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Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (4 followers)
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Epileptic Disorders     Hybrid Journal   (1 follower)
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EURO Journal of Transportation and Logistics     Hybrid Journal   (4 followers)
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Europaisches Journal fur Minderheitenfragen     Hybrid Journal  
European Actuarial Journal     Hybrid Journal   (2 followers)
European Archives of Oto-Rhino-Laryngology     Hybrid Journal   (3 followers)
European Archives of Paediatric Dentistry     Hybrid Journal   (1 follower)
European Archives of Psychiatry and Clinical Neuroscience     Hybrid Journal   (2 followers)
European Biophysics Journal     Hybrid Journal   (4 followers)
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European Clinics in Obstetrics and Gynaecology     Hybrid Journal   (3 followers)
European Food Research and Technology     Hybrid Journal   (8 followers)
European Journal for Education Law and Policy     Hybrid Journal   (5 followers)
European Journal for Philosophy of Science     Partially Free   (4 followers)
European Journal of Ageing     Hybrid Journal   (7 followers)
European Journal of Applied Physiology     Hybrid Journal   (5 followers)
European Journal of Clinical Microbiology & Infectious Diseases     Hybrid Journal   (7 followers)
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European Journal of Law and Economics     Hybrid Journal   (105 followers)
European Journal of Nuclear Medicine and Molecular Imaging     Hybrid Journal   (5 followers)
European Journal of Nutrition     Hybrid Journal   (16 followers)
European Journal of Orthopaedic Surgery & Traumatology     Hybrid Journal   (4 followers)
European Journal of Pediatrics     Hybrid Journal   (7 followers)
European Journal of Plant Pathology     Hybrid Journal   (2 followers)
European Journal of Plastic Surgery     Hybrid Journal   (2 followers)
European Journal of Population/Revue europĂ©enne de DĂ©mographie     Hybrid Journal   (3 followers)
European Journal of Psychology of Education     Hybrid Journal   (6 followers)
European Journal of Trauma and Emergency Surgery     Hybrid Journal   (8 followers)
European Journal of Wildlife Research     Hybrid Journal   (5 followers)
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European Journal of Plastic Surgery    [4 followers]  Follow    
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
     ISSN (Print) 1435-0130 - ISSN (Online) 0930-343X
     Published by Springer-Verlag Homepage  [2187 journals]   [SJR: 0.227]   [H-I: 13]
  • Management of ear keloids using custom-molded pressure clips: a
           preliminary study
    • Abstract: Background The application of mechanical pressure by compression devices has gained popularity in the treatment of keloid scars. In this present study, we analyze the long-term efficacy of our custom-molded pressure clip for ear keloids. Our secondary objective is to identify risk factors for the failure of the treatment in the group of the recurrence. Methods The patient group consisted of 9 men and 19 women with a mean age of 27 years and a mean follow-up of 8.5 years. For evaluation of the scars, scoring ratings, Patient and Observer Scar Assessment Scale (POSAS), and SF8-questionnaire have been used. Results Follow-up observations showed that 71 % were treated successfully. There were significant differences in the Fitzpatrick scale, cause of the ear keloids, overall opinion, and openness for re-treatment between the recurrence and nonrecurrence group. Furthermore, treatment with our custom-molded pressure ear clip resulted in a statistically significant improvement of all the item scores of the POSAS in both the patient and observer scales. Severe complications such as infections or necrosis were not noted. Conclusions In this study, we show that the results of adjuvant pressure therapy with our custom-molded ear clips are comparable with the recurrence rates of other studies recently published. The strength of this study is the long follow-up. Level of Evidence: Level III, therapeutic study
      PubDate: 2014-05-01
  • Flap reconstruction in two patients with rare blood coagulation disorders
    • Abstract: Abstract Coagulation disorders can be classified into two types: excessive bleeding and excessive clotting. Furthermore, the severity of the coagulation disorders can vary significantly among patients. We evaluated two relatively rare cases involving factor XIII subunit deficiency and antiphospholipid syndrome (APS) with concomitant systemic lupus erythematosus (SLE) in two patients undergoing flap reconstructions after tumor excision. In the patient with excessive bleeding as a result of a factor XIII subunit deficiency, flap necrosis occurred from a large subcutaneous hematoma that pressed on the perforator pedicle. Normal clotting function was restored during the surgery by administering a factor XIII preparation (Fibrogammin® P). The patient with excessive clotting as a result of APS and SLE suffered necrosis of the flaps after undergoing radial forearm free flap (RFFF) and pedicled pectoralis major musculocutaneous (PMMC) flap operations. With clotting factor deficiencies, there are patients in whom no evidence of a coagulation disorder exists preoperatively. It is important for surgeons to pay close attention to the potential for coagulation disorders patients and to consult with specialists promptly when indicated. Level of Evidence: Level V, risk/prognostic study.
