Number 1/July 2000

Original Articles

1 The Use of Pedicled Expanded Flaps for Aesthetic Konrad Hoekstra, MBBS Resurfacing of the Burned Face Donald A. Hudson, FRCS, MMed

; . ; A. Wayne Smith, FCS(SA) A series of facial burn patients is presented in which

hyperexpanded chest flaps were used to resurface aesthetic units of the face. Pedicles were divided two weeks later without flap loss.

The Use of Pedicled Perforator Flaps for Reconstruction —_ Nathalie A. Roche, MD of Lumbosacral Defects Koenraad Van Landuyt, MD Phillip N. Blondeel, MD, PhD

Four lumbosacral reconstructions were carried out using etal

perforator-based flaps based on the superior gluteal artery, the lumbar artery, or an intercostal artery. The flaps proved to be large and highly reliable with wide arcs of rotation and the

ability to close the donor defects primarily.

Abdominal Recovery After Laparotomy and Omental Yoav Barnea, MD

Transposition Into a Grossly Contaminated Median Meir Cohen, MD

Sternotomy Wound Michael Giladi, MD et al

A retrospective review of abdominal wound healing compared (1) 15 septic sternotomy wounds treated with omental flaps against (2) a control group of 15 elective splenectomies. No difference was seen in post-operative peritonitis or number of days to recovery of peristalsis, NG tube removal, oral feeding, or first bowel movement.

Anterior Oblique Ligament Reconstruction of the Thumb __M. W. Elmaraghy, MD, FRCSC Using the Transverse Carpal Ligament: Description of a New Procedure

A cadaver study demonstrated the feasibility of thumb anterior oblique ligament reconstruction using the transverse carpal ligament for stabilization.

Fingertip Reconstruction Using Two Variations of Direct- Huseyin Borman, MD

Flow Homodigital Neurovascular Island Flaps Tugrul Maral, MD

Mehmet Tancer, MD Eleven fingertips and seven more proximal amputation stumps

were resurfaced using two different methods of direct-flow homodigital neurovascular island flaps. No flap failures were seen, and good sensibility was achieved.

Verrucous Malformations: Their Presentation and Mahesh H. Mankani, MD Management Craig R. Dufresne, MD, FACS

Six patients with verrucous vascular malformations were excised in single or staged procedures. With only a single recurrence over seven years, excision is seen to be superior to laser ablation or cryosurgery.

Contents of Volume 45, July-December 2000


Prevention of Meatal Stenosis With W-Flap Glanuloplasty in Hypospadias Surgery: A Long-Term Follow-up

Three hundred fifty-six hypospadias cases repaired with incorporation of a W-flap glanuloplasty demonstrated a 0.8% meatal stenosis rate. The advantages included an anatomically located meatus, wider meatal diameter, avoidance of a circular anastomosis, a satisfactory urinary stream, and elimination of need for a stent.

Effect of the Delay Phenomenon in the Rat Single- Perforator-Based Abdominal Skin Flap Model

In a rat musculocutaneous, perforator-based, abdominal skin flap model, delay was effective if performed by incising the flap boundaries alone or by adding the ligation of all ipsilateral perforators except the pedicle artery.

The Role of Periosteum and Different Dissection Types on Callus Formation: Quantitative Analyses With Scintigraphy in a Rabbit Mandible Model

In a rabbit mandible model, callus formation progressed more rapidly the less periosteum had been stripped at the time of the initial osteotomy, confirming the beneficial effect of intact periosteum on fracture healing.

Secondary Venous Ischemic Injury Associated With Neutrophil Infiltration and Lipid Peroxidation: Amelioration of Injury by Cyclosporin A in a Rat Inguinal Island Flap

In a rat neurovascular island flap model, post-treatment of secondary venous ischemia with high-dose Cyclosporin A resulted in increased flap surviving area and lower MDA and MPO levels. The effect was probably a result of attenuation of neutrophil infiltration and reduction of lipid peroxidation.

Case Reports

Elongated Uvula With a Pleomorphic Adenoma: A Rare Cause of Obstructive Sleep Apnea Syndrome

Pneumomediastinum After Injection Injury to the Hand

A Modified Reversed Digital Island Flap Incorporating the Proper Digital Nerve

Seyhan Cenetoglu, MD Reha Yavuzer, MD Osman Latifoglu, MD et al

O. Koray CoSkunfirat, MD H. Seckin OkSar, MD H. Ege Ozgenta$, MD

Ufuk Bilkay, MD Naci Celik, MD Ulkem Bilkay, MD et al

Akin Yiicel, MD Cemal Senyuva, MD Giilnur Andican, MD et al

Hisashi Motomura, MD Teruichi Harada, MD Mitinari Muraoka, MD Toshiko Taniguchi, MD

C. L. F. Temple, MD R. S. Richards, MD, FRCSC W. B. Dawson, MD, FRCPC

Ahmet Karacalar, MD Cenk Sen, MD Mesut Ozcan, MD

Contents of Volume 45, July-December 2000

Functional Lip Reconstruction With a Radial Forearm Free Flap Combined With a Masseter Muscle Transfer After Wide Total Excision of the Chin

Malignant Fibrous Histiocytoma Arising in a Thoracotomy Scar

Metastatic Basal Cell Carcinoma of the Axilla: Report of a Case and Reconstruction With an Island Lateral Pectoral Flap

Review Article

Advances in the Biology of Flexor Tendon Healing and Adhesion Formation

Tips & Techniques

A New Test for Superficialis Flexor Tendon Function

Free Transfer of the Radial Forearm Flap With Preservation of the Radial Artery

Editorial A Thousand Authors


Distally Based Superficial Peroneal Neuroadipofascial Turnover Flap for Dorsal Foot Reconstruction

