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1.
Oral Health Prev Dent ; 19(1): 235-243, 2021 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-33829721

RESUMEN

PURPOSE: This systematic review addressed flap designs in endodontic surgery which can have an impact on the Oral Health Related Quality of Life (OHRQoL). MATERIALS AND METHODS: Four electronic databases were searched (PubMed, Cochrane Library, Web of Science, and Scopus) to identify all studies up to November 2019 that investigated the effect of flap designs on gingival recession and quality of life among healthy adults. RESULTS: The initial search identified 2701 references. Ten studies were included in this systematic review; two were randomised clinical trials and eight were non-randomised clinical trials. Studies showed that sulcular incision increases the risk of gingival recession and decreases OHRQoL. Two studies were included in the meta-analysis in relation to gingival recession. The pooled results demonstrated that submarginal incision showed a decreased weighted mean difference in gingival recession by 0.31 mm (95% CI: 0.12 - 0.51) (p = 0.002) compared to sulcular incision. CONCLUSION: Sulcular incision flap unfavourably affect the level of gingiva and OHRQoL. All nonrandomised studies had a statistically significant bias and the sample sizes in all studies were relatively small. More gingival recession and lower OHRQoL were associated with sulcular incision. Additional investigations are warranted to provide more evidence.


Asunto(s)
Recesión Gingival , Calidad de Vida , Adulto , Atención Odontológica , Encía/cirugía , Recesión Gingival/cirugía , Humanos , Colgajos Quirúrgicos
2.
Artículo en Chino | MEDLINE | ID: mdl-33832188

RESUMEN

Objective: To investigate the effect and satisfaction of using the postauricular tongue-shaped flap combined with deep fascia suspension in correcting severe cup ear malformation. Methods: Between August 2018 and November 2019, nine cases (10 ears) of Tanzer type Ⅲ severe cup ear malformation were treated with postauricular tongue-shaped flap combined with deep fascia suspension in this study. Results: Nine cases primary healed without hematoma, infection or skin necrosis, except one case with postoperative incision dehiscence. The cup ear deformity was significantly improved after the operation, the helix was intact, and the anti-helix was visible. The length, width, and circumference of the auricle were significantly enlarged three months following surgeries. There were no other complications except 1 patient recurrence 12 months after surgery. The patients were highly satisfied with the results of the surgery. Conclusions: Although the aesthctic of the reconstructed auricle is insufficient, this new technology makes full use of the autologous auricle tissue to correct severe cup ear malformation with good results.


Asunto(s)
Pabellón Auricular , Procedimientos Quirúrgicos Reconstructivos , Pabellón Auricular/cirugía , Oído Externo/cirugía , Humanos , Colgajos Quirúrgicos , Lengua
3.
Artículo en Chino | MEDLINE | ID: mdl-33832189

RESUMEN

Objective: To investigate the curative effect of rib cartilage framework supporting combined with local flap grafting for correction of cryptotia. Methods: Fourteen cases (nineteen ears) were corrected by rib cartilage framework supporting combined with local flap grafting method from January 2017 to March 2019. Part of the 7th rib cartilage was carved into a scalloped cartilage piece, which was implanted on the retroauricular cartilage to release and expand the deformed cartilage. A "M" incision was designed on the retroauricular skin to make the local flap grafting. Results: All corrected auricles were followed up for four months to three year and abtained satisfactory and stable appearance. In one case, the edge of the helix was broken two weeks after the operation, and well healed after repairing. Conclusions: The rib cartilage framework supporting combined with local flap grafting method can fully correct the deformity of cryptotia, and the long-term effect is satisfied. It can be an important complement to the classic methods.


