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Skin flap

Xiucun Li, Jianli Cui, Suraj Maharjan, Ziping Jiang, Laijin Lu, Xu Gong
OBJECTIVE: The posterior thigh region has been neglected as a donor site for free perforator flaps, likely due to difficulties in positioning the patient during surgery. This study describes the clinical application of the posterior thigh perforator flap based on the third perforating artery of the profunda femoris artery (PFA). METHODS: The free posterior thigh perforator flap based on the third perforating artery of the PFA was used for reconstruction of soft tissue defects in nine patients between February 2010 and May 2014...
October 19, 2016: Annals of Plastic Surgery
Bai-Lin Pan
BACKGROUND: An overlong upper lip or philtrum indicates aging. In the current study, a procedure for upper lip lift to alleviate this defect is illustrated and assessed for its esthetic effects and risks. METHODS: A total of 84 Chinese patients with overlong upper lip underwent surgery for upper lip lift from 2012 to 2014. Skin excision height was designed on the basis of the golden proportion of the lower region of the face. The incision was made at the subnasal (inferior border of the columella-nostril-alar) region...
September 15, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Alessandro Innocenti, Sara Tanini, F Mori, D Melita, M Innocenti
INTRODUCTION: Genitalia are linked to self-esteem and male sexual identity, especially among young men, who sometimes require a surgical procedure to acquire more confidence. Among the surgical procedures requested for aesthetical purposes, circumcision is one of the most popular. Although it can be considered to be a simple surgical practice, it may cause severe complications such as penile skin necrosis. PRESENTATION OF CASE: We report a case of a catastrophic situation after a circumcision performed on a 27-year-old HIV positive man resulted in a drastic reduction in the length of the penile shaft due to extensive skin loss; this was subsequently restored using dartos-fascio-myo-cutaneous flaps...
October 15, 2016: International Journal of Surgery Case Reports
Zhenglin Chi, Peng Yang, Dajiang Song, Zan Li, Liang Tang, Weiyang Gao, Yonghuan Song, Tingang Chu
INTRODUCTION: To investigate the results of resurfacing completely degloved digits using bilobed innervated radial artery superficial palmar branch (RASPB) perforator flap in a spiral fashion. METHODS: A detailed anatomic study on 30 adult fresh frozen cadavers preinjected with silicone rubber compound to demarcate arterial anatomy documented locations, numbers, and diameters of arteries and skin perforators with surrounding nerves. The flap-raising procedure was performed using four fresh cadaver specimen...
October 21, 2016: Surgical and Radiologic Anatomy: SRA
Kai-Che Wei, Kuo-Chung Yang, Lee-Wei Chen, Wen-Chung Liu, Wen-Chieh Chen, Wen-Yen Chiou, Ping-Chin Lai
With increasing use of cardiac fluoroscopic intervention, the incidence of fluoroscopy-induced radiation ulcer is increasing. Radiation ulcer is difficult to manage and currently there are no treatment guidelines. To identify the optimal treatment approaches for managing cardiac fluoroscopy-induced radiation ulcers, we retrospectively reviewed medical records of 13 patients with fluoroscopy-induced radiation ulcers receiving surgical interventions and following up in our hospital from 2012 to 2015. Conventional wound care and hyperbaric oxygen therapy were of little therapeutic benefit...
October 21, 2016: Scientific Reports
Andreas M Fichter, Lucas M Ritschl, Luisa K Robitzky, Stefan Wagenpfeil, David A Mitchell, Klaus-Dietrich Wolff, Thomas Mücke
The effects of antithrombotic drugs on random and free flap survival have been investigated in the past, but the experimental and clinical results are not in agreement. A perforator-based critical ischaemia model was used to evaluate the effects of different perioperatively administered pharmaceutical agents on tissue ischaemia and to assess the potential additional haemorheological or vasodilative effects of antithrombotics on flap microcirculation. Combined laser Doppler flowmetry and remission spectroscopy revealed an increase in certain microcirculation parameters in most groups in comparison with saline controls, and these changes correlated with flap survival...
October 21, 2016: Scientific Reports
Eva Meia Rüegg, Paul Gniadek, Ali Modarressi, Denise Baratti-Mayer, Brigitte Pittet-Cuénod
INTRODUCTION: Reconstruction of facial bone defects in children is challenging. The use of well-vascularized bone is mandatory to obtain stable lasting results. This study reports our experience of facial bone reconstruction using prefabricated vascularized calvarium flaps. METHODS: Retrospective case series of 50 patients who underwent 52 maxillary, malar, and mandibular reconstructions between 1988 and 2014 using prefabricated vascularized calvarium flaps. Forty-nine patients suffered from noma sequels; one patient had craniofacial cleft Tessier 3-11...
