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An Overview Algorithm for Perforator Free Flap Coverage of all Zones of the Mangled Upper Extremity.
A truly mangled upper extremity will undoubtedly need composite tissue rearrangement to ensure adequate wound healing; but often also the replacement of missing parts, always with the goal of maximizing functional rehabilitation. Whatever t…
- Reconstructive Microsurgery-What a Wonderful Life!
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On a Hunt for the "True" Septocutaneous Perforator: A Histology Cross-Section Study.
[BACKGROUND] Modern trends in reconstructive surgery involve the use of free perforator flaps to reduce the donor site morbidity. The course of perforator vessels has a great anatomic variability and demands detailed knowledge of the anato…
- The Life Cycle of the Plastic Surgeon.
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The free flap man: An heroic 50-year odyssey via multiple flaps.
Most lower extremity challenges can be solved by a solitary free flap. Yet if multiple wounds exist in a single extremity, or if bilateral extremities are involved, then multiple free flaps by necessity may be required to preserve ambulator…
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The Medial Sural Artery Perforator Flap: A Historical Trek from Ignominious to "Workhorse".
Rather than just another "review," this is intended to be an "overview" of the entire subject of the medial sural artery perforator (MSAP) flap as has been presented in the reconstructive literature from its inception in 2001 until the pres…
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Are "Free Flaps" "Free" Flaps?
[BACKGROUND] Even standard microvascular tissue transfers are time consuming, require great skill and intensity, and can be stressful. Not surprisingly, work-related relative value units are considered by many microsurgeons to be suboptima…
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Attributes of Perforator Flaps for Prophylatic Soft Tissue Augmentation Prior to Definitive Total Knee Arthroplasty.
[BACKGROUND] As our population ages, the demand for total knee arthroplasty (TKA) will dramatically increase to ensure an independent lifestyle with unimpeded and pain-free ambulation. Complications will be inevitable, especially in that p…
- Synchronous Closure of a Large Medial Perforator-Based Scip Free Flap Donor Site Using an Ipsilateral Lateral Perforator-Based Scip Propeller Flap (Reply).
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In Pursuit of the "Perforator" in the Perforator Skin Flap.
Another congress of the World Society for Reconstructive Microsurgery (WSRM) this past year in Bologna was magnificent not just for the presentation of so many keynote lectures by the giants of our field nor the novel and innovative ideas s…
- Basic Laws of Physics: Applied Plastic Surgery.
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Synchronous Closure of A Large Medial Perforator-Based Superficial Circumflex Iliac Artery Perforator Free Flap Donor Site Using an Ipsilateral Lateral Perforator-Based Superficial Circumflex Iliac Artery Perforator Propeller Flap.
A superior advantage of the superficial circumflex iliac artery perforator flap is that any donor site residue can easily be hidden by clothing. Usually designed as narrow or moderate-sized flaps based on medial perforators of the superfici…
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The Umbilicus Free Flap.
The morbidly obese patient has few reliable options if a single free flap is required for large surface area coverage. Usually, a latissimus dorsi muscle would be the primary option. If unavailable, a transverse-oriented abdominal flap base…
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The use of smartphone thermography to more safely unmask and preserve circulation to keystone advancement flaps in the lower extremity.
[BACKGROUND] The keystone perforator flap is a simple, popular form of advancement flap that can solve many defects of the lower extremity that can avoid consideration of a microsurgical tissue transfer. The actual circulation to this local…
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Gillies and Dunedin: The birthplace of modern plastic surgery.
Dunedin is a small city located in the southeastern part of the South Island of New Zealand, an enclave found in the Southern Hemisphere halfway around the World. How possibly would anyone consider such a remote place to be the birthplace o…
- The Facilitator.
- PGY∞.
- 24.
- Rational Treatment of the Basal Cell Carcinoma or Confessions of A "Part-Time Dermatologist".
- The Difficult Surgeon.
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Abdominoplasty as the patient impetus for selection of the deep inferior epigastric artery perforator free flap for knee coverage.
Extensive wounds about the knee can rarely be covered with local or even regional flaps. Free flaps often then become obligatory. Many factors will determine the surgeon's selection of the best donor site. Yet the patients' concerns with do…
- 20m.
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An introduction to the chimeric deep inferior epigastric artery perforator (DIEAP)-rectus abdominis muscle flap.
A muscle perforator flap is a unique form of fasciocutaneous flap whose circulation is derived from musculocutaneous perforators, but without including any muscle. This anatomic relationship intuitively should readily allow the formation of…
- The hospitalist plastic surgeon.
- The old, the young, and the computer or musings of a plastic surgery curmudgeon.
- The Venus de Milo: an icon of reconstructive surgery and the American Society of Plastic Surgeons.
- Recertification: now a reality.
- The plastic surgeon of the 20th century.
- Plastic surgeon: asset or mere mercenary?
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Simplified nomenclature for compound flaps.
The unique niche for compound flaps is their potential role for the repair of massive defects that demands the simultaneous restoration of multiple, missing tissue types. These complex flaps can be sorted into two major classes, and their s…