Isolated Perfused Skin Flap and Skin Grafting Techniques

AbstractThis article investigates an effective method with which to reconstruct the tragus and external auditory meatus for microtia reconstruction. The external ear was reconstructed using a delayed postauricular skin flap in patients with congenital microtia. After the first stage of delaying the postauricular skin flap and the second stage of otoplasty with ear framework fabricated from autogenous rib cartilage draping with the delayed skin flap, the third stage involved tragus and external auditory meatus canaloplasty. After designing the remnant auricle flap, the lower part was trimmed and the tragus was reconstructed. The upper part was trimmed into a thin skin flap, which was rotated and used to cover the hollowed wound posterosuperior to the tragus so as to mimic the external auditory meatus. If remnant wounds were present, skin grafting was conducted. In total, 121 patients with congenital microtia were treated from March 2010 to March 2016. The reconstructed tragus and external auditory meatus were well formed, and all wounds healed well. No severe complications such as flap necrosis occurred. Six months postoperatively, the morphology of the reconstructed tragus and external auditory meatus was good. Overall, the patients and their families were satisfied. The use of remnant auricle to reconstruct the tragus and external auditory meatus is an effective auricular reconstruction technique.

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Skin flap and skin grafting techinques in small animal surgery

Veterinary Quarterly ◽

10.1080/01652176.1997.9694790 ◽

1997 ◽

Vol 19 (sup1) ◽

pp. 24-25 ◽

Cited By ~ 5

Author(s):

M.M. Pavletic

Keyword(s):

Skin Flap ◽

Small Animal ◽

Skin Grafting ◽

Animal Surgery

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1322 Two Staged Skin Pedicle Reconstruction of Superior Helical Rim

British Journal of Surgery ◽

10.1093/bjs/znab259.634 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

Adam Holden ◽

Stergios Doumas ◽

Jag Dhandar

Keyword(s):

Local Anaesthetic ◽

Skin Flap ◽

Skin Grafting ◽

Skin Incision ◽

Outpatient Setting ◽

Reconstruction Technique ◽

Oral Antibiotics ◽

Posterior Aspect ◽

Skin Loss ◽

Staged Reconstruction

Abstract Introduction Skin grafting onto the ear has its challenges, loss of the skin results in inadequate vascular bed for the graft leading to decreased uptake 1,2. As a result, advancement flaps or sacrifice of the underlying cartilage allows primary closure with compromised aesthetics. A two staged procedure however leads to acceptable scarring, can be performed under local anaesthetic, is quick and easy enabling transfer of skin to acutely exposed cartilage. The authors demonstrate a two staged reconstruction technique of the superior helix after traumatic degloving of the dermal tissues. Method Under local anaesthetic an incision in line with the most inferior extent of the skin loss is made. A subdermal plane is expanded superiorly, and the exposed auricular cartilage inserted, healing of the adjacent margins occurs and enables later skin transfer. The patient was discharged on oral antibiotics and returns at two weeks to have the pedicle divided in an outpatient setting. A further skin incision superior to the extent of the tip of the helix is performed. This skin flap is then thinned and folded to reconstruct the posterior aspect of the ear. The skin is sutured in place and the patient is sent home on oral antibiotics. A further reviewed in two weeks to check healing is advised and the patient was subsequently discharged. Conclusions In conclusion, this is demonstrated to be a useful technique to add to the Oral and Maxillofacial Surgeons armament for reconstruction of the superior helix when iatrogenic or traumatic loss of skin coverage occurs.

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The possibility of simultaneous combined skin grafting during the installation of synthetic implants after cranial trepanation

Russian journal of neurosurgery ◽

10.17650/1683-3295-2021-23-3-69-74 ◽

2021 ◽

Vol 23 (3) ◽

pp. 69-74

Author(s):

P. G. Tunimanov ◽

V. A. Manukovskiy ◽

E. V. Zinoviev ◽

P. V. Chechulov ◽

D. V. Kostyakov

Keyword(s):

