Faculty Bibliography

Twenty fresh cadaver dissections examining the medial arm flap were completed. Blood supply to the medial arm skin was from the branches off the superior ulnar collateral artery (65%), direct cutaneous branches from the brachial artery (20%), or both (15%). Injection studies were completed demonstrating the extent of the medial arm flap. Four clinical cases were completed. The results in this article are different from some previous studies because they show that the superior ulnar collateral system is always present, the superior ulnar collateral vessels never directly supply the medial arm skin, and the medial arm skin may have a direct cutaneous supply from the brachial artery

Over the past four years we have performed total phallic reconstructions in 12 patients. Six patients underwent reconstruction following trauma, 3 were female-to-male transsexuals, and 3 had micropenis deformities. These reconstructions were one-stage microsurgical tissue transfers that included urethral reconstruction and coaptation of erogenous nerves. The surgical indications, techniques, and results are discussed

The authors' personal technique for mammary reconstruction, including the nipple-areola complex, is presented. The technique is simple and effective and is performed in only one surgical stage. It is applicable to mammary construction in the case of congenital absence as well as to reconstruction after mastectomy

Looking ahead, one envisions an era of remarkable progress in the study of the healing of bone and cartilage. The physical, biochemical, and biomechanical factors governing bone and cartilage healing will be defined and manipulated to accelerate the healing process. Joint stiffness, the undesirable sequela of many simple fractures of the hand as a result of prolonged immobilization, will be obviated. For cases of limited joint damage, techniques for joint reconstruction will be refined. For non-salvageable bone and joint destruction, microvascular allogenic transplantation of skeletal units will become a reality. Silastic implants in the wrist will become historical oddities.

The choice between repair or reconstruction in the management of nerve injury, and the determination on timing and the type of neurorrhaphy technique are clinical decisions that should be based on thorough understanding of the pathophysiology of nerve injury, the physiology of nerve healing, and the anatomy of peripheral nerves. The formulation of a treatment plan should be individualized.

This article presents a successful replantation of a completely severed rat ear. The procedure include re-union of the tubal cartilage and anastomosis of the surgically divided external carotid artery and posterior facial vein.

This is an experimental study comparing the suturing time and patency rate of a spiral interrupted suturing technique to those of conventional interrupted and continuous suturing technique in end-to-end as well as end-to-side anastomosis. The spiral interrupted suturing technique requires less time for either end-to-end or end-to-side anastomosis than conventional interrupted suturing technique, and does not result in stenosis as shown in the venous end-to-end anastomosis by continuous suturing technique.

The surgical and anatomic features pertinent to lower extremity nerve injury are reviewed. The common problems associated with specific nerve lesions are discussed and reparative recommendations are offered. A more informed, aggressive approach to lower extremity nerve repair is suggested.

Safe planes exist for plantar incisions that minimize the possibility of subcutaneous nerve injury and are therefore useful in flap design. Nerve branch orientation in the plantar subcutaneous tissue is specific and guides dissection so as to avoid producing anesthesia in weight-bearing areas. An extensive proximal plantar subcutaneous plexus exists that permits elevation of plantar flaps in a superficial plane. This is due to the major contribution that the dorsal circulation makes to the skin of the plantar surface. The blood supply to the non-weight-bearing midsole area is not from the medial plantar artery exclusively. This is a watershed area with important lateral plantar artery and dorsalis pedis artery contributions as well. It is not necessary or desirable to base plantar flaps on a myocutaneous or fasciocutaneous supply with its required deep dissection. Local plantar flaps can be designed to include sensation and abundant blood supply without the need for "subfascial" dissection. Subcutaneous sensory plantar flaps designed in accordance with these principles promise a more ideal solution for the treatment of plantar defects.