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Rotation flap

Milan V Stevanovic, Vanessa G Cuéllar, Alidad Ghiassi, Frances Sharpe
: In the upper extremity, the latissimus dorsi muscle can be used as an ipsilateral rotational muscle flap for soft-tissue coverage or functional reconstruction of arm and elbow. Patients who have both major soft-tissue loss and functional deficits can be successfully treated with a single-stage functional latissimus dorsi rotational muscle transfer that provides simultaneous soft-tissue coverage and functional reconstruction. METHODS: Our data base was queried for all patients undergoing a rotational latissimus dorsi muscle transfer for simultaneous soft-tissue coverage and functional reconstruction of elbow flexion...
September 2016: Plastic and Reconstructive Surgery. Global Open
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
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
So-Eun Han, Eun-Ji Kim, Hyun Hwan Sung, Jai-Kyong Pyon
BACKGROUND: Reconstruction of extensive penoscrotal defects is a surgical challenge. Resurfacing defects in highly complex three-dimensional structures and restoring their function are an essential part of the reconstruction of penoscrotal regions. OBJECTIVE: We describe a technique using internal pudendal artery perforator (IPAP) pedicled propeller flaps created from the gluteal fold. This could be a reliable surgical option that maintains a natural looking scrotal pouch with minimal donor site morbidity and optimal sexual activity...
October 12, 2016: European Urology
François Simon, Charlotte Celerier, Erea-Noël Garabedian, Françoise Denoyelle
OBJECTIVE: Cryptotia is one of the most common malformations of the upper auricle with aesthetic and functional consequences, however there is no standard treatment. We present the surgical technique and results of a kite flap procedure which can be used in the different cryptotia subtypes. METHODS: We reviewed all patients treated in our department from 2010 to 2015, using a mastoid fascia kite flap technique. The incision of this local flap follows the retro-auricular sulcus along the rim of the helix superiorly and drawing a skin paddle inferiorly...
November 2016: International Journal of Pediatric Otorhinolaryngology
Eugene Poh Hze-Khoong, Li-Qun Xu, Xue-Lai Yin, Shu-Kun Shen
PURPOSE: Drawbacks of the conventional supraclavicular overlay of the pectoralis major myocutaneous flap (PMMF) include the resultant unesthetic cervical bulge and the limited cephalad extension that limits its use to mandibular or cervical defects. This study discusses the technique and comparative advantages of a more esthetic subclavicular route through the clavipectoral fascia that allows an increased arc of rotation to reconstruct orofacial defects. MATERIALS AND METHODS: Patients with orofacial defects that were reconstructed with a PMMF through the modified subclavicular route were included in this retrospective cohort study, which aimed to compare the gain in extension accorded through the modified subclavicular tunnel over an initial conventional supraclavicular overlay...
September 14, 2016: Journal of Oral and Maxillofacial Surgery
Omer Gvirsman, Gabor Kosa, Amir Ayali
Locusts are known for their ability to jump large distances to avoid predation. The jump also serves to launch the adult locust into the air in order to initiate flight. Various aspects of this important behavior have been studied extensively, from muscle physiology and biomechanics, to the energy storage systems involved in powering the jump, and more. Less well understood are the mechanisms participating in control of the jump trajectory. Here we utilise video monitoring and careful analysis of experimental directional jumps by adult desert locusts, together with dynamic computer simulation, in order to understand how the locusts control the direction and elevation of the jump, the residual angular velocities resulting from the jump and the timing of flapping-flight initiation...
2016: PeerJ
Hossein Saremi, Reza Shahryar-Kamrani, Bahareh Ghane, Alireza Yavarikia
BACKGROUND: Nonunion of distal radius fractures is disabling. Treatment is difficult and the results are not predictable. However, posterior interosseous bone flap (PIBF) has been successful in treating forearm nonunion. OBJECTIVES: To treat distal radius fracture nonunion with PIBF as a new procedure. PATIENTS AND METHODS: This prospective non-randomized cohort study was performed at two hospitals in Tehran between January 2011 and September 2015...
