[The inferior gluteal musculocutaneous flap: Short and long-term results for 69 patients]

[Perforating flap for covering sacro-coccygeal cysts: About 8 cases]

INTRODUCTION

Multiple surgical revisions (exeresis and directed healing) of recurrent pilonidal cysts are sources of unstable scars. Chronic ulcerations often appear with or without authentic recidivism. A local fasciocutaneous perforating flap based on the parasacral arteries would bring healthy tissue and avoid the disadvantages of conventional techniques (musculo-cutaneous or random).

MATERIALS AND METHODS

A series of 8 cases of transposition flap covering based on parasacral perforators, in multi-operated patients. The perforators are identified by Doppler probe before the gesture, then the flap is traced obliquely according to the size of the loss of substance. The gesture is short, not morbid and accessible to all by a technique that excludes fine dissection of the pedicle. The duration of hospitalization is 2days.

RESULTS

Despite two minor and resolving complications (a hematoma and a disunion of the donor sit) the healing was complete and without recurrence in all patients at 2years, with 100% satisfaction.

CONCLUSION

This reliable and reproducible simple flap becomes the reference technique in our department for the sequelae of recurrent sacro-coccygeal cyst.

[Breast reconstruction with profunda artery perforator flap: A prospective study of 30 consecutive cases]

INTRODUCTION

Many flaps have been described in autologous breast reconstruction, the most common being the deep inferior epigastric perforator (DIEP) flap. This flap cannot be harvested in a certain range of patients. The profunda artery perforator (PAP) flap, based on perforators from profunda femoral artery, is therefore a good option.

OBJECTIVE

The goal was to highlight technical tips, particularities, and complications of our series of the 30 first PAP flaps for breast reconstruction in our department.

PATIENTS AND METHOD

We did a prospective study of all PAP flaps for breast reconstruction between November 2014 and October 2015. Thirty patients were included. We used 2 different types of skin design: classical or with vertical extension. The following parameters were recorded: pedicle length, flap weight, surgery duration, complications on donor or recipient site and type of recipient vessels.

RESULTS

Seventy-seven percent of the cases were delayed breast reconstruction, 23% were immediate. Twenty-five flaps were with classical skin design, and 5 with vertical extension. Mean flap weight was 301g (195-700g). Mean pedicle length was 9.88cm (8.2-12.5cm). Internal mammary vessels were the recipient vessels for 90% of the patients, versus 10% for circumflex scapular vessels. Mean surgery duration was 328min (195-610min). We had two total flap failures. The complications on the donor-site were 2 seroma, and 4 late healing scars. No lymphoedema occurred.

CONCLUSION

PAP flap is a good option when abdominal flap harvesting is not possible. The donor-site is well tolerated, with low morbidity. The indication is for patients with small to medium breast volume.