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Semin Plast Surg 2019 Feb 8;33(1):17-23. Epub 2019 Mar 8.

Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas.

With the advent of the Industrial Revolution, traumatic injuries of the upper extremity increased exponentially. As a result, surgeons began to reevaluate amputation as the standard of care. Following the Second World War, local and regional pedicled flaps became common forms of traumatic upper extremity reconstruction. Read More

J Plast Reconstr Aesthet Surg 2019 Jan 11. Epub 2019 Jan 11.

Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Hand and Plastic Surgery, University of Heidelberg, Ludwig-Guttmann-Strasse 13, 67071 Heidelberg, Germany. Electronic address:

Background: Though technically feasible, free tissue transfer carries the risk of perioperative morbidity and mortality in elderly patients. To minimize the operative treatment time and complication rates, we choose the rectus abdominis muscle (RAM) flap.

Methods: Between 2012 and 2017, 34 patients (mean age: 74±7 years, range: 65-89 years) with comorbidities underwent defect reconstruction with a free RAM flap. Read More

Eur J Orthop Surg Traumatol 2019 Feb 16;29(2):285-293. Epub 2019 Jan 16.

Department of Plastic Surgery, University of Tennessee Health Science Center (UTHSC), 1068 Cresthaven Road Suite 500, Memphis, TN, 38119, USA.

While free tissue transfer has long been established as a reliable microsurgical technique in the adult population, its application in pediatric reconstruction is a relatively recent phenomenon. Despite initial concerns regarding minute vessel diameters, increased propensity for vasospasm, and limited tissue availability, pediatric free tissue transfer is now a widely used technique that has demonstrated an acceptable level of donor and recipient site morbidity in children. Five flaps commonly used in the reconstruction of lower extremity trauma are discussed in this paper: the latissimus dorsi, rectus abdominis, anterolateral thigh, gracilis, and the subscapular and parascapular flaps. Read More

Arch Plast Surg 2018 Sep 15;45(5):441-448. Epub 2018 Sep 15.

Department of Plastic and Reconstructive Surgery, Yeungnam University College of Medicine, Daegu, Korea.

Background: Previously, surveys have been used to investigate breast reconstruction statistics. Since 2015, breast reconstruction surgery after mastectomy has been covered by the National Health Insurance Service in Korea, and data from breast reconstruction patients are now available from the Health Insurance Review and Assessment Service (HIRA). We investigated statistics in breast reconstruction in Korea through statistics provided by the HIRA Big Data Hub. Read More

J Craniofac Surg 2018 Oct;29(7):1733-1736

Neuroplastic and Reconstructive Surgery, Department of Plastic & Reconstructive Surgery, Johns Hopkins University School of Medicine.

Objective: Patients with cranioplasty in need of skull reconstruction are at increased risk of complications when presenting with abnormally thin scalps. As such, the authors sought to develop and investigate a new technique for scalp augmentation using autologous rectus fascia grafts (ARFGs) for prevention of implant extrusion and long-term scalp durability.

Methods: A retrospective review of our database, consisting of 450 consecutive cranial reconstructions from 2012 to 2017, was performed under institutional review board approval. Read More

Indian J Plast Surg 2018 Jan-Apr;51(1):24-32

Amandeep Hospital and Clinics, GT Road, Model Town, Amritsar 143001, Punjab, India.

Background: Many flaps have been described for reconstruction of lower extremity defects, including, Latissimus Dorsi, Rectus abdominis, Anterolateral thigh perforator flaps, each having advantages and disadvantages. The defect location, size and specific geometric pattern of defect influences the type of flap that can be used. In this case series, we describe the specific situations where the use of chimeric latissimus dorsi-serratus anterior (LD + SA) free flaps are of advantage in providing complete wound cover. Read More

J Surg Res 2018 Aug 12;228:253-262. Epub 2018 Apr 12.

Laboratory of Clinical and Experimental Research in Vascular Biology, Department of Physiological Sciences, Institute of Biology, UERJ, Rio de Janeiro, Brazil.

Background: Tissue necrosis caused by insufficient perfusion is a major complication in flap transfer. This study evaluated whether treatment with cilostazol or hydroalcoholic extract of seeds of Euterpe oleracea Mart. (açaí) protects the transverse rectus abdominis myocutaneous (TRAM) flap against ischemic damage in hamsters. Read More

J Reconstr Microsurg 2018 Oct 18;34(8):590-600. Epub 2018 May 18.

Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, Kansas.

Background:  Microvascular reconstruction of the anterior cranial fossa (ACF) creates difficult challenges. Reconstructive goals and flap selection vary based on the defect location within the ACF. This study evaluates the feasibility and reliability of free tissue transfer for salvage reconstruction of low, middle, and high ACF defects. Read More

Ann Plast Surg 2018 Jul;81(1):68-70

From the Hansjörg Wyss Department of Plastic Surgery, NYU Langone Medical Center, New York, NY.

Purpose: Free tissue transfer after lower extremity trauma is associated with notoriously high complication rates. Theoretically, the inclusion of a cutaneous paddle on muscle free flaps may improve clinical flap monitoring. The effect of skin paddle presence on muscle free flap salvage outcomes after take-back was examined. Read More

Curr Opin Otolaryngol Head Neck Surg 2018 Apr;26(2):127-133

Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital, Birmingham, West Midlands, UK.

Purpose Of Review: To review recent literature on the subject of free tissue transfer options in paediatric head and neck surgery, with a particular emphasis on highlighting the advantages and disadvantages of different reconstructions in the paediatric patient.

Recent Findings: Free tissue transfer in paediatric patients is predictable and applicable for a wide range of congenital and acquired defects in the head and neck. The free fibula flap is a mainstay of mandibular reconstruction and allows excellent implant-supported prosthodontic rehabilitation and growth potential at the recipient site with little or no donor site morbidity. Read More

Aesthetic Plast Surg 2017 Dec 20;41(6):1389-1399. Epub 2017 Jun 20.

Unidad de Cirugía Plástica, Departamento de Cirugía, Hospital Clínico Universidad de Chile, Santos Dumont 999, Independencia, Santiago, Chile.

Objective: To describe a new technique to achieve a fit-look in lipoabdominoplasty patients through liposculpture and rectus abdominis fat transfer (RAFT).

Methods: Patients with a body mass index under 26 and of both genders scheduled for abdominoplasty or body lift were selected for this procedure. Fat was transferred directly to the rectus abdominis muscle after flap elevation during lipoabdominoplasty. Read More

Plast Reconstr Surg 2017 Sep;140(3):604-613

Houston, Texas From the Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center.

Background: Early detection of compromised free flap perfusion is critical. A common modality of thrombosis detection, physical examination augmented with hand-held Doppler, provides only intermittent data and is insensitive to venous compromise. Visible light spectroscopy provides continuous, noninvasive evaluation of tissue perfusion. Read More

Ann Plast Surg 2017 Aug;79(2):221-225

From the Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH.

Background: Aortic graft infection (AGI) is a rare complication following reconstructive aortic surgery, yet it represents a significant source of morbidity and mortality. There is no consensus regarding the optimal surgical management, due in part to the small cohorts of patient reports. Pedicled muscle or omental flap coverage of AGI has been shown to improve outcomes, making them a valuable consideration in the treatment algorithm. Read More

J Craniofac Surg 2017 May;28(3):659-663

Department of Plastic, Reconstructive and Aesthetic Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Reconstruction of a midfacial defect can represent a difficult challenge for the plastic surgeon. Although many midfacial deformities have traumatic or congenital origins, the vast majority of head and neck defects occur after resection of malignant head and neck neoplasms. Autogenous reconstruction is now routinely performed for larger, complex defects resulting from surgical resection or trauma. Read More

Hand (N Y) 2018 Mar 7;13(2):150-155. Epub 2017 Apr 7.

1 Washington University School of Medicine, St Louis, MO, USA.

Background: Current management of brachial plexus injuries includes nerve grafts and nerve transfers. However, in cases of late presentation or pan plexus injuries, free functional muscle transfers are an option to restore function. The purpose of our study was to describe and evaluate the rectus abdominis motor nerves histomorphologically and functionally as a donor nerve option for free functional muscle transfer for the reconstruction of brachial plexus injuries. Read More

Otolaryngol Head Neck Surg 2017 04 21;156(4):627-635. Epub 2017 Mar 21.

