BACKGROUND Reconstruction of upper extremity deformities continues to be a challenge to the reconstructive surgeon. Various loco regional, distant and free flaps are available for reconstruction. However, each has its own set of advantages and disadvantages. Of the commonly performed local flaps, radial artery forearm flap, and the posterior interosseus artery flap stand out prominently. Rec...

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...

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...

BACKGROUND Reconstruction of soft tissue defects in the lower third of the leg remains challenging. Anatomical constraints limit the local options available for complex defects especially lower third of leg. Local flaps based on perforator vessels are raising interest in reconstructive surgery of the limbs. We present our experience with perforator flaps for reconstruction of soft tissue def...

BACKGROUND The anterolateral thigh perforator flap is a common workhorse flap for head and neck reconstruction. The authors present an alternative method using the posteromedial thigh profunda artery perforator flap and compare its characteristics, outcomes, donor-site morbidity, and donor-site cosmesis with those of the anterolateral thigh perforator flap. METHODS Between May of 2013 and Jul...

1 BACKGROUND Although flap anatomy is well studied on cadavers and microsurgical techniques are well practiced on rats, still there are few training models for learning the techniques of perforator flap harvesting. The cadaver has no bloodstream, so accuracy of dissection cannot be evaluated and flap viability cannot be verified. Training on humans carries a high risk of flap damage. A living m...

BACKGROUND Compromised perfusion in autologous breast reconstruction results in fat necrosis and flap loss. Increased flap weight with fewer perforator vessels may exacerbate imbalances in flap perfusion. We studied deep inferior epigastric perforator (DIEP) and muscle-sparing transverse rectus abdominis myocutaneous (MS-TRAM) flaps to assess this concept. METHODS Data from patients who under...

Flap transplantation has been an important procedure in plastic and reconstructive surgery to cover and fill various defects. Flap necrosis due to blood circulation failure leads to severe complications, especially in a patient undergoing reconstruction concerning the body cavity after tumor ablation. Surgical procedures for flap transplantation have been further improved and developed. We have...

BACKGROUND The maximum weight of tissue that a single perforator can perfuse remains an important question in reconstructive microsurgery. An empirically based equation, known as the flap viability index (FVI), has been established to determine what weight of tissue will survive on one or more perforators. The equation is FVI = Sum d(n)^4/W, where d is the internal diameter of each perforator a...

It is over 20 years since the inaugural deep inferior epigastric perforator (DIEP) flap breast reconstruction. We review the type of flap utilized and indications in 2,850 microvascular breast reconstruction over the subsequent 20 years in the senior author's practice (Robert J. Allen). Data were extracted from a personal logbook of all microsurgical free flap breast reconstructions performed b...