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Indian J Plast Surg 2018 Jan-Apr;51(1):40-45

Department of Anatomy, Ramaiah Medical College, Bengaluru, Karnataka, India.

Background: Reconstruction of the popliteal region has limited option in terms of muscle flaps or myocutaneous flaps. Gastrocnemius muscle or the myocutaneous flaps are the option for majority of cases. However, reach of Gastrocnemius is limited if the wound is on the distal one-third thigh or the lateral aspect of knee region. Read More

Plast Reconstr Surg Glob Open 2018 May 2;6(5):e1759. Epub 2018 May 2.

Plastic and Reconstructive Surgery, Plastic Reconstructive Surgery Center Hospital Vivian Pellas, Managua, Nicaragua.

Background: Local propeller flaps preserve the main vascular arteries of the lower extremity and muscle function, avoiding the need for a microsurgical anastomosis and the benefit of providing a "like with like" coverage. Our goal in this study was to demonstrate the versatility, safety, and complications of the local propeller flaps for lower extremity reconstruction.

Methods: We present a series of 28 patients in whom we used local propeller flaps to restore small-to-medium soft-tissue defects of the lower limb in different hospitals of Managua, Nicaragua. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018 Feb;32(2):210-214

Department of Burn and Plastic Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi Guizhou, 563003, P.R.China.

Objective: To explore the effectiveness of propeller facial artery perforator flap to repair the defect after resection of skin malignant tumor at upper lip.

Methods: Between July 2012 and January 2017, 17 cases with skin malignant tumor at upper lip underwent tumor resection and the remained defect was repaired with propeller facial artery perforator flap. Among the 17 patients, 3 were male and 14 were female, with an average age of 57 years (range, 35-82 years). Read More

Zhonghua Shao Shang Za Zhi 2018 May;34(5):266-270

Burn Center of PLA, Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, Xi'an 710032, China.

Strategy for wound repair of skin and soft tissue defect and systematic rehabilitation treatment for functional reconstruction of patients with severe burn or trauma on knees. From January 2015 to October 2016, 26 patients with skin and soft tissue defect on knees after severe burn or trauma were hospitalized in our unit. Among these patients, 14 patients had patellar ligament defect, and 16 patients had knee joint capsule defect. Read More

Ann Plast Surg 2018 May 17. Epub 2018 May 17.

Department of Plastic, Reconstructive and Aesthetic Surgery, South Hospital, University of Rennes 1, Rennes.

Background: In recent years, pedicled perforator flaps have revolutionized plastic surgery by reducing donor site morbidity and ensuring larger and deeper reconstructions with local pedicled cutaneous flaps. The aim of the study was to make a systematic review of perforator pedicled propeller flaps (PPPFs) in chest reconstruction.

Methods: Pubmed and Cochrane databases were searched from 1989 to October 2016 for articles describing the use of PPPFs in chest reconstruction. Read More

Ann Plast Surg 2018 May 14. Epub 2018 May 14.

Otolaryngology, Hanyang University Medical Center, Hanyang University College of Medicine, Seoul, Korea.

Purpose: The pectoralis major musculocutaneous (PMMC) flap is a classic flap for head and neck reconstruction, relatively unpopular with the advancement of microsurgery and free flaps. The classic parasternal paddle design provided a thick flap with a small rotation arch leaving objectionable scarring. Our new symmetric midsternal design overcomes these problems. Read More

Microsurgery 2018 May 2. Epub 2018 May 2.

Department of Plastic, Reconstructive and Maxillo-Facial Surgery, and Burn Unity, Centro Hospitalar de São João, Porto Medical School, Porto, Portugal.

Facial artery perforator flaps have been recently reported by different authors for perioral, nasal alar and cheek defects, but not for intraoral reconstruction. We have extended the use of the facial artery perforator flap in a 56-year-old man with a squamous cell carcinoma of left mouth floor, who was submitted to tumor resection with marginal mandibulectomy and left supraomohyoid neck dissection. The flap was designed according to the size of the defect (5 × 3 cm), centered on the perforator to create a symmetric flap and was tunnelled intraorally by means of a 90° rotation. Read More

Turk Neurosurg 2018 Apr 9. Epub 2018 Apr 9.