Malignant Clear Cell Hidradenoma with Giant Metastasis to the Axilla

Superior and Inferior Ulnar Collateral Arteries Originating As A Common Trunk In The Arm

Hiroshi Shinohara, MD Motonao Iwasawa, MD Takeshi Kitazawa, MD Hideo Kushima, MD

Sean Lille, MD Paul Schnur, MD

Yii, FRCS(plast) Niranjan, MS, FRCS(plast)

N. W. N.S.

Moneer Jaibaji, FRCS

Teoman Dogan, MD Ozhan Celebiler, MD Raffi Giriinlioglu, MD et al

Tunc Safak, MD Mustafa Akyiirek, MD

William D. Morain, MD

Shi-Min Chang, MD, PhD Chun-Lin Hou, MD

Serkan Yildrim, MD Tayfun Akéz, MD Iker Apaydin, MD et al

H. |. Canter, MD A. Erdem, MD, PhD C. C. Denk, MD, PhD

Contents of Volume 45, July-December 2000

Number 2/August 2000

Original Articles

Repair of Large, Anterior Palatal Fistulas Using Thin Tongue Flaps: Long-Term Follow-up of 10 Patients With Invited Discussion By Jeffrey C. Posnick, DMD, MD, FRCS(C), FACS, and Ramon L. Ruiz, DMD, MD

Ten thin anteriorly based tongue flaps were used for closure of large anterior palatal fistulas with 100% survival. One reoperation for bleeding occurred, and one recurrent fistula appeared during maxillary expansion.

Immediate Coverage of Exposed, Denuded Cranial Bone With Split-Thickness Skin Grafts

Five consecutive acutely denuded skull wounds were successfully closed by immediate burring of the outer table and skin grafting. Delaying until the formation of granulation tissue was unnecessary.

Long-Term Results of Tendon Transfers for Radial Nerve Palsy in Patients With Limited Rehabilitation

Long-term follow-up of 22 patients with tendon tranfers for isolated radial nerve palsy demonstrated improved function in all but one. Thirteen of 17 previously employed paiients returned to work following recovery.

Correlation of Electrodiagnostic Findings With Subjective Symptoms in Carpal Tunnel Syndrome

A retrospective record review of 138 patients (222 hands) evaluated for carpal tunnel syndrome with nerve conduction studies (NCS) and questionnaires demonstrated that NCS data correlated more closely with severity of symptoms than with functional status.

The Distally Based Superficial Sural Flap: Our Experience in Reconstructing the Lower Leg and Foot

Distally based superficial sural flaps were performed for 18 distal third and foot defects with only a single superficial necrosis resulting.

Rotation Ligamentoplasty for the Correction of Epicanthus Inversus

Congenital epicanthus inversus was permanently corrected in seven of eight patients by rotation of the medial canthal ligament during transnasal wiring.

M. Zeki Guzel, MD Fatis Altintas, MD

J. M. Pitkanen, MD M. M. Al-Qattan, MD N. A. Russel, MD

Paul J. Skoll, FRCS, FCS(SA)Plast

Donald A. Hudson, FRCS, FCS(SA)Plast, MMed

Wikus de Jager, FCS(SA)Ortho, MMed

Martin Singer, FRCS

Eun Sang Dhong, MD Seung Kyu Han, MD Byung Ii Lee, MD Woo Kyung Kim, MD

Marco Fraccalvieri, MD Giovanni Verna, MD Massimo Dolcet, MD et al

Ercan Karacaoglu, MD Erdem Tezel, MD M. Miimtaz Giiler, MD

The Limitation of Primary Excision of Cicatricial Alopecia: A Report of 63 Patients

A review of 63 patients operated for cicatricial alopecia of the scalp disclosed the clear superiority of tissue expansion over direct excision. Direct excision was satisfactory only in scars less than 10 mm in width.

Cartilage Shaping Using the Er:YAG Laser: Preliminary Report

In a rabbit ear cartilage model, stripping with the Er:YAG laser

resulted in controlled, progressive bending over a 10-day period,

suggesting its clinical value in cartilage shaping.

The Effect of Pedicle Artery Vasospasm on Microhemodynamics in Anatomically Perfused and Extended Skin Flap Tissue

In a hamster island skin flap model, recovery from clamp- induced vasospasm was accompanied by reactive arteriolar vasodilatation in the well-perfused portion of the flap, but no

vasodilatation in the extended portion of the flap. It is suggested

that distal ischemic necrosis may be a result of prolonged uncompensated vasospasm in poorly perfused areas.

Both Dermal Matrix and Epidermis Contribute to an Inhibition of Wound Contraction

In a swine excisional wound model, both dermal matrix and epidermal coverage inhibited wound contraction. Prompt epithelial coverage impeded contraction by reducing inflammation.

Hyperbaric Oxygen Therapy in Adriamycin Extravasation: An Experimental Animal Study

In a rat model, healing of an adriamycin-induced wound was accelerated by the use of hyperbaric oxygen administration.

