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“Ectopic transfer has been described as a salvage procedure in failing replants. The experience in three cases of infected failing replantations treated with secondary temporary ectopic transfer of the replanted part is presented. Three patients with replanted traumatic amputations (one transhumeral, one transmetacarpal, and one transtibial) that developed severe wound Belnacasan supplier infections and thrombosis of the anastomoses were treated with urgent ectopic

transfer of the replanted part. The ectopic recipient vessels were the femoral, posterior tibial, and the descending branch of the lateral femoral circumflex arteries. The stumps were surgically cleansed and the ectopically replanted parts were retransferred some days later. The infection reccurred in one case and the replant (transmetacarpal) was lost. The two other cases were successfully retransferred orthotopically, 9 and 20 days later, respectively. In one case (transtibial) multiple additional surgical procedures were necessary. Functional results in these two cases were acceptable. Delayed ectopic transfer is a useful, yet demanding technique for the salvage of complicated replants in the context of severe wound infection and vascular thrombosis or impending failure. Given the complexity of the procedure it should only be considered in selected cases. © 2011 Wiley-Liss, Inc. Microsurgery, 2011. “
“Anterolateral thigh (ALT) free flaps can result in donor

site wounds that cannot be closed directly, requiring

immediate or delayed split-thickness skin grafting. The use of skin grafts for such wounds can impose postoperative activity restrictions and additional wound morbidity. The purpose of the study Fossariinae was to Decitabine in vitro investigate the efficacy of continuous external tissue expander (CETE) in achieving staged direct closure of these wounds. Outcomes of 20 ALT free flap cases with flap widths up to 15 cm treated with CETE were retrospectively reviewed. Closure of the thigh wounds was achieved in 19 cases with an average expansion time of 9.6 days. The use of a CETE device was effective in achieving staged direct (tertiary) closure and avoiding skin grafting, which further decreased donor site morbidity of large ALT free flap reconstructions. © 2014 Wiley Periodicals, Inc. Microsurgery, 2014. “
“The purpose of this report is to describe the use of telecommunication to improve the quality of postoperative care following microsurgery, especially following microvascular transfer of intestinal transfer for which shortening of ischemia time is of utmost importance to achieve high success rate. From 2003 to 2009 microvascular transfer of intestinal flaps had been performed in 112 patients. After surgery the patients were put in intensive care unit and the flaps were checked every 1 hour. The image for circulatory status of the flaps was sent directly to the attending surgeon for judgment. The information was sent through intranet and the surgeon can get access to the intranet through internet if necessary.