Klipple-Trenaunay Syndrome: A Rare Disorder With Multisystemic Clinical Attributes.

Klippel-Trenaunay syndrome (KTS) is a rare disorder characterized by abnormal development of soft tissues, lymphatic system, and blood vessels. Major features include tissue and bone overgrowth, vein malformation, and port-wine stains with or without lymphatic abnormalities. It is crucial to review this rare syndrome to avoid any diagnostic delay. In addition, it is also vital to follow disease courses with symptomatic treatment for rare complex diseases, which would help clinicians understand and implement a better treatment plan in the future. We present the case of a 19-year-old male eventually diagnosed with KTS who initially presented with swelling of his feet and skin erosion with bloody discharge. Associated findings were bluish skin discoloration, nodularity, and bleeding per rectum, leading to anemia and subsequent heart failure. Colonoscopy/sigmoidoscopy showed vascular malformation and an active bleeding site. Our patient manifested most of the clinical attributes of KTS, with an interesting clinical course of arteriovenous, soft tissue, capillary, lymphatic, and vascular malformations. However, in our case, the patient is receiving only symptomatic treatment (blood transfusion) without any limb amputation or reconstruction surgery, leading to no further deterioration of the quality of life.

Transferring free scapular flap using microsurgical technique for large soft tissue missing in leg and foot areas

12 cases that were treated successfully by microsurgery in the Department of Plastic Surgery, Military Hospital 108 are involved in study. At time of operation, there were 7 cases with sub-acute infection and 3 cases with chronic infection. The scapular flaps used in procedure had not sense nerves. However, the flaps met requirements of treatment for large skin missing in sole of foot. This procedure is performed when there are not indications of conventional therapeutic methods or island and sub-island vascular stem flaps.

Cover small skin and soft tissue defects of wrist, hand and thumb by reverse posterior inter-osseous skin flaps

33 cases of posterior inter-osseous island flaps with reverse flow were done at the Reconstructive Microsurgery Department, Center for Trauma and Orthopedics of Ho Chi Minh City from January 1997 to September 1998. These flap transfers were used to cover small skin and soft tissue defects of wrist, hand thumb and MP Joint areas. The total surface of the island flap is from 32-60 cm2, the pedicle length is from 08-12cm. The survival rate was 94%, the graft skin was supplied, with very little fibrous and contractile scar. There was no sensibility except 03 were gradually recovered up to S1-S2. The conveniences of this procedure were acceptable: easy to perform, unnecessary to scarify a main artery and the survival rate of the flap is high. This island flap is always suitable to relapse the Chinese island flap in some indications.

Early results of distal pedicle fasciocutaneous flap for missing soft tissue at 1/3 under of leg, ankle and back of heel: a review 8 cases

Distal pedicle fasciocutaneous flap has good survival due to it is designed based on blood supply from consistent vascular pedicle. Blood perfusion is excellent in all 8 flaps. Leg cosmetic was not affected. The surgical procedure involves only one stage and is easy to use widely. The procedure appears have superiors and can overcome disadvantages of adjacent regional flaps

Mid-leg fasciocutaneous island flap without sural nerve

Masquelet A.C et al proposed a concept of a neuroskin flap using accompanying arteries of the cutaneous nerves and reported some clinical cases where the sural nerve was used. Sural nerve should be included in this flap (sural flap). The flap is outlined at the function of the relief of two heads of gastrocnemius. We used 8 distally based sural island flaps without sural nerve for leg and foot reconstruction. The island cutaneous is collected from two-third upper in the posterior portion of the leg. Here, the fasciocutaneous flap based only on the accompanying artery of the extreme saphenous vein. The sural nerve can be preserved without including in the flap.

Primarily study on the operation of transfer of distal pedicular cutunonervous flap in the treatment of soft tissue defects in the knee and foot cerveix

Vascularized sural flap with distal pedicle is using for covering of soft tissue defect of the heel-ankle region, when there are no impossibility for the internal plantar flap. With the application on 9 patients, we have the incidence of : -Excellent result: 7- Good result: 2. We hope that we could have good appreciation in future after we have worked on many patients