The free flap failure rate for the lower extremities is high, which adversely affects limb salvage efforts. In this article, we report a case of failure of a thoracodorsal artery perforator flap, which was simultaneously reconstructed with a serratus anterior muscle flap from the same donor site. A 56-year-old male patient had infected wound for 3 months due to Achilles tendon rupture. We reconstructed the defect using a thoracodorsal artery perforator flap. However, 2 days after the operation, we found the congested flap. We were obliged to discard the whole flap and harvested a serratus anterior muscle flap from the same donor site. The patient's foot healed uneventfully. After flap failure, the use of a second free flap from the same donor site may be an effective and safe procedure in specific cases.

Tumoral calcinosis is a rare calcifying disorder with deposition of calcium phosphate and calcium hydroxyapatite within the soft tissue at periarticular sites. There have been series of sporadic cases of tumoral calcinosis in the trunk and the extremities due to renal failure. However, we describe a 35-year-old woman without renal problems or trauma history who had tumoral calcinosis in the nose. This is the first report on facial occurrence.

No abstract

Fig. 4.We reconstructed the defect with an anterolateral thigh flap using the posterior tibial artery as the recipient vessel.