3 Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon.

Objective To compare outcomes after microvascular reconstructions of head and neck defects between overlapping and nonoverlapping operations. Study Design Retrospective cohort study. Setting Tertiary care center. Read More

Zhonghua Zheng Xing Wai Ke Za Zhi 2017 Mar;33(2):112-5

Objective: To investigate the feasibility of one-stage thinning of latissimus dorsi muscle, rectus abdominis muscle and gracilis flap in reconstruction of the hand and foot defects.

Methods: From June 2009 to April 2015,24 free muscle flaps were thinned during transfer operation by removing their superficial muscle layers on the basis of their vessel pedicles running in the deep surface of flaps. The surface of the muscle flaps were covered by split-thickness skin grafts. Read More

Urol Int 2017 24;99(1):56-62. Epub 2017 Feb 24.

Department of Urology, National Cancer Center Hospital East, Kashiwa, Japan.

Introduction: The study aimed to present our experience of surgical treatment for urorectal fistulas (URF) that develop after cancer surgery.

Materials And Methods: Fourteen patients with URF who were treated at our institution from 2005 through 2015 were retrospectively analyzed. Among these, 7 patients had previous surgical treatment of prostate cancer (PC) and the other 7 had been treated for rectal cancer (RC). Read More

J Reconstr Microsurg 2017 May 15;33(4):298-304. Epub 2017 Feb 15.

Department of Plastic and Reconstructive Surgery, Cleveland Clinic Florida, Florida.

 Autologous breast reconstruction has been noted in the literature to provide superior aesthetic outcomes and patient satisfaction. Additionally, free perforator flap tissue transfer has the potential for lower abdominal donor site morbidity. However, it has been noted that the percentage of women who are undergoing autologous breast reconstruction in the United States is decreasing. Read More

Aesthetic Plast Surg 2017 Feb 28;41(1):19-25. Epub 2016 Dec 28.

Department of Plastic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.

Background: Tissue transfer, such as use of the transverse rectus abdominis myocutaneous (TRAM) or deep inferior epigastric artery perforator (DIEP) free flaps, is considered a standard method. However, outcomes may vary among inset methods. Here we compared the aesthetic outcomes of breast reconstructions using vertical and horizontal flap inset methods. Read More

Radiology 2016 Nov 6;281(2):436-443. Epub 2016 May 6.

From the Institute of Diagnostic and Interventional Radiology (M.R., C.E., M.C.W., A.B.) and Department of Urology (M.R., D.H., S.S., D.E.), University Hospital Zurich, Rämistrasse 100, CH-8091 Zurich, Switzerland; and Laboratory for Biointerfaces, Empa, Swiss Federal Laboratories for Materials Science and Technology, St Gallen, Switzerland (M.R.).

Purpose To determine whether magnetization transfer (MT) magnetic resonance (MR) imaging may serve as a quantitative measure of the degree of fiber formation during differentiation of muscle precursor cells into engineered muscle tissue as a potential noninvasive monitoring tool in mice. Materials and Methods The study was approved by the local ethics committee (no. StV 01/2008) and the local Veterinary Office (license no. Read More

Microsurgery 2017 Jul 5;37(5):402-405. Epub 2016 Oct 5.

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

Background: Breast reconstruction with microvascular free tissue transfer has become a widely used method. Despite a high rate of success, a compromised flap necessitating re-exploration can occur. Here, we introduce direct thrombectomy as a flap salvage technique, and compared the results with conventional thrombectomy. Read More

Microsurgery 2017 Jul 5;37(5):377-382. Epub 2016 Oct 5.

Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO, 63110, USA.

Background: With complete plexus injuries or late presentation, free functional muscle transfer (FFMT) becomes the primary option of functional restoration. Our purpose is to review cases over a 10-year period of free functioning gracilis muscle transfer after brachial plexus injury to evaluate the effect of different donor nerves used to reinnervate the FFMT on functional outcome.

Methods: A retrospective study from April 2001 to January 2011 of a single surgeon's practice was undertaken. Read More

J Surg Res 2016 10 6;205(2):292-295. Epub 2016 Jul 6.

Department of Plastic and Reconstructive Surgery, Radboudumc, Nijmegen, The Netherlands.

