scholarly journals Masseter Flap for Reconstruction of Defects After Excision of Buccal Mucosa Cancers with Intact Mandible

2020 ◽  
pp. 014556132096344
Author(s):  
Pankaj Chaturvedi ◽  
Sandeep Lerra ◽  
Farheen Ustad ◽  
Prathamesh S. Pai ◽  
Devendra A. Chaukar ◽  
...  
Keyword(s):  
Buccal Mucosa ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Nasolabial Flap ◽  
Microvascular Anastomosis ◽  
Surgical Time ◽  
No Donor ◽  
Patient Load ◽  
Time Required ◽  
Better Than

Among the reconstructive options available for buccal mucosa defects with an intact mandible, free flap with microvascular anastomosis is the best option. However, in the developing world, with poor resources, limited in- frastructure, and high patient load, this cannot be offered to all patients. We report on the success of the masseter flap for reconstruction of such defects in carefully selected patients. Despite some known limitations, this flap is easy to learn and carries acceptable complications. The results of this flap may not be comparable to those of microvas- cular reconstructions, but they are better than those from other options such as skin graft, nasolabial flap, submental flap, etc. in terms of surgical time required, no donor site morbidity, and minimal aesthetic deformity.

Donor-site morbidity in buccal mucosa urethroplasty: lower lip or inner cheek?

2005 ◽  
Vol 96 (4) ◽  
pp. 619-623 ◽  
Author(s):  
Stefan Kamp ◽  
Thomas Knoll ◽  
Mahmoud Osman ◽  
Axel Hacker ◽  
Maurice S. Michel ◽  
...  
Keyword(s):  
Buccal Mucosa ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Lower Lip

Autologous osteochondral graft for traumatic defects of finger joints

2011 ◽  
Vol 37 (3) ◽  
pp. 251-257 ◽  
Author(s):  
W. C. Wu ◽  
M. W. M. Fok ◽  
K. Y. Fung ◽  
K. H. Tam
Keyword(s):  
Donor Site ◽  
Joint Space ◽  
Donor Site Morbidity ◽  
Finger Joint ◽  
Osteochondral Graft ◽  
Range Of Movement ◽  
No Donor ◽  
The Mean ◽  
Open Injuries

Finger joint defects in 16 adults were treated with an autologous osteochondral graft from the base of the second metacarpal, the radial styloid, the base of the third metacarpal or the trapezoid and these patients were followed up from between 12 and 62 months. There was no donor site morbidity. One patient had resorption of the graft and developed pain. The joint was subsequently fused. The mean range of movement was 55.8% of the opposite normal joint. At follow up, 15 patients had no discomfort or mild discomfort. Three had mild narrowing of the joint space and two had slight joint subluxation. Only two patients with concomitant severe injury to the same limb had difficulty performing daily activities. Ten were open injuries and these had poorer outcomes. A hemicondylar defect of a finger joint can be treated using an osteochondral graft obtained from the same hand.

Time and Speed of Vascular Pedicle Dissection in Deep Inferior Epigastric Artery Perforator Flap Elevation

2017 ◽  
Vol 33 (08) ◽  
pp. 557-562
Author(s):  
Ji Yim ◽  
Yeon Lee ◽  
Young Kim ◽  
Eun Kim ◽  
Taik Lee ◽  
...  
Keyword(s):  
Free Flap ◽  
Donor Site ◽  
Perforator Flap ◽  
Donor Site Morbidity ◽  
Vascular Pedicle ◽  
Inferior Epigastric Artery ◽  
Epigastric Artery ◽  
Deep Inferior Epigastric Artery ◽  
Time Required ◽  
Artery Perforator

