OBJECTIVE: To explore the clinical repair value of facial skin and tissue defect caused by tumour, trauma and infection with the axial flap. METHOD: The clinical data of 38 patients with facial skin and tissue defect were analyzed retrospectively. All of them were repaired by the axial flap. RESULT: The axial flap was alive in all patients, and all incision healed in the first stage. All patients had a satisfied result after the second stage of flap surgery. CONCLUSION The method of the axial flap in face can be clinically applied in the facial skin and tissue defects caused by tumour, trauma injury and infection. Because the axial flap cotained named blood vessel, the survival rate of it is high.
Dermatologic Surgical Procedures ; Face ; surgery ; Humans ; Reconstructive Surgical Procedures ; Retrospective Studies ; Skin Transplantation ; Surgical Flaps ; Wound Healing

BACKGROUND: Recently, increasing attention in the field of dermatological surgery has been paid to treating skin cancers, including both premalignant and malignant lesions. The rhombic flap, one of the transposition flaps, is an outstanding method for reconstructing small- to medium-sized defects after skin surgery. OBJECTIVE: The aim of this study was to evaluate our clinical results with the rhombic flap for reconstruction after Mohs micrographic surgery (MMS), including the cosmetic aspects, complete surgical excision, and recurrence. METHODS: Between June 2010 and September 2013, 37 patients who were diagnosed with premalignant and malignant lesions on the face and extremities were treated with rhombic flaps for the reconstruction of primary cutaneous defects following lesion excisions. We reviewed the medical records and evaluated the clinical aspects and surgical treatment outcomes, and the cosmetic results were scored as excellent, good, fair, or poor. In addition, we assessed the surgical treatment outcomes using the Vancouver Scar Scale (VSS). RESULTS: Thirty-seven patients received 37 rhombic flaps. The cosmetic results of the reconstructions were gratifying, and 28 of 37 patients (75.7%) showed good to excellent results. Specifically, the cosmetic results of the modified rhombic flaps were great, and 27 of 30 patients (90.0%) showed good to excellent results. The cosmetic results on the VSS showed a high mean score (2.9). CONCLUSION: Our study showed that the rhombic flap is a simple reconstruction method and provides aesthetically pleasing results. Therefore, it could be a useful option for reconstructing defects of the face and extremities.
Cicatrix ; Dermatologic Surgical Procedures ; Extremities ; Humans ; Medical Records ; Mohs Surgery* ; Recurrence ; Skin Neoplasms*

OBJECTIVETo investigate the application of medpor and split-thickness skin graft in formation of cranioauricular sulcus during auricular reconstruction with Nagata method.

METHODSThe first stage operation was fulfilled according to the Nagata two-stage method which involves fabrication and grafting of the costal cartilage framework. The second-stage ear elevation operation was undertaken 6 months later to form the cranioauricular sulcus. Split-thickness skin was taken from temporal and accipital area. After releasing the auricular framework and transplanting C shaped medpor at the rear side of framework, the temporaparietal fascia flap was transferred to cover postauricular medpor and framework. Then the split-thickness skin graft was implant on the fascia surface.

RESULTSFrom July 2010 to August 2012, 20 cases (22 ears) were treated. Partial necrosis of temporaparietal fascia flap and framework exposure happened in 1 case. Successful ear reconstruction was achieved in other cases with satisfactory cranioauricular sulcus during the follow-up period of 6-18 months (average, 13 months).

CONCLUSIONSThe application of medpor and split-thickness skin graft in the ear elevation of Nagata method for auricular reconstruction for microtia can achieve satisfactory results. It not only avoids the obvious scar in the donor site due to harvesting full-thickness and intermediate-thickness skin, but also reduces chest trauma due to harvesting costal cartilage.

Costal Cartilage ; transplantation ; Dermatologic Surgical Procedures ; methods ; Ear Auricle ; surgery ; Fascia ; Humans ; Polyethylenes ; therapeutic use ; Skin Transplantation ; Surgical Flaps ; transplantation

OBJECTIVETo improve the results of the soft tissue expansion technique.

METHODSTwo expanders were buried in the same soft tissue pocket in an overlapping pattern. The inflation process was carried out routinely.

RESULTS19 cases of various tissue defects were treated with the overlapping tissue expansion technique since March 1999. Good results have been achieved.

