After oncological tumor resections at the back, large defects can remain that depending on the size and location may represent reconstructive challenges to plastic surgeons. Flap selection includes the entire armamentarium of coverage, including transposition flaps, perforator flaps, pedicled muscle flaps, and free flaps. Most defects can be closed and reconstructed with local or pedicled muscl...

Descending necrotizing mediastinitis (DNM) is rare and aggressive. A 68-year-old female with no medical history, was admitted to our institution for cervical cellulitis. After a conventional medical treatment, multiple abscesses of the upper mediastinum appeared on computed tomography (CT) findings. Although two cervicotomies were performed, a new necrotic abscess appeared in the anterior upper...

We report a case of a young double-hand allotransplant patient who presented with a full-thickness skin necrosis of the dorsum of the left hand after vascular compromise of the allotransplantation. Considering the lack of viable dorsal tissue overlying the extensor tendons and the need for early hand rehabilitation, an ultrathin pedicled groin flap was used for the coverage. This procedure resu...

We report the use of a fillet of upper arm pedicled flap, which has not been previously reported in the literature. The fillet of upper arm flap follows the principle of "spare parts" surgery, and can provide vascularized soft tissue coverage for defects of the shoulder and the chest wall when the upper extremity cannot otherwise be salvaged, such as in cases of radical tumor excision. The fill...

OBJECTIVE The purpose of this study was to describe the endoscopic combined "transseptal/transnasal" approach with a pedicled nasoseptal flap for pituitary adenoma and skull base reconstruction, especially with respect to cerebrospinal fluid (CSF) fistula. METHOD Ninety-one consecutive patients with pituitary adenomas were retrospectively reviewed. All patients underwent the endoscopic combin...

Pedicle damage is a rare complication of latissimus dorsi (LD) flap breast reconstruction. We report a case of accidental avulsion of the vascular pedicle of a totally autologous (extended) LD flap during immediate breast reconstruction in a patient who had previously undergone contralateral breast reconstruction with a pedicled TRAM flap based on the opposite superior epigastric vessels. The i...

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...

1 Tissue of amputated or nonsalvageable limbs may be used for reconstruction of complex defects. Fillet flaps can be used to treat traumatic, oncologic, or pressureinduced wounds. The classical fillet flap is defined as an axial-pattern flap harvested from amputated, discarded or otherwise nonfunctioning or nonsalvageable areas of the body that can be used as a pedicled, island, or microvascula...

As microvascular techniques continue to improve, perforator flap free tissue transfer is now the gold standard for autologous breast reconstruction. Various options are available for breast reconstruction with autologous tissue. These include the free transverse rectus abdominis myocutaneous (TRAM) flap, deep inferior epigastric perforator flap, superficial inferior epigastric artery flap, supe...

Im ag es IMAGES area [2]. Various regional musculocutaneous flaps have played an important role in reconstruction of the posterior trunk [1,2]. However, they have shortcomings of sacrificing underlying muscle and donor site morbidity. Perforator flaps have recently been regarded as a good method for reconstruction of such defects [3,4]. Flap extendibility and less invasiveness without sacrifice...