Case Reports

Are Triglyceride Breast Implants Really Biocompatible? With Invited Discussion By V. Leroy Young, MD

Reconstruction of Hip Abduction Using Free Muscle Transplantation: A Case Report and Description of the Technique

Contents of Volume 45, July-December 2000

F. Duteille, MD

B. Le Fourn, MD

D. Hepner Lavergne, MD M. Pannier, MD

Metin Gorgii, MD Meltem Ayhan, MD Giircan Aslan, MD et al

Reto Wettstein, MD Robert Wessendorf, MD Axel Sckell, MD

et al

Jennifer L. Walden, MD Habacue Garcia, MS Hal Hawkins, MD et al

Samil Aktas, MD Akin Savas Toklu, MD Vakur Olgac, PhD

S. Papanastasiou, FRCSEd J. Odili, MRCS

P. Newman, FRCPath

J. Evans, FRCS(Plast)

Koichiro Ihara, MD Tetsuro Kishimoto, MD Shinya Kawai, MD Kazuteru Doi, MD

Contents of Volume 45, July-December 2000


Total Tongue Reconstruction With Free Functional Gracilis Muscle Transplantation: A Technical Note and Review of the Literature

New Multilobe “Accordion” Flaps for Three-Dimensional Reconstruction of Wide, Full-Thickness Defects in the Oral Floor

The Compound Sternal Flap for Laryngeal Reconstruction

When Is Surgical Treatment Not Appropriate for Morphea?

Reconstruction of a Tibial Defect With Microvascular Transfer of a Previously Fractured Fibula

Review Aricle

Clinical and Scientific Considerations in Leech Therapy for the Management of Acute Venous Congestion: An Updated Review

Editorial Rhapsody in Greek

Letters Re: What’s the Alternative?

Re: Transsacral Usage of an Island TRAM Flap for Sacral Defects

Urethral Fistula as the Cause of Circumcision Phobia

A New Tool to Eliminate Hyperpigmentation in Liposuction Scars

Pediatric Plastic Surgery in a Day Hospital: Use of Propofol and a Laryngeal Mask

Levent Yoleri, MD Hatice Mavioglu, MD

Isao Koshima, MD Masaru Hosoda, DDS Takahiko Moriguchi, MD Shinsaku Kawada, MD

Vladimir Shur, MD Ivor B. Kaplan, MD

Nandan V. Kamath, MD Arif Usmani, MD Arthur Pellegrini, MD

Sheel Sharma, MD Pankaj Tiwari, BS Armen K. Kasabian, MD Michael T. Longaker, MD

Adam B. Weinfeld, MD Eser Yuksel, MD Sean Boutros, MD et al

William D. Morain, MD

James W. Fox, MD

John P. Cederna, MD

Azize Kilic, MD Murat Emsen, MD Emre Ozdengil, MD

Carlo Gasperoni, MD Marzia Salgarello, MD Antonella Cimino, MD Paolo Gasperoni, MD

Francesco D’Andrea, MD A. Corcione, MD

G. Ferraro, MD

Sergio Brongo, MD

A Giant Recurrent Pyogenic Granuloma of the Thumb

Re: Soft Tissue Reconstruction of Sole and Heel Defects with Free Tissue Transfers

Microphthalmia With Linear Skin Deficiency Syndrome Accompanied by Cleft Lip and Palate

Simultaneous Use of a Tissue Expander and Skin Graft in Scalp Reconstruction

Pacinian Corpuscle Hyperplasia Coexisting With Dupuytren’s Contracture

Palliative Amputation for a Peculiar Case of Malignant Melanoma of the Lower Limbs

Idiopathic Calcinosis of the Scrotum

The Effects of Oxidized, Regenerated Cellulose on Diced Cartilage Xenografts: An Experimental Study

Re: Treatment of Painful Neuromas: A Case Report


Contents of Volume 45, July-December 2000

Akin Yiicel, MD Yagmur Aydin, MD Erol Benlier, MD et al

Mansoor S. Khan, MBBS, MRCS, AFRCS

Ufuk Bilkay, MD Naci Celik, MD Ciineyt Ozek, MD et al

Masamitsu Kuwahara, MD Mitsuo Hatoko, MD, PhD Aya Tanaka, MD

et al

Nalan Akyiirek, MD Omiir Ataoglu MD Seyhan Cenetoglu, MD et al

Francesco D’Andrea, MD Carlo Pellegrini, MD Sergio Brongo, MD

Yavuz Demir, MD Osman Latifoglu, MD Sibel Yenidiinya, MD Cemalettin Celebi, MD

Nilgiin Markal ErtaS, MD Sema Hiiciimenoglu, MD Omer BeSalti, PhD

et al

Marcel F. Meek, MD Peter H. Robinson, MD, PhD, FRCS

Number 3/September 2000

Special Article

Cleft Lip in the Talmud With Invited Discussion by Fred Rosner, MD, FACP

The author makes the case that cleft lip represents the “Sandal”

deformity described in the Talmud.

Melvyn Westreich, MD Samuel Segal, MD

Contents of Volume 45, July-December 2000

Original Articles

Elevating the Island: The Simplest Method of Delaying the TRAM Flap

Fifty-five pedicled TRAM flaps were delayed by pre-elevating the island 7-10 days prior to transfer, leaving the deep inferior epigastric pedicle intact. No total flap necrosis and only 3.6% partial necrosis resulted after subsequent transfer.

Elective Plastic Surgery in a Jehovah’s Witness: A Case Series and Review of the Literature

Three Jehovah’s Witnesses underwent complex surgical operations with the aid of supportive procedures, including monitoring, volume replacement, erythropoietin, and vitamin/ nutritional supplements. Legal and historical issues are reviewed.

A Prospective Blinded Evaluation of Nerve Conduction Velocity Versus Pressure-Specified Sensory Testing in Carpal Tunnel Syndrome

A new apparatus, the Pressure-Specified Sensory Device, was found to be as sensitive and specific as nerve conduction velocity (NCV) testing in the diagnosis of carpel tunnel syndrome in 79 patients. It was significantly less painful for the patient than NCV.

