Thumb tip injuries constitute one of the most common hand injuries. There are various reconstructive options for thumb tip injuries. We present our series of thumb tip injuries reconstructed using Elliot's modification of the Moberg flap, which provides like-for-like tissue. We also present our flap improvisation, which can be useful in the armamentarium of plastic surgeons. Background Moberg described the advancement flap for thumb defects in 1964, which was modified by O'Brien in which the proximal part of the flap is incised and advanced. Although it is a popular flap, it has the disadvantage of interphalangeal (IP) joint flexion deformity. Among the various modifications of the Moberg flap, Elliot's flap provided more tissue with minimal donor site morbidity and no usage of skin grafts or first web skin. Methods We retrospectively analyzed the patients who underwent reconstruction of thumb defects by Elliot's modified Moberg's flap. The size of the defect, etiology, and IP joint movement were analyzed. Two patients underwent our improvised flap where a daughter flap was elevated within Elliot's flap. Results Between January 2021 and September 2023, 12 patients underwent reconstruction by Elliot's flap. All flaps settled well. There was no IP joint deformity. Two patients had scar hypertrophy that was managed conservatively. Conclusion Elliot's modification of the Moberg flap is a very useful but underutilized flap for thumb tip injuries that provides like tissue with sensation and with little donor site morbidity. It can be used for thumb tip defects of up to 3 cm . It is possible to incorporate a second V-Y flap in patients for whom additional movement is required for tension-free closure.
{"title":"Revisiting Elliot's Modification of Moberg's Flap and Our Improvisation.","authors":"Anand Prasath Jayachandiran, Suresh Rajendran, Surya Rao Rao Venkata Mahipathy, Alagar Raja Durairaj, Narayanamurthy Sundaramurthy, Manoj Ananthappan","doi":"10.1055/s-0044-1779658","DOIUrl":"10.1055/s-0044-1779658","url":null,"abstract":"<p><p>Thumb tip injuries constitute one of the most common hand injuries. There are various reconstructive options for thumb tip injuries. We present our series of thumb tip injuries reconstructed using Elliot's modification of the Moberg flap, which provides like-for-like tissue. We also present our flap improvisation, which can be useful in the armamentarium of plastic surgeons. <b>Background</b> Moberg described the advancement flap for thumb defects in 1964, which was modified by O'Brien in which the proximal part of the flap is incised and advanced. Although it is a popular flap, it has the disadvantage of interphalangeal (IP) joint flexion deformity. Among the various modifications of the Moberg flap, Elliot's flap provided more tissue with minimal donor site morbidity and no usage of skin grafts or first web skin. <b>Methods</b> We retrospectively analyzed the patients who underwent reconstruction of thumb defects by Elliot's modified Moberg's flap. The size of the defect, etiology, and IP joint movement were analyzed. Two patients underwent our improvised flap where a daughter flap was elevated within Elliot's flap. <b>Results</b> Between January 2021 and September 2023, 12 patients underwent reconstruction by Elliot's flap. All flaps settled well. There was no IP joint deformity. Two patients had scar hypertrophy that was managed conservatively. <b>Conclusion</b> Elliot's modification of the Moberg flap is a very useful but underutilized flap for thumb tip injuries that provides like tissue with sensation and with little donor site morbidity. It can be used for <i>thumb tip defects of up to 3 cm</i> . It is possible to incorporate a second V-Y flap in patients for whom additional movement is required for tension-free closure.</p>","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"57 2","pages":"116-122"},"PeriodicalIF":0.8,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11105812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-30eCollection Date: 2024-02-01DOI: 10.1055/s-0044-1778704
U Rasheedha Begum, Mahadevan Kandasamy, Prethee Martina Christabel
Cochlear implant surgeries have become increasingly common in India, leading to a rise in complications such as cochlear implant exposure. To address this issue, we present a novel technique involving a single incision dual cover using the temporoparietal fascial flap (TPFF) and skin flap to give durable cover for exposed cochlear implants. Materials and Methods A retrospective study was conducted between December 2019 and December 2022 on patients who underwent the dual flap procedure for exposed cochlear implants. Results The average defect size was 2 × 2 cm, and the average length of hospital stay was 10 days. Fourteen skin flaps were closed primarily, while two required skin grafting for donor site closure. At the time of discharge, all wounds showed successful healing with intact skin coverage over the cochlear implant device site. The average follow-up period was 12 months, during which two patients had donor site scar alopecia, while others had adequate hair growth masking the scar. All patients consistently used their cochlear implants. Conclusion Our single-incision, dual cover TPFF + skin flap technique offers a reliable and innovative solution for managing exposed cochlear implants. With successful implant salvage and favorable postoperative outcomes, this approach demonstrates the versatility and reliability of the TPFF as an excellent option for reconstructive surgeons dealing with cochlear implant complications.
