A History of the Frenchay Hospital Plastic Surgery Unit, Bristol, United Kingdom.

Frenchay Hospital has long since been established as the center for plastic surgery in Bristol, providing care to the city and its surrounding catchment area. From humble origins in the Second World War when the site took on the role of a large military hospital providing reconstructive surgery for the victims of war to a busy modern-day National Health Service establishment, the plastic surgery unit at Frenchay Hospital has grown and developed through in parallel with the genesis and development of the specialty. Recent centralization of care in Bristol has seen a massive reorganization of services, and with it the closure of Frenchay Hospital. Because the plastic surgery unit establishes a new home at Southmead Hospital, this review documents the foundations of reconstructive surgery in Bristol and the South West United Kingdom.

The superficial outside-flap shunt (SOS) technique for free deep inferior epigastric perforator flap salvage.

A common cause for loss of a deep inferior epigastric perforator (DIEP) flap is venous congestion secondary to inadequate outflow via the deep perforating vessels. Further anastomosis of the superficial venous system provides effective outflow and salvage of the congested DIEP. Multiple methods have been described requiring dissection of additional recipient venous systems or around the perforating vessels in order to provide a vein onto which the superficial system may be anastomosed. These are potentially associated with increased morbidity and risk of damage to the pedicle. We describe an alternative technique of harvesting an additional length of deep inferior epigastric pedicle cranial to the perforator onto which an anastomosis may be performed. This avoids the need for additional dissection of recipient vessels or further handling of the perforator, its venae comitantes and the main pedicle of the flap thus reducing the risk of damage.