Background Breast reconstruction using deep inferior epigastric artery perforator (DIEP) free flap is widely used because of the advantages of minimizing donor-site morbidity, but it requires technical competency in vascular dissection. This study evaluated the influence of patient factors and vascular status on the time and speed of dissection of the vascular pedicle. Methods DIEP free flap procedures were performed in 49 patients assigned to immediate or delayed reconstruction groups. Factors that significantly influenced the time required and the speed of dissection were evaluated. Results The average total dissection time was 55.9 minutes (34.5 minutes for the intramuscular dissection and 21.4 minutes for the submuscular dissection). The dissection speed for the total vascular pedicle was 2.65 cm/10 minutes (1.71 cm/10 minutes for the intramuscular dissection and 4.30 cm/10 minutes for the submuscular dissection). The presence of a Pfannenstiel scar, length of the vascular pedicle in the intramuscular area, and the number of microclips used significantly correlated with the total dissection time. Conclusion The length of the intramuscular pedicle, number of microclips used, and presence of a Pfannenstiel scar significantly correlated with the total dissection time of the vascular pedicle. An assessment prior to the surgery can reduce the time of operation and make it easier to elevate the flap.

scholarly journals Regional Grafts for Closure of Postsurgical Defect in Anterior Maxilla: Versatility of Chin Graft and Local Rotational Flap

2013 ◽  
Vol 4 (1) ◽  
pp. 47-50
Author(s):  
Varsha Sunil Manekar
Keyword(s):  
Donor Site ◽  
Surgical Flaps ◽  
Donor Site Morbidity ◽  
No Donor ◽  
Anterior Maxilla ◽  
Mucosal Defect ◽  
Rotational Flap ◽  
Osseous Defect ◽  
The Right ◽  
Autogenous Grafts

ABSTRACT The management of postsurgical defect is a challenge for the maxillofacial surgeon. With the success of various autogenous grafts and surgical flaps the reconstruction surgery creates definitive results. This article is a case report of reconstruction of osseous defect and closure of soft tissue fenestration in the right anterior maxilla. An autogenous corticocancellous graft from the mandibular symphysis is used for reconstruction of the osseous defect of around 15 × 15 mm. The mucosal fenestration of around 10 × 10 mm is closed by rotational flap based in the labial sulcus. The defect and the donor site healed uneventfully. Both osseous and mucosal defect healed with esthetic results. Thus, the regional flaps prove the versatility by convenience of graft taking, no donor site morbidity and biological resemblance of tissues. How to cite this article Manekar VS. Regional Grafts for Closure of Postsurgical Defect in Anterior Maxilla: Versatility of Chin Graft and Local Rotational Flap. Int J Head and Neck Surg 2013;4(1):47-50.

REVISITING SUPRACLAVICULAR ARTERY FLAP FOR HEAD AND NECK ONCOLOGIC RECONSTRUCTION.

2021 ◽  
pp. 220-222
Author(s):  
Pranay Bhandari ◽  
Ameya Bihani ◽  
Pratiksha Pawar
Keyword(s):  
Prospective Study ◽  
Head And Neck ◽  
Buccal Mucosa ◽  
Gold Standard ◽  
Donor Site ◽  
Wound Dehiscence ◽  
Donor Site Morbidity ◽  
Partial Necrosis ◽  
Pros And Cons ◽  
A Prospective Study

Background: Head and neck oncologic resections defects are often difcult to reconstruct and are time consuming. An ideal ap should have qualities of both regional and free ap. Our aim in this study is to compare pros and cons of supraclavicular artery ap in comparison to other available ap. This report is a prospective study of cases that underwent supraclavicular artery ap of which, 5 are males and 3 are females. All cases were of carcinoma of Buccal mucosa. 5 cases were completely successful with no complication. One patient had partial necrosis, o Result: ne another patient had distal marginal necrosis with wound dehiscence and one patient had pus discharge with wound dehiscence and orocutaneous stula. No signicant donor site morbidity is seen. This ap has potential to Conclusion: become gold standard in reconstruction of head and neck defects.

