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Hand Clinics May 2014A local flap consists of skin and subcutaneous tissue that is harvested from a site near a given defect while maintaining its intrinsic blood supply. Local skin flaps... (Review)
Review
A local flap consists of skin and subcutaneous tissue that is harvested from a site near a given defect while maintaining its intrinsic blood supply. Local skin flaps can be a used as a reliable source of soft tissue replacement that replaces like with like. Flaps are categorized based on composition, method of transfer, flap design, and blood supply, but flap circulation is considered the most critical factor for the flap survival. This article reviews the classification of local skin flaps of the hand and offers a practical reconstructive approach for several soft tissue defects of the hand and digits.
Topics: Graft Survival; Hand Injuries; Humans; Plastic Surgery Procedures; Soft Tissue Injuries; Surgical Flaps
PubMed: 24731606
DOI: 10.1016/j.hcl.2013.12.004 -
Journal of Cancer Research and... 2013To assess the usefulness of single-staged posteriorly based dorsal tongue flap in oral cavity reconstruction following ablative surgery, in terms of flap viability,...
AIM
To assess the usefulness of single-staged posteriorly based dorsal tongue flap in oral cavity reconstruction following ablative surgery, in terms of flap viability, functional outcome and donor site morbidity.
MATERIALS AND METHODS
A prospective database of patients who were reconstructed with dorsal tongue flap between July 2006 and November 2010 was used.
RESULTS
There were 27 patients who had tongue flap reconstruction in this period. Size of the defect following excision ranged from 3.5-5 cm in greatest dimension. Marginal mandibulectomy was done in thirteen patients and in twelve patients mucoperiosteal stripping was done. There was no partial or total flap loss in our series. Two patients had minor salivary leak which was managed conservatively. All the patients had adequate mouth opening, good swallowing and speech following surgery.
CONCLUSION
Dorsal tongue flap is a simple and reliable flap for intra oral reconstruction. It provides good functional results without much morbidity.
Topics: Adult; Aged; Deglutition; Female; Humans; Male; Middle Aged; Mouth; Mouth Neoplasms; Prospective Studies; Plastic Surgery Procedures; Surgical Flaps; Tongue; Treatment Outcome
PubMed: 23771361
DOI: 10.4103/0973-1482.113354 -
Revista Brasileira de Anestesiologia Jul 2012Head and neck reconstructive surgery represents a major challenge facing the need to achieve a good cosmetic and functional outcome. Anesthesia may be an important and... (Review)
Review
BACKGROUND AND OBJECTIVES
Head and neck reconstructive surgery represents a major challenge facing the need to achieve a good cosmetic and functional outcome. Anesthesia may be an important and determining factor in the technique success due to its role in hemodynamic stability and regional blood flow. On the other hand, regional anesthesia, changes in blood volume, and vasoactive drugs may influence blood flow in the flap. Thus, due to the lack of recommendations based on evidence, the anesthetic technique of these procedures is most often inspired in pathophysiological considerations. The aim of this paper is to review relevant aspects regarding anesthetic practice in these cases.
CONTENT
Importance of the type of surgical flap, physiological considerations, and anesthetic approach.
CONCLUSIONS
In surgery with microvascular flaps, the anesthesiologist role includes optimizing the physiological conditions for the survival of the flap without increasing the non-surgical morbidity.
Topics: Anesthesia; Humans; Microvessels; Plastic Surgery Procedures; Surgical Flaps
PubMed: 22793973
DOI: 10.1016/S0034-7094(12)70156-3 -
Hand Clinics Feb 2020The VY advancement, thenar flaps, and cross-finger flaps are workhorse flaps used in reconstruction of fingertip defects. They are reliable and simple to raise without... (Review)
Review
The VY advancement, thenar flaps, and cross-finger flaps are workhorse flaps used in reconstruction of fingertip defects. They are reliable and simple to raise without need for microvascular dissection. In addition, they usually provide good results in terms of sensibility and range of motion. This article reviews the history, anatomy, and surgical technique of these flaps with a focus on aesthetic refinements with illustrative cases.
Topics: Amputation, Traumatic; Esthetics; Finger Injuries; Fingers; Humans; Plastic Surgery Procedures; Surgical Flaps
PubMed: 31757344
DOI: 10.1016/j.hcl.2019.08.003 -
World Journal of Surgical Oncology Jul 2022Posterior intercostal arteries perforators (PICAPs) and lateral intercostal arteries perforators (LICAPs) are great vascular pedicles. Between the 4th and 11th spaces,...
BACKGROUND
Posterior intercostal arteries perforators (PICAPs) and lateral intercostal arteries perforators (LICAPs) are great vascular pedicles. Between the 4th and 11th spaces, they arise from the thoracic aorta. These are large perforators that can be the basis of many flaps. Yet, these perforators are underrated as they are poorly studied and scarcely utilized in plastic reconstructions.
METHODS
Twenty (ten males and ten females) adult cadaveric dissections were done on both sides to study the types, locations, and sizes of posterior intercostal perforators to help design flaps based on them in the best possible way. Perforators were assigned into one of 3 topographical zones of the back (medial, intermediate, and lateral).
RESULTS
The skin of the back was divided into 3 vertical zones: medial, intermediate, and lateral. Posterior intercostal arteries perforators (PICAPs) were found in the medial and intermediate zones. Medial zone PICAPs were large and appeared at the medial border of erector spinae (Es). Intermediate zone PICAPs appeared at the lateral border of Es and passed through latissimus dorsi (Ld) before reaching the skin. Lateral zone perforators were branches of lateral intercostal arteries and were divided into 2 types: (1) posterior branches of lateral intercostal perforators: simply named posterior lateral perforators (PLs); they were small and present in most of the spaces, and (2) anterior branches of lateral intercostal perforators (LICAPs): they were large, dominant pedicles and were found mainly in the 4th to the 7th spaces.
