Measurements were carried out intra-operatively after clamping and declamping the perforator vessels. In the post-operative period measurements LDK378 were carried out every hour for the first 48 hours and from 3rd to 7th for every 2 hours. These dates were compared to findings of clinical assessment. Several intra-operative measurements, during the clamping and declamping the different perforator vessels, revealed a high correlation for all parameters: Flow (r = 0.89, P < 0. 05), Velo (r = 0.92, P < 0. 05), SO2 (r =0.84, P <0. 05), and rHB (r =0.83 P < 0.05). Vessel occlusion

was detected in five cases, of which three were due to arterial thrombosis and two further FK506 cases were due to venous occlusion. Of the five cases, one flap loss caused by venous occlusion was noted. The O2C-device seems to be a reliable, objective, and non-invasive device for the monitoring of free flaps. Thus, it may improve flap survival rates by detecting vascular compromise at an early stage. © 2013 Wiley Periodicals, Inc. Microsurgery 33:350–357, 2013. “
“In brachial

plexus injuries, though nerve transfers and root grafts have improved the results for shoulder and elbow reconstruction, wrist extension has received little attention. We operated on three young patients with C5–C8 root injuries of the left brachial plexus, each operated upon within 6 months of trauma. For wrist extension reconstruction, we transferred a proximal branch of the

to flexor digitorum superficialis to the motor branch of the extensor carpi radialis brevis. Twenty-four months after surgery, all patients recovered some degree of active wrist motion, from full flexion to near neutral. Independent control of finger flexion and wrist extension was not observed. In C5–C8 root injuries of the brachial plexus, transfer of a flexor digitorum superficialis motor branch to the extensor carpi radialis brevis produces limited recovery. © 2012 Wiley Periodicals, Inc. Microsurgery, 2013. “
“Composite defects of bone and soft tissues represent a reconstructive challenge. Several techniques have been described in the medical literature; however, extensive composite defects should be reconstructed with microvascular free tissue transfer. The purpose of this report is to present the use of a composite latissimus dorsi and serratus anterior and rib free flap (LD-SA/rib) as an alternative procedure in patients who cannot undergo more commonly used vascularized bone-containing free flap reconstruction. Since January 2009, 12 patients have undergone bone and soft tissues reconstruction with a composite LD-SA/rib flap. In this case series, indications for LD-SA/rib reconstruction were large mandibular defects after oral cancer ablation, scalp defects, and lower extremity defects. All flaps survived entirely.