Search Our Scientific Publications & Authors

JAMA Facial Plast Surg 2019 Mar 14. Epub 2019 Mar 14.

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

Importance: Paramedian forehead flaps are commonly used to reconstruct facial defects caused by skin cancers. Data are lacking on the complications from this procedure, postoperative outcomes, and association of cancer diagnosis with rate of deep venous thrombosis (DVT).

Objectives: The primary objective was to determine complication rates after paramedian forehead flap reconstruction for defects resulting from resection of facial cancers; and the secondary objective was to determine patient factors and complications that are associated with readmission. Read More

J Reconstr Microsurg 2019 Mar 5. Epub 2019 Mar 5.

BG Trauma Center Ludwigshafen, Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, University of Heidelberg, Heidelberg, Germany.

Background:  Success of free tissue transfer depends on standardized intraoperative flap design, microsurgical technique, and postoperative monitoring. We sought to investigate whether laser speckle imaging (LSI) is suitable for optimization of intraoperative flap design and postoperative monitoring of free flaps with skin paddles.

Methods:  Skin perfusion was assessed with LSI in 27 free flaps after dissection at the donor site, after anastomosis at the recipient site, after inset and on postoperative days (POD) 1, 5, and 10. Read More

J Pediatr Urol 2019 Jan 18. Epub 2019 Jan 18.

Department of Urology, University of Alexandria, Egypt.

Introduction: Residual curvature, scarred or absent urethral plate, shortage of skin, and paucity of vascularized tissues and flaps are all obstacles to overcome during repair of redo and cripple hypospadias after failed reconstruction. Limited articles address the outcome of repair of these cases using different grafts.

Objective: An analysis of outcomes and complications after the repair of redo and cripple hypospadias in a cohort of children operated by a single surgeon is presented, and data are retrieved from a prospectively designed database. Read More

Int J Oral Maxillofac Surg 2019 Feb 28. Epub 2019 Feb 28.

Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany.

Free microsurgical tissue transfer of the latissimus dorsi flap may be indicated for the restoration of intra- and extraoral defects, especially when a large-sized skin island flap is required. In many cases, use of the latissimus dorsi flap for coverage of large-sized intraoral defects results in bulkiness due to the proportion of subcutaneous fat. Prelamination of free flaps appears to be a promising technique to overcome this flap bulkiness. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2019 Feb;33(2):207-211

Department of Plastic Surgery, the First Affiliated Hospital of Nanchang University, Nanchang Jiangxi, 330006, P.R.China.

Objective: To explore the effectiveness of modified rhomboid flap for repairing facial skin and soft tissue defect.

Methods: Between January 2016 and May 2018, 23 patients with facial skin and soft defect were repaired by the modified rhomboid flap. There were 10 males and 13 females with the median age of 27 years (range, 11-72 years). Read More

Laryngorhinootologie 2019 Feb 8;98(2):117-128. Epub 2019 Feb 8.

Skin tumors are becoming more and more frequent due to an increased exposition to UV-radiation and the growing age of the population. At the same time expectations with regard to function and aesthetics are growing. An in-total resection of the tumor with clear margins is the first step in surgical treatment of such patients. Read More

J Surg Oncol 2019 Feb 4. Epub 2019 Feb 4.

Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.

Objective: We aimed to explore the efficacy of keystone flap combined with vacuum-assisted closure (VAC) in the repair of sacrococcygeal wounds.

Methods: This study is a retrospective review of patients undergoing keystone flap reconstruction between January 2014 and January 2018. A standardized data collection template was used to collect related variables. Read More

Med Sci Monit 2019 Jan 25;25:721-729. Epub 2019 Jan 25.

Department of Plastic Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou, China (mainland).

BACKGROUND The aim of this study was to define blood flow characteristics of multiple types of flaps and the theoretical basis of flap axis design. MATERIAL AND METHODS Sixty Sprague-Dawley (SD) rats were randomly divided into 6 groups: a normal skin group, and 5 groups with different types of flap: abdominal flap group, dorsal flap group, single-perforator flap group, double-perforators flap group, and delayed cutaneous nerve flap group. The vascular distribution characteristics of normal skin and various flap types were observed by gross morphology of specimens and X-ray after perfusion. Read More

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2019 Jan;33(1):85-89

After more than 20 years of development, submental artery island flap (SMAIF) has become a versatile flap for head and neck reconstruction of the defects after tumor resection,trauma or facial deformity.The design of SMAIF is flexible and diverse. According to repair requirements,various types of flap can be harvested based on the different composition. Read More

Plast Reconstr Surg Glob Open 2018 Dec 5;6(12):e1947. Epub 2018 Dec 5.

