Free Dermal Graft Research Articles

Management of Neuropathic Pain with Neurectomy Combined with Dermal Sensory Regenerative Peripheral Nerve Interface (DS-RPNI).

Neuropathic pain affects a large percentage of the U.S. population and leads to tremendous morbidity. Numerous nonsurgical and surgical treatments have been utilized to try and manage neuropathic pain with varying degrees of success. Recent research investigating ways to improve prosthetic control have identified new mechanisms for preventing neuromas in both motor and sensory nerves with free muscle and dermal grafts, respectively. These procedures have been used to treat chronic neuropathic pain in nonamputees, as well, in order to reduce failure rates found with traditional neurectomy procedures. Herein, we focus our attention on Dermal Sensory-Regenerative Peripheral Nerve Interfaces (DS-RPNI, free dermal grafts) which can be used to physiologically "cap" sensory nerves following neurectomy and have been shown to significantly decrease neuropathic pain.

Preliminary experience of autologous free myocutaneous flap combined with free dermal graft in the treatment of refractory empyema with bronchopleural fistula

ObjectivesTo explore the effects of autologous free dermal graft combined with free myocutaneous flap on bronchopleural fistula (BPF) with empyema, we summarized and analyzed two cases. MethodsTwo patients with refractory empyema and BPF were treated with autologous free dermal graft combined with free myocutaneous flap. The treatment included debridement of empyema, rib resection drainage, repair of bronchopleural fistula, and free vastus lateralis myocutaneous flap transplantation to eliminate the empyema. After the free dermal graft was harvested from the healthy skin around the incision, it was inserted into the fistula and sutured with the surrounding pleural tissue. The keys to the operation lies in the anastomosis of the lateral circumflex femoral artery (LCFA), vein and nerve that supply the vastus lateralis muscle flap to the thoracodorsal vessels and nerves. After surgery, the empyema, air leakage, and the survival of the myocutaneous flap were observed. ResultsThere was no disease recurrence after follow-up for seven and six months, respectively. Re-examination of the chest computed tomography (CT) or magnetic resonance imaging (MRI) indicated that the abscess cavity had disappeared. No necrosis of the myocutaneous flap was observed after surgery. ConclusionThe application of autologous free dermal graft combined with free vastus lateralis myocutaneous flap transplantation is effective in the treatment of patients with bronchopleural fistula with refractory chronic empyema, and the clinical effect is satisfactory.

Beyond resurfacing: CO2 lasers for autodermal grafts

Denis F. Branson, MD, Fayetteville, NY is a board-certified plastic surgeon and an ASAPS member. Autodermal grafting is a nonresurfacing application of the CO2 laser. Autodermal grafts are either in situ or free. Free autodermal grafts can replace allografts, such as Gore-Tex (W.L. Gore, Flagstaff, AZ) and Alloderm (LifeCell Corporation, The Woodlands, TX) grafts. Like skin resurfacing, the technique described here uses the CO2 laser for char-free ablation. The difference is in the depth of ablation. Inadequate ablation may lead to posttreatment inclusion cysts. Figure 1. A , Preoperative view of a 63-year-old woman. B , Postoperative view 15 months after upper-lid blepharoplasty and free dermal graft to the lower eyelid. C , Laser-treated upper-eyelid skin. Arrows indicate laser-treated redundant eyelid skin. D , Free dermal graft is placed at lower-eyelid hollow. Deepithelialized free grafts are near-full-thickness skin grafts. Autodermal free grafts have been widely used for scar revision, treatment of traumatic tissue loss, …

Dermal-fat flaps in the treatment of large post-incisional hernias ("cross-over flap" technique).

The use of dermal fat flaps or "cross-over" flap offers unquestionable advantages, even when compared with free dermal grafts. An excellent aesthetic appearance is achieved, dut to the very low incisional line. Nor does this technique leave scars in other parts of the body.

Use of Autogenous Split-Thickness Dermal Graft for Reconstruction of the Lining of the Exenterated Orbit

A surgical technique using an exposed dermal graft to line the exenterated orbit has been successful in nine patients. Eight of the nine patients had undergone total maxillectomy at the time of exenteration. A split-thickness (epidermal) skin graft is harvested with a dermatome and hinged at one end. A second split-thickness dermal graft is harvested from the dermal bed of the first graft. The hinged epidermal graft is sutured into its donor site, and the deeper free dermal graft is used to line the orbital cavity. The latter graft tends to be more viable than a split-thickness epidermal graft. Also, because the dermal graft can self-epithelialize or be epithelialized by adjacent tissues, it may be placed adjacent to skin or a mucous membrane.

Fingertip reconstruction with a palmar advancement flap and free dermal graft: A report of six cases

The palmar thumb advancement flap was first described by Moberg in 1964. It was further utilized for the thumb and defined by Posner and Smith in 1971. In 1980, Macht and Watson favorably reported their technique of palmar advancement that was applicable not only for the thumb, but also for all five digits with soft tissue tip losses. A further refinement of their technique is to augment the digital tip with an autogenous dermal graft. This dermal "padding" is placed directly over the bony tuft to act as a "shock absorber," add bulk and contour to the distal tip of the finger, increase soft tissue stability, eliminate direct percussive tenderness of the bone, and decrease disability for specific occupations such as those requiring typewriting. Six cases are reported.

Dermal grafts to bony defects in irradiated and nonirradiated tissues.

Coverage of intraoral ablative defects presents many different problems. Free dermal grafts have been used to cover exposed mandibular bone in dogs. Grafts were placed in animals both before and after irradiation. Grafts were uniformly successful in animals not previously irradiated but failed when placed after irradiation.

Dermal Graft Correction of Extraordinary Chordee

Severe degrees of primary chordee and persistent or recurrent chordee following previous surgical attempts at correction present a challenging problem. Inadequate resection of involved tissues, which may involve all layers of the penile investiture, or recurrent scarring of the ventral skin, Buck’s fascia and tunica albuginea is usually the cause. Reoperation to achieve penile straightening often is unsuccessful unless all chordee-bearing tissue is resected extensively. Excision of large segments of tunica albuginea or wide separation of the margins creates a defect that tends to heal by dense scarring unless the defect is bridged by a graft. Various autogenous materials have been used, including blood vessel, fascia, free fat graft, dermis and tunica albuginea, as well as prosthestic materials, such as polytetrafluoroethylene, with varying results. A series of patients with extensive chordee is presented in whom tunical resection was necessary to achieve penile straightening. The results of free dermal graft replacement of the tunica are reported.

Treatment of extensive incisional herniae (laparocele) by means of disepithelialised pedicle flaps

The authors propose a technique using disepithelialised pedicle flaps, rotated through 180° round their own axes, for the treatment of extensive incisional herniae. They discuss the merits of this technique over free dermal grafts, pointing out the advantages and presenting some cases which are thought to be particularly demonstrative.

Einseitige, totale Hypopharynxrekonstruktion nach Laryngopharyngektomie

The author reports upon his own experience with a one stage, total reconstruction following total laryngopharyngectomy first described by Lore, Jr. (1973). For the rebuilding of the anterior and lateral walls of hypopharynx a posterior tongue flap after Sisson (1956) and Hiranandani (1967) is used. The reconstruction of the posterior wall of hypopharynx is done using a free dermal graft from the tigh. This method seems to have certain merits: A radical procedure is possible; one stage operation; a good functional result concerning deglutition after a short time, which in the own two cases was not essentially injured after x-ray treatment with a full tumordosis.