Reading Man Research Articles

Repair of Radiation Ulcers After Breast Cancer Surgery With Simple Local Random Flaps.

Radiation ulcers that develop after breast cancer surgery are mainly repaired with pedicled flaps or free flaps rather than local random flaps or skin grafts due to large skin defects and poor wound healing. Complicated surgical techniques and donor site reconstruction increase the risk of failure. We report our experience of using the local random long neck reading man flap (LNRMF) to cover large chest wall radiation ulcers, achieving good outcomes. Eight patients who developed chest radiation ulcers after breast cancer surgery and were treated between January 2024 and June 2024 were included. The duration of the wounds ranged from 8 to 35 days. Necrotic and ischemic tissues were completely surgically removed, and subsequent wounds were repaired with LNRMFs. The wounds ranged from 6 cm × 8 cm to 15 cm × 16 cm in size. Visual analog scale scores were recorded during therapy. Eight patients healed well after the first stage. The sutures were removed 10-17 days (average, 12.63 days) after surgery, and no infections, necrosis, or necrotic skin flaps were observed. The average Visual analog scale score was 2.5. The follow-up period was 2-6 months (mean, 4.7 months). Slight linear scarring was observed, and no limitations in shoulder elevation were observed in seven patients; however, 1 patient had slightly limited shoulder elevation. The average SCAR scale score was 3.88, and all sensation scores (according to the Medical Research Council scale) were S3+. LNRMFs are easily created and effectively repair secondary wounds that develop after the resection of radiation ulcers that develop after breast cancer surgery and large skin defects. These flaps can be widely used and should be promoted at the grassroots level.

Reading man flap in four dogs: a case series

BackgroundThe reading man flap is a novel technique in human medicine for the closure of cutaneous circular defects. To the best of our knowledge, no recent clinical studies have described this procedure in small animals.Case presentationIn this case series, we present four dogs in which neoplasms were reconstructed using the reading man procedure, which is a double-advancement transposition subdermal flap. The reading man flap was applied in wound revision after surgical removal of a neoplasm in two dogs and in the closure following the excision of a neoplasm in another two dogs. Successful tension-free closure of the lesion site was achieved in all four patients. The postoperative period was uneventful in all patients, and there was no flap necrosis or surgical site infection, although surgical site infection preceded in two cases. Minor complications included partial suture dehiscence in one dog and seroma formation in two dogs. Only one dog required a second anesthesia to insert an active drainage system. The follow-up examination of all four dogs revealed no further complications with the reading man flap at time of the latest wound reevaluation conducted by the surgeon.ConclusionThe reading man flap is a well-vascularized fasciocutaneous flap that provides tension-free closure owing to its asymmetrical Z-plasty. It is a simple-to-use option for the closure of circular skin lesions in dogs.

44031 The Reading man flap as an option for reconstruction in areas subject to flexo-extension movements

44031 The Reading man flap as an option for reconstruction in areas subject to flexo-extension movements

The Reading Man in the Mirror of 21st Century Socio-Humanitarian Knowledge

The far reaching changes in reading practices associated with the explosive spread of screen culture have become a challenge both for specialists faced with the outflow of readers from libraries and the decline of in print circulation, and for researchers who need to conceptualize these changes from a theoretical perspective. The aim of the article is to identify possible points of growth for interdisciplinary research into the phenomenon of reading.The presentations at the 4th International Scholarly and Practice Conference “Homo legens in the past and present”, held on 23—25 March 2023 in Novosibirsk and Nizhny Tagil in inperson and remote formats, are reviewed. The event was attended by scholars representing various academic disciplines (cultural history, book studies, sociology, philology, library science, art studies, pedagogy, psychology) and specialists engaged in serving readers and popularizing reading.The method of thematic analysis allowed to identify five trends in studying of reading and reading practices: 1) the use of theoretical approaches inherent in various socio-humanitarian disciplines, which are applicable to the understanding of reading activity; 2) the study of historical aspects of reading; 3) studies formed by representatives of contemporary socio-humanitarian knowledge, who study the phenomenon of reading with the orientation on the use their findings in professional practices; 4) transformations produced by librarians and educators who implement various socio-cultural projects to promote reading; 5) the development of science at the intersection of art studies, literary studies, cultural studies and museum practices. Since the reading is the most important practice that provides the mass audience with socially meaningful information, the authors believe that the scholarly forum, which brought together specialists related to the study of the Reading Man, should serve not only to demonstrate the already achieved scholarly and practice-based results, but also to form the prospects for further research on reading as a complex interdisciplinary phenomenon.This review may be helpful both to scholars and practitioners to working in the field of book and library science to engage readers.

