Journal of plastic, reconstructive & aesthetic surgery : JPRAS
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J Plast Reconstr Aesthet Surg · Sep 2010
Distally based peroneus brevis muscle flap in reconstructive surgery of the lower leg: Postoperative ankle function and stability evaluation.
Defects of the distal third of the lower leg with exposed tendons or bone require either local or free flap coverage. Several flaps have been developed, and the distally pedicled peroneus brevis muscle flap has been proven to be a valid local flap alternative. ⋯ The reverse peroneus muscle flap is ideally suited for small-to-moderate defects of the distal third of the lower leg. This flap offers a convincing alternative for covering defects in the distal leg region. Its arc of rotation allows coverage of more anterior defects of the ankle, of defects of the Achilles tendon and of the heel area as well as of lateral and medial malleolus areas. It is simple to raise and is often transposed easily within the wound without further dissection. As long as the peroneus longus is preserved, ankle instability is not expected.
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J Plast Reconstr Aesthet Surg · Sep 2010
Case ReportsComplications related to abdominal microdermal implants during pregnancy.
Microdermal implants are a new uprising form of body modification very close to surface body piercing. They can be placed almost everywhere on the skin, giving the appearance that the jewellery is simply stuck on the skin's surface. ⋯ Young women should be careful when choosing the setting of their microdermal implants. They should be discouraged to have it performed on the abdominal area in case of wanting pregnancy.
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J Plast Reconstr Aesthet Surg · Aug 2010
Case ReportsDigital artery perforator (DAP) flaps: modifications for fingertip and finger stump reconstruction.
Various fingertip reconstructions have been reported for situations where microsurgical finger replantation is impossible. One method is the digital artery perforator (DAP) flap. Herein we report 13 DAP flaps for fingertip and finger stump reconstruction following traumatic finger amputations, highlighting modifications to the originally described DAP flap. ⋯ Modified DAP flaps allow for preservation of digital length, volume and finger function. They can be raised as adiposal-only flaps or extended flaps and supercharged through perforator-to-perforator anastomoses. The donor defect on the lateral pulp can be closed primarily or by skin grafting. For traumatic fingertip and finger stump reconstructions, DAP flaps deliver consistent aesthetic and functional results.
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J Plast Reconstr Aesthet Surg · Aug 2010
Case Reports Comparative StudySoft-tissue coverage of an extensive mid-tibial wound with the combined medial gastrocnemius and medial hemisoleus muscle flaps: the role of local muscle flaps revisited.
The proper soft-tissue management for an extensive mid-tibial wound of the leg with a less aggressive surgical approach has rarely been discussed in the literature and the reliability and the usefulness of such an approach to this challenging clinical problem remains uncertain. In this series, four patients with an extensive mid-tibial wound (12x3 to 22x6 cm) of the leg underwent the combined medial gastrocnemius and medial hemisoleus muscle flaps for soft-tissue reconstruction. Both muscle flaps were elevated with emphasis on the preservation of the critical perforators from the posterior tibial vessels to the medial hemisoleus muscle flap as possible and on the possible preservation of foot planter flexion by reconstruction of the proximal Achilles tendon to minimise functional loss. ⋯ Limb salvage was achieved in all four patients during follow-up. Thus, the combined medial gastrocnemius and medial hemisoleus muscle flaps can be a valid option for soft-tissue coverage of an extensive mid-tibial wound of the leg when both local muscle flaps are not traumatised. Such an approach offers relatively simple but more cost-effective way to manage this complex clinical problem and should be revisited by reconstructive surgeons.