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    Mohs Surgical Reconstruction Educational Activity: a resident education tool.
    Adv Med Educ Pract 2017 8;8:143-147. Epub 2017 Feb 8.
    Department of Dermatology.
    Background: Surgical reconstructive planning following Mohs surgery can be a difficult subject for dermatology residents to master. Prior research demonstrates that active learning is preferred and more effective compared to passive learning models and that dermatology residents desire greater complexity and volume in surgical training. We present a novel, active, problem-based learning tool for the education of Mohs reconstruction with the goal of improving residents' ability to plan surgical reconstructions. Read More

    One - staged reconstruction of bladder exstrophy in male patients: long - term follow-up outcomes.
    Int Braz J Urol 2017 Jan-Feb;43(1):155-162
    Divisão de Urologia do Departamento de Cirurgia, Universidade de São Paulo, SP, Brasil.
    Introduction: The surgical correction of bladder exstrophy remains challenging. In our institution, the repair has evolved from a staged repair to one-stage reconstruction. The one-stage reconstruction includes; bladder closure, Cantwell-Ransley neourethroplasty and abdominoplasty using groin flaps, without the need of pelvic ostheotomies. Read More

    Endonasal septal perforation repair using posterior and inferiorly based mucosal rotation flaps.
    Am J Otolaryngol 2017 Jan 16. Epub 2017 Jan 16.
    Department of Otolaryngology - Head and Neck Surgery, Case Western Reserve University, Cleveland, OH, United States; Department of Otolaryngology - Head and Neck Surgery, MetroHealth Medical Center, Cleveland, OH, United States. Electronic address:
    Importance: Repair of nasal septal perforations is challenging regardless of surgical technique due to their location and the health of surrounding tissue. There is currently no surgical procedure which is completely effective in the treatment of anteriorly located perforations.

    Objective: To report a novel method of closing anterior septal perforations using an inferiorly based mucosal rotation flap and an acellular dermal interposition graft, as well as expand upon a previous series. Read More

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

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

    Anatomical Basis and Clinical Application of Synovial Flaps in the Wrist and Distal Forearm.
    Plast Reconstr Surg 2017 Jan 12. Epub 2017 Jan 12.
    *Resident, Division of Plastic and Reconstructive Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania ** Division of Trauma, Department of Plastic and Reconstructive Surgery, Chang-Gung University medical department, Chang-Gung Memorial Hospital, Taipei, Taiwan, R.O.C. ***Professor of Surgery (Plastic and Reconstructive Surgery), Eastern Virginia Medical School, Norfolk, Virginia.
    Neuropathic symptoms after median nerve repair at the wrist or secondary to refractory carpal tunnel syndrome may become debilitating. These symptoms develop due to perineural adhesions, intraneural fibrosis and fixation of the nerve to the transverse carpal ligament after surgery and often require neurolysis. Interposition of vascularized soft tissue over the median nerve at the time of neurolysis prevents recurrence of such adhesions. Read More

    Rotation Flap Closure of Moderate Size Scalp Defects - Technique and Outcome.
    J Clin Diagn Res 2016 Nov 1;10(11):PD21-PD23. Epub 2016 Nov 1.
    Assistant Professor, Deparment of Surgery, Believers Church Medical College, Hospital , Tiruvalla, Kerala, India .
    Many patients present to general surgeons with scalp lesions which require wide local excision with margin, following which the defect is too large to be closed primarily. These lesions can be benign or malignant. Skin grafting of these defects gives poor cosmetic outcome. Read More

    Abdominoplasty and gluteoplasty after massive weight loss: an all-in-one technique.
    Acta Chir Belg 2016 Dec 8:1-5. Epub 2016 Dec 8.
    a Department of Plastic Surgery , Ghent University Hospital , Ghent , Belgium.
    Introduction: Patients requesting body-contouring surgery after massive weight loss often present with abdominal and lumbar skin excess as well as gluteal ptosis and loss of gluteal projection. In order to restore gluteal projection a circular abdominoplasty in combination with an autologous gluteal augmentation (all-in-one technique) can be performed.

