Heel Reconstruction With Bipedicled Flap: A Salvage Procedure

2020 ◽  
Vol 19 (4) ◽  
pp. 377-381
Author(s):  
Alper Burak Uslu ◽  
Ramazan Erkin Ünlü
Keyword(s):  
Free Flaps ◽  
Salvage Procedure ◽  
Older Individuals ◽  
Peripheral Vascular ◽  
Fat Pad ◽  
Exposed Bone ◽  
Thin Skin ◽  
A New Technique ◽  
Subdermal Fat ◽  
Heel Reconstruction

Reconstruction of the heel region poses great challenge to plastic surgeons not only due to calcaneal bone lying just deep to the subdermal fat pad but also due to easily exposed Achilles tendon. In order to achieve permanent closure of the heel defect, exposed bone or tendon—or both—should be covered with durable, preferably sensate, well-vascularized, thin skin flaps. Even though fasciocutaneous free flaps remain the gold standard in the reconstruction of heel defects with exposed bone or tendon, a significant number of these patients are older individuals with multiple comorbidities such as diabetes mellitus, hypertension, atherosclerosis, and peripheral vascular disease. In this study, with a clinic series consisting of 6 patients (1 female, 5 males), we present a new technique of reconstruction with a bipedicled flap as a safe, reliable, and efficient reconstructive modality in the treatment of heel defects in cases where free flaps and other more sophisticated reconstructive options are either not feasible or have failed. Achieving complete reconstruction of defects in all 6 patients, this technique proves to be successful as a salvage procedure in reconstruction of heel defects.

scholarly journals Use of Silicone Sizers in Implantation of Porous Polyethylene Nasal Dorsal Implants in Asians

2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
Randal Pham
Keyword(s):  
Selection Criteria ◽  
High Density ◽  
Nasal Surgery ◽  
Porous Polyethylene ◽  
Asian Patients ◽  
Thin Skin ◽  
History Of ◽  
A New Technique ◽  
Patient Selection Criteria ◽  
Porous Polyethylene Implants

Introduction. A new technique of implantation of high-density porous polyethylene nasal dorsal implants in Asians is described in this paper. Silicone sizers, which have smooth surfaces, were used to facilitate implantation of porous polyethylene implants in Asian patients. Materials and Methods. Twenty-three patients of Asian descent underwent dorsal augmentation rhinoplasty with open technique using high-density porous polyethylene implants. In all cases, silicone sizers were used to facilitate implantations of high-density porous polyethylene nasal dorsal implants. Patient selection criteria exclude patients with history of cocaine use, history of nasal or sinus disorders, previous nasal surgery, deviated septum, poor cartilage support, and thin skin. Results. No bleeding, infection, rejection, displacement, or extrusion was noted. One implant was removed because of a patient's dissatisfaction with the resulting tip height. Conclusion. The use of silicone sizers to facilitate implantations of high-density porous polyethylene nasal dorsal implants was safe and efficacious.

A New Technique for Nonsurgical Repair of Peripheral Pseudoaneurysm

1995 ◽  
Vol 36 (1) ◽  
pp. 100-101 ◽  
Author(s):  
W. D. Jeans ◽  
H. O. Leven
Keyword(s):  
Ultrasound Imaging ◽  
New Technique ◽  
Vascular Lesions ◽  
Peripheral Vascular ◽  
Direct Puncture ◽  
Image Guided ◽  
A New Technique

Peripheral vascular lesions may be inaccessible to treatment using catheter techniques. Ultrasound imaging in combination with Doppler may identify such lesions and provide possibilities for image-guided compression, injection of embolizing material by direct puncture, or both.

scholarly journals Cross-Leg as Salvage Procedure after Free Flaps Transfer Failure: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
F. Contedini ◽  
L. Negosanti ◽  
E. Fabbri ◽  
V. Pinto ◽  
B. Tavaniello ◽  
...  
Keyword(s):  
Free Flap ◽  
Latissimus Dorsi ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Lower Leg ◽  
Salvage Procedure ◽  
Soft Tissue Defects ◽  
Vascular Thrombosis ◽  
Flap Failure ◽  
Tissue Defects