scholarly journals Case Report

Hand ◽  
2016 ◽  
Vol 11 (4) ◽  
pp. NP38-NP40 ◽  
Author(s):  
Sanjay Naran ◽  
Joseph E. Imbriglia
Keyword(s):  
Case Report ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
No Donor ◽  
Metacarpophalangeal Joints ◽  
Active Function ◽  
Patient Reported ◽  
Long Term Follow Up

Background: A case is discussed in which a young girl was born with symbrachydactyly of multiple digits in whom nonvascularized proximal toe phalanges were transferred to the aphalangic digits at the age of four. At 39 years of age, she presented incidentally to our clinic and was observed to have a very functional hand with mobile metacarpophalangeal joints in all reconstructed digits. Methods: We present a case report which is discussed in the context of long-term follow-up, and phalangeal growth in the absence of distraction, and a review of the current literature in regards to outcomes for this modality of treatment. Results: We document growth of the transplanted phalanges, despite surgery occurring after the reported optimum age of before 18 months, and the patient not undergoing distraction. The patient reported no donor site morbidity in regards to function or psychosocial impact. Furthermore, we observed active function at the metacarpophalangeal joints of all operated digits. Conclusions: We report the longest follow-up (35 years) following nonvascularized proximal toe phalangeal transfer for short finger type symbrachydactyly. We highlight the long-term functional outcome of nonvascularized toe phalangeal transfers, and present an overview of the current outcome literature for this type of procedure, advocating that nonvascularized toe phalangeal transfers remain a viable treatment option for select cases of symbrachydactyly.

Aneurysmal Bone Cysts in the Hand Treated by Free Non-Vascular Transfer of Metatarsal or Proximal Phalanx from the Foot

1993 ◽  
Vol 18 (6) ◽  
pp. 736-741 ◽  
Author(s):  
G. S. RAO ◽  
P. KEOGH ◽  
H. WEBSTER ◽  
P. G. LUNN ◽  
F. D. BURKE
Keyword(s):  
Donor Site ◽  
Bone Cyst ◽  
Proximal Phalanx ◽  
Donor Site Morbidity ◽  
No Donor ◽  
Joint Reconstruction ◽  
Articular Surfaces ◽  
Aneurysmal Bone Cysts ◽  
And Function ◽  
Second Toe

Two cases of aneurysmal bone cyst in the hand are reported. In one case the entire first metacarpal was resected and grafted using the fourth metatarsal. In the second case diaphysectomy of the middle phalanx of the index digit was performed, and the proximal phalanx of the second toe was used as graft. Satisfactory length and function were maintained, the grafts remained viable and there was no donor site morbidity. Transplant of a metatarsal or toe phalanx to the hand, as a free non-vascularized graft, is a relatively straight forward operation, requires minimal refashioning of the graft, provides articular surfaces for joint reconstruction and leaves little donor site morbidity.

Onlay Fascial Grafts to Silicone-Polytetrafluorethylene Composite Implants in Augmentation Rhinoplasty: A Retrospective Study of 241 Cases

2019 ◽  
Vol 39 (11) ◽  
pp. 1182-1190
Author(s):  
Lee Seng Khoo ◽  
Cheng-I Yen ◽  
Chun-Shin Chang ◽  
Hung-Chang Chen ◽  
Chih-Jung Huang ◽  
...  
Keyword(s):  
Patient Group ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Control Group ◽  
Complication Rates ◽  
Augmentation Rhinoplasty ◽  
Level Of Evidence ◽  
No Donor ◽  
Asian Ethnicity