      PubDate: 2014-05-01
  • The pattern of hand injuries in amateur cricket
    • Abstract: Background Cricket is a sport in which hand injuries occur commonly, and yet the only players allowed to wear protective gloves are the batsman and wicketkeeper. This study aims to analyse the pattern of hand injuries occurring at the amateur level of the game. Methods A prospective analysis was performed of all cricket hand injuries presenting to a specialist plastic surgery unit over the course of 3 months. Data was collected on the types, mechanisms and sites of injury, as well as their distribution amongst different playing positions. Results There were a total of 28 injuries, the majority of which were sustained whilst fielding (n = 22), with only five injuries occurring in batsmen or wicketkeepers. Twenty-three injuries were sustained by way of a direct blow or axial load to the fingers, with the ulnar digits and thumb most commonly affected. There were 20 fractures and eight dislocations, and 25 were associated with soft tissue injury. The distal phalanx was the most frequently injured site (n = 11), followed by the distal interphalangeal (DIP) joint. Most of the injuries were suitable for conservative management with only three patients requiring bony fixation. Only 15 of the 27 players stopped playing at the time of their injury, with significant delay to presentation to our unit in ten cases. Conclusions Our survey highlights that hand injuries are common amongst amateur cricket players, and that a lack of protective gloves, improper catching technique and delay in seeking treatment may be important factors. Level of Evidence: Level IV, diagnostic study.
      PubDate: 2014-05-01
  • Superficial circumflex iliac artery perforator flap in a case of
           Fournier’s gangrene
    • Abstract: Abstract Fournier’s gangrene (FG) is a rare and acute form of necrotizing fasciitis involving the perineal region and genitalia with occasional extension up to the abdominal wall. The etiology of the FG is only partially understood, but in the majority of cases, aerobic and anaerobic bacteria are involved. FG is characterized by mortality rate ranging from 15 to 20 %, and for this reason, the disease must be treated aggressively. The key of management, after the emergency debridement of necrotic tissue, is a functional and esthetic reconstruction. We reported a case of FG in which the wide scrotal skin and fascia loss was managed with a propeller superficial artery perforator flap. Level of Evidence: Level V, therapeutic study.
      PubDate: 2014-05-01
  • The exposed implant in breast reconstructive surgery: a strategy for
           salvage using acellular dermal matrix and platelet-rich plasma
    • Abstract: Abstract The use of breast implants in breast reconstructive surgery is currently the most popular choice among surgeons. Following the introduction of acellular dermal matrices in breast reconstruction, some surgeons proposed their use also in complication repair surgery. In this work, we present our method of treatment of the exposed breast implant using an acellular dermal matrix (Strattice) combined with a series of mesotherapy with platelet-rich plasma (PRP). A group of five women, all treated with radiotherapy, who had a breast implant exposure following post-oncological reconstructive surgery were treated in our unit in the period from March 2011 to November 2012. Only those patients who presented an extrusion area less than 3–3.5 cm, without evident signs of implant infection, were included in this study. After perilesional tissue excision and pocket lavage, the acellular dermal matrix was fixed in the pocket and a new implant was positioned. After the surgery, patients underwent a four-session cycle of mesotherapy with autologous PRP. In four patients, the implant exposure was successfully resolved using the acellular dermal matrix without postoperative complications. One patient developed a prosthesis infection which required its explant and subsequent reconstruction with latissimus dorsi flap. The surgical technique that we describe is proposed, in selected cases, as an alternative to the classical procedures for those patients who are undecided about undergoing further surgery, with long time and demanding demolition. Further studies involving larger case series are necessary. Level of Evidence: Level V, therapeutic study.