Posttraumatic wounds of the lower leg with soft tissue defects and exposed fractures are a reconstructive challenge due to the scarce availability of local tissues and recipient vessels. Even when a free tissue transfer can be performed the risk of failure remains considerable. When a free flap is contraindicated or after a free flap failure, the cross-leg flap is still nowadays a possible option. We report a case of a male with a severe posttraumatic wound of the lower leg with exposed tibia fracture firstly treated with two consecutive latissimus dorsi muscular free flaps, failed for vascular thrombosis; the coverage was then achieved with a cross-leg flap with acceptable results.

scholarly journals Pedicle Temporalis Fascial Flap with Axial Scalp Flap Obviates Need of Free Flap in Extensive Scalp Wound

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
F. W. Nangole ◽  
S. O. Khainga
Keyword(s):  
Wide Local Excision ◽  
Operative Time ◽  
Free Flaps ◽  
Local Flaps ◽  
Donor Side ◽  
Scalp Flap ◽  
Fascial Flap ◽  
Scalp Defect ◽  
Exposed Bone ◽  
Scalp Wound

Extensive scalp defect with exposed bone is best reconstructed with flaps. Majority of these wounds are now routinely reconstructed with free flaps in many centers. Free flaps however require lengthy operative time and may not be available to all patients, where possible less extensive options should thus be encouraged. A sixty-eight-year-old patient presented to us with a Marjolin’s ulcer on the vertex of the scalp. After wide local excision a defect of about 17 cm and 12 cm was left. The defect was successfully covered with a combination of an ipsilateral pedicle temporalis fascial flap and an axial supraorbital scalp flap with good outcome. In conclusion wide defects of the scalp can be fully covered with a combination of local flaps. The axial scalp flap and the pedicle temporalis fascial flap where applicable provide an easy and less demanding option in covering such wounds. These flaps are reliable with good blood supply and have got less donor side morbidity.

A double buccal fat pad flap for middle palate defect closure—a new technique for palate closure

2006 ◽  
Vol 35 (11) ◽  
pp. 1057-1059 ◽  
Author(s):  
G. De Riu ◽  
S.M. Meloni ◽  
C. Bozzo ◽  
F. Meloni ◽  
A. Tullio
Keyword(s):  
New Technique ◽  
Defect Closure ◽  
Fat Pad ◽  
Buccal Fat Pad ◽  
A New Technique

Buried Free Flaps for Breast Reconstruction: A New Technique Using the Cook-Swartz Implantable Doppler Probe for Postoperative Monitoring

2010 ◽  
Vol 125 (4) ◽  
pp. 171e-172e ◽  
Author(s):  
Warren M. Rozen ◽  
Iain S. Whitaker ◽  
Marcus J. D. Wagstaff ◽  
Thorir Audolfsson ◽  
Rafael Acosta
Keyword(s):  
Breast Reconstruction ◽  
Free Flaps ◽  
New Technique ◽  
Postoperative Monitoring ◽  
Doppler Probe ◽  
A New Technique

scholarly journals Perforator-Pedicled Propeller Flaps for Lower Extremity Reconstruction

2020 ◽  
Vol 34 (03) ◽  
pp. 200-206
Author(s):  
Mohamed A. Ellabban ◽  
Ahmed I. Awad ◽  
Geoffrey G. Hallock
Keyword(s):  
Lower Extremity ◽  
Donor Site ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Peripheral Vascular ◽  
Perforator Flaps ◽  
Vascular Insufficiency ◽  
Lower Extremity Reconstruction ◽  
Extremity Reconstruction ◽  
Bone Exposure

AbstractReconstruction of the lower extremity is considered a major challenge due to frequent bone exposure and the absence of local tissue redundancy, as well as often due to the presence of vascular insufficiency. Many surgeons have preferred free flaps especially for reconstructing the more distal lower limb defects until the evolution of pedicled perforator flaps and propeller flaps in particular provided a like-with-like reconstruction of the lower extremity without affecting the main vessels of the limb or the underlying muscles, and without the risk of any microanastomosis especially in patients with multiple comorbidities. Perforator-pedicled propeller flaps as local flaps in the lower extremity are best suited for small- and medium-sized defects with minimal donor-site morbidity, regardless of the cause of the defect. Any of the three source vessels of the leg can provide reliable perforators for propeller flap coverage of the distal leg and foot. The three main risk factors that are relative contraindications may be advanced age, diabetes mellitus, and atherosclerotic peripheral vascular disease.

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