&iris/i Journal 0fPlmic

Surgery (1992). 45. X4-255

B 1992 Bntish Association of Plastic Surgeons

BRITISH

JOURNAL

OF

Letters to the Editor liferation of fibrovascular tissue in their Figure 1B. This subjective statement may be verified by an immunohistochemical detection of basement membrane components such as laminin and collagen IV which are produced by capillary cells but not by fibroblasts. Also, multiplying undifferentiated microvascular endothelial cells may undergo inflammatory activation and manifest some phenotypic features of bone marrow derived inflammatory cells (Beranek, 1991). It is quite probable that some of the perivascular round cells described by Hayward et al. are, in reality, undifferentiated vascular endothelial cells distinguishable from inflammatory cells by their production of collagen.

A method to ensure safer skin stapling Sir, To avoid the occasionally seen problem of metal staples becoming buried within new epithelium after their use to attach grafts in bums cases, we have found it most helpful to incorporate a continuous non-absorbable running suture along and under the path of the staples (see diagram). At removal the suture is lifted, identifying each staple in turn.

Yours faithfully, Jiri T. Beranek, MD

Visiting Scientist Division of Cardiology Department of Medicine University of Missouri-Columbia Columbia, MO 65212, USA

References Berawk, J. T. (1991). Atherosclerosis: a personal view. Cardiac Chronicle, 5, 1. Hayward, P. G., A&on, W. E., Carp, S. S., Hui, P. S. and Rohson, M. C. (1991). Local infiltration of an angiogenic growth factor does not stimulate the delay phenomenon. Lirirish Journal of

Plastic Surgery, 44, 526.

Yours faithfully, Motonobu Nakamura,

MD

Senior Registrar, Department of Plastic and Reconstructive School of Medicine. Kitasato University, 1-15 1, Kitasato, Sagamihara, Kanagawa 228, Japan

Reconstruction deltoid flap

Surgery,

Sir, In 1990 we published

an article in this Journal (British Journal of Plastic Surgery, 43, 217) in which two cases of reconstruction of the penis with a free deltoid flap were described. One case was a 26-year-old man who had a traffic accident and lost his penis only three months after his marriage. A rib cartilage graft was incorporated into the reconstructed penis and the sensory nerve of the deltoid flap was sutured to the pudendal nerve, which supplies the penis with erogenous sensibility and correct cortical localisation (Gilbert et al., 1987). Postoperatively the patient could enjoy sexual intercourse and had good sensory recovery all over his reconstructed penis, though the quality was not erogenous. The patient lives far from our hospital and was lost to follow up. Recently I made contact with him after a three and a half year interval and discovered that he and his wife now have two babies. He also reports that he now has almost normal tactile and protective sensation as well as erogenous sensation on his reconstructed penis. At the 10th Symposium of the International Society of Reconstructive Microsurgery which was held in Munich on September 15-21, 1991, I, as one of the moderators of the breast, thoracic wall and urogenital session, asked the audience if anyone had or knew of such a case as ours. who

Reference Yamada, N., Uchinumn, E., Ishihara, S., Matuskura, T., Shioya, N.,

Utsugi, R. and Ishikawa, S. (1990). Experimental and clinical using buried staples. Japanese Journal of Plastic and Reconstructive Surgery, 10, 323.

studies on skin grafting

Angiogenesis factor

and basic fibroblast

of the penis with a free

growth

Sir, The conclusion of Hayward et al. (British Journal of PIastic Surgery, 44, 526) that there is no angiogenesis after bFGF infiltration in their experimental model must be taken with caution. Even though their photographs are small, the morphologist immediately recognises that there is a pro254

Angiogenesis and basic fibroblast growth factor.

&iris/i Journal 0fPlmic Surgery (1992). 45. X4-255 B 1992 Bntish Association of Plastic Surgeons BRITISH JOURNAL OF Letters to the Editor lifera...
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