      PubDate: 2014-05-01
  • Uniform full-thickness and thick split-thickness skin graft harvest from
           the groin: the quickest and convenient approach
    • PubDate: 2014-05-01
  • Circum-alar flap for full-thickness alar rim defect of the nose
    • Abstract: Abstract Various methods of nasal alar reconstruction has been described in the medical literature but very few for defects involving the alar rim. These are single- or multistage procedures and have their pros and cons. The authors have designed a novel technique for alar rim defects by advancing a flap alongside the alar crease. This flap is simple, easy to execute and provides desirable results for full-thickness defects in a single-stage procedure. Level of evidence: Level V, therapeutic study.
      PubDate: 2014-05-01
  • Review of implant sizes in 146 consecutive asymmetrical augmentation
    • Abstract: Background Breast and chest asymmetries have been reported with varying incidences in patients requesting augmentation mammoplasty. However, there is a paucity of information regarding the sizes of different implants used, their relative distribution on either side, complications and revision rates in this cohort when compared with primary augmentation mammoplasty using similar size implants. Methods A retrospective data using the Excel spreadsheet was performed. All patients had muscle splitting technique for augmentation mammoplasty in asymmetrical breasts. Patients requiring augmentation with mastopexy, sternal notch to nipple areolar complex level discrepancy of more than 1 cm, and patients having same size implants were excluded from the analysis. Insignificant asymmetries, not noticed by patients, were not chosen for two different size implants. Patients, who chose two different size implants for mammoplasty, were divided into three groups based on the relative difference in the size of different implants used. Results A total of 164 patients had primary augmentation mammoplasty between 2005 and 2011, using two different size implants for augmentation mammoplasty in asymmetrical breasts. Mean age of the patients (n = 164) was 29.2 ± 7.79 years (range 18–50), and 46 (28.0 %) were smokers. Complete data on differential implant sizes used was available in 146 patients. Mean size of the implant on the right (n = 146) was 346.27 ± 70.581 cc (range 220–605). The mean size of the implant on the left (n = 146) was 333.46 ± 74.419 cc (range 200–655). Out of these 146 patients, 46 (31.5 %) patients had larger implants on the left as compared to 100 (68.5 %) patients on the right. Mean volume difference between the two sides when larger implants were used on left side was 55.76 ± 37.785 cc as compared to 44.35 ± 26.166 cc when larger implants were used on the right side. Low profile combination was used in 2.73 %, moderate size implant combination was used in 9.58 %, mixed profile combination was used in 3.42 % and high profile combination was used in 84.24 % of the patients. Overall revision surgery was performed in three patients (1.8 %), and out of these three revisions, only one (0.6 %) patient needed surgery for volume correction. Conclusions Primary augmentation mammoplasty in asymmetrical breasts using differential size implants is a procedure with low revision rates, provided that strict exclusion criteria are used along with adequate informed consent in this group. Level of Evidence: Level IV, risk/prognostic study.
