Özlem Karataş

The distally based superficial sural artery island flap: clinical experiences and modifications.

&NA; The coverage of defects of the Achilles tendon, malleoli, and heel remains a challenge to reconstructive surgeons. The distally based superficial sural artery island flap is vascularized by the median superficial sural artery, posterolateral septal perforators originating from the peroneal artery, neurovascular arteries of the sural nerve, and combinations of these systems as suprafascial plexus. We used distally based superficial sural artery island flaps for the reconstruction of defects of ankle, malleolus, and heel in 17 patients between 1991 and 1997. The largest flap we have used until today was 12 cm in width and 15 cm in length. All flaps have survived. However, we observed venous congestion and edema in two flaps. Also, marginal necrosis occurred in two flaps for which we had not taken the sural nerve with the flap. After these complications, we made some modifications. We left a skin extension over the fasciovascular pedicle and used it as a roof of the tunnel. We took the sural nerve and the deep fascia in all cases. The main advantage of this flap is a constant and reliable blood supply without sacrifice of a major artery. In addition, this is a one‐stage, safe and easy procedure that can be used for large defects. (Plast. Reconstr. Surg. 102: 2358, 1998.)

Free arterialised venous forearm flaps for limb reconstruction

Arterialised venous flaps are an alternative method to conventional flaps. Arterialised venous flaps include only the venous network and afferent blood comes from the arterial system. Arterialised venous flaps have been mostly used for closure of small defects. We have designed an arterialised venous flap utilising the venous network of the forearm and applied this flap in 5 patients with various defects in the extremities ranging in size from 6 x 8 cm to 10 x 12 cm. Four flaps totally survived. One flap had 30% partial necrosis. Overall clinical results were successful. The free arterialised venous forearm flap provides large, thin, good quality tissue with less morbidity at the donor site without sacrificing one major artery of the hand and can be an alternative for the conventional radial forearm flap.

Delayed prefabricated arterial composite venous flaps: an experimental study in rabbits.

&NA; Prefabrication of composite arteriovenous flaps with implantation of an autologous graft (cartilage) or an alloplastic material (porous polyethylene) was studied in 40 rabbits. Abdominal flaps based on bilateral epigastric pedicles were elevated. An ear cartilage graft or a porous polyethylene implant was inserted under the flap. Two weeks after the operation, 10 flaps with cartilage graft and 10 flaps with porous polyethylene were raised, converted to arteriovenous flaps, and resutured in place in the experimental groups. In the other 20 rabbits of the control groups, the flaps (10 with cartilage graft and 10 with porous polyethylene) were raised and resutured in place as conventional axial flaps. At the end of the second and fourth week postoperatively, samples were obtained from the flap tissues (including a part of the graft or implantation material) and were prepared for histologic examination in all rabbits. The viable areas of all flaps were assessed at the end of fourth week after the second operation. The mean survival rates were 99.4%, 99.7%, 99.5%, and 99.8% in the arteriovenous and control flaps prefabricated with cartilage graft and the arteriovenous and control flaps prefabricated with porous polyethylene respectively. The features of wound healing in the experimental and control groups were similar. The study showed that arteriovenous perfusion can nourish a prefabricated flap containing an implanted material (autologous or alloplastic) and these 2‐week delayed composite flaps have a similar survival rate to delayed prefabricated conventional axial flaps. Karataş Ö, Atabey A, Demirdöver C, Barutçu A. Delayed prefabricated arterialized composite venous flaps: an experimental study in rabbits. Ann Plast Surg 2000;44:44‐52

Postauricular dermoid cyst: a case report

A rare localization of dermoid cyst in the postauricular region is presented.

Mentosternal pterygium with teratoma

A 7-year-old girl with a cervical midline pterygium and teratoma is presented. Pterygium (congenital webbing) of the skin is a rare congenital anomaly. Teratomas are tumors formed by pluripotential primordial germ cells that constitute heterogeneous types of tissues foreign to the organ from which they originate. The undefined connection of two conditions of pterygium and teratoma in the cervical region is reviewed in this case report.

Mirror imaging cleft lip in monozygotic twins

Although genetic and environmental factors have been found to effect the occurrence of cleft lip, many aspects of its etiology are still unclear. The value of the studies on monozygotic twins has been accepted by many authors. Especially the concordant anomalies gain importance in the monozygotic twins who are influenced by the same genetic and environmental factors. Here we present a case of monozygotic twins with cleft lip deformities showing “mirror image” concordance.