Objective: To investigate the effect of O-Z flap for the reconstruction of round-or elliptical-shaped defects following the scalp tumor removal. Methods: The resection of the scalp tumor resulted in a round or elliptical-shaped defect. Intraoperative frozen section identified pathological diagnosis, while also ensured margin being tumor-free. Based on the size and location of the defect, the mobility of the surrounding scalp and hair distribution, two local flaps were designed in opposite directions on each side of the defect. The two flaps were rotated to close the defect in an O-Z fashion. Results: From April 2016 to November 2017, 6 patients underwent defect reconstruction using the scalp O-Z flap. The etiologies included basal cell carcinoma (n=2), squamous cell carcinoma (n=2), and trichilemoma and epidermoid cyst (n=2). The defect size ranged from 3.0cm×3.5cm to 5.0cm×6.0cm. Necrosis on the distal of the flap had occurred in 1 patient. It was taken approximately 6% of the flap size, and healed after conservative management. Other flaps survived without any complications. After 3 to 12 months follow-up, the appearance of the sclap was satisfactory and tumor recurrence was not noticed. Conclusions The O-Z flap technique can be considered as an alternative for the medium-sized defect reconstruction of the scalp. The postoperative outcome of scalp was satisfactory, without disrupted hair orientation.

Objective:To explore the effect of plastic surgery suture technique and its proficiency in facial scar inhibition after trauma, and to explore the key factors to improve the suture proficiency of junior residents.Methods:The data of patients with facial trauma who underwent plastic surgery suture in the Department of Plastic and Reconstructive Surgery of Ningbo First Hospital from June 2017 to July 2019 were retrospectively analyzed. They were divided into senior group and junior group according to the seniority of chief surgeon. The general condition, scar appearance and local symptoms of the two groups were evaluated by the scar cosmesis assessment and rating scale(SCAR), including scar expansion, erythema, hyperpigmentation or hypopigmentation, suture marks, hyperplasia or atrophy, scar pruritus, scar pain, and the results were statistically analyzed.The mean of continuous data were calculated and expressed as Mean ± SD, the differences between groups were tested by t-test, and the classified data were expressed by rate, and the differences between groups were tested by chi-square test. Results:A total of 83 patients (54 females and 29 males) were included in this study, the maximum age was 63, the minimum age was 3, and the average age was 31.7±13.3 years old, including senior group (52 cases) and junior group (31 cases). The differences were not statistically significant in gender, age, injury time, wound length and complications between the two groups. The total scores of SCAR scale in the senior and junior groups were 2.18±0.98 and 2.78±1.30, respectively, the difference was statistically significant ( P=0.020). The senior group was better than the junior group in inhibiting scar expansion ( P=0.035), eliminating suture marks ( P=0.018), overall scar impression ( P=0.038) and reducing pigment abnormality ( P=0.045). However, in inhibiting erythema and inhibiting scar hyperplasia or atrophy, the differences were not statistically significant between two groups. In the senior group, 4 patients had pain within 24 hours, 3 patients had pruritus; in the junior group, 2 patients had pain, 3 patients had pruritus. Conclusions:Plastic surgery suture technique will effectively improve the appearance of facial scar after trauma, especially in inhibiting scar expansion, erythema, hyperplasia or atrophy, and overall impression.Junior doctors can be competent for this work to a certain extent, but thay need long-term training to master the technology, and skilled operation can further improve the curative effect.

