The reverse lip design: a design for safe and effective abdominoplasty

Conventional abdominoplasty includes the removal of an ellipse-shaped section of abdominal tissue between the umbilicus and mons pubis. However, this method can result in tension of the undermined flap, especially in the midline. To address this problem, we present reverse lip design as a modified method that also has aesthetic advantages. The reverse lip design entails a longer lower flap edge while preserving the triangular tissue in the vascularly stable pubis area. These markings create an image of a reverse lip shape with a cleft at the bottom of the lower markings. After typical lipoabdominoplasty is performed, redundant waist tissues can easily be pulled inward and downward. The reverse lip design abdominoplasty demonstrated no complications and required no further revisions after the procedure. Patients were generally satisfied with the aesthetic improvements in their body shape. They were also able to return to their routine activities approximately 1 week after the operation while wearing a supporting undergarment. This modified abdominoplasty using the reverse lip design reduces low midline tension of the undermined abdominal flap while enhancing body aesthetics with a slimmer waistline, leading to higher patient satisfaction.

Accuracy of the 24-hour diet recall method to determine energy intake in elderly women compared with the doubly labeled water method / 한국영양학회지

Purpose@#This study evaluated the accuracy of the 24-hour diet recall method for estimating energy intakes in elderly women using the doubly labeled water (DLW) method. @*Methods@#The subjects were 23 elderly women with a mean age of 70.3 ± 3.3 years and body mass index (BMI) of 23.9 ± 2.8 kg/m 2 . The total energy expenditure (TEEDLW ) was determined by using the DLW and used to validate the 24-hour diet recall method. The total energy intake (TEI) was calculated from the 24-hour diet recall method for three days. @*Results@#TEI (1,489.6 ± 211.1 kcal/day) was significantly lower than TEEDLW (2,023.5 ± 234.9 kcal/day) and was largely under-reported by −533.9 ± 228.0 kcal/day (−25.9%). The accurate prediction rate of elderly women in this study was 8.7%. The Bland-Altman plot, which was used to evaluate the TEI and the TEEDLW , showed that the agreement between them was negatively skewed, ranging from −980.8 kcal/day to −86.9 kcal/day. @*Conclusion@#This study showed that the energy intake of elderly women was underreported.Strategies to increase the accuracy of the 24-hour diet recall methods in the elderly women should be studied through analysis of factors that affect underreporting rate. Further studies will be needed to assess the validity of the 24-hour diet recall method in other population groups.

Amounts of physical activity and sedentary behavior patterns in older adults: using an accelerometer and a physical activity diary / 한국영양학회지

PURPOSE: This study evaluated amounts of physical activity and sedentary behavior patterns in older adults using an accelerometer and physical activity diary. METHODS: Forty-nine older adults (male 26, female 23) participated in this study. They wore a triaxial accelerometer (ActiGraph wGT3X-BT) for one week and wrote a physical activity diary concurrently for three days. Amounts of physical activity, sedentary behavior patterns, and percentage of meeting the World health organization (WHO) physical activity guidelines were analyzed using an accelerometer. In addition, the contents recorded in the physical activity diary were reclassified to 18 levels and the average daily times spent on each level and physical activity level (PAL) were calculated. RESULTS: The subjects were sitting more than half of the day except for bedtime and shower time (59.2%). The numbers of prolonged ≥30, 40 minutes sedentary bouts were significantly higher in males (3.10 ±1.34, 1.78 ±1.09, respectively) than in females (2.34 ±1.22, 1.32 ±1.07, respectively) and the number of breaks per sedentary hour was significantly less in males (5.74 ±0.89) than in females (6.44 ±0.71). Among the activities corresponding to sedentary behavior surveyed by the physical activity diary, only the amount of time spent ‘resting, speaking and watching TV’ showed a significant correlation with the sedentary behavior pattern measured by the accelerometer. The persistence of sedentary behavior was interrupted primarily when low intensity activity was performed. Only 22.4% of the subjects met WHO physical activity guidelines. CONCLUSION: Based on these results, the physical activity guidelines for older adults should be developed that reflects the appropriate strength, including low activity level and maintenance time of moderate to vigorous physical activity.