    Objective: To compare outcomes for patients who underwent a circular abdominoplasty with or without autologous gluteal augmentation. Read More

    Injectable Diphenhydramine Used as Anaesthetic for Wide Local Excision With Flap Closure.
    J Cutan Med Surg 2016 Dec 5. Epub 2016 Dec 5.
    The Ottawa Hospital Riverside Campus, Ottawa, ON, Canada.
    Background: Lidocaine-allergic patients pose a challenge for cutaneous surgical procedures. We present a case of a successful wide local excision with flap closures on the face using topical tetracaine followed by infiltration with 1% diphenhydramine.

    Case Summary: An 84-year-old woman, with a lidocaine intolerance, presented to the Mohs surgery clinic for wide local excision of a nodular basal cell carcinoma on her right medial cheek. Read More

    Pre-expanded Internal Mammary Artery Perforator Flap.
    Clin Plast Surg 2017 Jan;44(1):65-72
    Division of Plastic Surgery, Baylor Scott & White Health, 2401 South 31st Street, Temple, TX 76508, USA. Electronic address:
    Internal mammary artery (IMA)-based pedicled perforator flaps can be used to reconstruct defects of the neck and anterior chest wall. Pre-expansion causes a possible delay phenomenon, improves flap survival, and decreases donor site morbidity. It also increases the area that can be covered. Read More

    Endoscopic closure of large septal perforations with bilateral Hadad-Bassagasteguy flaps.
    Eur Arch Otorhinolaryngol 2017 Mar 16;274(3):1521-1525. Epub 2016 Nov 16.
    Servicio de Otorrinolaringología, Hospital General Universitario los Arcos del Mar Menor, Pozo Aledo, Murcia, Spain.
    Surgical closure of nasal septal perforations is one of the most challenging procedures in nasal surgery. Defects greater than 2 cm are especially difficult to repair with the traditional approaches due to the challenges of mobilizing enough mucosa to close big gaps, and avoiding airway stenosis in the process. We present a new technique to endoscopically close major septal perforations using bilateral Hadad-Bassagasteguy flaps. Read More

    One - staged reconstruction of bladder exstrophy in male patients: long - term follow-up outcomes.
    Int Braz J Urol 2017 Jan-Feb;43(1):155-162
    Divisão de Urologia do Departamento de Cirurgia, Universidade de São Paulo, SP, Brasil.
    Introduction: The surgical correction of bladder exstrophy remains challenging. In our institution, the repair has evolved from a staged repair to one-stage reconstruction. The one-stage reconstruction includes; bladder closure, Cantwell-Ransley neourethroplasty and abdominoplasty using groin flaps, without the need of pelvic ostheotomies. Read More

    Extending the Arc of Rotation of the Pectoralis Major Myocutaneous Flap for Orofacial Reconstruction via a Modified Subclavicular Route Through the Clavipectoral Fascia.
    J Oral Maxillofac Surg 2017 Jan 14;75(1):222.e1-222.e6. Epub 2016 Sep 14.
    Consultant, Department of Oral Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University, Shanghai, China.
    Purpose: Drawbacks of the conventional supraclavicular overlay of the pectoralis major myocutaneous flap (PMMF) include the resultant unesthetic cervical bulge and the limited cephalad extension that limits its use to mandibular or cervical defects. This study discusses the technique and comparative advantages of a more esthetic subclavicular route through the clavipectoral fascia that allows an increased arc of rotation to reconstruct orofacial defects.

    Materials And Methods: Patients with orofacial defects that were reconstructed with a PMMF through the modified subclavicular route were included in this retrospective cohort study, which aimed to compare the gain in extension accorded through the modified subclavicular tunnel over an initial conventional supraclavicular overlay. Read More

    Reconstruction after Anterior Chest Wall Keloid Resection Using Internal Mammary Artery Perforator Propeller Flaps.
    Plast Reconstr Surg Glob Open 2016 Sep 29;4(9):e1049. Epub 2016 Sep 29.
    Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan.
    It is difficult to completely resect huge anterior chest wall keloids and then close the wound directly. We report here our retrospective analysis of our case series of patients with such keloids who underwent reconstruction with internal mammary artery perforator (IMAP) pedicled propeller flaps and then received postoperative high-dose-rate superficial brachytherapy.