Objective:To explore the effect of plastic surgery suture technique and its proficiency in facial scar inhibition after trauma, and to explore the key factors to improve the suture proficiency of junior residents.Methods:The data of patients with facial trauma who underwent plastic surgery suture in the Department of Plastic and Reconstructive Surgery of Ningbo First Hospital from June 2017 to July 2019 were retrospectively analyzed. They were divided into senior group and junior group according to the seniority of chief surgeon. The general condition, scar appearance and local symptoms of the two groups were evaluated by the scar cosmesis assessment and rating scale(SCAR), including scar expansion, erythema, hyperpigmentation or hypopigmentation, suture marks, hyperplasia or atrophy, scar pruritus, scar pain, and the results were statistically analyzed.The mean of continuous data were calculated and expressed as Mean ± SD, the differences between groups were tested by t-test, and the classified data were expressed by rate, and the differences between groups were tested by chi-square test. Results:A total of 83 patients (54 females and 29 males) were included in this study, the maximum age was 63, the minimum age was 3, and the average age was 31.7±13.3 years old, including senior group (52 cases) and junior group (31 cases). The differences were not statistically significant in gender, age, injury time, wound length and complications between the two groups. The total scores of SCAR scale in the senior and junior groups were 2.18±0.98 and 2.78±1.30, respectively, the difference was statistically significant ( P=0.020). The senior group was better than the junior group in inhibiting scar expansion ( P=0.035), eliminating suture marks ( P=0.018), overall scar impression ( P=0.038) and reducing pigment abnormality ( P=0.045). However, in inhibiting erythema and inhibiting scar hyperplasia or atrophy, the differences were not statistically significant between two groups. In the senior group, 4 patients had pain within 24 hours, 3 patients had pruritus; in the junior group, 2 patients had pain, 3 patients had pruritus. Conclusions:Plastic surgery suture technique will effectively improve the appearance of facial scar after trauma, especially in inhibiting scar expansion, erythema, hyperplasia or atrophy, and overall impression.Junior doctors can be competent for this work to a certain extent, but thay need long-term training to master the technology, and skilled operation can further improve the curative effect.

To investigate the clinical efficacy of one-stage repairing the wounds after excision of soft tissue malignant tumor in lower limb with deep inferior epigastric perforator (DIEP) flaps. Methods From Au-gust, 2016 to July, 2018, 11 patients(8 males and 3 females; aged 35-76 years) with the soft tissue defects in the low-er limb underwent immediate reconstructive operations with DIEP flap after their tumor resection. The defects ranged in area from 11 cm×7 cm to 25 cm×10 cm after extended resection, including 5 cases of bone exposure. The DIEP flap area ranged from 11 cm×8 cm to 26 cm×18 cm.Among them, 9 cases were treated with free transplantation and 2 cases with pedicle transplantation.The donor sites were closed directly. The patients’ limb function, tumor recurrence and the healing of surgical incision had been followed-up. Results Eleven flaps survived and the donor sites healed directly. One flap had skin pigmentation due to postoperative vascular crisis, and the other flaps had satisfied texture and appearance. All patients were followed-up from 6 to 30 months. The lower limb movement was normal. All the donor sites had a good healing with no pain and abdominal complications. No tumor recurrence was observed during the followed-up period. Conclusion DIEP flap have many advantages, such as large cutting area, which is suitable for large-area wound repair after extended excision of soft tissue malignant tumor in lower limb. At the same time, the perforator vessel is constant and the caliber are thick, also the donor area is concealed and can be sutured directly.This kind of the technique for reconstruction of lower limb soft tissue defects after malignant tumor resection is well acceptable.