Validity of the dietary reference intakes for determining energy requirements in older adults

BACKGROUND/OBJECTIVES: The objectives of this study were to evaluate the accuracy of the Dietary Reference Intakes (DRI) for estimating the energy requirements of older adults, and to develop and validate new equations for predicting the energy requirements of this population group. MATERIALS/METHODS: The study subjects were 25 men and 23 women with a mean age of 72.2 ± 3.9 years and 70.0 ± 3.3 years, and mean BMI of 24.0 ± 2.1 and 23.9 ± 2.7, respectively. The total energy expenditure (TEE) was measured by using the doubly labeled water (DLW) method, and used to validate the DRI predictive equations for estimated energy requirements (EER) and to develop new EER predictive equations. These developed equations were cross-validated by using the leave-one-out technique. RESULTS: In men, the DRI equation had a −7.2% bias and accurately predicted the EER (meaning EER values within ±10% of the measured TEE) for 64% of the subjects, whereas our developed equation had a bias of −0.1% and an accuracy rate of 84%. In women, the bias was −6.6% for the DRI equation and 0.2% for our developed equation, and the accuracy rate was 74% and 83%, respectively. The predicted EER was strongly correlated with the measured TEE, for both the DRI equations and our developed equations (Pearson's r = 0.915 and 0.908, respectively). CONCLUSIONS: The DRI equations provided an acceptable prediction of EER in older adults and these study results therefore support the use of these equations in this population group. Our developed equations had a better predictive accuracy than the DRI equations, but more studies need to be performed to assess the performance of these new equations when applied to an independent sample of older adults.

A novel technique for placing titanium mesh with porous polyethylene via the endoscopic transnasal approach into the orbit for medial orbital wall fractures

BACKGROUND: The endoscopic transnasal approach is widely used for reconstructing the medial orbital wall by filling it with a silicone sheet or Merocel, but this technique has the disadvantage of retaining the packing for a long time. To overcome this drawback, a method of positioning an absorbable plate in the orbit has been introduced, but there is a risk of defect recurrence after the plate is absorbed. Here, the authors report the results of a novel surgical technique of placing a nonabsorbable titanium mesh with porous polyethylene into the orbit through the endoscopic transnasal approach. METHODS: Fourteen patients underwent surgery using the endoscopic transnasal approach. Preoperative computed tomography (CT) was used to calculate the size of the bone defect due to the fracture, and the titanium mesh was designed to be shorter than the anteroposterior length of the defect and longer than its height. The titanium mesh was inserted into the orbit under an endoscopic view. The authors then confirmed that the titanium mesh supported the orbital contents by pressing the eyeball and finished the operation. Immediately after surgery, CT results were evaluated. RESULTS: Postoperative CT scans confirmed that the titanium mesh was well-inserted and in the correct position. All patients were discharged without any complications. CONCLUSIONS: We obtained satisfactory results by inserting a titanium mesh with porous polyethylene into the orbit via the transnasal approach endoscopically.

Simultaneous preaxillary mound correction using liposuction through a breast augmentation incision

The preaxillary mound (PAM) is an aesthetic unit that is often overlooked in breast surgery, although it is intimately associated with the outcomes of breast augmentation. Over 18 months, a series of 76 patients who underwent simultaneous PAM correction using liposuction through a breast augmentation incision were reviewed retrospectively to evaluate the effectiveness of this approach. The mean follow-up was 9 months. In total, 150 PAMs were treated with suction alone. The inframammary approach was used in 72 cases, and the periareolar approach was used in four cases. Satisfactory results were achieved in 99% of cases. One patient presented postoperatively with remaining tissue. The use of a breast augmentation incision to treat PAM is an effective and safe technique that eliminates the need for an additional suction cannula incision.

Anatomical popliteal artery entrapment syndrome

PURPOSE: The aim of this study was to analyze anatomical popliteal artery entrapment syndrome (PAES) and to individualize the treatment of this condition according to the anatomical status of the artery and the adjacent structure. METHODS: A total of 35 anatomical PAES legs in 23 consecutive patients treated within the Asan Medical Center, Seoul, Korea between 1995 and 2011 were analyzed retrospectively. Anatomical PAES was diagnosed by MRI and/or CT scans of the knee joint, and CT or conventional transfemoral arteriography of the lower extremities. RESULTS: We noted a type II gastrocnemius medial head (GNM) anomaly, a type III GNM anomaly, or an aberrant plantaris muscle in 51.4%, 20%, and 28.6% of PAES legs, respectively. In assessments of the arterial lesions, popliteal or tibial artery occlusion was noted in 19 of 26 symptomatic PAES legs. For cases without popliteal artery lesions, myotomy of the anatomically deranged muscle was performed in 5 of 7 symptomatic and 4 of 9 asymptomatic PAES legs. For occluded popliteal arteries, we performed ten direct repairs of the pathological popliteal artery and 4 femoro-below the knee popliteal bypass surgeries. As a result of the arterial Surgery, 9 direct procedures with myotomy yielded a patent artery, while 3 graft failures were noted in the bypass group. The median follow-up period was 84 months (range, 12–206 months). CONCLUSION: We recommend that treatment of PAES should be individualized based on pathology, symptoms, and various imaging studies.