Mersin University Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery, Mersin, Turkey.

Aim: Bilateral rotation flaps are considered the workhorse flaps in reconstruction of myelomeningocele defects. Since the introduction of perforator flaps in the field of reconstructive surgery, perforator flaps have been used increasingly in the reconstruction of various soft tissue defects all over the body because of their appreciated advantages. The aim of this study was to compare the complications and surgical outcomes between bilateral rotation flaps and dorsal intercostal artery perforator (DICAP) flaps in the soft tissue reconstruction of myelomeningocele defects. Read More

Ann Plast Surg 2018 Jun;80(6):648-652

Gynecologic Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.

Background And Aim: Because of the associated high recurrence rate, future reconstructive options should be reckoned with during surgical treatment of primary or recurrent (pre)malignant vulvoperineal lesions. One of the claimed advantages of the gluteal fold flap is the possibility of repeated use of the flap in case of recurrence. We present our experience with such reuse of gluteal fold flaps to illustrate this possibility. Read More

Acta Bioeng Biomech 2018 ;20(1):185-190

Department Rehabilitation, The Children's Memorial Health Institute The Children's Memorial Health Institute, Warsaw, Poland.

Purpose: Patients with malignant tumours of the oral cavity require its surgical removal and reconstruction of the bone and soft tissues. The grafts are obtained either from leg (fibula) or pelvis (iliac crest). The removal of grafts from the locomotor apparatus can impair the gait. Read More

Ann Chir Plast Esthet 2018 Apr 11. Epub 2018 Apr 11.

Service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier Saint-Joseph Saint-Luc, 20, quai Claude-Bernard, 69007 Lyon, France.

Introduction: The ischiatric pressure sore is a common pathology in rehabilitated spinal cord injured people, despite careful prevention. Medical treatment by discharge and directed healing is not always sufficient and surgery using local musculocutaneous flaps is often essential. Unfortunately, recidivism is frequent and the availability of local flaps is limited. Read More

J Craniomaxillofac Surg 2018 May 14;46(5):868-874. Epub 2018 Mar 14.

Maxillo-Facial Surgery Department. (Head: Professor C. Marchetti), Sant'Orsola-Malpighi Hospital, University of Bologna, via Albertoni 15, Bologna, Italy.

Recent facial paralyses, in which fibrillations of the mimetic muscles are still detectable by electromyography (EMG), allow facial reanimation based on giving new neural stimuli to musculature. However, if more time has elapsed, mimetic muscles can undergo irreversible atrophy, and providing a new neural stimulus is simply not effective. In these cases function is provided by transferring free flaps into the face or transposing masticatory muscles to reinstitute major movements, such as eyelid closure and smiling. Read More

Eplasty 2018 19;18:e15. Epub 2018 Mar 19.

Division of Plastic and Reconstructive Surgery, Department of Surgery, Louisville, Ky.

: There are many approaches to nipple-areola complex reconstruction. Tissue quality and thickness, desired nipple location and size, scar position, and surgeon preference all play a role in selecting a technique. We present the rectangle-to-cube nipple flap, a new technique for challenging nipple reconstruction. Read More

Plast Reconstr Surg Glob Open 2018 Feb 8;6(2):e1651. Epub 2018 Feb 8.

Department of Plastic and Aesthetic Surgery, Peking University People`s Hospital, Beijing, PR China.

Background: Free-style flaps allow surgeons to overcome anatomical variations and raise perforator flaps wherever a pulsatile signal can be detected. We performed a systematic review and meta-analysis to identify the risk factors for complications and indications for free-style flaps in soft-tissue defect reconstructions.

Methods: This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Read More

Arch Craniofac Surg 2018 Mar 20;19(1):64-67. Epub 2018 Mar 20.