CONCLUSIONThe overlapping tissue expansion technique can provide much more expanded tissue and reduce complications compared with the traditional expansion technique. It is especially suitable for repair of the defects at the facial and cervical region.

Adolescent ; Adult ; Burns ; surgery ; Child ; Dermatologic Surgical Procedures ; Female ; Humans ; Male ; Skin ; injuries ; Skin Transplantation ; Surgical Flaps ; Tissue Expansion ; methods

BACKGROUND: Skin grafting is a commonly performed operation in plastic and reconstructive surgery. The tie-over dressing is an effective technique to secure the grafted skin by delivering persistent downward pressure. However, if an additional dressing is required due to incomplete graft healing, the process of re-implementing the tie-over dressing may be frustrating for both patients and surgeons. Therefore, we introduce the double tie-over dressing, which readily allows for an additional tie-over dressing after the first dressing, and we present a comparison of its effectiveness with that of the simpler bolster dressing. METHODS: Of 128 patients with a skin defect, 69 received a double tie-over dressing and 59 patients received a simple bolster dressing. Using the independent t-test, the mean healing time, which was defined as the mean time it took for the wound to heal completely so that no additional dressing was required and it was washable with tap water, was compared between the 2 groups in both the head and neck region and in other areas. RESULTS: The mean healing time for the head and neck region in the double tie-over dressing group was 9.19±1.78 days, while it was 11.05±3.85 days in the bolster dressing group. The comparison of the 2 groups by the independent t-test revealed a P-value of 0.003 for the mean healing time. CONCLUSIONS: In the head and neck area, the double tie-over dressing required less time to heal than the simple bolster dressing.
Bandages* ; Dermatologic Surgical Procedures ; Head ; Humans ; Neck ; Occlusive Dressings ; Plastics ; Skin ; Skin Transplantation ; Surgeons ; Transplants ; Water ; Wounds and Injuries

OBJECTIVETo investigate the repair of skin and soft tissue defect by skin and soft tissue distraction tecnique and evaluate clinical results.

METHODSTwenty-five patients with skin and soft tissue defect were repaired by skin and soft tissue distraction technique including 16 male and 9 female. The age ranged from 8 to 66 years with an average age of 29.3 years. Parallel Kirschner wires were inserted through the defect skin margin at the interval of every 0.5 to 1.5 cm, the Kirschner wire was gradually drawed to the close by thick silk thread or tiny steel-wire, the defect of skin and soft tiuuse was closed from two sides and the wound disappeared.

RESULTSThe wounds of 15 patients were anastomosed dircetly through skin and soft tissue distraction for 20 to 60 minutes, other ten wounds were anastomosed from 3 to 26 days, all healed well. By the follow up from 2 to 26 months, the wound skin looked as line scar, corresponding to the result of common debridement anastomosis.

CONCLUSIONSkin and soft tissue distraction tecnique can not replace skin grafting, flap transferring and flap grafting. But it may avoid damage to the supply area and the risk of flap necrosis. Skin and soft tissue distraction tecnique is a good method to repair skin and soft tissue defect.

Adolescent ; Adult ; Aged ; Child ; Dermatologic Surgical Procedures ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Skin ; injuries ; Skin Transplantation ; methods ; Soft Tissue Injuries ; surgery

OBJECTIVETo investigate the method for creation of auriculocephalic sulcus.

METHODSThe reconstruction was performed 4-12 months after the first surgery. Skin incision was made 5mm posterior to the outer margin of the auricle. The ear framework was elevated with a thick fascia at the deep surface. The costal cartilage banked at the first operation was shaved and transplanted to the deep surface of the concha with sutures. The position and angle of the ear framework was adjusted to be familiar to the healthy ear. The auriculocephalic angle was slightly larger than that in the contralateral ear. Two flaps were designed at the upper and lower area of reconstructed ear and rotated to cover the cartilage. The wound at the donor site was closed with skin graft.

RESULTSA total of 72 patients were treated. All the flaps survived completely. 51 patients were followed up for 3-24 months with satisfactory results. The auriculocephalic sulcus maintained at about 20-30 degree.

CONCLUSIONSIt is a simple, safe and reliable method to create a auriculocephalic sulcus with two random skin flaps from mastoid area combined with skin graft.

