OBJECTIVE The anterolateral thigh flap has recently been rediscovered in Asia as a perforator flap. The objective of this study was to describe the reliability and donor morbidity of the anterolateral thigh flap for head and neck reconstruction without transmuscular perforator dissection. DESIGN Consecutive case series by a single surgeon. SETTING A regional tertiary-referral head, neck, an...

BACKGROUND The anterolateral thigh perforator flap is a well-described and versatile flap that has specific advantages. However, the variable anatomy makes flap elevation challenging. Furthermore, the dissection of the proximal part of the pedicle that runs underneath the rectus femoris muscle demands continuous pull by an assistant and is inconvenient and tiring for the surgeon. A technique th...

METHODS Patients who underwent abdominoperineal resections for anorectal or vulvovaginal cancer were retrospectively analyzed. We include all the patients who could not be repaired by direct closure due to excessive skin tension. We assessed the different flaps used, the surgical complications rate, wound healing, or the progression to chronic wounds. RESULTS We identified 20 patients who under...

Performing a greater number of free flap procedures inevitably results in an increase in the number of cases that experience free flap failure. In cases that require a second free flap after the failure of the first, recipient vessel selection becomes difficult. Furthermore, recipient vessel selection can be complicated if the vessel is deep in the recipient site, or if there is an increased ri...

Background: The perforator-based propeller flap is a versatile technique that has proven utility in complex lower extremity and lumbar reconstructions. Yet, this flap is prone to venous congestion due to its single-perforator design. In the setting of a congested propeller flap, it is often abandoned and a secondary flap option is utilized. The vascular delay technique has been successfully use...

BACKGROUND The goal of this study was to investigate the anatomy of the peroneal artery and its perforators, and to report the clinical results of reconstruction with peroneal artery perforator flaps. METHODS The authors dissected 4 cadaver legs and investigated the distribution, course, origin, number, type, and length of the perforators. Peroneal artery perforator flap surgery was performed...

Reconstruction of lower limb defects is quite challenging in terms of scarcity of locally available flaps, poor wound healing and need for prolonged immobilization. Normally also there is decreased blood supply in the anterolateral aspect of leg and foot. Leg and foot is like a peninsula with no distal tissues available for proximal reconstruction. Also there is a paucity of loose tissue in leg...

OBJECTIVE Previous abdominal wall surgery is viewed as a contraindication to abdominal free tissue transfer. We present two patients who underwent multiple abdominal liposuction procedures, followed by successful free deep inferior epigastric artery perforator flap. We review the literature pertaining to reliability of abdominal free flaps in those with previous abdominal surgery. METHODS Rev...

BACKGROUND "Superthin flap" is a distinctively thin flap that is thinned primarily to the point that the subdermal vascular network can be seen through a minimal fat layer. Reconstruction of severely disfigured neck and face can be performed using the occipito-cervico-dorsal superthin flap that is harvested from the dorsal region and supercharged by the circumflex scapular vessels. We used bipe...

The deep inferior epigastric artery (DIEA) perforator (DIEP) flap has been widely described as a safe flap with reliable vascular anatomy. One of its limitations is potentially lengthy operating times during flap harvest, and many techniques have been reported to reduce operating times. One such technique is the preoperative selection of perforators with imaging, which has been shown to substan...