Regional analysis of soft tissue thickness on korean buttocks and application to fasciocutaneous flap design.

BACKGROUND: Various shapes and designs of the gluteal artery perforator flap have been used for treating sacral pressure sores and reconstructing breasts. To establish the ideal fasciocutaneous flap design for use in the gluteal area, the soft tissue thickness distribution was measured. METHODS: Twenty-one buttocks of adult Korean cadavers were analyzed through rectangular subfascial dissection. Each buttock was divided horizontally into 10 sections and vertically into 10 sections, and then, the thickness at the corners of the sections was measured. For the sake of comparison and statistical verification with living bodies, computed tomography (CT) images of 120 buttocks of patients were randomly selected. Five horizontal sections and 4 vertical sections were made, and the thickness at each corner was recorded. RESULTS: According to the dissection and the CT images, the area with the thinnest soft tissues in the buttock was around the posterior superior iliac spine, close to the sacral area. The thickest area was the superolateral area of the buttock, which was 3.24 times and 2.15 times thicker than the thinnest area in the studies on cadaver anatomy and the CT images, respectively. CONCLUSIONS: The thickness of the soft tissues in the buttocks differed by area. The superolateral area had the thickest soft tissues, and the superomedial area had the thinnest. This study includes information on the distribution of the thickness of the gluteal soft tissues of Koreans. The outcome of this study may contribute to the design of effective local flaps for pressure sore reconstruction and free flaps for breast reconstruction.

Chest wall reconstruction with a lateral thoracic artery perforator propeller flap for a radiation ulcer on the anterior chest.

A lateral thoracic artery perforator propeller flap is advantageous because it does not require microvascular anastomosis, only rarely involves donor-site morbidity and provides sufficient blood flow. Moreover, by rotating the flap, remote tissues with less radiation-induced damage can be used at the site of the defect. In this article, we report the use of a lateral thoracic artery perforator propeller flap to treat a radiation ulcer.

Effects of a Topical Angiotensin-Converting Enzyme Inhibitor and a Selective COX-2 Inhibitor on the Prevention of Hypertrophic Scarring in the Skin of a Rabbit Ear.

UNLABELLED:  Angiotensin-converting enzyme (ACE) inhibitors have been reported to inhibit fibrogenesis, and cyclooxygenase-2 (COX-2) inhibitors, to reduce scarring by reducing the initial inflammation. The authors reasoned that the topical application of these 2 agents may have a complementary effect on scar reduction. METHODS: Captopril (ACE inhibitor), celecoxib (COX-2 inhibitor), or a combination of captopril and celecoxib were topically applied to a skin wound in a rabbit ear, and investigated for the effects on scar formation. RESULTS: The level of scar elevation decreased in the captopril group and the level of infiltration of inflammatory cells decreased in the celecoxib group. In the group where a combination of the 2 drugs was used, the level of scar elevation decreased the most, and collagen deposition and organization returned to normal most rapidly. Celecoxib was found to inhibit the initial inflammation in the ear wound of the rabbit, and captopril inhibited scar elevation. CONCLUSION: Clinical application of these drugs will require further studies with regard to adverse events and their absorptivity as topical agents. However, these findings suggest that the combined topical administration of an ACE inhibitor and COX-2 inhibitor to a skin wound could be an effective treatment for the prevention of hypertrophic scarring. .