The management of soft-tissue defects in the lower third of the leg and foot presents a considerable problem because of composite tissue defects, inadequate and tight local tissue for reconstruction, and poor circulation. Although the reverse sural flap is frequently preferred and is fairly reliable, some complications arising from the circulation may be encountered in large flaps or in diabetic patients. In the present study, we developed a new modification by supercharging the sural flap to reduce venous congestion and edema and to increase the reliability of the flap. We treated 3 patients (2 men and 1 woman) by utilizing a supercharged reverse sural flap. All flaps survived and healed uneventfully. We also suggest a new and more distinctive classification for supercharging and turbocharging, which defines the vessel type to be anastomosed and the relationship of the vessel to be anastomosed with the main vessel to the flap.
In cleft palate cases with delayed diagnosis, appropriate application of muscle repair will be sufficient for anatomic repair of VPI without any extra procedures. In addition, dynamic magnetic resonance imaging is an objective, noninvasive, reliable, and effective modality that may be used in the diagnosis and treatment of VPI without any extra investigations.
Alveolar echinococcosis (AE) is a chronic disease caused by ingestion of the eggs of the parasitic cestode Echinococcosis multilocularis (EM). In severe cases, liver transplantation (LT) may represent the only possibility of survival and cure. Patients undergoing LT associated with hepatic AE at our institution between April 2011 and October 2014 were investigated retrospectively. The clinical findings of the 27 patients who participated in the study were noted. Kaplan-Meier and chi-square tests were used to investigate the effect of these characteristics on survival and mortality. Living donor LT was performed on 20 patients (74.1%), and deceased donor LT was performed on 7 patients (25.9%). Hilar invasion was the most common indication (14 patients, 51.9%) for transplantation. The patient follow-up was 16.1 6 11.4 months, and the overall survival rate was 77.8%. Primary nonfunction developed only in 2 patients in the posttransplantation period. Six patients died during monitoring, the most common cause of death being sepsis (3 patients). The relationship between the mortality rate of the patients and the invasion of the bile duct and/or portal vein by alveolar lesions was found to be statistically significant (P 5 0.024 and P 5 0.043, respectively). According to PNM staging, when the AE disease exceeds the resectability limits, the only alternative for the treatment of the disease is LT. However, different from LT due to cirrhosis, it is extremely difficult to perform a transplantation for AE disease because of the invasive characteristics of it. In order to decrease the difficulty of the operation and the postoperative mortality, the intracystic abscess and cholangitis which occur because of AE must be treated via medical and percutaneous methods before transplantation.
Objective: The aim of this study is to present our clinical experience with rhomboid flaps.
Materials and Methods:Twenty-four patients who were operated on between January 2006 and October 2010 were included in the study. All defects were reconstructed using rhomboid flaps.
Results:Twenty-four patients were operated on for various reasons, and 26 rhomboid flaps were performed. Eleven of the 24 cases were male, and the median age of participants was 47.5 years. Eight cases were operated on under general anesthesia, and 13 were locally anesthetized; the remaining cases were operated on under regional anesthesia. In 17 cases, the defect was due to a benign or malignant tumor excision, and five cases were operated on due to burn contracture. There were no occurrences of partial or total flap necrosis or hematoma in our series.
Conclusion:Our series indicates that rhomboid flaps can be safely used to reconstruct small to moderately sized skin defects.
Freezing fat grafts in liquid nitrogen and storing them at -35 degrees C is an effective way of preserving tissue for future use, with clear superiority over other methods.
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