Background: Under ideal circumstances, creation of the anastomosis during free flap transfer is a routine task and can be performed under short ischemia time. However, vessels may be in suboptimal state due to atherosclerosis, radiotherapy or trauma, increasing difficulties regarding receptor vessel identification, and anastomosis which in turn may lead to lengthening of ischemia time resulting in postoperative wound problems or even flap loss. In the current pilot study, a modified heart-lung machine was assembled to achieve continuous oxygenated extracoporeal perfusion using porcine myocutaneous rectus abdominis flaps, aimed at minimizing tissue damage occurring during ischemia time. Read More

Microsurgery 2017 Jul 16;37(5):406-409. Epub 2016 Sep 16.

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

Introduction: Fibrin sealants have had applications in hemostasis, cohesion, and promotion of healing in plastic surgery. In this article, we review cases where fibrin sealant was used to stabilize microvascular pedicles and compared with previous free flaps performed without fibrin sealant.

Methods: Between 2008 and 2010, 62 consecutive patients underwent free tissue transfer for reconstruction; this involved 33 latissimus dorsi perforator flaps, 14 thoracodorsal artery perforator flaps, 9 latissimus dorsi myocutaneous flaps, 3 lateral thoracic artery perforator flaps, and 3 transverse rectus abdominis myocutaneous flaps, used in head and neck reconstruction, lower limb reconstructions, breast reconstructions, and facial palsy reconstruction. Read More

J Reconstr Microsurg 2017 Jan 5;33(1):32-39. Epub 2016 Sep 5.

Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

 A successful free flap transfer is achieved, in part, by having a thorough understanding of vascular anatomy and blood flow dynamics. We previously reported that vascular resistance differs by type of free flap. To test the hypothesis that the difference reflects the proportion of tissue components within free flaps, we calculated blood flow and vascular resistance for free flaps in which we determined the volume of each tissue component. Read More

Plast Reconstr Surg Glob Open 2016 Mar 17;4(3):e642. Epub 2016 Mar 17.

Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass.

Abdominal-based free flaps are commonly used for breast reconstruction, and the internal mammary or thoracodorsal vessels are typically used as recipient sites. Conversely, free tissue transfer is less commonly used for chest wall reconstruction in the setting of chest wall recurrence, in part, because of a paucity of recipient vessels. Here, we describe a case of a 68-year-old female smoker with metastatic breast cancer, who presented with a chest wall recurrence. Read More

Plast Reconstr Surg Glob Open 2016 Mar 8;4(3):e636. Epub 2016 Mar 8.

Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan; Department of Plastic and Reconstructive Surgery, Tottori University Faculty of Medicine, Yonago, Tottori, Japan; Department of Plastic and Reconstructive Surgery, Nagoya City University Hospital, Nagoya, Aichi, Japan; Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan; Department of Neurosurgery, Fukushima Medical University, Fukushima, Fukushima, Japan; and Department of Otorhinolaryngology, Kariya Toyota General Hospital, Kariya, Aichi, Japan.

Background: Although we have seen tremendous advancement in microsurgery over the last 2 decades and free tissue transfer has become standard for head and neck reconstruction, surgeons still struggle to prevent postoperative complications. We examined the relationship between body mass index (BMI) and postoperative complications in patients undergoing rectus abdominis free flap transfer after anterolateral craniofacial resection.

Methods: This was a retrospective review of reconstructive surgery using rectus abdominis musculocutaneous free flap in patients with locally advanced maxillary sinus carcinoma from 2003 to 2014 (n = 35, 27 men and 8 women; average age, 60. Read More

Aesthetic Plast Surg 2016 Aug 3;40(4):519-25. Epub 2016 May 3.

Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, No. 17 Changle Western Road, Xi'an, Shaanxi, China.

Background: Bulky appearance is a major shortcoming after surface coverage using free muscle flaps. The one-stage thinning procedure at the time of transfer can improve the appearance and avoid additional debulking surgery. We present our experiences in the reconstruction of complex lower extremity defects using thinned free muscle flaps. Read More

J Plast Reconstr Aesthet Surg 2016 May 25;69(5):598-603. Epub 2015 Nov 25.