{"title":"Single Incision Dual Cover with Temporoparietal Fascial Flap for Exposed Cochlear Implant: A Novel Take on a Workhorse Flap.","authors":"U Rasheedha Begum, Mahadevan Kandasamy, Prethee Martina Christabel","doi":"10.1055/s-0044-1778704","DOIUrl":"10.1055/s-0044-1778704","url":null,"abstract":"<p><p>Cochlear implant surgeries have become increasingly common in India, leading to a rise in complications such as cochlear implant exposure. To address this issue, we present a novel technique involving a single incision dual cover using the temporoparietal fascial flap (TPFF) and skin flap to give durable cover for exposed cochlear implants. <b>Materials and Methods</b> A retrospective study was conducted between December 2019 and December 2022 on patients who underwent the dual flap procedure for exposed cochlear implants. <b>Results</b> The average defect size was 2 × 2 cm, and the average length of hospital stay was 10 days. Fourteen skin flaps were closed primarily, while two required skin grafting for donor site closure. At the time of discharge, all wounds showed successful healing with intact skin coverage over the cochlear implant device site. The average follow-up period was 12 months, during which two patients had donor site scar alopecia, while others had adequate hair growth masking the scar. All patients consistently used their cochlear implants. <b>Conclusion</b> Our single-incision, dual cover TPFF + skin flap technique offers a reliable and innovative solution for managing exposed cochlear implants. With successful implant salvage and favorable postoperative outcomes, this approach demonstrates the versatility and reliability of the TPFF as an excellent option for reconstructive surgeons dealing with cochlear implant complications.</p>","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"57 1","pages":"54-59"},"PeriodicalIF":0.8,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10914538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-30eCollection Date: 2024-02-01DOI: 10.1055/s-0044-1779470
Ramesh B A, Preetam A, Singaravelu V, Sathish Kumar J
{"title":"Utilizing Laparoscopic Camera with Indocyanine Green Fluorescence Filters in Lymphovenous Bypass Surgery.","authors":"Ramesh B A, Preetam A, Singaravelu V, Sathish Kumar J","doi":"10.1055/s-0044-1779470","DOIUrl":"10.1055/s-0044-1779470","url":null,"abstract":"","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"57 1","pages":"71-73"},"PeriodicalIF":0.8,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10914540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. M. Balakrishnan, Abinaya Karthikeyan, M. Sridharan, Indian J Plast
Schwannomas are well-circumscribed, solitary benign encapsulated tumors arising from Schwann cells, which originate from neural crest cells. 1 They constitute only 4% of the head and neck tumors and involve the paranasal sinuses and nasal cavities. 2 About 80% of cases involve the vestibulocochlear nerve, followed by the trigeminal nerve in this region. 3 A 27-year-old woman presented to us with complaints of swelling over the nose for the past 8 months. She was medically managed for associated tension headaches. She gave no history of nasal obstruction, trauma, epistaxis, localized facial numbness, anosmia, or other swellings. Clinical examination showed a hemispherical, fi rm swelling of size 1.5 (cid:1) 1.0 (cid:1) 0.75cm over the rhinion and left keystone area in the subcutaneous plane, with side-to-side mobility and pinchable overlying skin. Deep palpation caused dyses-thesia at thetip of the nose.Anterior rhinoscopyexamination revealed no intranasal extension. High-de fi nition ultrasonography (HD-USG) imaging showed no cystic degeneration. Computed tomography (CT) scan revealed a hyperintense lesion over the rhinion and left keystone area of the nose, with no bony or cartilaginous erosions. Contrast magnetic resonance imaging (MRI) showed the same with delayed centripetal fi lling
{"title":"Schwannoma of the Nose at the Keystone Area in Relation to the Dorsal Nasal Nerve","authors":"T. M. Balakrishnan, Abinaya Karthikeyan, M. Sridharan, Indian J Plast","doi":"10.1055/s-0043-1778097","DOIUrl":"https://doi.org/10.1055/s-0043-1778097","url":null,"abstract":"Schwannomas are well-circumscribed, solitary benign encapsulated tumors arising from Schwann cells, which originate from neural crest cells. 1 They constitute only 4% of the head and neck tumors and involve the paranasal sinuses and nasal cavities. 2 About 80% of cases involve the vestibulocochlear nerve, followed by the trigeminal nerve in this region. 