Subcutaneously pedicled island flaps.

Subcutaneously pedicled island flaps (SPIF) are very mobile local flaps bringing into the surgical defect skin of similar texture and color to that of the recipient site. SPIF flaps are eminently simple to create: an island of skin is incised until the fatty tissue is visualized and the flap connections to surrounding tissue are carefully disconnected without damaging the nutrient vessels. The viability of such flaps is excellent. If appropriately performed, side effects such as pincushioning are rare.

The reversed dermal graft: surgical procedure and clinical applications.

The reversed dermal graft has been employed in reconstructive plastic surgery for almost 80 years. It is recommended that the dermatologic surgeon use this graft technique whenever a case calls for the combined advantages of the split-thickness skin graft for poorly vascularized areas and the axial pedicle flap appropriate to areas subject to marked mechanical strain. We present cases in which defects on the scalp, sole, palm, and great toe have been covered by reversed dermal graft and split-thickness skin graft in a single operation with excellent results. Our modification of the technique has proved that simultaneous grafting with reversed dermis and split-thickness skin graft produces satisfactory results, reduces postoperative care by 2 weeks, and obviates repeated anesthesia.