July 2016: Iranian Red Crescent Medical Journal
P-L Vincent, B Pinatel, R Viard, J-P Comparin, P Gir, D Voulliaume
AIM OF THE STUDY: The coverage of ischiatic pressure ulcers is characterized by a significant recurrence rate (8-64% depending on the series). It therefore seems necessary to introduce the concept of saving in the use of muscle flaps available to avoid being in a situation of therapeutic impasse. The gluteus maximus inferior split-muscle flap allows a tailored coverage to the ischiatic pressure ulcers grade IV with skin defect less than 8cm after surgical debridement. It is associated with an advancement-rotation skin flap removed above the sub-gluteal fold...
September 21, 2016: Annales de Chirurgie Plastique et Esthétique
Esben M Quistgaard, Ulrich Weininger, Yonca Ural-Blimke, Kristofer Modig, Pär Nordlund, Mikael Akke, Christian Löw
BACKGROUND: Peptidyl-prolyl isomerases (PPIases) catalyze cis/trans isomerization of peptidyl-prolyl bonds, which is often rate-limiting for protein folding. SlyD is a two-domain enzyme containing both a PPIase FK506-binding protein (FKBP) domain and an insert-in-flap (IF) chaperone domain. To date, the interactions of these domains with unfolded proteins have remained rather obscure, with structural information on binding to the FKBP domain being limited to complexes involving various inhibitor compounds or a chemically modified tetrapeptide...
2016: BMC Biology
L Zikmund
AIM: In the contemporary medicine, strong emphasis is put on early closing of body surface defects, which contributes to good and early healing, but, of course, closes the entrance gate for possible infection as well. The easiest closing of the defect is the direct suture of the emerged wound. But some defects are of such an extent, so their closure is necessary to handle other way than simple suture, e.g. by rotating flap plastic surgery. In the paper are evaluated results of flap surgery technique in 56 patients...
2016: Ceská a Slovenská Oftalmologie
Emily A Mistick, Andrew M Mountcastle, Stacey A Combes
Insect wings do not contain intrinsic musculature to change shape, but rather bend and twist passively during flight. Some insect wings feature flexible joints along their veins that contain patches of resilin, a rubber-like protein. Bumblebee wings exhibit a central resilin joint (1m-cu) that has previously been shown to improve vertical force production during hovering flight. In this study, we artificially stiffened bumblebee (Bombus impatiens) wings in vivo by applying a micro-splint to the 1m-cu joint, and measured the consequences for body stability during forward flight in both laminar and turbulent airflow...
September 16, 2016: Journal of Experimental Biology
Yuan Zheng Zhang, Ying Li Li, Chao Yang, Shuo Fang, Hao Fan, Xin Xing
The objectives of the study were to introduce and investigate the reliability of a new flap for postauricular defects using the retroauricular artery perforator.Twenty auricles from 10 Asian human cadavers were dissected to examine the retroauricular perforator distribution and diameter. Fourteen patients with postauricular defects underwent reconstruction using the retroauricular artery perforator from 2013 to 2015. After locating the position of the perforator by ultrasound Doppler blood flow detection, a suitable flap was designed according to the defect's size, condition, and distance from the pedicle...
September 2016: Medicine (Baltimore)
Daniel D Lee, Tyler Kenning, Carlos D Pinheiro-Neto
The osteotemporoparietal fascia flap (OTPFF) has been used for bony defects, especially on the maxilla and orbital floor. However, there are limited reports about the reconstruction of the zygoma. We report the use of composite OTPFF for reconstruction of zygomaticomaxillary complex. The patient had undergone zygomaticomaxillary complex reconstruction with composite OTPFF because of the resection of recurrent postradiation tumor. Extratemporoparietal fascia was harvested and rotated to cover the medullary surface of the bone flap...
