Reducing the donor site morbidity in radial forearm free flaps by utilizing a narrow radial forearm free flap

BACKGROUND: The radial forearm free flap (RFFF) has remained a leading choice of many plastic surgeons as a fasciocutaneous flap due to its versatility, pedicle length, and simple elevation technique. However, donor site morbidity has led many reconstructive surgeons to limit their use of the RFFF and to use other flaps instead. We propose that using a narrow RFFF (nRFFF) decreases the aesthetic and functional morbidity of the donor site. METHODS: We report our experiences with the nRFFF from April 2012 through May 2015 at the Department of Plastic, Reconstructive, and Hand Surgery at Liaquat National Hospital, Karachi. The donor defects were closed primarily. The Stony Brook Scar Evaluation Scale and comparison with the contralateral hand were used to assess aesthetic and functional outcomes, respectively. RESULTS: A total of 24 patients underwent nRFFF procedures during the study period. The donor arm showed excellent motor function in 22 cases (91.7%), and very good function in the remaining two cases (8.3%). The aesthetic outcomes were excellent in four patients (16.6%), very good in eight patients (33.3%), good in 10 patients (41.6%), and fair in two patients (8.3%) who developed a hypertrophic scar. All flaps were successful and there were no cases of partial or complete loss. CONCLUSIONS: For small to medium-sized soft tissue defects, the nRFFF had acceptable outcomes due to its thinness, pliability, and major reduction in donor site aesthetic and functional morbidity.

Early breast cancer in females presenting with palpable breast lumps

To determine the frequency of early breast cancer in women presenting with palpable breast lumps. Prospective cohort study. Surgical Unit - IV Civil Hospital Karachi, from December 2011 to June 2012. All female patients 13 year and above with palpable breast lumps were recruited in this study after seeking their consent. Triple assessment was carried out and core biopsies taken. Histopathology reports were recorded. Two hundred and eighty two females between 15 to 80 year [mean= 36.5 year] presented with breast lumps. Of the total 72% [n=199] lumps were benign on histopathology while 29% [n=83] showed malignancy. There were 19 [7%] cases of breast abscess. The frequency of breast cancer was 29% in present group of patients presenting with breast lumps