3,113 results match your criteria Skin Flaps Design


Boomerang latissimus dorsi flap in immediate or delayed breast reconstruction.

Gland Surg 2023 Jul 5;12(7):894-904. Epub 2023 Jul 5.

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.

Background: Breast reconstruction using the latissimus dorsi (LD) flap is one of the most popular and common breast reconstruction techniques among Asian patients. There are increasing numbers of cases wherein breasts need to be reconstructed to moderate to large sizes among the Asian population. Most reconstructive surgeons use abdominal-based flaps-such as the deep inferior epigastric perforator and transverse rectus abdominis myocutaneous flap, or LD flap with an implant-to supplement the volume. Read More

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Unveiling the "Kebab" technique: A case report on a two-stage reconstruction method for repeated complex cranioplasty.

Medicine (Baltimore) 2023 Sep;102(35):e34963

Section of Neurosurgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Rationale: Cranioplasty after decompressive craniectomy provides brain protection and improves cerebral hemodynamics. However, recurrent infection and sinking skin flap syndrome after cranioplasty remain cumbersome complications that require a well-planned reconstruction strategy.

Patient Concerns: A 74-year-old man presented with traumatic subdural hematoma and underwent decompressive craniectomy. Read More

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September 2023

Simplifying Forehead and Temple Reconstruction: A Narrative Review.

Authors:
Pedro Redondo

J Clin Med 2023 Aug 19;12(16). Epub 2023 Aug 19.

Department of Dermatology, University Clinic of Navarra, 28027 Madrid, Spain.

The forehead and temporal region are frequent areas of skin cancer development. After tumor removal, reconstruction must be performed, maintaining the frontal-temporal line of the scalp and symmetry of the eyebrows in an attempt to hide the scars within these marks or natural folds and wrinkles. Second wound healing and skin grafts generally do not produce an acceptable cosmetic result. Read More

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The Preferred Design of the Profunda Artery Perforator Flap for Autologous Breast Reconstruction: Transverse or Diagonal?

Plast Reconstr Surg Glob Open 2023 Aug 23;11(8):e5188. Epub 2023 Aug 23.

From the Memorial Sloan Kettering Cancer Center, New York, N.Y.

Background: Since its introduction for autologous breast reconstruction in 2010, the profunda artery perforator (PAP) flap has emerged as a preferred choice when an abdominal flap is suboptimal. The traditional transverse design (tPAP) was popularized, given the inconspicuous donor scar. A diagonal design (dPAP) has since evolved to address some of the shortcomings of the tPAP. Read More

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A Systematic Review of Pressure Injuries Associated with Urethrocutaneous Fistula.

Adv Skin Wound Care 2023 Sep;36(9):1-8

At Hotel Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon, Serge Zogheib, MD, is Plastic Surgeon, Department of Plastic, Reconstructive, and Cranio-Maxillo-Facial Surgery, and Nour Khalil, MD, MSc, is Urology Resident, Department of Urology. Georges Mjaess, MD, is Urology Resident, Department of Urology, Université Libre de Bruxelles, Brussels, Belgium. Also in the Department of Plastic, Reconstructive and Cranio-Maxillo-Facial Surgery, Hotel Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Charbel Feghaly, MD; Bechara Daou, MD, and Cyril Hanna, MD, are Urology Residents, and Marwan Nasr, MD, is Plastic Surgeon. The authors have disclosed no financial relationships related to this article. Submitted August 2, 2022; accepted in revised form December 1, 2022.

Objective: To review the literature about combined urologic and reconstructive management of pressure injuries (PIs) with urethral fistulas.

Data Sources: Authors searched the PubMed, MEDLINE, EMBASE, and Cochrane databases using the following keywords: "Perineum" or "Perineal" and "Pressure Ulcers" or '' Pressure Injury'' and "Urethral Fistula."

Study Selection: The search yielded a total of 95 articles. Read More

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September 2023

Advancing Surgical Education: A Comprehensive Systematic Review with Meta-Analysis and Novel Approach to Training Models for Local Skin Advancement Flaps.

Cureus 2023 Jul 18;15(7):e42066. Epub 2023 Jul 18.

Division of Plastic Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, SAU.

Performing local skin flaps is a challenging task that requires cognitive and technical skills to design flaps with proper orientation to avoid distorting normal anatomy. Junior trainees need adequate exposure to gain confidence and expertise in such procedures. This article systematically reviews the literature's different local skin advancement flap training models and describes a new, easy-to-use training model. Read More

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The reconstruction of fingertip injury by mini hallux toenail flap pedicled with the hallux transverse artery and toe pulp vein transplantation technique based on the equivalent design theory.

BMC Surg 2023 Aug 11;23(1):231. Epub 2023 Aug 11.

