Excisional techniques and procedures

Surgical strategy for lower extremity skin and soft tissue defects in children – case series

“…Smaller defects can be solved with local rotational flaps. When local and technical issues interfere, such as insufficient skin elasticity 1,3,10 , length of the incision needed to mobilize the flap or tension in the suture, we can combine two opposite flaps, as the O to Z plasty 11 or the double helix flaps 2,8 , in order to close the wound without tension and to avoid long-term complications like dehiscence, distal flap necrosis or scar enlargement 11 . The O to Z plasty was the technical choice for our third patient.…”

A systematic approach to the failed plastic surgical reconstruction of the diabetic foot

“…The wound depth is critical for the procedure selection. A superficial wound can be treated with surgical debridement, non-weight-bearing, and secondary healing or skin grafting ( 2 ). For deeper wounds, a fasciocutaneous, adipofasciocutaneous, or muscle flap is indicated.…”

“…Soft tissue coverage for most diabetic foot wounds represents a challenge to the reconstructive surgeon. In our experience, patients suffering with diabetic foot and ankle soft tissue defects that require plastic reconstruction could be divided into two broad categories concerning their etiological mechanism: ( 1 ) traumatic wounds with a ‘pathological evolution’ such as degloving injuries, burns, and/or open fractures to diabetic patients and ( 2 ) chronic wounds that could be related to decubitus ulcerations in a diabetic background such as heel ‘pressure’ wounds, wounds associated with peripheral neuropathy including Charcot foot deformity or an osseous prominence with ulceration, with or without diabetic foot infections. Wounds could be associated with peripheral arterial disease or vascular insufficiency in diabetic patients.…”

“…It is common for a patient to be brought back to the operating room several times for débridement before the wound is optimized for flap coverage. Failure to have an adequately débrided wound will most likely lead to failure of any attempt at flap coverage ( 2 – 9 ).…”

Recurrent proliferating pilar tumour of the scalp mimicking squamous cell carcinoma successfully treated surgically using S-plasty

“…After excision, the wound edges are undermined, rotated in opposite orientations and advanced toward one another [ 12 ]. This method decreases the area of removed normal skin and increases the length to width ratio of the incision [ 13 ]. The wound tension is better controlled as the distribution of the tension is multidirectional.…”