Department of Plastic and Reconstructive Surgery, Bundang CHA Medical Center, CHA University, Seongnam, South Korea.

Nipple reconstruction is an essential procedure to change an amorphous breast mound to a distinct breast. Various skin flaps have been proposed for nipple reconstruction. In the C-V flap technique, which is one of the most commonly used flaps for nipple reconstruction, the scar that is developed after closure of the donor site of the V-flap frequently extends beyond a new areola area. Read More

J Burn Care Res 2019 Feb;40(2):255-258

Department of Plastic Surgery, Faculty of Medicine, Qena University Hospital, South Valley University, Egypt.

Flexion contracture affecting the knee joint is considered a challenging obstacle which usually affects patients' quality of life with significant functional disability. Several surgical procedures have been described for proper closure of surgical defects following contracture release over popliteal fossa. Although keystone flap reported for closure of full thickness burns defects, to the best of our knowledge, it has never been used previously in management of hypertrophic scar contracture around the knee joint. Read More

Arch Craniofac Surg 2018 Dec 27;19(4):260-263. Epub 2018 Dec 27.

Department of Plastic and Reconstructive Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.

Background: The alar and nasal tip are important subunits of the nose. Determining the optimal procedure for reconstructing a cutaneous defect in a nasal subunit depends on several factors including size, location, and involvement of deep underlying structures. We treated cutaneous defects after tumor ablation in the alar and nasal tip with a local flap, using an S-shaped design and a modified V-Y advancement flap with a croissant shape. Read More

J Craniofac Surg 2018 Dec 14. Epub 2018 Dec 14.

Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

Facial defects following Mohs surgery can cause significant functional, cosmetic, and psychologic sequelae. Various techniques for nasal reconstruction after Mohs surgery have been analyzed in the medical literature, yet there has been less attention given to procedures for other crucial facial aesthetic regions. A literature search using PubMed, EMBASE, and ISI Web of Science for studies assessing reconstructive techniques of the forehead, cheek, and perioral regions after Mohs surgery was performed. Read More

Scand Cardiovasc J 2018 Oct 4;52(5):275-280. Epub 2019 Jan 4.

a Department of Plastic Surgery , Kuopio University Hospital , Kuopio , Finland.

Objectives: There are multiple treatment strategies and flap options to cover defects after deep sternal wound infections and other similar sternal defects. The choice of flap is made according to surgeons' preferences and the size and location of the defect. Our aim is to introduce a new option to cover these kinds of defects with an internal mammary artery perforator flap combined with a pectoralis major muscle flap mostly raised with a muscle-sparing technique. Read More

Ann Plast Surg 2019 Jan;82(1S Suppl 1):S86-S94

Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chiayi Branch, Taiwan.

Background: The medial sural artery perforator (MSAP) flap has become increasingly popular because it is thin and pliable for small to moderate defect soft tissue reconstruction. Furthermore, chimeric MSAP flap, which includes a skin paddle and a separated piece of medial gastrocnemius muscle, allowed more freedom for flap insetting, especially in 3-dimensional defect reconstruction. Here we describe our experience regarding this clinical application. Read More

Clin Otolaryngol 2018 Nov 9. Epub 2018 Nov 9.

Institute for Head and Neck Diseases, Evangelical Hospital Vienna, Vienna, Austria.

Objectives: The main purpose of this study was to evaluate flap size and flap design of skin islands in myocutaneous serratus anterior free flaps (SAFFs) in fresh cadavers and to further investigate whether myocutaneous SAFFs are suitable flaps for pharyngeal reconstruction after laryngopharyngectomy.

Methods: Dissection and injection of methylene blue were performed in 20 hemithoraces of 13 fresh cadavers to evaluate flap size and location of skin islands. Based on these pre-clinical data, we performed pharyngeal reconstruction with myocutaneous SAFF in five patients after laryngopharyngectomy. Read More

J Craniofac Surg 2018 Nov 2. Epub 2018 Nov 2.