Two New Intramedullary Implant Designs for Phalanx Fixation in Digital Replantation: An Experimental Study

Two new intramedullary implants, a two-sided asymmetric screw and a hook-trap device provided rapid and rigid fixation for digital replantation when tested in 40 cadaver phalanges.

Correction of Crooked Nail Deformity by Modified Osteoplastic Reconstruction

Ten crooked nail deformities were treated by modified osteoplastic reconstruction, elevating a dorsally based volar skin flap and placing an iliac bone graft beneath. All nails were lengthened and straightened postoperatively.

Endoscope-Assisted Parotidectomy for Benign Parotid Tumors

Sixteen endoscope-assisted parotidectomies were performed through 7-cm incisions. The combination of magnification and enhanced illumination was valuable in avoiding facial nerve injury.

Edward Towpik, MD, PhD Slawomir Mazur, MD, PhD Tadeusz Witwicki, MD

et al

Robert F. Centeno, MD Charles D. Long, MD Mark S. Granick, MD

Robert A. Weber, MD John A. Schuchmann, MD James H. Albers, MD Jaime Ortiz, CHT

Aycan Kayikcioglu, MD Sebat Karamiirsel, MD Emin Mavili, MD Abdullah Kecik, MD

Yoonho Lee, MD, PhD Sungtack Kwon, MD, PhD Kyoungho Ko, MD

Sin-Daw Lin, MD Chih-Cheng Tsai, MD Chung-Sheng Lai, MD et al

Contents of Volume 45, July-December 2000

Free Flap Closure in Complex Congenital and Acquired Defects of the Palate

Six patients with congenital and acquired palatal defects underwent free flap coverage using rectus abdominis flaps and radial forearm flaps with and without bone. One patient required revision and another underwent placement of Branemark osseointegrated implants into the transferred bone.

Combined Microvascular Anastomosis: Experimental and Clinical Experience

A combined microanastomotic technique is presented, incorporating a continuous suture with interrupted ties. Studies of the rat aorta and inferior vena cava demonstrated more rapid execution with this technique, and 150 clinical cases demonstrated no technique-related failures.

Reverse Fasciosubcutaneous Flap Versus Distally Pedicled Sural Island Flap: Two Elective Methods for Distal-Third Leg Reconstruction

Twenty-five soft tissue defects of the lower third of the leg and heel were resurfaced with the fasciosubcutaneous reverse and sural reverse flaps, resulting in six minor complications. The fasciosubcutaneous flap was more suitable for large defects.

Sequential Segmental Neuromuscular Stimulation Reduces Fatigue and Improves Perfusion in Dynamic Graciloplasty

Using a canine dynamic graciloplasty model for urinary neo- sphincter, sequential segmental neuromuscular stimulation (SSNS) was compared to conventional, single-channel, continuous stimulation. SSNS proved superior in muscle endurance and blood perfusion.

Effect of Surgical Denervation on the Viability of Inferior Epigastric Neurovenous Flaps in the Rat

In a rat neurovenous inferior epigastric flap model, acute denervation produced a significant decrease in surviving flap area, whereas chronic denervation demonstrated no survival difference from control flaps.

A Rat Musculocutaneous Flap Model: The Biceps Femoris Musculocutaneous Flap

Based on the caudal femoral-popliteal vascular pedicle, the biceps femoris musculocutaneous flap is described in the rat. The flap has a consistent perforating vessel, supports a large skin island, and is at no risk for autocannibalization because of its dorsal position.

Andrew E. Turk, MD James Chang, MD

A. Ebbie Soroudi, MS et al

Tsan-Shiun Lin, MD Yuan-Cheng Chiang, MD

Antonio Bocchi, MD Stefano Merelli, MD Andrea Morellini, MD et al

Erik D. H. Zonnevijlle, MD Naveen N. Somia, MD, PhD Gustavo Perez Abadia, MD et al

Ahmet Karacalar, MD Hiilya Oztiirk, MD Mesut Ozcan, MD

Mustafa Akyiirek, MD Tung Safak, MD

ilker Manavbasi, MD Abdullah Kecik, MD

Contents of Volume 45, July-December 2000

Case Reports

Congenital Volkmann-Lesser Ischemic Contracture of the Upper Limb

Congenital Pressure Necrosis of the Forearm in a Newborn Infant With Invited Discussion by Joseph Upton, MD

Tips & Techniques

A Method for Minimizing Donor Site Complications of the Radial Forearm Flap

Guest Editorial

Whither Subatmospheric Pressure Dressing?

Editorial Response


Subcutaneous Emphysema of Hand and Forearm After High-Pressure Injection of Air During Scuba Diving

Hypospadias Repair: Collaboration Between Urologist and Plastic Surgeon

A New Concept for the Treatment of Postburn Contracture of the Elbow Foreign Body Infection of Methicillin-Resistant

Staphylococcus aureus in a Sternal Wound

Elastofibroma Dorsi

Antihelical Folding for Pinnaplasty Using One Posterior Cartilage Score and Horizontal Mattress Sutures