Long-necked reading man flap for distal dorsal finger defect reconstruction

Long-necked reading man flap for distal dorsal finger defect reconstruction

Comparison of reading man flap and skin grafting for closure of resultant donor defects in homodigital reverse flow flaps

The reading man procedure is a valuable treatment option for circular defects of different parts of the body. The aim of this study was to compare reading man procedure and skin grafting for coverage of resultant donor defects in homodigital reverse flow flaps. From January 2018 to October 2020, 38 patients underwent fingertip reconstruction using homodigital reverse flow flaps. The donor sites were resurfaced with full-thickness skin grafts in 20 patients and with reading man flaps in 18 patients. Flap survival, postoperative complications, operative time for closure of donor site, return work time, range of motion of the injured fingers, static two-point discrimination, and aesthetic results were evaluated. All the outcomes, including flap survival, postoperative complications, operative time for closure of donor site, return work time, range of motion of the injured fingers, static two-point discrimination, and aesthetic results, were similar between the two groups. No patients complained of cold intolerance or hypersensitivity. The reading man flap is useful and reliable for covering resultant donor defects in homodigital reverse flow flaps. The functional and aesthetic outcomes in both groups are similar.

Reading Man Flap: A Nasal Reconstruction Technique.

Closure of the nasal skin defects that resulted from excision of the skin neoplasms represents a challenging problem in reconstructive surgery. Here, the use of the reading man procedure as a new alternative in reconstruction of the skin defects of the nose is presented. In this procedure, 2 local flaps designed in an unequal Z-plasty manner are used. Defect coverage is achieved by transposing the first flap to the defect area, whereas the second flap is used for closure of the first flap's donor site. In last 10 years, this technique has been used for closure of the nasal skin defects that resulted from removal of skin cancers in 28 patients (15 men and 13 women) aged from 45 to 98 years. The defects were ranging between 1.5 and 3.1 cm in diameter. In all patients, a tension-free 1-stage closure was obtained. There was no patient with dog ear formation and/or distortion of the mobile anatomical structures, such as nasal tip, alar lobules, and nostrils. All patients healed without complications. A mean follow-up of 52 months (8 months to 6.5 years) revealed satisfactory cosmetic results in all patients. No tumor recurrence was observed. Using the advantage of extra tissue relaxation provided by an unequal Z-plasty, the reading man procedure seems to be a useful alternative for the closure of nasal defects with alike local skin. As a critical achievement, this procedure does not require excision of additional healthy tissue. Borrowing tissue from multiple directions, it avoids dog ear formation and distortion of the mobile anatomic structures.

Reading Man Flap for Sacral Pressure Ulcer Reconstruction

Background: The treatment of pressure sores represents a great challenge to health care professionals.Although, pressure ulcers management requires a multidisciplinary approach, the soft tissue defects requiringreconstruction are mainly considered for surgical repair. Local myocutaneous and fasciocutaneous flaps canprovide stable coverage of pressure sores.Aim of Study: To evaluate the versatility and outcomes of “reading man flap” in the reconstruction of sacralpressure sores.Patients and Method: Between April 2015 to January 2017, ten patients with sacral pressure sore weretreated by using Reading man flap. The patient’s ages were ranging between 35-65 years (mean 53), 6 ofthem were males, and 4 were females. All of them were subjected to local wound care and managementwithout considerable benefit. We exclude those patients with poor medical status and patients with severecontracture and spasticity. The diameter of the sacral pressure sores ranging from 4cm to 7cm (mean 5.5cm).Results: The “reading man flap” technique was seen to be a useful, versatile and simple flap for coverageof pressure sores, with no postoperative complications in 8 of our patients during the follow up period. Theother 2 patients, one of them developed partial flap necrosis (treated conservatively), and the other onedeveloped recurrence after 2 months.Conclusion: The “reading man flap” was found to be a versatile and easily performed technique for closureof small to medium sized sacral pressure sores.