    Methods: All consecutive patients with large/severe keloids on the anterior chest wall who underwent keloid resection followed by reconstruction with IMAP-pedicled propeller flaps and then high-dose-rate superficial brachytherapy in our academic hospital were identified. Read More

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

    [Classification of massive postburn scars on neck and the reconstruction strategy using pre-expanded perforator flaps from the back].
    Zhonghua Shao Shang Za Zhi 2016 Aug;32(8):463-8
    Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, China.
    Objective: To explore the classification of massive postburn scars on neck and the reconstruction strategy using pre-expanded perforator flaps from the back.

    Methods: Thirty-seven patients with massive postburn scars on neck were admitted from January 2010 to December 2014 and treated by our treatment group. The massive postburn scars on neck were categorized into three types according to their size and location. Read More

    Risk Factor Analysis of Freestyle Propeller Flaps.
    J Reconstr Microsurg 2017 Jan 19;33(1):26-31. Epub 2016 Aug 19.
    Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
    Background Freestyle propeller flaps have been widely used as a reconstructive option for both trunk and extremities. It offers the advantage of "like-with-like" reconstruction with an adjacent tissue with no dissection to the source vessels. However, there is the risk of vascular complications. Read More

    Perforator-based propeller flaps for leg reconstruction in pediatric patients.
    J Plast Reconstr Aesthet Surg 2016 Oct 30;69(10):e205-11. Epub 2016 Jul 30.
    Division of Plastic and Aesthetic Surgery, Dicle University, Diyarbakır, Turkey.
    Background: Perforator-based propeller flaps provide adequate soft tissue coverage for leg reconstruction. The aim of this study was to assess the versatility and reliability of the use of propeller flaps for leg reconstruction in pediatric patients.

    Method: Seven male pediatric patients ranging in age from 2 to 13 years with a mean age of 6. Read More

    HIDRADENITIS SUPPURATIVA: A CASE SERIES OF EIGHT PATIENTS.
    Med Pregl 2016 Jan-Feb;69(1-2):48-52
    Introduction: Hidradenitis suppurativa is a persistent, inflammatory and recurrent disease of the hair follicles which, in time, results in ugly scars. Inflammation and obstruction of channel of sweat glands used to be thought to be the basis of this disease.

    Case Reports: This paper presents the cases of 8 patients operated on in the past 3 years. Read More

    Scleral fixation of a foldable intraocular lens with polytetrafluoroethylene sutures through a Hoffman pocket.
    J Cataract Refract Surg 2016 Jul;42(7):955-60
    From the Department of Cataract and Refractive Lens Services, Narayana Nethralaya, Post Graduate Institute of Ophthalmology, Bangalore, India.
    Unlabelled: Scleral fixation of intraocular lenses (IOLs) is traditionally performed after conjunctival dissection and preparation of scleral flaps. The Hoffman pocket technique creates scleral pockets without conjunctival dissection. We describe a technique that uses a Hoffman pocket and 7-0 polytetrafluoroethylene (Gore-Tex) sutures for scleral fixation of a foldable posterior chamber IOL in patients with insufficient capsule support. Read More

    Repair of Fingertip Defect Using an Anterograde Pedicle Flap Based on the Dorsal Perforator.
    Plast Reconstr Surg Glob Open 2016 Jun 7;4(6):e730. Epub 2016 Jun 7.
    Department of Hand Surgery, The Affiliated Hospital of Medical College, Ningbo University, Ningbo, Zhejiang, China; and Department of Anatomy, Wenzhou Medical University, Wenzhou University Town, Wenzhou, Zhejiang, China.
    Background: The purposes of this article are to introduce and assess the results of a long-term follow-up of using anterograde pedicle flap based on the dorsal branches of proper digital neurovascular bundles from the dorsum of the middle phalanx for the fingertip defect.