Department of Plastic Reconstructive and Aesthetic Surgery, Training and Research Hospital, Erzurum, Turkey.

Background: Myelomeningocele and/or meningocele is a defect of spine and spinal cord, and it is congenital. Although meningocele is a mild form of spina bifida, myelomeningocele is a more complex and serious form. There is a sac in both forms at the back. Read More

J Craniofac Surg 2019 Jan;30(1):e36-e39

Department of Stomatology, Sichuan Provincial Academy of Medical Sciences, Affiliated Hospital to School of Medicine, University of Electronic Science and Technology of China (UESTC), Sichuan Provincial People's Hospital.

Background: It is hardly to reconstruct a huge defect of lower lip by using of partial flap which brings no mouth closing functional problem. In this study, we would like to introduce our experience in large full-thickness vermilion and lower lip/chin defects reconstruction, and also focus on the evaluation of the surgery effects.

Methods: The large lower lip and chin (include vermilion) reconstruction were performed in Sichuan Provincial People's Hospital (2012-2015). Read More

Zhonghua Shao Shang Za Zhi 2018 Oct;34(10):677-682

Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China.

To explore application effects of CT angiography (CTA) and three-dimensional reconstruction technique in repairing scar around the mouth and chin with expanded forehead axial flap. From June 2013 to October 2017, 9 patients with hyperplastic scar around the mouth and chin after deep burns on face were admitted to our unit. The sizes of scars of patients ranged from 8 cm×7 cm to 13 cm×8 cm. Read More

JAMA Facial Plast Surg 2019 Jan;21(1):5-10

Boston University School of Medicine, Boston, Massachusetts.

Importance: Smoking is a known risk to wound healing, but whether electronic cigarettes present the same risk remains unknown.

Objective: To evaluate the rate of flap necrosis in the e-cigarette vapor-exposed group and the unexposed control and to detect a difference in the rate of flap necrosis between the traditional cigarette smoke-exposed group and the unexposed control.

Design, Setting, And Participants: From March 10, 2018, to May 4, 2018, a cohort study was conducted on 45 male Sprague-Dawley rats at Boston University School of Medicine. Read More

Clin Anat 2018 Oct 14;31(7):1077-1084. Epub 2018 Oct 14.

Bengbu Medical College Fuzhou General Teaching Hospital (Fuzhou General Hospital of PLA) Orthopedics Institute, Fuzhou, China.

Soft tissue defects of the forefoot represent a challenging surgical modality to reconstructive microsurgeons. This study describes the anatomical basis and design of the perforator-based intermediate dorsal pedal neurocutaneous vascular flap. Thirty fresh human lower limb specimens were injected with red latex and used for dissection of the dorsal vascular and neural anatomy of the foot. Read More

Vet Surg 2018 Nov 10;47(8):1101-1105. Epub 2018 Oct 10.

Clinica Veterinaria Nervianese, Nerviano, Milan, Italy.

Objective: To describe a local interpolation flap based on the upper lip for the reconstruction of the dorsal aspect of the nasal plane in dogs.

Study Design: Ex vivo and in vivo case report.

Animals: A 2-year-old medium-sized spayed female mixed-breed dog and a canine cadaver of a medium-sized mixed-breed dog. Read More

J Biomed Opt 2018 Sep;23(9):1-9

University of Kentucky, F. Joseph Halcomb III, M.D. Department of Biomedical Engineering, Lexington,, United States.

A noncontact electron multiplying charge-coupled-device (EMCCD)-based speckle contrast diffuse correlation tomography (scDCT) technology has been recently developed in our laboratory, allowing for noninvasive three-dimensional measurement of tissue blood flow distributions. One major remaining constraint in the scDCT is the assumption of a semi-infinite tissue volume with a flat surface, which affects the image reconstruction accuracy for tissues with irregular geometries. An advanced photometric stereo technique (PST) was integrated into the scDCT system to obtain the surface geometry in real time for image reconstruction. Read More

World Neurosurg 2018 Dec 7;120:185-189. Epub 2018 Sep 7.

