Background: Electrical injury is daily compromise of our life and upper and lower extremities   are common sites of injury .   Case Presentation: A 23 years old man who had suffered high voltage electrical injury referred   to our center. He had severe left upper extremity burn and suffered from head and thoracic   injuries due to falling down from high altitude.   Treatment: Fasciotomy of th...

Background Propeller flaps require torsion of the vascular pedicle of up to 180 degrees. Contrary to free flaps, where the relevance of an intact vascular pedicle has been documented, little is known regarding twisted pedicles of propeller flaps. As secondary surgeries requiring undermining of the flap are common in the extremities, knowledge regarding the necessity to protect the pedicle is re...

Superficial circumflex iliac artery perforator flap (SCIP) is one of the most convenient flaps to cover distal extremity defects because it conceals scar donor area well and can be raised as a thin or super-thin flap. In recent years, various chimeric SCIP were reported, including sartorius muscle, lateral femoral cutaneous nerve, bone. However, sometimes difficult on pedicle, absence communica...

IMPORTANCE The paramedian forehead flap is used to reconstruct medium to large nasal defects. The staged nature, with its vascular pedicle bridging the medial eyebrow to the nose, results in significant facial deformity. Earlier division lessens this morbidity. OBJECTIVES To quantify flap neovascularization 2 weeks after the initial flap transfer and to describe an algorithm for earlier divis...

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...

Alternative techniques for pedicle transfer of a reverse radial forearm flap for hand coverage, and a latissimus dorsi myocutaneous free flap for pelvic wound coverage, are illustrated. Exteriorization of the vascular pedicle of a reverse radial forearm flap allows a greater arc of movement of the flap for more distal coverage, and avoids the potential vascular compromise of tunnelling under a ...

A subcutaneous pedicle ulnar flap used to cover a skin defect around the wrist is reported. Unlike the standard ulnar flap, which is isolated around the dorsal branch of the ulnar artery and its associated veins, this flap is based on the ascending branch of the dorsal branch of the ulnar artery more proximally to obtain a longer vascular pedicle. A subcutaneous pedicle flap that contained the ...

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...

In free-flap surgery, if the appropriate length of the pedicle and the distance necessary for separation of the artery and vein are determined earlier during flap elevation, the operative time and the stress placed on the flap pedicle can be reduced. However, the pedicle of a flap passes through 3-dimensional structures, particularly in head and neck reconstructions, and because of the differen...

The origin of the muscolocutaneous latissimus dorsi flap dates back to 1906 when Igino Tansini, an Italian surgeon, described a procedure to reconstruct the mastectomy defect. After a detailed study of Tansini's original description and drawings, new insights about the pedicle of its compound flap have been found, showing that it has the same pedicle of the scapular flap. In the end, Tansini's ...