    Methods: Between February 2011 and December 2012, 31 patients underwent reconstruction of fingertip defects using a homodigital flap based on the dorsal perforator in the middle phalanx. The defect size ranged from 1. Read More

    Basiespinal Cerebrospinal Fluid Leak as a Complication After Adenoidectomy: Case Report and Literature Review.
    World Neurosurg 2016 Sep 22;93:484.e9-484.e12. Epub 2016 Jul 22.
    Department of Otolaryngology, University Hospital Virgen del Rocío, Sevilla, Spain.
    Background: Adenoidectomy is one of the most common procedures in the field of pediatric otolaryngology. Postoperative bleeding is one of the most frequent complications (0.4%). Read More

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

    [CLINICAL APPLICATION OF LATERAL ARM LOBULATED FLAPS TO REPAIR MULTIPLE SOFT TISSUE DEFECT OF HAND].
    Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2016 Apr;30(4):444-6
    Objective: To explore the effectiveness and operation of repairing multiple soft tissue defects in hands with lateral arm lobulated flaps.

    Methods: Between October 2013 and September 2015, 13 cases of multiple soft tissue defects in the hand with tendon or bone exposure were treated with lateral arm lobulated flaps. All patients were males with average age of 28 years (range, 23-45 years). Read More

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

    An algorithm for using expanded cervical flaps to resurface facial defects based on five different methods.
    Burns 2016 Dec 2;42(8):1867-1874. Epub 2016 Jul 2.
    Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China. Electronic address:
    Background: For patients with healthy skin in the cervical region, the expanded cervical flap method is highly recommended for resurfacing facial skin defects. Many methods exist that use an expanded cervical flap. However, a gold standard for selecting the appropriate method for each patient is lacking. Read More

    Combined V-Y Fasciocutaneous Advancement and Gluteus Maximus Muscle Rotational Flaps for Treating Sacral Sores.
    Biomed Res Int 2016 6;2016:8714713. Epub 2016 Jun 6.
    Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
    The sacral area is the most common site of pressure sore in bed-ridden patients. Though many treatment methods have been proposed, a musculocutaneous flap using the gluteus muscles or a fasciocutaneous flap is the most popular surgical option. Here, we propose a new method that combines the benefits of these 2 methods: combined V-Y fasciocutaneous advancement and gluteus maximus muscle rotational flaps. Read More

    Rotational repair of pressure ulcer using double-perforators based flaps: A report of 11 cases.
    J Tissue Viability 2016 Nov 16;25(4):244-248. Epub 2016 Jun 16.
    Department of Burn Surgery, The First Hospital of Jilin University, China. Electronic address:
    National Pressure Ulcer Advisory Panel (NPUAP) stage 3 and 4 pressure ulcers typically require surgical repair with perforator-based flaps and fasciocutaneous flaps. We designed advancement/rotation flaps based on two different perforators originating from two different mother vessels that covered large pressure ulcers without the need for additional skin grafts for donor sites. In this paper, we describe the surgical technique on the use of the advancement/rotation flaps and report the preliminary results of surgical management of 11 cases of pressure ulcers using advancement/rotation flaps. Read More

    Use of Perforator-Based Fasciocutaneous Flaps for Pressure Sore Reconstruction: Single-Perforator-Based Versus Multiple-Perforator-Based Flaps.
    Aesthetic Plast Surg 2016 Aug 14;40(4):540-8. Epub 2016 Jun 14.
    Division of Plastic Surgery, Department of Surgery, Taipei Veterans General Hospital, 19F., No. 201, Sec. 2, Linong St., Beitou Dist., Taipei, 112, Taiwan.
    Background: A perforator-based fasciocutaneous flap is an alternative type of flap for pressure sore reconstruction. The aim of the present study was to determine whether a single-perforator-based flap or a multiple-perforator-based flap is better for pressure sore reconstruction.