Accuracy of 24-hour Diet Recalls for Estimating Energy Intake in Elderly Men using the Doubly Labeled Water Method / 대한지역사회영양학회지

OBJECTIVES: This study assessed the accuracy of the 24-hour diet recall method for estimating the energy intake of elderly men using the doubly labeled water as a reference method. METHODS: Seventeen subjects (mean age 72.5 ± 3.9 years), who maintained the same body weight during the two weeks study period, were included in this study. Three 24-hour diet recalls (two weekdays and one weekend) were obtained over a 14 day period to estimate the mean energy intake. The total energy expenditure was measured over the same 14 days using the doubly labeled water method. The total energy intake and total energy expenditure were compared by paired t-test. RESULTS: The total energy intake from the 24-hour diet recalls method was 2536.7 ± 350.6 kcal/day, and the total energy expenditure from the doubly labeled water method was 2659.8 ± 306.8 kcal/day. The total energy intake was slightly under-reported by −123.2 ± 260.8 kcal/day (−4.4%). On the other hand, no significant difference was observed between the total energy intake and total energy expenditure of the subjects (p=0.069). The percentage of accurate predictions was 64.7%. The correlation between the total energy intake and total energy expenditure was statistically significant (r=0.697, p < 0.005). CONCLUSIONS: The present study supports the use of the 24-hour diet recall method to estimate the mean energy intake in elderly men group. More studies are needed to assess the validity of 24-hour diet recall method in other population groups, including elderly women, adults and children.

Accuracy of 24-hour Diet Recalls for Estimating Energy Intake in Elderly Men using the Doubly Labeled Water Method / 대한지역사회영양학회지

OBJECTIVES: This study assessed the accuracy of the 24-hour diet recall method for estimating the energy intake of elderly men using the doubly labeled water as a reference method. METHODS: Seventeen subjects (mean age 72.5 ± 3.9 years), who maintained the same body weight during the two weeks study period, were included in this study. Three 24-hour diet recalls (two weekdays and one weekend) were obtained over a 14 day period to estimate the mean energy intake. The total energy expenditure was measured over the same 14 days using the doubly labeled water method. The total energy intake and total energy expenditure were compared by paired t-test. RESULTS: The total energy intake from the 24-hour diet recalls method was 2536.7 ± 350.6 kcal/day, and the total energy expenditure from the doubly labeled water method was 2659.8 ± 306.8 kcal/day. The total energy intake was slightly under-reported by −123.2 ± 260.8 kcal/day (−4.4%). On the other hand, no significant difference was observed between the total energy intake and total energy expenditure of the subjects (p=0.069). The percentage of accurate predictions was 64.7%. The correlation between the total energy intake and total energy expenditure was statistically significant (r=0.697, p < 0.005). CONCLUSIONS: The present study supports the use of the 24-hour diet recall method to estimate the mean energy intake in elderly men group. More studies are needed to assess the validity of 24-hour diet recall method in other population groups, including elderly women, adults and children.

Quality of Life and Physical Ability Changes After Hospital-Based Cardiac Rehabilitation in Patients With Myocardial Infarction

