Nonhealing wounds represent a problem involving inadequate oxygenation of the tissues that can lead to hypoxic injury. Hyperbaric oxygen therapy can be used as an adjunctive therapy for compromised grafts and flaps that have failed to show improvement with standard wound therapy and offer additional physiologic benefits in the reversal of wound hypoxia and hypoperfusion. A literature review con...

BACKGROUND The list of complications reported after decompressive craniectomy (DC) and cranioplasty is progressively increasing. Nonetheless, the exact incidence of these events is still ill-defined. Problems affecting skin flaps after DC and cranioplasty have never been accurately analyzed in papers and their impact on patients' prognosis is largely underestimated. METHODS In a 10-year time,...

Accurate and early prediction of tissue viability is the most significant determinant of tissue flap survival in reconstructive surgery. Perturbation in tissue water content (TWC) is a generic component of the tissue response to such surgeries, and, therefore, may be an important diagnostic target for assessing the extent of flap viability in vivo. We have previously shown that reflective terah...

OBJECTIVE Providing adequate soft tissue cover while preventing wound breakdown and infection can present a challenge when repairing large meningomyeloceles. Adding an extra barrier to protect the underlying dural elements in the event of complications should lower the morbidity and mortality associated with large repairs, which are at risk of dehiscence and subsequent exposure of the neural el...

Perforator flaps represent the latest in the evolution of soft tissue flaps. They allow the transfer of the patient’s own skin and fat in a reliable manner with minimal donor-site morbidity. The powerful perforator flap concept allows transfer of tissue from numerous, well-described donor sites to almost any distant site with suitable recipient vessels. The inferior gluteal artery perforator (I...

Facial reconstruction is one of the most challenging problems faced by a reconstructive surgeon. We present a case of complex facial reconstruction with a composite trauma to the nose resulting in near total loss of skin and lining along with complete loss of left eyebrow with exposed frontal bone and partial loss of the left eyelid. We combined a temporoparietal fascial flap for reconstruction...

We have found prefabrication of hairless radial forearm free flap to be a useful technique for nasal reconstruction. Prior skin grafting and a suitable period of maturation permits safe, reliable surgery. Its use should be considered in those patients whose forehead tissue is not suitable or in whom appropriate distant flaps are not available, as is often the case with hirsute males.

BACKGROUND AND PURPOSE To explore the methods of clinical classification in chronic radiation-induced ulcers in the chest wall (CRUCWs). MATERIALS AND METHODS A total of 64 patients with CRUCWs were treated. We divided the cases into 3 types (mild, moderate, or severe) according to their clinical manifestations. Conservative treatments, axial-pattern myocutaneous or local flaps, or filleted f...

Lower-extremity amputations in the presence of soft tissue loss represent an unresolved conundrum because surgeons must consider sacrificing bone length to obtain adequate soft tissue coverage. Local flaps and microvascular soft tissue transfers are established strategies for maintaining residual limb length. However, the use of skin grafts remains controversial due to the presumed inferiority ...

PURPOSE To evaluate the morphology, necrotic area and collagen content in skin flaps of rats subjected to hyperbaric oxygenation (HBO). METHODS Forty adult rats were divided into four groups: GEC - epilated; GE/HBO - epilated subjected to HBO; GER - epilated submitted to skin flap (2 cm in width /8 cm length in the dorsal area) and GER/HBO - epilated, subjected to skin flap and HBO. HBO (2.4 ...