      PubDate: 2014-05-01
  • Sessile and pedunculated facial keloid scar: a comparison of response to
           intralesional triamcinolone injection
    • Abstract: Background Intralesional injection of steroid is a reported treatment method for keloids. There are no prior studies comparing the response of sessile and pedunculated keloids to triamcinolone injections. Methods Fifty-two patients who attended the Maxillofacial Unit of the National Hospital Abuja between March 2006 and February 2010 for treatment of facial keloids were the subjects of this study. They were distributed into two groups. Twenty-six people in group A had sessile keloid scars, and 26 in group B presented with pedunculated keloid scars. Fortnightly injection of 10 mg of triamcinolone per centimetre of keloid lesion was administered on both groups for a maximum of 6 months. Results Values of proportion of flattened lesions in each group were estimated. Flattening of lesion was achieved in 23 (88.46 %) cases in group A, with no such change observed in 3 (11.54 %). None (0 %) of the lesions in group B showed complete flattening after therapy. Conclusions Intralesional triamcinolone injection caused flattening of sessile keloid lesions, but does not have such effect on pedunculated lesion. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2014-05-01
  • Pituitary gland malfunction after aesthetic breast surgery
    • PubDate: 2014-05-01
  • Jet-assisted fat transfer to the female breast: preliminary experiences
    • Abstract: Background Nowadays, autologous fat grafting is used as a versatile tool for distinct touch-ups after performed breast reconstruction or aesthetic augmentation. Different approaches of fat harvest, filtering, and reinjection have been described in last three decades. After the first report in 2010, the Berlin Autologous Lipotransfer (BEAULI) method became one of the latest popular techniques in the field of large volume fat grafting. Preliminary experiences with the rising jet-assisted fat transfer in a large case series of two specialized European centers are presented. Methods Retrospective analysis enrolled over 167 female nonsmokers with reconstructive or aesthetic indications treated with at least one procedure according to the standardized protocol of the BEAULI™ technique from February 2010 to June 2012. Patients with weight changes >5 kg and endocrine or cardiovascular comorbidities have been excluded. Demographics and items of the treatment (i.e., grafted volumes per procedure) were enlisted for evaluation. The first outcome has been estimated based on complications rate, pain report (VAS score), and digital photographs after at least 6 months of follow-up. Results The included 132 patients (240 breasts) had a mean age of 39.7 years and underwent 487 autologous jet-assisted fat transfer procedures with minor complications (5.35 %) like tiny oil cysts formations or hematoma of the donor site. Low postoperative pain (88.6 % with VAS 1 to 4) has been reported during the first week, and final aesthetic evaluation showed good to excellent results. We observed a higher frequency of procedures, especially in irradiated patients (>3.62) compared to the rest of reconstructive cases (>2.78). The presented data helped us to differentiate the treatment according to the respective indications (reconstructive vs. aesthetic) and to optimize our intern protocol. Conclusions Water-jet-assisted liposuction with consecutive immediate mammary fat injection is a procedure with a short hospitalization and low complication rate. Based on the preliminary results in the use of the BEAULI™ technique for breast reconstruction and aesthetic augmentation, the authors presume that it can be safely applied for these specific patient groups. Although further studies including long-term follow-up are certainly required to constantly control and compare the presented method to other autologous fat grafting techniques. Level of Evidence: Level III, therapeutic study.
      PubDate: 2014-05-01
  • Primary thinning of the anterolateral thigh flap in Caucasians is a safe
    • Abstract: Background The anterolateral thigh (ALT) perforator flap is a well-described and versatile flap, regularly used for resurfacing and reconstructing soft tissue defects, but it is often too bulky to produce an aesthetically satisfactory result. Although primary thinning of the ALT has been successful in Eastern populations, studies have demonstrated that this may be inadvisable in Caucasians. This is the biggest clinical study demonstrating the clinical safety of primary thinning of ALT flaps in Caucasians. Methods A retrospective analysis was performed between January 2009 and August 2011 on 57 patients (mean age 43) undergoing ALT free flap reconstruction by three surgeons. They were all thinned via sharp dissection using loupe magnification except for 1–2 cm around the perforator by removing the larger fat globules of deep fascia and preserving the superficial fat layer. The resultant flap thickness was approximately 6 mm. Results In 77 % of cases, the flap was used for lower limb, 16 % for upper limb and 7 % for head and neck reconstruction. The mean flap surface area was 124 cm2. There was one flap loss (1.8 %) and three flaps returned to theatre for perioperative complications. Conclusions Careful primary thinning of ALT flaps is safe in Caucasian populations and can achieve improved cosmetic results. Level of Evidence: Level IV, risk/prognostic study.
      PubDate: 2014-04-13
  • The facial keloid: a comparison of treatment outcome between intralesional
           steroid injection and excision combined with radiotherapy
    • Abstract: Background Various conflicting claims of superiority of particular treatment modalities or regimens abound in the literature for the treatment of keloid. This study was designed to determine the more reliable method to flatten keloid between intralesional triamcinolone injection and excision combined with radiotherapy. Methods One hundred and seven consecutive patients presenting with facial keloids were alternately allocated into two groups. Group A was managed by intralesional injection of 10 mg per linear centimetre of keloid scar, fortnightly for a maximum of 6 months, while group B underwent excision combined with 16 Gray of radiation administered in four fractions, in as many consecutive days, commencing immediately preoperatively. Results Flattening of lesion was achieved in 81 % of scars managed with triamcinolone, while 58 % of those treated by excision combined with radiotherapy remained flat during the course of study. The difference between the two results was statistically significant (P < 0.01). Conclusions Intralesional injection of triamcinolone is significantly more efficacious than excision combined with radiotherapy in the management of facial keloids. Level of Evidence: Level II, therapeutic study.