Dermoid Cyst at the Suprasternal Notch

Ram Silfen, MD Abraham Amir, MD Lea Sirota, MD

Daniel J. Hauben, MD

Arun K. Gosain, MD Forrest O. Moore, MD Linda G. Rabinowitz, MD

Adam R. Kolker, MD Christopher J. Coombs, FRACS John G. Meara, MD, DMD

Steven E. Greer, MD

Louis C. Argenta, MD

Halil |. Canter, MD Ibrahim Vargel, MD Tacettin Giiger, MD

Yvonne L. Karanas, MD James Chang, MD Richard Yagol, MD

et al

Vishwa Prakash S. P. Bajaj

Tomoharu Kiyosawa, MD, PhD Toshio Demitsu, MD

Naoto Yamamoto, MD

et al

Reha Yavuzer, MD Selahattin Gzmen, MD Tarik Cavusoglu, MD et al

Peter Sylaidis, FRCS David Gault, FRCS

Mustafa Yilmaz, MD Haluk Vayvada, MD Cenk Demirdéver, MD

Contents of Volume 45, July-December 2000

Cleft Lip and Dental Eruption

Book Review

Lasers in Aesthetic Surgery


Giircan Aslan, MD Naci Karacgal, MD Bilent Erdogan, MD

Martha S. Matthews, MD, FACS

Number 4/October 2000


Characteristics of Women With Cosmetic Breast Augmentation Surgery Compared With Breast Reduction Surgery Patients and Women in the General Population of Sweden With Invited Discussion by Tina S. Alster, MD

A retrospective questionnaire study of 1,369 women with cosmetic breast implants, 2,211 with prior breast reduction, and 49,262 with neither of these demonstrated that those with implants were more likely to smoke, to have a lower body mass index, to have undergone a miscarriage or induced abortion, and to have had fewer live births than the others. The data reflect that women who undergo cosmetic breast surgery tend to have distinct characteristics.

Using the Pulsed Dye Laser to Influence Scar Formation After Breast Reduction Surgery: A Preliminary Report

An examination of 11 patients undergoing breast reduction demonstrated that early scars showing tiny transverse vessels were destined to become hypertrophic and wide. Use of the Pulse Dye Laser disrupted this vessel pattern and inhibited further hypertrophic change.

The Use of External Ultrasound Combined With Superficial Subdermal Liposuction

Using the superwet technique, 30 patients underwent external ultrasound application, followed immediately by superficial liposuction and then deep liposuction. The superficial subdermal areas pretreated with external ultrasound produced an oilier and less bloody aspirate than in those areas without ultrasound.

Hazards of Piercing and Facial Body Art: A Report of Three Patients and Literature Review

Three complications of body piercing are presented, including perichondrial auricular abscess, nasal alar granulomatous perichondritis, and stud embedding of the lower lip.

Jon P. Fryzek, PhD Elisabete Weiderpass, MD Lisa B. Signorello, ScD et al

P. G. Shakespeare, PhD E. Tiernan, FRCS(Plast) A. E. Dewar, PhD

J. Hambleton, MPhil

Carlo Gasperoni, MD Marzia Salgarello, MD

Benedikt J. Folz, MD Burkard M Lippert, MD Christoph Kuelkens, MD Jochen A. Werner, MD

Contents of Volume 45, July-December 2000


Endoscopic-Assisted Harvest of the Temporoparietal Fascial Flap

Nine microtia patients underwent endoscope-assisted harvesting of the temporoparietal fascial flap through two 2-cm incisions. Two patients required wider intraoperative exposure to achieve hemostasis.

Extraoral vs. Intraoral Distraction Osteogenesis in the Treatment of Hemifacial Microsomia

Twelve hemifacial microsomia patients treated with an extraoral distraction device were compared to ten treated with an intraoral device. Although the intraoral method was more socially convenient, the extraoral device permitted greater elongation, better vector control, and more accurate gonial angle preservation.

Reliability of Island Flaps Raised After Superficial and Deep Burn Injury

Rat epigastric island flaps were raised and resutured 4 days after administration of a superficial or deep burn to the flap site. There were no significant differences in flap survival between burned and unburned flaps.

The Free Musculocutaneous Tensor Fascia Lata Flap as a Backup Procedure in Tumor Surgery

Nine free TFL flaps were successfully transferred for reconstruction after recurrent tumor resections of the chest and abdominal walls. The two-team procedures resulted in no functional deficits, and all donor sites were closed primarily or skin grafted.

An Anatomic Examination of the Suprascapular Flap

A cadaver injection study demonstrated a highly variable branching pattern of the suprascapular artery, confirming that a “suprascapular flap” is not practicable.

The Effect of Blood Supply in Muscle and an Elevated Muscle Flap on Endogenous Tissue-Engineered Bone by rhBMP-2 in the Rat

Implantation of recombinant human bone morphogenetic protein-2 into rat latissimus dorsi muscle and muscle

pouches resulted in heterotrophic osteoinduction. The difference in bony tissue between the two groups suggested that the blood supply is an important factor in promoting osteoinduction by rhBMP-2.

Akihiko Takushima, MD Hirotaka Asato, MD Kiyonori Harii, MD

Adi Rachmiel, DMD, PhD Dror Aizenbud, DMD Stavros Eleftheriou, DMD et al

Huseyin Borman, MD Tugrul Maral, MD

Beyhan Demirhan, MD Mehmet Haberal, MD, FACS

C. Heitmann, MD M. Pelzer, MD H. Menke, PhD G. Germann, PhD

Takeshi Kitazawa, MD Kiyoshi Matsuo, MD, PhD Tetsuji Moriizumi, MD, PhD Yoshinori Hataya, MD

Kenji Kusumoto, MD Kazuhisa Bessho, DDS, DMSc Kazuma Fujimura, DDS, DMSc et al

Contribution of Conventional Axial Computed Tomography (Nonhelical), in Conjunction With Panoramic Tomography (Zonography), in Evaluating Mandibular Fractures

In a series of 66 mandibular fractures in 39 patients, axial computed tomography demonstrated two parasympheseal fractures and several instances of undiscovered comminution not seen on Panorex. The data added by axial computed tomography could have changed an operative plan based solely on Panorex in 44% of the cases.