    Methods: We reviewed the general data and postoperative complications in patients who received single-perforator-based or multiple-perforator-based fasciocutaneous flaps for pressure sore reconstruction between July 2009 and July 2012. Read More

    Simplifying Forehead Reconstruction: A Review of More Than 200 Cases.
    Facial Plast Surg 2016 Jun 1;32(3):309-14. Epub 2016 Jun 1.
    Department of Surgery, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
    The forehead is a unique facial region with distinct boundaries and variability in shape from patient to patient. When reconstructing the forehead, it is critical to take into account the regional boundaries as their distortion may result in noticeable facial asymmetry. We propose subdividing the forehead into newly defined zones and put forth a rational algorithm for forehead repair based on these divisions. Read More

    Pulp Rotation Flap for Lateral Oblique Fingertip Defects.
    Ann Plast Surg 2016 May 23. Epub 2016 May 23.
    From the *Department of Plastic Reconstructive and Aesthetic Surgery, Goztepe Training and Research Hospital, T.C. Medeniyet University, Istanbul, Turkey; and †Department of Plastic and Reconstructive Surgery, Mengucek Gazi Training and Research Hospital, Erzincan, Turkey.
    Background: Fingertip amputations are among the most common injuries seen in the hand. According to the geometry of the amputation, it may be classified as transverse or oblique (dorsal, volar, or lateral type). Although numerous repair techniques have been described in the literature, there are few alternatives suitable for lateral oblique type fingertip amputations. Read More

    Propeller Flaps With Reduced Rotational Angles: Clinical Experience on 40 Consecutive Reconstructions Performed at Different Anatomical Sites.
    Ann Plast Surg 2017 Feb;78(2):202-207
    From the Plastic, Reconstructive and Aesthetic Surgery Department, Campus Bio-Medico of Rome University, Rome, Italy.
    Background: Despite of the widespread use of 180-degree propeller flaps in the field of soft tissue reconstruction, less information are available in the current literature to standardize the use of propeller flaps with reduced degrees of rotation.The authors report their experience with propeller flaps with reduced rotational angles reviewing clinical applications and outcomes of the technique in a series of 40 consecutive reconstructions.

    Patients And Methods: Forty elective defects of various etiologies located in different regions of the body (head and neck, trunk, buttocks and perineum, extremities) were reconstructed with less than 180 degrees rotated propeller flaps. Read More

    A Double-Lobe Flap Design Combined Nasolabial Advancement and Infraorbital Rotation for Reconstruction of Infraorbital Defect.
    J Craniofac Surg 2016 Jun;27(4):e389-90
    *The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine, Ministry of Education †Department of Oral Maxillofacial-Head Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
    Various adjacent flaps have been designed to close infraorbital defect, and each of them is trying to get an aesthetic outcome and meanwhile circumvent eyelid retraction, ectropion, and functional disability. Here, the authors report an adjacent double-lobe flap, which took advantage of nasolabial advancement and infraorbital rotation of the 2 lobes, combinatorially closed a pentagon infraorbital defect by removal of 2 small skin paddles as donor sites, and finally yielded an acceptable aesthetic and functional outcome. This flap may be a new option for closure of polygon infraorbital defects. Read More

    Reconstruction of Congenital Isolated Alar Defect Using Mutaf Triangular Closure Technique in Pediatric Patients.
    J Craniofac Surg 2016 Jun;27(4):1087-9
    *Department of Plastic and Reconstructive Surgery at Mustafa Kemal University, School of Medicine, Hatay †Department of Plastic and Reconstructive Surgery at SEV American Hospital, Gaziantep ‡Department of Otolaryngology at Mustafa Kemal University, School of Medicine, Hatay, Turkey.
    Congenital isolated alar defects are extremely rare, occurring in approximately 1 in 20,000 to 40,000 live births. The patients are presented here of 2 pediatric patients operated on for congenital isolated alar defect. The reconstruction of congenital isolated alar defects was made in a 3-layered fashion. Read More

