Sacral defect reconstruction using a sensate superior gluteal artery perforator flap based on the superior cluneal nerves: A report of two cases

Microsurgery ◽  
2021 ◽  
Author(s):  
Takuya Iida ◽  
Yuki Isozaki ◽  
Takao Numahata ◽  
Mutsumi Okazaki
2021 ◽  
Vol 15 (9) ◽  
pp. 2268-2269
Author(s):  
Muhammad Sohaib Anwer ◽  
Faisal Waheed ◽  
Atta Ur Rehman Khan ◽  
Sana Ullah ◽  
Naeem Ul Haq ◽  
...  

Aim: To observe the outcome of closure of wide based defects by various rotational flaps for meningomyelocele defects. Study setting: Neurosurgery Department, Sheikh Zayed Hospital, Rahim yar khan Duration: From Oct 2018 to Oct 2020, Methodology: We included 15 patients with wide based myelomeningocele anomalies in the neurosurgery department, Sheikh Zayed Hospital, Rahim yar khan. Age ranged from four days to eight years. The flaw had a diameter of between 8x5cm and 12x8cm. Rotational flaps were used to restore soft tissue defects in all cases. Result: In this study, we did posterior intercostal artery perforator flap(superiorly based) in 40% patients, double rotation flap (yin yang) in 26.7% patients, superior gluteal artery perforator flap in 20 % patients and z plasty in 13.3 % patients. Regarding complications, 2 (13.3%) individuals had a superficial wound dehiscence. One individual (6.7%) developed necrosis of the distal portion of the flap, which was conventionally handled. Postoperatively, no neurosurgical problem occurred. After an average of 6 months, no patient experienced reappearance or dural sac herniation. Conclusion: Restoration of large meningomyelocele defects using local rotational flaps is a secure and reliable approach for abnormalities in the lumbosacral region. Keywords: Meningomyelocele, rotational flaps


2018 ◽  
Vol 9 (2) ◽  
pp. 178-183
Author(s):  
Vikas Kakkar ◽  
◽  
Gurlal Singh Pura ◽  
Harpreet Singh ◽  
Balcharan Singh Bajwa ◽  
...  

2020 ◽  
Author(s):  
Zhangcan Li ◽  
Dawei Zheng ◽  
Jian Zheng ◽  
Weiya Qi ◽  
Qiang Qi ◽  
...  

Abstract Objectives: This paper describes imaging and anatomical features, in order to assess the feasibility of superficial circumflex iliac artery perforator (SCIP) flap with a single-pedicle bilobed design for multi-digit skin and soft tissue reconstruction in pediatric patients.Methods: A total of 7 pediatric patients who were being treated with free single-pedicle bilobed SCIP flap reconstruction for multi-digit defects were included in this study. The details of the clinical features were collected, and the following were successively analyzed: the preoperative Computed Tomographic Angiography (CTA) and Color Doppler Sonography (CDS) examinations for flap design, the intraoperative anatomy for perforator vessel, defect reconstruction and interphalangeal range of motion (ROM) and tactile sense, pain sense and two-point discrimination recovery results.Results: CTA and CDS performed preoperatively could accurately and rapidly identify the position, location and course of the SCIP flap. All wounds healed by the first follow-up and no complications occurred at the follow-up visit. All flaps survived, the patients achieved proximal interphalangeal joint (PIP) ranges of motions (ROM) from 80 to 100 degree and distal interphalangeal joint (DIP) ROM from 65 to 80 degree. The tactile sense and pain sense recovered, and average of the two-point discrimination scores was 9.3mm (range 7-12mm). The donor area was primarily sutured with good scar concealment in the underwear region.Conclusion: CTA and CDS performed preoperatively are accurate and intuitive methods for assessing the location and course of SCIP. The SCIP flap is highly suitable for pediatric patients due to its small caliber, specific functional and aesthetic benefits. It can be designed in a lobulated fashion in order to repair two or more wounds during one surgery. We suggest that the free single-pedicle bilobed SCIP flap should be considered an optimal choice for multi-digit defect reconstruction in pediatric patients in the clinic.


2002 ◽  
Vol 34 (4) ◽  
pp. 257-261 ◽  
Author(s):  
A.-M. Feller ◽  
I. Richter-Heine ◽  
K.-D. Rudolf

2018 ◽  
Vol 17 (2) ◽  
pp. 106-112
Author(s):  
Sun-June Park ◽  
Kyeong-Tae Lee ◽  
Byung-Joon Jeon ◽  
Kyong-Je Woo

Pedicled perforator flaps (PPFs) have been widely used to treat pressure sores in the gluteal region. Selection of a reliable perforator is crucial for successful surgical treatment of pressure sores using PPFs. In this study, we evaluate the role of magnetic resonance imaging (MRI) in planning PPF reconstruction of pressure sores in the gluteal region. A retrospective chart review was performed in patients who had undergone these PPF reconstructions and who had received preoperative MRI. Preoperatively, the extent of infection and necrotic tissue was evaluated using MRI, and a reliable perforator was identified, considering the perforator location in relation to the defect, perforator size, and perforator courses. Intraoperatively, the targeted perforator was marked on the skin at the locations measured on the MRI images, and the marked location was confirmed using intraoperative handheld Doppler. Superior gluteal artery, inferior gluteal artery, or parasacral perforators were used for the PPFs. Surgical outcomes were evaluated. A total of 12 PPFs were performed in 12 patients. Superior gluteal artery perforator flaps were performed in 7 patients, inferior gluteal artery perforator flaps were performed in 3 patients, and parasacral perforator flaps were performed in 2 patients. We could identify a reliable perforator on MRI, and it was found at the predicted locations in all cases. There was only one case of partial flap necrosis. There was no recurrence of the pressure sores during the mean follow-up period of 6.7 months (range = 3-15 months). In selected patients with gluteal pressure sores, MRI is a suitable means for not only providing information about disease extent and comorbidities but also for evaluating perforators for PPF reconstructions.


Microsurgery ◽  
2010 ◽  
Vol 30 (5) ◽  
pp. 339-347 ◽  
Author(s):  
Ariel N. Rad ◽  
Jaime I. Flores ◽  
Roni B. Prucz ◽  
Sahael M. Stapleton ◽  
Gedge D. Rosson

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