OBJECTIVETo evaluate the effect of insular pectoralis major myocutaneous flap on repair of jaw and neck tissue defect as a result of high-voltage electric burn.

METHODSEighteen patients with large area tissue defect in jaw and neck caused by high-voltage electric burn hospitalized from August 2001 to December 2007 were repaired with insular pectoralis major myocutaneous flap. The flaps (from 12 cm x 10 cm to 16 cm x 13 cm) was transplanted in 8 patients after early wound debridement, and in 10 patients on infected wounds.

RESULTSAll flaps survived wells except in 4 patients necrotic area (length 2-5 cm, width 1-2 cm) appeared in the distal wound edge, localized dehiscence of wound edge in 2 cases, which were healed after dressing change or secondary suturing. Patients were followed up from 6 months to 3 years, and the appearance and function were satisfactory.

CONCLUSIONSPectoralis major muscle island myocutaneous flap has the advantage of large tissue mass, with thin and flat muscle belly, and rich blood supply, which is suitable for repair of large deep tissue defect in jaw and neck.

Adolescent ; Adult ; Burns, Electric ; surgery ; Female ; Humans ; Middle Aged ; Muscle, Skeletal ; transplantation ; Neck ; surgery ; Skin Transplantation ; Surgical Flaps ; Young Adult

OBJECTIVEThe traditional gracilis musculocutaneous flap is supplied by a branch of deep femoral artery, which enters the muscle in between the upper and middle third of it. So the flap barely reaches the pelvis and perineum region for reconstruction. By exploring the blood supply pattern we tried to rotate the flap Upon at the higher point starting at the obturator foramen in order to let it cover a bigger area.

METHODSanatomical reviewing of the blood supply of the gracilis branches of obturator, medial femoral circumflex and deep femoral arteries. Based on this a new type of longitudinal gracilis musculocutaneous flap supported only by the obturator artery was designed to reach the pelvis, female genitalia, pubic symphysis, inguinal area easily.

RESULTSThe new kind of flap has been applied to 9 patients for deformity repairing and tissue replacement in the pelvic and perineal area. All the flaps survived and achieved satisfactory result with 3 months to 3 years' follow up.

CONCLUSIONSLongitudinal gracilis musculocutaneous flaps supplied by the obturator artery can be used as regular musculocutaneous flap clinically.

Female ; Femoral Artery ; surgery ; Humans ; Muscle, Skeletal ; blood supply ; transplantation ; Surgical Flaps ; blood supply

OBJECTIVETo design an animal model for the reconstruction of penile erectile function with segmental gracilis musculocutaneous flap.

METHODSThe rabbit gracilis muscle was split longitudinally into two approximately equal halves completely according to the principles of muscle compartmentalization. An animal model was designed for the reconstruction of erectile function with segmental musculocutaneous flap based on the anterior gracilis muscle bundle, with a silicone stick implanted as a supporter. A multi-channel physiological signal acquisition and processing system were used to stimulate the reconstructed penis and its CMAP was measured synchronously.

RESULTSWhen its nerve was electric stimulated, the muscle bundle contracted, which made the reconstructed penis moving accordingly. It satisfactorily simulated the way of a normal penis's erection.

CONCLUSIONSThe reconstructed penis with rabbit segmental gracilis musculocutaneous flap according to the principles of muscle compartmentalization has achieved the erectile function satisfactorily. It has met the requirements of both improving reconstructive penis's appearance and retaining muscle' s contractive function.

Animals ; Male ; Muscle, Skeletal ; transplantation ; Penile Erection ; Penis ; surgery ; Rabbits ; Reconstructive Surgical Procedures ; Surgical Flaps ; Thigh

The purpose of this study was to evaluate a new extracapsular surgical technique for the treatment of cranial cruciate ligament rupture in small breed dogs. Nine small breed dogs (seven females and two males) weighing < or = 15 kg were treated with biceps femoris muscle transposition (BFT). The duration of the BFT procedure was 20 min. Each patient underwent a standard clinical protocol and a questionnaire for the owners. Follow-up (at 1, 3, and 12 months postoperative) confirmed significant improvement in all patients, especially at 1 month postoperatively (p < 0.01) and again after complete stifle joint assessment at 3 months postoperatively. After 12 months, only two patients showed a slight increase in osteoarthritis. According to our results, BFT is a simple extracapsular surgical technique that can be used for the treatment of cranial cruciate ligament rupture in small breed dogs.
Animals ; Anterior Cruciate Ligament/*injuries/*surgery ; Dog Diseases/*surgery ; Dogs ; Female ; Male ; Muscle, Skeletal/*transplantation ; Questionnaires ; Rupture/veterinary ; Stifle/*surgery

OBJECTIVETo explore the clinical effects of pedicled muscular flaps of brachioradialis in repairing wounds at proximal forearm resulted from hot crush injury.

METHODSFrom February 2003 to December 2008, 5 wounds at proximal forearm resulted from hot crush injury were repaired with pedicled muscular flaps of brachioradialis. The size of muscular flaps ranged from 6 cm x 4 cm - 9 cm x 5 cm. The wounds at donor sites were closed directly or by free skin grafts.

RESULTSAll the muscular flaps of brachioradialis were survived completely. 4 patients were followed up for 3 to 36 months. The cosmetic and functional results were satisfactory both in recipient areas and in donor sites.

CONCLUSIONSPedicled muscular flap of brachioradialis can not only repair wounds at proximal forearm resulted from hot crush injury, but also repair extensor muscle defects. It is an ideal method and is very practical.

Adult ; Barotrauma ; surgery ; Burns ; surgery ; Female ; Forearm Injuries ; surgery ; Humans ; Male ; Middle Aged ; Muscle, Skeletal ; transplantation ; Surgical Flaps ; Young Adult

OBJECTIVETo investigate the effects of free and pedicled thoracodorsal artery perforator (TDAP) flaps for repairing skin and soft tissue defects in limbs, neck, axillary and shoulder.

