HYPOTHESIS Transverse rectus abdominus musculocutaneous (TRAM) flap breast reconstruction provides excellent cosmetic results. Pedicle flap viability is greatly enhanced by prereconstruction inferior epigastric vessel ligation, which encourages collateral arterial flow (delayed TRAM). We report our initial experience with laparoscopic inferior epigastric vessel ligation. DESIGN Prospective ca...

Introduction: The heel has two parts, weight bearing and non-weight bearing part. Soft tissue heel reconstruction has been a challenge due to its complex nature of anatomy, weight bearing part of foot and the mechanism of injury requiring reconstruction. The pattern of injury includes from simple laceration to a complex wound with loss of soft tissue and fracture involving various degrees of ca...

The paramedian forehead flap is a widely used method of nasal reconstruction. The flap requires a bridge of tissue from forehead to the nose, for a period of 2 to 3 weeks, before it can be divided at a second procedure. During this time, patients often have difficulty positioning and wearing their eyewear underneath the pedicle of the flap. Here we present a novel approach to the problem. It re...

BACKGROUND Pharyngeal flaps have been widely used for the correction of velopharyngeal incompetence. The aim of this study was to compare the outcomes of velopharyngeal surgery between those who received the superiorly and inferiorly based pharyngeal flaps. METHODS A retrospective review of medical records of patients with cleft palates who received pharyngeal flap surgery for the correction ...

PURPOSE The modified Hughes procedure is used to reconstruct full-thickness lower eyelid defects. A tarsoconjunctival flap from the upper eyelid replaces the posterior lamella, whereas a skin graft, a skin flap, or a skin-muscle flap restores the anterior lamella. The conjunctival pedicle from the upper eyelid is divided after vascularization of the reconstructed lower eyelid is judged to be ad...

OBJECTIVES/HYPOTHESIS Hematomas may develop in the postoperative setting after free tissue transfer. When hematomas occur, they can exert pressure on surrounding tissues. Their effect on the vascular pedicle of a free flap is unknown. We describe our incidence of hematoma in free flaps and outcomes when the flap is compromised. STUDY DESIGN Retrospective chart review of 1,883 free flaps perfo...

BACKGROUND Reconstruction of nasal skin after tumor resection is imperative for full patient rehabilitation; and use of similar skin is necessary to achieve best esthetic and functional results. METHODS This clinical series study represent management of patients with large nasal defects (up to 4x7 cm) using subcutaneous pedicle island paramedian forehead flap, during a period of 2007-2009, 8 ...

Medium to large defects on the dorsal hand pose a reconstructive challenge following dermatologic surgery. Repairs in this location can be complicated by paucity of adjacent tissue reservoirs, competing tension vectors, thin cutaneous tissue, and superficial tendons vasculature. In such cases, double V-Y island pedicle flap is an effective solution. It preserves function, harnesses local with r...