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The Use of Three Free Flaps in the Simultaneous Reconstruction of the Nose after Extensive Resection Due to Malignant Cancer

100%
Grajek M., Maciejewski A., Szumniak R., Krakowczyk Ł.
Polish Journal of Surgery
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2012
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vol. 84
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issue 2
99-101
EN
Reconstructive techniques for extended posttraumatic or post-resectional nose defects are well described. Small defects can usually be closed using local flaps with a good esthetic result. Extended resections in the mentioned area require more complex reconstruction methods, including microvascular techniques. The Authors' presented a case of whole nose and partial cheek simultaneous reconstruction using three free flaps. Two auricular free flaps and one radial forearm free flap were used to cover the defect. Meticulous preoperative planning and harvesting of flaps enabled to achieve good esthetic and functional results.
2
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The Use of a Pedunculated, Extended Latissimus Dorsi Flap in Primary and Secondary Breast Reconstruction Procedures - Case Report

88%
Maciejewski A., Ulczok R., Dobrut M., Szumniak R., Półtorak S.
Polish Journal of Surgery
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2012
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vol. 84
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issue 7
367-370
EN
The extended latissimus dorsi flap (LD) is used in breast reconstruction since the 70's. LD flap is often used in corrective surgery in cases of unsatisfactory cosmetic results after breast-conserving therapy. In our department LD flap has several uses. In addition to free microvascular flaps - which applies in breast reconstructive surgery is routine, there are clinical situations where the use of pedicled LD flap is justified. The main indications for its use are: the inability to apply microvascular flap, the general condition (diabetes, advanced atherosclerosis), smoking, previous surgery of abdominal wall, abdominal obesity, patient preferences. Approximately 30% of patients after breast reconstruction require corrective procedures. Group which uses extended LD flap account for 24 patients. In 16 cases it was used for elective breast reconstruction. In the remaining eight cases it was used in the corrective procedures symmetry and shape of the previously reconstructed breast. Based on our own experience it can be concluded that the LD flap with an alternative to microvascular techniques. Complication rate when using the LD flap is relatively low and includes: seroma and slight motor disability of the shoulder girdle.
3
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Transverse (Tram) rectus abdominis myocutaneous flaps for Rectovaginal and Rectovesical Fistulas Treatment after low Anterior rectal Resection due to Adenocarcinoma

76%
Krakowczyk Ł., Maciejewski A., Wierzgoń J., Szumniak R., Grajek M., Dobrut M., Półtorak S.
Polish Journal of Surgery
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2010
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vol. 82
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issue 5
279-282
EN
The rectovaginal or rectovesical fistula is a rare complication after low anterior resection for rectal cancer. Treatment is difficult and the result is often unsatisfactory.The aim of this paper was to present results of treatment with transverse rectus abdominis myocutaneous flaps of rectovaginal and rectovesical fistulas as complication of low anterior rectal resection due to adenocarcinoma.Material and methods. We report six patients with rectovaginal or rectovesical fistulas as a postoperative complication after low anterior resection of rectal cancer in Department of Oncological and Reconstructive Surgery in 2006-2008. Transverse rectus abdominis myocutaneous flaps are used for rectovaginal and rectovesical fistulas treatment.Results. In the follow-up period from 4 to 30 months no rectovaginal or rectovesical fistula recurrences and any postoperative complications were noted in all cases.Conclusions. Transverse (TRAM) rectus abdominis myocutaneous flaps are an effective, surgical method for rectovaginal or rectovesical fistulas treatement, especially in patients who recived pre or postoperative radiotherapy.
4
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The Use of Double Independent Free Flaps for Tissue Reconstruction After Extensive Head and Neck Tumors Resection

52%
Maciejewski A., Jędrzejewski P., Szymczyk C., Wierzgoń J., Dobrut M., Szumniak R., Grajek M., Krakowczyk Ł., Półtorak S., Ulczok R., Oleś K.
Polish Journal of Surgery
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2010
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vol. 82
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issue 12
666-676
EN
Malignant tumors of head and neck regions usually need wide radical resections and may cause significant functional and aesthetic deficits. When a surgeon has to deal with extensive 3-D defect in lower or middle face region, double or multiple free flaps can be used.The aim of the study was to present own methods modifications and results of double free flaps techniques in patients with extensive defects of head and neck region. The authors present quality of life evaluation related to different flaps reconstructions.Material and methods. Clinical material consists of 33 patients with locally advanced cancer of lower or middle face region, who underwent surgical treatment in Departmant of Surgical and Reconstructive Surgery, Cancer Center Maria Skłodowska-Curie Instytute, Gliwice, Poland. In all patients double free flaps were chosen.Results. Whole group good functional and aesthetic results have been achieved. The QOL analysis show that the use of double flap in middle of lower face reconstruction gives generally very good results.Conclusions. The use of double free flaps after extensive resections of head and neck tumors is an efficient solution. The above-mentioned technique enables to reconstruct several different anatomical structures, restore optimal functioning, and assure a satisfactory psychosocial effect.
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