BACKGROUND Current teaching suggests increased perfusion in free transverse rectus abdominis myocutaneous (TRAM) flaps over pedicled TRAM flaps, broadening indications for its use in high risk patients. This study compared perfusion analysis of free muscle-sparing versus pedicle TRAM flaps in vivo in the peri-operative and late post-operative periods. METHODS The SPY-Elite system using...

BACKGROUND The usage of submental flap is a good method for head and neck reconstruction, but it has some risk also, such as anatomical variations and surgical errors. In this article, we present a modified incision design for the submental flap. METHODS We designed a modified submental flap incision method based on the overlap of the incision outline of the submental flap, platysma myocutane...

Historical review. “By arterial injection with an opaque medium, one can discern a network of fine vessels from the capsule, entering the convex border of the meniscus but disappearing almost immediately. Because of this, one might expect healing in peripheral meniscus detachments, but none in tears limited to the semilunar cartilage itself”. These were the opening sentences of King’s paper at ...

BACKGROUND The pectoralis major myocutaneous (PMMC) flap has been used as a versatile and reliable flap since its first description by Ariyan in 1979. In India head and neck cancer patients usually present in the advanced stage making PMMC flap a viable option for reconstruction. Although free flap using microvascular technique is the standard of care, its use is limited by the availability of ...

OBJECTIVE Theobjective of this study was to determine the indications, utility, advantages and surgical approach for the anteromedial thigh (AMT) flap. MATERIALS AND METHODS We reviewed the records of the patients in whom the AMT flap was used for head and neck reconstruction. We use an anterior approach to harvest the anterolateral thigh (ALT) flap with a non-committal straight line incision...

A Spigelian hernia is a very rare type of anterior abdominal wall hernia. The etiology revolves around the dehiscence transverse abdominis and internal oblique aponeurosis. majority hernias develop in lower abdomen where posterior sheath absent. This condition also known as spontaneous lateral ventral or semilunar line. It mostly asymptomatic generally proven by radiological diagnosis. In worst...

It is over 20 years since the inaugural deep inferior epigastric perforator (DIEP) flap breast reconstruction. We review the type of flap utilized and indications in 2,850 microvascular breast reconstruction over the subsequent 20 years in the senior author's practice (Robert J. Allen). Data were extracted from a personal logbook of all microsurgical free flap breast reconstructions performed b...

Eukaryotic Okazaki fragments are initiated by a RNA/DNA primer, which is removed before the fragments are joined. Polymerase delta displaces the primer into a flap for processing. Dna2 nuclease/helicase and flap endonuclease 1 (FEN1) are proposed to cleave the flap. The single-stranded DNA-binding protein, replication protein A (RPA), governs cleavage activity. Flap-bound RPA inhibits FEN1. Thi...

case presentation a 43-year-old man was referred to our institution for a severe aortic regurgitation and an ascending aorta enlargement associated with a relapsing sub-aortic membrane, which had been treated in his childhood. he underwent a redo ascending aorta replacement and an aortic valve replacement (mechanical prosthesis) along with a resection of the relapsing sub-valvular membrane. som...

BACKGROUND The purpose of this study was to compare postoperative morbidities and functional outcomes of pectoralis major myocutaneous (PMMC) flap and cutaneous free flap reconstruction approaches in hypopharyngeal squamous cell carcinoma patients. METHODS We retrospectively reviewed records from 99 patients who underwent hypopharyngeal reconstruction with a cutaneous free flap (n=85) or PMMC...