ABSTRACT
A 33-year-old man suffered from locally recurrent malignant fibrous histiocytoma of his left thigh unresponsive to previous excision, radiation therapy, chemotherapy, and hyperthermic treatment. He underwent radical hemipelvectomy for cure. Because of extensive tumor involvement, a free flap consisting of his distal left leg based on the popliteal artery was utilized to close the defect. Both the tibia and fibula were removed from their periosteal sheaths, and the foot was excised from the flap. The popliteal artery and vein were anastomosed to the iliac vessels. The flap survived, and the patient was discharged home after physical rehabilitation. We suggest that uninvolved portions of the distal leg may be utilized as a free flap to successfully close hemipelvectomy defects in selected patients when conventional pedicle flaps are unavailable.
Subject(s)
Hemipelvectomy , Popliteal Artery/surgery , Popliteal Vein/surgery , Surgical Flaps/methods , Thigh/surgery , Adult , Amputation Stumps/blood supply , Combined Modality Therapy , Histiocytoma, Benign Fibrous/therapy , Humans , Male , Pelvic Neoplasms/therapyABSTRACT
Best Start is an innovative social marketing approach to promote breastfeeding among low-income women. Focus group interviews were used to identify the determinants of infant-feeding decisions and the most effective strategies for encouraging women to breastfeed. Motivations and perceived barriers related to breastfeeding and social network influences on feeding choice are discussed. The findings were used to design a multifaceted breastfeeding promotion campaign aimed at new mothers, family members, health professionals, and the community at large.
