Microsurgery
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Reconstruction of extensive abdominal wall defects is a challenge for reconstructive surgeons. In this report, a case of reconstruction of a large abdominal wall defect using an eccentric perforator-based pedicled anterolateral thigh (ALT) flap is presented. A 30-year-old man presented with recurrent desmoid-type fibromatosis in the abdominal wall. ⋯ Plication of the fascia along the sutured portion was performed to relieve the skin tension between the flap and the marginal skin of the abdominal defect. Eight months after surgery, the reconstructed abdomen had an acceptable esthetic appearance without tumor recurrence or hernia. The use of an eccentric perforator-based pedicled ALT flap may be an alternative method for the reconstruction of extensive abdominal wall defects.
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The Iraq and Afghanistan Wars have presented military reconstructive surgeons with a high volume of challenging extremity injuries. In recent years, a number of upper and lower extremity injuries requiring multiple tissue transfers for multiple limb salvages in the same casualty have been encountered. Our group will discuss the microsurgical challenges, algorithms, and success and complication rates for this cohort of war injured patients. ⋯ The last decade of war trauma has provided a high volume of extremity injuries requiring limb salvage procedures including casualties who underwent single and multiple free flap coverage procedures. Although multiple flap limb salvage procedures have a higher complication rate, they can be performed within the same patient without concern for increased failure rate in carefully selected and appropriately managed patients.
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Comparative Study
Histologic and functional outcomes of nerve defects treated with acellular allograft versus cabled autograft in a rat model.
Acellular nerve allograft is a new option for bridging nerve defects that allows appropriate diameter matching. The aim of the study was to compare the histologic and functional recovery of nerve defects treated with acellular nerve allograft versus cabled sural nerve autograft. ⋯ In conclusion, acellular nerve allograft demonstrated equal functional recovery when compared to reversed autograft (control), and superior recovery compared to the cabled nerve autograft.