Radial forearm fl aps. Experience in ten patientsBackground: Radial forearm fl ap is extraordinarily versatile thanks to its irrigation by the radial artery and its minor pedicles. It provides assorted alternatives for the reconstruction of proximal or distal defects of the arm and can be used as a free fl ap in head, neck, posterior trunk region, lower limb, esophagus and penis. It allows the incorporation of bone, tendons, nerves and muscle for complex lesion repair. Aim: To report our experience with radial forearm fl ap. Patients and Methods: Ten patients aged 20 to 65 years (four women) are reported. The lesions repaired were traumatic in four, infectious in three, secondary to tumors in two (a squamous intra oral adenocarcinoma in both patients) and vascular in one patient. Results: No patient had a partial or total loss of the fl ap. Five patients required complementary dermo epidermic grafts in a second intervention. Mean hospital stay was 30 days. All patients reported a favorable degree of satisfaction with the procedure. Conclusions: Radial forearm fl aps are a good alternative for the repair of a great variety of lesions.

Coupler ® venous mechanic microanastomosis. An important technological contribution to microvascular surgery Aim: The aim of the present paper is to show the experience of the Plastic Surgery Division at the University of Chile Clinical Hospital, with the Coupler ® anastomotic device (Synovis Corp, Birmingham, AL) for venous microanastomoses in patients undergoing reconstructive microsurgery. Material and Methods: A retrospective review of 48 consecutive patients with free flaps between March 2009 and in February 2013. All microsurgical venous anastomoses were performed with the Coupler ® device and the arterial anastomoses with interrupted or continuous 9-0 or 10-0 nylon sutures. The collected data were: personal and medical patient information, location of the defect, flap used, vessels diameter, arterial anastomoses, Coupler ® used, time of anastomosis, postoperative complications, arterial and venous thrombosis. Results: A total of 48 free flaps were performed for reconstruction of lower extremity (n = 25, 52.1%); head-neck (n = 15, 31%); breast (n = 5, 10.4%

CT Angiography in preoperative identification of perforator vessels Introduction: Perforator flaps have become a coverage option validated and increasingly used in reconstructive surgery. These flaps require preoperative identification and intraoperative dissection of the perforator vessels. The aim of this study was to evaluate the use of Angio CT in the preoperative assessment of perforating vessels and its correlation with intraoperative findings. Material and Methods: We retrospectively reviewed all perforator flaps performed at the Division of Plastic Surgery, University of Chile Clinical Hospital between June 2009 and June 2012. All patients were asked for an Angio CT according to the protocol of the University of Gent (Belgium). Data points were used and a specific coordinate system to locate the point at which the perforator vessel fenestrate the deep fascia. The information provided in the Angio CT was compared with surgical findings. Results: A total of 41 patients underwent perforator flap planning during the study period. 40 underwent surgery: 18 women and 22 men, with a mean age of 46.6 ± 5.7 years. Flaps were performed as follows: anterolateral thigh (ALT) = 14, inferior epigastric (DIEP) = 18, superior gluteal (SGAP) = 5, posterior tibial (PTAP) = 4 and thoracodorsal (TDAP) = 2. In all cases the Angio CT identified one or more perforator vessel with a 100% concordance with intraoperative findings. Conclusions: CT Angio is a test with high performance in preoperative characterization of perforator vessels. It is a helpful tool that must be considered whenever planning this type of flaps.

Validation of the Spanish version of the breast Q reduction and mastopexy module xxxxBackground: The Breast Q Reduction and Mastopexy Module evaluate breast related quality of life from the perspective of the patients. Body self-image, social performance, sexuality and physical symptoms are assessed. Aim: To translate the Breast Q Reduction and Mastopexy Module to Spanish and validate the translated version to be used in Chile. Material and Methods: The linguistic validation guidelines of the MAPI/TRUST Research institute were used and the survey was applied to six patients aged 29 ± 6 years with 14 ± 2 years of studies. The internal stability of the test was assessed using Cronbach alpha. Results: The mean body mass index of the patients was 25 ± 1 kg/m

Microvascular free tissue transferBackground: Microvascular free tissue transfer has gained world-wide acceptance as a means of reconstructive plastic surgery. Since1979, the authors have introduced this microsurgical procedure in our country and a total of 317 free flaps have been carried out during a period of 33 years. Aim: To present the consecutive free flaps performed at Hospital Clinico Universidad de Chile and Hospital Mutual de Seguridad between 1979-2011. Patients and Methods: Retrospective analysis of 293 patients underwent 317 microsurgical flaps. Results: 293 patients. Median age 43 years old (range 12-81). The lower limb has been the most common site (181 cases), followed by head and neck, upper limb and trunk. The most frequently used flap was the gracilis flap. A survival rate of 95% has been achieved. Follow-up range from 6 months to 9 years. Conclusion: This pioneering series in Chile using microsurgical flaps, shows a satisfactory solution in an one-stage procedure. The authors believe that free flap would be part of the armamentarium of modern plastic surgeons, frequently as a first choice.