Surgical treatment of intraarticular calcaneal fractures is often associated with postoperative wound problems. Soft tissue necrosis, bone loss and uncontrollable infection are a challenge for the surgeon and amputation may in some cases be the ultimate solution. A free flap can be very helpful to cover a significant soft tissue defect and help in fighting the infection. However, the free flap ...

813 free perforator flap surgery and always have a second option in mind in case of flap failure. Further, a sufficient understanding of the wound characteristics, donor and recipient vessels, and design for insetting should precede the surgery. Lastly, the skin graft over the muscle flap is less durable than the fasciocutaneous flap and tends to form a callus. To prevent this complication, a p...

Free flap success rates are in excess of 95%. Vascular occlusion (thrombosis) remains the primary reason for flap loss, with venous thrombosis being more common than arterial occlusion. The majority of flap failures occur within the first 48 hours. With early recognition and intervention of flap compromise salvage is possible. Successful salvage rates range from 28% to over 90%. Rapid re-explor...

BACKGROUND We have adopted an intraoral microsurgical anastomosis to the facial vessels to eliminate the need for any visible facial incisions. METHODS Cadaveric dissection was used to demonstrate accessibility of the facial artery and vein through an intraoral approach. Additionally, 5 patients underwent free tissue transfer for reconstruction of major defects of the midface through an intra...

The early experience of free flap reconstruction in a regional plastic surgery unit was reviewed. Forty-seven free flap surgical procedures were performed for 46 patients during a 2-year period from 1 January 1995 to 31 December 1996 in a regional plastic surgery centre that specialises in head and neck, and breast reconstruction. Twenty-six free transverse rectus abdominus myocutaneous flaps w...

Pedicle damage is a rare complication of latissimus dorsi (LD) flap breast reconstruction. We report a case of accidental avulsion of the vascular pedicle of a totally autologous (extended) LD flap during immediate breast reconstruction in a patient who had previously undergone contralateral breast reconstruction with a pedicled TRAM flap based on the opposite superior epigastric vessels. The i...

BACKGROUND Early identification of failing free flaps may allow for potential intervention and flap salvage. The predictive ability of flap temperature monitoring has been previously questioned. The present study investigated the ability of an infrared surface temperature monitoring device to detect trends in flap temperature and correlation with anastomotic thrombosis and flap failure. METHO...