September 10, 2016: Journal of Cranio-maxillo-facial Surgery
Shih-Lun Lo, Yu-Hsiu Yen, Pi-Jung Lee, Charles Chih-Ho Liu, Chi-Ming Pu
PURPOSE: The present study aimed to analyze multiple variables and to determine the factors influencing postoperative complications in reconstructive microsurgeries for head and neck cancer. MATERIALS AND METHODS: This was a retrospective review of the medical records of patients with head and neck cancer who underwent free flap reconstruction after ablation surgery at the Cathay General Hospital (Taipei, Taiwan) from January 2010 to December 2014. Clinical and surgical procedure-related factors were retrieved from a database and analyzed...
September 23, 2016: Journal of Oral and Maxillofacial Surgery
Kun Hwang
The aim of this paper was to review the origins and history of deltopectoral flaps and the pectoralis major myocutaneous flap.The first published paper on the deltopectoral flap was written by Aymard in 1917. He described raising a medially based fasciocutaneous flap from the shoulder skin, which was then tubed and used for staged nasal reconstruction. Conley introduced the laterally based deltopectoral flap, which was supplied by the lateral thoracic and thoracocranial branches. Bakamjian used a medially based deltopectoral flap for pharyngoesophageal reconstruction; this was an axial flap based medially on the intercostal perforating vessels of the internal mammary artery...
October 2016: Journal of Craniofacial Surgery
Andreas Gravvanis, Despoina Kakagia, Nick Katsikeris, Dimosthenis Tsoutsos
BACKGROUND: This report aims to first present Integra as an adjunct to complex mandibular reconstruction for intraoral lining resurfacing, and to review the literature on the use of dermal matrices for mucosal resurfacing of the floor of the mouth. CLINICAL REPORT: A 62-year-old female patient with previous ablation surgery for squamous cell carcinoma of the floor of the mouth, presented with extrusion of the mandibular plate through the chin skin and serious tongue tethering...
October 2016: Journal of Craniofacial Surgery
Ali Ebrahimi, Mohammad Hosein Kalantar Motamedi, Nasrin Nejadsarvari, Azin Ebrahimi, Hamid Reza Rasouli
OBJECTIVE: A variety of nasal skin reconstruction methods are available to meet the esthetic patient's needs. In this article, we review some of modifications of these procedures and share our experience in reconstruction of different parts of the nasal skin following skin tumor ablation. PATIENTS AND METHODS: From January 2010 to January 2014, 171 patients underwent nasal skin reconstruction after excising cancerous lesions of the involved nasal skin. The patient's history, pre- and post-operation photographs, and the surgery data were collected and assessed...
July 2016: Journal of Cutaneous and Aesthetic Surgery
B S Wang, H Y Yang, Y Han
Objective: To determine the effects of adipose-derived stem cells (ADSCs) on the survival rate of flaps by transplanting ADSCs into the experimental flaps pre-operatively. Methods: ADSCs were isolated from fresh human fat and cultured in vitro. Their morphological characters were observed, and flowcytometry and differentiation test and evaluation were conducted. A total of 40 BALB/c mice were divided into 5 groups randomly with each of 8 mice. 1 cm×4 cm random skin flap was designed on the mice back, ADSCs were injected in advance into subcutaneous tissues of 3 groups, the operation was performed on the 2(nd,) 5(th) and 7(th) day after the ADSCs injection, meanwhile skin flap operation was conducted in the immediate injection group and control group...
September 27, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Ryan P Cauley, Sean A Hickey, Charles Scott Hultman, Katie Mathews, Jeremy Goverman
BACKGROUND: Postburn axillary contractures are common and significantly impact quality of life. Simple release combined with split thickness skin grafting necessitates a donor site, requires immobilization, and may result in poor functional outcome. Common methods of adjacent tissue rearrangement are not well designed to treat broad linear contractures. Flaps from the back, flank, or arm can be used, but may come with significant donor site morbidity. We demonstrate the use of the STARplasty, a novel adjacent tissue rearrangement initially developed to treat neosyndactyly, as a useful reconstructive option for the release of Kurtzman type 1 posterior or anterior axillary contractures...