Objective:To explore the effect of plastic surgery suture technique and its proficiency in facial scar inhibition after trauma, and to explore the key factors to improve the suture proficiency of junior residents.Methods:The data of patients with facial trauma who underwent plastic surgery suture in the department of plastic and reconstructive surgery of Ningbo First Hospital from June 2017 to July 2019 were retrospectively analyzed. They were divided into senior group and junior group according to the seniority of chief surgeon. The general condition, scar appearance and local symptoms of the two groups were evaluated by SCAR Scale, including scar expansion, erythema, hyperpigmentation or hypopigmentation, suture marks, hyperplasia or atrophy, scar pruritus, scar pain, and the result were statistically analyzed.Results:A total of 83 patients (54 females and 29 males) were included in this study, the maximum age was 63, the minimum age was 3, and the average age was (31. 7±13. 3), including senior group (52 cases) and junior group (31 cases) . The differences were not statistically significant in gender, age, injury time, wound length and complications between the two groups. The total scores of SCAR Scale in the senior and junior groups were 2. 18±0. 98 and 2. 78±1. 30, respectively, the difference was statistically significant ( P=0. 020 ). The senior group was better than the junior group in inhibiting scar expansion ( P=0. 035 ), eliminating suture marks ( P =0. 018 ) , overall scar impression ( P=0. 038 ) and reducing pigment abnormality ( P =0. 045 ). However, in inhibiting erythema and inhibiting scar hyperplasia or atrophy, the differences were not statistically significant between two groups. In the senior group, 4 patients had pain within 24 hours, 3 patients had pruritus; in the junior group, 2 patients had pain, 3 patients had pruritus. Conclusions:Plastic surgery suture technique will effectively improve the appearance of facial scar after trauma, especially in inhibiting scar expansion, erythema, hyperplasia or atrophy, and overall impression. Junior doctors can be competent for this work to a certain extent, but thay need long-term training to master the technology, and skilled operation can further improve the curative effect.

Objective:To explore the effect of plastic surgery suture technique and its proficiency in facial scar inhibition after trauma, and to explore the key factors to improve the suture proficiency of junior residents.Methods:The data of patients with facial trauma who underwent plastic surgery suture in the department of plastic and reconstructive surgery of Ningbo First Hospital from June 2017 to July 2019 were retrospectively analyzed. They were divided into senior group and junior group according to the seniority of chief surgeon. The general condition, scar appearance and local symptoms of the two groups were evaluated by SCAR Scale, including scar expansion, erythema, hyperpigmentation or hypopigmentation, suture marks, hyperplasia or atrophy, scar pruritus, scar pain, and the result were statistically analyzed.Results:A total of 83 patients (54 females and 29 males) were included in this study, the maximum age was 63, the minimum age was 3, and the average age was (31. 7±13. 3), including senior group (52 cases) and junior group (31 cases) . The differences were not statistically significant in gender, age, injury time, wound length and complications between the two groups. The total scores of SCAR Scale in the senior and junior groups were 2. 18±0. 98 and 2. 78±1. 30, respectively, the difference was statistically significant ( P=0. 020 ). The senior group was better than the junior group in inhibiting scar expansion ( P=0. 035 ), eliminating suture marks ( P =0. 018 ) , overall scar impression ( P=0. 038 ) and reducing pigment abnormality ( P =0. 045 ). However, in inhibiting erythema and inhibiting scar hyperplasia or atrophy, the differences were not statistically significant between two groups. In the senior group, 4 patients had pain within 24 hours, 3 patients had pruritus; in the junior group, 2 patients had pain, 3 patients had pruritus. Conclusions:Plastic surgery suture technique will effectively improve the appearance of facial scar after trauma, especially in inhibiting scar expansion, erythema, hyperplasia or atrophy, and overall impression. Junior doctors can be competent for this work to a certain extent, but thay need long-term training to master the technology, and skilled operation can further improve the curative effect.