3 A 27-year-old woman presented to us with complaints of swelling over the nose for the past 8 months. She was medically managed for associated tension headaches. She gave no history of nasal obstruction, trauma, epistaxis, localized facial numbness, anosmia, or other swellings. Clinical examination showed a hemispherical, fi rm swelling of size 1.5 (cid:1) 1.0 (cid:1) 0.75cm over the rhinion and left keystone area in the subcutaneous plane, with side-to-side mobility and pinchable overlying skin. Deep palpation caused dyses-thesia at thetip of the nose.Anterior rhinoscopyexamination revealed no intranasal extension. High-de fi nition ultrasonography (HD-USG) imaging showed no cystic degeneration. Computed tomography (CT) scan revealed a hyperintense lesion over the rhinion and left keystone area of the nose, with no bony or cartilaginous erosions. Contrast magnetic resonance imaging (MRI) showed the same with delayed centripetal fi lling","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"57 18","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139441951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background Skin grafting plays a vital role in post-burn and post-traumatic wound management. Split-thickness skin grafts (STSG) are traditionally fixed using staples or sutures, which have tedious application and their removal necessitates painkillers, medical equipment, and human intervention. As an alternative, fibrin sealant is a biological tissue adhesive, composed of thrombin, calcium, and fibrinogen. Fibrin sealant promotes hemostasis and acts as a biological adherent. Objective The aim of this study was to evaluate the outcomes (graft take, wound healing and complications) of fibrin sealant and staples for STSG fixation. Methods It is a randomized controlled trial on 40 patients with wounds of minimum 400 cm 2 . Wound area was divided into equal halves and randomly allocated to the study group or control group. In the study group, 4 mL per 200 cm 2 of fibrin sealant was sprayed followed by STSG application. In the control group, STSG was fixed with only skin staples. Evaluation was done on postoperative days 3, 5, 15, and 30 for graft take, hematoma/seroma, infection, and complete wound healing. Results The mean graft take was significantly higher ( p -value < 0.05) in the study group than in the control group (91 vs. 89%). No seroma or hematoma formation was seen in either group. Complete wound healing was seen in more patients in the study group, but the difference was statistically insignificant. Conclusion Fibrin sealant is an excellent alternative to staples for skin grafting, with the advantage of better graft take and being free of pain that is incurred during staple removal.
{"title":"An Outcome Analysis of Fibrin Sealant versus Staples for Fixation of Split-Thickness Skin Grafts","authors":"Akshara Shuchi, Deepti Gupta, Sujata Sarabahi","doi":"10.1055/s-0043-1777867","DOIUrl":"https://doi.org/10.1055/s-0043-1777867","url":null,"abstract":"Abstract Background Skin grafting plays a vital role in post-burn and post-traumatic wound management. Split-thickness skin grafts (STSG) are traditionally fixed using staples or sutures, which have tedious application and their removal necessitates painkillers, medical equipment, and human intervention. As an alternative, fibrin sealant is a biological tissue adhesive, composed of thrombin, calcium, and fibrinogen. Fibrin sealant promotes hemostasis and acts as a biological adherent. Objective The aim of this study was to evaluate the outcomes (graft take, wound healing and complications) of fibrin sealant and staples for STSG fixation. Methods It is a randomized controlled trial on 40 patients with wounds of minimum 400 cm 2 . Wound area was divided into equal halves and randomly allocated to the study group or control group. In the study group, 4 mL per 200 cm 2 of fibrin sealant was sprayed followed by STSG application. In the control group, STSG was fixed with only skin staples. Evaluation was done on postoperative days 3, 5, 15, and 30 for graft take, hematoma/seroma, infection, and complete wound healing. Results The mean graft take was significantly higher ( p -value < 0.05) in the study group than in the control group (91 vs. 89%). No seroma or hematoma formation was seen in either group. Complete wound healing was seen in more patients in the study group, but the difference was statistically insignificant. Conclusion Fibrin sealant is an excellent alternative to staples for skin grafting, with the advantage of better graft take and being free of pain that is incurred during staple removal.","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"2 6","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139380967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Cutis verticis gyrata (CVG) is a rare skin condition characterized by ridges and furrows resembling the brain. CVG falls under three categories: primary essential, primary nonessential, and secondary. This case report focuses on primary essential CVG, where approximately a fourth of the scalp and a significant portion of the forehead and eyelid were involved. Flap advancement after skin expansion was performed to rectify the disorder. This technique adequately covers the residual defect postexcision and preserves hair growth in affected regions. It is a successful skin expansion technique to cover the exposed scalp, preserve hair growth, and achieve excellent cosmetic results. Our approach demonstrates a promising solution for severe cosmetic disfigurement in primary essential CVG, positively impacting both the physical appearance and psychosocial well-being of the patient.
