Interpolated subcutaneous tissue pedicle melolabial flap for internal lining in full-thickness nasal defects

SummaryObjective: To compare the hydro-surgical technique to traditional techniques for removal of subcutaneous tissue in the preparation of full-thickness skin grafts.Study design: Ex vivo experimental study and a single clinical case report.Sample population: Four canine cadavers and a single clinical case.Methods: Four sections of skin were harvested from the lateral flank of recently euthanatized dogs. Traditional preparation methods used included both a blade or scissors technique, each of which were compared to the hydro-surgical technique individually. Preparation methods were compared based on length of time for removal of the subcutaneous tissue from the graft, histologic grading, and measurable thickness as compared to an untreated sample.Results: The hydro-surgical technique had the shortest skin graft preparation time as compared to traditional techniques (p = 0.002). There was no significant difference in the histological grading or measurable subcutaneous thickness between skin specimens.Clinical significance: The hydro-surgical technique provides a rapid, effective debridement of subcutaneous tissue in the preparation of full-thickness skin grafts. There were not any significant changes in histological grade and subcutaneous tissue remaining among all treatment types. Additionally the hydro-surgical technique was successfully used to prepare a full-thickness meshed free skin graft in the reconstruction of a traumatic medial tarsal wound in a dog.Presented at the ACVS symposium during the resident seminar, Seattle, Washington,USA on October 22, 2010.

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Combined, two-layered reconstruction technique for full-thickness nasal defects

JDDG Journal der Deutschen Dermatologischen Gesellschaft ◽

10.1111/ddg.13678 ◽

2018 ◽

Vol 16 (11) ◽

pp. 1399-1401

Author(s):

Alexandra Reichel ◽

Matthias Goebeler ◽

Gerhard Weyandt

Keyword(s):

Reconstruction Technique ◽

Full Thickness ◽

Nasal Defects

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Use of a Single Anatomic Donor Site for Harvesting a Full-Thickness Skin Graft and a Free Cartilage Graft for Nasal Defects

Dermatologic Surgery ◽

10.1097/dss.0000000000001363 ◽

2018 ◽

Vol 44 (7) ◽

pp. 1023-1024

Author(s):

Jessica Olander ◽

Melanie Wong ◽

Mariah Brown

Keyword(s):

Skin Graft ◽

Donor Site ◽

Cartilage Graft ◽

Full Thickness ◽

Full Thickness Skin Graft ◽

Full Thickness Skin ◽

Thickness Skin ◽

Nasal Defects

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Complex Nasal Defects: Structure and Internal Lining

Facial Plastic Surgery Clinics of North America ◽

10.1016/j.fsc.2004.12.004 ◽

2005 ◽

Vol 13 (2) ◽

pp. 333-343 ◽

Cited By ~ 7

Author(s):

Travis T. Tollefson ◽

J. David Kriet

Keyword(s):

Internal Lining ◽

Nasal Defects

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THE RECONSTRUCTION OF EXTERNAL NASAL FULL-THICKNESS DEFECTS WITH PLASTIC MATERIAL USING ALLOCARTILAGE

Health and Ecology Issues ◽

10.51523/2708-6011.2016-13-2-21 ◽

2016 ◽

pp. 99-104

Author(s):

S. A. Ivanov ◽

I. D. Shlyaga

Keyword(s):

Wound Healing ◽

Clinical Outcomes ◽

Visual Analog Scale ◽

Plastic Material ◽

Full Thickness ◽

Surgical Wound ◽

Analog Scale ◽

Cosmetic Results ◽

Fascial Flap ◽

Nasal Defects

The worked out technique of the reconstruction of full-thickness nasal defects consists in formation of three-layer plastic material based on skin-fascial flap, allogene cartilage and dermal transplantation. We have performed 13 operations, and all the patients have achieved acceptable clinical outcomes. The article presents the data on surgical wound healing, detection of the transplanted allocartilage, estimation of the cosmetic results by the visual analog scale.

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Reconstruction of the alae nasi by folded nasolabial flap

Acta chirurgica iugoslavica ◽

10.2298/aci0702029j ◽

2007 ◽

Vol 54 (2) ◽

pp. 29-32 ◽

Cited By ~ 2

Author(s):

M. Jovanovic ◽

M. Colic ◽

L. Rasulic ◽

M. Stojicic ◽

M. Malis

Keyword(s):

Skin Color ◽

Nasolabial Fold ◽

Full Thickness ◽

Nasolabial Flap ◽

Normal Breathing ◽

Step Procedure ◽

One Step ◽

Nasal Defects ◽

Alar Region ◽

Made In

Reconstruction of the nose is very old surgical procedure and, in fact, represents the beginnings of plastic surgery. In reconstruction, an effort has to be made in order to achieve a normal look. A surgeon must choose carefully the method of reconstruction, taking into consideration the skin color, texture and nasal topography. Full-thickness nasal defects in alar region are very difficult for reconstruction due to anatomic characteristics and structures, which are very important for normal breathing and cosmetic result. Our study analyzed 16 patients with full-thickness defect of alae nasi. Folded nasolabial flaps were used for reconstruction of these defects. Good results were achieved in all cases. The flap was vital. No flap necrosis was reported in any of these patients. The lining of the nose was good. Postoperatively, the alar edge was thickened, but it became thinned after six months. The incision in donor?s region was well placed in the natural line of nasolabial fold. It was concluded that folded nasolabial flap was extremely good one-step procedure for reconstruction of full-thickness defects of alar region. .

