Scapular Flaps

  • Scapular Flaps

    These flaps are perfused by branches of the circumflex scapular artery and its associ-ated veins. The artery is formed by division of its parent vessel, the subscapular, itself a branch of the axillary artery. The subscapular artery passes down on the posterior wall of the axilla for approximately 4 cm, where it divides into the […]

  • Pressure Sore Management

    NON-PARAPLEGIC PRESSURE SORES The usual sites of pressure sores in the non-para-plegic are the sacral area and heel, occasionally the iliac crest, and the background to their occur-rence is immobility of the patient. Although immobility is ultimately responsible for the local pressure being prolonged for sufficiently long to produce the local ischaemia which leads to […]

  • Management

    If a keloid is surgically excised, the probability that the resulting scar will develop into a fresh keloid is extremely high, and the more florid the keloid the greater the probability. For this reason surgery of keloids is generally to be avoided. However, when the scar is hypertrophic rather than keloid and is bridging a […]

  • The Clinical Picture

    A precise picture of the condition is difficult to draw, for clinical generalisations do not necessarily apply to the individual case and the condition itself is extremely variable and unpredictable. In the description which follows, the term keloid will be used to cover both conditions. The tendency to develop keloids appears to diminish with age, […]

  • Omental Flap

    The surgeon is occasionally confronted with a large defect which requires reconstruction without delay, which will not accept a free skin graft, and for which, for technical reasons, no flap is suitable, whether skin, fasciocutaneous, muscle or myocutaneous, pedicled or free. The sites most likely to give rise to such a problem are the scalp […]

  • Hypertrophie Sears And Keloids

    When a scar, instead of becoming soft and pale in the usual manner, becomes red and thickened it is described as being either a hypertrophic scar or a keloid. These terms tend to be used rather indiscriminately, probably because it is difficult to define each with certainty. The hypertrophic scar is raised above the level […]

  • Lasers

    In treating the port wine stain type of haemangioma, the use of cover by cosmetics, and surgical removal, have been the unavoidable mainstays despite their manifest inadequacy, but the development of laser technology has now added a third therapeutic possibility. Two main types of laser are currently used, argon and tuneable dye lasers. Both instruments […]

  • Liposuction

    Liposuction is a technique which permits ‘blind’ removal of subcutaneous fat through a small skin incision. Its most frequent clinical role is a cosmetic one, in the removal of unwanted subcutaneous fat as an element in ‘body sculp-turing’, but it also has a small place in routine plastic surgical practice, in removing large lipomas and […]

  • Vein Grafts

    On occasion when planning reconstruction it is clear from the outset that the intended free flap lacks the pedicle length to reach adequate, healthy receptor vessels. This deficiency may not be apparent until the pro-cedure is underway. Whether no alternative reconstruction is possible or whether past the point of no return, this shortfall, due to […]

  • Suturing Sequence

    The sequence in which the sutures are placed may vary, but the same technique is used for each individual suture. For end-to-end anastomosis, a suture is inserted at each end of the opening. The back wall is then sutured, followed by the front wall. For end-to-side anastomosis, the triangulation technique classically described by Carrel is […]