OBJECTIVE: To evaluate the effect of hospital-based cardiac rehabilitation (CR) on quality of life (QOL) and physical ability in patients with myocardial infarction (MI). METHODS: Patients with MI who were referred to the Cardiac Health and Rehabilitation Center 2 weeks after percutaneous coronary intervention were divided into CR and non-CR groups. The CR group performed supervised exercises 3 times a week for 2 months. QOL assessment, using the 36-item Short-Form Health Survey (SF-36) and physical ability evaluation were performed at the beginning and end of CR. RESULTS: The CR group demonstrated statistically significant improvements in physical functioning (PF), physical role functioning (RP), bodily pain (BP), general health perceptions (GH), vitality (VT), social role functioning (SF), emotional role functioning (RE), mental health (MH), physical component summary (PCS), and mental component summary (MCS). The non-CR group showed improvement in RP. Secondary outcomes, including resting heart rate (RHR), maximal oxygen consumption (VO(2max)), metabolic equivalent of task (MET), maximal exercise time (ET(max)), stage 3 Borg rating of perceived exertion (3RPE), maximal Borg rating of perceived exertion (RPEmax), and stage 3 rate pressure product (3RPP), improved in the CR group. The non-CR group showed improvements in VO(2max), MET, ET(max), and 3RPE. There were significant differences in improvements in PF, RP, BP, VT, SF, MH, MCS, RHR, VO(2max), MET, ET(max), 3RPE, and 3RPP between the two groups. CONCLUSION: Male patients with MI demonstrated improvements in QOL and physical ability following hospital-based CR; the impact on the mental component was greater than that on the physical component.

Asian Sand Dust Enhances the Inflammatory Response and Mucin Gene Expression in the Middle Ear

OBJECTIVES: Asia sand dust (ASD) is known to cause various human diseases including respiratory infection. The aim of this study was to examine the effect of ASD on inflammatory response in human middle ear epithelial cells (HMEECs) in vitro and in vivo. METHODS: Cell viability was assessed using the cell counting kit-8 assay. The mRNA levels of various genes including COX-2, TNF-a, MUC 5AC, MUC 5B, TP53, BAX, BCL-2, NOX4, and SOD1 were analyzed using semiquantitative realtime polymerase chain reaction. COX-2 protein levels were determined by western blot analysis. Sprague Dawley rats were used for in vivo investigations of inflammatory reactions in the middle ear epithelium as a result of ASD injection. RESULTS: We observed dose-dependent decrease in HMEEC viability. ASD exposure significantly increased COX-2, TNF-a, MUC5AC, and MUC5B mRNA expression. Also, ASD affected the mRNA levels of apoptosis- and oxidative stress-related genes. Western blot analysis revealed a dose-dependent increase in COX-2 production. Animal studies also demonstrated an ASD-induced inflammatory response in the middle ear epithelium. CONCLUSION: Environmental ASD exposure can result in the development of otitis media.

The Effects of a Positive Psychology Improvement Program on Elders' Depression and Death Anxiety

PURPOSE: This study was conducted to investigate the effects of a positive psychology improvement program on elders' depression and death anxiety. METHODS: This was conducted as a quasi-experimental study with non-equivalent control group pretest-posttest design. The participants were community elders aged over 65 recruited by convenient sampling. A total of 94 elders (32 in the individual experimental group, 32 in the collective experimental group, and 30 in the control group) participated. Data were collected between April and September, 2012 and analyzed by using SPSS/WIN 21. RESULTS: The individual and group approach experimental groups had significantly lower scores of depression than the control group after the treatment (F=7.50, p=.001). For death anxiety, however, only the individual experimental group had a significantly lower score compared to the control group (F=4.56, p=.013). CONCLUSION: These results indicate that the positive psychology improvement program was effective in decreasing depression and death anxiety in the elderly. Therefore, the program needs to be applied in a customized way fittingly to the characteristics of the elderly in community, and individually and/or collectively according to its purposes.

Microarray Analysis of Gene Expression Alteration in Human Middle Ear Epithelial Cells Induced by Asian Sand Dust

OBJECTIVES: The primary aim of this study is to evaluate the gene expression profile of Asian sand dust (ASD)-treated human middle ear epithelial cell (HMEEC) using microarray analysis. METHODS: The HMEEC was treated with ASD (400 microg/mL) and total RNA was extracted for microarray analysis. Molecular pathways among differentially expressed genes were further analyzed. For selected genes, the changes in gene expression were confirmed by real-time polymerase chain reaction. RESULTS: A total of 1,274 genes were differentially expressed by ASD. Among them, 1,138 genes were 2 folds up-regulated, whereas 136 genes were 2 folds down-regulated. Up-regulated genes were mainly involved in cellular processes, including apoptosis, cell differentiation, and cell proliferation. Down-regulated genes affected cellular processes, including apoptosis, cell cycle, cell differentiation, and cell proliferation. The 10 genes including ADM, CCL5, EDN1, EGR1, FOS, GHRL, JUN, SOCS3, TNF, and TNFSF10 were identified as main modulators in up-regulated genes. A total of 11 genes including CSF3, DKK1, FOSL1, FST, TERT, MMP13, PTHLH, SPRY2, TGFBR2, THBS1, and TIMP1 acted as main components of pathway associated with 2-fold down regulated genes. CONCLUSION: We identified the differentially expressed genes in ASD-treated HMEEC. Our work indicates that air pollutant like ASD, may play an important role in the pathogenesis of otitis media.