Abstract Background Silicone-polytetrafluoroethylene composite implants are fast gaining popularity in Asian rhinoplasty. Nonetheless, implant displacement, erythematous reactions, and infections still occur in the authors’ patient group during long-term follow-up. Objectives The authors reported successful experience of combining the utilization of silicone-polytetrafluoroethylene composite implants with onlay temporal fascial grafts to circumvent these complications. Methods Sixty-four patients of Asian ethnicity underwent augmentation rhinoplasty utilizing an I-shaped composite implant with an onlay fascial graft from January 2015 to June 2018, with a mean follow-up period of 13.5 months. This patient group was compared with a control group of 177 Asian patients who underwent augmentation rhinoplasty utilizing the same composite implant but without the addition of a fascial graft; the control group was treated from February 2012 to June 2015, with a mean follow-up of 42.0 months. Complications were compared between these 2 patient groups, specifically focusing on malposition/deviations, erythema, and infections. Results There was a marked decrease in complication rates with the addition of an onlay temporal fascial graft to cover the composite implant in augmentation rhinoplasty (7.8% vs 14.7%) as well as the rate of erythematous reactions (0% vs 6.2%, P = 0.04), infection (1.6% vs 1.1%), and implant malposition/deviation (0% vs 4.5%). Harvesting the temporal fascia and fashioning the onlay graft added an additional 33 minutes on average per procedure. No donor site morbidity was encountered. Conclusions Although the operative time increased, the benefits of adding onlay fascial grafts to silicone-polytetrafluoroethylene implants in alloplastic augmentation rhinoplasty outweigh the drawbacks, as evidenced by the decrease in erythematous reactions. Level of Evidence: 4

scholarly journals Pick-up Test: An Indication for Opponensplasty in Patients with Severe Carpal Tunnel Syndrome

2009 ◽  
Vol 17 (2) ◽  
pp. 183-186 ◽  
Author(s):  
Siu-Leung Yip ◽  
Chi-Hung Yen ◽  
Wai-Lam Chan ◽  
Hon-Bong Leung ◽  
Kan-Hing Mak
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Motor Deficit ◽  
No Donor ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release ◽  
Test Failure

Purpose. To use a pick-up test to assess thenar motor deficit and results of opponensplasty. Methods. Eight consecutive patients with idiopathic severe carpal tunnel syndrome and severe thenar motor deficit were identified. All were females aged 39 to 60 (mean, 53) years and right-hand dominant. The severity of thenar motor deficit was assessed using the pick-up test. Failure to pick up a coin with the thumb and index finger only in a normal pulp-to-pulp pincer grip was an indication for an opponensplasty (in addition to open carpal tunnel release) to hasten recovery of thumb abduction. Treatment outcome was assessed using the pick-up test at 6, 8, and 12 weeks. Results. Preoperatively, all patients were unable to perform the pick-up test. At postoperative 6 weeks, all patients could pick up the coin with no difficulty and were satisfied with the result of opponensplasty. There was no relapse at subsequent follow-ups and no donor-site morbidity in terms of cosmesis, scar pain or infection. Grip strength and the range of wrist motion were 63% and 92% of the normal side, respectively. Conclusion. The pick-up test is a simple and reliable means of identifying those in need of an opponensplasty.

scholarly journals Ear Reconstruction

2021 ◽  
pp. 731-745
Author(s):  
Paritkumar Ladani
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Congenital Deformity ◽  
Ear Reconstruction ◽  
No Donor ◽  
Rib Cartilage ◽  
Self Confidence ◽  
Emerging Trends ◽  
The Face ◽  
Reconstructive Techniques

AbstractMicrotia is a congenital deformity of the external ear, with a prevalence rate of approximately 1 in 10,000 live births worldwide. The auricle is a distinguishing feature of the face. Its deformity may have severe psycho-social implications on the affected children, affecting their self-confidence. Current reconstructive techniques for microtia mainly include the auricular prosthesis, implantation of alloplastic or an autologous rib cartilage framework. Alloplastic implant reproduces an excellent shape of the ear with no donor site morbidity, however its bio-integration is questionable and may make them prone for extrusion and infection. Sub-cutaneous implantation of autologous rib cartilage still remains the gold-stand treatment for microtia. However this technique has its surgical morbidities and skill demands, which makes it difficult to master. Translational research in the fields of tissue engineering for generation of bone and cartilage for ear reconstruction are emerging trends.

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