suppurativa (aHS) is important to optimize outcomes, but there is no consensus on which reconstruction strategy should be preferred.

Objective: Evaluate which reconstruction strategy after wide excision in patients with severe aHS is associated with the best outcomes in terms of recurrence rate, complications and patient-reported outcomes on range of motion, pain, appearance, sexual health and satisfaction.

Methods: Multicenter retrospective analysis between 2009 and 2019 of wide excision and reconstruction by primary closure, secondary intention healing, split-thickness skin grafts or fasciocutaneous flaps (FCF). Read More

Indian J Thorac Cardiovasc Surg 2021 Jan 7;37(1):82-88. Epub 2020 Aug 7.

Department of Plastic and Reconstructive Surgery, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.

Chest wall resection is defined as partial or full-thickness removal of the chest wall. Significant morbidity has been recorded, with documented respiratory failure as high as 27%. Medical records of all patients who had undergone chest wall resection and reconstruction were reviewed. Read More

J Orthop Surg Res 2021 Jan 13;16(1):52. Epub 2021 Jan 13.

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

Background: No large series have analysed distally based sural fasciocutaneous (DBSF) flaps in paediatric patients. The aims of this study were to assess the reliability and analyse the potential risk factors for these flaps and to describe complications in the donor site and the functional follow-up results.

Methods: Between June 2002 and November 2017, 88 DBSF flaps were used to reconstruct soft tissue defects in paediatric patients. Read More

Gynecol Oncol Rep 2021 Feb 19;35:100675. Epub 2020 Nov 19.

New York University Langone Health, 550 First Avenue, New York, NY 10016, USA.

Vulvar reconstruction can be performed following radical vulvectomy and is known to be associated with urologic complications. We describe the use of antegrade cystoscopy to manage acute urinary retention secondary to an obliterated urethral meatus following radical vulvectomy and reconstruction for radiation dermatitis. Antegrade cystoscopy was performed by applying the surgical concepts for suprapubic catheterization and general laparoscopy. Read More

Plast Reconstr Surg Glob Open 2020 Dec 18;8(12):e2901. Epub 2020 Dec 18.

Plastic Surgery Department, Zagazig University, Egypt.

Pilonidal sinus is a chronic recurrent medical disease. The exact etiology of the disease is still unknown, but the most accepted theory is an acquired condition characterized by infected sinus in the natal cleft area containing a lifeless hair tuft. Multiple techniques were prescribed for its treatment; however, the ideal method is not yet defined. Read More

Rev Bras Ortop (Sao Paulo) 2020 Dec 29;55(6):736-741. Epub 2020 May 29.

Departamento de Ortopedia e Traumatologia da Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brasil.

 To describe and demonstrate the outcomes of the modified Monteiro (1991) technique for lower limb reconstruction with a fasciocutaneous flap of the distal pedicle in a series of 15 cases.  We present the technique and outcomes from a series of 15 cases of the modified technique using a fasciocutaneous flap of the distal pedicle to repair the lower third of the leg and the foot.  Outcomes were satisfactory since these flaps provided good cutaneous and subcutaneous tissue coverage in cases with bone exposure and skin loss. Read More

J Oral Maxillofac Surg 2021 May 2;79(5):1156-1167. Epub 2020 Dec 2.

Professor, Interim Chair, Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL.

Purpose: Historically, free tissue transfer has been reserved for advanced stage osteoradionecrosis (ORN) of the jaw with pathologic fracture or cutaneous fistula. The purpose of this study was to evaluate if in patients with recalcitrant intermediate stage ORN, would mandibular debridement in combination with vascularized soft tissue coverage result in durable symptom and disease resolution.

Patients And Methods: A retrospective cohort study of patients with mandibular ORN was performed comparing a mandibular preserving approach with a fasciocutaneous forearm flap for progressive treatment-resistant intermediate stage ORN to mandibulectomy and vascularized bone flap (VBF) reconstruction for advanced stage ORN. Read More