Journal of plastic, reconstructive & aesthetic surgery : JPRAS
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J Plast Reconstr Aesthet Surg · Jan 2006
Versatility of the sural fasciocutaneous flap in the coverage of lower third leg and hind foot defects.
Reconstruction of soft tissue defects of the lower third of the leg, the heel and the hind foot remains a challenge. The distally based sural artery fasciocutaneous flap has been used effectively to resurface these defects. In many instances, it has obviated the need for free tissue transfer. ⋯ The distally based superficial sural artery flap is a versatile, reliable procedure, useful in reconstruction of lower third leg, heel, malleoli and hind foot defects. The surgical technique is safe, of short duration and provides alternative to microsurgical reconstruction.
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J Plast Reconstr Aesthet Surg · Jan 2006
Case ReportsSalvage of the lower extremity free flap using cross-leg venous repair.
This retrospective study was designed to evaluate a salvage technique for free flaps suffering venous congestion by using a cross-leg vein repair in patients with venous-impaired lower extremities. Four free flap reconstructions were performed using the latissimus dorsi muscle to reconstruct soft tissue defects in the lower extremity. The recipient artery was confined to the ipsilateral leg and the venous anastomosis was performed with a long saphenous vein from the contralateral side. ⋯ All flaps survived after pedicle division without venous congestion. There were no complications such as joint stiffness or donor site morbidity except for a linear scar. The cross-leg venous repair is a refinement of a salvage procedure for compromised free flaps used in the reconstruction of severe soft tissue defects in vascularly compromised lower extremities.
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J Plast Reconstr Aesthet Surg · Jan 2006
Randomised clinical trials in plastic surgery: survey of output and quality of reporting.
Randomised clinical trials (RCTs) are considered the best level of evidence when evaluating interventions. Report quality is often used as a surrogate measure of methodological quality, with poorly reported trials assumed to be poorly conducted. To address this problem the CONsolidated Standards of Reporting Trials (CONSORT) statement was published, encouraging authors to explicitly report certain items of information. ⋯ This study indicates the annual output of plastic surgery RCTs is increasing and a variety of topics are covered. However, reporting of certain key items is inadequate. Awareness of the CONSORT statement and more attention to the quality of reporting may improve matters.
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J Plast Reconstr Aesthet Surg · Jan 2006
Case ReportsDelayed leech-borne infection with Aeromonas hydrophilia in escharotic flap wound.
Medicinal leeches (Hirudo medicinalis) are commonly used in plastic surgery for the salvage of congested flaps and replanted parts compromised by venous congestion. Infection associated with leech therapy is a documented complication of leech application, with reported incidences ranging from 2.4 to 20% [De Chalain TM. ⋯ J Reconstr Microsurg 1996;12(3):165-72.1]. We describe a case of delayed leech-borne infection, from the escharotic portion of a latissimus dorsi flap, which developed several days after stopping leech therapy for venous congestion in a reconstructed breast.