Reconstruction of the penis in transsexual patients.

In the article, the authors offer a review of the modalities available for phalloplasty in transsexual patients. The classic methods for multi-stage transplantation of tubulized flaps in the lumbar and inguinal regions, in mid-thigh as well as current methods for one-stage reconstruction are discussed. The paper contains the case report of a transsexual patient undergoing one-stage reconstruction of the penis using m. rectus abdominis with the inferior pedicle, urethral reconstruction by a skin graft from simultaneous mastectomy with a free forearm flap covering the muscle. The paper examines the pros and cons of each method for reconstruction.

[Covering skin defects in the area of achilles tendon.]. / Krytí kozních defektu v krajine Achillovy slachy.

The authors refer to the possibilities of the treatment of skin defects in the area of Achilles tendon in case of complication after an injury or operation. They discuss advantages and disadvantages, achievements and techniques of treatment with the application of Thiersch skin grafts, cross leg flap, tubulized Filatov flap and free microsurgical transfer. The authors emphasize the advantages of free flap transfer and present three most frequently used types of flaps in this location: forearm flap, the flap of the dorsum of foot and scapular flap. Out of 17 flaps transferred to the lower extremity 6 were used in the area of Achilles tendon with 100% success of survival and healing. The authors prefer the scapular flap for its advantages and simplicity of operation. Key words: Achilles tendon, skin defect, Thiersch skin grafts, cross leg flap, tubulized flap, free transfer.

[Spastic complications in free flap transfers]. / Spastické komplikace u volných lalokových prenosu.

The authors follow up spastic reactions in free flap transplantations. In experiments on rats groin flaps were transplanted and during their preparation models of four types of spasms were made--segmental spasms of the afferent artery of the flap, spasms of the whole artery, spasms in the flap and tissue shock of the flap. The authors discuss possibilities of influencing and preventing spasms under experimental conditions and in clinical practice.

[Replantation of traumatically amputated parts of extremities-- indications and nomenclature]. / Replantace traumaticky amputovaných cástí koncetin--indikace a nomenklatura.

The authors submit a brief report on replantation activities during the past five years and discuss the problem of indications and terminology of traumatic amputations. The paper contains instruction regarding communication by telephone between the attending surgeon and a specialized microsurgical department. There are also instruction how to handle the amputated portion of the limb and how to transport the patient and the amputated portion of the limb. The authors discusses traditional procedures in replantation surgery on the basis of his own experience with 292 replantations or revascularizations.

[Tissue shock in free flaps in the experiment on the rat. Significance, classification and effect]. / Gewebeschock bei freien Lappen im Experiment an der Ratte. Bedeutung, Klassifikation und Beeinflussung.

In free transfers of groin flaps in neurotized rats, spasms of the pedicle and of the vessels of the flap itself were observed. These spasms were in many cases the cause of complications. Four kinds of spasms were distinguished: 1. Segmental spasm--practically always on the inferior epigastric artery, characterized by short sections of spasm of the artery, alternating with sections of normal dilatation. 2. Spasm of the whole artery. 3. Spasm in the flap itself--characterized by normal dilatation of the artery stem of the flap and by slowing or stopping of blood circulation through the flap. 4. Tissue shock of the flap characterized by spasm of the pedicle in the flap also. The present work further shows a method of assessing the amount of blood circulation through the flap and the results of local medication influencing spasm, including 1% Mesocain, 0.5% Marcain and Solutio Vischnjevskij.