Department of Plastic and Reconstructive Surgery, Busan Paik Hospital, Inje University School of Medicine, Busan, Korea.

Varying degrees of complications can occur after hyaluronic acid filler injections. Tissue necrosis due to interruption of the vascular supply is an early complication that can be severe. If the site of tissue necrosis due to the filler injection is the forehead, successfully reconstructing the region without distorting the key landmarks is challenging. Read More

Medicine (Baltimore) 2018 Mar;97(12):e0191

Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital, Beijing, China.

Rationale: A significant clinical issue for treating patients with large upper lip defects is how to reconstruct the lip functionally and aesthetically. Traditional methods usually lead to asymmetry of the nasal base, philtrum and the lips.

Patient Concerns: A 22-year-old lady presented with a large congenital nevus on her upper lip which involved the cutaneous, vermilion, and the philtrum. Read More

Medicine (Baltimore) 2018 Mar;97(12):e0168

Department of Plastic and Reconstructive Surgery, Konyang University Hospital, University of Konyang College of Medicine, Myunggok Medical Research Center, Daejeon, Korea.

This study aimed to present a simple, fast, and safe technique, called freestyle perforator-based peninsular flap (FPBPF), for pressure sore reconstruction.Among the 21 patients who underwent pressure sore reconstruction between May 2013 and October 2016, 12 patients (Group A) and 9 patients (Group B) were subjected to perforator-based island flap (PBIF) and FPBPF, respectively. We retrospectively reviewed and statistically analyzed the data of both groups. Read More

Eye (Lond) 2018 Mar 14. Epub 2018 Mar 14.

South Australian Institute of Ophthalmology, Royal Adelaide Hospital, North Terrace, Adelaide, SA, Australia.

Purpose: Propeller flaps are island flaps that reach the recipient site through an axial rotation. The flap has a subcutaneous pedicle on which it pivots, thereby resembling a helicopter propeller. We present our series of propeller flaps for the reconstruction of large eyelid defects. Read More

J Surg Oncol 2018 Apr 26;117(5):1100-1106. Epub 2018 Feb 26.

Universidad de Antioquia, Medellín, Colombia.

Purpose: The previous cadaveric studies of facial artery perforators have frequently reported high variability, and those results remain to be validated in the Colombian population. Thus, we aimed to describe the vascular anatomy of the lateral nasal artery cutaneous branches and their clinical applications using Colombian cadavers.

Materials And Methods: Nine hemifaces from six fresh cadavers were included in the study. Read More

J Plast Reconstr Aesthet Surg 2018 Jun 13;71(6):863-869. Epub 2018 Feb 13.

Yotsuya Medical Cube Hand Surgery and Microsurgery Center, Tokyo, Japan.

Background: Reconstruction of the finger and thumb dorsum has been considered difficult because of the need for a thin and flexible flap, and the surrounding tissue is sometimes insufficient for a local flap. The purpose of this report is to describe our concept for finger and thumb dorsum reconstruction with free-style perforator flaps and our clinical experience with transfer of various perforator flaps.

Methods: Thirty-two finger dorsum defects in 32 patients were covered with pedicled free-style perforator flaps. Read More

Phys Rev Lett 2018 Feb;120(6):068101

Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford Street, Cambridge, Massachusetts 02138, USA.

Reconstructive surgeries often use topological manipulation of tissue to minimize postoperative scarring. The most common version of this, Z-plasty, involves modifying a straight line cut into a Z shape, followed by a rotational transposition of the resulting triangular pedicle flaps, and a final restitching of the wound. This locally reorients the anisotropic stress field and reduces the potential for scarring. Read More

J Indian Assoc Pediatr Surg 2018 Jan-Mar;23(1):27-31

Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India.

Aim: The aim of this study is to report the technique and outcome of ischiopubic (IP) osteotomy for pelvic ring closure in classic exstrophy bladder.

