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The medial gastrocnemius flap

This classic muscle flap is now being used with increasing frequency following revision knee joint surgery. Following the Nahai and Mathes classification, the gastrocnemius muscle is a Type I muscle with a single dominant vascular pedicle (Figure 1). The gastrocnemius...

Auricular reconstruction: flip-flop flap

Describing an approach to the straightforward and reliable flip-flop axial flap for reconstruction of the conchal bowl subunit of the auricle. The ‘flip-flop’ flap describes an axial subcutaneous island flap lying between the auricular sulcus and mastoid process. The flap...

The double-half bilobed flap or traditional bilobed flap – which is better?

Reconstruction of the nasal tip following ablative surgery can be taxing. The nasal tip is a very visible area with largely immovable skin and reconstruction needs an appreciation of the various sub-units to achieve best results. The traditional superiorly based...

Review of free flap use in burns

The authors looked at 346 studies of the use of free flaps in burns and undertook a systematic review of 30 of these studies after applying inclusion and exclusion criteria. They found that the use of free flaps could be...

A new free flap for the head and neck

Whilst the radial forearm free flap (RFFF) is well known and tested, this group of surgeons from Sunderland, UK, discuss their experience with a comparable flap. They advocate the medial sural artery perforator flap (MSAPF), with a long pedicle if...

Sliding lower lid tarsal flap

This is a retrospective review of a lower lid reconstructive technique utilising a sliding tarsal flap. Thirty-two patients who had undergone Mohs surgery were included and each had a shallow marginal defect with at least one remaining tarsal edge having...

A tarso-conjunctival flap for paralytic ectropion

This is a review of 110 patients with paralytic ectropion who underwent a lateral tarso-conjunctival flap procedure. The technique involves fashioning a 4-8mm wide lateral tarso-conjunctival flap in a similar way to a lateral Hughes flap. This is then sutured...

A modification of the crescentic flap for nasal skin reconstruction

Non melanoma skin cancers are the most frequent malignant skin tumours and in over 25% of cases affect the nose. Following excision, the reconstruction can be challenging. The nasal complex has adjacent concave and convex surfaces, minimal laxity and nasal...

A useful regional flap for head and neck reconstruction

This article explains the experience of the head and neck department of the Massachusetts Eye and Ear Infirmary with a seldom used regional flap, the supraclavicular artery (SCA) fasciocutaneous flap. This versatile flap is based on the supraclavicular artery, a...

A new autologous flap option for breast reconstruction

The authors of this paper present the first meaningful series utilising the lateral thigh perforator flap for breast construction. Eight patients had delayed unilateral reconstruction, each with two stacked flaps. Anastamoses were performed antegrade and retrograde to one internal mammary...

The use of platelet-rich plasma in skin flap grafts

This study was conducted to evaluate the ability of platelet rich plasma (PRP) to stimulate angiogenesis following skin flaps graft surgery, and its effect on flap survival rate. The use of PRP to improve the quality of bone regeneration and...

Submental island flap to reconstruct the lower lip

The lips are necessary for oral competence, cosmesis, speech and feeding. Non melanoma cancers can affect the lips, and the lower lips are about 80% more likely to be affected. A large number of these cancers are squamous cell carcinomas....