OBJECTIVE: To seek a simple, safe and effective method for the instant repair of soft-tissue defects after excision of superficial tumor, chronic ulcer and scar constructure as well as injury. METHODS: From August 1993 to October 1997, according to the location and size of the lesion, adjacent single or double reverse tongue-shaped skin flaps were designed to repair the defects of head, face, limb and shoulder in 31 cases, and the donor sites were closed directly. RESULTS: The wounds were healed by first intention and the skin flaps were all survived postoperatively. CONCLUSION: It suggests that the tongue-shaped flap have the following characteristics: abundant blood supply, high survival rate, wide application, less trauma, and adjacent tissue can be fully used. It is a simple, safe and effective method for the instant repair of soft-tissue defects.
Objective To introduce the application of the scrotal flap on reconstructing partial urethra defect. Methods From March 1998 to August 2004, 31 patients with urethra defect were treated with scrotal flap. Their ages ranged from6 to 34 years. Thirty-one patients included 8 cases of congenital deformity of urethra and 23 cases of complication of urethral fistula, urethral stenosis and phallus bend after hypospadias repair. The flap widths were 1. 2. cm in child and 2.3. cm in adult. The flap lengthwas 1. -2.0 times as much as the width. Nine cases were classified as penile type, 10 cases as penoscrotal type, 7 cases as scrotal type(3 children in association withcleft scrotum) and -cases as perrineal type because of pseudohermaphroditism.Urethroplasty was given by scrotal fascia vascular net flap to reconstruct urethra defect. Results All the flaps survived, and the incision healed well. Twenty four cases achieved healing by first intention and 7 cases by second intention. And fistula occurred and healed after 2 weeks in 1 case. 27 cases were followed up 14 years, 2 cases had slight chordee, the others were satisfactivly. Conclusion Urethroplasty with scrotal fascia vascular net flap is an ideal method for the partial defect urethra.
Objective To investigate the outcome of repairing hand composite defects using pedicle osteocutaneous groin flap. Methods From February 1998 to May 2004, 33 cases of hand composite defects were repaired with pedicle osteocutaneous groin flap. There were 22 males and 11 females. The age was 19 to 54 years with an average of 243 years. The defect was caused by palmar penetrating injury in 17 cases, by dorsal hand crushing injury in 9 cases and by other injury in 7 cases. Twentythree cases complicated by metacarpal defect, 10 by phalanx defect. Thesize of skin defect was 3.5 cm×2.0 cm to 15.0 cm×10.0 cm, the size of bonedefect was 1.5 to 3.5 cm. After 3 to 7 days of primary debridement, defect was repaired by the pedicle osteocutaneous groin flap based on the superficial circumflex iliac vessels. The flap size was 4.0 cm×2.5 cm to 17.0 cm×11.0 cm. Results All the osteocutaneous flaps survived. During the 4 to 22 months follow-up postoperatively, thetexture, appearance and function of the flap were excellent and bone union was obtained in all cases after 7 to 9 weeks of operation.Conclusion The pedicle osteocutaneous groin flap is an ideal flap to repair the composite defect of the hand, with the benefit of simple procedure and reliable blood supply.
OBJECTIVE: To discuss the method to repair the defects of palm with the improved flaps pedicled with the dorsal carpal branch of ulnar artery. METHODS: The improved flaps were designed on the basis of anatomical distribution of the dorsal carpal branch of ulnar artery and the medial antebrechial cutaneous nerve, the ulnar artery was ligated and cut at the beginning of its dorsal carpal branch. The flap pedicled with dorsal carpal branch including the distal ulnar artery was achieved and applied clinically to repair 15 cases of the skin and soft tissue defects of palm from August 1997 to November 2001. The size of flaps ranged from 7 cm x 5 cm to 12 cm x 8 cm. RESULTS: All of the cases were followed up 3 weeks to 6 months, and the flaps completely survived. There was no ischemia and necrosis at the distal part of flaps and the appearance and function was satisfactory. CONCLUSION: The improved flap has long vascular pedicle, abundant blood supply and sensitive sensation, so it can be used to repair defect of palm.
OBJECTIVE: To evaluate the clinical efficacy of fasciocutaneous flap in the repair of the III degree burn wound in the facio-cervical region. METHODS: From January 1997 to October 2001, 11 cases of III degree burn wounds in the facio-cervical region were repaired with the cervical-thoracic fasciocutaneous flap ranging from 18 cm x 8 cm to 13 cm x 5 cm. Donor sites were covered with "Z" plasty or skin grafting. RESULTS: Except for partial necrosis of distal end of the flap in 1 case, the flaps in the other 10 cases all survived and presented satisfactory appearance and function during the following up. CONCLUSION: The fasciocutaneous flap in the cervical-thoracic region may provide a large area of flap, and can be easily transferred. It’s an ideal flap for the repair of skin defect in the facio-cervical region, especially for the repair of the wounds with infection or exposure of vessel, nerve and tendon.
During apt. 1986 to Dec. 1988. the axial flap methodwas used for the treatment of the congenital blakker exstro-phy. The preliminary is reported in this paper. This group in-cluded 10 patients, 4 men and 6 women, and their agesranged from 4 to 20. Seven patients had experienced 1-3 op-erations with failure to repair the exstrophy or to urinarycontinence before admission to our hospetal. Using the axialflap method only 1 in 10 cases can not control the urinationwell, the others achive well the requcirement of functional bladder. The longest follow-up pcriod has lasted for more than 2 years. and the renal and bladder function ars completely normal. the axial flaps of the present method included skin flap, facial and vascular pedicles of 8 types. The application of the flaps has developed a new serjies of procedures that ars suitable for the treatmen of a varicty of extrophy deformities.
A new method of transfer of the nasolabial skin flap, the myocutaneous flap with pediculated guadratus labii superioris muscle was introduced. It was applied in 9 cases mid-face defects with satisfactory results. The applied anatomy and the its operative technique were briefly discussed.
The first dorsal metacarpal vascular axial skin flap ofsixty adults were measured by the surface-projectingmethod. The line from the styloid process of the radius to thehead of the second metacarpal bone was designed as the sru-face signs. The result revealed that the surface projection ofthe artery was 0. 5cm lateral to the connecting line,and mostof them were situated at 4-8cm distal to the styloid processof the radius. How to obtain the skin flap quickly ,accurate-ly,approxiately and its application in the hand jnjury were investigated.
The canine saphaneous skin flap was used as a model in this experiment. The cutaneous autograft would give long-term survival, whereas the allograft without pretreatment would only survive 10. 2±1.9 days from its transplantation. If the pretreatment consisted of the use of immunosuppressive agent as PHA or infusion of dexamesone, the survival days of the allografts could be prolonged to 15.1±2.5 and 13.7±2.8, respectively(Plt;0.01). The histological examination gave the evidence that drug perfusion delayed the rejection.