Qingdao Hospital, University of Health and Rehabilitation Science (Qingdao Municipal Hospital), Qingdao, 266011, Shandong, China.

Introduction: How to reconstruct the damaged fingertip is a clinical problem. Our team propose the theory of equivalent design and use the mini toenail flap pedicled with the hallux transverse artery and toe pulp vein transplantation technique to reconstruct Allen's type II fingertip injury. Thus, we perform the retrospective study to evaluate the effects of this technique on fingertip injury. Read More

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Reconstruction option in complex lower extremity defects where microsurgical repair is not possible: Randomized bipedicled flaps.

Ulus Travma Acil Cerrahi Derg 2023 Aug;29(8):877-882

Department of Plastic, Reconstructive and Aesthetic Surgery, İzmir Katip Celebi University, İzmir-Türkiye.

Background: Lower extremity defects may occur due to many etiological causes such as trauma, peripheral arterial disease, diabetic foot infections, tumor resection, gunshot injuries, and burns. Lower extremity defects show a wide clinical presentation ac-cording to the affected anatomical localization, amount of tissue, and tissue content. In this study, it is aimed to present the use of bipedicled flaps as a simple and reliable salvage method in cases where microsurgical repairs such as free flaps are not possible. Read More

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Bilateral Transposition Flap for Postoperative Anal Stenosis after Reconstruction for Paget Disease.

Plast Reconstr Surg Glob Open 2023 Aug 3;11(8):e5142. Epub 2023 Aug 3.

From the Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.

One of the complications of anal surgery or disease is anal stenosis. To release the tension of the anus, a tension-releasing incision in the perianal skin and various anoplasty procedures are usually considered. The aim of this article is to describe a straightforward technique with local flaps for severe anal stenosis after anal reconstruction. Read More

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Outcomes of leaflet-shaped acellular dermal matrix with a thickness-gradient for abdominal fascial defect repair in muscle-sparing TRAM flap-based breast reconstruction.

Asian J Surg 2023 Sep 1;46(9):3581-3586. Epub 2023 Aug 1.

Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Seoul National University School of Medicine, South Korea. Electronic address:

Background: Numerous fascial closure techniques have been used to reduce donor site morbidities after transverse rectus abdominis myocutaneous (TRAM) flap harvest. A leaflet-shaped acellular dermal matrix (ADM) with a thickness gradient was designed to cover the defect effectively and to withstand the pressure applied to the lower portion of the defect. The complication and functional recovery rates of the donor site of the custom ADM were compared with those of previous methods of fascial closure (primary closure and polypropylene mesh assisted closure). Read More

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September 2023

Tissue Is the Issue: Use of 2 Bipedicled "Bucket-Handle" Local Advancement Flaps to Close a Nonhealing Wound.

Eplasty 2023 6;23:e41. Epub 2023 Jul 6.

Division of Plastic and Reconstructive Surgery, Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana.

Introduction: Soft tissue loss following total knee arthroplasty can result in catastrophic complications. Defects can be covered using various flaps and grafts, including fasciocutaneous flaps. Here, we discuss one case of double bipedicled "bucket-handle" local advancement flaps used for a nonhealing midline knee dehiscence wound following total knee arthroplasty. Read More

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The QUILT study: quilting sutures in patients undergoing breast cancer surgery: a stepped wedge cluster randomized trial study.

BMC Cancer 2023 Jul 17;23(1):667. Epub 2023 Jul 17.

Department of Surgical Oncology, Canisius Wilhelmina Hospital, Weg Door Jonkerbos 100, 6532 SZ, Nijmegen, The Netherlands.

Background: Seroma is the most common complication following breast cancer surgery, with reported incidence up to 90%. Seroma causes patient discomfort, is associated with surgical site infections (SSI), often requires treatment and increases healthcare consumption. The quilting suture technique, in which the skin flaps are sutured to the pectoralis muscle, leads to a significant reduction of seroma with a decrease in the number of aspirations and surgical site infections. Read More

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Indocyanine Green (ICG)-Guided Onlay Preputial Island Flap Urethroplasty for the Single-Stage Repair of Hypospadias in Children: A Case Report.

Int J Environ Res Public Health 2023 Jun 28;20(13). Epub 2023 Jun 28.

Department of Pediatric Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.

First described by Duckett in 1981, and initially employed for the surgical correction of mid-penile hypospadias, the onlay preputial island flap urethroplasty has progressively gained increasing popularity, extending its indication to proximal forms. However, with the complexity of the penile anomaly, the rate of postoperative complications related to poor tissue perfusion (including skin and glans dehiscence, urethral stenoses, and fistulas) has also increased. Conventionally, the visual assessment of the onlay preputial island flap is the only option available to establish the appropriate tissue vascularization during surgery. Read More

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Clinical Classification of Urethrocutaneous Fistulas Developing after Hypospadias Repair.

