Ankle fractures are among the most common orthopaedic surgical procedures. Skin‐related complications of these surgeries are difficult to reconstruct due to the inadequacy of soft tissue in the region. Although free flaps are generally considered as the first choice in reconstruction of this area, free flaps may not be a suitable option especially in patients with advanced age and comorbidities. Perforator flaps offer a fast and safe alternative in lower extremity reconstruction. In the literature, there are a limited number of studies using perforator flaps in managing the postoperative complications of the lower extremity trauma surgeries. In our study, we report our experience with reconstruction of soft‐tissue defects of medial malleolar region using posterior tibial artery perforator flap for postoperative complications of ankle fracture‐related surgeries.

Isolated paralysis of the marginal mandibular nerve results in an asymmetrical lip appearance with aesthetic and functional losses. Until today treatment options include mainly muscle transfers, and botulinium toxin injections for temporary issues. Since it was first reported by Edgerton, the technique of anterior belly of digastric transfer has been one of the most preferred. Alternatives for this technique still remain limited. In this clinical report, a new alternative technique was defined, stylohyoid muscle transfer, for the situations that digastric muscle is absent. The technique was compared with other conventional treatment methods and the outcomes were discussed.

Aim: Nicolau syndrome (NS) is the necrosis of skin and subcuticular tissue, following injection of many drugs, which covers nearly a perforasome. This study aims to unveil our clinical approach and treatment alternatives against this rare pathology subsequent to diclofenac sodium. Material and Methods: In this retrospective study, our approach to 16 patients who developed NS at the injection site after diclofenac sodium injection was evaluated. Patients' demographic data, concomitant diseases, location and size of necrosis, and surgical techniques were collected. Post-operative complications, hospitalization period and results were evaluated. Results: There were total of 16 patients, 2 of which were male and 14 were female. The mean age was 60±14.4 years, and the mean body mass index (BMI) was 33±1.4 kg/m 2 . The major concomitant comorbidity was diabetes mellitus, followed by primary hypertension. The mean defect size was 8x8x5 cm. Surgical debridement was applied to all 16 necrosis. Following the surgical debridement of necrosis, 8 patients were reconstructed with primary closure, 6 patients with fasciocutaneous flaps and 2 patients with delayed primary closure after a week. All patients heal completely without complications. Conclusion: Utmost care must be given when performing diclofenac sodium injections to the patients with comorbidities, such as high BMI, diabetes mellitus, and primary hypertension. The caregiver must be certain that the needle is in the muscular plane and no perforator vessel to be harmed during this procedure. In case of a post-injection necrosis, an early intervention with surgical debridement and reconstruction is an efficient treatment.

Extracorporeal perfusion of organs has a wide range of clinical applications like prolonged vital storage of organs, isolated applications of drugs, bridging time to transplant, and free composite tissue transfer without anastomosis, but there are a limited number of experimental models on this topic. This study aimed to develop and evaluate a human extracorporeal free flap perfusion model using an extracorporeal membrane oxygenation device. Five patients undergoing esthetic abdominoplasty participated in this study. Deep inferior epigastric artery perforator flaps were obtained abdominoplasty flaps, which are normally medical waste, used in this model. Deep inferior epigastric artery perforator flaps were extracorporeally perfused with a mean of 6 days. The biochemical and pathological evaluations of the perfusions were discussed in the article.

Aim: Gynecomastia is a benign enlargement of the breast in males. Surgical treatment options include liposuction, glandular excision and the combination of liposuction and glandular excision. In this study, it was aimed to evaluate 65 consecutive gynecomastia patients who were operated using different techniques and to present the treatment approach, and results and complications related to surgical techniques. Material and Methods: Sixty five patients who underwent gynecomastia operation in our clinic between June 2016 and January 2019 were included in this study. Demographic data, preoperative and postoperative photographs, clinical classification, perioperative details, postoperative results and complications were evaluated retrospectively. Results: Fifty five (84.6%) patients had bilateral gynecomastia and 10 (15.4%) patients had unilateral gynecomastia. Of the 120 breasts operated, 91 (75.8%) were Grade II, 20 (16.7%) were Grade III and 9 (7.5%) were Grade I, according to the Simon classification. Twenty-eight (43.1%) patients underwent liposuction and glandular excision, 35 (53.8%) patients underwent liposuction alone, and two (3.1%) patients underwent glandular excision only. Skin excision was performed for two patients at the first operation. Only two patients, one for inadequate reduction and the other for skin excess, were demanded revision surgery. Conclusion: Surgical treatment options for gynecomastia patients can be determined according to clinical evaluation of breast tissue and skin excess. In young patients with good skin quality, skin excision can be left for a second session. Although there was no significant difference between the methods used in this study, more complications were found with the excisional technique.