    Supraclavicular artery island flap (SCAIF): a rising opportunity for head and neck reconstruction.
    Eur Arch Otorhinolaryngol 2016 Dec 11;273(12):4403-4412. Epub 2016 May 11.
    Otolaryngology Service, Head and Neck Department, "San Raffaele" Hospital, "Vita-Salute" University, Via Olgettina 60, 20123, Milan, Italy.
    Over the last 20 years, free flaps have represented the gold standard for moderate to large head and neck reconstruction. However, regional flaps continue to evolve and still play an important role in a reconstructive surgeon's armamentarium, especially for the more delicate patients who would certainly benefit from simpler surgical procedures. The supraclavicular artery island flap (SCAIF) is a pedicled flap that has recently gained great popularity for reconstruction of most head and neck sites, because of its unusual versatility and wide arc of rotation. Read More

    Lower Eyelid Reconstruction.
    Facial Plast Surg Clin North Am 2016 May;24(2):183-91
    Department of Ophthalmology, Saint Louis University School of Medicine, 1755 S. Grand Boulevard, St. Louis, MO 63104, USA; Department of Otolaryngology/Head and Neck Surgery, Saint Louis University School of Medicine, 3635 Vista Avenue, St. Louis, MO 63110, USA; Ophthalmic Plastic and Cosmetic Surgery, Inc., 12990 Manchester Road, #102, Des Peres, MO 63131, USA. Electronic address:
    Lower eyelid defects are common, and a systematic approach to reconstruction of the lower eyelid is required. Attention to the bilaminar eyelid anatomy and canthal support structures, with efforts to maintain functionally important structures, such as the lacrimal canalicular system, is vital to appropriate lower eyelid reconstruction. Techniques of advancement and rotation flaps and grafting of skin and mucosa are mainstays of lower eyelid reconstruction. Read More

    Cleft Lip Repair: The Hybrid Subunit Method.
    Facial Plast Surg 2016 Apr 20;32(2):150-5. Epub 2016 Apr 20.
    Department of Otolaryngology, University of California, Davis, Sacramento, California.
    The unilateral cleft lip repair is one of the most rewarding and challenging of plastic surgery procedures. Surgeons have introduced a variety of straight line, geometric, and rotation-advancement designs, while in practice the majority of North American surgeons have been using hybrids of the rotation-advancement techniques. The anatomic subunit approach was introduced in 2005 by Fisher and has gained popularity, with early adopters of the design touting its simplicity and effectiveness. Read More

    Is Early Nasal Shaping With a Limited Alar Base Incision Possible in the Repair of Cleft Lips?
    J Craniofac Surg 2016 May;27(3):571-7
    *Department of Plastic, Reconstructive and Aesthetic Surgery, Adana State Hospital, Adana†Department of Plastic, Reconstructive and Aesthetic Surgery, Kartal Lutfi Kirdar Education and Training Hospital, Istanbul‡Faculty of Dentistry, Department of Ortodonty, Adnan Menderes University, Aydin§Department of Biostatistics, Dicle University Medical Faculty, Diyarbakir, Turkey.
    The repair of cleft lips has an important place in plastic and reconstructive surgery. In the treatment of these deformities, the aim was to restore the normal lip morphology in the cleft area as well as repairing any coexisting nasal deformities. Various methods are in use for this purpose. Read More

    Optimising Aesthetic Reconstruction of Scalp Soft Tissue by an Algorithm Based on Defect Size and Location.
    Ann Acad Med Singapore 2015 Nov;44(11):535-41
    Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore.
    Introduction: Scalp soft tissue defects are common and result from a variety of causes. Reconstructive methods should maximise cosmetic outcomes by maintaining hair-bearing tissue and aesthetic hairlines. This article outlines an algorithm based on a diverse clinical case series to optimise scalp soft tissue coverage. Read More