Case Reports

A Unique Case of Secondary Microvascular Glansplasty: The Last Genitoreconstructive Frontier?

Critical Leg Ischemia Resulting From Interruption of Collaterals by Harvest of the Rectus Abdominis Free Flap: Endovascular Salvage

Pregnancy as a Tissue Expander in the Repair of a Massive Ventral Hernia

The Sandwich Technique for Closure of a Palatal Fistula

Docetaxel (Taxotere) Extravasation: A Report of Five Cases With Treatment Recommendations

Giant Plexiform Neurofibroma of the Back

Multiple-Digit Onychomycosis: A Simple Surgical Cure

Unilateral Virginal Breast Hypertrophy

Sclerosing Lobular Hyperplasia of the Breast After Reduction Mammaplasty

Tips and Techniques

Use of Triamcinolone Acetonide Injection in Ear Reconstruction

Contents of Volume 45, July-December 2000

lan F. Wilson, MD Adam Lokeh, MD Charles |. Benjamin, MD et al

J. Joris Hage, MD, PhD

Keith Hodge, MD James Yuen, MD Mohammed Moursi, MD John F. Eidt, MD

Eric T. Elwood, MD Walter L. Ingram, MD Grant W. Carlson, MD

Ismail Kuran, MD Bugra Sadikoglu, MD Tugrul Turan, MD

et al

Jeffrey A. Ascherman, MD Sean L. Knowles, BA Keith Attkiss, MD

Maurice Y. Nahabedian, MD Shai M. Rozen, MD

James D. Namnoum, MD Craig A. Vander Kolk, MD

Maurice Y. Nahabedian, MD

Galip Agaoglu, MD Figen Ozgiir, MD Yiicel Erk, MD

W. Glenn Lyle, MD Kerrie R. Bossard, BA D. Scott Day, MD

P. S. Bhandari, MCh

Contents of Volume 45, July-December 2000


The “Stegosaurus” Dressing: A Simple and Effective Method of Securing Skin Grafts in the Burn Patient

Editorial Of Boobs and Bobos


Endoscopic Harvest of Pectoralis Major Muscle Flap for Correction of a Neck Deformity

Drains in Reduction Mammaplasty

Rhomboid Flap for Surgery of the Scalp With or Without Expansion: An Experimental Study


James K. Fullerton, MD

Christopher E. Smith, MD

Stephen M. Milner, MBBS, BDS, FRCS(Ed)

William D. Morain, MD

Kazuya Matsumoto, MD Hideki Nakanishi, MD Takuya Seike, MD

Alastair Brown, MB, BCh, BAO, FRCS

Chris Hill, MB, BCh, BAO, FRCS

Khalid Khan, MB, BCh, FRCS, FRCS(Plast)

F. Duteille, MD P. LaCroix, MD G. Duport, MD

Number 5/November 2000

Original Articles

One-Stage Immediate Breast and Nipple—Areolar Reconstruction With Autologous Tissue I: A Preliminary Report

Seven women with early breast cancer underwent skin-sparing mastectomy and immediate breast reconstruction using de-epithelized TRAM flaps. A full-thickness areola graft from the specimen was combined with a CV flap on Zone II of the TRAM flap to complete the single-stage reconstruction.

Brachytherapy: Reconstructive Options and the Role of Plastic Surgery

Nineteen patients received brachytherapy and reconstruction for cancer of the upper and lower extremities and trunk. Despite local catheter irradiation of 45-50 Gy (Ir192) beginning 5 days after flap closure, all flaps survived with only 10% complications. Local recurrences were seen in 42%.

Donald A. Hudson, FRCS David M. Dent, ChM, FRCS Dirk Lazarus, FCS(SA)

Haluk Duman, MD Gregory R. D. Evans, MD Gregory Reece, MD

et al

Contents of Volume 45, July-December 2000

Total Reconstruction of the Alar Cartilages With a Partially Split Septal Cartilage Graft

In 22 secondary rhinoplasties, deficient lower lateral cartilages were present. Tip support was supplied with a hockey stick-shaped septal graft partially split to create double domes. All gained greater tip projection, and three reported functional improvement.

Philtral Construction by Composite Skin—-Muscle Rotation and Orbicularis Oris Muscle Advancement in Secondary Cleft Lip Deformity

Ten secondary unilateral cleft lip repairs were performed using a hinged muscle flap from the medial side to augment the cleft philtral ridge. Final results demonstrated a more symmetric philtrum and cupid’s bow.

Sentinel Node Biopsy in Melanoma Using Technetium- 99m Rhenium Colloid: The London Experience

Fifty-six consecutive patients with stage 1b or 2 melanoma underwent sentinel node biopsy assisted by preoperative lymphoscintigraphy using 99m-technetium rhenium colloid or filtered sulfur colloid. Scans identified sentinel nodes in 55 of 56 patients (18 in unpredicted locations), and 12 were found to be positive.

An Experimental Study of Skin Flap Associated With Muscle: Is Muscle Nourishment Possible Through the Musculocutaneous Perforators? With Invited Discussion by Thomas J. Krizek, MD

A rat flap model with both muscle and skin based on the inferior superficial epigastric vessels demonstrated that muscle may survive by reverse flow through the musculocutaneous perforators when elevated with an axial skin flap.

Crossover Innervation After Digital Nerve Injury: Myth or Reality?

In a retrospective review of 74 sharp epineural digital nerve repairs in 54 patients, there was no significant difference in final 2-point discrimination between unilateral and bilateral repairs. Crossover innervation did not appear to influence long-term outcome after digital neurorrhaphy.