Delayed Onset of Acute Limb Compartment Syndrome With Neuropathy After Venoarterial Extracorporeal Membrane Oxygenation Therapy

Acute limb compartment syndrome (ALCS) is defined as compound symptoms resulting from poor oxygenation and decreased nutrition supply to muscles and nerves in a tightly confined compartment. The most common cause of ALCS is tibia fracture, followed by blunt trauma to soft tissue. However, non-traumatic causes are rare. We report an iatrogenic, non-traumatic ALCS case after venoarterial extracorporeal membrane oxygen (VA-ECMO) therapy. A 14-year-old male received VA-ECMO therapy due to cardiorespiratory failure after drowning. Although he had no symptoms during therapy, leg swelling appeared 10 hours after ECMO treatment. Two days after the leg swelling, the patient underwent a fasciotomy. Unfortunately, nerve conduction studies and electromyography showed multiple neuropathies in the lower leg. Despite 2 weeks of rehabilitation with electrical stimulation, an exercise program, and physical therapy, there was no definite change in muscle strength. To our knowledge, this is the first reported case of non-traumatic ALCS after VA-ECMO therapy in Korea.

Zoonotic encephalitides caused by arboviruses: transmission and epidemiology of alphaviruses and flaviviruses

In this review, we mainly focus on zoonotic encephalitides caused by arthropod-borne viruses (arboviruses) of the families Flaviviridae (genus Flavivirus) and Togaviridae (genus Alphavirus) that are important in both humans and domestic animals. Specifically, we will focus on alphaviruses (Eastern equine encephalitis virus, Western equine encephalitis virus, Venezuelan equine encephalitis virus) and flaviviruses (Japanese encephalitis virus and West Nile virus). Most of these viruses were originally found in tropical regions such as Africa and South America or in some regions in Asia. However, they have dispersed widely and currently cause diseases around the world. Global warming, increasing urbanization and population size in tropical regions, faster transportation and rapid spread of arthropod vectors contribute in continuous spreading of arboviruses into new geographic areas causing reemerging or resurging diseases. Most of the reemerging arboviruses also have emerged as zoonotic disease agents and created major public health issues and disease epidemics.

Analysis of Scientific Papers Included in the Sciences Citation Index Expanded Written by South Korean Plastic Surgeons: 2001-2010

BACKGROUND: The purpose of our study was to analyze scientific papers published by South Korean plastic surgeons in journals included in the Science Citation Index Expanded (SCIE), and to evaluate the publication and research activities of Korean plastic surgeon. METHODS: We conducted a survey of SCIE papers in the field of plastic surgery published by South Korean authors between 2001 and 2010 using Web of Science software. We further analyzed these results according to the number of publications per year, journals, institution, and type of papers. We also compared the total number of citations to published scientific papers. We analyzed the rank of South Korea among other countries in representative journals. RESULTS: Overall, 667 papers were published by South Korean authors between 2001 and 2010. The number of publications increased dramatically from 2003 (n=31) to 2010 (n=139). Subsequently, the ten most productive Korean medical colleges were identified. All published papers received 2,311 citations and the citation to paper ratio was 3.49. The rank of Korea among other countries in terms of the number of published papers remained in the top 10 during the recent 10 years. CONCLUSIONS: Publication output of Korean plastic surgeon over the last 10 years showed a remarkable growth in terms of quantity and quality. Currently, Korea is among the top six countries in representative plastic surgery journals. Korean plastic surgeons have played a central role in this progress, and it is anticipated that they will continue to do so in the future.