Objective: To analyze the causes of local necrosis and hemodynamics after pedicle peroneal perforator flap and try to find out prevention strategies. Methods: Retrospective 17 tissue defect cases admitted by Plastic and Reconstructive Surgery of Ningbo First Hospital, which treated by pedicle perforator flap with kinds of complications. 3 of 17 were naked the perforators to reduce reverse pressure. Patients involved 12 male, 5 female, ages from 22 to 46, with defected area from 5.0 cm×11.0 cm to 8.0 cm×14.0 cm, located in lateral ankle. Results: 3 to 5 days postoperative 12 cases with distal local necrosis, all of which were designed interregional, one with performator naked, turned back after drainage and wound dressing, 3 cases were gradually swelling and purple postoperative, two of them were perforator naked. 1 weeks later, the distal skin of flap necrosis and were gradually turning black scab appeared.With scab cutting and fascia survived, no bony tissues exposure, after 0.5% povidone iodine wet dressing regularly, endothelial cells crawled to cover. 2 cases with larger ranger of swelling and purple, not be better even pedicale releasing was conducted, 2 weeks later most part of the flap necrosis and the distal turned black eschar. After debridement and skin grafting, wounds healed later.All patients were followed up for 3 months with no flap transplantation required. Conclusions Coaxial homology, within 2 choke vessel areas, perforator skeletonization, kick out the small saphenous vein, might be the ways to reduce the complication of the cross area designing trans pedicled peroneal perforator flap.

Objective:To explore the feasibility and effect of using free-style perforator pedicled propeller flap to repair the wound after extended resection of skin malignant tumor on the shoulder and back.Methods:From December 2017 to June 2019, 9 patients (7 males and 2 females, aged from 51 to 84 years, with an average age of 67.5 years) with skin malignant tumor of the shoulder and back were treated in the Department of Plastic and Reconstructive Surgery of Ningbo First Hospital.The etiologies included squamous cell carcinoma( n=4), basal cell carcinoma( n=3), skin juga fibrosarcoma( n=1) and malignant melanoma( n=1). Color Doppler ultrasound was used to detect and mark the perforating vessels before operation. After extended resection was performed, intraoperative frozen section identified pathological diagnosis, while also ensured margin and base being tumor-free. The defect size ranged from 3.0 cm×7.0 cm to 8.0 cm×9.0 cm. According to the wound size and shape, the perforator pedicled propeller flap ranged from 3.0 cm×10.0 cm to 8.0 cm×12.0 cm was designed to repair the wound. The donor area was closed directly. Results:All 9 flaps survived with primary wound healing in donor and recipient areas. Follow-up for 5-20 months showed no tumor recurrence and there was no obvious bulky and scar formation. The movement of left shoulder joint was smooth.Conclusions:The blood supply of the shoulder and back is extensive, and the skin perforating vessels are abundant. Free-style perforator pedicled propeller flap on the shoulder and back is a simple technique. It is an ideal flap to repair the wound defect after extended resection of skin malignant tumor on the shoulder and back.

Objective:To explore the feasibility and effect of using free-style perforator pedicled propeller flap to repair the wound after extended resection of skin malignant tumor on the shoulder and back.Methods:From December 2017 to June 2019, 9 patients (7 males and 2 females, aged from 51 to 84 years, with an average age of 67.5 years) with skin malignant tumor of the shoulder and back were treated in the Department of Plastic and Reconstructive Surgery of Ningbo First Hospital.The etiologies included squamous cell carcinoma( n=4), basal cell carcinoma( n=3), skin juga fibrosarcoma( n=1) and malignant melanoma( n=1). Color Doppler ultrasound was used to detect and mark the perforating vessels before operation. After extended resection was performed, intraoperative frozen section identified pathological diagnosis, while also ensured margin and base being tumor-free. The defect size ranged from 3.0 cm×7.0 cm to 8.0 cm×9.0 cm. According to the wound size and shape, the perforator pedicled propeller flap ranged from 3.0 cm×10.0 cm to 8.0 cm×12.0 cm was designed to repair the wound. The donor area was closed directly. Results:All 9 flaps survived with primary wound healing in donor and recipient areas. Follow-up for 5-20 months showed no tumor recurrence and there was no obvious bulky and scar formation. The movement of left shoulder joint was smooth.Conclusions:The blood supply of the shoulder and back is extensive, and the skin perforating vessels are abundant. Free-style perforator pedicled propeller flap on the shoulder and back is a simple technique. It is an ideal flap to repair the wound defect after extended resection of skin malignant tumor on the shoulder and back.