Scrotal skin has unique cosmetic and functional features that make its reconstruction difficult. Coverage of the testicles and constituting a good cosmetic appearance are major expectations from a successful reconstruction. Usually flaps are the choice for scrotal reconstruction, but every single flap has its own characteristics. In our series, between January 2006 and January 2010, the medial circumflex femoral artery perforator flap was used in 7 male patients for scrotal coverage after Fournier gangrene. Six flaps were raised based on a single perforator from the gracilis muscle; however in one flap 2 perforators were used. Flaps were carried to the defect either by transposition or by V-Y advancement. Donor areas were closed directly in all patients, and stable scrotal coverage was achieved with an acceptable scrotal contour and cosmesis. No major complication was seen due the perforator flap surgery, in 2 patients wound dehiscence were noted and they healed by secondary intention or by secondary suturing. For scrotal reconstruction, the medial circumflex femoral artery perforator flap is a good option with its good mobility, thinness for scrotal contour, possibility for muscle preservation, and direct closure of the donor site. All these advantages can be accomplished in 1 procedure.

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

En sık görülen kapak tümörü 39 (%29,5) olguyla melanositik dermal nevüs idi. Fibroepitelyal polip 36 (%27,3) olguda, ksantelezma 23 (%17,4) olguda, epidermal inklüzyon kisti 14 (%10,6) olguda ve seboreik keratoz 12 (%9) olguda izlendi. Kadınlarda en sık gözlenen tümör melanositik dermal nevüs iken (%34,61), erkeklerde en sık fibroepitelyal polip (%35,18) izlendi. Sonuç: Çalışmamızda kapaklarda en sık gözlenen benign tümör melanositik nevüs iken, en sık malign tümör bazal hücreli karsinom olarak saptandı. Kapak tümörleri büyük oranda benign lezyonlar olarak tespit edildi. Benign tümörler 40-50 yaş grubunda sık gözlenirken, malign tümörler 60-70 yaş arasında daha sık gözlendi.

Despite versatility of the forearm as a flap source, anterior interosseous flaps from the dorsal forearm has not gained popularity among other alternatives. In our clinical experience, we investigated the feasibility of free anterior interosseous flap as a donor site. Between January 2002 and January 2006, 10 free anterior interosseous flaps were used in 10 consecutive cases. Five flaps were used for coverage of the defects of the hand and fingers, whereas another 5 flaps were used for head and neck defects. In all cases, this flap was selected when a thin flap was needed. All flaps survived completely except 1, where partial marginal necrosis was seen, and this necrosis was healed by secondary intention. Only 2 donor sites could be closed directly, and the others were skin grafted. Free anterior interosseous flap is a useful alternative with distinct advantages: it is a thin flap, major extremity arteries are preserved, the vascular pedicle is long enough and caliber is satisfactory for microsurgery, composite flaps with tendon, bone, nerve, and muscle are available, and it has a good texture, especially for hand defects. The 2 major disadvantages are visible donor area scar and technically demanding dissection. In conclusion, free anterior interosseous flaps are a good selection and should be in the armamentarium of a microsurgeon, when a thin flap is needed for hand and head and neck reconstruction.

No abstract

Background and Design: A retrospective study on the clinical, demographic and pathological features of keratinous cysts of the whole body seen in the Central Anatolia Region of Turkey. Material and Methods: We retrospectively analyzed the medical records of patients with keratinous cysts of the body who attended Çankırı State Hospital between 2011 and 2012. Age, gender, histologic diagnosis, anatomic localization and diameter of the lesion were recorded. The pathology specimens were reevaluated and the histopathologic diagnoses were confirmed. Results: The mean age of the 418 patients was 42.3 years. Hundred and sevety-four of them (41.6%) were female and 244 of them (58.4%) were male. Epidermal inclusion cysts (60.8%) were more common than pilar cysts (39.2%). The mean diameter of the cysts was 13.8 mm, pilar cysts (16.3 mm) were larger than the others. The patients with pilar cysts were older with the mean age of 45.8 years. The scalp was the most commonly affected site (44.3%), predominantly with pilar cysts (84.8%) and with female predominance. Pilar cysts were seen in females more often with the percentage of 62.8. Male predominance was detected for all body sites except for the scalp with the female

In a patient with a high-voltage electrical burns, the extent of burning is greatest at the entrance and exit points of the electric current. As the exit point is usually the ankle and/or foot, these areas may be the most severely damaged. As local tissue is limited in this region, free tissue transfer is usually required for reconstruction. Eleven anterolateral thigh free flaps were placed for the reconstruction of foot and ankle defects caused by electrical burns. When the defects were large, we placed the flaps with two or three perforators. In six patients, recipient vessels were prepared in the trauma region or immediately adjacent thereto. Reconstructions were performed at an average of 23.18 days after the burns, and the average hospitalization time was 42.27 days. Patients with burns on the dorsum of the foot often required toe amputations. In patients who underwent direct reconstruction (without debridement), re-operations were required because of graft loss in other burnt areas. The foot and ankle are the regions most damaged by electrical burns. Vessels in the trauma zone or immediately proximal thereto can serve as recipient vessels. Even when the defect is sizeable, a large anterolateral thigh flap with multiple perforators can be harvested. No vascular problem was encountered during early or late reconstruction. The free flap is very reliable when used to reconstruct foot tissue defects caused by electrical burns.