      PubDate: 2014-04-05
  • Breast reconstruction by tissue expander after radiotherapy: When the skin
           does not expand, the rib cage is at risk
    • Abstract: Background Expander-based breast reconstructions in irradiated chest walls have been documented to result in an increased risk of complications including skin necrosis, extrusion, displacement, and capsule contracture. In this article, thoracic cage deformity and rib fractures were investigated following breast reconstruction by tissue expansion. Methods A prospective series of 89 immediate postmastectomy tissue expander breast mound reconstructions in 81 patients, the patients were divided into two groups, reconstruction with radiotherapy (n = 37) and without radiotherapy (n = 52). The patients were observed for any sudden severe pain and development of capsule contracture; intraoperative assessment was done first during expander insertion then after exchange of expander with implant to detect any deformity of the chest wall. CT scans were done as an objective way to support the clinical findings in patients who developed flat or concave chest wall deformities. Results Patients who had reconstructions with radiotherapy developed severe capsular contractures causing severe pain and limitation in breast expansion in 35 % of reconstructions compared with 5.7 % in the control group. Twenty-six reconstructions (70.2 %) in the study group developed chest wall deformities; in four of them, the deformity was concave, and two patients (5.4 %) developed multiple rib fractures at the expander site. The overall rate of ribcage deformities in the control group was 32.6 %; all of them were simple flattening with no concave deformities. No fractures were noted in the control group. Conclusions Expander-based breast reconstruction in combination with radiotherapy and tight unyielding overlying skin and capsule can redirect the expansion force toward the thoracic ribcage rather than the skin causing rib deformities and possible fractures. Level of Evidence: Level IV, risk/prognostic study
      PubDate: 2014-04-05
  • Management of large dorsal diffuse plexiform neurofibroma
    • Abstract: Abstract Neurofibromas are considered one of the hallmark signs of neurofibromatosis type 1(NF1). Diffuse plexiform neurofibroma is a congenital NF1-associated tumor, characterized by overgrowth and interference with function of the affected area. The rich vascular plexus associated with neurofibromas, together with their infiltrative pattern, makes them difficult to eradicate. Complications of neurofibromas are rare but include malignant transformation and potentially life-threatening hemorrhages. The use of the term “giant” to define a neurofibroma is controversial because there is no clear consensus and descriptions are limited to few case reports. We report a case of a large dorsal diffuse plexiform neurofibroma responsible for significant worsening of a patient’s quality of life. These features make us believe that the mass can be defined as “giant.” Comprehensive perioperative management, including arterial embolization of the feeding vessels and stabilization of the patient’s conditions, is required to perform a safe surgical procedure in such a complicated case. Level of Evidence: Level V, therapeutic study
      PubDate: 2014-04-02
  • Recurrent orbital squamous cell carcinoma with extension to the middle
           cranial fossa
    • Abstract: Abstract Squamous cell carcinoma (SCC) of the orbit may arise from various sources. SCC of the orbit commonly is the result of metastases or invading tumors of the paranasal sinus. Cysts of various etiologies may also give rise to orbital SCC. Last year, perhaps the first case of SCC arising from multiple cutaneous epidermoid cysts was described in the literature. While perineural spread of cutaneous SCC to the orbit has been thoroughly reported; this is not likely to be the etiology of our case. Squamous cell carcinoma arising de novo in the orbit is also exceedingly rare, and to our knowledge not described in the English-language literature. Below, we describe a unique presentation of possibly de novo squamous cell carcinoma of the orbit that was diagnosed and resected in a multidisciplinary fashion by ophthalmology, neurosurgery, and plastic surgery. Level of Evidence: Level V, diagnostic study.
