Latissimus dorsi muscle flap based on arterial branch to serratus anterior as salvage of a failed bipedicled transverse rectus abdominis muscle flap. A case report.

We present a case of a failed bipedicled (unilateral rectus flap with superior epigastric pedicle preserved and inferior epigastric vessels anastomosed to the thoracodorsal trunk as the second pedicle) transverse rectus abdominis muscle flap that had compromised the dominant pedicle of the latissimus dorsi muscle. A salvage procedure was possible using this muscle as a pedicle flap based on the back-flow from the serratus anterior arterial branch with success. The use of the reconstructive ladder is highlighted.

Latissimus dorsi muscle flap based on arterial branch to serratus anterior as salvage of a failed bipedicled transverse rectus abdominis muscle flap. A case report

We present a case of a failed bipedicled (unilateral rectus flap with superior epigastric pedicle preserved and inferior epigastric vessels anastomosed to the thoracodorsal trunk as the second pedicle) transverse rectus abdominis muscle flap that had compromised the dominant pedicle of the latissimus dorsi muscle. A salvage procedure was possible using this muscle as a pedicle flap based on the back-flow from the serratus anterior arterial branch with success. The use of the reconstructive ladder is highlighted

Nitric oxide levels in children with febrile illnesses - Poster abstract

OBJECTIVE: To determine nitric oxide (NO) levels in children with febrile illness and to investigate its prognostic value in early dengue virus infections. DESIGN AND METHOD: A pilot case control study was conducted from September 1998 to March 1999 at the Eric Williams Medical Sciences Complex, Priority Care Facility (PCF), in Trinidad. Serum NO concentrations were measured in children <12 years presenting with febrile illnesses in the absence of clinically significant bacterial infection. RESULTS: Of 59 blood samples collected, there were 22 from individuals diagnoses as virally induced gastroenteritis (VGE), with 31 non-specific viral illnesses (VI), and 6 viral infections associated with upper-respiratory tract infection (URTI-VI). The mean (NO) in all cases was above normal (11.9 uM SD 5.9) 81.17 uM in VGE, 41.30 uM in VI and 57.83 uM in URTI-VI. Krushkal-Wallis test revealed that there was a significant difference (p = 0.007) between all three means and that the mean (NO) for VGE was significantly higher (p = 0.003) than that of VI. CONCLUSIONS: The degree of elevation of NO varies between viral illnesses in children and its potential as a rapid prognostic marker warrants further investigation.(AU)