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The variety of techniques feasible for reduction mammaplasty depends on the patient's anatomy. The inferior pedicle technique and its manifold variations have been described by several authors, probably being the most popular breast reduction technique. The advantages include the ease of performance, good preservation of the neuro-vascular supply of the nipple, new configuration of the breast and fixation like an endo-brassière. Here we present the method of breast reduction, as we currently use it, as well as the principles and the technical considerations necessary to achieve an optimal outcome. Additionally, a retrospective study of selected patients is performed. Results have been very gratifying, not only concerning the esthetical appearance of the breast, but also the long-term preservation of it's new shape. Complications like necrosis of the NAC complex were not observed till yet.

Applying standardized and sound operative techniques, impaired wound healing following reduction mammoplasty is rare. A postoperative case of pyoderma gangraenosum is reported. This necrotizing skin disorder seemed at first to be a postoperative bacterial infection, but correct diagnosis was finally made histopathologically. The clinical course, etiology, diagnostic findings, and therapy are discussed and a review of the literature is presented.

Gluteus maximus myocutaneous sliding flaps from one or both sides are useful in covering deep, usually infected sacral pressure sores. Although skin is known to tolerate higher pressure in the covered area, muscle offers far better conditions for flap healing of infected defects. In spite of excellent early results, the long-term fate of the transposed muscle remains uncertain. An electromyography study was performed on eleven patients out of 29 with sliding gluteus maximus myocutaneous flaps in periods up to seven months after surgery. Our results show that signs of denervation parallel reinnervation and functional integrity of the transposed muscle.

Burns to the eyelid often constitute difficult problems for reconstruction or repair. Functional and aesthetic aspects have to be considered, and suitable donor sites are not readily available in severely burned patients. In male patients, the prepuce yields an almost ideal skin for eyelid repair because of its high elasticity and adequate texture. Two patients with repair of both upper eyelids using the prepuce are demonstrated. The color match of this skin graft is satisfying. If both layers of the prepuce are transplanted, they yield enough tissue to cover both upper eyelids. This method seems to be an adequate method of reconstruction of burned eyelids in severely burned male patients when the usual donor sites for skin grafts are not available.

The use of myocutaneous flaps for the treatment of pelvic pressure sores is well accepted, yet there are still unanswered questions about why myocutaneous flaps are clinically superior to skin flaps. An experiment involving 16 pigs revealed new data on the diffusion of infection through myocutaneous and cutaneous flaps, showing that the muscles can act as a barrier against such infection. In 51 patients seen consecutively in 1988, osseous specimens of the infected bottom of the decubital ulcers were taken. There was florid osteomyelitis in 65.9% of all specimens, further emphasizing the importance of muscle flaps in the treatment of pelvic pressure sores when infection is still present. The fate of 16 transposed gluteus maximus muscles was monitored by electromyography postoperatively; 15 still showed voluntomotoricity up to 7 months after transposition.