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Propeller perforator flaps (PPFs) have long been proven as valid reconstructive tools for a wide range of soft tissue defects in different body regions. During the last decade, despite their numerous advantages, many authors have thoroughly analyzed outcomes of these flaps, sometimes discouraging their use mainly because of a high failure rate. Accurate patient selection, adequate preoperative planning, and an appropriate dissection technique seem to potentially improve outcomes. Our study provides a review of the relevant literature related to PPF complications and of our experience, describing reasons for failure, measures for preventing them, and approaches for a prompt evaluation and management of complications.

Reconstruction after resection of advanced stage hidradenitis suppurativa is currently performed with pedicled perforator flaps, that allow functional reconstruction and preservation of shoulder function. Skin availability is limited by the possibility of closing the donor site primarily. Bilateral cases need to be treated in two stages, since the operation is carried out in the lateral decubitus. In this manuscript the application of bilateral and bipedicled DIEAP flaps to bilateral and extensive cases is presented.Between October 2008 and October 2018, 39 patients were treated for axillary hidradenitis suppurativa. Of these, 11 patients had bilateral reconstruction with bilateral DIEAP flaps (22 flaps) and one patient had unilateral reconstruction with a bipedicled DIEAP flap. 23 flaps were used. Twelve flaps were raised above Scarpa's fascia, 6 flaps werethinned after dissection. Three flaps were not thinned in the first stage. Average flap size was 14 × 17cm for the bilateral flaps, while the bipedicled flap was 15 × 32cm.Average operative time was 324 minutes. No flap necrosis was observed. Two patients had wound dehiscences in the axilla and one in the abdomen, all treated conservatively. One patient had a pyoderma gangrenosum at both surgical sites that healed after cortisone therapy. No revisions were needed for the flaps that were thinned during the primary operation. The three patients whose flaps where not thinned needed liposuction after three months for thinning. There was one disease recurrence, unilateral and treated surgically. Mean follow up was 64 months.Axillary reconstruction with the DIEAP flap allows reconstruction of large and bilateral defect in a single operation closing the donor site primarily. If the flap is thinned during the operation, no thinning seems to be needed postoperatively. Otherwise the flap shall be thinned by liposuction three months after the initial procedure. We believe that the benefits of this technique outweigh the added complexity of a microsurgical procedure when bilateral resections are needed, the defects are too wide to close the donor site of a pedicled flap primarily and the lower abdomen is free of disease.EINFüHRUNG: Die Rekonstruktion der Axilla nach Resektion bei fortgeschrittener Hidradenitis suppurativa (Akne inversa) erfolgt in unserer Erfahrung mit gestielten Perforans-Lappenplastiken, die eine funktionelle Rekonstruktion und einen Funktionserhalt der Schulter erlauben. Die Verfügbarkeit der Haut ist um die Axilla durch die Notwendigkeit eines primären Verschlusses der Entnahmestelle begrenzt. In dieser Arbeit werden die Anwendung und die Ergebnisse von bilateralen freien DIEP-Lappenplastiken bei Patienten mit bilateraler und großflächiger Resektion vorgestellt. Von Oktober 2008 bis Oktober 2018 wurden 39 Patienten mit Hidradenitis suppurativa chirurgisch behandelt. Bei 11 dieser Patienten erfolgte eine bilaterale Rekonstruktion mit bilateraler DIEP-Lappenplastik (22 Lappenplastiken). Bei einem Patienten wurde eine unilaterale Rekonstruktion mithilfe einer doppelt gestielten DIEP-Lappenplastik durchgeführt. Insgesamt wurden 23 Lappenpkastiken verwendet. Zwölf Lappenplastiken wurden über der Scarpa-Faszie gehoben, 6 Lappenplastiken wurden nach der Dissektion ausgedünnt. Drei Lappenplastiken wurden in der ersten Phase nicht ausgedünnt. Die durchschnittliche Lappengröße betrug bei den bilateralen Lappenplastiken 14 × 17 cm und beim doppelt gestielten Lappenplastiken 15 × 32 cm. Die mittlere Nachbeobachtungszeit lag bei 64 Monaten. Die durchschnittliche Operationsdauer lag bei 324 Minuten. Es wurden keine Lappennekrosen festgestellt. In zwei Fällen kam es zu einer axillären, in einem Fall zu einer abdominalen Wunddehiszenz. Diese wurden alle konservativ behandelt. Bei einem Patienten wurde an beiden Operationsstellen ein Pyoderma gangraenosum beobachtet, das nach Kortisontherapie abheilte. Bei den Lappenplastiken, die während des primären Eingriffs ausgedünnt wurden, war keine Revision erforderlich. Die drei Patienten mit den nicht ausgedünnten Lappen benötigten nach drei Monaten eine Liposuktion zur Ausdünnung. In einem Fall kam es zu einem Krankheitsrezidiv. Dieses war unilateral und wurde chirurgisch behandelt. Die Rekonstruktion der Axilla mit DIEP-Lappenplastiken ermöglicht die Rekonstruktion großer und bilateraler Defekte in einem einzigen Eingriff mit primärem Verschluss der Entnahmestelle. Wenn die Lappenplastik während der Operation ausgedünnt wird, scheint postoperativ keine weitere Ausdünnung erforderlich zu sein. Ansonsten sollte der Lappen drei Monate nach dem Ersteingriff durch Liposuktion ausgedünnt werden.