Department of Neurosurgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon-si, Gyeonggi-do, Republic of Korea. Electronic address:

Background: Combined revascularization is the preferred surgical management of adult Moyamoya disease. However, postoperative flap necrosis of the scalp is not an uncommon complication. We investigated the role of scalp incision design on the basis of the course of the superficial temporal artery (STA) to prevent postoperative scalp necrosis. Read More

J Craniofac Surg 2018 Oct;29(7):1813-1816

iWELL Plastic Surgery Clinic, Seoul.

Redraping is an increasingly common epicanthoplasty method. However, hooding usually remains at the medial part of the upper eyelid. The authors innovated a modification of redraping epicanthoplasty using excision, resulting in a boomerang-shaped defect that does not lead to hooding of the medial upper eyelid. Read More

Plast Reconstr Surg 2018 09;142(3):351e-360e

Mie and Tokyo, Japan; Singapore, Republic of Singapore; and London, United Kingdom From the Department of Plastic and Reconstructive Surgery, Mie University, School of Medicine; the Departments of Plastic and Reconstructive Surgery and Otorhinolaryngology, Tokyo University, School of Medicine; the Department of Plastic Surgery, Tan Tock Seng Hospital; and the Academic Plastic Surgery Group, Queen Mary University of London.

Background: Recently, a superthin "pure skin perforator" flap without any subcutaneous tissue was proposed, but the vascularity is still unclear. The authors therefore investigated the vascularity of the proposed superficial circumflex iliac artery-pure skin perforator along with its clinical applications and findings on indocyanine green imaging.

Methods: The locations and dimension of 70 pure skin perforators on 40 flaps were investigated and classified into central-peripheral and mediolateral parts. Read More

Ann Plast Surg 2019 Jan;82(1):46-52

From the Division of Plastic Surgery, Mayo Clinic.

Background: Reconstruction of the lower eyelid represents a unique challenge to the reconstructive surgeon. Studies evaluating the utility of the nasolabial V-Y advancement flap in lower eyelid reconstruction are limited and techniques to optimize outcomes following eyelid reconstruction with this technique are not well described. We seek to evaluate our experience and outcomes with lower eyelid reconstruction using the nasolabial perforator-based V-Y advancement flap. Read More

Am J Otolaryngol 2018 Nov - Dec;39(6):693-697. Epub 2018 Jul 27.

Department of Maxillofacial and Dental Surgery, United Christian Hospital, Hong Kong Special Administrative Region.

Purpose: Submental flap is gaining popularity for head and neck reconstruction. We have reported in 2007 our early experience of using submental flap for aggressive orofacial malignancy. Novel flap design and application is described in this updated series. Read More

J Reconstr Microsurg 2018 Oct 24;34(8):658-668. Epub 2018 Jul 24.

Institute for Plastic Surgery, Southern Illinois University School of Medicine, Southern Illinois University, Springfield, Illinois.

Background:  The anterolateral region of the thigh is one of the most used donor areas for flaps. However, there are cases in which large defects require more than the conventional skin island provided by the anterolateral thigh flap (ALT). For an extended skin island flap, we developed a new boomerang thigh flap (BTF), in which a boomerang design includes perforators from multiple branches of the lateral circumflex femoral artery (LCFA), providing a single-pedicle, large, reproducible, and reliable flap. Read More

Arch Plast Surg 2018 Jul 15;45(4):340-344. Epub 2018 Jul 15.

Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.

Background: In performing extended latissimus dorsi (ELD) flap procedures, a skin paddle design on the bra line helps reduce visible scarring. This improves the patient's satisfaction with the outcome. However, such a design leads to a longer operation time and increased fatigue of the surgeon due to the narrow operative field. Read More

Facial Plast Surg 2018 Aug 28;34(4):407-411. Epub 2018 Jun 28.

Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan.

Without well recognizing the vascular territories of the perforator, surgery might damage the pedicle and diminish flap survival. This study described a transillumination method for intraoperative mapping of the subfascial plexus of the perforator in the head and neck reconstruction with an anterolateral thigh (ALT) flap and also compared the perioperative outcomes and complications of the method with those of the conventional two-pedicle ALT flap. Between January 2011 and December 2017, 26 patients who underwent head and neck reconstruction with ALT flaps were evaluated as follows: 13 underwent the transillumination method (case group), and 13 (age- and sex-matched) underwent standard two-pedicle flap procedures (control group). Read More

Medicine (Baltimore) 2018 Jun;97(22):e10849

Department of surgery.

