This article reports our experiences treating soft tissue and bone defects in the lower extremity with free flaps. One of the most common causes for lower extremity wounds are high-energy injuries. These kinds of injuries contain soft tissue and bone defects beyond neurovascular complications. The rate of infection and nonunion is very high in these injuries. Between 1988 and 1996, we applied 3...

BACKGROUND The trapezius muscle flap is not usually the first reconstructive option for skin and soft tissue defects in the posterior neck and scalp due to surgeons' unfamiliarity with the surgical anatomy and developments in free tissue transfer techniques. The goals of this study were to describe the clinical use of trapezius flaps in posterior neck and scalp reconstruction, and to investigat...

BACKGROUND The eyelid and canthal areas are common locations for cutaneous tumors. The medial canthus includes, among many other apparatuses, the canthal tendon and lacrimal canaliculi, and its characteristic thin and supple skin is hard to mimic and restore using tissue from other regions. Accordingly, reconstruction of the canthal area can prove challenging for surgeons. Although various meth...

M edial canthal defects resulting from cancer resection after Mohs micrographic surgery present challenging reconstruction dilemmas. In fact, medial canthal reconstruction has been controversial because of the time-honored method of second-intention healing in wound management of this area. Yet, small flaps and grafts for repair of cutaneous medial canthal defects may result in a quicker healin...

We have developed a biodegradable temporizing matrix (BTM) capable of supporting secondary split-skin graft-take in animal studies. We report its first long-term implantation and use as a dermal scaffold in humans. This preliminary study assesses its ability to integrate, its ease of delamination, its ability to sustain split-skin graft in complex wounds, the degree of wound contraction, and ul...

The distally based sural island flap was first described by Masquelet, et al., in 1992. It is a skin island flap supplied by the vascular axis of the sural nerve. The aim of this paper is to demonstrate that it can be applied in coverage of difficult wound in the lower third of the leg. We treated nine patients with nine distally based sural island flaps. All the flaps survived, most of the fla...

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...