Asunto(s)
Oído Externo , Procedimientos Quirúrgicos Reconstructivos , Cartílago , Oído Externo/cirugía , Humanos , Costillas , Colgajos Quirúrgicos
4.
Artículo en Chino | MEDLINE | ID: mdl-33832197

RESUMEN

Objective: To evaluate the application of three-staged paramendian forehead flap technique in reconstruction of severe full-thickness nasal defect. Methods: Clinical data of 7 cases with nasal reconstruction by three-staged forehead flap technique in the First Affiliated Hospital of Xinjiang Medical University and HongKong University Shenzhen Hospital between June 2016 and October 2019 was retrospectively reviewed. All were males aged from 10 to 71 years. There were 4 cases of basal cell carcinoma of the external nose, 2 cases of traumatic nasal defects and 1 case of large rhinophyma. All the operations were performed with the paramedian forehead flap in three stages. In stage Ⅰ, full layered forehead flap was transposed to the nasal detect. Lining flaps were reconstructed with folded forehead skin (n=4), turn-over flap plus septal chondro mucosal pivotal flap (n=2), or bipedicled vestibular skin and nasal mucosa advancement flap (n=1). According to the reconstruction mode of the lining flaps, whether to implant cartilage to reconstruct the external nasal stent at stage Ⅰ was determined. At stage Ⅱ, the folded flaps were partly or completely separated from the covering flaps along the free edges of nasal alar. All the excess soft tissue including subcutaneous fat and frontalis muscle were excised, cartilage grafts were placed or sculpted to make an ideal nasal contour. The covering flaps were then returned on the recontoured, three-dimensional recipient bed. At stage Ⅲ, the pedicles were divided. Descriptive statistical method was used to analyze the data. Results: In all cases, restoration of the nasal contour was remarkably good, no flap necrosis occurred. All patients were followed up for 6 months to 2 years, and the appearance and function of the nose recovered well. All patients were satisfied with their final aesthetic results. Conclusions: Three-staged paramedian forehead flap technique ensures maximal blood supply for the lining flap and the inserted cartilage graft, and restores an ideal three-dimensional nasal contour for reconstruction of large full thickness nasal defects.


Asunto(s)
Neoplasias Nasales , Rinoplastia , Neoplasias Cutáneas , Anciano , Frente/cirugía , Humanos , Masculino , Nariz/cirugía , Neoplasias Nasales/cirugía , Estudios Retrospectivos , Neoplasias Cutáneas/cirugía , Colgajos Quirúrgicos
5.
Artículo en Inglés | MEDLINE | ID: mdl-33819320

RESUMEN

Modern dentistry is focused on patient needs, with the current trend shifting from merely restoring the loss of function to pursuing the esthetic satisfaction of patients and professional operators, as well as achieving optimal and stable results. Ideal smile esthetics depend on the balance between white and pink components, and therefore papilla reconstruction is one of the most challenging goals in periodontal plastic surgery and restorative procedures. The present case report proposes a surgical technique for the combined treatment of RT2 and RT3 recession defects and interdental papilla loss by means of a modified coronally advanced flap with an interdental subepithelial connective tissue graft.


Asunto(s)
Recesión Gingival , Procedimientos Quirúrgicos Reconstructivos , Tejido Conectivo , Estética Dental , Encía , Recesión Gingival/cirugía , Humanos , Colgajos Quirúrgicos , Resultado del Tratamiento
6.
Artículo en Inglés | MEDLINE | ID: mdl-33819324

RESUMEN

Numerous surgical techniques for root coverage have been suggested with different degrees of success, as assessed by the proportion of complete root coverage. Mandibular incisors, teeth with a high frequency of gingival recession defects (GRDs), were associated with the least favorable outcomes due to unfavorable anatomical conditions. In the present series of three cases, a modified version of the free gingival graft technique for the purpose of root coverage at mandibular incisors is illustrated. The purpose of the modification of the original technique was to achieve improved blood supply from the recipient site to the graft, with the ultimate aim of enhancing predictability and outcomes of the procedure. In all included cases, complete or almost complete root coverage was achieved at challenging GRDs in the mandibular incisor area.


