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 ...

Soft tissue coverage of distal medial ankle wounds is a challenging problem in orthopedic surgery because of the limited local tissues and prominent instrumentation. Traditionally, these wounds required free tissue transfer to achieve suitable coverage and subsequent bony union. To better respect the reconstructive ladder and to avoid the inherent difficulty of free flap coverage, rotational fl...

BACKGROUND Free and pedicled medial and lateral thigh-based flaps are common reconstructive procedures. However, there have been no comparative studies of morbidity between medial and lateral donor sites. METHODS We conducted an Enterprise Data Warehouse-based review of all the senior authors' (R.D.G., G.A.D., and M.S.A.) thigh-based free and pedicled flaps. Patient demographic data, donor-si...

Recently, combined tissues or flaps have been used for the repair of extensively massive or wide defects resulting from radical wide resection. To further advance the development of combined tissue transfers, they should be reclassified. Based on our cases with free tissue transfers, we have created a new classification of combined flaps composed of "bridge", "chimeric", "siamese", "mosaic", an...

OBJECTIVES/HYPOTHESIS Endoscopic endonasal skull base surgery defects require effective reconstruction. Although the nasoseptal flap (NSF) has become our institution's workhorse for large skull base defects with cerebrospinal fluid (CSF) leaks, situations where it is unavailable require secondary flaps. Clinical outcomes, pearls and pitfalls, and an algorithm will be presented for these seconda...

BACKGROUND AND PURPOSE Myocutaneous flaps are commonly used for reconstruction in head and neck surgery. The purpose of this study was to characterize the MR imaging findings of the muscular component of these flaps, with an emphasis on enhancement patterns. Recognition of these imaging findings is important in differentiating postoperative changes from recurrent tumor. METHODS MR studies wer...

OBJECTIVE To create a comprehensive algorithmic approach to reconstruction after vulvar cancer ablative surgery, which includes both traditional and perforator flaps, evaluating anatomical subunits and shape of the defect. METHODS We retrospectively reviewed 80 cases of reconstruction after vulvar cancer ablative surgery, performed between June 2006 and January 2016, transferring 101 flaps. W...

Local advancement flaps are a key tool in the armamentarium of reconstructive surgeon. They can be used to repair small and large defects on all areas face with excellent skin color texture match, limited donor site morbidity, flexibility hide scars. In this review, we outline common categories discuss situations for their use.