[Repair of tissue defects with free composite anterolateral femoral fascia lata perforator tissue flaps].

OBJECTIVE: To observe the clinical effects of repair of complicated tissue defects of several body parts with composite anterolateral femoral fascia lata perforator tissue flaps (fascial flap or fascial skin flap) with the aid of micro-surgery. METHODS: From February 2008 to August 2012, complicated tissue defects in 12 patients were repaired with composite anterolateral femoral fascia lata perforator tissue flaps. Two of the 12 patients suffered from a defect of scalp, skull, and dura mater as a result of resection of a malignant tumor of the scalp; 3 patients showed a defect of skin and tendo calcaneus in the heel and lower leg; 2 patients showed a defect of skin and extensor tendon in the dorsum of hands; the other 5 patients suffered from defects of skin and extensor tendon in the foot and ankle combined with exposure of bone or internal buttress plate. The size of tissue flaps ranged from 12 cm ×6 cm to 19 cm ×18 cm. The donor sites were closed by immediate suturing or skin grafting. RESULTS: All 12 tissue flaps survived. Patients were followed up for 2 to 36 months. The flaps were shown to have good appearance, texture and function. Two patients with the defect of the scalp, skull and dura mater after a resection of the malignant tumor of the scalp did not have recurrence or herniation of brain tissue. The foot-raising function in 3 patients with the defect of skin and tendo calcaneus in the heel and lower leg was recovered, and according to Arner-Lindholm criteria the result was excellent in 2 cases and good in 1 case. The extension function of fingers of 2 patients with defects of skin and extensor tendon in the dorsum of hands was good according to the evaluation criteria of Chinese Medical Association Society of Hand Surgery for tendon repair of hand. The extension function of toes of 5 patients with defects of skin and extensor tendon in the foot and ankle combined with exposure of bone or internal buttress plate was recovered and improved. CONCLUSIONS: Transplantation of composite anterolateral femoral fascia lata perforator tissue flaps with the aid of micro-surgery is an effective method in repairing the tissue defects of skull, dura mater, and the extensor tendon of hands or feet, with restoration of the extension function.

[Fabricated expanded thoracodorsal artery perforator flap to repair cervical scar in children].

OBJECTIVE: To investigate ideal methods to repair cervical cicatricial contracture in children. METHODS: The expanders were implanted subcutaneously around the cervical scar and above the latissimus. After expansion was completed, the cervical cicatricial contracture was released and the wound was covered with local expanded flaps and free expanded prefabricated thoracodorsal artery perforator flap, leaving no injury to thoracodorsal nerves and latissimus. The wound at the donor site was closed directly. RESULTS: From July 2007 to October 2009, 10 patients were treated. All the flaps survived completely. All the wounds were repaired totally and the deformities were corrected completely. The patients were followed up for 3-30 months. When the patients grew up, the flaps enlarged simultaneously. The flaps were not bulky and had a good color match. The scar at the donor site was inconspicuous with no functional morbidity. CONCLUSION: The fabricated expanded thoracodorsal artery perforator flaps is an ideal method for severe cervical cicatricial contracture in children.