Asunto(s)
Recesión Gingival , Procedimientos Quirúrgicos Orales , Tejido Conectivo , Encía , Recesión Gingival/cirugía , Humanos , Incisivo/cirugía , Colgajos Quirúrgicos , Raíz del Diente , Resultado del Tratamiento
7.
Artículo en Inglés | MEDLINE | ID: mdl-33819332

RESUMEN

The aim of the present case series was to evaluate the outcomes of the modified coronally advanced tunnel technique (MCAT) using the width of keratinized tissue (KTW) as an indicator to apply the connective tissue graft (CTG) specifically. Seven patients requiring treatment for the presence of multiple gingival RT1 recession defects in the maxilla were enrolled in the study. A total of 36 recessions were treated with MCAT, and the CTG was applied in 16 sites presenting < 2 mm of KTW at baseline. The mean root coverage from baseline to 1 year postsurgery was 90% for the sites treated with MCAT alone and 93.7% for those treated with MCAT+CTG. The increase of KTW was higher in the sites treated with CTG than in the sites treated without it. Within the limitations of the present case series, it can be concluded that the proposed surgical technique is extremely effective in gaining root coverage and reducing the amount of connective tissue harvested from the donor site.


Asunto(s)
Recesión Gingival , Tejido Conectivo , Encía , Recesión Gingival/cirugía , Humanos , Maxilar/cirugía , Colgajos Quirúrgicos , Raíz del Diente , Resultado del Tratamiento
8.
Artículo en Inglés | MEDLINE | ID: mdl-33819337

RESUMEN

Keratinized mucosa (KM) is regarded as a key factor in peri-implant health. A lack of KM has been associated with discomfort, higher plaque accumulation, and mucosal inflammation. Persistent inflammation might lead to progressive peri-implant bone loss. Several approaches to manage peri-implantitis have been advocated. Despite the effectiveness shown by surgical therapeutic modalities, soft tissue conditioning seems pivotal for long-term peri-implant health and stability. Free epithelial grafts have been demonstrated to efficiently augment the band of KM. Nevertheless, morbidity, dynamic soft tissue changes, and longer healing periods are shortcomings to be considered. The purpose of this technical note is to provide an alternative therapeutic modality for the surgical management of peri-implantitis combined with simultaneous soft tissue conditioning by means of pedicle flaps. Three main clinical scenarios are provided to conceive pedicle epithelial or connective tissue flaps, combined or not with collagen matrices, as predictable approaches to augment KM in the surgical therapy of peri-implantitis.


Asunto(s)
Implantes Dentales , Placa Dental , Periimplantitis , Tejido Conectivo , Implantes Dentales/efectos adversos , Humanos , Periimplantitis/cirugía , Colgajos Quirúrgicos
9.
Oral Maxillofac Surg Clin North Am ; 33(2): 249-262, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33685787

RESUMEN

Oroantral communication and fistula are commonly seen complications in the field of oral and maxillofacial surgery. Oral surgeons must be familiar with the diagnosis and proper management including multiple soft and hard tissue approaches to this surgical dilemma.


Asunto(s)
Cirugía Bucal , Colgajos Quirúrgicos , Humanos , Cirujanos Oromaxilofaciales , Fístula Oroantral/cirugía
10.
Ann R Coll Surg Engl ; 103(4): 278-281, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33682450

RESUMEN

INTRODUCTION: Microvascular reconstruction is the gold standard for reconstruction in oral cavity cancers. Age and comorbidities determine the type of reconstruction. We aimed to analyse the impact of high-risk comorbidities on perioperative morbidity. METHODS: This is a retrospective study of 317 patients undergoing microvascular reconstruction from January 2014 to December 2017. High risk patients were based on age, American Society of Anaesthesiologists (ASA) grade (III/IV) and Charlson comorbidity index (CCI) score >4; overall, 73 out of 317 patients were evaluated. RESULTS: Median age was 59 years. Five patients (6.8%) had complete flap failures and seven (9.5%) had minor complications (wound breakdown, bleeding, wound dehiscence, partial flap loss). ASA score of IV was significantly associated with morbidity while age >65 years and CCI >4 was not associated. The overall flap success rate was 93.2%. CONCLUSIONS: A high-risk population has nearly similar outcomes for microvascular reconstruction as a younger age group. High ASA score adversely affects surgery-related outcomes.