The problem of treating tissue defects of the scalp to date remains one of the actual problems of modern medicine. Low elasticity, stiffness, and the presence of hair follicles and skin deficit dictate the need for new treatments, cosmetic relevant requirements of this zone. The use of expander dermotension in recent years has found its wide distribution in the treatment of defects and deformities of covering tissue anywhere on the body. On the example of a patient K.32 years old hospitalized with diagnosis-basal cell epithelioma of the scalp-the defect of soft tissues, we demonstrated the use of expander plastic in the treatment of defect covering tissues of the scalp. Thus, when there is a defect or deformation of covering tissues of the scalp, the most optimal is defect removal by tissues expander plastic. Transposition of pre fabricated by dermotension tissue complexes allows to liquidate quickly the defect of soft tissues, restoring normal full layered structure of the affected area of the scalp, and get good aesthetic results of treatment in these patients.

Background: To provide quantitative objective data demonstrating the longevity and amount of volume augmentation in the fatty dystrophy of the facial tissue obtained with autologous lipofilling. Methods: In our clinic had been operated 8 patients for last 2 years with fatty dystrophy of the facial tissue. A prospective analysis of all patients who underwent at our private practice and were followed up for at least 1,5 year. Surgery was performed under general anesthesia it is necessary for clear results tissue correction. We based on the literature has seen numerous clinical reports highlighting the benefits of autologous fat transfer for face from that areas, fat was collected from the abdomen (most frequently used donor site), hips, outer thighs (saddle-bags), internal knee or thigh, with quantitative volume measurements evaluating the amount of postoperative volume change. Results: Twenty eight patients were included in the study. The mean follow-up time was 18 months. The mean amount of autologous fat injected into each face region was 10-70 mL. Hypercorrection was performed after 3 months and it was 20-50% of the initial injected fat volume. Overall, the mean absolute volume augmentation measured at their last (after 6 month) post operative visit was 10-25%. There was variability between patients in the volume amount and percentage that remained. The resorption process was observed in two patients after 6 month. We made correction with hyaluronic acid and silicone implants. Conclusion: To our knowledge, this study is the first clinical quantification in our practise of autologous fat transfer and/or grafting in the literature that provides definitive evidence on the amount as well as the resultant longevity in the face. Autologous fat transfer to the face has definite long-term volume augmentation results. On average, approximately 25-35% of the injected volume remains at 18 months. However, some variability exists in the percentage of volume that remains that may require a touch-up procedure.

We investigate a mechanism responsible for the observed very short times of the photon-echo decay (of the order of a few femtoseconds) in semiconductors. It is associated with the loss of phase memory as a result of the interaction of the interband mixed state with an unscreened random Coulomb potential of the photocarriers and/or charged impurities. A time characteristic of a system of interacting electrons is found. This is the time of phase breaking ${\mathrm{\ensuremath{\tau}}}_{\mathit{c}\mathit{p}\mathit{h}\mathit{i}}$, which we calculate within the eikonal approximation using diagrammatic techniques. ${\mathrm{\ensuremath{\tau}}}_{\mathit{c}\mathit{p}\mathit{h}\mathit{i}}$ is shown to be typically much shorter than both the time of electron-electron collisions and the period of plasma oscillations. We demonstrate that the screening of Coulomb potential cannot be built up during this time. ${\mathrm{\ensuremath{\tau}}}_{\mathit{c}\mathit{p}\mathit{h}\mathit{i}}$ is proportional to ${\mathit{n}}^{\mathrm{\ensuremath{-}}1/\mathit{d}}$ (where n is the carrier concentration and d the dimensionality of a system), which is consistent with the experimental results. The derived law of echo decay of the form exp[-(\ensuremath{\tau}/${\mathrm{\ensuremath{\tau}}}_{\mathit{c}\mathit{p}\mathit{h}\mathit{i}}$${)}^{\mathit{d}}$] agrees with the results of numerical simulation, although it does not agree with the existing results of physical experiment. We believe that such a disagreement is of a fundamental nature and manifests a basic need for further experimental and theoretical work.

A theory of femtosecond photon echo pulse decay in semiconductors is developed. The echo is due to band-to-band transitions produced by two successive pulses of coherent light. We propose that the decay is a result of the unscreened carrier-carrier interaction that brings about dephasing of the electron-hole wave function. We come to the conclusion that the time of dephasing is proportional to n-1/3, where n is the carrier concentration.

The theory of electric-dipole two-pulse echo in semiconductors under the conditions of micronvave hopping conductivity is developed. It is shown that the echo signal is due to the interaction of an a.c. electric field with pairs of neighboring donors. The characteristic spatial distance between them is much smaller than the average distance. Each such pair consists of one impurity center which is occupied by an electron and another center that is empty. Such a pair (the so-called close pair) is a two-level electron system and different pairs have, in general, different interlevel spacings. The interlevel spacings have random values distributed within a wide range of energies of the order of the impurity bandwidth. The echo pulse form is analyzed as a function of the pumping pulse amplitude for a broad range of amplitudes