BACKGROUND A soft tissue defect requiring flap cover which is longer than that provided by the conventional "long" free flaps like latissimus dorsi (LD) and anterolateral thigh (ALT) flap is a challenging problem. Often, in such a situation, a combination of flaps is required. Over the last 3 years, we have managed nine such defects successfully with a free "Boomerang-shaped" Extended Rectus Ab...

The free muscle-sparing transverse rectus abdominis myocutaneous (MS-TRAM) and deep inferior epigastric perforator (DIEP) flaps involve transferring skin and subcutaneous tissue from the lower abdominal area and have many features that make them well suited for breast reconstruction. The robust blood supply of the free flap reduces the risk of fat necrosis and also enables aggressive shaping of...

We have found prefabrication of hairless radial forearm free flap to be a useful technique for nasal reconstruction. Prior skin grafting and a suitable period of maturation permits safe, reliable surgery. Its use should be considered in those patients whose forehead tissue is not suitable or in whom appropriate distant flaps are not available, as is often the case with hirsute males.

INTRODUCTION The free anterolateral thigh (ALT) skin perforator flap has gained enormous popularity as a free skin perforator flap. Currently being used for various reconstructions primarily in Asia, its routine application for soft-tissue reconstruction of the lower extremity remains unknown in the United States. The purpose of the present study was to review the current trend of flap selectio...

BACKGROUND The free fibular osteocutaneous flap is a commonly used flap for mandible and buccal mucosa reconstruction in head and neck cancer surgery. However, the skin paddle restriction from the intermuscular septum often limits the soft tissue reconstruction. METHODS We have proposed a new modified chimeric fibular osteocutaneous flap design based on the combination of a traditional fibula...

The effectiveness of heparin for thromboprophylaxis during microvascular free flap transfer is uncertain. The purpose of this meta-analysis was to determine the effect of heparin on the prevention of flap loss in microsurgical free flap transfer.A search of PubMed, Cochrane databases, and Google Scholar using combinations of the search terms heparin, free flap, flap loss, free tissue transfer w...

BACKGROUND Large post burn scars are a very difficult problem to treat. Available methods include skin grafts and tissue expansion. The reconstructive method used should be tailored according to individual patient rather than following a textbook approach in each. PATIENTS AND METHODS A retrospective analysis was done of cases with extensive facial burn scars in whom secondary reconstruction ...

The loss of a free flap is a feared complication for both the surgeon and the patient. Early recognition of vascular compromise has been shown to provide the best chance for flap salvage. The ideal monitoring technique for perioperative free flap ischemia would be noninvasive, continuous, and reliable. Visible light spectroscopy (VLS) was evaluated as a new method for predicting ischemia in mic...

conclusions our findings showed that the treatment of flaps with bm-msc and aam transplantations significantly promoted flap survival compared to a control group. the viability of the flap was improved by combining bm-mscs with aam matrix scaffolds. materials and methods bm-mscs and aams were transplanted into subcutaneous tissue in the flap area. on the 7th postoperative day, the surviving fla...

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...