METHODSFrom October 2009 to Auguest 2011, 16 TDAP flaps were used to repair skin and tissue defects. Among them, five ipsilateral pedicled flaps were used to repair wounds in neck, axillary and shoulder. 11 free TDAP flaps were used to repair the wounds with bone or tendon exposure. In 12 cases, the flaps were pedicled with thoracodorsal artery and vein-lateral branches-perforators, in 4 cases, pedicled with thoracodorsal artery and vein-serratus anterior muscular branches-perforators. The deep fascia, the latissimus dorsi and thoracodorsal nerve were not included in all flaps. The flaps size ranged from 10 cm x 5 cm to 26 cm x 10 cm.

RESULTSAll 16 flaps survived completely with primary healing both at donor site and recipent area. After a follow-up of 3 to 24 months, all flaps gained good texture and appearance. Only linear scar was left at donor area. The shoulder could move freely.

CONCLUSIONSTDAP flap has good texture, long vascular pedicle,and reliable blood supply, leaving less morbidity at donor site. The latissimus dorsi and thoracodorsal nerve are also preserved. The pedicled TDAP flap is an ideal flap for repairing the ipsilateral skin and soft tissue defects of the neck, shoulder, axillary. The free TDAP flap is suited for repairing skin and soft tissue defects of the extremities.

Arteries ; Axilla ; Humans ; Muscle, Skeletal ; Perforator Flap ; transplantation ; Surgical Flaps ; blood supply ; transplantation ; Thoracic Wall ; Wound Healing ; Wounds and Injuries ; surgery

OBJECTIVETo explore the methods and effects of repair of occipital and nuchal wounds with inferior trapezius myocutaneous flap after deep electrical bum.

METHODSTwelve patients with high-voltage electrical burn in occipital and nuchal regions were hospitalized to our ward from March 2003 to September 2007. They were repaired with improved inferior trapezius myocutaneous flaps after debridement. Flaps were of two types: (1) blood supply from cutaneous and perforator branches of the original segment of the superficial descending branch of transverse cervical artery. (2) combined blood supply from both superficial and deep descending branches of transverse cervical artery C, i.e., dorsal scapular artery). All flaps carried segmental and limited trapezius muscle cuff surrounding the vascular pedicle of the flap similar to a perforator flap.

RESULTSFlaps survived completely primarily in eight cases. In two patients, infection developed in flaps adjacent to wounds with lignification; they healed after dress change. Necrosis appeared in distal end of flap (one case), it healed after re-operation. One patient with surviving flaps died of sepsis and multiple organ failure 21 days after operation. The flaps which survived were not swollen ; the donor sites at scapular region looked normal without pterygoid or pendulous scapula deformities.

CONCLUSIONInferior trapezius myocutaneous flaps can be used to repair occipital and nuchal wounds, with the advantages of constant blood vessels, reliable blood supply, convenience for application.

Adult ; Burns, Electric ; surgery ; Humans ; Male ; Middle Aged ; Muscle, Skeletal ; transplantation ; Neck Injuries ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps

OBJECTIVE: To explore a method for the repairment of laryngeal fistula following electrical burn. METHOD: Sternocleidomastoid myocutaneous flap was applied to restore laryngeal fistula following electrical injuries. RESULT: The patient was cured with good repairment of cutaneous defect and laryngeal function following operation. CONCLUSION Application of neighboring myocutaneous flap is beneficial for the reconstruction of damaged tissue.
Adult ; Burns, Electric ; surgery ; Fistula ; etiology ; surgery ; Humans ; Larynx ; injuries ; Male ; Muscle, Skeletal ; transplantation ; Reconstructive Surgical Procedures ; Surgical Flaps

Adult ; Aged ; Bone Transplantation ; Female ; Fibula ; transplantation ; Free Tissue Flaps ; Humans ; Male ; Mandible ; surgery ; Maxilla ; surgery ; Middle Aged ; Muscle, Skeletal ; transplantation ; Reconstructive Surgical Procedures ; methods

OBJECTIVETo evaluate the efficacy of free transplantation of denervated muscles and vessels in the treatment of long-standing facial paralysis.

METHODSA total of 26 patients with facial paralysis (10 males and 16 females, aged 16-65 years, mean: 47 years) were enrolled in this study to receive transplantation of denervated extensor digitorum brevis (EDB) and extensor hallusis brevis (EHB). The muscle tendon was slung to the ala nasi, the middle point of the nasolabial sulcus, the angulus oris and the chin to correct the nasal and oral deformity. The muscle belly was buried around the nerves that innervated the masseter muscle. Microsurgery was applied to anastomosing the tarsus lateral vessels to the superficial temporalis vessels.

RESULTSAfter operation, all the patients immediately obtained satisfied static appearance. The movement of the paralyzed corner of the mouth could be obtained one month later and the smile of the paralyzed side could be restored after 3 months of training. And 88% patients achieved perfect results, 8% obtained satisfactory results, and 4% got improvement 6 months after operation according to Stennert's paresis scoring system.

CONCLUSIONSFree transplantation of denervated muscles and vessels for the treatment of long-standing facial paralysis, which seldom causes atrophy or liquefaction of the transferred muscles, can maintain muscle viability and induce reliable nerve regeneration. Therefore, it is a safe and efficient treatment method for the patients suffering from facial paralysis.

Adolescent ; Adult ; Aged ; Facial Paralysis ; surgery ; Female ; Humans ; Male ; Microsurgery ; methods ; Middle Aged ; Muscle, Skeletal ; innervation ; transplantation ; Nerve Regeneration