The propeller-type flap design is increasingly used in reconstructive surgery for various regions of the body. To date, determinants of perforator patency when subjected to twisting have not been elucidated. We propose a simulation model to study parameters affecting perforator patency under such conditions. Nonlinear finite element procedure was used to simulate a perforator consisting of an a...

In 2009, we have described the use of freestyle facial artery perforator flaps for one-stage nose reconstruction. Since then, several articles have reported the use of facial artery perforator flaps for nose reconstruction. The purpose of this article is to provide an update of the published technique after 10 years of experience. Since 2004, 21 patients have been treated with a freestyle facia...

BACKGROUND Peripheral vascular disease and/or diabetic neuropathy represent one of the main etiologies for the development of lower leg and/or diabetic foot ulcerations, and especially after acute trauma or chronic mechanical stress. The reconstruction of such wounds is challenging due to the paucity of soft tissue resources in this region. Various procedures including orthobiologics, skin graf...

Amputation by crush injuries generally represents a contraindication for replantation, and especially when the lesion is caused by the summation of multiple concomitant traumatic mechanisms. We present the case of a 22 year- old female who arrived in our service with a crush/torsion amputation of all long fingers at the metacarpo-phalangeal level of the right hand. After the unsuccessful attemp...

Neurogenic pain can develop after microsurgical repair of a median nerve injury or when the lesion is underestimated and therefore not treated at all. Nerve injury with neuromatous pain may be associated with tumefaction at the wrist, increased pain and tingling when tapped [1]. The aim of the treatment is to both minimize pain and preserve residual function of the median nerve. Surgical proced...

BACKGROUND The deep inferior epigastric perforator flap is rapidly becoming a more widely employed method of autologous breast reconstruction. The technical considerations involved in the execution of the flap are many and include the selection of perforators to be incorporated in the flap. We attempt to give a mathematical explanation, based on the physics of flow through vessels and the prope...

We provide here a proof theoretic account of constraint programming that attempts to capture the essential ingredients of this programming style. We exemplify it by presenting proof rules for linear constraints over interval domains, and illustrate their use by analyzing the constraint propagation process for the SEND + MORE = MONEY puzzle. We also show how this approach allows one to build new...

815 Plast Surg 1998;51:431-5. 2. Hallock GG. The medial sural(MEDIAL GASTROCNEMIUS) perforator local flap. Ann Plast Surg 2004;53:501-5. 3. Innocenti M, Menichini G, Baldrighi C, et al. Are there risk factors for complications of perforator-based propeller flaps for lower-extremity reconstruction? Clin Orthop Relat Res 2014;472:2276-86. 4. Kosutic D, Pejkovic B, Anderhuber F, et al. Complete ma...

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...

There are numerous perforator flaps reported in the literature for head and neck reconstruction. We are presenting a case report of squamous cell carcinoma of Tongue which was operated by hemi glossectomy, modified radical neck dissection and reconstruction was done with medial sural artery perforator flap (MSAP). Preoperatively handheld Doppler was used to identify the perforator. The size of ...