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MALIGNANT FIBROUS HISTIOCYTOMA OF THE CHEST WALL: 104-MONTH SURVIVED WITH INITIAL FULL-THICKNESS WIDE RESECTION AND 5 RESECTIONS FOR METASTASIS TO THE BILATERAL LUNG, RIBS, SUBCUTANEOUS TISSUE, AND LOCALLY-A CASE REPORT-

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) ◽

10.3919/jjsa.64.1613 ◽

2003 ◽

Vol 64 (7) ◽

pp. 1613-1617

Author(s):

Osamu MISHIMA ◽

Takahisa NAKAMURA ◽

Moto FUKAI ◽

Motomu IGARASHI ◽

Hiroshi KONDO

Keyword(s):

Case Report ◽

Chest Wall ◽

Malignant Fibrous Histiocytoma ◽

Fibrous Histiocytoma ◽

Subcutaneous Tissue ◽

Wide Resection ◽

Full Thickness ◽

Bilateral Lung

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The Bilobe Flap for Nasal Reconstruction

Facial Plastic Surgery ◽

10.1055/s-0040-1712160 ◽

2020 ◽

Vol 36 (03) ◽

pp. 276-280

Author(s):

Tyler S. Okland ◽

Yu Jin Lee ◽

Akshay Sanan ◽

Sam P. Most

Keyword(s):

Surgical Technique ◽

Subcutaneous Tissue ◽

Retrospective Chart Review ◽

Nasal Reconstruction ◽

Flap Reconstruction ◽

Transposition Flap ◽

Scar Revision ◽

Facial Plastic ◽

Ear Cartilage ◽

Nasal Defects

AbstractRepair of nasal defects is technically challenging due to inelastic nasal skin and unforgiving nasal geometry. The bilobe flap is a double transposition flap that can transpose skin from cephalad to caudad to repair defects of the lower third of the nose. However, pincushioning may complicate this flap, yielding untoward aesthetic outcomes. We review our single surgeon series of patients who underwent bilobe flap reconstruction of nasal defects, and describe our surgical technique to minimize pincushioning and poor aesthetic outcomes. This was a retrospective chart review of patients who underwent bilobe flap reconstruction of nasal defects at a tertiary referral facial plastic and reconstructive surgery clinic between January 1, 2010 and February 12, 2019. All postoperative clinic notes were analyzed for complications, reports of unfavorable cosmetic outcome, and rates of revision procedures. Surgical technique is described. In the analysis, 125 patients were included, of whom 84 (67%) patients were women, and the mean (standard deviation) age was 60.7 (12.5) years. Complications were reported in 20 (16%) patients, including scars, pincushioning, and nasal obstruction. Five patients underwent revision surgery (4%), including scar revision and z-plasty. Pincushioning was reported in four patients (3.2%), of whom three underwent scar revision procedures. One patient had alar notching requiring correction. There was no statistically significant association between ear cartilage graft and complications (p = 0.84) or requirement of intervention (p = 1.0). Univariate and multivariate logistic regression did not show statistically significant association between size of the defect and the presence of complications (p > 0.05). The bilobe flap is an excellent transposition flap for the repair of small nasal tip defects. By adequately thinning the transposition flap of excess subcutaneous tissue prior to inset, rates of poor aesthetic outcomes, revision procedures, and pincushioning are minimized.

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Vascularized Fascia as a Transferable Bed for Experimental Laryngeal Reconstruction

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949410300309 ◽

1994 ◽

Vol 103 (3) ◽

pp. 215-221 ◽

Cited By ~ 14

Author(s):

Pierre R. Delaere ◽

Boudewijn Van Damme ◽

Louw Feenstra

Keyword(s):

External Support ◽

Epithelial Lining ◽

Cartilage Graft ◽

Full Thickness ◽

Wall Defect ◽

Buccal Mucosal Graft ◽

Vascular Bed ◽

Internal Lining ◽

Supporting Material ◽

Posterior Glottis

Laryngeal defects were reconstructed with a combined vascular flap consisting of lateral thoracic fascia used as a transferable vascular bed. A buccal mucosal graft was fixed on this bed as an internal lining. An autogenous cartilage graft, circumferentially wrapped in vascular connective tissue, was used as external support. The first focus of interest of this experimental study was to investigate the necessity of epithelial lining in the repair of a full-thickness laryngeal wall defect. The second focus of interest was to study reconstruction of the posterior glottis by introducing additional supporting material.

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