{"title":"Flap Advancement Technique for Scalp Hair Preservation in Massive Cutis Verticis Gyrata","authors":"Bilal Javed, Amina Rao, Waleed Abdullah, Akasha Amber, Mughese Amin","doi":"10.1055/s-0043-1777075","DOIUrl":"https://doi.org/10.1055/s-0043-1777075","url":null,"abstract":"Abstract Cutis verticis gyrata (CVG) is a rare skin condition characterized by ridges and furrows resembling the brain. CVG falls under three categories: primary essential, primary nonessential, and secondary. This case report focuses on primary essential CVG, where approximately a fourth of the scalp and a significant portion of the forehead and eyelid were involved. Flap advancement after skin expansion was performed to rectify the disorder. This technique adequately covers the residual defect postexcision and preserves hair growth in affected regions. It is a successful skin expansion technique to cover the exposed scalp, preserve hair growth, and achieve excellent cosmetic results. Our approach demonstrates a promising solution for severe cosmetic disfigurement in primary essential CVG, positively impacting both the physical appearance and psychosocial well-being of the patient.","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"29 39","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139382542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ally Ha, Kassra Garoosi, Elijah W. Hale, Ty Higuchi, J. Winocour, David W. Mathes, C. Kaoutzanis
Abstract Introduction: In 2017, an estimated 1.6 million adults and 150,000 teenagers identified as transgender in the United States. With ever-changing legislative developments regarding health care benefits for this population and the increasing number of patients presenting for gender-affirming surgery (GAS), there is a scarcity of literature on the temporal trends within the past decade. The objective of this study was to examine the temporal trends of the utilization of GAS. Methods: We conducted a cross-sectional study using TriNetX, a federated research network containing deidentified aggregate patient data. Using International Code of Disease (ICD) and Current Procedural Terminology (CPT) codes, we identified patients with a diagnosis of gender dysphoria who underwent GAS from 2010 to 2021. Basic demographic information and complications were analyzed. Complications of interest included site failure, infection, and systemic complications. Results: We identified a total of 8,403 patients who underwent GAS between January 2010 and December 2021. The number of procedures per year increased nearly 500% between 2016 and 2021 from 421 procedures to 2,224 procedures. Our demographic results were consistent with previous survey-based studies. The average age of patients who underwent masculinizing surgeries was consistently younger than those who underwent feminizing surgeries. Most patients undergoing GAS were of white race. The overall complication rate was 4.7%. Conclusion: In conclusion, our study reveals a significant and rapid rise in the utilization of GAS in the United States, with a fivefold increase in procedures between 2016 and 2021. The demographic characteristics and low complication rates observed highlight the evolving landscape of health care for transgender individuals and the need for ongoing assessment and support in this field.
