[Reconstruction of defects on the hand]. / Defektrekonstruktionen an der Hand.

From a reconstructive viewpoint, injuries of the hand are particularly challenging. They are often associated with exposed tendons, bones, nerves and vessels, whereas little skin and soft tissue reserves are available for coverage. Functional and esthetic requirements necessitate a differentiated approach, depending on the location and extent of the defect. This article gives an overview of reconstruction techniques and flap surgery on the hand for various defect sizes and locations.

[Subcutaneous Washout Procedure (SWOP) for Treating Severe Complications of an Aesthetic Gluteal Augmentation with a Copolyamide Filler]. / Subcutaneous Washout Procedure (SWOP) zur Behandlung schwerwiegender Komplikationen einer ästhetischen Glutealaugmentation durch Copolyamid-Filler.

BACKGROUND: Apart from surgical procedures for breast and buttock augmentation, copolyamide fillers can be locally injected for an increase in volume. This method is especially popular in Asia. PATIENT: A 39-year-old female patient had received a buttock augmentation by injection of a copolyamide filler. She presented with multiple abscesses six years after the augmentation. She had developed multiple fistulas and the filler had migrated down to the thigh muscles. RESULTS: In the presented case, the patient experienced multiple complications such as abscess formation, filler migration and chronic infection, with a significant time delay. Complete removal of the filler is only possible by removing surrounding tissue as well. Surgical treatment with repeated debridements and administration of an intravenous broad-spectrum antibiotic are the current standard of care. In contrast, the SWOP technique presented here appears to be less invasive and less likely for local recurrence. CONCLUSION: A breast or buttock augmentation with copolyamide fillers is associated with a high risk of abscess and fistula formation leading to a permanent disfigurement of the patient.

[Turbo-propeller flap for elbow reconstruction under regional anesthesia]. / Turbopropellerlappen zur Rekonstruktion eines Ellenbogendefektes in Regionalanästhesie.

A method for the reconstruction of an extensive soft tissue defect after a complicating olecranon fracture is presented. A perforator-based retrograde pedicled propeller flap was used from the lateral upper arm with additive microvascular "turbo"-anastomosis to the radial artery and vein. The turbo-flap was performed under regional anesthesia.