Plastic & Reconstructive Surgery:
Adler, Neta M.D.; Dorafshar, Amir H. M.D.; Agarwal, Jayant P. M.D.; Gottlieb, Lawrence J. M.D.
Plastic and Reconstructive Surgery Department, Hadassa University Hospital, Jerusalem, Israel (Adler)
Plastic and Reconstructive Surgery Department, The Johns Hopkins Hospital, Baltimore, Md. (Dorafshar)
Division of Plastic and Reconstructive Surgery, University of Utah, Salt Lake City, Utah (Agarwal)
Section of Plastic and Reconstructive Surgery, University of Chicago, Chicago, Ill. (Gottlieb)
Correspondence to Dr. Gottlieb, Section of Plastic and Reconstructive Surgery, University of Chicago Medicine and Biological Sciences, 5841 South Maryland Avenue, Room J-641, MC6035, Chicago, Ill. 60637 firstname.lastname@example.org
We appreciate Dr. Li and colleagues' attempt to study our 12-step approach for harvesting the lateral femoral circumflex perforator chimera flap in a cadaver. Unfortunately, they evaluated only the first five steps. They mention that they had trouble finding the perforators by performing the proximal medial incision and dissecting from the pedicle to the perforators. However, in our article, we describe this first incision primarily for orientation and finding the location of the lateral femoral circumflex pedicle. Extension of this incision allows for further exploration with little risk of inadvertently injuring any perforators. An additional benefit of this approach is that this exploration can be performed simultaneously with the extirpation of tumor or recipient-site preparation before knowing the size, type, and number of each tissue component of the chimera flap needed to fulfill the reconstructive requirements. We then describe, in step 6 of our article, a free-style retrograde and antegrade approach to dissecting cutaneous perforators. Therefore, although our skin marking and initial incision are different from theirs, the actual dissection of the perforators is similar.
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Neta Adler, M.D.
Plastic and Reconstructive Surgery Department, Hadassa University Hospital, Jerusalem, Israel
Amir H. Dorafshar, M.D.
Plastic and Reconstructive Surgery Department, The Johns Hopkins Hospital, Baltimore, Md.
Jayant P. Agarwal, M.D.
Division of Plastic and Reconstructive Surgery, University of Utah, Salt Lake City, Utah
Lawrence J. Gottlieb, M.D.
Section of Plastic and Reconstructive Surgery, University of Chicago, Chicago, Ill.
The authors have no financial interest to declare in relation to the content of this communication.
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