Our Clinical Algorithmic Approach for Meningomyelocele Defects Reconstruction with Fasciocutaneous Flaps.

To evaluate fasciocutaneous flaps used for reconstruction of meningomyelocele defects in our clinic and to suggest an algorithm for flap selection. A retrospective analysis of 45 patients with meningomyelocele, who underwent repair with fasciocutaneous flaps, was carried out. Preoperative and postoperative photos were analyzed. The defect areas were measured by Adobe Photoshop CC. Limberg flap, bilateral Limberg flaps, bilateral bipedicled advancement flaps, bilobed flap and reading man flap were performed. Wound dehiscence and partial necrosis occurred in 8 patients. All wounds were managed conservatively and healed successfully. No other complications were observed. The mean defect size for all patients was 36 cm². The mean defect size was 45.3 cm² in bilateral bipedicled flaps cases; 33.5 cm² in bilateral Limberg flaps cases; and 19.6 cm² in the unilateral Limberg flap cases. According to the algorithm, a unilateral Limberg flap or bilobed flap or reading man flap can be used for the defects smaller than 25 cm²; bilateral Limberg flaps can be used for the defects between 25 and 35 cm²; and bilateral bipedicled advancement flaps can be used for the defects larger than 35 cm². Fasciocutaneous flaps can be preferred in meningomyelocele defect reconstruction due to the easy planning of flaps, easy and fast flap elevation, and low complication rates due to their reliable circulation. The measurement of the defect area allows this algorithm selecting a flap in a more practical way.

Clinical application of Reading man flap for repair of the wound of donor site at the dorsum of the finger

Objective To introduce the surgical technique and clinical efficacy of Reading man flap for repair of the wound of donor site at the dorsum of the finger. Methods From February 2016 to August 2018, 9 cases (9 fingers) of fingertip defects were treated with reverse dorsal digital island flap of the same finger. The donor site of dorsal digital flaps was repaired with Reading man flap. After repair of fingertip defects, the defect area of dorsal digital donor site ranged from 2.0 cm×1.3 cm to 2.5 cm×1.6 cm. Results All the flaps survived uneventfully. The average hospitalization time was 10 days. The follow-up time was 3 to 9 months. The texture, color, plumpness and elasticity of the dorsal digital donor site were good. No tendon adhesion, interphalangeal joint and metacarpophalangeal joint stiffness occurred. All the patients were satisfied with the appearance and function of the injured fingers. Conclusion The repair of the dorsal digital donor site with Reading man flap takes into account both appearance and durability, which is beneficial to the early rehabilitation of injured finger and less damage to donor site. The method of operation is safe and simple. It is an improvement on the repair of the donor site of the reverse dorsal digital island flap of the same finger. Key words: Finger injuries; Surgical flaps; Reading man flap; Flap donor site

Reading man flap for repair of soft tissue defects in distal fingers

Objective To explore the Reading man flap for the treatment of soft tissue defects in distal fingers. Methods From May, 2014 to June, 2017, Reading man flaps were transferred in the emergency room to repair soft tissue defects in distal fingers in 46 patients. There were 28 cases of finger pulp defects, 6 cases of dorsal defects and 12 cases of finger stump defects with the size of soft tissue defects ranged from 1.0 cm×0.9 cm to 2.2 cm×2.0 cm (average, 1.2 cm×1.3 cm). The volar, dorsal and hybrid flaps were 28, 6 and 12 cases respectively. The average size of the major flap and minor flap were 1.8 cm×1.2 cm and 1.4 cm×0.8 cm, respectively. All donor sites were sutured directly. All patients were followed-up by review in the outpatient department. Results The consumed operative time was 35-48 min, with an average of 37.8 min. Prophylactic antibiotics and wound dressing were conducted postoperatively. The tip of the minor flaps occurred inflammation and small blister in 2 cases and eased by removal of the tip sutures. Traumatic neuralgia occurred in 1 case and self-healed after 3 months. Twenty-six cases were followed-up at least 11 months, which were 16 cases of finger pulp defects, 3 of dorsal defects and 7 of finger stump defects. On an average of 10.5 (9-27) months followed-up, all flaps survived. Except 4 cases with slim hook nail deformity, the remaining flaps were observed with satisfactory texture and appearance, the bulky deformity and scar contracture did not occur. Two points distinguishment on the major and minor flaps were 3.3-6.2 (average, 4.5) mm and 5.5-9.8 (average, 7.1) mm respectively. According to the Trial Standard for Evaluation of Upper Limb Function of Chinese Society of Hand Surgery, it was excellent in 28 cases, good in 11 cases and moderate in 7 cases, with the overall excellent and good rate of 84.8%. Conclusion The Reading man flap is a good option for treatment of the small size soft tissu defect in distal fingers with the advantages of simple procedure, high success rate, good appearance and sensory recovery. Key words: Reading man flap; Surgical flap; Soft tissue defect; Finger; Repair