Asunto(s)
Neoplasias de Cabeza y Cuello/cirugía , Microcirugia/métodos , Procedimientos Quirúrgicos Reconstructivos/métodos , Carcinoma de Células Escamosas de Cabeza y Cuello/cirugía , Procedimientos Quirúrgicos Vasculares/métodos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Colgajos Quirúrgicos , Resultado del Tratamiento
11.
Int. j. med. surg. sci. (Print) ; 8(1): 1-7, mar. 2021. ilus
Artículo en Inglés | LILACS | ID: biblio-1151627

RESUMEN

Basal cell carcinoma (BCC) is the most common type of nonmelanoma skin cancer (NMSC). It grows slowly and very rarely metastasizes but can cause substantial morbidity due to its tendency to relapse and locally invasive nature, especially when located on the face. Excision surgery is still the gold standard treatment for primary BCC and is usually followed by reconstruction procedure. Skin flap techniques vary widely, one of which is flap advancement technique. The main benefit of flap advancement technique is the ability to hide the excision line, thus resulting in an aesthetically sound outcome. We report a case of 72-year-old female with hyperpigmented plaque brownish lump on the left lateral cheek. A diagnosis of igmented basal cell carcinoma had been confirmed through histopathological examination. The patient was treated with wide excision surgery and the defectwas closed by multiple advancement flaps. Follow-up after three months showed excellent cosmetic and functional outcome.


El carcinoma basocelular (CBC) es el tipo más común de cáncer de piel no melanoma. Crece lentamente y rara vez hace metástasis, pero puede causar una morbilidad sustancial debido a su ubicación en la cara, tendencia a la recidiva y su comportamiento invasivo local. La cirugía de escisión sigue siendo el tratamiento estándar de oro para el CBC primario y generalmente se acompañan de procedimientos reconstructivos. Las técnicas de flap varían ampliamente, una de las cuales es la técnica de avance del colgajo. El principal beneficio de la técnica de avance es la capacidad de ocultar la línea de escisión y, por lo tanto, se obtiene un resultado más estético. En este artículo reportamos el caso de una mujer de 72 años con placa hiperpigmentada y abultada en su mejilla lateral izquierda. Se había confirmado un diagnóstico de carcinoma de células basales pigmentadas mediante un examen histopatológico. El paciente fue tratado con una amplia cirugía de escisión y el defecto fue cerrado por múltiples colgajos de avance. El seguimiento después de tres meses mostró un excelente resultado cosmético y funcional.


Asunto(s)
Humanos , Femenino , Anciano , Neoplasias Cutáneas/complicaciones , Neoplasias Cutáneas/rehabilitación , Procedimientos Quirúrgicos Reconstructivos/métodos , Colgajos Quirúrgicos/trasplante , Carcinoma Basocelular/complicaciones , Resultado del Tratamiento
12.
BMC Surg ; 21(1): 167, 2021 Mar 28.
Artículo en Inglés | MEDLINE | ID: mdl-33775250

RESUMEN

BACKGROUND: Reconstructions the soft-tissue defects of the distal lower extremities in the elderly patients (≥ 60 years old) are full of challenges because of many comorbidities. The purpose of this study was to report the clinical application of the distally based sural flap in the elderly patients, and to verify the reliability of this flap in the elderly patients. METHODS: Between March of 2005 and December of 2019, 53 patients aged over 60-year-old and 55 patients aged 18 to 30-year-old who underwent the procedure have been included in this study. The reconstruction outcomes, medical-related complications, flap viability-related complications and potential risk factors are compared between the group A (≥ 60 years old) and group B (ranging from 18 to 30 years old). RESULTS: The partial necrosis rate in group A (9.43%) is higher than group B (9.09%), but the difference is not significant (P > 0.05). The constitute ratio of the defects that were successfully covered using the sural flap alone or combining with simple salvage method (i.e., skin grafting) is 96.22% and 98.18% in group A and B, respectively (P > 0.05). The differences of the risk flaps factors that affected the survival of distally based sural flap were not significant between group A and B (P > 0.05). CONCLUSIONS: The distally based sural flap can be effectively used to repair the soft-tissue defect of the lower extremity in the elderly patients. It is safe and reliable to harvest and transfer the flap in one stage, and the delay surgery is not necessary.