Plastic and Reconstructive Surgery, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany. Electronic address:

Background: Currently, autologous breast reconstruction with a free tissue transfer from the lower abdomen is considered to be a safe method that provides a stable long-term solution. The DIEP-flap and the ms-2-TRAM-flap reconstructions have helped reduce donor site morbidity. In order to assess the potential differences between these techniques, we carried out myosonographic evaluations that assessed the muscle dynamics pre- and post-operatively. Read More

J Plast Surg Hand Surg 2016 Aug 7;50(4):208-15. Epub 2016 Mar 7.

c Department of Histology and Embryology , Marmara University School of Medicine , Istanbul , Turkey.

Background Being an inevitable component of free tissue transfer, ischemia-reperfusion injury tends to contribute to flap failure. TNF-α is an important proinflammatory cytokine and a prominent mediator of the ischemia-reperfusion injury. Etanercept, a soluble TNF-α binding protein, has shown anti-inflammatory and anti-apoptotic effects in animal models of renal and myocardial ischemia-reperfusion injury. Read More

PLoS One 2016 25;11(1):e0147650. Epub 2016 Jan 25.

The Nick Davey Laboratory, Human Performance Group, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Charing Cross Hospital, London, United Kingdom.

Evidence suggests that the primary motor cortex (M1) is involved in both voluntary, goal-directed movements and in postural control. Trunk muscles are involved in both tasks, however, the extent to which M1 controls these muscles in trunk flexion/extension (voluntary movement) and in rapid shoulder flexion (postural control) remains unclear. The purpose of this study was to investigate this question by examining excitability of corticospinal inputs to trunk muscles during voluntary and postural tasks. Read More

J Plast Reconstr Aesthet Surg 2016 Apr 17;69(4):545-53. Epub 2015 Dec 17.

Department of Vascular Surgery, University Hospital Erlangen, Krankenhausstrasse 12, 91054 Erlangen, Germany.

Purpose: Free flap transplantation to vascular reconstructions as arteriovenous (AV) loops has been established in centers as a feasible therapeutic option for defect reconstruction in the absence of proper recipient vessels, caused by oncologic resections, radiation, or trauma. We report our 10-year experience in free flap transplantation after vascular reconstruction with special emphasis on complication rate and postoperative mobility.

Patients And Methods: Forty-seven patients (mean age: 60 years, range: 19-86) were included. Read More

Microsurgery 2016 Nov 21;36(8):658-663. Epub 2016 Jan 21.

Department of Plastic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.

Objective: This report evaluates the behavior of anastomosed vessels and transferred flaps after anastomosed site infection in head and neck reconstruction.

Patients And Methods: Eleven free-flap cases after infection at the vascular pedicle site were included, the patency of which was observed macroscopically after re-exploration and pus drainage. Location was in the tongue (5 cases), oropharynx (3 cases), mouth floor (1 case), mandible (1 case), and hypopharynx (1 case). Read More

J Craniofac Surg 2016 Jan;27(1):242-6

*Department of Plastic, Reconstructive and Aesthetic Surgery, Mersin University Hospital, Mersin University School of Medicine, Mersin †Department of Plastic, Reconstructive and Aesthetic Surgery ‡Department of Biochemistry §Department of Pathology, Turgut Ozal Medical Center, Inonu University School of Medicine ||Turgut Ozal Medical Center, Inonu University ¶Department of Biochemistry, Inonu University School of Medicine, Turgut Ozal Medical Center, Malatya, Turkey.

Background: The aim of this study is to investigate effects of selenium and enlighten the possible mechanism of action in a rat transverse musculocutaneous flap model following ischemia-reperfusion injury.

Materials And Methods: In this study, an experimental model, which mimicked free tissue transfer, was applied. Twenty-four male Wistar Albino rats were divided into a control group (N = 12), and a selenium treated group (N = 12). Read More

J Craniofac Surg 2015 Oct;26(7):e622-4

*Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Kobe †Department of Plastic Surgery, Kobe University Graduate School of Medicine, Gunma, Japan.

The double free flap procedure is a preferred treatment for extensive composite defects of the oromandibular area. In this procedure, the choice and use of the flaps are both important. Flaps with adequate soft tissue are required to fill the extensive dead space for huge oromandibular defects. Read More

Int J Colorectal Dis 2016 Feb 26;31(2):385-91. Epub 2015 Sep 26.

