Objective To study the method and effect of free rectusabdominis muscle flaps with intermediate split thickness skin graft in repairing defects on legs and ankles.Methods From May 1998 to December 2002, 11 cases of defects on legs(2 cases) and on ankles( 9 cases) were repaired by use of unilateral free rectus abdominis flap with skin graft. The soft tissue defects were accompanied by osteomyelitis or the exposure of bone or tendon.The disease course was 1 month to 10 years. The defect size ranged 3 cm×4 cm to 8 cm×14 cm. The area ofrectus abdominis muscle flaps was 4 cm×6 cm to 8 cm×15 cm. Results All patients were followed up 6 months to 4 years after operation. All rectusabdominis flaps survived with good appearances and functions.The primary healing was achieved in 8 cases, intermediate split thickness skin graft necrosed in 3 cases and the wound healed after skin re-graft.Conclusion Free rectus abdominis flap is a proper option for repair of the soft tissue defects or irregular woundson legs and ankles. It has the advantages of abundant blood supply, b anti-infection ability, good compliance and satisfied appearance.
Objective To introduce a new design of the scapular flap.Methods The lateral descending cutaneous branch of the circumflex scapular artery was investigated in 10 cadavers with radiography. Based on the results, we usedthe scapular flap(from 8 cm×25 cm to 11 cm×35 cm) pedical on the lateral descending cutaneous branch of the circumflex scapular artery to reconstruct defects offaciocervical region after burning in 7 patients, with direct suture the donatearea,or skin grafting.Results Sever flaps survived completely, satisfactoryresults were obtained except 2 patients’ flap to need to be thinned during the following up.Conclusion This flap can be designed to extend to the inframamary fold, the donor-site scar of the flap is well hidden. The design of the flap broadens the application of the scapular flap.
Twenty cases with skin defect of forearm and hand were treated by free skin graft with subcutaneous fat from 0.5 to 0.7 cm in thickness. The maximal area of free skin graft is 27×10cm, and the smallest one is 1.5×2cm. All of skin flaps survived except one having partial necrosis. Follow up shown round external figure, clasticity, and no change of skin color. It preserved the function of sweat gland and the cutaneous sensation began to recover 4 months postoperation.
efect of the eyebrow is a common facialdefect. It was resulted from a variety of causes,but the most common was burn. The operationby using free postauricular scalp graft to repairthe defect of eyebrow was intreduced. The var-ious metheds of eyebrow reconstruction werecompared. The treatment of 79 patients with thedefect of eyebrow was summarized. It was notedthat it had the following advantages , such as theoperation being simple and easy, a naturallooking, appropriate density and r...
Abstract In order to find a new method to repair large bone defect, the free periosteum autograft was investigated in experiment, and then the method was used clinically. In the experiment, a 6mm×18mm×5mm bone defect was made at upper end of both tibiae of 42 rabbites. The periosteum of each rabbit was cut into 1mm cubes, and implanted randomly into the tbial bone defect on one side and the other side was used as control. After 2, 4, 8 weeks, the bone defects of each group were examined for bone formation by roentgenography, radionuclide and histology. The results showed that the defects treated by free periosteum autografts healed twice as fast as the controls (its natural healing). The reason probably was that the periosteum provided with many osteogenic cells. On thebasis of these results, 21 cases of bone defects (the largest was 10.5cm×4cm×4cm, the smallest was 2cm×2cm×2cm) including 17 cases of benign bone tumor and4 cases of chronic osteomyelitis, were treated by free periosteum autografts. The defects were all healed, and the function of the joints was restored.