Asunto(s)
Extremidad Inferior , Procedimientos Quirúrgicos Reconstructivos , Nervio Sural , Colgajos Quirúrgicos , Adolescente , Adulto , Anciano , Humanos , Extremidad Inferior/lesiones , Extremidad Inferior/cirugía , Persona de Mediana Edad , Procedimientos Quirúrgicos Reconstructivos/métodos , Reproducibilidad de los Resultados , Traumatismos de los Tejidos Blandos/cirugía , Adulto Joven
13.
Quintessence Int ; 52(4): 284-291, 2021 Mar 03.
Artículo en Inglés | MEDLINE | ID: mdl-33655740

RESUMEN

OBJECTIVE: The objective of this study was to systematically review the literature regarding the effect of root coverage procedures on tooth survival and periodontal outcomes. DATA SOURCES: A systematic search of the literature was performed according to the PRISMA guidelines. A PICO-based search strategy was performed in six databases. Eligibility criteria included studies comparing tooth survival and periodontal outcomes of teeth treated with root coverage procedures versus teeth that had no treatment. The search resulted in 3,646 articles; 212 articles were downloaded for review, and six articles (three studies) were included. Only a single study reported on tooth survival and found no difference between teeth that underwent root coverage procedures versus those that did not. Although the surgeries described in each study were mostly successful in reducing recession and increasing keratinized gingiva, teeth which did not undergo surgery did not seem to have a clinically significant change in recession. The study with the longest follow-up (18 to 35 years) showed an average increase in recession of 0.5 ± 0.9 mm and a decrease in keratinized tissue of 0.3 ± 0.8 mm in the control group. CONCLUSION: This systematic review highlights the need for randomized controlled trials to assess the influence of root coverage surgeries on tooth longevity in order to better inform evidence-based practice. When compared to no surgical intervention, there is presently no evidence to suggest that root coverage surgeries increase tooth longevity. Furthermore, the amount of recession does not appear to increase a clinically significant amount over time without surgical intervention in the presence of proper maintenance and home care.


Asunto(s)
Recesión Gingival , Tejido Conectivo , Estudios de Seguimiento , Encía , Recesión Gingival/cirugía , Humanos , Colgajos Quirúrgicos , Raíz del Diente/cirugía , Resultado del Tratamiento
14.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(3): 263-267, 2021 Mar 09.
Artículo en Chino | MEDLINE | ID: mdl-33663156

RESUMEN

Objective: To explore the application value of digital three-dimensional(3D) reconstruction technology in the repair of oral and maxillofacial defects with superficial inferior epigastric artery (SIEA) flap. Methods: Twelve cases of oral cancer patients, including 8 males and 4 females; aged (57.4±12.6) years, were selected from the Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Bengbu Medical College from January 2018 to October 2019 and were proposed to repair with SIEA flap. There were 10 cases of squamous cell carcinoma, one case of adenoid cystic carcinoma and 1 case of mucinous epidermal carcinoma. The data were imported into AW4.7 software for post-processing. The left or right dominant donor area was selected to clarify the origin, diameter, alignment, and location of penetration point of the flap blood supply, and digital 3D reconstruction technology was used to guide the flap preoperative design. Results: Eleven cases were repaired by SIEA flap in 12 patients, one case was repaired by superficial iliac artery flap because the source artery was undiscovered, one case had venous vascular crisis after surgery, and the rest of the flap survived. In 11 patients repaired with SIEA flap, there was no significant difference between the preoperative SIEA diameter measured by CTA [(1.0±0.3) mm] and the actual measured value [(1.1±0.3) mm] (P>0.05). The follow-up was 6 to 12 months, with an average of 10 months, and the donor-receiver areas were all healed in phase Ⅰ. No obvious complications occurred, and the abdominal scar was hidden. Conclusions: In the SIEA flap repair oral and maxillofacial defect reconstruction surgery, the use of digital 3D reconstruction technology can objectively reflect the diameter and the location of the superficial artery of the abdominal wall before surgery, effectively reduce the difficulty and risk of flap surgery.


