On the basis of the results, selection of the most suitable mode of examination depending on the characteristics of flap is recommended.

Extended pectoralis major flaps have a wide range and more stable blood flow, so they are thought to be useful in situations in which free flaps cannot be used for a variety of reasons.

Summary:A postoperative aerodigestive fistula is one of the rare but critical complications after esophagectomy, and management is challenging. The essential keys to successful treatment of these fistula are thorough debridement and complete closure followed by separation of the respiratory and digestive tract. We present a case of a recurrent bronchoesophageal fistula between the left main bronchus and neo esophagus, which was successfully treated through a contralateral approach. The fistula was debrided and closed primarily through a right thoracotomy, and the interposition of a pedicled latissimus dorsi musculocutaneous flap from the right side was carried out. The patient was able to resume oral feeding at 16th postoperative day.

Adults with Down syndrome are more prone to develop intellectual, physical, and psychological disorders than their pediatric counterparts. It is pertinent to prevent the occurrence of severe complications in these patients. This case demonstrates the importance of support, regular follow‐up, and wound management in self‐care of adults with Down syndrome.

A congenital nasal septal defect involving vomeral bone is a rare nasal anomaly, and few reconstructed cases have been reported. Reconstruction of the nasal septum using the outer table of skull to allow the use of glasses was performed. The patient's postoperative course was uneventful, and the patient was discharged on the tenth postoperative day. A transferred bone remains and shows no deviation to the right or left in the ninth postoperative month. The tubercle of the nasal part remains, and the patient is satisfied with the cosmetic result 9 months postoperatively. The timing of the operation and the surgical procedure are discussed.

In plastic surgery, hyperbaric oxygen therapy is used to promote healing of intractable ulcers caused by severe diabetes mellitus, peripheral circulatory disorders, and severe scald burns. We performed hyperbaric oxygen therapy to improve blood flow disorders of transferred flaps and reported the utility of and problems with this method. We performed hyperbaric oxygen therapy for 10 patients with postoperative blood flow disorder after flap transfer. All cases were reconstruction using pedicled flaps. Subject disorders were intractable ulcers with myelitis in three cases, decubitus ulcers in three cases, gas gangrene in one case, injury in one case, hair loss in one case, and defect after tumor resection in one case. Among the 10 patients for whom we performed hyperbaric oxygen therapy, eight experienced local chronic inflammation or systemic wound healing protraction factors. The transferred flaps in 4 of 10 patients treated with hyperbaric oxygen therapy were salvaged, and the diseases were cured. In one patient, the flap was saved; however, myelitis symptoms were caused by an intramedullary bone screw. The other five patients showed epidermal or adiposal partial necrosis of the transferred flap and closed wounded area. We performed hyperbaric oxygen therapy for 10 patients with unstable flap blood flow. A therapy effect was apparent in all cases, and supplemental surgical procedures were not required in five cases. Hyperbaric oxygen therapy is a useful flap salvation method for institutions that have access to hyperbaric oxygen devices.