Methods: A total of 85 male classic exstrophies were selected based on trapezoid-shaped space between IP ramus on three-dimensional computed tomography pelvis. Using midline scroto-perineal approach, after bladder plate mobilization and radical corporal detachment; the pelvic surface of superior pubic ramus (SPR) was exposed. Read More

An Bras Dermatol 2017 ;92(5 Suppl 1):132-134

Dermatological Surgery Outpatient Clinic of the Department of Tropical Dermatology of Hospital Central do Exército (HCE) - Rio de Janeiro (RJ), Brazil.

In some cases, keratoacanthomas can be indistinguishable from squamous cell carcinoma, making the gold standard treatment surgical excision with histopathological evaluation. The surgical defects created on the back of the hand can be challenging to repair. We describe the use of bilateral rotation flap as an option in this area, and discuss the indications and contraindications of some of the possible surgical techniques for reconstruction of the dorsum of the hand. Read More

Asia Pac J Sports Med Arthrosc Rehabil Technol 2017 Apr 21;8:13-17. Epub 2017 Jan 21.

Department of Orthopaedics, CLINTEC, Karolinska University Hospital, Stockholm, Sweden.

Background/objective: Impingement syndromes are a common cause of shoulder pain in overhead athletes. Anterior internal impingement is a recently suggested mechanism for activity-related pain of the shoulder. Impingement syndromes were initially described to occur due to repetitive or excessive contact between the rotator cuff and other structures in the shoulder. Read More

J Stomatol Oral Maxillofac Surg 2017 Nov 26. Epub 2017 Nov 26.

Oral and Maxillofacial Surgery Department, Hospital Universitario La Princesa, 28006 Madrid, Spain.

Lip cancer represents between 12-15% of all oral cavity cancers; 95% affect the lower lip. The main objectives in lip reconstruction after tumoral mass resection are functionality and esthetics. We present the case of an 81-year-old male with a past medical history of squamous cell carcinoma of the maxilla. Read More

Int Braz J Urol 2017 Nov 17;43. Epub 2017 Nov 17.

Seção de Urologia, Hospital Federal da Lagoa - Rio de Janeiro, RJ, Brasil.

Objectives: Buccal mucosa grafts and fascio-cutaneous flaps are frequently used in long anterior urethral strictures (1). The inlay and onlay buccal mucosa grafts are easier to perform, do not need urethral mobilization and generally have good long-term results (2-4). In the present video, we present a case where we used a double buccal mucosa graft technique in a simultaneous penile and bulbar urethral stricture. Read More

J Reconstr Microsurg 2018 Mar 12;34(3):185-192. Epub 2017 Nov 12.

Division of Plastic Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.

Background:  Free flaps have a well-established role in breast reconstruction after mastectomy; however, their role in partial breast reconstruction remains poorly defined. We reviewed our experience with partial breast reconstruction to better understand indications for free tissue transfer.

Methods:  A retrospective review was performed of all patients undergoing partial breast reconstruction at our center between February 2009 and October 2015. Read More

ANZ J Surg 2017 Nov 9. Epub 2017 Nov 9.

Department of Surgery, St Vincent's Hospital, Melbourne, Victoria, Australia.

Background: Reconstruction of posterior thoracic and trunk defects can prove challenging even to the most seasoned surgeons. Many commonly used techniques for closing back defects include primary closure and split skin grafts. Often times, however, other techniques are needed in order to give the patient the best aesthetic and functional outcome. Read More

Arch Plast Surg 2018 Jan 27;45(1):62-68. Epub 2017 Oct 27.

Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Background: Amputation is commonly performed for toe necrosis secondary to peripheral vascular diseases, such as diabetes mellitus. When amputating a necrotic toe, preservation of the bony structure is important for preventing the collapse of adjacent digits into the amputated space. However, in the popular terminal Syme's amputation technique, partial amputation of the distal phalanx could cause increased tension on the wound margin. Read More

Arch Plast Surg 2018 Jan 27;45(1):85-88. Epub 2017 Oct 27.

