The authors present an overview of the various techniques which can be used to achieve coverage of exposed bone, particularly in cases of bone exposure associated with an underlying fracture or osteomyelitis. Adequate debridement, possibly in several stages, is necessary in all cases to prepare the receptor site for the next step which is soft tissue coverage, achieved using various types of su...

The ring fixator is an ideal apparatus to treat infected gap nonunion of the tibia and to correct deformity in multiple planes. However soft tissue problems may arise during transport and at docking. Although various options such as free flaps, neurocutaneous flaps, fasciocutaneous flaps and cross leg flaps are available for flap cover, this is always done prior to application of a ring fixator...

INTRODUCTION Diabetic foot ulcers occur in approximately 2,5% of patients suffering from diabetes and may lead to major infections and amputation. Such ulcers are responsible for a prolonged period of hospitalization and co- morbidities caused by infected diabetic foot ulcers. Small, superficial ulcers can be treated by special conservative means. However, exposed bones or tendons require surgi...

AIM In the literature currently available monitoring devices are usually divided into two major groups: those for monitoring perfusion and those for measuring tissue oxygenation. The O(2)C (oxygen to see) system combines these two ways of monitoring free flap viability. The aim of this prospective study was to determine the necessity of flap revision and when unnecessary revision can be avoided...

Ballistic facial wounds present daunting reconstructive challenges to the most experienced of surgeons. The early Waltzing method tissue transfer, perfected by Sir Gillies, was superseded free flaps and transplantation as methods for reconstruction. In low resource setting, however, Waltz may be only suitable option. This case study describes use reconstruction at Port Spain General Hospital in...

Defects in head and neck after tumor resection often provide significant functional and cosmetic deformity. The challenge for reconstruction is not only the aesthetic result, but the functional repair. Cancer may involve composite elements and the in sano resection may lead to an extensive tissue defect. No prospective randomized controlled studies for comparison of different free flaps are ava...

A popular strategy in the treatment of articular cartilage lesions involves the introduction of cell suspensions into the defect void and its closure with a periosteal flap (autologous chondrocyte transplantation technique). We applied this methodology in goats and discovered that all sutured flaps (n = 6 animals) became detached from nonimmobilized joints during the recovery period. The purpos...

BACKGROUND Posttraumatic, high-energy defects of the midface can be challenging to reconstruct because they involve extensive composite tissue loss and result in significant permanent functional and cosmetic deformity. These injuries require replacement of the bony framework, external soft tissue, and intraoral mucosa. Local skin flaps and nonvascularized bone grafts have been used for reconstr...

OBJECTIVES/HYPOTHESIS Standard operating procedures have been developed in many surgical practices to ensure quality of care as it relates to specimens removed from the body. Most of these specimens are sent to pathology. Some, such as calvarial bone harvested during craniotomy are replaced in the body. Free tissue transfer involves harvesting tissue from one body site, storage for a variable p...

OBJECTIVE To describe a novel use of fluorescent angiography in assessing donor limb perfusion prior to free tissue harvest in microvascular free tissue transfer. STUDY DESIGN Retrospective case series. METHODS From January 2012 to June 2013, 59 patients underwent head-and-neck microvascular free tissue reconstruction. Evaluation of donor site perfusion via indocyanine green (ICG) fluoresce...