UNLABELLED Soft tissue defects of the lower extremity pose an important surgical challenge, often because of inviability of primary covering. Therapeutic modalities of choice comprise of local perforator flaps, as well as of free flaps created with the use of microsurgical skills. However, these methods cannot be applied in patients with important comorbidities, and it is in such cases where th...

BACKGROUND Abdominal wall free flaps are used most frequently in autologous breast reconstruction, and these flaps require intact and robust deep inferior epigastric perforator (DIEP) vessels. Pfannenstiel incisions are often present during preoperative visits for breast reconstruction and could potentially signal compromised blood supply to the lower abdominal wall. In this study, we compared ...

OBJECTIVE Previous abdominal wall surgery is viewed as a contraindication to abdominal free tissue transfer. We present two patients who underwent multiple abdominal liposuction procedures, followed by successful free deep inferior epigastric artery perforator flap. We review the literature pertaining to reliability of abdominal free flaps in those with previous abdominal surgery. METHODS Rev...

AIM To compare the outcomes of finger reconstruction using arterialized venous flap (AVF), superficial palmar branch of the radial artery (SPBRA) flap, posterior interosseous perforator flap (PIPF), and ulnar artery perforator free (UAPF) flap harvested from the ipsilateral extremity. METHODS We retrospectively reviewed the outcomes for 41 free flaps from the ipsilateral extremity in the reco...

Perforator flaps have been introduced for coverage of local and distant defects. Various designs of this flap are possible, but their role in the setting of trauma is debated. We report that it is possible to raise these flaps in cases of post-traumatic lower limb reconstruction with good results. Consideration must be given to the type of movement that is planned vis-a-vis the number of perfor...

Background Although supermicrosurgical anastomosis is a widely known reconstructive microsurgical technique, it is difficult to perform. To expand the clinical use of supermicrosurgery, we used hemi-intravascular stenting (hemi-IVaS), which is performed by inserting an intravascular stent into one side of the vessel. We conducted lymphaticovenular anastomosis, free perforator flap transfer, and...

INTRODUCTION: Patients with large breasts are often the most difficult to reconstruct utilizing free tissue transfer after mastectomy. This is especially true when suitable abdominal tissue is unavailable. These subjects often require two simultaneous free flaps to provide adequate tissue. 1,2 This study provides a review of our experience and lessons learned utilizing unilateral dual free tiss...

PURPOSE: Breast reconstruction is uniquely personal with many options available for patients and surgeons to consider. Among the methods of autologous breast reconstruction, abdominal based free flaps (ABFFs) including the transverse rectus abdominis myocutaneous (TRAM), deep inferior epigastric perforator (DIEP), and superficial inferior epigastric artery (SIEA) flaps are the most common, with...

Reconstruction of the lower limb presents a complex problem after skin cancer surgery, as proximity of skin and bone present vascular and technical challenges. Studies on vascular anatomy have confirmed that the vascular plane on the lower limb lies deep to the deep fascia. Yet, many flaps are routinely raised superficial to this plane and therefore flap failure rates in the lower limb are high...