    A Modified Technique to Improve Reliability of Distally Based Sural Fasciocutaneous Flap for Reconstruction of Soft Tissue Defects Longitudinal in Distal Pretibial Region or Transverse in Heel and Ankle.
    J Foot Ankle Surg 2016 Jul-Aug;55(4):753-8. Epub 2016 Apr 5.
    Department of Orthopaedics, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.
    Partial flap loss is a common complication of the distally based sural fasciocutaneous flap. We present a modified technique of a sloped skin island design to improve the reliability of the flap when used to reconstruct a longitudinal distal pretibial defect or transverse heel and ankle defect. Thirty-one flaps with the slope-designed skin island were used to reconstruct such defects in 30 patients. Read More

    [CLINICAL APPLICATION AND EXPERIENCE IN RECONSTRUCTION OF SOFT TISSUE DEFECTS FOLLOWING MALIGNANT TUMOR REMOVAL OF LIMBS USING PERFORATOR PROPELLER FLAPS].
    Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2016 Jan;30(1):82-6
    Objective: To explore the feasibility and technical essentials of soft tissue defect reconstruction following malignant tumor removal of limbs using perforator propeller flaps.

    Methods: Between July 2008 and July 2015, 19 patients with malignant limb tumor underwent defect reconstruction following tumor removal using the perforator propeller flaps. There were 13 males and 6 females with an average age of 53. Read More

    Aesthetic Unit-Based Reconstruction of Periorbital Defects.
    J Craniofac Surg 2016 Mar;27(2):429-32
    Plastic Reconstructive and Aesthetic Surgery Clinic, Okmeydani Training and Research Hospital, Istanbul, Turkey.
    Purpose: The aim of this study was to perform a retrospective analysis of patients who underwent periorbital area reconstructions, determine their sociodemographic characteristics, analyze the effects of defect etiologies and locations classified according to periorbital subunits on our reconstruction options, and to present our treatment outcomes and clinical experience.

    Methods: A retrospective chart review of 23 patients operated in our department between January 2010 and March 2013 and underwent periorbital area reconstructions, was performed. In addition to the demographic characteristics of the patients; defect etiologies, locations according to Spinelli aesthetic subunits, and the degrees of involvement were determined. Read More

    [A SACRAL BEDSORE PLASTY, USING ROTATIONAL CUTANEO-FASCIAL GLUTEAL FLAPS].
    Klin Khir 2015 Oct(10):57-60
    The method of rotational cutaneo-fascial plasty, applying preservation of perforating arteries in subfascial dissection with mobilization and subsequent rotation of the flaps was improved, guaranteeing preservation of blood flow from multiple perforating arteries in them. The method was successfully applied in 3 patients with a Grade IV sacral bedsores. Read More

    Aplasia Cutis Congenita of the Scalp, Composite Type: The Criticality and Inseparability of Neurosurgical and Plastic Surgical Management.
    Pediatr Neurosurg 2016 4;51(3):111-20. Epub 2016 Mar 4.
    Department of Neurosurgery, University of Colorado Denver School of Medicine, Aurora, Colo., USA.
    Background/aims: The object of this report is to review the management of patients having the composite type of aplasia cutis congenita in the context of the relevant literature on this condition.

    Methods: Clinical records, neuroimaging and photographic documentation of identified cases of composite type aplasia cutis congenita, with a comprehensive review of the literature, are the material basis of this report.

    Results: Two neonates with composite type aplasia cutis congenita are described as examples of this disorder, and their management, including complications, is discussed. Read More

    The Deltopectoral Flap Revisited: The Internal Mammary Artery Perforator Flap.
    J Craniofac Surg 2016 Mar;27(2):e189-92
    *American University of Beirut Medical Center, Beirut, Lebanon †The University of Texas MD Anderson Cancer Center, Houston, TX.
    Pharyngo-esophageal and tracheostomal defects pose a challenge in head and neck reconstruction whenever microanastomosis is extremely difficult in hostile neck that is previously dissected and irradiated. The deltopectoral (DP) flap was initially described as a pedicled flap for such reconstruction with acceptable postoperative results. A major drawback is still that the DP flap is based on 3 perforator vessels leading to a decreased arc of rotation. Read More

