OBJECTIVE To quantify the perfusion of forehead flaps and compare blood flow from the supratrochlear artery with vascular in-growth at the recipient bed. METHODS Patients with nasal defects necessitating forehead flap closure were prospectively enrolled to study flap perfusion dynamics. Laser-assisted indocyanine green angiography was used to obtain the measurements. When possible, patients r...

The paramedian forehead flap has become the standard of care for major nasal reconstruction. The classic procedure involves a second-stage operation to divide and inset the external pedicle. We present our experience in a clinical series using single-stage forehead flap reconstruction. Our indications include elderly patients, pediatric patients treated during mission trips, and any patient in ...

ImageS gested reverse-flow anterolateral thigh flap and the clinical course of this flap with a literature review. A 54-year-old male patient presented with a mass of 7×6 cm on the left knee. Biopsy of the lesion revealed a myxofibrosarcoma. The distant metastasis was not detected in preoperative evaluation. After wide excision of the malignancy, a soft tissue defect with a dimension of 8×8 cm ...

Two patients with penile skin loss who were operated in 1991 are reviewed retrospectively. In both of them skin grafting was mandatory (due to large skin defects on the penile shaft). Causative factors were localized infection in one case and verrucae accuminata in another. In both cases a random flap from the skin of the inner surface of the thigh was applied. The pedicle flap was later t...

IMPORTANCE The vascular supply of anterolateral thigh (ALT) free flaps is variable, and the pedicle length and ability to capture perforators to the flap may be limited by the anatomic configuration. We describe the reasoning behind performing the auto flow-through procedure, as well as the steps to carry this procedure out. OBSERVATIONS A retrospective medical chart review was performed within...

INTRODUCTION In nasal reconstruction all anatomic layers as cover, lining, and support, have to be replaced to restore proper aesthetics. Forehead skin has been acknowledged as the best donor site to resurface the nose. Traditionally forehead flap reconstruction is performed in two stages, but Millard described an intermediate third stage between flap transfer and pedicle division. This study c...

PURPOSE To evaluate the role of pedicle occlusion on the viable area of a skin island flap. METHODS An epigastric skin island flap was performed in 160 Wistar rats. The animals were randomly divided into four groups: G-1: occlusion of inferior epigastric artery; G-2: inferior epigastric vein; G-3: inferior epigastric vessels (artery/vein). At varying times postoperatively (2,3,4,5th day), ani...

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 indocyan...

UNLABELLED Autologous tissue transfer, in addition to replacing tissue that was lost during injury or surgery, offers women an excellent option to improve cosmetic appearance and self-confidence following mastectomy due to breast cancer. However, flap necrosis is a complication in obese patients undergoing this procedure. We created a mouse model to study the flap-related complications that lea...

Developments in microsurgical techniques and instruments have enabled the high success rate of microvascular tissue transfers. Initially, the survival of a free flap is dependent on its vascular pedicle, and the failure of flaps generally occurs within seven days of surgery. Several experimental studies have shown that pedicles can be ligated 5 to 10 days after the operation. Hence, at that tim...