The lower abdominal region is the most useful donor site for breast reconstruction. After Holmström and Robbins described the free transverse rectus abdominis myocutaneous flap, Koshima and Soeda transformed the flap into the deep inferior epigastric artery perforator (DIEP) flap.1–3 The DIEP flap has become popular for breast reconstruction throughout the world. However, free flap transfer req...

BACKGROUND The anterolateral thigh perforator flap is a well-described and versatile flap that has specific advantages. However, the variable anatomy makes flap elevation challenging. Furthermore, the dissection of the proximal part of the pedicle that runs underneath the rectus femoris muscle demands continuous pull by an assistant and is inconvenient and tiring for the surgeon. A technique th...

Soft tissue deficiency in the upper limb is a common presentation following trauma, burns infection and tumour removal. Soft tissue coverage of the upper limb is a challenging problem for reconstructive surgeons to manage. The ultimate choice of soft tissue coverage will depend on the size and site of the wound, complexity of the injury, status of surrounding tissue, exposure of the vital struc...

A case of difficult oncologic oral reconstruction is illustrated, in which soft tissue deficits resulting from failure of conventional techniques were treated by successive free tissue transfers. A thirty-eight-year-old man presented with squamous cell carcinoma in the right retrotrigonal region. The tumor was resected and the defect was reconstructed with the use of a tongue flap and skin graf...

Local perforator flaps have evolved over the time to provide complete and stable coverage of soft tissue defects. Technical advances and experience with the perforator flaps have allowed the harvest of local perforator flaps in a free style manner by offering greater freedom in flap selection. We have proposed a technical modification in the harvest of a perforator flap by relo-cating the perfo...

OBJECTIVES Free flaps are widely used to reconstruct head and neck defects. Despite the improvement in the surgical techniques and the surgeons' experiences, flap failures still occur due to thrombotic occlusion after small vessels anastomosis. To reduce the possibility of flap loss as a result of thrombotic occlusion, various anticoagulants have been used. In this study we decided to evaluate ...

OBJECTIVES Does the large zone of injury in high-energy, combat-related open tibia fractures limit the effectiveness of rotational flap coverage? DESIGN Retrospective consecutive series. SETTING This study was conducted at Brooke Army Medical Center, Walter Reed Army Medical Center, and National Naval Medical Center between March 2003 and September 2007. PATIENTS/PARTICIPANTS We identifie...

BACKGROUND The goal of reconstruction is to provide coverage of exposed vital structures with well-vascularized tissue for optimal restoration of form and function. Here, we present our clinical experience with the use of the scapular fascial free flap to correct facial asymmetry and to reconstruct soft tissue defects of the extremities. METHODS We used a scapular fascial free flap in 12 case...

Covering the elbow soft tissue defects is a difficult task for the plastic surgeon. Because of, the important anatomical structures situated superficially and the high tendency for stiffness of the elbow, the reconstructive method must be chosen carefully. Traditionally the free flaps were the choice method for elbow reconstruction. In our department, we use the perforator pedicled flaps for co...