The pectoralis major musculocutaneous (PMMC) flap has been a useful technique for head and neck reconstruction since its first description by Ariyan in 1979. However, techniques in microvascular surgery have since evolved and recently free tissue transfer has played an important role in head and neck reconstruction. Although we use free flaps as the first choice for head and neck reconstruction...

BACKGROUND Locoregional flaps are sufficient in most sacral reconstructions. However, large sacral defects due to malignancy necessitate a different reconstructive approach, with local flaps compromised by radiation and regional flaps inadequate for broad surface areas or substantial volume obliteration. In this report, we present our experience using free muscle transfer for volumetric reconst...

the distally based sural fasciocutaneous flap has become a main part of the reconstruction of the lower leg, heel and foot. however, perfusion problems and venous congestion have been reported. over the past decade, several flap modifications have been reported to improve flap viability and to solve a myriad of reconstructive needs. the purpose of this paper is to describe our experience in har...

Head and neck tumors often require radiotherapy as part of the treatment protocol. Although it improves the survival rate in cancer patients, it may cause osteoradionecrosis, especially in the mandible and maxilla. Twelve patients with osteoradionecrosis of the maxilla were treated with microsurgical free tissue transplantations between April of 1996 and August of 2002. There were 10 male and t...

INTRODUCTION Reconstruction of intraoral soft tissue defects is important in restoring function and esthetic. In large defects, there will be demand for regional pedicle flaps or free flaps. Hard palate separates nasal and oral cavities. Due to the small surface area between flap and remaining palate after surgical resections, optimal blood supply of the flaps for hard palate reconstructions ar...

Ablative surgery for head and neck tumors is associated with significant disfigurement and loss of function. The main aim of the surgeon is to provide functional ability and esthetics of the patient. Type and extent of tissue loss from surgery relates to loss of soft tissue and bone. Reconstructions of jaw and mouth defects represent a challenge to the surgeon and are most commonly indicated in...

Background: Lip carcinoma is a common cancer with a good prognosis and when patients refer early in the course of disease the results of treatment are acceptable. Surgical procedures for reconstruction of lip defects are the use of remaining lip tissue, tissue from the opposite lip, adjacent cheek tissue, distant flaps and microvascular free flaps. The bitemporal (visor) flap is a regional...

BACKGROUND The Veterans Affairs (VA) population is considered to have generally poorer health than its non-VA counterpart. METHODS We reviewed our experience with 55 consecutive patients undergoing free tissue transfers for head and neck reconstruction at the Dallas VA Hospital between July 2000 and September 2006, with 6 months' follow-up. RESULTS The overall success rate was 93% (51 of 55...

Achieving adequate coverage of soft tissue defects located on the lower third of the legs and feet is challenging for reconstructive surgeons. Fasciocutaneous flaps can be used to meet this challenge. Two common fasciocutaneous flaps used in this context are the reverse sural flap and lateral supramalleolar flap (LSMF). Plastic and reconstructive surgeons are relatively unfamiliar with the seco...

BACKGROUND The reconstruction of ankle and heel defects remains a significant problem for plastic surgeons. The following options exist for reconstructing such defects: local random flaps, reverse flow island flaps, and free flaps. However, each of these methods has certain drawbacks. Peroneal artery perforators have many advantages; in particular, they are predictable and reliable for ankle an...