British journal of plastic surgery
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The super-thin flap technique was first devised in China. Flaps thinned by this technique are especially useful in the neck, face or hands of patients with extensive burn scarring, where the combination of thinness and suppleness is needed. However, some of these radically thinned flaps may suffer from superficial or full thickness necrosis due to the unpredictability of survival of the super-thinned area. In this paper, we present a technique of microvascular augmentation of the blood supply of the thinned flap, an example of so-called "supercharging".
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Currently used tendon transfers for persistent traumatic paralysis of the common peroneal nerve are based on the transfer of the posterior tibial muscle, an antagonist muscle to the paralytic group of muscles. In order to achieve voluntary active dorsiflexion of the foot and automatic walking we have transposed the lateral head of the gastrocnemius to the anterior side of the lower leg, at the same time suturing the undamaged proximal end of the deep branch of the peroneal nerve to the motor branch of the tibial nerve innervating the lateral head of gastrocnemius muscle. After nerve regeneration and neurotisation the transposed lateral head of gastrocnemius was innervated by the deep branch of the peroneal nerve and thus it took over the function of the paralytic muscles. The indications for the operation, the surgical technique, and the results obtained in 6 cases are presented.