Latissimus dorsi free flap for reconstruction of extensive full-thickness abdominal wall defect. A case of desmoid tumor

Desmoid tumor is a rare, benign fibroblastic tumor that is characterized by highly aggressive local invasiveness. The authors report the case of a 35-year-old male who presented with a 20 cm para-umbilical tumor invading the right rectus abdominis muscle. This required a wide excision of the abdominal wall. The resulting defect was closed with a single-stage latissimus dorsi myocutaneous free flap in combination with a prosthetic mesh reconstruction. The authors discuss the therapeutic options for management of these rare tumors and the variety of available techniques for coverage and reconstruction after extensive parietal loss of substance.

[Calvarial bone grafting in augmentation rhinoplasty. Long-term results]

INTRODUCTION

Various clinical situations may require an important increase of the size of the nose. The aim of our work was to analyze long-term results of calvarial bone grafts used in rhinoplasties.

MATERIAL AND METHOD

We retrospectively studied the files of 20 patients having undergone a calvarial bone graft. Photogrammetry was used to determine morphological modifications and the stability of results.

RESULTS

The average follow-up was 8 years. The parietal donor site morbidity was low. All nose sizes were dramatically augmented and the stability of results ranged between 74.5 and 95%.

DISCUSSION

The calvarial bone graft can be used for important nose augmentation with a good stability. There are few alternative techniques. This method is only limited by available skin and endonasal lining. Calvarial bone graft in rhinoplasty is not frequent but it is our first choice for the correction of important hypoplasia or saddling of the nose.

[Reconstruction of the nasal alar defect with the superiorly based nasolabial flap described by Burget: report of seven cases]

BACKGROUND

The reconstitution of a nasal alar rim and lobule defect represent a difficult challenge in consideration of his situation, anatomy and function. This article describes the technique and the interest of the nasolabial flap when used to cover the entire alar subunit.

METHODS

We present 7 cases of alar rim and lobule defect after skin cancer excision. In the series, there are two full-thickness with lining defect. The patients were reconstructed with a superiorly based nasolabial flap, according to the subunit principle as introduced by Burget. A free cartilage graft was used to restore structural support with marginal skin flaps were turned over for intranasal lining when necessary.

RESULTS

The cosmetic and functional outcomes of each repair were judged from good to excellent by patients and surgeons. No case of flap infection or necrosis occurred.

CONCLUSION

The superiorly based nasolabial flap, describe by Burget, provides an excellent choice for cosmetic and functional reconstruction of the nasal alar defect.

L'abdominoplastie : vers une chirurgie en deux temps ? Étude rétrospective des complications postopératoires à propos de 100 cas

Abdominoplasty has become in France a frequent, appearing to be technically easy but nevertheless source of potentially serious complications clearly deteriorating the aesthetic results and the satisfaction rate of the patients. By studying the results of a hundred abdominoplasties performed between 2001 and 2004, we could count the incidence of the various complications by seeking their possible factors of risk (tobacco or ponderal overload). In spite of the use of a lymphatic preserving technique, the percentage of séroma reaches 12%. The high complications rate or the number of insufficient results explains a rate of surgical reoperation of 31%. Abdominoplasty passed from the statute of repairing surgery to that of aesthetic surgery. The level standard in terms of result became equivalent to the other purely aesthetic interventions. Obtaining an optimal result thus requires often two operational stages, data element that it henceforth seems essential to us to provide to the patients.