October 17, 2016: Annals of Plastic Surgery
Minyan Zhang, Xiaochen Tian, Jun Shi, Huxian Liu, Ning Liu, Zhengjun Cui
OBJECTIVE: This study aims to observe the efficacies of microsurgical technique combined with the Zhuang's skin soft tissue expander in treating Hunter type III congenital microtia. METHODS: Fifty-eight patients (61 ears) were enrolled from 2003 to 2012; the skin tissue expander was embedded subepidermally in the first stage via the intrahairline longitudinal incision in the postauricular mastoid area, the diseased-side rib cartilage was then taken for preparing the ear bracket in the second stage, and the tragus was surgically reconstructed in the third stage...
October 17, 2016: Annals of Plastic Surgery
Rei Ogawa, Shimpei Ono, Satoshi Akaishi, Teruyuki Dohi, Takeshi Iimura, Junichi Nakao
: It is difficult to completely resect huge anterior chest wall keloids and then close the wound directly. We report here our retrospective analysis of our case series of patients with such keloids who underwent reconstruction with internal mammary artery perforator (IMAP) pedicled propeller flaps and then received postoperative high-dose-rate superficial brachytherapy. METHODS: All consecutive patients with large/severe keloids on the anterior chest wall who underwent keloid resection followed by reconstruction with IMAP-pedicled propeller flaps and then high-dose-rate superficial brachytherapy in our academic hospital were identified...
September 2016: Plastic and Reconstructive Surgery. Global Open
Joseph Château, Aram Gazarian, Fabien Boucher, Lionel Badet, Fabienne Braye, Michel Saint-Cyr, Ali Mojallal
We report a case of a young double-hand allotransplant patient who presented with a full-thickness skin necrosis of the dorsum of the left hand after vascular compromise of the allotransplantation. Considering the lack of viable dorsal tissue overlying the extensor tendons and the need for early hand rehabilitation, an ultrathin pedicled groin flap was used for the coverage. This procedure resulted in salvaging the allotransplantation, and the patient was able to successfully return to work after his surgery...
September 2016: Plastic and Reconstructive Surgery. Global Open
Ross M Clark, Brittany Coffman, Paul G McGuire, Thomas R Howdieshell
BACKGROUND: Murine models of diabetes and obesity have provided insight into the pathogenesis of impaired epithelialization of excisional skin wounds. However, knowledge of postischemic myocutaneous revascularization in these models is limited. MATERIALS AND METHODS: A myocutaneous flap was created on the dorsum of wild type (C57BL/6), genetically obese and diabetic (ob/ob, db/db), complementary heterozygous (ob(+)/ob(-), db(+)/db(-)), and diet-induced obese (DIO) mice (n=48 total; five operative mice per strain and three unoperated mice per strain as controls)...
2016: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
Mona Taleb, Lydia Choi, Steve Kim
BACKGROUND: After wide local excision of cutaneous melanoma, large defects not amenable to simple primary closure are often covered with skin grafts. We report our experience using the rhomboid and keystone flaps to immediately close large axial and extremity wounds after potentially curative surgery for non-head and neck melanomas. METHODS: Between January 2011 and September 2016, demographic, operative, pathologic, and outcome data were prospectively collected on 60 patients who underwent wide local excision of melanoma followed by immediate flap reconstruction...
October 19, 2016: World Journal of Surgical Oncology
Min Seok Kang, Eun Jung Lee, Ji Seop Kim, In Sik Yun, Hyung Kwon Byeon
Microcystic adnexal carcinoma (MAC) is a rare malignant cutaneous adenocarcinoma that typically occurs in the head and neck, particularly at the central face. There are only slightly more than 300 patients reported worldwide, and most patients occur in Caucasians. A 72-year-old man was referred to our hospital for definitive treatment of known MAC from previous biopsy. Wide excision of nasal tip and reconstruction of nasal defect with paramedian forehead flap and nasolabial flap transposition were performed rather than conventional Mohs surgery, due to grossly evident disease...
October 14, 2016: Journal of Craniofacial Surgery
Ning Ma, Yang Qun Li, Yong Tang, Wen Chen, Zhe Yang, Mu Xin Zhao, Wei Xin Wang, Li Si Xu, Jun Feng
Resurfacing large facial defect is a continuing challenge for plastic surgeons. Skin graft or free flap is hard to obtain satisfactory results or is beyond the skill of most surgeons. The authors performed 13 expended submental island flaps to resurface middle and lower facial defects and achieved satisfactory results. In the first stage operation, the authors implanted one soft tissue expander in the anterior neck region which was expanded over an average of 3 months. In the second stage operation, the authors elevated the expanded submental island flap to resurface facial defect...
October 14, 2016: Journal of Craniofacial Surgery
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