University Department of General and Visceral Surgery, Klinikum Oldenburg, Rahel-Straus-Strasse 10, 26133, Oldenburg, Germany.

Introduction: Pelvic floor defects following pelvic exenteration constitute a challenge to the reconstructive surgeon. Whenever the common reconstruction options such as the gluteus maximus myocutaneous flap (GLM) and the vertical rectus abdominis myocutaneous flap (VRAM) are not feasible, free tissue transfer will be the only remaining option. Being one of the most reliable and versatile flaps used for microsurgical reconstruction, the free latissimus dorsi (LD) muscle flap provides an adequate solution to this problem. Read More

Aesthetic Plast Surg 2015 Oct 17;39(5):686-93. Epub 2015 Jul 17.

Department of Plastic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, 88 Olympic ro 43 Gil, Songpa gu, Seoul, 138-736, Korea,

Purpose: The present study aimed to analyze patients' aesthetic concerns after breast reconstruction with abdominal free flap by reporting secondary cosmetic procedures performed based on the patients' request, and analyzed the effect of adjuvant therapies and other variables on such outcomes.

Methods: All patients who underwent unilateral immediate reconstruction were enrolled prospectively. Free abdominal flaps were placed horizontally with little manipulation. Read More

J Plast Surg Hand Surg 2015 Oct 10;49(5):306-310. Epub 2015 Jun 10.

b 2 Department of Plastic Surgery, Brugmann University Hospital, Free University of Brussels, Brussels , Belgium.

Background: Chronic osteomyelitis is still a big reconstructive challenge. Even with standard care, therapeutic failures and recurrences are common. Multiple techniques of tissue transfer have increased the success rate. Read More

Indian J Plast Surg 2015 Jan-Apr;48(1):38-42

Baby Memorial Hospital, Calicut, Kerala, India.

Crush injuries of severe magnitude involving lower limbs require complex bone and soft tissue reconstructions in the form of microvascular free tissue transfers. However, satisfactory recipient vessels are often unavailable in the leg due to their vulnerability to trauma and post traumatic vessel disease (PTVD), which extends well beyond the site of original injury. In such situations, healthy recipient vessels for free flap anastomosis can be made available by constructing temporary arteriovenous loops with saphenous vein grafts, anastomosed to corresponding free flap vessels. Read More

Ann Plast Surg 2015 May;74 Suppl 1:S33-40

Stanford Plastic Surgery, Stanford, CA.

Introduction: Risk of abdominal free flaps complications and the risk of abdominal wound complications from surgery are significantly increased in patients with previous abdominal surgeries. Previous scars can limit the vascularized territories suitable for transfer and can lead to significant partial flap necrosis.

Methods: A retrospective review of abdominal free flap breast reconstructions performed by the senior author (GKL) over 5 years (2008-2013). Read More

Microsurgery 2016 Feb 25;36(2):121-7. Epub 2015 Mar 25.

Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany.

Background: Various local flaps have been described for patients suffering from sternal osteomyelitis and are regarded as a standard procedure for defect reconstruction. In contrast, the use of microsurgical free flaps has been reported anecdotally only. We present our experiences with the combination of an arteriovenous loop and a free flap transfer in defects larger than half of the sternum. Read More

Microsurgery 2016 Feb 16;36(2):115-20. Epub 2015 Mar 16.

Division of Head and Neck Surgery, National Cancer Center Hospital East, Chiba, Japan.

Objective: Mandibular reconstruction with a mandibular reconstruction plate (MRP) and free flap transfer can involve serious plate-related complications. The aim of our study is to present our new "no-touch-technique" which keeps an MRP not contaminated to saliva during the entire operation for the reduction of plate-related complications.

Patients And Methods: Data were retrospectively collected on 29 patients who had undergone segmental mandibulectomy for head and neck tumor and mandibular reconstruction with an MRP and free flap transfer from 2004 to 2013; 12 patients were reconstructed with our no-touch-technique from 2010 to 2013 (no-touch-technique group), and 17 patients with the conventional technique from 2004 to 2009 (conventional group). Read More

Scand J Med Sci Sports 2016 Mar 10;26(3):275-83. Epub 2015 Mar 10.

Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.

