Replantation and triple expansion of a three-piece total scalp avulsion: Six-year follow-up

Total scalp avulsion in three scalp segments is an unusual injury. The authors describe the replantation of three scalp segments in a 15-year-old girl. Replantation of the middle scalp piece was unsuccessful, but a satisfactory aesthetic and functional result was obtained by expanding the same replanted tissue three times. Every effort should be undertaken to save the avulsed scalp, even in a severely damaged situation

Cross-leg free flap for emergency extremity salvage: Case report

The use of a cross-leg free flap and consequent limb salvage was successfully performed in a 10-year-old boy with a compound open fracture of the tibia, involving extensive skin and soft-tissue loss. This method should be kept in mind, as it may sometimes, in an emergency situation, lead to lower-extremity salvage, as in the case reported

Long term results of free flaps in facial contour restoration

Facial defects can be reconstructed by utilization of free tissue transfers. This can be the result of a congenital, post-traumatic, post-radiotherapy or post-surgical condition. Microsurgical reconstruction techniques enable one stage correction. We have utilized various free flaps (omentum 4, serratus anterior muscle Rap 3, scapular flap 4 and groin flap 1) for facial contour restoration in 12 patients who had tissue deficits because of Romberg's disease, hemifacial microsomia, hypoplasia due to radiotherapy, tumor resection and post trauma. All vessel anastomosis were performed by the second author. No flap was lost. In conclusion, late descent of omentum, muscle and dermal fat tissue could not be prevented, whereas there was relatively minimal sagging of scapular tissue, therefore multiple flap revisions were performed in all patients in the long term

Use of free serratus anterior muscle slips for the reconstruction of dorsal-side defects of the hand resulting from hot press injury

Mutilation of the hand as a result of hot press injury, the common characteristics of which are extensive soft tissue and extensor tendon loss, metacarpal and phalangeal necrosis, exposition of multiple joints, and infection, presents a serious challenge to the hand surgeon. Free transfer of the inferior three slips of the serratus anterior muscle is a useful surgical option for the reconstruction of dorsal-side defects in the hand. The versatility of the three separate slips, which are easily divisible for contouring, enables individual reconstruction of the different digits. Long vascular pedicle, low donor-site morbidity, and durability are other advantages. Four male patients with hot press injury of the dorsal side of the hand were treated with free transfer of serratus anterior muscle slips and split-thickness skin grafts. Follow-up period ranged between 5 and 12 years. Late functional and cosmetic results are presented

Actinomycosis of the frontal and parotid regions

Cervicofacial actinomycosis still occurs infrequently and should be included in the differential diagnosis of neoplasms, and chronic suppurative and granulomatous lesions of the head and neck region. The authors present two cases of actinomycosis. Patient 1 was a 32-year-old man who was first seen with a firm, suppurative mass at his left frontal region. Patient 2 was a 36-year-old woman with an indurated mass at her left parotid area. Both patients were diagnosed histopathologically with cervicofacial actinomycosis, but each patient had a different clinical course and different response to antimicrobial and surgical treatments

THE EFFECT OF PARENTERAL PENTOXIFYLLINE THERAPY ON SKIN FLAP SURVIVAL

The effect of pentoxifylline as a hemorrheologic agent on skin flap survival has been observed. A caudally pedicled dorsal flap with an ischemic component in rats was used as the model. The flap survival was calculated to be 0.807+/-0.049 in the control group (n = 15), where flap survival was found to be 0.9713+/-0.018 in the pentoxifylline treated group (n = 15) (t = 12.19, p < 0.005). In the meantime, living flap length was measured as 9.96+/-0.72 in the control group, and 11.84+/-0.18 in the pentoxifylline treated group. With these results, we have come to the conclusion that parenteral pentoxifylline therapy is effective on ischemic skin flap survival in the rat model

False aneurysm of the princeps pollicis artery of the hand

Aneurysms of the arteries of the wrist and hand are uncommon, and traumatic aneurysm of the princeps pollicis artery is extremely rare. In this paper, a 24-year-old man who had a traumatic aneurysm of the princeps pollicis artery in his right wrist is presented

"Extracorporeal loop" (blind loop): An alternative microsurgical technique for prelaminated flap transfer

Free tissue transfer is frequently used for reconstruction in the head and neck region. In patients who suffer tissue loss due to a high-energy trauma, the reconstructive surgeon is often faced with a large gap between the defect and the site of anastomosis outside the zone of injury. Utilization of long vein grafts for reestablishment of blood flow to the transferred tissue vessels is a common procedure. Arteriovenous fistula (AVF) formation on the side table is an alternative solution. In this paper, an "extracorporeal loop" (blind loop) technique is presented as an alternative microsurgical method for prelaminated flap transfer to two different traumatic recipient areas in the face (nose and ear)