Asunto(s)
Arterias Epigástricas , Mamoplastia , Adulto , Anciano , Arterias Epigástricas/cirugía , Femenino , Humanos , Imagenología Tridimensional , Masculino , Persona de Mediana Edad , Colgajos Quirúrgicos
15.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(3): 276-278, 2021 Mar 09.
Artículo en Chino | MEDLINE | ID: mdl-33663158

RESUMEN

To explore the feasibility of using the posteromedial thigh flap as an alternative source for oral and maxillofacial reconstruction. During January 2019 to January 2020, twenty-three patients underwent oral and maxillofacial tumor ablation and defect reconstruction with 23 posteromedial thigh flaps were enrolled in the Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhengzhou University. Thirteen of the patients were male and ten were female, with age of (54.5±9.7) years (33-72 years). The numbers and types of perforators, the dimension of flap and the vascular pedicle length were measured. The outcomes of flaps and donor-site complication were recorded. The patients' satisfaction with donor-site cosmesis were evaluated by the visual analogue scale (VAS). More than one sizable perforators was found in each case and the median number of perforators was 2 (range, 1 to 4), and all of the perforators were musculocutaneous. The pedicle length was (9.8±1.5) cm (range, 7.3 to 13.4 cm). The diameters of artery and the larger vein were 2.0 mm (range, 1.5 to 2.5 mm) and 2.0 mm (range, 1.5 to 3.0 mm), respectively. The dimension of the flaps ranged from 8 cm×6 cm to 12 cm×8 cm, and the donor sites were all closed primarily. All of the flaps were clinically survived, only one patient experienced partial wound dehiscence of donor site 14 days postoperatively and no donor site infection or permanent muscular weakness was reported. The VAS scores of the patients' satisfaction with donor-site cosmesis were all more than 8. The perforators of the posteromedial thigh flap is consistent and the donor-site scar is well concealed, which make the posteromedial thigh flap an excellent option for oral and maxillofacial reconstruction.


Asunto(s)
Colgajo Perforante , Procedimientos Quirúrgicos Reconstructivos , Adulto , Arterias , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trasplante de Piel , Colgajos Quirúrgicos , Muslo/cirugía
16.
BMC Surg ; 21(1): 120, 2021 Mar 08.
Artículo en Inglés | MEDLINE | ID: mdl-33685447

RESUMEN

BACKGROUND: Most of the head and neck cancers are time-critical and need urgent surgical treatment. Our unit is one of the departments in the region, at the forefront in treating head and neck cancers in Pakistan. We have continued treating these patients in the COVID-19 pandemic with certain modified protocols. The objective of this study is to share our experience and approach towards head and neck reconstruction during the COVID-19 pandemic. RESULTS: There were a total of 31 patients, 20 (64.5%) were males and 11 (35.4%) patients were females. The mean age of patients was 52 years. Patients presented with different pathologies, i.e. Squamous cell carcinoma n = 26 (83.8%), mucoepidermoid carcinoma n = 2 (6.4%), adenoid cystic carcinoma n = 2 (6.4%) and mucormycosis n = 1 (3%). The reconstruction was done with loco-regional flaps like temporalis muscle flap n = 12 (38.7%), Pectoralis major myocutaneous flap n = 8 (25.8%), supraclavicular artery flap n = 10 (32.2%) and combination of fore-head, temporalis major and cheek rotation flaps n = 1 (3%). Defects involved different regions like maxilla n = 11 (35.4%), buccal mucosa n = 6 (19.3%), tongue with floor of mouth n = 6 (19.3%), mandible n = 4 (12.9%), parotid gland, mastoid n = 3 (9.6%) and combination of defects n = 1 (3%). Metal reconstruction plate was used in 3 (9.6%) patients with mandibular defects. All flaps survived, with the maximum follow-up of 8 months and minimum follow-up of 6 months. CONCLUSION: Pedicled flaps are proving as the workhorse for head and neck reconstruction in unique global health crisis. Vigilant use of proper PPE and adherence to the ethical principles proves to be the only shield that will benefit patients, HCW and health system.


