Secondary Reconstruction of Recurrent Primary Intraosseous Meningioma of the Calvarium Using a Fasciocutaneous Anterolateral Thigh Free Flap

We present a patient with a primary intraosseous meningioma of the calvarium that recurred three years after initial resection and reconstruction with a free anterolateral thigh (ALT) flap. The patient re-presented with progressive swelling in the same area. Imaging confirmed aggressive tumour recurrence with both intra- and extra-cranial diseases and also extension to the ipsilateral orbit. The original anterolateral free flap was raised on anterior pedicle and further debulking of the tumour was performed. Histology confirmed widely infiltrative atypical meningioma (WHO grade II). This case highlights the benefit of using a fasciocutaneous free flap for reconstruction given the potential for tumour recurrence.

The relationship of tension and blood flow of the expanded pedicled fasciocutaneous flap in pig

Objective To evaluate the effect of wound closure tension on the blood flow of the expanded pedicled fasciocutaneous flap,so as to find the best tension for the blood supply of the flap.Methods 8 piglets,aged 9-12 months,were used.On

Single stage management of Gustilo type Ⅲ A/B tibia fractures： Fixed with nail ＆ covered with fasciocutaneous flap

PurposeTo 评估胫骨与 intramedullary 钉和 fasciocutaneous flap.MethodsFrom 2010年8月到2012年7月折断的 Gustilo 类型 III A/B 的立即、权威的管理的角色，有 Gustilo 等级 III A/B 胫骨破裂的 22 个病人与 ipsilateral fasciocutaneous 的单个阶段治疗被管理钉的拍动与铰大的 intramedullary 并且在学习被包括。损害的严厉与病人的 Ganga 医院损害严厉 score.ResultsThe 平均数年龄被计算 41 年和后续时间从六个月被变化到一年。在 22 个病人之中， 73% 是类型 III B 破裂，上面的腿在他们中的 55% 个包含了。到外科的结束的从损害的时间间隔是 8-14 h。要求第二等的过程的骨头感染的发生是 9% ；专业和次要的软织物复杂并发症率分别地是 9% 和 14% 。手足抢救率是严重更低的手足损伤的 100%.ConclusionMultidisciplinary 管理是重要的并且提供好结果。钉的 Intramedullary 和立即的拍动固定能完成早骨头联合和好软织物范围，导致在有等级 III A 与 B 胫骨破裂的病人的好结果。

Distally based perforator sural flaps for foot and ankle reconstruction

Distally based perforator sural flaps from the posterolateral or posteromedial lower leg aspect are initially a neurofasciocutaneous flap that can be transferred reversely to the foot and ankle region with no need to harvest and sacrifice the deep major artery. These flaps are supplied by a perforating artery issued from the deep peroneal artery or the posterior tibial artery, and the chainlinked adipofascial neurovascular axis around the sural/saphenous nerve. It is a versatile and reliable technique for soft-tissue reconstruction of the heel and ankle region with 180-degrees rotation. In this paper, we present its developing history, vascular basis, surgical techniques including flap design and elevation, flap variations in pedicle and component, surgical indications, and illustrative case reports with different perforating vessels as pivot points for foot and ankle coverage.

Recent advances in microvascular autologous breast reconstruction after ablative tumor surgery

Breast cancer is a ubiquitous disease and one of the leading causes of death in women in western societies. With overall increasing survival rates, the number of patients who need post-mastectomy reconstruction is on the rise. Especially since its psychological benefits have been broadly recognized, breast reconstruction has become a key component of breast cancer treatment. Evolving from the early beginnings of breast reconstruction with synthetic implants in the 1960 s, microsurgical tissue transfer is on the way to become the gold standard for post oncology restoration of the breast. Particularly since the advent of perforator based free flap surgery, free tissue transfer has become as safe option for breast reconstruction with low morbidity. The lower abdominal skin and subcutaneous fat tissue typically offer enough volume to create an aesthetically satisfying breast mound. Nowadays, the most commonly used flap from this donor site is the deep inferior epigastric artery perforator flap. If the lower abdomen is not available as a donor site, the gluteal area and thigh provide a number of flaps suitable for breast recon-struction. If the required breast volume is small, and there is enough tissue available on the upper medial thigh, then a transverse upper gracilis flap may be a practicable method to reconstruct the breast. In case of a higher amount of required volume, a gluteal artery perforator flap is the best choice. However, what is crucial in addition to selecting the best flap option for the individual patient is the timing of the operation. In patients with confirmed post-mastectomy radiation therapy, it is advisable to perform microvascular breast reconstruction only in a delayed fashion.

Nursing care of vascular crisis in a child with neck skin contracture and skin flap transplantation after burn:A case report

In this report,we aimed to summarize the nursing points of fasciocutaneous flap transplantation due to scar contracture caused by a large area of head and face scald.A 4-year-old girl suffered from wound bleeding,respiratory tract edema,and vascular crisis and was transferred to the intensive care unit after flap transplantation.The child’s scar recovered well before she was discharged,and the follow-up results were satisfactory.After recovery,she had fewer complications under careful and scientific nursing care.The nursing points were to provide a stable treatment environment through regular wound observation and strict aseptic operation;ensure the nutrition of the child;give the child personalized sedative and analgesic care;and perform anticoagulation,antispasm,and dressing change and provide warmth for vascular crisis.Dressing changes by plastic surgery specialists combined with sedation and analgesia can alleviate children’s pain,enable them to better cooperate with surgical site observation and dressing care,increase the survival rate of the skin in the surgical area,and help improve the prognosis of the child.

Vascular anatomy of fascia skin flap in leg

The fascial vessels of skin flap in leg were studied systematically and quantitatively so as to find out the survival mechanism of fasciocutaneous flap and provide morphological basis for clinical application. Methods: Thirteen legs from adultcadavers were observed and measured by dissection under operating and biological microscopes, tissue clearing, slice and imageanalysis. Results: There were four types of source artery in fascia of leg and the intermuscular septal cutaneous artery was predominant and often anstomosed as a chain. The source arteries had supra- and subfascial branches in deep fascia and the former wasmore in number and larger in diameter. In the same way, the vascular network was thicker in the suprafascial level than in the subfascial. Aa% of the deep fascia was larger than that of the superficial fascia. Conclusion: The deep fascial vasculature is the basis of the blood supply of fasciocutaneous flap in leg and the suprafascial vascular network is especially important. It is suggestedthat the fascial pedicle should be selected wilers the arterial chain exists.