Use of a Strait Cannula Microdebrider for Debulking of a Free Tissue Transfer Flap Skin Paddle: A Technical Note

2021 ◽  
Author(s):  
Kevin Francois ◽  
Ariel Farahi ◽  
Rabie M. Shanti
Keyword(s):  
Free Tissue Transfer ◽  
Technical Note ◽  
Skin Paddle ◽  
Tissue Transfer ◽  
Free Tissue Transfer Flap

scholarly journals Supraclavicular Flap for Large Anterior Chest Wall Defects–A Road Less Travelled

2020 ◽  
Vol 53 (03) ◽  
pp. 427-430
Author(s):  
Amrita More ◽  
Anoop Sivakumar ◽  
Gupta K Gaurav
Keyword(s):  
Chest Wall ◽  
Free Tissue Transfer ◽  
Anterior Chest Wall ◽  
Head And Neck Reconstruction ◽  
Skin Paddle ◽  
Skin Defects ◽  
Tissue Transfer ◽  
Supraclavicular Flap ◽  
Large Skin ◽  
Chest Wall Defects

AbstractLarge upper central chest wall defects are a reconstructive challenge. The commonly described flaps for this area do not provide very large skin paddle, and free tissue transfer remains the only option for large skin defects. Supraclavicular flap as a local flap is widely used for head and neck reconstruction and has been described for upper chest wall defects earlier. We have used nonislanded supraclavicular flap for reconstruction of two cases of large chest wall defects, which would otherwise need free tissue transfer, single flap in one case and bilateral flaps in the other. It is easy to do and has minimal morbidity. Supraclavicular flap offers a simple solution for large skin defects of the upper central chest wall and is especially useful in patients with high-operative risk and guarded prognosis.

Simultaneous reconstruction of large skin and mucosal defect following head and neck surgery with a single skin paddle pectoralis major myocutaneous flap

2005 ◽  
Vol 119 (4) ◽  
pp. 303-305 ◽  
Author(s):  
P Chaturvedi ◽  
P S Pai ◽  
K A Pathak ◽  
D A Chaukar ◽  
M S Deshpande ◽  
...  
Keyword(s):  
Head And Neck ◽  
Free Tissue Transfer ◽  
Pedicled Flap ◽  
Pectoralis Major ◽  
Head And Neck Reconstruction ◽  
Skin Defect ◽  
Skin Paddle ◽  
Tissue Transfer ◽  
Mucosal Lining ◽  
Large Skin

The pectoralis major myocutaneous (PMMC) flap is commonly used for head and neck reconstruction especially in impoverished nations. PMMC is a sturdy pedicled flap with relatively fewer complications, the learning curve is short and no specialized training in microvascular surgery is needed in order to use this flap. In a defect that requires a large skin and mucosal lining the authors routinely use either a bi-paddle PMMC or a combination of PMMC (for the mucosal lining) and a delto-pectoral flap (for the skin defect). It is indisputable that free tissue transfer is a better way of reconstruction for the majority of most such defects. Unfortunately, not all patients can be offered this form of reconstruction due to the cost, time, expertise and infrastructural constraints in high volume centres such as ours. Bi-paddling of PMMC is hazardous in obese males and most female patients. In such patients the skin defect is reconstructed usually by the delto-pectoral (DP) flap but this, for obvious reasons, is less welcomed by the patients. The authors suggest a technique wherein mucosal lining is created by the myofascial lining (inner surface) of the flap and the skin defect is reconstructed by the skin paddle of the single paddle PMMC. It should be considered wherever a DP flap is unacceptable, or bi-paddling or free tissue transfer is not possible.

scholarly journals Long-term results of microvascular free-tissue transfer reanimation of the paralyzed face: Three cases

2008 ◽  
Vol 87 (4) ◽  
pp. 226-233
Author(s):  
John P. Leonetti ◽  
Chad A. Zender ◽  
Daryl Vandevender ◽  
Sam J. Marzo
Keyword(s):  
Facial Nerve ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Free Tissue Transfer ◽  
Long Term Results ◽  
Wide Field ◽  
Facial Movement ◽  
Tissue Transfer ◽  
Facial Reanimation

We conducted a retrospective case review at our tertiary care academic medical center to assess the long-term results of microvascular free-tissue transfer to achieve facial reanimation in 3 patients. These patients had undergone wide-field parotidectomy with facial nerve resection. Upper facial reanimation was accomplished with a proximal facial nerve–sural nerve graft, and lower facial movement was achieved through proximal facial nerve–long thoracic (serratus muscle) nerve anastomosis. Outcomes were determined by grading postoperative facial nerve function according to the House-Brackmann system. All 3 patients were able to close their eyes independent of lower facial movement, and all 3 had achieved House-Brackmann grade III function. We conclude that reanimating the paralyzed face with microvascular free-tissue transfer provides anatomic coverage and mimetic function after wide-field parotidectomy. Synkinesis is reduced by separating upper-and lower-division reanimation.

scholarly journals Free Tissue Transfer in Pressure Ulcer Reconstruction: A Systematic Review

2021 ◽  
Vol 06 (01) ◽  
pp. e35-e39
Author(s):  
Chelsi Robertson ◽  
Charles Patterson ◽  
Hugo St. Hilaire ◽  
Frank H. Lau
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Final Analysis ◽  
The United States ◽  
Local Flap ◽  
Recurrence Rates ◽  
Tissue Transfer ◽  
Cochrane Database

Abstract Background Pressure ulcers (PUs) affect 2.5 million people in the United States annually and incur health-care costs of 11 billion dollars annually. Stage III/IV PU often require local flap reconstruction. Unfortunately, PU recurrence is common following reconstruction; recurrence rates as high as 82% have been reported. When local flap options are inadequate, free tissue transfer may be indicated but the indications have yet to be delineated. To develop evidence-based guidelines for the use of free flaps in PU reconstruction, we performed a systematic review. Methods A systematic review of the available English-language, peer-reviewed literature was conducted using PubMed/MEDLINE, Google Scholar, Scopus, EMBASE, and the Cochrane Database of Systematic Reviews. Articles were manually reviewed for relevance. Results Out of 272 articles identified, 10 articles were included in the final analysis. Overall, this systematic review suggests that free-flap PU reconstruction yields fewer recurrences compared with local flaps (0–20 vs. 13–82%). Further, several types of free flaps for PU reconstruction were identified in this review, along with their indications. Conclusion Free tissue transfer should be considered for recurrent PU. We offer specific recommendations for their use in PU reconstruction.

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