The endoscopic technique has been utilized to harvest muscle flaps and detect perforators of fasciocutaneous flaps. This study aimed to compare the perioperative outcomes between the endoscope-assisted technique and handheld acoustic Doppler for perforator identification in fasciocutaneous flaps.This retrospective case-control study included patients who underwent fasciocutaneous flap reconstruction for traumatic soft tissue defects. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018 Mar;32(3):354-357

Department of Plastic Surgery, the First Affiliated Hospital of Nanchang University, Nanchang Jiangxi, 330006,

Objective: To introduce a modified transsection and longitudinal suture in epicanthoplasty and summarize its effectiveness.

Methods: The clinical data of 119 patients underwent epicanthoplasty with modified transsection and longitudinal suture and with a follow-up time over 6 months between February 2014 and December 2016 were retrospectively analyzed. There were 8 males and 111 females with an average age of 22. Read More

JAMA Dermatol 2018 Jun;154(6):708-711

Department of Dermatology, University Clinic of Navarra, Pamplona, Spain.

Importance: Forehead reconstruction after Mohs surgery has become a challenge for dermatology surgeons, and achieving an excellent cosmetic and functional result is imperative in this location.

Objective: To highlight the utility of a frontalis myocutaneous transposition flap (FMTF) for forehead reconstruction after Mohs surgery.

Design, Setting, And Participants: Surgical technique case series including 12 patients with large forehead defects recruited between January 2010 and June 2017 at the Dermatology Department of the University Clinic of Navarra, Spain. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2017 Jun;31(6):702-708

Department of Oral and Maxillofacial Surgery, Southwest Medical University Affiliated Stomatological Hospital, Luzhou Sichuan, 646000,

Objective: To investigate the efficacy of anterolateral thigh (myocutaneous) flap designed with computed tomography angiography (CTA) to reconstruct oral and maxillofacial soft tissue defects.

Methods: Between January 2011 and December 2015, 23 cases of oral and maxillofacial tumors were treated. There were 14 males and 9 females with the age range from 45 to 72 years (mean, 56. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2017 Aug;31(9):1106-1110

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

Objective: To investigate the effectiveness of latissimus dorsi Kiss flap for repairing composite tissue defects and functional reconstruction of upper arm.

Methods: Between March 2010 and November 2016, 12 cases of composite tissue defects of upper arm were repaired by latissimus dorsi Kiss flap with blood vessel and nerve bunch. There were 8 males and 4 females with a median age of 34 years (range, 21-50 years). Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2017 May;31(5):564-569

Department of Orthopedics, Kunming General Hospital of Chengdu Military Region, Kunming Yunnan, 650032, P.R.China.

Objective: To investigate the effectiveness of the digital technology in repairing tiny hand wounds with superficial lateral sural artery perforator flap.

Methods: Between August 2013 and October 2016, 10 cases of tiny hand wounds were treated with the superficial lateral sural artery perforator flap. There were 6 males and 4 females, aged 19 to 47 years (mean, 31. Read More

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018 Feb;32(4):241-243;249

Department of Otorhinolaryngology Head and Neck Surgery, Anhui Province Hospital, Anhui Medical University, Hefei, 230000, China.

The aim of this study is to explorethe application of improving the design of the myocutaneous flap and the transfer mode in nasal facial defect. Six cases with nasal defects were treated by using lateral or median vascular frontal flap which is nourished by supratrochlear and supraorbital arteries. Three patients with basal cell carcinoma of external nose and three patients with cranial base tumor were hospitalized and underwent surgeries. Read More

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017 Dec;31(24):1875-1879

Department of Interventional Radiology, Suzhou Municipal Hospital.

Using digital technique to design the preoperative flap of oral and maxillofacial soft tissue defect, to instruct the operation and to provide the basis for making the individual femoral flap. We chosed 7 patients with oral and maxillofacial malignancies to undergo thin-line CT scans of lower extremities and analyzed the data of CTA examination to measure the diameter, shape and length of vascular pedicle. Then selected the appropriate perforation as the source of blood supply for flap. Read More

Ann Plast Surg 2018 Jul;81(1):62-67

Otolaryngology (ENT), Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.

