The incidence of extramammary Paget's disease (EMPD) is very low. An 84-year-old Korean man was treated with topical and oral medications at a local dermatologic clinic for a year, but the symptoms did not improve. He visited Severance Hospital and underwent a perianal skin biopsy and was finally diagnosed with EMPD. The authors performed a wide local excision according to a 1-cm margin around ...

INTRODUCTION The evolving concept of free-style flaps with one or more perforators able to lend support, has been shown to have noteworthy advantages in the context of reconstructive surgery, especially in relation to the distal portion of the lower limb. Among the advantages, an analogy of the covering tissues with pre-existing ones in the compromised area, reduced morbidity of the donor site,...

BACKGROUND Partially resecting ribs of the recipient site to facilitate easy anastomosis of the internal mammary vessels to free flaps during breast reconstruction can cause chest wall pain or deformities. To avoid this, the intercostal perforating branches of the internal mammary vessels can be used for anastomosis. The purpose of this study was to investigate the location and size of the inte...

BACKGROUND Defects of the Achilles tendon region still represent a tricky issue in lower limb surgery. Among the several reconstructive possibilities, local propeller perforator flaps have gained popularity in the last decade. MATERIALS AND METHODS We report our experience with eight patients affected by small-to-moderate soft-tissue defects of the Achilles tendon region, who underwent surgic...

We make an attempt to define the safe extent of local perforator flap for lower limb reconstruction by comparing it with the limb length of the patient. The maximum flap length from the perforator was compared to the limb length in 35 patients using EPI info 6.04 D software. On comparison of flaps that were less than one-third of limb length to those which were more than one-third of limb lengt...

Background and objectives: Perforator flaps, both pedicled and free flaps, are increasingly used in reconstructive surgery. However, the microvascular perfusion pattern within these flaps still remains essentially unknown. It is well known that in random-pattern flaps, flap length correlates directly with the width of the flap base. In perforator flaps, the importance of preserving a skin base ...

BACKGROUND The maximum weight of tissue that a single perforator can perfuse remains an important question in reconstructive microsurgery. An empirically based equation, known as the flap viability index (FVI), has been established to determine what weight of tissue will survive on one or more perforators. The equation is FVI = Sum d(n)^4/W, where d is the internal diameter of each perforator a...

BACKGROUND The profunda artery perforator flap has been emerging as an alternative method of autologous breast reconstruction. This flap uses upper posterior thigh tissue. The profunda artery perforator perforasome is investigated using three-dimensional computed tomographic angiography. METHODS Ten cadaveric thighs were dissected centered over the profunda artery perforator. The perforator w...

BACKGROUND The aim of this study was to determine the efficacy of lateral intercostal artery perforator-based adipofascial free flaps for facial reconstruction in patients with facial soft tissue deficiency. METHODS We conducted a retrospective study of five consecutive patients diagnosed with facial soft tissue deficiency who underwent operations between July 2006 and November 2011. Flap des...

Abstract Background Volar finger defects where critical structures exposed are always challenging for plastic surgeons. In these types of defects, local flaps, cross abdominal and free flaps used. Free dorsoulnar artery perforator (DUAP) superficial palmar branch radial (SPBRA) also this case, we present a patient who was scheduled to receive DUAP flap address defect on the second right hand; h...