The “reading man” flap for reconstruction of large periorbital defects

ABSTRACTPurpose: The “reading man” flap (RMF), a double advancement transposition cutaneous flap named for its appearance, has been described in the reconstruction of various circular skin defects, particularly in the malar region. We describe two cases where this flap was used to reconstruct the lower eyelid/periorbital region.Methods: Two oculoplastic patients with lower eyelid basal cell carcinomas underwent Mohs micrographic excision resulting in a large skin defects. In both cases, reconstruction was performed using the RMF.Results: At 6 months, both patients achieved good cosmetic results with no case of secondary eyelid malposition.Conclusion: The RMF is a useful adjunct to the armamentarium of the oculoplastic surgeon for the reconstruction of large periorbital defects.

Clinical application of the improved " reading man" procedure flap

Objective To evaluate the improved reading-man procedure (RMP) flap for closure of circular skin defect. Methods From January 2011 to June 2014, the improved RMP flap has been used for closure of the circular skin defects in 24 patients (14 men and 10 women) aged from 16 to 83 years. In this technique, the length of the central limb of the improved RMP flap was shorter than one of the RMP flap and the limb of the flap 1 was arc line. Then, the circular defect was closed by transposition of two skin flaps designed in an unequal Z-plasty manner. The first flap (hatchet) was transposed to the defect area whereas the second flap (triangle) was used for closure of the first flap’s donor site. The perforator of the flap provided its vascular basis. Results Tension-free defect closure was obtained in all patients and the all flaps survived. A follow-up of 1-6 months revealed an esthetically acceptable scar formation in all patients. No tumor recurrence occurred, and the repaired tissues were well matched with surrounding tissue. The cosmetic results were satisfactory. Conclusions The improved RMP flap seems to be an easy going and useful alternative for the closure of circular skin defects with different sizes and locations. Key words: Z-plasty; Improved RMP flap; Defect

Intraoperative local flap transforming (iLoFT) method; from hachet to reading-man flap

Local flaps are widely used in soft tissue reconstruction because they result in good colour and texture match. They can be quickly placed without donor site morbidity. However, it is not always easy to preoperatively design a feasible procedure, predict the final scar line or image the tension that may occur on and around the flap, especially for inexperienced surgeons. Because the elasticity of the skin varies with anatomical location and among individuals, unpredictable intraoperative design changes are sometimes required. Therefore, a preoperative back-up plan would be helpful. We evaluated the possibilities and advantages of an intraoperative switch from a hatchet flap (HF) to a reading man flap (RMF) procedure. Using a previously reported computer simulation with the finite element method (FEM) analysis, we developed an intraoperative local flap transformation (iLoFT) model.

Reading man flap to repair malar skin defects

Reading man flap to repair malar skin defects

The Use of the “Reading Man” Flap in the Reconstruction of Lumbar and Sacral Defects

The Use of the “Reading Man” Flap in the Reconstruction of Lumbar and Sacral Defects

Reconstruction of large rectangular infraorbital and malar skin defects in elderly patients with a modified "reading man flap" using local tumescent anesthesia.

