[Analgesia of the axilla using a paravertebral catheter in the lamina technique]. / Analgesie der Achselhöhle durch Paravertebralkatheter in Laminatechnik.

A 62-year-old female suffered from therapy-resistant pain in the axilla after lymphadenectomy. The pain ranged from 8-10 on the numeric rating scale (NRS) despite multimodal pain therapy (non-steroid anti-rheumatics, opioids, physiotherapy, acupuncture). A paravertebral trial injection was performed preoperatively on the laminae of the thoracic vertebrae Th 2-Th 4. As the patient responded well, a paravertebral catheter was inserted close to Th 4 directly before the revision operation took place the following day. The case study describes the possibilities of eliminating pain segmentally in the axilla and an alternative technique to a paravertebral block (lamina technique).

[The superior gluteal artery perforator flap (S-GAP-Flap)]. / Der "Superior Gluteal Artery Perforator Flap" (S-GAP-Flap).

Superior gluteal artery perforator flap for breast reconstruction with autologous tissue (S-GAP-flap): With the introduction of perforator flaps for breast reconstruction with autologous tissue the gluteal region became again investigated as a possible donor site. With the S-GAP-flap breast reconstruction from the gluteal region is possible utilising skin and fat without muscle sacrifice. 52 S-GAP-flaps for autologous breast reconstruction with a flap loss rate of 7.7 % were performed at the Department of Plastic and Hand surgery, Behandlungszentrum Vogtareuth, Germany from 1997 till 2002. Although there is an obvious learning curve also with this free tissue transfer, the S-GAP-flap is a reliable alternative in autologous breast reconstruction, when tissue from the lower abdomen is not available.