Indian J Plast Surg 2023 Jun 10;56(3):228-237. Epub 2023 Mar 10.

Department of Burns and Plastic Surgery and Hypospadias and VVFs Clinic, Postgraduate Institute of Medical Sciences, University of Health Sciences, Rohtak, Haryana, India.

 Clinical classification of the urethrocutaneous fistulas (UCFs) was designed to help the surgeons in (1) categorizing the fistulas, (2) selecting appropriate treatments, (3) keeping record at presentation and discharge, and (4) transferring information while referring a patient with recurrent fistula to a higher center.  This retrospective study comprised of 68 patients with UCFs who reported in the "Hypospadias and VVFs Clinic" between 2004 and 2016. The study was performed to determine the incidence or etiology of the UCFs. Read More

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Multiple digit resurfacing with a lateral thoracic free flap: Two-stage mitten hand and division procedures.

Microsurgery 2023 Sep 7;43(6):570-579. Epub 2023 Jul 7.

Department of Plastic and Reconstructive Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.

Purpose: The conventional abdominal and groin flaps for resurfacing the defect have several disadvantages, including the risk of flap failure due to accidental traction or detachment, immobilization of the arm before division, and aesthetic dissatisfaction because of the flap bulkiness. The aim of this study was to share our experiences with the free lateral thoracic flap and elucidate the optimal timing of division in complex hand reconstruction, which yielded favorable outcomes in terms of both functionality and aesthetics.

Methods: This article is a retrospective review of multiple digit resurfacing using free tissue transfer from 2012 to 2022. Read More

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September 2023

The free Thenar flap for thumb pulp reconstruction: A case report.

Microsurgery 2023 Jul 6. Epub 2023 Jul 6.

Department of Plastic and Reconstructive Surgery, Royal Free NHS Foundation Trust Hospital, London, UK.

The thumb is acknowledged to contribute significantly to hand function, accounting for up to 40% of its overall capability. Consequently, injuries affecting the thumb can have a profound impact on the quality of life experienced by patients. When it comes to the surgical reconstruction of thumb injuries, the primary objective is to promptly provide coverage of the affected area with glabrous skin, thus preserving both the length and functionality of the thumb. Read More

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Clinical applications of skin traction technique with adjustable tension in treatment of large area skin defects.

BMC Musculoskelet Disord 2023 Jul 6;24(1):556. Epub 2023 Jul 6.

Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Objective: To explore the clinical applications of the adjustable skin traction technique in the treatment of large area skin defects.

Research Design: A prospective study.

Background: The skin is the largest organ of the human body and skin tissue exposed to external environment which makes it vulnerable to damage. Read More

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Construction of Sensitive Labia Minora-Clitoris-Clitoral Hood Complex in Sex Reassignment Surgery in Circumcised Populations: Butterfly Flap.

Authors:
Ozan Balik

Ann Plast Surg 2023 Sep 5;91(3):370-375. Epub 2023 Jul 5.

From the Doğalife Beauty Clinic, Plastic Reconstructive and Aesthetic Surgery Department Istanbul, Pendik, Turkey.

Introduction: The construction of the labia minora from preputial tissues in uncircumcised patients and the preservation of the sensitivity of the labia minora are not new ideas. However, evidently, this technique is designed for uncircumcised cases.There is no preputial tissue in the circumcised population. Read More

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September 2023

Medial Plantar Artery Perforator Kiss Flap for Salvage of Extensive Palmar Skin Defect.

Plast Reconstr Surg 2023 Jul 4. Epub 2023 Jul 4.

Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University College of Medicine, Shanghai, China.

Background: Flaps based on the medial plantar artery (MPA) accomplish favorable surgical outcomes in palmar resurfacing due to its outstanding texture, pliability and contour, but primary closure could not be achieved at the donor site when the flap was designed to be relatively large. In this study, the kiss technique was employed for the reconstruction of extensive palmar defects which minimized donor site morbidity.

Methods: A modified flap surgical strategy was systemically developed based on the perforator distribution of the MPA through our cadaver study. Read More

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The Pacman Flap and Its Modifications for Reconstruction of Skin Cancer Surgical Wounds on the Scalp and Other Body Areas: A Review of 23 Cases.

Actas Dermosifiliogr 2023 Sep 29;114(8):T661-T667. Epub 2023 Jun 29.

Dermatologic Clinic, Department of Medicine and Aging Science, Università degli Studi «G. d'Annunzio» Chieti-Pescara, Chieti, Italia.