Objective To study the anatomical basis of micro transverse flap pedicled with the superfical palmar branch of radial artery from the palmar wrist for using this free flap to repair soft tissue defect of the finger. Methods Thirty-eight fresh upper limb specimens (22 males and 16 females; aged 26-72 years with an average of 36 years; at left and right sides in 19 limbs respectively) were dissected and observed under operating microscope. Two specimens were made into casting mould of artery with bones, and 2 specimens were injected with red emulsion in radial artery. Thirty-four specimens were injected with 1% gentian violet solution in the superfical palmar branch of the radial artery. A transverse oval flap in the palmar wrist was designed, the axis of the flap was the distal palmar crease. The origin, distribution, and anastomosis of the superfical palmar branch of the radial artery were observed. Results The superficial palmar branch of the radial artery was constantly existed, it usually arises from the main trunk of the radial artery, 1.09-3.60 cm to proximal styloid process of radius. There were about 2-5 branches between the origin and the tubercle of scaphoid bone. The origin diameter was 1.00-3.00 mm, and the distal diameter at the styloid process of radius was 1.00-2.90 mm. The venous return of flap passed through 2 routes, and the innervations of the flap mainly from the palmar cutaneous branch of the median nerve. The area of the flap was 4 cm × 2 cm-6 cm × 2 cm. Conclusion The origin and courses of the superficial palmar branch of the radial artery is constant, and its diameter is similar to that of the digital artery. A transverse oval flap pedicled with the superfical palmar branch of radial artery in the palmar wrist can be designed to repair defects of the finger.
OBJECTIVE: To sum up transplantation of free scapular flap to repairing injury of faciocervical region, 103 cases in past 16 years were reviewed. METHODS: The scapular flap contained the ascending, descending, and transverse branches of the circumflex scapular artery. The range of the flap was as following: across the scapular spine to the acromion in upper edge, to the level of anterior iliac spine in lower edge, to the bilateral middle axillary line in both sides. RESULTS: The clinical result was good. Fifty eight cases were followed up for 3 months to 10 years, the function of the faciocervical region was recovered with satisfied contour. In part of the patients, a second-stage operation was performed to make the flap thinner. CONCLUSION: The maximal range of the flap can be 45 cm x 16 cm. For its sufficient blood supply, it should be of no influence on survival of the flap if the window is open in suitable site. Because of its large range of donating region and sufficient blood supply, it is fit for children.
OBJECTIVE: To study the availability of transplantation of anterolateral femoral skin flap with absence of the first branch of musculocutaneous artery. METHODS: One hundred and sixty cases of anterolateral femoral skin flap transplantation in the past 15 years were reviewed, to investigate the relationship between the outcome of the transplantation and the types, distribution, original point, diameter of blood vessels. Among the 160 cases, there were 10 cases, 6.3% in total, of skin flap transplantation with the pedicle of high site direct cutaneous femoral artery, ranging from 10 cm x 14 cm to 12 cm x 18 cm in size, applied to repair soft tissue defect. RESULTS: There were 149 cases, among the 160 cases, survived and all the 10 cases of femoral skin flap transplantation with high site anterolateral cutaneous artery survived. CONCLUSION: The femoral skin flap with high site anterolateral cutaneous artery has good blood supply, larger size available, and easier operation. When the first branch of descending anterolateral femoral artery is absent, the femoral skin flap with high site anterolateral cutaneous artery is an optimal alternative.
Objective To explore the technique for reconstructing nasal subunits with the reversed vascularized preauricular and ear composite flap. Methods From June 2003 to August 2005 the preauricular and ear composite flap, which was pedicled by the reversed superficial temporal vessel, was harvested and transplanted to repair the defects of the nasal tip, soft triangle, and ala by the microsurgical technique. The flap ranged in area from 3.5 cm×2.5 cm to 2.0 cm×1.5 cm, with the pedicles 4 to 6 cm in length. The reversed superficial temporal vessel pedicles were directly anastomosed to the angular artery and vein adjacent to the nasal ala. Results Among the 12 patients who had been treated, 11 had their vessel pedicles successfully anastomosed to the angular vessels, while the remaining 1 patient had the stump of the superficial temporal vessel anastomosed after the flap harvest via the vessel graft because the angular vessels were not found in the recipient area. All the flaps survived with a satisfactory esthetic result after operation. Conclusion The technique for reconstructing nasal subunits with the reversed vascularized preauricular and ear composite flap, which is directly anastomosed to the angular vessel, can avoid the vessel grafting and therefore it can avoid an additional damage to the patient.