      PubDate: 2014-04-01
  • Treatment of infantile hemangiomas before and after the introduction of
           propranolol: a retrospective study
    • Abstract: Background Propranolol was introduced as systemic pharmacotherapy for problematic hemangiomas in 2008 and is now considered superior to corticosteroid. Other available treatment modalities include surgery and laser therapy. In November 2008, the first patient was treated with propranolol at The Center for Vascular Anomalies, Aarhus University Hospital. The aim of this study was to compare the treatment modalities applied before and after the actual date. Methods The present study was a retrospective study of patients treated for hemangioma between 1995 and 2012 at the University Hospital of Aarhus, Denmark. Outcome measures of interest included age at referral, the extent of evaluation by different specialties, and the treatments administered. Results One hundred twenty-one patients were included in the study. The patients were divided into two groups, patients treated before (study period 1) and after (study period 2) November 2008, respectively. In study period 2, patients were referred earlier for evaluation (0.82 versus 1.91 years, p = 0.011). Fewer patients were seen by plastic surgeons in study period 2 (63.9 versus 98.8 %, p < 0.001), with more patients being referred for systemic treatment (12.9 versus 86.1 %, p < 0.001). No difference in the number of patients evaluated by dermatologists was detected (p = 0.417). In study period 2, fewer patients were treated with surgery (38.9 versus 92.2, p < 0.001) and laser therapy (13.9 versus 42.4, p = 0.003). After November 2008, more patients have been treated with systemic pharmacotherapy (4.7 versus 80.6 %, p < 0.001). Conclusion The introduction of propranolol has resulted in a decline in surgery and laser therapy at our institution. More patients are being referred for systemic pharmacotherapy due to the treatment protocol of propranolol. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2014-04-01
  • Global health inequalities in plastic surgery—addressing the
    • PubDate: 2014-04-01
  • Upper lip shortening combined with Lefort 1 maxillary intrusion: a novel
           approach to correct the long face syndrome
    • Abstract: Abstract Lip lengthening is a common characteristic of aging caused by the weakening of the fascial attachments and decrease of lip volume. We report a comprehensive combined plastic-orthognathic surgery of a long face syndrome uncharacteristically associated with a long upper lip in a 37-year-old Caucasian woman. The deformity comprised increased lower face height, vertical maxillary excess, and increased gingival display upon smiling. The long lip (30.7 mm; norm, 20.1 + 2 mm) constituted a limitation to the routine maxillary Lefort impaction because of the expected deficient display of maxillary teeth at rest and during smile. Lip shortening (5 mm) through a crescent flap was combined with maxillary impaction (6 mm), mandibular advancement (8 mm), and genioplasty (8 mm). Post-treatment results revealed normal relations between the upper lip and both the lower facial features and the dentition, at rest and during smile. Research should explore the predictability of the observed hard and soft tissue changes in similar dysmorphologies. Level of Evidence: Level V, therapeutic study.
      PubDate: 2014-04-01
  • Single-stage reconstruction of complex lateral thoracoabdominal defect
           using free tissue transfer and an arteriovenous loop
    • Abstract: Abstract Thoracoabdominal defects usually result from trauma, tumour resection, infection or they may be congenital. Reconstruction of these defects is absolutely necessary, for function preservation, especially in cases of full-thickness and complex defects. Use of flaps or combination of flaps and alloplastic materials is usually the key to a successful reconstruction. Several different methods for the reconstruction of thoracoabdominal defects have been described with very good to excellent results. We present the case of a 69-year-old patient who presented to our unit with a rapidly growing mass on the right lateral thoracoabdominal wall. After full-thickness tumour resection, the defect was reconstructed by using a free anterolateral thigh flap along with the central part of the vastus lateralis muscle and a larger surrounding part of the fascia lata. The ipsilateral greater saphenous vein was dissected to mid-calf, reversed and anastomosed to the femoral artery in an end to side fashion thus creating an arteriovenous loop which was later divided in the middle, for anastomoses with flap’s vessels. Flap survived in its entity without any complication from the donor or the recipient site. The patient had an uneventful recovery and left the hospital 7 days later. No abdominal wall herniation was noted on 3 months of follow-up. Single-stage reconstruction of complex lateral thoracoabdominal defect by using free anterolateral thigh together with a part of the fascia lata and an arteriovenous loop might be a reliable solution in cases where proper vessels are not available for anastomosis or other options are not feasible. Level of Evidence: Level V, therapeutic study.
      PubDate: 2014-03-21
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