Versatility of the posterior auricular flap in partial ear reconstruction.

BACKGROUND: The posterior auricular flap alone has always been popular because of its prompt availability, its rich vascularity, and the ease of closing the donor-site defect primarily. METHODS: Fifty-seven patients with partial ear defects covered with posterior auricular flaps during the period between 2002 and 2007 were reviewed. In the authors' series, posterior auricular flaps were harvested based on a simple random vascularization and tailored to reach almost any defect of the ear by a simplified and standardized approach. RESULTS: The authors propose a simple nomenclature after grouping the flaps according to skin paddle type, pedicle type, pedicle base, flap transfer method, and flap movement; they present a standardized algorithm with which to choose the flap design for a given defect from this group. CONCLUSIONS: The authors contribute three new flap designs to enhance the versatility of the posterior auricular flap. These are the superiorly and inferiorly based twisted island flaps and the posterior auricular propeller flap.

"Distally based dorsal hand flaps": clinical experience, cadaveric studies and an update.

Many developments have taken place in the area of distally based dorsal hand flaps since 1988. This paper reported these developments as well as our clinical experience and cadaveric studies. Thirty-three reverse dorsal metacarpal artery (RDMA) flaps, 11 reverse dorsal digital artery (RDDA) flaps and five extended RDMA flaps done in the Institute for Research and Rehabilitation of Hand, Stanley Hospital, Chennai, India during the period between 1996 and 2002 are reviewed. In our series, we used simple, composite, fasciocutaneous and adipofascial flaps, encountered 4% total loss and 6% partial loss. A series of injected cadaveric hands were studied in the Institute D'Anatomie de Paris. An important anatomical finding in this cadaveric study is the dorsal metacarpal artery terminating at the confluence of common digital artery branching into digital arteries proper to the neighbouring digits in all the eight hands dissected. We undertake a critical review of the literature, highlighting the sequence of developments in the knowledge of relevant anatomy and various flap designs as distally based dorsal hand flaps since their first popular report in 1990.