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Reconstruction of complex chest wall defects is often challenging for plastic surgeons as it demands both framework repair and stable soft tissue cover to protect internal organs. There are many synthetic and autologous options for skeletal reconstruction, and latissimus dorsi (LD) is the workhorse flap for soft tissue reconstruction. However, for larger chest wall defects, the availability of a skin paddle in the LD flap is a problem. Multiple modifications of skin harvest methods have been reported to overcome this problem. One of them is the kiss flap or double skin paddle technique, which is widely reported in the reconstruction of breasts, but has limited evidence of its use in chest wall defects. We present a case of composite anterior chest wall defect, which is covered by polypropylene mesh and a double skin paddle LD flap.

Background Giant cell tumors of the tendon sheath (GCTTS) of the hand are considered the second most common benign tumors of the hand after ganglion cysts. Excision biopsy is considered the standard treatment at present. They are notorious for having a very high rate of recurrence as given in many studies. Many factors are said to be associated with recurrence of the tumors. The goal of this study is to evaluate the long-term results of a series of 48 patients operated on at a single institute and to find out if there is any correlation between the proposed risk factors with recurrence.

Background: Repairing a wide cleft palate is a challenging task for surgeons. The goals of cleft palate repair such as achieving anatomical closure of the defect, complete velopharyngeal closure, speech development, and to minimize dentoalveolar anomalies are difficult to achieve in wide and massive cleft palates. Several methods have been described for the same. We performed double transposition flaps combined with intravelar veloplasty in our patients. In this article, we share our experience with the same. Materials and Methods: We reviewed 9 cases, in which double transposition flaps with intravelar veloplasty were performed. Patient demographics, clinical data, and outcomes were analyzed. Functional status including nasal resonance and palatal mobility were assessed with nasal endoscopy. Results: The average age at the time of surgery was 17 months. Four patients had associated diseases. The mean operative time was 55.7 min. The mean follow-up period is 23.7 months. Only posterior palatal closure was done in all the cases and patients were managed temporarily with obturators and are planned for delayed closure later. Conclusion: Double transposition flap is a safe, effective, and technically less demanding procedure. It has no wound complications and can avoid the need for osteotomy to correct maxillary retrusion. The main drawback of the procedure is the creation of an anterior palatal fistula that needs closure later.

Background: Glomus apparatus maintains flow in capillaries in response to changes in temperature. Glomus tumors are rare perivascular hamartomas arising from glomus bodies at fingertips. They are associated with classic triad of symptoms including paroxysmal pain, cold hypersensitivity, and pinpoint tenderness. Due to its rarity and peculiar presentation, they are often misdiagnosed and inappropriately treated. Surgical excision is the treatment of choice either by transungual or lateral periosteal approach. Materials and Methods: We conducted a retrospective analysis of the cases of glomus tumors that were operated in the past 5 years in our institute. Patient demographic details, clinical features, imaging parameters, operative details, photographs and complications if any during follow up were analysed. QuickDASH was the primary statistical parameter, and change in QuickDASH score was analyzed with paired t-test. Results: The average age at diagnosis was 29.77 years. The male-to-female ratio was 1:5. The mean duration of symptoms is 10.08 months. The mean preoperative QuickDASH score was 25.27 (range: 11.25–34). The mean follow-up was 26.7 months (range: 6–48 months). At 6-month follow-up, the mean score was 1.52 (range: 0–13.64). The difference in mean scores was 23.7708 with significant P < 0.001. Conclusion: Glomus tumors are rare but debilitating lesions. They are often misdiagnosed and intervened inappropriately before arriving at an actual diagnosis. With complete excision by magnification-assisted surgery, quality of life generally improves, and recurrence is prevented.

Background: Glomus apparatus maintains flow in capillaries in response to changes in temperature. Glomus tumors are rare perivascular hamartomas arising from glomus bodies at fingertips. They are associated with classic triad of symptoms including paroxysmal pain, cold hypersensitivity, and pinpoint tenderness. Due to its rarity and peculiar presentation, they are often misdiagnosed and inappropriately treated. Surgical excision is the treatment of choice either by transungual or lateral periosteal approach. Materials and Methods: We conducted a retrospective analysis of the cases of glomus tumors that were operated in the past 5 years in our institute. Patient demographic details, clinical features, imaging parameters, operative details, photographs and complications if any during follow up were analysed. QuickDASH was the primary statistical parameter, and change in QuickDASH score was analyzed with paired t‑test. Results: The average age at diagnosis was 29.77 years. The male‑to‑female ratio was 1:5. The mean duration of symptoms is 10.08 months. The mean preoperative QuickDASH score was 25.27 (range: 11.25–34). The mean follow‑up was 26.7 months (range: 6–48 months). At 6‑month follow‑up, the mean score was 1.52 (range: 0–13.64). The difference in mean scores was 23.7708 with significant P < 0.001. Conclusion: Glomus tumors are rare but debilitating lesions. They are often misdiagnosed and intervened inappropriately before arriving at an actual diagnosis. With complete excision by magnification‑assisted surgery, quality of life generally improves, and recurrence is prevented. [ABSTRACT FROM AUTHOR]

Background: Repairing a wide cleft palate is a challenging task for surgeons. The goals of cleft palate repair such as achieving anatomical closure of the defect, complete velopharyngeal closure, speech development, and to minimize dentoalveolar anomalies are difficult to achieve in wide and massive cleft palates. Several methods have been described for the same. We performed double transposition flaps combined with intravelar veloplasty in our patients. In this article, we share our experience with the same. Materials and Methods: We reviewed 9 cases, in which double transposition flaps with intravelar veloplasty were performed. Patient demographics, clinical data, and outcomes were analyzed. Functional status including nasal resonance and palatal mobility were assessed with nasal endoscopy. Results: The average age at the time of surgery was 17 months. Four patients had associated diseases. The mean operative time was 55.7 min. The mean follow‑up period is 23.7 months. Only posterior palatal closure was done in all the cases and patients were managed temporarily with obturators and are planned for delayed closure later. Conclusion: Double transposition flap is a safe, effective, and technically less demanding procedure. It has no wound complications and can avoid the need for osteotomy to correct maxillary retrusion. The main drawback of the procedure is the creation of an anterior palatal fistula that needs closure later. [ABSTRACT FROM AUTHOR]

Resection of advanced oral malignancies often leads to extensive composite tissue defects, which may involve skin, oral mucosa, mandible, and a significant amount of soft tissue. While the free fibula flap remains the primary choice of reconstruction, there are instances where a second flap is necessary for coverage. In such cases, the anterolateral thigh (ALT) flap is commonly employed as a second free flap. We recently utilized a superficial circumflex iliac artery perforator (SCIP) flap in combination with the free fibula flap to reconstruct a large oromandibular defect. This report emphasizes the significance of the SCIP flap and the benefits of combining free flaps, supported by relevant literature.