{"title":"Trends in Gender-Affirming Surgeries in the United States from 2010 to 2021","authors":"Ally Ha, Kassra Garoosi, Elijah W. Hale, Ty Higuchi, J. Winocour, David W. Mathes, C. Kaoutzanis","doi":"10.1055/s-0043-1778096","DOIUrl":"https://doi.org/10.1055/s-0043-1778096","url":null,"abstract":"Abstract Introduction: In 2017, an estimated 1.6 million adults and 150,000 teenagers identified as transgender in the United States. With ever-changing legislative developments regarding health care benefits for this population and the increasing number of patients presenting for gender-affirming surgery (GAS), there is a scarcity of literature on the temporal trends within the past decade. The objective of this study was to examine the temporal trends of the utilization of GAS. Methods: We conducted a cross-sectional study using TriNetX, a federated research network containing deidentified aggregate patient data. Using International Code of Disease (ICD) and Current Procedural Terminology (CPT) codes, we identified patients with a diagnosis of gender dysphoria who underwent GAS from 2010 to 2021. Basic demographic information and complications were analyzed. Complications of interest included site failure, infection, and systemic complications. Results: We identified a total of 8,403 patients who underwent GAS between January 2010 and December 2021. The number of procedures per year increased nearly 500% between 2016 and 2021 from 421 procedures to 2,224 procedures. Our demographic results were consistent with previous survey-based studies. The average age of patients who underwent masculinizing surgeries was consistently younger than those who underwent feminizing surgeries. Most patients undergoing GAS were of white race. The overall complication rate was 4.7%. Conclusion: In conclusion, our study reveals a significant and rapid rise in the utilization of GAS in the United States, with a fivefold increase in procedures between 2016 and 2021. The demographic characteristics and low complication rates observed highlight the evolving landscape of health care for transgender individuals and the need for ongoing assessment and support in this field.","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"41 6","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139385729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sir Benjamin Keith Rank (1911–2002): A Founding Father and Ambassador of Plastic Surgery","authors":"Dinesh Kadam","doi":"10.1055/s-0043-1777364","DOIUrl":"https://doi.org/10.1055/s-0043-1777364","url":null,"abstract":"","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"3 9","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138601174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Jaiswal, Firoz Borle, S. Mathews, Mayur Mantri, Vineet Kumar, A. Bindu, P. Yadav, V. Shankhdhar
Abstract Background The deep inferior epigastric artery perforator (DIEP) flap is a workhorse flap for breast reconstruction. Its use for head and neck (HN) reconstruction is rare. Abdomen provides a donor site abundant in skin and subcutaneous tissue, amenable to primary closure; sizeable, robust, and consistent perforators and a long, sizeable pedicle for comfortable microvascular anastomosis. Its offers all the donor variables needed for HN reconstruction in abundance. Methods It is a quasiexperimental design study. DIEP flap use for HN reconstruction in our series was opportunistic, that is, when donor site matched the defect. Cases that had very thick thighs and lesser bulk in abdomen and cases that had very thin thighs but much more bulk in abdomen were considered for reconstruction using DIEP flap. Results The DIEP flap was done in 11 cases for HN reconstruction. There were two re-explorations during postoperative period: one flap loss and another had partial necrosis. Conclusion Abdomen is an excellent donor site option for HN reconstruction in selected cases, especially when harvested as a perforator flap.
{"title":"DIEP Flap for Head and Neck Reconstruction: An Underutilized Option!","authors":"D. Jaiswal, Firoz Borle, S. Mathews, Mayur Mantri, Vineet Kumar, A. Bindu, P. Yadav, V. Shankhdhar","doi":"10.1055/s-0043-1777076","DOIUrl":"https://doi.org/10.1055/s-0043-1777076","url":null,"abstract":"Abstract Background The deep inferior epigastric artery perforator (DIEP) flap is a workhorse flap for breast reconstruction. Its use for head and neck (HN) reconstruction is rare. Abdomen provides a donor site abundant in skin and subcutaneous tissue, amenable to primary closure; sizeable, robust, and consistent perforators and a long, sizeable pedicle for comfortable microvascular anastomosis. Its offers all the donor variables needed for HN reconstruction in abundance. Methods It is a quasiexperimental design study. DIEP flap use for HN reconstruction in our series was opportunistic, that is, when donor site matched the defect. Cases that had very thick thighs and lesser bulk in abdomen and cases that had very thin thighs but much more bulk in abdomen were considered for reconstruction using DIEP flap. Results The DIEP flap was done in 11 cases for HN reconstruction. There were two re-explorations during postoperative period: one flap loss and another had partial necrosis. Conclusion Abdomen is an excellent donor site option for HN reconstruction in selected cases, especially when harvested as a perforator flap.","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":"8 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139224537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}