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Consecutive flap transfer for repairing massive soft tissue defects in the opisthenar with improved donor site closure

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Chinese Journal of Traumatology 2014年第5期17卷 256-260页

作者： Wu Lehao Tong Dedi Zhu Shan Zang Mengqing Tian Guanglei Chen Shanlin Plastic Surgery Hospital Chinese Academy of MedicalScience Peking Union Medical College Beijing 100730China Department of Hand-surgery Jishuitan HospitalPeking University Beijing 100035 China Division of Plastic and Reconstructive Surgery TongjiHospital Huazhong University of Science and TechnologyWuhan 430030 China

Objective：To explore a surgical model of utilizing consecutive free scapular flap and adjacent pedicled flap transfer for repairing massive soft tissue defects on the dorsum of the hand while minimizing the donor site ***：Six patients with massive soft tissue injuries on the opisthenar and forearm were treated with free scapular ***,a pedicled flap adjacent to the donor site was transferred to cover the donor site defect by direct ***：All six free scapular flaps survived without signs of *** adjacent pedicled flaps presented minor signs of insufficient blood flow on the distal apex,which resolved after six weeks with only conservative *** the incisions healed without other *** six-month follow-up,the patients regained full shoulder ***：With the assistance of an adjacent pedicled flap,the scapular flap is a highly applicable approach in repairing massive soft tissue defects in the *** can achieve positive outcomes in both reconstructive and aesthetic aspects.

关键词： soft tissue defect Free scapular flap Perforator flap

Free peroneal perforator-based sural neurofasciocutaneous flaps for reconstruction of hand and forearm

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Chinese Medical Journal 2009年第14期122卷 1621-1624页

作者： CAI Pei-hua LIU Sheng-he CHAI Yi-min WANG Hai-ming RUAN Hong-jiang FAN Cun-yi Department of Orthopedic Surgery Sixth People's Hospital Shanghai Jiao Tong University Shanghai 200233 China

Background Sural neurofasciocutaneous flap has been popularly used as an excellent option for the coverage of soft tissue defects in the lower third of leg, ankle and foot, but its free transplantation has been rarely reported. The objective of our work was to investigate the operative technique and clinical results of repairing the soft tissue defects of hand and forearm with free peroneal perforator-based sural neurofasciocutaneous flap. Methods Between May 2006 and March 2007, 10 patients including 7 men and 3 women were treated. Their ages ranged from 22 to 51 years. They presented to emergency with large soft tissue defects of 16 cm × 7 cm to 24 cm × 10 cm in size in hand and forearm after injured by motor vehicle accidents （2 cases） or crushed by machine （8 cases）. Thorough debridements and primary treatments to associated tendon ruptures or bone fractures were performed on emergency. And free peroneal perforator-based sural neurofasciocutaneous flaps were transplanted when the wound areas were stable at 5 to 7 days after emergency treatment. The flaps were designed along the axis of the sural nerve according to the shape and size of the soft tissue defects, with the peroneal perforator above the lateral malleolus as the pedicle and along with a part of the peroneal artery for vascular anastomosis. Then the flaps were harvested to repair the recipient sites with the peroneal artery anastomosed to the radial （or ulnar） artery and the peroneal veins to one of the radial （or ulnar） veins and the cephalic vein respectively. The flap sizes ranged from 18 cm × 8 cm to 25 cm × 12 cm. The donor areas were closed by skin grafts. Results All of the 10 flaps survived after surgeries. Marginal necrosis occurred in only 2 cases. The skin grafts survived entirely in the donor sites, and no obvious influence on the donor legs was observed. All of the transplanted flaps presented favourable contours and good functions at 9 to 12 months＇ follow-up. Conclusions Peroneal perfora

关键词： free transplantation peroneal perforator sural neurofasciocutaneous flap soft tissue defect

Quadrilobed superior gluteal artery perforator flap for sacrococcygeal defects

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Chinese Medical Journal 2013年第9期126卷 1743-1749页

作者： HAI Heng-lin SHEN Chuan-an CHAI Jia-ke LI Hua-tao YU Yong-ming LI Da-wei The People's Liberation Army Burn Center the First Affiliated Hospital of People's Liberation Army General Hospital Beijing 100048 China Department of Burns and Plastic Surgery the 98th Hospital of People's Liberation Army Huzhou Zhejiang 313000 China Burn Unit Department of Surgery Massachusetts General Hospital and Shriners Burns Hospital-Boston Boston MA 02114 USA

Background Perforator flaps are used extensively in repairing soft tissue defects. Superior gluteal artery perforator flaps are used for repairing sacral defects, but the tension required for direct closure of the donor area after harvesting of relatively large flaps carries a risk of postoperative dehiscence. This research was to investigate a modified superior gluteal artery perforator flap for repairing sacrococcygeal soft tissue defects. Methods From June 2003 to April 2010, we used our newly designed superior gluteal artery perforator flap for repair of sacrococcygeal soft tissue defects in 10 patients （study group）. The wound and donor areas were measured, and the flaps were designed accordingly. Wound healing was assessed over a follow-up period of 6-38 months. From January 1998 to February 2003, twelve patients with sacrococcygeal pressure sores were treated with traditional methods, VY advancement flaps or oblong flaps, as control group. Results After debridement, the soft tissue defects ranged from 12 cm× 10 cm to 26 cm× 22 cm （mean 16.3 cm× 13.5 cm）. Four patients were treated using right-sided flaps ranging from 15 cm × 11 cm to 25 cm × 20 cm （mean 18.2 cm × 14 cm）. Four patients were treated using left-sided flaps, and two were treated using both right- and left-sided flaps. Suction drains were removed on postoperative Days 3-21 （mean 5.9） and sutures were removed on postoperative Days 12-14. Each flap included 1-2 perforators for each of the donor and recipient sites. Donor sites were closed directly. All flaps survived. In eight patients, the wounds healed after single-stage surgery. After further debridement, the wounds of the remaining two patients were considered healed on postoperative Days 26 and 33, respectively. The rate of first intention in the study group （80%, 8/10） significantly increased than that of control group （（25%, 3/12）, X2=4.583, P=0.032）. Follow-up examinations found that the flaps had a soft texture without ulceration. In the tw