August 2016: Plastic and Reconstructive Surgery. Global Open
Richard L Purcell, John P Cody, Mary O'Donnell, Romney Andersen, Carlos J Rodriguez, Scott Tintle
OBJECTIVE: There are several options for soft tissue coverage following external hemipelvectomy; however, in cases of war-related blast trauma, standard flaps are not always available as a result of the extensive soft tissue damage. METHODS: We detail a novel closure technique following a subtotal hemipelvectomy with exposed abdominal viscera using a residual hamstring myofascial cutaneous flap. RESULTS: This flap allowed for fascial tissue to fill the pelvic defect and provided excellent soft tissue coverage for future prosthetic wear...
September 2016: Military Medicine
Nanda Kishore Sahoo, Ajay P Desai, Indranil Deb Roy, Vishal Kulkarni
Breach in the palatal vault leading to an abnormal communication between oral and nasal cavity is known as oro-nasal communication. It is an uncommon presentation in day-to-day clinical practice except in some patients of cleft lip and palate.Etiology may be congenital or acquired. Alveolar and palatal cleft defects are the most common etiological factor. The acquired causes may be trauma, periapical pathology, infections, neoplasms, postsurgical complications, and radio and chemo necrosis.Clinical features like nasal regurgitation of food, defective speech, fetid odor, bad taste, and upper respiratory tract and ear infection are associated with oro-nasal communication...
September 2016: Journal of Craniofacial Surgery
Bo Cheng, Bret W Tobalske, Donald R Powers, Tyson L Hedrick, Susan M Wethington, George T C Chiu, Xinyan Deng
Hummingbirds are nature's masters of aerobatic manoeuvres. Previous research shows hummingbirds and insects converged evolutionarily upon similar aerodynamic mechanisms and kinematics in hovering. Herein, we use three-dimensional kinematic data to begin to test for similar convergence of kinematics used for escape flight and to explore the effects of body size upon manoeuvring. We studied four hummingbird species in North America including two large species (magnificent hummingbird, Eugenes fulgens, 7.8 g and blue-throated hummingbird, Lampornis clemenciae, 8...
September 5, 2016: Journal of Experimental Biology
Kenji Hayashida, Hiroto Saijo, Masaki Fujioka
We describe the use of a composite flap composed of a sural neurofasciocutaneous flap and a vascularized peroneus longus tendon for the reconstruction of severe composite forearm tissue defects in a patient. A 43-year-old man had his left arm caught in a conveyor belt resulting in a large soft-tissue defect of 18 × 11 cm over the dorsum forearm. The extensor carpi radialis, superficial radial nerve, and radial artery were severely damaged. A free neurofasciocutaneous composite flap measuring 16 × 11 cm was outlined on the patient's left lower leg to allow simultaneous skin, tendon, nerve, and artery reconstruction...
September 4, 2016: Microsurgery
Bong Gun Lee, Joon Kuk Kim, Sung Hyouk Choi, Hee Chang Ahn, Min Sung Chung
BACKGROUND: To compare shoulder morbidity between patients who received transverse rectus abdominis myocutaneous (TRAM) flaps after mastectomy (MX + TRAM) and patients who underwent mastectomy only (MX). METHODS: Thirty patients in each group were followed for a minimum of 2 postoperative years. Visual analog scale (VAS) score, restricted range of motion (ROM), rotator cuff disease, muscle strength, shoulder function scores (American Shoulder and Elbow Score and Shoulder Pain and Disability Index), measurement of scapular tilt on chest radiography and standing position in each group were compared...
August 31, 2016: ANZ Journal of Surgery
T Zan, Y S Gao, H Z Li, B Gu, F Xie, H N Zhu, Q F Li
OBJECTIVE: To explore the classification of massive postburn scars on neck and the reconstruction strategy using pre-expanded perforator flaps from the back. METHODS: Thirty-seven patients with massive postburn scars on neck were admitted from January 2010 to December 2014 and treated by our treatment group. The massive postburn scars on neck were categorized into three types according to their size and location. Based on the principles of reconstructive ladder, matching in color and texture between donor site skin and neck skin, large size and thinner thickness of tissue of donor site skin, donor-recipient sites balance, and dominant supplying vessel, we proposed the following treatment strategy for choosing perforator flaps from the back...
August 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
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