Plastic Surgery ◽

Optimal Algorithm ◽

Skin Flap ◽

Skin Grafting ◽

Two Stage ◽

Surgical Interventions ◽

Skin Defects ◽

Satisfactory Condition ◽

Decompressive Craniotomy ◽

Treat Ment

Introduction. Over the past 20 years, with an increase in the number of decompression trepanations in the Russian Federation and abroad, the number of cranioplasties performed has increased. Despite the development of technology, these surgical interventions are inevitably accompanied by a number of complications (up to 36 %), including the for‑ mation of skin defects. The choice of the optimal algorithm for the treatment of skin defects after cranioplasty remains the subject of debate.The purpose of the publication is to demonstrate by a clinical example the possibility of simultaneous combined skin grafting during the installation of synthetic implants after cranial trepanation, as well as to analyze the outcomes and com‑ plications of such operations.Materials and methods. For the period 2017–2019 under our supervision there were 42 patients after craniotomy, 32 of which were cranioplasty, and 10 plastic surgery of the defects of the scalp after removal of synthetic implants. In the course of the analysis, the structure and terms of surgical interventions, the length of hospitalization, the frequen‑ cy and structure of complications, as well as the timing of their development were studied.The article presents one of the cases of treatment and simultaneous installation of a titanium plate, combined skin grafting in a patient who has undergone previously decompressive craniotomy, cranioplasty with protacryl.Results. Simultaneous cranioplasty with skin grafting was performed in 3 out of 42 patients. The average hospitalization time after such an intervention was significantly less than with two‑stage plastic surgery (28.0 ± 3.9 and 52.0 ± 2.7 days, respectively, p <0.05). There were no complications in the postoperative period after a single‑stage plastic surgery, but after a two‑stage one, 2 cases of divergence of the wound edges and the formation of fistulas above the implants were registered.Conclusion. The data obtained illustrate that, given the technical feasibility, as well as the satisfactory condition of the skin flap, simultaneous cranioplasty with combined skin grafting can be one of the methods of choice in the treat‑ ment of extensive defects in the skin of the head and skull.

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Management of carotid artery exposure with pectoralis major myofascial flap transfer and split-thickness skin coverage

The Journal of Laryngology & Otology ◽

10.1017/s0022215100132360 ◽

1995 ◽

Vol 109 (12) ◽

pp. 1176-1180 ◽

Cited By ~ 7

Author(s):

C. R. Leemans ◽

A. J. M. Balm ◽

R. T. Gregor ◽

F. J. M. Hilgers

Keyword(s):

Carotid Artery ◽

Skin Flap ◽

Skin Grafting ◽

Neck Surgery ◽

Pectoralis Major ◽

Split Thickness Skin Graft ◽

Flap Transfer ◽

Thickness Skin ◽

Split Thickness Skin Grafting ◽

Skin Coverage

AbstractThe risk for post-operative exposure of the carotid artery due to skin flap necrosis after major head and neck surgery is increased after previous radiation and in severely malnourished patients. Eight patients are described who presented with an (imminent) carotid exposure one to eight weeks after surgery. Pectoralis major myofascial flap transfer with split thickness skin graft coverage was used for protection of the carotid artery. All cases were managed successfully and healed primarily in two to four weeks with acceptable cosmesis. We advocate immediate treatment in the event of an exposed carotid (or imminent exposure) by a pectoralis major myofascial flap with split-thickness skin grafting.

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Retrograde Island Flap Bridge Transfer of Adjacent Phalangeal Artery Combined With Vascular Pedicle Tubular Skin Grafting to Repair Finger Pulp Defect

10.21203/rs.3.rs-907874/v1 ◽

2021 ◽

Author(s):

Weibin Du ◽

Fangbing Zhu ◽

Qiao Hou ◽

Shenghu Hong ◽

Guohua Ren ◽

...

Keyword(s):

