The anterolateral thigh flap (ALTF) has been in wide clinical use for the last two decades, its major disadvantage has been its variable anatomy. We are presenting a case in which no substantial perforators were found to be arising from either the lateral septum of thigh or Vastus Laterlis muscle. In this case, instead of raising another flap, we used the same skin paddle raised on the musculoc...

BACKGROUND The anterolateral thigh flap is known for variations of its vascular pedicle. This is a prospective intraoperative analysis of the vascular anatomy of the lateral thigh that focuses on clinically important variations that impact flap harvest. METHODS Eighty-nine consecutive anterolateral thigh flaps were harvested. A detailed intraoperative analysis was performed of the vasculature...

: Osteoradionecrosis (ORN) following radiation therapy is a much-feared complication of the treatment head and neck cancer. Free flap reconstruction in ORN patient has specific challenges for surgeon. From 2014 to 2020 Head Neck Microvascular unit Oral Maxillofacial Surgery Division at Jackson Health/University Miami treated 149 patients with free reconstruction. The fibula (n=65) anterior late...

Chronic recurrent ischial sores are an important cause of morbidity in paraplegics and geriatric patients. Compared to sacral and trochanteric ulcers, ischial sores are the most difficult to treat, with a low success rate following conservative therapy and a high recurrence rate after surgical treatment. We report the use of the pedicled anterolateral thigh (pALT) flap for reconstruction of a c...

In patients with sarcomas, or regional recurrence of the disease, radical resection and radiation therapy is indicated to achieve cure or palliation. As a result of radical surgery, extensive radiation, or infection in the pelvic, groin or thigh region, the development of large pelvic / groin / thigh defects present a difficult surgical problem. Musculocutaneous deep epigastric island-flaps, as...

SUMMARY This study introduces the options for supercharging and augmenting venous drainage of an anterolateral thigh free flap. Clinical indications and options for additional microvascular anastomoses are reviewed in 5 consecutive patients. The indications were simultaneous mucosal and cutaneous defects, divergent mucosal defects, and extensively wide and long cutaneous defects. Three addition...

This article presents the case of a 53 years old patient, with ulcerated and infected dermatofibrosarcoma, extended on the anterolateral side of the left knee. The postexcisional defect, exposing patella, was covered through a regional cutaneous flap of the distal third of the thigh, upper lateral genicular artery-based, measuring 20/10 cm, together with expanded free skin split grafts, applied...

This is the first instance where the technique of supercharging a flap with a second pedicle, combined with a third pedicle using the flow-through technique, is described in literature. We present the case of a 66-year-old man with multiple recurrent squamous and basal cell carcinomas of the face. He underwent a wide local excision resulting in a 20 × 26-cm defect. This was reconstructed with n...

Abstract We present a case report of an unexpected pathology in addition to rare complication 62-year-old female following anterior exenteration and abdominal wall reconstruction. Initial biopsies characterised the malignancy as potential urachal adenocarcinoma, but final revealed solitary endometrial adenocarcinoma metastasis from cancer 6 years previously. Due nature tumour, resection was req...

The complex reconstruction of nerves and soft tissue in the head and neck region is still challenging, especially in cases requiring external auditory canal reconstruction with facial nerve reconstruction. We report a case of left facial schwannoma extending into the external auditory canal beyond the tympanic membrane with facial paralysis in which the reconstruction of both the facial nerve a...