A propeller superficial transverse cervical artery perforator flap for defect coverage of the submental area: a case report

Reconstruction of submental defects is a challenge that needs to be approached carefully, since many important anatomical structures are located in this small space. Both aesthetic and functional outcomes should be considered during reconstruction. In this report, we describe a case where a superficial branch of the transverse cervical artery (STCA) perforator propeller flap was applied for coverage of the submental area. An 85-year-old woman presented with a 3-cm ovoid mass on her submental area. We covered the large submental defect with a STCA rotational flap in a 180° propeller pattern. The flap survived well without any complications at 1 year of follow-up. A STCA propeller flap is a useful surgical option in reconstruction for defect coverage of the submental area.

Full-Thickness Skin Graft according to Surrounding Relaxed Skin Tension Line Improves Scar Quality in Facial Defect Coverage: A Retrospective Comparative Study

A full-thickness skin graft (FTSG) is useful for covering small skin and soft tissue defects. In this paper, we suggest FTSG in consideration of the relaxed skin tension line (RSTL) concept for scar quality improvement since FTSG has disadvantages, including contour irregularities and mismatches of color and texture. We conducted a retrospective chart review of twenty-one patients with skin cancer on the face who underwent wide excision and FTSG by a single surgeon from October 2013 to July 2019. Twenty-one patients with skin cancer on the face were divided into RSTL-matched and RSTL-unmatched groups, and FTSG was performed. Each group was subjected to scar assessment three months after surgery. Observer assessment was performed by five independent observers using the observer component of the patient and observer scar assessment scale (POSAS) and Vancouver scar scale (VSS). Our results indicate that there were significant differences between the RSTL-matched and RSTL-unmatched groups in the VSS and POSAS components. In addition, the RSTL-matched group showed a natural appearance with surrounding tissue in the dynamic animation phase compared to the unmatched group. RSTL-matched FTSG can be an attractive option for face skin and soft tissue defect coverage. (An earlier version of this paper has been presented at the International Conference on PRS Korea 2020.)

Abdominal Wall Defects—Current Treatments

Gastroschisis and omphalocele reflect the two most common abdominal wall defects in newborns. First postnatal care consists of defect coverage, avoidance of fluid and heat loss, fluid administration and gastric decompression. Definitive treatment is achieved by defect reduction and abdominal wall closure. Different techniques and timings are used depending on type and size of defect, the abdominal domain and comorbidities of the child. The present review aims to provide an overview of current treatments.

Odontogenic cervical necrotizing fasciitis with descending mediastinitis: a case report and discussion

<p class="abstract">Mr KE is a 46 years old gentleman with a background of type 2 diabetes mellitus who was referred to our department for severe polymicrobial cervical necrotising fasciitis with descending mediastinitis after mandibular dental extraction. He was managed with endotracheal intubation, cervicotomy and video assisted thorascopic surgery (VATS), antibiotic and antifungal therapy and myocutaneous flap coverage. This case describes a classical presentation of an uncommon pathology and discusses options for airway management, surgical debridement, antimicrobial therapy and definitive defect coverage. </p>

Comparison of Interface Pressure, Contact Surface Area, and Percent Area of Coverage Between Two Suture Configurations for Hill-Sachs Remplissage

Purpose: To compare maximum contact pressure, contact surface area, and the percent area of coverage of the bone-tendon interface in the remplissage procedure between two different suture configurations (independent mattress versus double-pulley). Methods: A sample size of seven specimens per group was defined by a 96% power analysis. Hill-Sachs lesions were created in all fourteen ex vivo ovine shoulders, corresponding to a 30% defect of the axial diameter of the humeral head (significant lesion according to literature). The defects were repaired using the remplissage technique applying one of the two randomly chosen suture configurations: two independent mattress sutures or a double-pulley. The contact pressure and contact surface area, as well as percent defect coverage, were recorded using a film sensitive to these parameters. Independent nonparametric tests (Mann-Whitney) were used for the statistical analysis. Results: The double-pulley group exhibited an average pressure of 0.128 ± 0.018 mPa, the contact surface of 0.199 ± 0.044 cm2, and 41.97 ± 9.8% defect coverage. The independent mattress group showed an average pressure of 0.102 ± 0.01 mPa, the contact surface of 0.081 ± 0.041 cm2, and defect coverage of 15.6 ± 8.1%. All three parameters were statistically superior in the double-pulley group (p=0.038, p=0.008, and p=0.008, respectively) Conclusion: The remplissage technique using the double-pulley configuration, presented superior biomechanical characteristics, in terms of contact pressure, contact area, and percent coverage of the defect, compared to the simple independent mattress configuration.