title: Gains from the separation of two cases of conjoined twins.
abstract: BACKGROUND
  Conjoined twins are rare congenital malformations. Those who were successfully separated with both twins surviving are even more rare.
  
  
  METHODS
  Two pairs of gastrothoracopagus were admitted to our hospital. The first pair was separated by emergency surgery following the rupture of an umbilical hernia. The wound was repaired by local skin flaps grafting and artificial skin. For the second pair, skin expanders were embedded in the thoracic and abdominal wall, the separation was performed 1 month later, the defects were reconstructed by allogenic pericardium, porous high-density polyethylene implant (Medpor) monofilament polypropylene patch and expanded rotation flap.
  
  
  RESULTS
  The first twins, died of respiratory failure and circulatory and respiratory failure 2 h and 39 h, respectively, after the separation, while both of the second pair survived and were discharged after healing.
  
  
  CONCLUSIONS
  If the general status is allowed, the separation of gastrothoracopagus should be performed after skin expansion, it is better to use Medpor to reconstruct the sternum, and the best time to perform the separation is 3 months after birth.
authors.affiliation: Plastic Surgery Department, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China. gkiseric@126.com
authors.forename: Jiaming
authors.initials: J
authors.lastname: Sun
authors.forename: Yiming
authors.initials: Y
authors.lastname: Zhang
authors.forename: Qinglan
authors.initials: Q
authors.lastname: Ruan
authors.forename: Shaotao
authors.initials: S
authors.lastname: Tang
authors.forename: Zongquan
authors.initials: Z
authors.lastname: Sun
authors.forename: Rui
authors.initials: R
authors.lastname: Zeng
mesh_terms: D000015:Abnormalities, Multiple / Q000601:surgery*; D000367:Age Factors; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D010496:Pericardium / Q000002:abnormalities / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods; D013249:Sternum / Q000601:surgery; D013524:Surgical Flaps; D015626:Tissue Expansion / Q000379:methods; D014428:Twins, Conjoined / Q000601:surgery*