Hand Function ◽

Skin Flap ◽

Skin Grafting ◽

Island Flap ◽

Function Evaluation ◽

Vascular Pedicle ◽

Dorsal Branch ◽

Donor Area ◽

Functional Exercise ◽

And Function

Abstract Objective: To investigate the surgical method and therapeutic effect of retrograde island flap bridge transfer of adjacent phalangeal artery combined with vascular pedicle tubular skin grafting to repair finger pulp defect.Methods: From June 2008 to May 2020, 14 patients (16 fingers) with severe contusion of proximal and middle phalangeal body combined with finger pulp defect, and 5 patients (5 fingers) with finger pulp defect more than distal interphalangeal joint were repaired by retrograde island flap bridge transfer of adjacent phalangeal artery combined with vascular pedicle tubular skin grafting. The dorsal branch of digital nerve was carried in the skin flap for anastomosis with the proper nerve at the stump of the injured finger. The donor area was covered with medium thickness skin of abdominal or elbow transverse stripes, and the vascular pedicle was wrapped with tubular skin. The pedicle was severed 16-22 days after surgery. The survival rate and complications of postoperative flaps were observed. The finger function was evaluated by the Michigan functional questionnaire and Dagan functional criteria, and the clinical effect was evaluated. Result: All flaps survived and all patients were followed up for a period of 6 to 46 months. The skin flap of the affected finger was of good texture, and the appearance was naturally not bloated. The two-point discrimination was 7 ~ 11mm, and no obvious complications were observed in the donor area. Evaluation of the Michigan Hand Function Questionnaire: Nineteen patients were satisfied with the overall appearance and function of the hand. Finger joint Dargan function evaluation: excellent in 15 cases, good in 4 cases.Conclusions: It is a safe and effective operation to repair finger pulp defect with the retrograde island flap of adjacent finger artery combined with vascular pedicle tubular skin grafting. the skin flap has the advantages of simple cutting, good texture and concealed donor area, which is convenient for the early functional exercise of the finger body.

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Patchwork Flap for Immediate Nipple-Areolar Complex Reconstruction

Surgical Case Reports ◽

10.31487/j.scr.2021.02.01 ◽

2021 ◽

pp. 1-2

Author(s):

Elijah Z. Cai ◽

Janet Hung ◽

Hanjing Lee ◽

Thiam Chye Lim ◽

...

Keyword(s):

Skin Flap ◽

Skin Grafting ◽

Nipple Areolar Complex ◽

Areolar Complex ◽

Complex Reconstruction

Loss of nipple projection is commonly encountered during nipple-areolar reconstruction. The patchwork flap was developed to overcome this problem. The thickness of the buried dermofat flap can be modified to the desired nipple projection. Areolar is reconstructed with multiple skin flap islands, which negates the need for skin grafting. The dimensions of the skin islands can be modified to the desired areolar size.

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Supplementation of bone marrow aspirate-derived platelet-rich plasma for treating radiation-induced ulcer after cardiac fluoroscopic procedures: A preliminary report

Indian Journal of Plastic Surgery ◽

10.4103/0970-0358.96599 ◽

2012 ◽

Vol 45 (01) ◽

pp. 109-114 ◽

Cited By ~ 9

Author(s):

Soh Nishimoto ◽

Kenji Fukuda ◽

Kenichiro Kawai ◽

Toshihiro Fujiwara ◽

Tomoko Tsumano ◽

...

Keyword(s):

Bone Marrow ◽

Heart Disease ◽

Ischaemic Heart Disease ◽

Conservative Therapy ◽

Platelet Rich Plasma ◽

Skin Flap ◽

Bone Marrow Aspiration ◽

Skin Grafting ◽

Radiation Induced ◽

Unbearable Pain

ABSTRACT Background: The frequency of encountering radiodermatitis caused by X-ray fluoroscopic procedures for ischaemic heart disease is increasing. In severe cases, devastating ulcers with pain, for which conservative therapy is ineffective, emerge. Radiation-induced ulcers are notorious for being difficult to treat. Simple skin grafting often fails because of the poor state of the wound bed. A vascularized flap is a very good option. However, the non-adherence of the well-vascularized flap with the irradiated wound bed is frequently experienced. Aim: To ameliorate the irradiated wound bed, bone marrow-derived platelet-rich plasma (bm-PRP) was delivered during the surgery. Materials and Methods: Four patients with severe cutaneous radiation injury accompanied by unbearable pain after multiple fluoroscopic procedures for ischaemic heart disease were treated. Wide excision of the lesion and coverage with a skin flap supplemented with bm-PRP injection was performed. Results: All patients obtained wound closure and were relieved from pain. No complication concerning the bone marrow aspiration and delivery of bm-PRP was observed. Conclusions: Supplementation of bm-PRP can be an option without major complications, time, and cost to improve the surgical outcome for irradiated wounds.

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