BACKGROUND Despite the most heroic efforts, sometimes free flaps fail. Perforator free flaps are not invincible and can suffer the same fate. The real challenge is how to decide what is the next best choice for achieving the desired outcome. METHODS Over the past decade, 298 free perforator flaps were used in our institution. Total failure occurred in 16 patients, and partial failure requirin...

An important and vital area of the head &neck entail the coverage of defects throughout the head and neck area. These defects usually covered by flaps, during the last 6 decades since the introduction of tube pedicle flap till the early sixty of the last century (Macgregor 1960) advocated his temporal fascial flap for coverage of intra oral defect after radical cancer surgey, this flap was a gr...

We have devised a technique of two-stage tracheal reconstruction using S-shaped skin flaps and an aural conchal cartilage graft. During the first operation, S-shaped skin flaps were elevated before resection of the trachea. A tracheocutaneous fistula was created at the tracheal defect using S-shaped skin flaps while placing the conchal cartilage graft underneath. During the second operation, a ...

Inadequate venous drainage can lead to congestion and necrosis of flaps used in the repair of defects, thereby elevating the risk of flap failure. In this study, we sought to test the hypothesis that the venous drainage was better in flow-through flaps than in conventional dorsalis pedis free flaps used in the repair of dorsal foot defects. In this retrospective study, we investigated the data ...

the distal third of the tibia, ankle and heel area is difficult to reconstruct. for small to medium size defects, local flaps are often an easier alternative than free flap. in lower limb surgery, the sural flap is based on this principle and this flap is becoming increasingly popular. the distally based superficial sural artery flap, first described as a distally based neuro skin flap by masqu...

BACKGROUND For reconstructing moderate-to-high projection breasts in nulliparous patients with insufficient abdominal tissue or prior abdominal surgeries, a unilateral inferior gluteal artery perforator (IGAP) flap is an alternative procedure. In patients with slim hips, however, unilateral gluteal tissue is insufficient and inferior gluteal crease displacement may develop postoperatively. Dono...

Simple or complex defects in the lower leg, and especially in its distal third, continue to be a challenging task for reconstructive surgeons. A variety of flaps were used in the attempt to achieve excellence in form and function. After a long evolution of the reconstructive methods, including random pattern flaps, axial pattern flaps, musculocutaneous flaps and fasciocutaneous flaps, the reapp...

BACKGROUND Surgical ablation for locally advanced breast cancer results in large chest wall defects, which can then be managed with local flaps or skin grafts. The purpose of this article is to evaluate the outcomes of three types of local skin flaps. METHODS Among 25 local flaps in 24 patients, 6 were bilateral advancement (BA) flaps, 9 were thoracoabdominal (TA) flaps, and 10 were thoracoep...

BACKGROUND AND PURPOSE To explore the methods of clinical classification in chronic radiation-induced ulcers in the chest wall (CRUCWs). MATERIALS AND METHODS A total of 64 patients with CRUCWs were treated. We divided the cases into 3 types (mild, moderate, or severe) according to their clinical manifestations. Conservative treatments, axial-pattern myocutaneous or local flaps, or filleted f...

Obviously, restoring the nasal lining is a great challenge in the reconstruction of nasal defects. Full thickness nasal defects usually require special flaps for reconstructing the nasal lining. Intranasal mucosal flaps, hinge over flaps, perinasal second flaps, folded or second forehead flaps and finally free flaps are examples that can be used for this purpose. Moreover, the case presented in...