Short and long term follow up results of [the versatile] reverse sural artery flap

This study was designed to see the long and short term outcome of the reverse sural artery flap.Case series. From January 2009 to December 2011, data was collected and analyzed for this study. Eighty nine patients with wounds on the ankle, heel, sole, distal leg, and foot were included in the study.they were followed up at 01 week, 02 weeks, and then 4 weekly for 06 months and at one year time from operation. They were examined for necrosis, congestion, surgical site infection, dehiscence of suture line, epidermolysis, donor site infection and functional outcome. Most of the flaps healed nicely but two [2.25%] failed completely. Six flaps were delayed. However early follow up [within 04 weeks] revealed that there was partial loss of the distal 1-1.5 cm of flap in 04 patients [4.50%]. Two patients [2.25%] developed superficial surgical site infection. Six patients [6.74%] developed venous congestion of the flaps which recovered within two weeks. Other minor complications included dehiscence of suture line in 3 patients [3.37%], and superficial Epidermolysis in four [4.50%] [Table-2]. Twenty two patients [24.72%] returned to their work in 12-16 weeks, 31 [34.83%] in 16-20 weeks and 36 [40.45%] in 20-24 weeks. Long term follow-up to 06 months revealed hypertrophic scars at the donor site in three patients [4.91%] and recurrence of ulcer in 2 patients [3.27%]. The sural fasciocutaneous flap provides reliable supple and durable most single-stage coverage of wounds of the distal third of the leg, heel, and foot with the results comparable to free-tissue transfer

Rapunzel syndrome

A trichobezoar may be confined to the stomach or unusually it may extend from stomach to the small intestine or beyond when it is labelled as Rapunzel syndrome. Bezoars are concretions in the gastrointestinal tract that increase in size by continuous accumulation of non-absorbable food or fibre. Most bezoars in children are trichobezoars from swallowed hair. Repunzal syndrome is an uncommon condition in children with less than 40 cases reported. We present a case of an 8 year old girl with Rapunzel syndrome. She presented with vague abdominal pain and epigastric fullness of one year duration. On investigation she was found to have a trichobezoar. At laparotomy a large dark foul smelling trichobezoar that occupied the stomach, duodenum and proximal jejunum was removed via gastrostomy