    Surgical Management of Chronic Wounds.
    R I Med J (2013) 2016 Feb 1;99(2):30-3. Epub 2016 Feb 1.
    Department of Plastic and Reconstructive Surgery, Rhode Island Hospital.
    In this article, we outline the important role the surgeon plays in the management of chronic wounds. Debridement and washout are required for grossly infected wounds and necrotizing soft tissue infections. Cutaneous cancers such as squamous cell carcinomas may contribute to chronic wounds and vice versa; if diagnosed, these should be treated with wide local excision. Read More

    A Real-Time Local Flaps Surgical Simulator Based on Advances in Computational Algorithms for Finite Element Models.
    Plast Reconstr Surg 2016 Feb;137(2):445e-452e
    Madison, Wisc.; and New York, N.Y. From the Department of Computer Science, University of Wisconsin; Division of Plastic Surgery, University of Wisconsin Medical Center; Department of Plastic Surgery, New York University Medical Center; and Biodigital Systems, LLC.
    Background: This article presents a real-time surgical simulator for teaching three- dimensional local flap concepts. Mass-spring based simulators are interactive, but they compromise accuracy and realism. Accurate finite element approaches have traditionally been too slow to permit development of a real-time simulator. Read More

    The Effect of Normovolemic and Hypervolemic Hemodilution on a Perforator Flap with Twisted Pedicle Model: Experimental Study in Rats.
    Plast Reconstr Surg 2016 Feb;137(2):339e-346e
    Antalya, Turkey; and Rome, Italy From the Departments of Plastic, Reconstructive and Aesthetic Surgery and Pathology, Akdeniz University School of Medicine; and Sant'Andrea Hospital, School of Medicine and Psychology, "Sapienza" University of Rome.
    Background: Several studies showed the detrimental effect of pedicle torsion on flap survival; however, the impact of hemodilution in this peculiar condition has never been investigated. This study evaluated the effect of acute normovolemic and hypervolemic hemodilution on flap survival in a perforator flap with twisted pedicle model.

    Methods: Sixty-three female Wistar rats were divided into three groups of 21 rats each: group 1, superficial inferior epigastric artery flap, which was elevated bilaterally and transposed back to the abdominal wall with different angles of rotation (i. Read More

    The Wave Flap: A Single-Stage, Modified Nasal Sidewall Rotation Flap for the Repair of Defects Involving the Mid-Alar Groove.
    Dermatol Surg 2016 Feb;42(2):176-82
    *Department of Dermatology, Saint Louis University School of Medicine, St. Louis, Missouri; †Department of Dermatology, Virginia Commonwealth University, Richmond, Virginia; ‡Department of Radiology, Eastern Virginia Medical School, Norfolk, Virginia; §Department of Dermatology, Saint Louis University, St. Louis, Missouri.
    Background: Reconstruction of defects straddling the alar groove presents the dual challenges of resurfacing the nasal sidewall and alar subunits while simultaneously recreating the alar groove. The wave flap (WF) is a modified, medially based, nasal sidewall rotation flap that uses locally recruited tissue from the nasal sidewall to facilitate color and texture match and permit camouflage of scars.

    Objective: To detail a surgical repair for defects in the horizontally oriented middle third of the alar groove. Read More

    Comparison of tubularized incised plate urethroplasty combined with a meatus-based ventral dartos flap or dorsal dartos flap in hypospadias.
    Pediatr Surg Int 2016 Apr 18;32(4):411-5. Epub 2016 Jan 18.
    Southern Medical University, Guangzhou, 510515, People's Republic of China.
    Purpose: Tubularized incised plate urethroplasty (TIPU) is the preferred surgical option for distal and mid-shaft hypospadias repair. Neourethra dartos flap coverage is routinely used as a protective layer with good results. We modified meatus-based ventral dartos flap (MBVDF) to TIPU by dissecting the proximal mid-ventral dartos attached urethra and leaving the subcutaneous fascia connecting the meatus, and retrospectively compared the outcomes of using MBVDF with single dorsal dartos flap (DDF) on the complication rates of TIPU. Read More

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