Background: Defects after total pharyngolaryngectomy for hypopharyngeal cancer often require reconstruction via free tissue transfer. Recently, anterolateral thigh (ALT) flap has become the gold standard in many centers because of its advantages with respect to versatility, minimal donor-site morbidity, good speech quality, and relatively low fistula and anastomotic leakage rates. Moreover, ALT allows 2 surgical teams to work simultaneously. Read More

Ann Plast Surg 2018 Aug;81(2):186-191

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

Ann Plast Surg 2018 Jul;81(1):45-49

From the Department of Plastic and Reconstructive Surgery, Ninth People's Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, China.

Background: For extensive postburn neck deformities, the preexpanded flaps in the upper back region were used and gained a uniform skin appearance and esthetic contours. Free-style perforator-based free-tissue transfer that represents the most recent advance in reconstructive surgery may provide more versatility of these flaps.

Methods: We retrospectively reviewed 31 patients treated at our institution for postburn neck contracture from March 2010 to May 2016. Read More

J Dermatol 2018 Jul 9;45(7):844-849. Epub 2018 May 9.

Department of Plastic and Reconstructive Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea.

The reconstruction of soft tissue defects with a similar type of tissue and minimizing morbidities are important. Herein, we describe our surgical experience using customized reconstruction with a series of modified keystone flaps. We retrospectively reviewed data of 48 consecutive soft tissue reconstructions using modified keystone flaps between March and December 2017. Read More

J Oral Maxillofac Surg 2018 Oct 10;76(10):2220-2230. Epub 2018 Apr 10.

Assistant Professor of Surgery and Program Director, Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic and Mayo College of Medicine, Rochester, MN.

Virtual surgical planning (VSP), computer-aided design and computer-aided modeling, and 3-dimensional printing are 3 distinct technologies that have become increasingly employed in head and neck oncology and microvascular reconstruction. Although each of these technologies have long been utilized for treatment planning in other surgical disciplines such as craniofacial surgery, trauma surgery, temporomandibular joint surgery, and orthognathic surgery, its widespread use in head and neck reconstructive surgery remains a much more recent advent. In response to the growing trend of VSP being used for the planning of fibular free flaps in head and neck reconstruction, some surgeons have questioned the technology's implementation based upon its perceived inadequacy in addressing other reconstructive considerations beyond hard tissue anatomy. Read More

BMJ Open 2018 04 19;8(4):e020213. Epub 2018 Apr 19.

Centre for Chronic Disease Prevention, James Cook University, Cairns, Queensland, Australia.

Objectives: There is limited published research studying the effect of antibiotic prophylaxis on surgical site infection (SSI) in dermatological surgery, and there is no consensus for its use in higher-risk cases. The objective of this study was to determine the effectiveness of a single oral preoperative 2 g dose of cephalexin in preventing SSI following flap and graft dermatological closures on the nose and ear.

Design: Prospective double-blinded, randomised, placebo-controlled trial testing for difference in infection rates. Read More

Plast Reconstr Surg Glob Open 2017 Dec 22;5(12):e1614. Epub 2017 Dec 22.

Department of Skin Cancer, School of Medicine, University of Queensland, Brisbane, Australia; Department of Surgery, University of Auckland, Auckland, New Zealand; and Department of Design and Creative Technologies, Auckland University of Technology, Auckland, New Zealand.

Background: Closing of defects of the lower limb after skin cancer excision poses a challenge in lower limb skin. Although the concept of relaxed skin tension lines has been established as ideal on the face, on the lower limb there remains confusion between Langer's lines and wrinkle lines, and this study was done with the task of identifying and mapping biodynamic excisional skin tension (BEST) lines on the lower limb.

Methods: Following studies on BEST lines elsewhere on the body, the author investigated BEST lines on the lower limb. 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

Microsurgery 2019 Feb 30;39(2):108-114. Epub 2018 Mar 30.

Division of Plastic and Reconstructive Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.

Objective: To reconstruct extensive head and neck defects usually necessitates double free flaps, which require a time-and-manpower-consuming surgical procedure. We present using a single fibula or peroneal flap with the novel design of obliquely-arranged double skin paddles to reconstruct an extensive head and neck defect.

Methods: From 1998 to 2016, eight patients with the age of 52. Read More