Department of Plastic Surgery, Ankara Training and Research Hospital, Ankara, Turkey.

Local flaps exhibit excellent color matching that no other type of flap can compete with. Moreover, surgery using a local flap is easier and faster than surgery using a distant or free flap. However, local flaps can be much more difficult to design. Read More

BMC Ophthalmol 2017 Oct 10;17(1):187. Epub 2017 Oct 10.

Department of Ophthalmology, Dongguk University, Ilsan Hospital, 814, Siksadong, Ilsan-dong-gu, Goyang, Kyunggido, 410-773, South Korea.

Background: To report the recurrence rate for an anchored conjunctival rotation flap technique in primary pterygium surgery.

Methods: Primary pterygium surgeries performed using anchored conjunctival rotation flap techniques (110 eyes in 110 patients) with a minimum follow-up of 12 months were reviewed. In this technique, a conjunctival flap is rotated to cover the bare sclera and suture-fixated with either 8-0 polyglactin (41 eyes) or 10-0 nylon (69 eyes). Read More

Plast Reconstr Surg 2017 Oct;140(4):757-764

Oxford and Salisbury, United Kingdom From Spires Cleft Centre, Oxford University Hospitals NHS Trust, John Radcliffe Hospital; and the Spires Cleft Centre, Salisbury Foundation NHS Trust.

Background: Cleft lip repair aims to create symmetric nasolabial morphology with minimal scarring. Poor aesthetic outcomes may have damaging psychosocial implications. Determining the optimal method of recreating lip symmetry is a major goal of applied cleft clinical research. Read More

J Craniofac Surg 2017 Nov;28(8):1972-1975

*Department of Plastic Surgery, Konkuk University School of Medicine †Laree Plastic Surgery Clinic, Seoul, Korea.

The medial epicanthal fold is one of the racial anatomic characteristics of Asians. As medial epicanthoplasty has become one of the most common cosmetic surgeries among Asians, the need for revision of overcorrected medial epicanthus also increased. In revision medial epicanthoplasty, an autologous tissue graft to the subcutaneous plane is used to reduce postoperative scar. Read More

Arch Craniofac Surg 2017 Jun 26;18(2):112-116. Epub 2017 Jun 26.

Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul, Korea.

The ideal scalp reconstruction involves closure of the defect with similar hair-bearing local tissue in a single step. Various reconstructions can be used including primary closure, secondary healing, skin grafts, local flaps, and microvascular tissue transfer. A 53-year-old female patient suffered glioblastoma, which had recurred for the second time. Read More

Arch Craniofac Surg 2016 Dec 23;17(4):190-197. Epub 2016 Dec 23.

Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, Korea.

Background: The cheek rotation flap has sufficient blood flow and large flap size and it is also flexible and easy to manipulate. It has been used for reconstruction of defects on cheek, lower eyelid, or medial and lateral canthus. For the large defects on central nose, paramedian forehead flap has been used, but patients were reluctant despite the remaining same skin tone on damaged area because of remaining scars on forehead. Read More

Dermatol Surg 2017 10;43(10):1233-1235

Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah.

Cir Pediatr 2017 04 20;30(2):111-116. Epub 2017 Apr 20.

Cirugía Maxilofacial. Hospital Universitari Sant Joan de Déu. Barcelona.

Introduction: Isolated cleft lip is the mildest form of the cleft lip and palate spectrum; however those patients are often treated with the same surgical techniques that are used for the more severe cases (advancement-rotation flaps, quadrangular flaps). Meara's cheiloplasty technique may be a less aggressive option for lip repair in isolated cleft lip or whenever the gap between labial segments is not wide.

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

Int J Low Extrem Wounds 2017 Sep 21;16(3):208-211. Epub 2017 Aug 21.

