Paraspinal transposition flap for reconstruction of sacral soft tissue defects: a series of 53 cases from a single institute.

STUDY DESIGN: Case series. PURPOSE: To describe paraspinal transposition flap for coverage of sacral soft tissue defects. OVERVIEW OF LITERATURE: Soft tissue defects in the sacral region pose a major challenge to the reconstructive surgeon. Goals of sacral wound reconstruction are to provide a durable skin and soft tissue cover adequate for even large sacral defects; minimize recurrence; and minimize donor site morbidity. Various musculocutaneous and fasciocutanous flaps have been described in the literature. METHODS: The flap was applied in 53 patients with sacral soft tissue defects of diverse etiology. Defects ranged in size from small (6 cm×5 cm) to extensive (21 cm×10 cm). The median age of the patients was 58 years (range, 16-78 years). RESULTS: There was no flap necrosis. Primary closure of donor sites was possible in all the cases. The median follow up of the patients was 33 months (range, 4-84 months). The aesthetic outcomes were acceptable. There has been no recurrence of pressure sores. CONCLUSIONS: The authors conclude that paraspinal transposition flap is suitable for reconstruction of large sacral soft tissue defects with minimum morbidity and excellent long term results.

Franz kaspar hasselbach (1759-1816).

Franz Kaspar Hasselbach (1759-1816) was an eminent anatomist and surgeon, remembered for his invaluable contributions in fields of anatomy and surgery. He gave accurate discription of triangle of Hasselbach made almost 200 years back, and it forms the basis of classification of inguinal hernia and is the cornerstone for laparoscopic repair of hernia, unheard of in his era. He has a number of eponyms named after him.

Improvised laparoscopic stone picker.

Laparoscopic cholecystectomy is the treatment of choice for calculus cholecystitis. It is frequently complicated by stone spillage and retrieval of these stones is a cumbersome process which is frequently complicated by injuries. Moreover left over stones frequently leads to complication. We have hereby improvised a laparoscopic hand instrument which quickly and easily recovers intraabdominal free and scattered gall stones with a loss of little bit of intra-abdominal CO(2). This stone picker was applied in over 50 cases with successful recovery of stones and a mean loss of about 0.1 Lts of carbon dioxide gas.