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Abstract: A series of 11 inferior gluteal free flaps is presented in eight patients with a mean age of 3 years and 3 months. The flap has been used four times for breast reconstruction, five times for the sequelae of axillary and popliteal burns, and twice for posttraumatic problems. Three necrosis were observed due to poor limb vascularity (electric burns, atheroma, sequelae of trauma). It is possible to form a pedicle of 7–8 cm. There is minimal donor site scarring which is the flap’s strong point. Undoubtedly this flap deserves a place with other classical breast reconstruction techniques. It can also be used as a back-up technique for release of contractures over joints.

The free jejunal graft is a very useful procedure for hypopharyngeal reconstruction after total pharyngo-laryngectomy. Between 1985 and 1994 56 patients with squamous cell carcinoma of the hypopharynx were treated by this method. The median age was 54 (range 35-76). There were 54 men and 2 women. The mortality rate was 4% (2/56). The graft failure was 4% (2/56). Good swallowing function was achieved in 91% (49/54 assessable patients). Nine patients developed local recurrences, four patients had local and neck recurrences. Distant metastases occurred in six patients and five developed metachronous cancers. Follow-up analysis showed a 5-yr survival rate of 33%. After 10 yr, the free jejunal graft has become, for us, the method of choice for hypopharyngeal reconstruction after total pharyngolaryngectomy.

In pedicle musculocutaneous flaps, a local circulatory insufficiency with a total or subtotal ischemia may occur and jeopardize the result of the reconstructive surgery. Transcutaneous oxygen pressure (PtcO2) monitoring has been shown to reflect tissue perfusion and has been advocated to predict the final outcome of ischemic flaps. Unfortunately, under normal atmospheric conditions, this test is not sufficiently discriminative. We evaluate the effect of hyperbaric oxygen conditions on the efficiency of this test.

Le lévamisole, antihelminthique et immunomodulateur (en ATU nominative) est un inducteur de vascularite à ANCA. Les cas de purpuras vasculaires induits par lévamisole sont rares et peu étendus. Leur prévalence augmente depuis que le lévamisole est utilisé comme produit de coupage de la cocaïne. Nous rapportons un cas de purpura très étendu induit par lévamisole.