Reconstruction of large abdominal wall defects is challenging. We herein report the successful reconstruction of an extensive abdominal wall defect using a novel combination of flaps after sarcoma resection. A 74-year-old man presented with a dedifferentiated liposarcoma on his abdominal wall. He underwent excision of the tumor, which resulted in an extensive abdominal wall defect. The defect w...

OBJECTIVE To increase the armamentarium of plastic surgeons with description of one of the relatively newer flap for the reconstruction of congenital absence of vagina. METHODS All patients of congenital absence of vagina selected for surgery were explained every detail about the procedure. Five out of ten opted for this procedure. In all patients bilateral pudendal thigh flap based on poster...

1 Koichi Tomita, MD, PhD Megumi Yokoi-Fukai, MD Takayoshi Ishihara, MD Kosuke Morita, MD Ko Hosokawa, MD, PhD Department of Plastic and Reconstructive Surgery Graduate School of Medicine Osaka University Osaka, Japan Sir: R of large defects in the gluteal region remains challenging. Although regional flaps (eg, anterolateral thigh flap) or myocutaneous flaps (eg, tensor fasciae latae) are optio...

The selection of recipient vessels is crucial when reconstructing traumatized lower extremities using a free flap. When the dorsalis pedis artery and/or posterior tibial artery cannot be palpated, we utilize computed tomography angiography to verify the site of vascular injury prior to performing free flap transfer. For vascular anastomosis, we fundamentally perform end-to-side anastomosis or f...

The composite anterolateral thigh flap with vascularized fascia lata has emerged as a workhorse at our institution for complex Achilles defects requiring both tendon and soft tissue reconstruction. Safe elevation of this flap, however, is occasionally challenged by absent or inadequate perforators supplying the anterolateral thigh. When discovered intraoperatively, alternative options derived f...

Alternative Vascular Pedicle of the Anterolateral Thigh Flap: Does an Oblique Branch Really Exist? Sir: W read with interest the article by Wong et al.1 and the recently published letter to the editor by da Costa and Lancelotti2 concerning the oblique branch of the lateral circumflex femoral artery. Wong et al. described a distinct vascular pedicle lateral to the descending branch of the latera...

SUMMARY Advancements in microsurgical techniques as applied to perforator flaps have made harvesting flaps in a free-style manner a practical reality. A hand-held Doppler identifies sizable perforators on which flaps can be based. In free-style free flap harvesting, any region of the body can be chosen as a donor site as long as there is an audible pulsatile Doppler signal. The value of the fre...

Abstract 30 year old male, who had been hit at 90mph whilst on a motorbike sustaining femoral, tibial and right foot open fractures. He underwent an reduction internal fixation (ORIF) of his lateral femoral condyle, retrograde nail, ORIF the tibia. 2 separate free flaps (a chimera scapular/parascapular antero-lateral thigh-ALT) to lower leg, split skin grafting remainder limb. Upon regular post...

This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. It provides recommendations on the work up and management of lateral skull base cancer based on the existing evidence base for this rare condition. Recommendations • All patients with more than one of: chronic otalgia, bloody otorrhoea, bleeding, mass, facial sw...