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The authors contribute three new flap designs to enhance the versatility of the posterior auricular flap. These are the superiorly and inferiorly based twisted island flaps and the posterior auricular propeller flap.

with the tip of the catheter being close to the median nerve (Fig 1). In the postoperative period, ropivacaine 2 mg/ml in a 200 ml bag with a continuous outflow of 5 ml/h (10 mg/h), bolus 5 ml (10 mg) and lock out period 60 min, is delivered by an electronic pump for 3 days. Should the analgesia be inadequate, the patient is allowed to deliver additional boluses. Adequate placement of the catheter is confirmed if the patient reports paraesthesiae in the median and radial nerve territories, once the brachial block has resolved. The advantage of this procedure is to achieve analgesia in two different nerve territories by means of a single catheter.

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