Overexpression of Transforming Growth Factor Beta-2 and Its Receptor in Rhinophyma: An Alternative Mechanism of Pathobiology

TGF-B2 and TGF-B II receptor immunoreactivity staining of rhinophyma tissue was stronger than that in normal skin, confirming overexpression of this fibrogenic protein and its receptor in rhinophyma tissue. The data support the hypothesis that fibrosis plays an important role in the pathobiology of rhinophyma.

Luiz Carlos Ishida, MD Jorge Ishida, MD

Luis Henrique Ishida, MD et al

Ushio Haramoto, MD Takashi Kamiji, MD Satoshi Takagi, MD et al

C. L. F. Temple, MD C. G. Scilley, FRCSC C. J. Engel, FRCSC et al

Sikri Yazar, MD Oguz Cetinkale, MD Osman Senel, MD et al

Norman Weinzweig, MD, FACS

Lee L. Q. Pu, MD, PhD Paul D. Smith, MD Wyatt G. Payne, MD

et al

Contents of Volume 45, July-December 2000


Thrombogenic Effects of a Nonthrombin-Based Fibrin Sealant Compared With Thrombin-Based Fibrin Sealant on Microvenous Anastomoses in a Rat Model

Although high concentrations of thrombin are known to be harmful at the site of a microvenous anastomosis, use of a nonthrombin-based fibrin sealant was no different from controls when applied to a microvenous anastomosis in a rat flap model.

Patterns of Radial Dysmorphology With the VACTERL Association in the Adriamycin-Exposed Prenatal Rat

The spectrum of upper limb deformities seen in adriamycin- exposed prenatal rats closely paralleled that seen in the human VACTERL association of multiple anomalies, suggesting a reliable embryological model for further study of the VACTERL deformity.

Case Reports

Occult Craniocerebral Injuries From Dog Bites in Young Children

Using the Ilizarov External Fixation Device for Skin Expansion

Bilateral Eyelid Edema: Cutis Laxa or Blepharochalasis?

A Vascularized Osteocutaneous Fibular Free Flap for Reconstruction of a Complex Injury of the Foot

The Full-Thickness Retroangular Flap

Secondary Epispadias Repair With Rectus Abdominis Musculocutaneous Flap

Review Article

A Guide to Establishing the Risk for Breast Cancer in the Plastic Surgery Patient

David B. Drake, MD Brent C. Faulkner, MD Lester R. Amiss Jr, RN et al

Adam R. Kolker, MD Christopher J. Coombs, FRACS John G. Meara, MD, DMD

et al

A. Corde Mason, MD David D. Zabel, MD Ernest K. Manders, MD

Alexander Lerner, MD Yehuda Ullmann, MD Haim Stein, MD Isaac J. Peled, MD

A. Braakenburg, MD J.-P. A. Nicolai, MD, PhD

Yoon-Kyu Chung, MD, PhD Joon Pio Hong, MD Sang-Yoon Kang, MD

et al

Naoshige lida, MD Noboru Ohsumi, MD Yoshiaki Tsutsumi, MD Mamoru Tonegawa, MD

Mustafa Yilmaz, MD Haluk Vayvada, MD Adnan Menderes, MD Ali Barutcu, MD

Karen A. Gronau, MD, MSc John L. Semple, MD, MSc, FRCSC, FACS

Contents of Volume 45, July-December 2000

Tips and Techniques

Staged Closure of Complicated Bronchopleural Fistulas

An Improved Design for Vacuum Tube Drains

Editorial For Whom the Bell Tolls


Re: Nonsurgical Delay of Cutaneous Flaps Using the Flash Lamp Pumped Pulsed Dye Laser


Re: Aeromonas Species Isolated From Medicinal Leeches

Re: Increased Axonal Regeneration Through a Biodegradable Amnionic Tube Nerve Conduit: Effect of Local Delivery and Incorporation of Nerve Growth Factor/Hyaluronic Acid Media

Different Approaches in Extreme Nasal Septum Deviation

Axillary Reduction Mammaplasty

Book Review

Manual of Sclerotherapy


Andrew E. Turk, MD Yvonne L. Karanas, MD Walter Cannon, MD James Chang, MD

Oren Lapid, MD

Yuval Kreiger, MD

Ronen Glesinger, MD

Alexander Bogdanov-Berezovsky, MD, PhD

William D. Morain, MD

M. M. Al-Qattan, FRCSC

G. Aslan, MD N. Karagal, MD M. Gorgii, MD B. Erdogan, MD

Ethem Guneren, MD Murat Hokelek, MD, PhD Cafer Eroglu, MD

O. Ata Uysal, MD

Marcel F. Meek, MD J. Henk Coert, MD Peter H. Robinson, MD, PhD, FRCS

Sergio Brongo, MD Giuseppe Ferraro, MD Francesco D’Andrea, MD

Yhelda Felicio, MD

Brian M. Kinney, MD, FACS

Contents of Volume 45, July-December 2000

Number 6/December 2000

Original Articles Outcomes in Breast Reduction Surgery

A prospective series of 69 women undergoing reduction mammaplasty was evaluated pre-operatively and post- operatively with quality-of-life and psychological testing. Whereas pre-operative physical health was rated poorer than control patients, significant improvement was noted in all areas

nine months post-operatively with health status similar to controls.

Prefabrication of Combined Composite (Chimeric) Flaps

in Rats With Invited Discussion by Geoffrey G. Hallock, MD

A rat chimeric flap with four different tissues was successfully prefabricated by wrapping a fascial graft and local muscle flap around the saphenous and superficial inferior epigastric pedicles, adding an ear cartilage graft, and implanting the structure subcutaneously. Re-elevation demonstrated 86% and 100% survival at six and twelve weeks, respectively.

