A case of difficult oncologic oral reconstruction is illustrated, in which soft tissue deficits resulting from failure of conventional techniques were treated by successive free tissue transfers. A thirty-eight-year-old man presented with squamous cell carcinoma in the right retrotrigonal region. The tumor was resected and the defect was reconstructed with the use of a tongue flap and skin graf...

Local perforator flaps have evolved over the time to provide complete and stable coverage of soft tissue defects. Technical advances and experience with the perforator flaps have allowed the harvest of local perforator flaps in a free style manner by offering greater freedom in flap selection. We have proposed a technical modification in the harvest of a perforator flap by relo-cating the perfo...

OBJECTIVES Free flaps are widely used to reconstruct head and neck defects. Despite the improvement in the surgical techniques and the surgeons' experiences, flap failures still occur due to thrombotic occlusion after small vessels anastomosis. To reduce the possibility of flap loss as a result of thrombotic occlusion, various anticoagulants have been used. In this study we decided to evaluate ...

OBJECTIVES Does the large zone of injury in high-energy, combat-related open tibia fractures limit the effectiveness of rotational flap coverage? DESIGN Retrospective consecutive series. SETTING This study was conducted at Brooke Army Medical Center, Walter Reed Army Medical Center, and National Naval Medical Center between March 2003 and September 2007. PATIENTS/PARTICIPANTS We identifie...

BACKGROUND The goal of reconstruction is to provide coverage of exposed vital structures with well-vascularized tissue for optimal restoration of form and function. Here, we present our clinical experience with the use of the scapular fascial free flap to correct facial asymmetry and to reconstruct soft tissue defects of the extremities. METHODS We used a scapular fascial free flap in 12 case...

Covering the elbow soft tissue defects is a difficult task for the plastic surgeon. Because of, the important anatomical structures situated superficially and the high tendency for stiffness of the elbow, the reconstructive method must be chosen carefully. Traditionally the free flaps were the choice method for elbow reconstruction. In our department, we use the perforator pedicled flaps for co...

Surgeons conventionally use electrocautery dissection and surgical clip appliers to harvest free flaps. The ultrasonic Harmonic Scalpel is a new surgical instrument that provides high-quality dissection and hemostasis and minimizes tissue injury. The aim of this study was to evaluate the effectiveness and advantages of the ultrasonic Harmonic Scalpel compared to conventional surgical instrument...

OBJECTIVE The purpose of this study is to determine the correlation between non-technical risk factors and the perioperative flap survival rate and to evaluate the choice of skin flap for the reconstruction of foot and ankle. METHODS This was a clinical retrospective study. Nine variables were identified. The Kaplan-Meier method coupled with a log-rank test and a Cox regression model was used...