Journal of plastic, reconstructive & aesthetic surgery : JPRAS
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J Plast Reconstr Aesthet Surg · Oct 2012
Fasciocutaneous flaps of the subscapular artery axis to reconstruct large extremity defects.
The scapular, parascapular and thoracodorsal artery perforator (TDAP) flaps represent fasciocutaneous flaps derived from the subscapular artery axis. These flaps can be harvested individually or combined as conjoint flaps, tailored to reconstruct a wide variety of defects in the extremities. ANALYSIS AND METHODS: All patients undergoing free-flap reconstruction at North Bristol trust with a fasciocutaneous flap of the subscapular axis from April 2006 until April 2010 were included. This cohort of 45 patients was retrospectively analysed. The Enneking score for return of limb function was used as an outcome measure after reconstruction. Donor-site morbidity analysis was carried out prospectively using Oxford Medical Research Council (MRC) score, Vancouver Scar Scale and disability of arm, shoulder and hand questionnaire (DASH) scores. ⋯ In this case series of fasciocutaneous flaps of the subscapular artery axis, we establish that these flaps are robust and versatile. They replace 'like-with-like' and have good patient satisfaction. The donor site can be closed primarily, is discrete and has minimal donor morbidity. The conjoint flaps can be used for reconstruction of very large defects without the need to sacrifice functionally important muscle.
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J Plast Reconstr Aesthet Surg · Oct 2012
Comparative StudyFacing the World: audit of activity 2002-2010.
Craniofacial anomalies, although uncommon, can have considerable effects on the individual, their family and society.(1-4) They carry with them a large morbidity and require a highly specialized, multidisciplinary approach to treatment.(5) Facing the World (FTW), was founded in 2002, to offer facial reconstructive surgery to children with complex, craniofacial anomalies with no prospect of local treatment, from developing countries anywhere in the world. ⋯ III.
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J Plast Reconstr Aesthet Surg · Oct 2012
Case ReportsReconstruction of elbow region defects using radial collateral artery perforator (RCAP)-based propeller flaps.
Perforator-based propeller flaps permit flap rotation up to 180°. This ability to transfer skin from one longitudinal axis to another has led to the increasing use of perforator-based propeller flaps in extremity reconstruction, especially lower-extremity reconstruction. However, the application of perforator-based propeller flaps to upper-extremity reconstruction is still limited. ⋯ Among them, the RCAP seems to be one of the most reliable options. This is because there are less anatomical variations of perforators' location on the lateral upper arm than on the medial upper arm. By using an RCAP perforator as a flap pedicle, the small-to-medium sized defects (<6 cm in diameter) around elbow regions can be closed primarily without skin grafts.
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J Plast Reconstr Aesthet Surg · Oct 2012
Reconstruction of penetrating injuries of the hand with dorsalis pedis composite free flaps: a series of 23 patients.
Reconstruction of severe hand injuries remains a challenge. We herein report the use of dorsalis pedis composite free flaps (DPCFFs) for the reconstruction of penetrating injuries of the hand. ⋯ III.