Adolescent ; Cartilage ; transplantation ; Dermatologic Surgical Procedures ; methods ; Ear ; Ear Auricle ; surgery ; Ear Deformities, Acquired ; surgery ; Fascia ; Humans ; Mastoid ; Ribs ; Skin Transplantation ; methods ; Surgical Flaps ; transplantation

OBJECTIVETo explore the clinical effect of using dorsal two wing-shaped flap to reconstruct finger web for treatment of congenital syndactyly.

METHODSThis technique has been used in 19 children with congenital syndactyly. At the dorsum, a flap with V-shaped tip and two wing-shaped pedicle were designed and was just sewed up with an anchor-shaped incision at the palm. The web was primarily reconstructed without skin graft at base of fingers. Distal end of fingers were separated by using serrated flap and were closed after removal of fatty tissue. At some cases with tight skin connection. The defect area at lateral and distal end of fingers was closed by small pieces of skin graft.

RESULTSAll the webs were reconstructed primarily without skin graft at the base of fingers. 7 cases with tight skin connection had small pieces of skin graft at lateral and distal end of fingers. Primary healing was achieved in all cases. After 1 to 6 months of follow-up, both the appearance and function were satisfactory without conspicuous scar. The reconstructed finger webs were in normal depth and width.

CONCLUSIONSPrimary web space can be achieved by dorsal two wing-shaped flap without skin graft at base of fingers. It is one of the best choices for treatment of congenital syndactyly.

Adipose Tissue ; surgery ; Child ; Cicatrix ; Dermatologic Surgical Procedures ; methods ; Fingers ; surgery ; Humans ; Skin Transplantation ; Surgical Flaps ; transplantation ; Syndactyly ; surgery ; Wound Healing

OBJECTIVETo investigate a method of auricular reconstruction by soft tissue expansion techniques without skin grafting.

METHODSTwo tissue expanders (50 ml and 70 ml) were implanted under the skin of mastoid in 15 patients with grade II or III microtia. One big expander (100 ml) were implanted under the skin of mastoid in 13 patients with grade I microtia and 3 patients with grade II or III microtia. After skin expansion, the expanders were taken out. The autologous rib cartilage or Medpor scaffolds were implanted. The superior expanded skin flap was used to cover the frontal surface and the upper part of the back surface of the framework. The inferior expanded skin flap was transplanted to cover the lower part of the back surface of the framework. The remained expanded skin flap was transplanted to cover the wound in the lateral of head.

RESULTSNo skin graft was needed in all the patients. Epidermis blister occurred at the distal part of flap in one case. No other complication was happened. A follow-up of 6 to 12 months (mean 10.9 months) was carried out in all patients with good cosmetic result when the reconstructed ear underwent second-stage operation. The scar size on the dornor site was (5.2 +/- 0.6) cm2 The satisfactory rate was 90% (28/31).

CONCLUSIONSThe expanded skin with this new method is enough for auricular reconstruction without skin grafting, leaving less complication and less scar at donor site.

Adolescent ; Dermatologic Surgical Procedures ; methods ; Ear Auricle ; surgery ; Humans ; Mastoid ; Polyethylenes ; Skin Transplantation ; Surgical Flaps ; transplantation ; Tissue Expansion ; methods ; Tissue Expansion Devices

OBJECTIVETo classify the blood vessel distribution of the expanded skin in the mastoid region and its relevance to reasonable and reliable design of the expanded flap for auricular reconstruction in congenital microtia.

METHODSThe blood vessel distribution of the expanded skin in the mastoid region was observed by light permeation test. The expanded flaps with different ratio of length to width were designed according to their blood vessel distribution types.

RESULTSThe vascular distribution of the expanded skin in 403 cases was divided into five types. All the flaps survived completely.

CONCLUSIONSThe blood vessel distribution type of the expanded skin in mastoid region has great significance for the design of post-auricular expanded flap in auricular reconstruction.

Congenital Abnormalities ; surgery ; Dermatologic Surgical Procedures ; Ear ; abnormalities ; Female ; Humans ; Male ; Mastoid ; surgery ; Skin ; blood supply ; Skin Transplantation ; Surgical Flaps ; blood supply ; Tissue Expansion Devices