[Clinic application of compound flap pedicled with arterial arch of palpebral margin].

OBJECTIVE: To study the clinic application of compound flap pedicled with arterial arch of palpebral margin in repairing severe full defect of eyelid. METHODS: According to eyelid structure and the defect size, the two compound flaps were designed beside the defect based on the arterial arch of the palpebral margin. If the defective area was too large, the lateral compound flap may be extended to lower or upper eyelid 0.5 cm away from the outer canthus, then cut and propelled the two compound flaps to repair the full eyelid defect. RESULTS: 20 cases had been cured with this method since 1998. In this cases, 4 cases were basal cell carcinoma of eyelid, 2 cases were squamous carcinoma, 3 angiomas, 6 chromatophore nexuses, 3 traumatic defects, 2 congenital defects. The largest length of eyelid full defect was 1.7 cm and the smallest was 0.8 cm. 6 cases were upper eyelid defect and 14 cases were lower eyelid defect. All the compound flaps survived completely without any complications. All cases obtained satisfactory results functionally and esthetically. CONCLUSIONS: Repairing full eyelid defect with the compound eyelid flap is the same kind tissue repairing. It can not only provide enough tissues to primary repair large full defect of the upper or lower eyelid to restore normal anatomical structure and appearance of the eyelid, but also is easy to be operated without severe secondary deformities. The arterial arch of the palpebral margin is constant and the blood supply of the compound flap is reliable. It is an ideal method of repairing the eyelid defect.

[Modified radical operation for early breast cancer for preserving nipple-areolar complex and breast reconstruction using transverse rectus abdominis myocutaneous (TRAM) flap].

BACKGROUND & OBJECTIVE: Modified radical mastectomy (MRM) operation has become an important surgical therapy for early stage breast cancer, but how to reconstruct breast and preserve nipple-areolar complex (NAC) is controversial. In this study, we applied a modified radical mastectomy for early stage breast cancer for preserving NAC and breast reconstruction using transverse rectus abdominis myocutaneous (TRAM) flap. METHODS: During operation we performed the subcutaneous glandular excision and axillary dissection, and reconstructed the breast using TRAM flap in 10 patients with early stage breast cancer; meanwhile, maximam extent of breast skin and NAC were preserved. RESULTS: The appearance of the reconstructed breast was better preserved after operation. No local recurrence and distant metastasis occurred in the patients during the follow up time (range 24-48 months). No skin flap necrosis, atrophy, and scleroses surround the NAC were observed; and no abdominal wall hernia occurred at the donor site. The nipple sensation was recovered half a year after surgery. CONCLUSION: Modified radical operation for preserving NAC and breast reconstruction using TRAM flap may be a better way for breast cancer patients in early stage who request well preserving of breast. More samples are needed for proving the effects of this operation.

[Experience of vaginal reconstruction by using a pudendal-thigh island flaps].

OBJECTIVE: To evaluate a pudendal-thigh island flap for vaginal reconstruction. METHODS: Forty-seven patients with congenital absence of vagina were undergoing the treatment. Based on the pedicle including the posterior labial neurovascular bundle, a pudendal-thigh island flap was designed and raised in the groin crease just lateral to the labia majora under the deep fascia. It was then transferred to the tunnel between the urethra and the anus for reconstruction of the vagina. RESULTS: From May of 1993 to July of 2001, 47 patients were successfully treated for the vaginal reconstruction with the flap. The results were satisfactory without complications. CONCLUSION: The above mentioned technique could be a safe and effect method for vaginal reconstruction with the advantages of reliable blood supply, good sensation and few complications. The areaes with the bilateral pudendal-thigh could be large enongh for the vaginal reconstruction without problem of the donor closure.