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Background Cross-leg flaps are a good choice for reconstructing traumatized lower extremities, especially when free flaps cannot be used. In this article, we present our experience in the treatment of traumatic lower extremity wounds by using cross-leg flaps. Study Design A total of 56 patients suffering traumatic lower extremities were treated with cross-leg flaps. Patients with diabetes mellitus and those who were heavy smokers were also included in this study. Results Most flaps survived without complications. Flap necrosis occurred in 2 cases. The hospital stay was 20.0 ± 6.2 days and the flaps were divided at 13.3 ± 2.8 days. The diabetes patients were mostly elderly, and they had longer hospital stays and duration for flap division. Follow-up was an average of 16.2 ± 8.2 months. Conclusions The cross-leg flap is an effective and simple method for treating traumatic lower extremity wounds. It should have priority over microsurgery, not just be an alternative to it.

Construction of a neourethra is always considered to be a difficult part in phalloplasty, especially for the female-to-male (FTM) transsexual patients. We report our experience with prefabricated pars pendulans urethrae using vaginal mucosal graft for phalloplasty in FTM transsexuals. We retrospectively reviewed notes on the 22 FTM patients treated with pedicled-flap phalloplasty with prefabricated pars pendulans urethrae using vaginal mucosal graft between January 2008 and December 2012. Surgical outcome, urological function, and complications were recorded. Histological difference between normal mucosa and skin, and pathological changes of vaginal mucosal graft were also observed. All the reconstructive penis survived, and patients could void in a standing position finally at a median follow-up of 25.4 ± 6.0 months. Urethral fistula and urethral stricture rates were 31.8 % (7/22 patients) and 4.5 % (1/22 patients), respectively. The occurrence of the urethral stricture was remarkably low compared with previous reports. Our histological results also showed a pronounced similarity between vaginal and buccal mucosa. Morphologically, they resembled urethral epithelium more closely than the forearm skin. Following the free transfer, the vaginal mucosal graft also showed a good revascularization and the inflammatory reaction and the extent of fibrosis of the mucosa decreased to the normal level after a 6-month prefabrication. With prefabrication of vaginal mucosal graft, we reconstruct a competent phallic neourethra in these FTM transsexuals. According to its histological similarities and source character, the vaginal mucosa is the excellent substitute material for promising urethral reconstruction in FTM transsexuals.

The present study was performed to quantitatively analyze the three-dimensional morphology of the nasal septa of patients with alveolar and alveolopalatal clefts.Twenty-five unilateral complete cleft lip patients with alveolar clefts only (alveolar cleft group) and 35 unilateral complete cleft lip patients with alveolar and palatal clefts (alveolar and palatal cleft group) were included in the study. Although no patient in either group had undergone alveoloplasty, all patients had undergone palatoplasty. The degree of nasal septum deviation was studied for each patient at three different depths along the anteroposterior axis using three-dimensional computed tomographic data; the data were compared between the two groups to elucidate whether the difference in cleft type affects the morphologic patterns of the nasal septum.The nasal septa of the alveolar and palatal cleft group patients presented more uneven morphologic patterns than those of the alveolar cleft group patients. In the alveolar cleft group, the nasal septa did not present significantly different degrees of deviation at their anterior and posterior parts. In the alveolar and palatal cleft group, however, the posterior parts of the nasal septa presented greater deviation than the anterior parts. In the alveolar and palatal cleft group, furthermore, a significant correlation was observed between the severity of the cleft and the degree of the nasal septum deviation.The nasal septa present different three-dimensional morphologic patterns between the patients with alveolar clefts only and those with alveolopalatal clefts. This difference should be considered when performing surgical treatments for these patients.

In search of a simpler and safer technique for auricular reconstruction with good appearance.Medpor implant was used as auricular framework, and covered by temporal fascia flap and skin graft.Ear reconstruction was successfully achieved in 19 cases, the newly formed ears all had good appearance after edema disappeared 1 or 2 months postoperatively.Medpor is a kind of good implant material because it is steady in nature, easy to be sculptured. Temporal fascia flap is rich in blood supply, tough and tensile in biomechanics. So the combination of Medpor implant framework with temporal fascia flap is preferable in auricular reconstruction.