Effective combination of lymphatico-venous anastomosis and negative pressure wound therapy for lymphocyst: A Case Study.

Lymphorrhea and lymphocysts are complications that occur after lymph node dissection or biopsy and are difficult to treat. Conventional treatments for lymphocysts are not always effective. For instance, lymphatico-venous anastomosis has a limited treatment efficacy when the cyst wall is thickened, and negative pressure wound therapy is limited by the installation site and longer treatment times. To overcome these individual shortcomings, we aimed to assess whether a combination of both interventions would be effective. In this study, we report the application of a lymphatico-venous anastomosis combined with negative pressure wound therapy for treating bilateral inguinal lymph nodes and pelvic lymph node dissection following treatment of vaginal cancer. Short-term improvements were observed with no recurrence of lymphocysts at 1-year follow-up.

Method to prevent cheek depression using an island sternocleidomastoid muscle flap with the middle pedicle as a feeding vessel in immediate reconstruction of the facial nerve with the sural nerve following resection of a parotid gland tumor.

Many surgeons have demonstrated the validity of sternocleidomastoid muscle flaps for the reconstruction of head and neck tumors. We present a case in which we used an island sternocleidomastoid muscle flap to reconstruct a cheek depression after excision of a malignant parotid tumor. A 44-year-old woman presented with a right malignant parotid tumor. We performed total resection of the parotid gland and facial nerve with the sural nerve and reconstructed the facial nerve and cheek depression with an island sternocleidomastoid muscle flap. The sternal head of the right sternocleidomastoid muscle was cut at the cranial and caudal segments to elevate it as an island flap. We used the superior thyroid artery as the sole pedicle for the island muscle flap. At 1 year and 3 months after the operation, the mimic muscles had gradually recovered and progressed without complications such as Frey syndrome, cervical motor dysfunction, or concave deformation of the neck and cheeks.

The Internal Oblique Muscle Flap with Synthetic Mesh Reinforcement for a Large, Contaminated Abdominal Wall Defect.

We report a case of a large mediocaudal abdominal defect in contaminated circumstances with no residual rectus abdominis muscle that was reconstructed using an internal oblique muscle flap with large-pore polypropylene mesh reinforcement. The internal oblique muscle flap can reconstruct the lower abdominal midline without leaving any additional conspicuous scar. Previous studies showed that large-pore polypropylene mesh in contaminated wounds has a minimal difference in terms of infection rate, and less frequent occurrence of hernia, compared even with biological meshes. We believe that this method could be a strong and cosmetically satisfying option for large mediocaudal abdominal wall reconstruction.