3 Fairview Hospital, Fairview Park, OH, USA.

Loss of soft tissue coverage distally around the foot poses threats of amputation of the exposed boney structures. An amputation of a portion of the foot leads to loss of the biomechanical structural integrity of the foot. This promulgates an imbalance with its inherent risks of developing new ulcers. Read More

Radiat Oncol 2017 Aug 15;12(1):135. Epub 2017 Aug 15.

Department of Plastic Surgery, The Affiliated Hospital of Academy of Military Medical Sciences, Beijing, 100043, China.

Background And Purpose: To explore the methods of clinical classification in chronic radiation-induced ulcers in the chest wall (CRUCWs).

Materials And Methods: A total of 64 patients with CRUCWs were treated. We divided the cases into 3 types (mild, moderate, or severe) according to their clinical manifestations. Read More

J Refract Surg 2017 Aug;33(8):568-570

Purpose: To describe a new technique for implantation of capsule-fixated intraocular lenses (IOLs) (FEMTIS; Oculentis, Berlin, Germany) in patients with small pupils.

Methods: In 4 eyes with small pupils, an anterior capsule-fixated IOL was implanted into the capsular bag after femtosecond laser treatment. The two large and two small flaps of the IOL were elevated to the front of the iris and the anterior capsule. Read More

Acta Stomatol Croat 2017 Mar;51(1):60-64

Professor,DM, MSc, PhD at the School of Medicine, University of Zagreb, Department of Oral and Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia.

The early techniques of cleft lip repair involved the straight-line technique, the triangular flap technique or some kind of geometric line (triangular, quadrangular closure). A turning point in cleft lip surgery was in 1955 when doctor. Millard presented his method: the rotation-advancement technique or flap, at the First International Congress of Plastic Surgery in Stockholm. Read More

World J Plast Surg 2017 May;6(2):144-151

Department of Plastic Surgery, University California Irvine, 200 South Manchester Ave. Suite 650, Orange CA 92868, USA.

Background: Current teaching suggests increased perfusion in free transverse rectus abdominis myocutaneous (TRAM) flaps over pedicled TRAM flaps, broadening indications for its use in high risk patients. This study compared perfusion analysis of free muscle-sparing versus pedicle TRAM flaps in the peri-operative and late post-operative periods.

Methods: The SPY-Elite system using indocyanine green dye was used to analyze flap perfusion intra-operatively and at 1 week and 3 months post-operatively. Read More

Facial Plast Surg Clin North Am 2017 Aug 30;25(3):313-321. Epub 2017 May 30.

Department of Otolaryngology, University at Buffalo, 1237 Delaware Avenue, Buffalo, NY 14209, USA. Electronic address:

In many cases of complex facial defects, because of advanced cutaneous malignancies, primary wound closure is impossible. In these instances, ideal results can be obtained through recruitment of adjacent tissue with the use of local flaps. Advances in local flap techniques have raised the bar in facial reconstruction; however, acceptable results to the surgeon and patient require high levels of planning and surgical technique. Read More

J Plast Reconstr Aesthet Surg 2017 Nov 9;70(11):1620-1623. Epub 2017 Jun 9.

7th Department, Peking Union Medical College, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing 100144, China.

Background: Cryptotia is a common congenital ear deformity in Asian populations. In cryptotia, a portion of the upper ear is hidden and fixed in a pocket of the skin of the mastoid. Here we describe our method for cryptotia correction by using an ultra-delicate split-thickness skin graft in continuity with a full-thickness skin rotation flap. Read More

Actas Dermosifiliogr 2017 Oct 27;108(8):729-737. Epub 2017 Jun 27.

Servicio de Dermatología, Hospital Infanta Sofía, San Sebastián de los Reyes, Madrid, España.

Background And Objectives: A broad range of skin flaps can be used to repair facial surgical defects after the excision of a tumor. The aim of our study was to develop a practical guideline covering the most useful skin grafts for each of the distinct facial cosmetic units.

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

J Dermatol 2017 Nov 21;44(11):e302-e303. Epub 2017 Jun 21.

Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.