CONCLUSION
PICAPs and LICAPs are constant and of enormous size and run for a great distance in the skin. They can be utilized as any type of flap.
Topics: Adult; Female; Humans; Male; Plastic Surgery Procedures; Skin; Superficial Back Muscles; Surgical Flaps; Thorax
PubMed: 35902870
DOI: 10.1186/s12957-022-02711-1 -
Medicina (Kaunas, Lithuania) Jun 2020The reconstruction of the nipple-areola complex is the last step in the breast reconstruction process. Several techniques have been described over the years. The aim of... (Review)
Review
The reconstruction of the nipple-areola complex is the last step in the breast reconstruction process. Several techniques have been described over the years. The aim of this review is to provide clarity on the currently available reconstructive options.
Topics: Adult; Breast Neoplasms; Female; Humans; Mastectomy; Middle Aged; Nipples; Plastic Surgery Procedures; Surgical Flaps
PubMed: 32560062
DOI: 10.3390/medicina56060296 -
Asian Journal of Surgery Aug 2019To identify surgical techniques applied in case of recurrence in patients with pilonidal sinus, who have undergone primary treatment with Limberg flap, and to present... (Review)
Review
To identify surgical techniques applied in case of recurrence in patients with pilonidal sinus, who have undergone primary treatment with Limberg flap, and to present our cases treated with Limberg flap reconstruction prepared from the contralateral gluteal region. Nine patients with recurrence out of 219 patients who underwent Limberg flap reconstruction between 2009 and 2016 at our clinics, and 6 patients who have been referred to our clinics with total 15 recurrence after primary Limberg flap reconstruction at other institutes were included in the study. Total excision and primary repair was applied in 3 patients while 2 patients underwent excision with lay open procedures. The remaining 10 patients underwent rhomboid excision of the recurrence area and Limberg flap repair from the contralateral gluteal area. All patients who underwent primary repair or excision-lay open procedures recurred again. These two patients also underwent contralateral Limberg flap reconstruction as their second revision surgery. There were no complications or recurrences in the study group. We believe that reconstruction with contralateral Limberg flap is an effective and feasible method in recurrent pilonidal sinus cases who have been initially treated surgically by the Limberg flap.
Topics: Buttocks; Feasibility Studies; Humans; Pilonidal Sinus; Plastic Surgery Procedures; Recurrence; Reoperation; Sacrococcygeal Region; Surgical Flaps
PubMed: 30711442
DOI: 10.1016/j.asjsur.2018.12.008 -
Scientific Reports Apr 2023This article reviewed our experience of Chinese nasal reconstruction over 12 years and evaluated the effect of expanded forehead flap both aesthetically and... (Review)
Review
This article reviewed our experience of Chinese nasal reconstruction over 12 years and evaluated the effect of expanded forehead flap both aesthetically and functionally. The special skin type and other anatomic features of Chinese patients was understood thoroughly during the treatment. This article thus catered for the need of multiracial nasal reconstruction. We analyzed existing clinical data and demonstrated a typical case in detail. The postoperative result supported our strategy which advocated the extensive application of expanded forehead flap, together with flip scar flap as the internal lining. The features of Chinese patients also prompted the use of costal and auricular cartilage. Emerging technology like 3D-printing would benefit nasal reconstruction from more aspects.
Topics: Humans; Rhinoplasty; Forehead; Nose; Surgical Flaps; Nose Neoplasms
PubMed: 37015929
DOI: 10.1038/s41598-023-30245-3 -
Cirugia Pediatrica : Organo Oficial de... Oct 2022Ectopic scrotum is a rare clinical entity, potentially associated with other congenital abnormalities. We present the case of a patient with buried penis secondary to... (Review)
Review
INTRODUCTION
Ectopic scrotum is a rare clinical entity, potentially associated with other congenital abnormalities. We present the case of a patient with buried penis secondary to ectopic scrotum. The surgical technique was described, and a literature review was carried out.
CLINICAL CASE
1-year-old patient with ectopic right hemiscrotum and the testes within the scrotal sac. A double Z-plasty was performed with two flaps - one above the penis, surrounding the ectopic scrotum, and the other one at the scrotum to modify the bifid scrotum. The upper flap was rotated downwards, which allowed ectopy to be repaired, and the lower flap was used to repair bifidity. No postoperative complications were recorded. Follow-time was 6 months, with good final cosmetic results.
DISCUSSION
Ectopic scrotum is an infrequent congenital malformation. Cutaneous rotation flaps with Z-plasties are a valid treatment option, with good long-term cosmetic results.
Topics: Humans; Infant; Male; Penis; Plastic Surgery Procedures; Scrotum; Surgical Flaps; Testis; Urogenital Abnormalities
PubMed: 36217791
DOI: 10.54847/cp.2022.04.21 -
Hand Clinics Feb 2020The vascular supply of the hand and wrist is derived from the radial and ulnar arteries. This forms a complex network of vessels on the palmar and dorsal surfaces of the... (Review)
Review
The vascular supply of the hand and wrist is derived from the radial and ulnar arteries. This forms a complex network of vessels on the palmar and dorsal surfaces of the hand. Anastomoses and branching patterns of vessels at the level of the carpals, metacarpals, and phalanges form the basis of old and new flap designs. This article provides an overview on the vascular anatomy of the hand and forearm with emphasis on the blood supply to various flaps.
Topics: Arteries; Hand; Humans; Surgical Flaps
PubMed: 31757342
DOI: 10.1016/j.hcl.2019.08.001