Background: The Pacman flap is a modified V-Y advancement flap that showed to be versatile in repairing surgical and non-surgical wounds. Indeed, this flap has been used in any anatomical localization, except for the scalp, where its use has not been reported. Moreover, the versatility of the Pacman flap can be enhanced by applying simple modifications to its original design. Read More

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September 2023

Using a Novel Method to Quantify and Confirm the Variable Vertical Vector of the Deep Plane Facelift.

Facial Plast Surg Aesthet Med 2023 Jun 26. Epub 2023 Jun 26.

Farrior Facial Plastic Surgery, Tampa, Florida, USA.

In deep plane rhytidectomy, it is accepted that a more vertical vector will lead to a more natural rejuvenated look than a horizontal vector of pull. Among patients undergoing deep plane rhytidectomy, can skin angle measurements designed by the authors be used as a proxy for vector of tension to confirm a vertical vector? Case series measuring the rhytidectomy vector of pull for a series of patients performed by a single surgeon. Results were compared between the vectors of the pre- and postauricular flaps as well as comparing the vector of pull in male versus female patients, patients undergoing facelift alone versus in conjunction with other rejuvenation procedures, and between primary versus revision rhytidectomy patients. Read More

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Variations in Payer-Negotiated Prices for Head and Neck Reconstructive Surgery.

Otolaryngol Head Neck Surg 2023 Jun 19. Epub 2023 Jun 19.

Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, USA.

Objective: Little is known about pricing for reconstructive procedures of the head and neck. As of January 2021, the Centers for Medicare and Medicaid Services requires hospitals to disclose payer-negotiated prices for services, offering new insight into prices for privately insured patients.

Study Design: Cross-sectional analysis. Read More

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Masseteric nerve ultrasound identification for dynamic facial reanimation purposes.

Plast Reconstr Surg 2023 Jun 20. Epub 2023 Jun 20.

Shared senior co-authorship. Chief of the Departmenrt of Plastic Surgery, Hospital Germans Trias i Pujol. Universitat Autònoma de Barcelona. Barcelona, Spain.

Background: the masseteric nerve is one of the main options to neurotize free muscle flaps in irreversible long-term facial paralysis. Several preoperative skin marking techniques for the masseteric nerve have been proposed to limit the surgical dissection area, shorten the surgical time, and enable a safer dissection. However, these have shown variability amongst them and cannot preoperatively visualize the nerve. Read More

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The anatomic relationship of dorsal arterial perforators of the distal forearm, wrist, and dorsum of the hand with conclusions for the clinic.

J Plast Reconstr Aesthet Surg 2023 Aug 25;83:141-147. Epub 2023 Apr 25.

Department of Plastic and Reconstructive Surgery, Radboud University Medical Center Nijmegen (Radboudumc), Geert Grooteplein 10, 6525 GA Nijmegen, the Netherlands.

Background: Extended soft tissue defects of the fingers are often challenging to treat, and therefore, we performed cadaver dissections to elucidate the anatomic relationship between dorsal arterial perforators of the distal upper extremities to support the development of new local flaps.

Methods: Ten fixated cadaveric distal dorsal lower forearms were dissected to their arterial perforators down to 0.1 mm diameter in size with identification of their relationship. Read More

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Firm elevation of the auricle in reconstruction of microtia with a retroauricular fascial flap wrapping two titanium plate struts.

J Plast Reconstr Aesthet Surg 2023 Aug 24;83:134-140. Epub 2023 Apr 24.

Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639, Zhi Zao Ju Rd, Shanghai 200011, China.

Background: Reconstruction of the cephaloauricular sulcus in patients with microtia in ear reconstructions remains challenging. Costal cartilage and other support materials wedge were used for ear elevation. Each material has its disadvantages. Read More

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Oblique Axis Hypothenar Free Flaps: Tips for Harvesting Larger Flaps with Minimal Donor Site Morbidity.

Arch Plast Surg 2023 May 29;50(3):279-287. Epub 2023 May 29.

Department of Plastic and Reconstructive Surgery, Saeson Hospital, Daejeon, Republic of Korea.

 Hypothenar free flaps (HTFFs) have been widely used for reconstructing palmar defects. Although previous anatomical and clinical studies of HTFF have been conducted, this technique still has some limitations. In this study, we describe some tips for large flap design that allows for easy harvesting of HTFFs with minimal donor site morbidity. Read More

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Teaching Models for Correct Rhombic Flaps.

J Craniofac Surg 2023 May 29. Epub 2023 May 29.

Department of Surgery, Division of Trauma Surgery, Seoul National University Hospital, Seoul, Republic of Korea.

The aim of this study was to introduce teaching models for correct rhombic flaps. For the line of maximal extensibility (LME) and flap design, surgical fabric (model 1), scored corrugated cardboard (model 2), and scored polyethylene sheet (model 3) were used. For choosing the correct flaps, a silicone face (model 4) was used. Read More

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