OBJECTIVE To review our experience with use of the thoracoacromial/cephalic (TAC) system in the free flap reconstruction of complicated head and neck defects. DESIGN Case series. SETTING Tertiary care referral center. POPULATION A consecutive sample of 11 patients requiring free flap reconstruction of head and neck defects using the TAC system for microvascular anastomoses was identified ...

BACKGROUND Free-flap surgery and skin grafting can be used to reconstruct large facial defects that may result after skin cancer removal by Mohs micrographic surgery (MMS). However, these two methods may produce low postsurgical patient satisfaction with aesthetics, and free-flap surgery may produce an undue burden for the majority of skin cancer patients, who are of advanced age. Hence, the au...

The local fasciocutaneous flap has the advantage of low donor-site morbidity when used for the coverage of lower limb defects. However, flap reliability remains a major problem with its use. The purpose of this study was to determine the feasibility of preserving perforators to the tip of conventional local fasciocutaneous flaps to improve its vascularity. The technical considerations of raisin...

Reconstruction of the bone defects due to various causes is still one of the challenging problems in plastic and reconstructive surgery. Periosteum is accepted to be the essential source for the repair of the bone tissue, which constitutes the basis of the support and the mobility functions of the surrounding tissues. Periosteal grafts and flaps have been used for various purposes by numerous t...

During DNA replication, synthesis of the lagging strand occurs in stretches termed Okazaki fragments. Before adjacent fragments are ligated, any flaps resulting from the displacement of the 5' DNA end of the Okazaki fragment must be cleaved. Previously, Dna2 was implicated to function upstream of flap endonuclease 1 (Fen1 or Rad27) in the processing of long flaps bound by the replication protei...

Background Propeller flaps require torsion of the vascular pedicle of up to 180 degrees. Contrary to free flaps, where the relevance of an intact vascular pedicle has been documented, little is known regarding twisted pedicles of propeller flaps. As secondary surgeries requiring undermining of the flap are common in the extremities, knowledge regarding the necessity to protect the pedicle is re...

BACKGROUND Coverage of defects of the pretibial area remains a challenge for surgeons. The difficulty comes from the limited mobility and availability of the overlying skin and soft tissue. We applied variable pedicled perforator flaps to overcome the disadvantages of local flaps and free flaps on the pretibial area. METHODS Eight patients who had the defects in the anterior tibial area were ...

Craniectomy is a life-saving procedure. Subsequent cranioplasty with autologous skull bone has a bone resorption rate from 4% to 22.8% and an infection rate from 3.3% to 26%. There are concerns with their viability and the potential microbial contamination as they were explanted for a long period of time. Eighteen cranial bone flaps stored at Prince of Wales Hospital Skull Bone Bank during the ...

Adnexal carcinomas of the skin are rare and they derive from structures such as sweat glands, sebaceous glands, and hair follicles. Adnexal tumors represent 1-2% of skin cancers. Between 1998 and 2004, eight patients with malignant adnexal tumors of the head and neck were treated in the Plastic Surgery Service in Argerich Hospital in Buenos Aires, Argentina. Four (50%) of them had malignant cyl...

Recent reports of breast reconstruction with the deep inferior epigastric perforator (DIEP) flap indicate increased fat necrosis and venous congestion as compared with the free transverse rectus abdominis muscle (TRAM) flap. Although the benefits of the DIEP flap regarding the abdominal wall are well documented, its reconstructive advantage remains uncertain. The main objective of this study wa...