[Emergency care by the practitioner in injuries of the hand].
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Biomedical subjects
Publications and source records attributed to P Rheiner.
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Important loss of tissue in the distal third of the leg sets a difficult problem in reconstruction. The first case gives an example of a free vascularized bone graft, the second of application of the dorsalis pedis flap as an island. The indications are discussed and some points of the operative procedure are mentioned.
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A 20 year old patient is reported who suffered traumatic amputation of both testicles, the proximal skin of the penis and the scrotum. Scrotal reconstruction was achieved with a sensitive free dorsalis pedis flap.
The transfer of the omentum majus by microvascular anastomosis has been used for correction of a severe hemifacial atrophy (Romberg's disease) in a young woman. The operation was performed by two teams working simultaneously. The right gastro-epiploic artery was anastomosed to the facial artery and the corresponding vein to the jugular vein. 22 months later, new distribution and volume-reduction of the omentum was performed. During this last operation the exellent vascular condition of the transferred tissue and unexpected recovery of the atrophic skin was confirmed. The final esthetic result can be considered satisfactory.
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