Feasibility and Effects of Newly Developed Balance Control Trainer for Mobility and Balance in Chronic Stroke Patients: A Randomized Controlled Trial

OBJECTIVE: To investigate the feasibility and effects of balance training with a newly developed Balance Control Trainer (BCT) that applied the concept of vertical movement for the improvements of mobility and balance in chronic stroke patients. METHOD: Forty chronic stroke patients were randomly assigned to an experimental or a control group. The experimental group (n=20) underwent training with a BCT for 20 minutes a day, 5 days a week for 4 weeks, in addition to concurrent conventional physical therapy. The control group (n=20) underwent only conventional therapy for 4 weeks. All participants were assessed by: the Functional Ambulation Categories (FAC), 10-meter Walking Test (10mWT), Timed Up and Go test (TUG), Berg Balance Scale (BBS), Korean Modified Barthel Index (MBI), and Manual Muscle Test (MMT) before training, and at 2 and 4 weeks of training. RESULTS: There were statistically significant improvements in all parameters except knee extensor power at 2 weeks of treatment, and in all parameters except MBI which showed further statistically significant progress in the experimental group over the next two weeks (p<0.05). Statistically significant improvements on all measurements were observed in the experimental group after 4 weeks total. Comparing the two groups at 2 and 4 weeks of training respectively, 10mWT, TUG, and BBS showed statistically more significant improvements in the experimental group (p<0.05). CONCLUSION: Balance training with a newly developed BCT is feasible and may be an effective tool to improve balance and gait in ambulatory chronic stroke patients. Furthermore, it may provide additional benefits when used in conjunction with conventional therapies.

Mycobacterium fortuitum Infection Associated with Facial Fat Grafting: Simultaneous Infection of Liposuction and Liposculpture Site

We report a case of Mycobacterium fortuitum infection of the face and abdomen in a 25 years old man following cosmetic autologous fat injection. The goal of this manuscript is to increase awareness and suspicion of such as atypical mycobacterial infections complicating liposuction and fat injection. The clinical presentation, laboratory studies utilizing acid-fast stains and cultures, prevention and treatment including surgical debridement, and pharmacologic regimens in the ultimate diagnosis for Mycobacterium fortuitum infections are discussed.

Validation of a Scoring System for Predicting Malignancy in Patients Diagnosed with Atypical Ductal Hyperplasia Using an Ultrasound-Guided Core Needle Biopsy / 한국유방암학회지

PURPOSE: The need for surgical excision in patients with ultrasound-guided core needle biopsy (CNB)-diagnosed atypical ductal hyperplasia (ADH) remains an issue of debate. The present study sought to validate a scoring system (the U score, for underestimation) that we have previously developed for predicting malignancy in CNB-diagnosed ADH. METHODS: The study prospectively enrolled 85 female patients with CNB-diagnosed ADH who underwent subsequent surgical excision. Underestimation was defined as a surgical specimen having malignant foci. RESULTS: The overall underestimation rate was 37% (31/85). Multivariate analysis showed that a clinically palpable mass, microcalcification on imaging, size >15 mm and a patient age of > or =50 years were independently associated with underestimation. When applied to the scoring system, the validation score was significant (p<0.001; area under the curve, 0.852). No patient with a U score <3.5 had an underestimated lesion. CONCLUSION: The present study successfully validated the efficacy of our scoring system for predicting malignancy in CNB-diagnosed ADH. A U score of < or =3.5 indicates that surgical excision may not be necessary.

Microsurgical Free-tissue Transfer in Super-Elderly Patients with Cancer: Outcomes and an Interview Study of Patients and Their Caregivers

BACKGROUND: Increasing numbers of super-elderly patients (>80 years old) with cancer now require microvascular-free tissue transfer. The objectives of this study were to evaluate potential applications of microvascular tissue transfer in this patient population, and post-surgical changes in quality of life. METHODS: The records of cancer patients 80 years or older who had undergone microsurgical tissue transfer were retrospectively reviewed. Structured interviews were conducted with patients and family caregivers after surgery, and the patients'quality of life was qualitatively assessed. RESULTS: The study cohort consisted of seven patients with a mean age 87.6 years (range, 81 to 95). Wound and medically-related complications were minimal. During the patient interviews, eight of the nine respondents reported remarkable improvements in quality of life following surgery and expressed a high level of satisfaction with their surgical results. CONCLUSIONS: Our study showed that microsurgical reconstruction performed in super-elderly patient not only appropriately repairs post-oncologic defects but also significantly improves the patients' quality of life.