Microsurgery
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Few studies in the recent literature have investigated the reliability of dorsal intercostal artery perforator (DICAP) flap in posterior trunk reconstruction. The purpose of this report is to describe our clinical experience with the use of DICAP flaps in a cohort of oncological patients. ⋯ DICAP based flaps proved to be a reliable option to resurface posterior trunk defects following oncological resection, allowing to achieve like-with-like reconstruction with excellent contour and minimal donor-site morbidity. © 2015 Wiley Periodicals, Inc. Microsurgery 36:546-551, 2016.
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Breast procedures are among the most common surgeries performed by Plastic Surgeons. The prevalence of persistent pain remains unknown. Our experience has been that persistent breast pain is often related to intercostal nerve trauma. The purpose of this article was to increase awareness of this problem while describing the diagnostic and management strategies for patients with post-operative breast pain. ⋯ Intercostal neuromas can be the source of breast pain following breast surgery. The same clinical and diagnostic approach used for upper and lower extremity neuroma pain can be used in patients with breast pain. © 2016 Wiley Periodicals, Inc. Microsurgery 36:535-538, 2016.
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In this report, we described the use of hypoglossal-facial neurorrhaphy with end-to-side coaptation between the jump interpositional nerve graft and the hypoglossal nerve for facial reanimation and analyzed the relationship between the outcome of surgery and duration of preoperative paralysis. ⋯ To achieve successful reanimation of the corners of the mouth, hypoglossal-facial neurorrhaphy with end-to-side coaptation between the jump interpositional nerve graft and the hypoglossal nerve should be performed within 6 months after the onset of facial nerve paralysis. © 2015 Wiley Periodicals, Inc. Microsurgery 36:460-466, 2016.
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This study was to investigate intraoperative assessment of side-to-end lymphovenous anastomosis (LVA) with indocyanine green (ICG) and the correlation between its patency and surgical outcome. ⋯ Side-to-end LVA can be an effective treatment for early-stage lower extremity lymphedema. ICG lymphodynamic assessment is useful not only in the preoperative identification of functional lymphatics but also in the intraoperative visualization of new drainage routes in LVA surgery. © 2015 Wiley Periodicals, Inc. Microsurgery 36:310-315, 2016.
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Case Reports
Reconstruction of the lateral malleolus and calcaneus region using free thoracodorsal artery perforator flaps.
Reconstruction of the lateral malleolus or calcaneus region is challenging because of poor vascularity, minimal presence of soft tissue, and difficulties with flap positioning during and after the operation. In many cases, local flaps are limited in terms of size, durability, and vascularity. Free tissue transfer can be useful for complicated wounds. ⋯ All but one were able to walk. The thoracodorsal artery perforator flap can be made super-thin, allowing patients to wear shoes, and it can be harvested in a chimeric-pattern for complex defects. Therefore, it may represent a viable alternative choice for the reconstruction of the lateral malleolus and calcaneus region.