Slackline training (balancing on nylon ribbons) has been shown to improve neuromuscular performance in children and adults. Comparable studies in seniors are lacking. Thus, 32 seniors were randomly assigned [strata: age, gender, physical activity (PA)] to an intervention [INT; n = 16, age: 65 ± 4 years, PA: 9 ± 5 h/week] or control [CON, n = 16, age: 63 ± 4 years, PA: 8 ± 4 h/week] group. Read More

Plast Reconstr Surg 2015 Mar;135(3):643-58

Miami, Fla.; Verona, Italy; Ann Arbor, Mich.; and Houston, Texas From the Miami Breast Center; the Herbert Wertheim College of Medicine at Florida International University; the University of Verona; the University of Michigan Medical School; the University of Miami Miller School of Medicine; and Baylor College of Medicine.

Background: The ability of autologous fat transfer to reconstruct an entire breast is not established. The authors harnessed the regenerative capabilities of external expansion and autologous fat transfer to completely reconstruct breasts.

Methods: The authors performed 1877 Brava plus autologous fat transfer procedures on 616 breasts in 488 women to reconstruct 99 lumpectomies, 87 immediate breast reconstructions, and 430 delayed total breast reconstructions. Read More

Ann Plast Surg 2015 May;74 Suppl 1:S19-21

From the Division of Plastic Surgery, Department of Orthopedic Surgery, University of California, Davis Medical Center, Sacramento, CA.

Introduction: Osteomyelitis of the elbow may be a complex clinical problem. Treatment goals include the eradication of infection and preservation of maximal joint function. Bony debridement may be necessary in addition to elbow joint arthroplasty. Read More

Eplasty 2014 30;14:e47. Epub 2014 Dec 30.

Department of Plastic Surgery, Hull and East Yorkshire NHS Trust, Hull, United Kingdom.

Objective: Previous abdominal wall surgery is viewed as a contraindication to abdominal free tissue transfer. We present two patients who underwent multiple abdominal liposuction procedures, followed by successful free deep inferior epigastric artery perforator flap. We review the literature pertaining to reliability of abdominal free flaps in those with previous abdominal surgery. Read More

Chirurg 2015 Mar;86(3):242-50

Plastisch- und Handchirurgische Klinik, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstr. 12, 91054, Erlangen, Deutschland,

Prevention of perioperative and postoperative complications resulting from surgical oncology in the pelvic region remains a major interdisciplinary challenge. With modern interdisciplinary concepts joining forces of various surgical specialties, tumor resection can be sufficiently carried out with wide margins and the patients benefit from reduced morbidity even in complex situations. As an example chronic fistulation and secretion from the presacral cavity and sinus may result as potential sequelae from intra-abdominal and intrapelvic tumor resection, especially when neoadjuvant multimodal therapies have been applied. Read More

J Vasc Surg 2015 May 13;61(5):1239-48. Epub 2015 Jan 13.

Department of Vascular Surgery, University Hospital Erlangen, Erlangen, Germany.

Objective: Combined vascular reconstruction and free flap transfer has been established in centers as a feasible therapeutic option in cases with critical limb ischemia (CLI) and large tissue defects otherwise destined for major amputation. However, the number of patients treated with this combined approach is limited, and data regarding long-term follow-up and functional outcome are scarce. We therefore report our 10-year experience in free flap transplantation after vascular reconstruction as a last attempt for limb salvage, with special emphasis of complication rate, limb salvage, and postoperative mobility. Read More

Indian J Plast Surg 2014 Sep-Dec;47(3):447-9

Department of Plastic and Reconstructive Surgery, Nottingham University Hospitals NHS Trust, United Kingdom.

Background: Free tissue transfer provides an optimal means for breast reconstruction in creating an aesthetically natural appearance that is durable over time. The choice of donor vessels vary from surgeon to surgeon, but the internal mammary axis is one of the most popular choices together with the thoracodorsal vessels.

Aims And Results: We present the case of a salvaged free transverse rectus abdominis myocutaneous breast reconstruction in which end-to-end antegrade anastomosis to the internal mammary artery (IMA) was not possible due to frail vessel walls, but retrograde anastomosis to the IMA and antegrade anastomosis of internal mammary vessel resulted in a perfused and viable flap. Read More