关键词： quadrilobed superior gluteal artery perforator flap sacrococcygeal region pressure sore soft tissue defect

The forehead flap:a valuable option in resource depleted environment

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Plastic and Aesthetic Research 2016年第1期3卷 115-120页

作者： Rowland Agbara Benjamin Fomete Athanasius Chukwudi Obiadazie Kelvin Uchenna Omeje Olushola Ibiyinka Amole Oral and Maxillofacial Surgery Unit Dental and Maxillofacial Surgery DepartmentJos University Teaching HospitalJos 930001Nigeria Oral and Maxillofacial Surgery Department Ahmadu Bello University Teaching HospitalShika-Zaria 810222Nigeria Oral and Maxillofacial Surgery Unit Dental and Maxillofacial Surgery DepartmentAminu Kano University Teaching HospitalKano 700233Nigeria

Aim:Reconstruction of orofacial soft tissue defect is often challenging and this is more difficult in resource challenged *** retrospective study highlights our experience with the use of forehead flap to overcome some of the challenges of orofacial reconstruction in a resource depleted ***:A 23-year retrospective analysis of all patients who had orofacial defect reconstruction using forehead flap in our department was *** was sourced from patient’s case notes and operating theatre *** was analyzed using Statistical Package for Social Sciences(SPSS)version 16(SPSS Inc.,Chicago,IL,USA)and Microsoft Excel 2007(Microsoft,Redmond,WA,USA).Results:A total of 43 patients were managed within the period reviewed and consisted of 31(72.1%)males and 12(27.9%)*** 24(55.8%)accounted for most defect and the lip was the commonest site of *** forehead flap was used in 31(72.1%)of cases and when timing of defect repair is considered,delayed reconstruction was the preferred *** complications was observed in 8(18.6%)patients and consisted of failed flap in 2(25.0%)patients,tumor recurrence in reconstructed site in 2(25.0%)patients and tumor occurrence in forehead flap donor site in 1(12.5%)***:The forehead flap remains a reliable option in orofacial soft tissue defect *** is easy to raise and can provide coverage for wide defects as far as the paramandibular and submandibular ***,it does not require patient repositioning.

关键词： Orofacial soft tissue defect forehead flap delayed reconstruction

Flap transplantation for treatment of pelvic fracture and defective hip

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Discussion of Clinical Cases 2014年第1期1卷 33-39页

作者： Bo Feng Kecheng Niu Zhi Zhang Lan Zhang Yunyan Tan The Third Affiliated Hospital of Inner Mongolia Medical University HohhotChina

A case of flap transplantation for treatment of pelvic fracture and defective hip in the Third Affiliated Hospital of Inner Mongolia Medical University was collected and analyzed on the basis of diagnosis,physical examination and *** patient was in serious condition with large necrotic area and prone to lead to various *** paper aims to share experience and provide references for similar cases amongst surgeons.

关键词： Pelvic fracture soft tissue defect Skin flap transplantation

Superiorly based perforator plus fl ap for inguinal defects

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Plastic and Aesthetic Research 2014年第1期1卷 89-93页

作者： Pradeoth Mukundan Korambayil Prashanth Varkey Ambookan Vinoth Kumar Dilliraj Department of Plastic Surgery and Burns Jubilee Institute of Surgery for HandAesthetic and MicrosurgeryJubilee Mission Medical College and Research InstituteThrissur 680005KeralaIndia

Aim:Inguinal block dissections for metastasis to inguinal lymph nodes and occasionally trauma are always associated with soft tissue loss over the groin region.A clinical study was undertaken to demonstrate the ability to utilize a superiorly-based perforatorﬂap with reliable vascularity and less donor site morbidity to cover defects in the inguinal ***:A prospective study was performed on 7 patients with inguinal soft tissue defects managed in our institution from January 2013 to September *** the study period,a“superiorly-based perforator plusﬂap”was used for soft tissue coverage over the femoral vessels in the inguinal *** oxygen therapy was administered *** postoperative period,hospital course,and follow-up after radiotherapy was documented in patients with inguinal block ***:Seven patients presented with soft tissue defects in the inguinal *** of the defects were secondary to prior surgery,and 2 were secondary to trauma.A superiorly-based perforator plusﬂap was performed in all *** defect sizes ranged from 9 cm×4 cm to 17 cm×8 ***ﬂap dimensions ranged from 12 cm×5 cm to 20 cm×10 *** secondary procedures were necessary following ***,there was no evidence of partial or totalﬂap ***ﬂap revisions were required,and no complications were experienced at either the donor or recipient site following *** were followed-up for 10-18 ***:Inguinal defects require stable soft tissue coverage to withstand radiotherapy following inguinal block dissection surgery,and are susceptible to wound *** superiorly-based perforator plusﬂap technique is simple,requires little operative time,and is a reliableﬂap for coverage of the femoral vessels and inguinal region with improved tolerance to postoperative radiotherapy.

关键词： Hyperbaric oxygen therapy inguinal lymph nodes soft tissue defect superiorly-based perforator plus flap