the distal third of the tibia, ankle and heel area is difficult to reconstruct. for small to medium size defects, local flaps are often an easier alternative than free flap. in lower limb surgery, the sural flap is based on this principle and this flap is becoming increasingly popular. the distally based superficial sural artery flap, first described as a distally based neuro skin flap by masqu...

BACKGROUND The conventional method of bridging anatomic defects of the upper digestive tract in the neck is by tissue transfer--either gastric or colon pull-through, free jejunal graft, or full-thickness skin flaps. An alternative way of closing such defects is to flex the neck. This moves the remnant proximal esophagus or pharynx a considerable distance downwards--a standard tension-releasing ...

BACKGROUND For reconstructing moderate-to-high projection breasts in nulliparous patients with insufficient abdominal tissue or prior abdominal surgeries, a unilateral inferior gluteal artery perforator (IGAP) flap is an alternative procedure. In patients with slim hips, however, unilateral gluteal tissue is insufficient and inferior gluteal crease displacement may develop postoperatively. Dono...

Simple or complex defects in the lower leg, and especially in its distal third, continue to be a challenging task for reconstructive surgeons. A variety of flaps were used in the attempt to achieve excellence in form and function. After a long evolution of the reconstructive methods, including random pattern flaps, axial pattern flaps, musculocutaneous flaps and fasciocutaneous flaps, the reapp...

BACKGROUND Surgical ablation for locally advanced breast cancer results in large chest wall defects, which can then be managed with local flaps or skin grafts. The purpose of this article is to evaluate the outcomes of three types of local skin flaps. METHODS Among 25 local flaps in 24 patients, 6 were bilateral advancement (BA) flaps, 9 were thoracoabdominal (TA) flaps, and 10 were thoracoep...

BACKGROUND AND PURPOSE To explore the methods of clinical classification in chronic radiation-induced ulcers in the chest wall (CRUCWs). MATERIALS AND METHODS A total of 64 patients with CRUCWs were treated. We divided the cases into 3 types (mild, moderate, or severe) according to their clinical manifestations. Conservative treatments, axial-pattern myocutaneous or local flaps, or filleted f...

Obviously, restoring the nasal lining is a great challenge in the reconstruction of nasal defects. Full thickness nasal defects usually require special flaps for reconstructing the nasal lining. Intranasal mucosal flaps, hinge over flaps, perinasal second flaps, folded or second forehead flaps and finally free flaps are examples that can be used for this purpose. Moreover, the case presented in...

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...

Neurotized fasciocutaneous flaps and split-skin grafted muscle flaps are the most frequently used free flap alternatives for the reconstruction of weight-bearing surfaces of the foot. An objective comparison of the innate characteristics of these two flap types, with respect to long-term stability, has not been possible because sensory reinnervation in the fasciocutaneous flaps has been a confo...

Background and objectives: Perforator flaps, both pedicled and free flaps, are increasingly used in reconstructive surgery. However, the microvascular perfusion pattern within these flaps still remains essentially unknown. It is well known that in random-pattern flaps, flap length correlates directly with the width of the flap base. In perforator flaps, the importance of preserving a skin base ...