Asunto(s)
Neoplasias de Cabeza y Cuello , Procedimientos Quirúrgicos Reconstructivos , Femenino , Neoplasias de Cabeza y Cuello/cirugía , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Reconstructivos/métodos , Colgajos Quirúrgicos
17.
Zhonghua Shao Shang Za Zhi ; 37(2): 187-190, 2021 Feb 20.
Artículo en Chino | MEDLINE | ID: mdl-33648330

RESUMEN

Objective: To explore the clinical effects of anterograde sural neurovascular flap in repairing skin and soft tissue defect around the knee. Methods: Nine patients with skin and soft tissue defect around the knee admitted to Beijing Fengtai YouAnMen Hospital from May 2011 to December 2018, were included in this retrospective descriptive study, including 8 males and 1 female, aged 16 to 65 years. The wound area after debridement ranged from 8 cm×5 cm to 18 cm×10 cm. Anterograde sural neurovascular flap was used to repair the wounds in 9 patients, with the area ranging from 9 cm×6 cm to 20 cm×12 cm. The donor sits of flaps in 2 patients were closed and sutured directly, and the donor sits of flaps in 7 patients were repaired with medial split-thickness skin graft of the ipsilateral thigh. The flap survival, complications, and follow-up after operation were recorded. Results: The flaps survived and the blood supply was good in 8 patients and the wounds were closed. One patient developed skin ischemic necrosis which was cured after three weeks of dressing change. All the skin grafts in the donor site of flap in 7 patients survived. In 6 months to 5 years of follow-up after surgery, the skin flap had good texture, color, and shape, and normal sensation. Except for one patient whose knee had poor recovery of function, the knee joint function of the other patients recovered well. Conclusions: The anterograde sural neurovascular flap has the advantages of high survival rate, satisfactory appearance and functional recovery post surgery, and is an ideal flap for repairing the skin and soft tissue defect around the knee.


Asunto(s)
Colgajo Perforante , Procedimientos Quirúrgicos Reconstructivos , Traumatismos de los Tejidos Blandos , Adolescente , Adulto , Anciano , Femenino , Humanos , Articulación de la Rodilla , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Trasplante de Piel , Traumatismos de los Tejidos Blandos/cirugía , Colgajos Quirúrgicos , Resultado del Tratamiento , Adulto Joven
18.
Ann R Coll Surg Engl ; 103(3): e106-e108, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33645268

RESUMEN

Transposition scalp flaps are a versatile solution for soft-tissue cover in a multitude of scalp defects. They are frequently used to reconstruct larger skin cancers that involve the outer table of the cranium in addition to covering neurosurgical bony defects and hardware. The transposition flap requires the donor site to be grafted using a split-thickness graft, which results in a secondary wound elsewhere on the body, commonly the lateral thigh. Although quite routine in such surgery, this procedure does require another body area to be prepared and draped. We sought to streamline this procedure with an adjustment to the location of the donor site. In harvesting the graft from the skin of the flap itself, we localised all surgery to one area, which has a number of logistical and patient-care advantages. Our experience has shown significant benefits from this technique and this is now our chosen and recommended donor site for these reconstructions.


Asunto(s)
Neoplasias de Cabeza y Cuello/cirugía , Procedimientos Quirúrgicos Reconstructivos/métodos , Cuero Cabelludo/cirugía , Neoplasias Cutáneas/cirugía , Trasplante de Piel/métodos , Colgajos Quirúrgicos , Sitio Donante de Trasplante , Humanos , Masculino
19.
Oral Maxillofac Surg Clin North Am ; 33(2): 177-184, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33541783

RESUMEN

This article presents an overview of the history of the buccal fat pad flap, its relevant anatomy, and its indications and contraindications. The surgical technique for its harvest is described, as are the postoperative care and possible complications.


Asunto(s)
Procedimientos Quirúrgicos Reconstructivos , Tejido Adiposo/trasplante , Mejilla/cirugía , Humanos , Colgajos Quirúrgicos
20.
J Hand Surg Asian Pac Vol ; 26(1): 92-95, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33559567

RESUMEN

An exceptional case like our patient who was a 24-year-old man presented 6 weeks after type 4 Allen amputation to his right index finger where primary surgical stump closure was done, presented to us with the amputated distal part warm preserved. The reposition of distal amputated part using the authors described GRF (Graft Reposition on Flap) technique was done and followed. Good consolidation and bone graft union, good nail with near normal pulp and normal sensation with good functional outcome was achieved at the one-year final follow up.


Asunto(s)
Muñones de Amputación/cirugía , Amputación Traumática/cirugía , Traumatismos de los Dedos/cirugía , Reimplantación , Colgajos Quirúrgicos , Adulto , Humanos , Masculino , Tiempo de Tratamiento , Adulto Joven
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