Journal of plastic, reconstructive & aesthetic surgery : JPRAS
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J Plast Reconstr Aesthet Surg · Jan 2010
Case ReportsFree-fillet flap harvested in 'severe, high-energy landmine explosion' injuries of lower extremity: a case report.
Fillet flaps harvested from the non-replantable or unsalvageable amputated segment can be used to cover tissue defects. We discuss the case of a patient who had suffered a severe high-energy landmine injury, including severe leg damage, resulting in a below-knee amputation and soft-tissue defect around the forearm region. We successfully harvested the fillet from the amputated part of the extremity to the forearm region. We conclude that harvesting of a fillet flap from severely injured lower extremity, resulting from a high-energy landmine explosion, is technically feasible.
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J Plast Reconstr Aesthet Surg · Jan 2010
Superior gluteal artery perforator flap in the reconstruction of pilonidal sinus.
Pilonidal sinus is a difficult disease to treat. Many treatment modalities from secondary-intention healing to various types of flaps have been used with each having different rates of success. ⋯ The superior gluteal artery perforator flap (SGAP) offers many advantages over random (better vascularity and flap safety) or larger flaps (decreased operating time and donor-area morbidity) in the treatment of pilonidal sinus disease. We present our results with the use of the SGAP flap, which is designed at a 45( degrees )-angle to the defect created by the excision of the pilonidal sinus. Compared to the previously described techniques, it has the advantage of closing defects of any size within a short surgical time and minimal blood loss. The hospital stay, time to mobilisation and return to daily activities and work are shortened, in addition to zero complications and recurrence rates.
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J Plast Reconstr Aesthet Surg · Jan 2010
Therapeutic applications of the larvae for wound debridement.
It has been known for centuries that application of larvae is useful to heal certain wounds by facilitating debridement of necrotic tissue. Their therapeutic use was popularised in the beginning of the 19th century, but waned in the 1940s with the advent of antiseptic wound management and antibiotics. In more recent years, larvae are once again in vogue for management of difficult wounds. ⋯ In our study, wound debridement was achieved satisfactorily in 29 of 34 patients (85%) with chronic wounds. In the remaining five patients, failures occurred due to inadequate sealing in two patients (6%), death of larvae in two patients (6%) and treatment intolerance in one patient (3%). Larval therapy should be considered as a therapeutic option in the management of certain difficult wounds.