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Secondary Reconstruction of Recurrent Primary Intraosseous Meningioma of the Calvarium Using a fasciocutaneous Anterolateral Thigh Free Flap

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Neuroscience & Medicine 2013年第4期4卷 280-283页

作者： Raakhi Mistry Chris Tsimiklis Marcus Wagstaff Amal Abou-Hamden Yugesh Caplash Department of Neurosurgery Royal Adelaide Hospital Adelaide South Australia Department of Plastic & Reconstructive Surgery Royal Adelaide Hospital Adelaide South Australia Department of Plastic & Reconstructive Surgery Royal Adelaide Hospital Adelaide South Australia

We present a patient with a primary intraosseous meningioma of the calvarium that recurred three years after initial resection and reconstruction with a free anterolateral thigh (ALT) flap. The patient re-presented with progressive swelling in the same area. Imaging confirmed aggressive tumour recurrence with both intra- and extra-cranial diseases and also extension to the ipsilateral orbit. The original anterolateral free flap was raised on anterior pedicle and further debulking of the tumour was performed. Histology confirmed widely infiltrative atypical meningioma (WHO grade II). This case highlights the benefit of using a fasciocutaneous free flap for reconstruction given the potential for tumour recurrence.

关键词： Primary Intraosseous Meningioma fasciocutaneous Free Flap

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Recent advances in microvascular autologous breast reconstruction after ablative tumor surgery

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World Journal of Clinical Oncology 2016年第1期7卷 114-121页

作者： Michael S Pollhammer Dominik Duscher Manfred Schmidt Georg M Huemer Section of Plastic Aesthetic and Reconstru-ctive Surgery Department of General Surgery Kepler University Hospital Linz MAZ - Microsurgical Training and Research Center

Breast cancer is a ubiquitous disease and one of the leading causes of death in women in western societies. With overall increasing survival rates, the number of patients who need post-mastectomy reconstruction is on the rise. Especially since its psychological benefits have been broadly recognized, breast reconstruction has become a key component of breast cancer treatment. Evolving from the early beginnings of breast reconstruction with synthetic implants in the 1960 s, microsurgical tissue transfer is on the way to become the gold standard for post oncology restoration of the breast. Particularly since the advent of perforator based free flap surgery, free tissue transfer has become as safe option for breast reconstruction with low morbidity. The lower abdominal skin and subcutaneous fat tissue typically offer enough volume to create an aesthetically satisfying breast mound. Nowadays, the most commonly used flap from this donor site is the deep inferior epigastric artery perforator flap. If the lower abdomen is not available as a donor site, the gluteal area and thigh provide a number of flaps suitable for breast recon-struction. If the required breast volume is small, and there is enough tissue available on the upper medial thigh, then a transverse upper gracilis flap may be a practicable method to reconstruct the breast. In case of a higher amount of required volume, a gluteal artery perforator flap is the best choice. However, what is crucial in addition to selecting the best flap option for the individual patient is the timing of the operation. In patients with confirmed post-mastectomy radiation therapy, it is advisable to perform microvascular breast reconstruction only in a delayed fashion.

关键词： Breast cancer Microsurgery Autologous tissue transfer Breast reconstruction Flap Transverse musculocutaneous gracilis fasciocutaneous infragluteal Deep inferior epigastric perforator

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Distally based perforator sural flaps for foot and ankle reconstruction

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World Journal of Orthopedics 2015年第3期6卷 322-330页

作者： Shi-Min Chang Xiao-Hua Li Yu-Dong Gu Department of Orthopedic Surgery Yangpu Hospital Tongji University School of Medicine Department of Hand Surgery Huashan Hospital Fudan University Key Laboratory of Hand Reconstruction Ministry of Health Shanghai Key Laboratory of Peripheral Nerve and Microsurgery

Distally based perforator sural flaps from the posterolateral or posteromedial lower leg aspect are initially a neurofasciocutaneous flap that can be transferred reversely to the foot and ankle region with no need to harvest and sacrifice the deep major artery. These flaps are supplied by a perforating artery issued from the deep peroneal artery or the posterior tibial artery, and the chainlinked adipofascial neurovascular axis around the sural/saphenous nerve. It is a versatile and reliable technique for soft-tissue reconstruction of the heel and ankle region with 180-degrees rotation. In this paper, we present its developing history, vascular basis, surgical techniques including flap design and elevation, flap variations in pedicle and component, surgical indications, and illustrative case reports with different perforating vessels as pivot points for foot and ankle coverage.

关键词： fasciocutaneous flap Distally based flap Foot and ankle Perforator flap Neurocutaneous flap Sural flap Propeller flap

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Vascular anatomy of fascia skin flap in leg

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Journal of Medical Colleges of PLA(China) 1998年第1期13卷 66-68,72页

作者：陶凯忠陈尔瑜党瑞山纪荣明

The fascial vessels of skin flap in leg were studied systematically and quantitatively so as to find out the survival mechanism of fasciocutaneous flap and provide morphological basis for clinical application. Methods: Thirteen legs from adultcadavers were observed and measured by dissection under operating and biological microscopes, tissue clearing, slice and imageanalysis. Results: There were four types of source artery in fascia of leg and the intermuscular septal cutaneous artery was predominant and often anstomosed as a chain. The source arteries had supra- and subfascial branches in deep fascia and the former wasmore in number and larger in diameter. In the same way, the vascular network was thicker in the suprafascial level than in the subfascial. Aa% of the deep fascia was larger than that of the superficial fascia. Conclusion: The deep fascial vasculature is the basis of the blood supply of fasciocutaneous flap in leg and the suprafascial vascular network is especially important. It is suggestedthat the fascial pedicle should be selected wilers the arterial chain exists.

关键词： deep fascia fasciocutaneous flap leg vascular anatomy

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