The Use of Serial Tissue Expansion in Pediatric Plastic Surgery With Invited Discussion by Bruce S. Bauer, MD

Serial tissue expansion with 63 expanders was performed on 12 children for reconstruction of giant nevi and burn deformities. Complication rates for the first to fourth expansions were 4%, 20%, 18% and 0%, respectively.

Management of Lawnmower Injuries to the Lower Extremity in Children and Adolescents

Sixteen pediatric lower-extremity lawnmower injuries required early debridement and bony fixation in all cases, with half sustaining amputations. Three of five long bone fractures

underwent external fixation, and five free flap transfers were required.

New Eyebrow Lift Technique Using a Semiautomatic

Suturing Device (Maniceps) for Patients With Facial Paralysis

Thirteen facial paralysis patients underwent fascia lata suspension browlift through two small post-hairline incisions with the aid of a semiautomatic suturing device.

Tuberous Breast Deformity: Principles and Practice

Sixteen patients with 23 tuberous breast deformities were surgically treated in accordance with an algorithm based on a three-tiered anatomic classification system.

Ramin A. Behmand, MD De-Hong Tang, PA David J. Smith, Jr. MD

Atay Atabey, MD

Edward McCarthy, MD Paul Manson, MD

Craig A. Vander Kolk, MD

Donald A. Hudson, FRCS Dirk Lazarus, FCS(SA) Ram Silfen, MD

Detlev Erdmann, MD Ben Lee, MD

Craig D. Roberts

L. S. Levin, MD

Atsushi Niu, MD, DDS Kazuki Ueda, MD

Mutsumi Okazaki, MD Akira Momosawa, MD

John G. Meara, MD, DMD Adam Kolker, MD

Glenn Bartlett, FRACS

et al

Contents of Volume 45, July-December 2000

The Cross-Leg Soleus Muscle Flap

Nine large lower-extremity defects were closed with cross-leg soleus flaps. The flap is advantageous when the recipient vessels are too damaged for a free flap, and its donor site is superior to that of the conventional cross-leg flap.

Lateral—-Dorsal Neurovascular Island Flaps for Pulp Reconstruction

Seventeen acute traumatic digital pulp losses were reconstructed with two types of homodigital lateral-dorsal neurovascular island flaps. Mean static two-point discrimination was 5.2 and 9.3 mm in the two types, and 71% had no loss of interphalangeal motion.

Reducing Postoperative Morbidity After the Insertion of Gold Weights to Treat Lagophthalmos

A review of 76 facial paralysis patients with prior gold lid loading demonstrated a 12% revision rate for inadequate weighting and a 16% extrusion rate. All extrusions and most

migrations of the implant occurred in the absence of suture fixation.

The Effects of Hyperglycemia on Skin Graft Survival in the Burn Patient

A study of 74 burn patients indicated that skin graft take was significantly decreased in the presence of hyperglycemia and/or gram-positive bacterial counts = 10° per gram of tissue.

Application of Artificial Dermis Graft to Correct a Depression After Tissue Resection

Seven patients with contour depression following tissue resection underwent implantation of 5-mm thick sheets of atelocollagen sponge. No allergic or infectious complications occurred, and significant residual thickness of the implants was noted on MRI at eight months after placement.

Case Reports

End-to-Side Neurorrhaphies of the Ulnar and Median Nerves at the Wrist: Report of Two Cases Without Sensory or Motor Improvement

Phlegmasia Cerulea Dolens of the Upper Extremity

Severe Extensor Tendon Attrition and Multiple Tendon Ruptures Resulting from Kienbéck’s Disease

Chris Ladas, FCS (Plast) Roger Nicholson, FCS (Plast) Vernon Ching, FCS (Plast)

Chien-Tzung Chen, MD Fu-Chan Wei, MD, FACS

A. Misra, MRCS

R. Grover, FRCS

S. Withey, FRCS (Plast) et al

Arian Molavi, MD Kris Andrews, MD

Stephen Milner, MB, BS, BDS, FRCS (Ed) et al

Mitsuo Hatoko, MD, PhD Masamitsu Kuwahara, MD Aya Tanaka, MD

et al

Aycan Kayikcioglu Sebat Karamirsel Galip Agaoglu

et al

D. Glynn Bolitho, MD, PhD Eric T. Elwood, MD Fred Roberts, PA-C

S. Ramkumar, MBBS 1. C. Josty, FRCS P. J. Sykes, FRCS

Contents of Volume 45, July-December 2000


Three Different Types of Congenital Lacrimal Sac Fistulas

A Rare Craniofacial Cleft: Bilateral Tessier No. 5 Cleft Accompanied by No. 1 and No. 6 Clefts

Bilateral Congenital Pits of the Upper Lip

Pilar Leiomyoma: A Case Report and Review of the Literature

Review Article

The Evolution of Velopharyngeal Imaging

Guest Editorial Was the Power Really Off?


Re: Breast Reduction Outcome Study


Re: Endoscopic Harvest of the Rectus Abdominis Muscle

Perioperative Use of the Endoscope in Cleft Palate Surgery: A Preliminary Report

Sight Lost After Lower Lid Blepharoplasty

The Use of Hirudo medicinalis in Nipple-Areolar Congestion

Human Skin Allograft for Difficult Extremity Wounds

Chiaya Toda, MD

Keisuke Imai, MD Kounosuke Tsujiguchi, MD et al

Ufuk Bilkay, MD