The classical "reading man flap" is a recently described flap named after its appearance and mainly used for reconstruction of circular malar or infraorbital skin defects. It avoids surgical complications such as lower lid retraction and ectropion but is limited to circular skin defects. Local tumescent anesthesia uses a diluted local anesthetic together with diluted epinephrine to anesthetize large skin areas without the need for general anesthesia. To assess the esthetic outcome, pain control, and complications of a modified "reading man flap" under local tumescent anesthesia in elderly patients with rectangular malar or periorbital skin defects. Two flaps are used to close the surgical defect, the first rectangular flap is transposed to the defect area, then approximately half to two-thirds of the flap's donor site are closed directly as done with transposition flaps, whereas a second smaller triangular flap is advanced for the closure of the last third of the remaining now triangular donor site, where the greatest tension would occur if closed directly. The median age of patients was 83 years (range 64-92 years) of the total 12 patients, 10 (83%) were women, and two were men. The mean defect size was 9.2 cm(2) (5.5-22.1 cm(2) ). The defect closure was possible in all patients, no lasting postoperative complications occurred, and cosmetic results were satisfactory. Twenty to 70 ml of local tumescent anesthesia were used, and a larger volume (≥ 40 ml) was associated with better pain control (P = 0.03). The modified "reading man flap" is a good option for the closure of larger rectangular facial skin defects especially in elderly patients, and the use of at least 40 ml of tumescent solution is suggested to achieve optimal pain control.

The Nuptial Mystery, the Sacrament of Marriage and John Paul II’s Man and Woman He Created Them

Antiphon 18.1 (2014) 69–105 The Nuptial Mystery, the Sacrament of Marriage and John Paul II’s Man and Woman He Created Them David H. Delaney Introduction The pre-papal manuscript Man and Woman He Created Them1 of Blessed John Paul II (to be canonized by Pope Francis on April 27, 2014) is a compelling theological anthropology that opens new pathways for investigating a broad range of theological topics and for showing their unity. One obvious topic is the sacrament of marriage, which, as a sacrament in the service of communion , is simultaneously a theme around which the unity of Catholic teaching can be expounded in an evangelical manner. John Paul II’s intellectual project is variously characterized as one of Lublin Thomism, Trinitarian personalism, Schelerian phenomenology, and Communio theology, among others. All of these capture aspects of his thinking, but I would argue that his intellectual foundation is first grounded in the metaphysics of St. Thomas Aquinas. He situates every other philosophical and theological influence within Thomas’ metaphysical framework. In much the same way that St. Thomas integrated Aristotelian metaphysics into the 13th century Christian patrimony, John Paul II likewise incorporated many new lines of thought into the received tradition, and this is what we encounter in his catecheses on the embodied human person. With Thomist metaphysics as his foundation, he integrates new methods (foremost phenom1 Commonly called the “theology of the body” after he delivered it in the form of 129 Wednesday Audience catecheses from September 1979 to November 1984: John Paul II, Man and Woman He Created Them: A Theology of the Body, trans. Michael Waldstein (Boston: Pauline Books and Media, 2006). 70 David H. Delaney enology as a tool of inquiry) and new insights (e.g., from the various schools of personalism) in order to explicate the truths of the Catholic faith to an age that has seemingly lost its ability to receive them through the classical manner of presenting them. Reading Man and Woman from the above hermeneutical perspective opens one to the profound insights John Paul II unearths. John Paul II wants to help man to rediscover himself, his greatness. He intends to provide an anthropology for a contemporary audience and so he goes to divine revelation to better understand who and what man is. Beginning with the insight that the doctrine of the Trinity reveals a Communio Personarum, a Communion of Three Persons, he considers anew the meaning of man created in the image of God. Returning to the Genesis creation narratives and using the analogia entis, he ponders the revelation that man is created in God’s image as male and female, and what this means for the human person. This becomes his personal approach to the theology of the nuptial mystery that has recently arisen from within the Communio school. But before continuing this line of thought, I should say a few words about the nuptial mystery.2 I. The Nuptial Mystery Tradition The Scottish Dominican Fergus Kerr of the English Dominican Province reluctantly points to nuptial mysticism as the theology that has become dominant in the new millennium, especially in Catholic ecclesiology and theological anthropology.3 The nuptial mystery marks much of John Paul II’s teaching, and we also see it present in his successor. Even if it is not a central theme in his theological work, as the prefect of the Congregation for the 2 It is not possible in this context to do more than provide a broad sketch of this theme. For a more detailed treatment of the nuptial mystery see Angelo Cardinal Scola, The Nuptial Mystery (Grand Rapids MI: Eerdmans, 2005). For a systematic treatment of the Scriptural foundations of the nuptial mystery, see the forthcoming book by Brant Pitre, Jesus the Bridegroom: Seeing Christ and the Cross through Ancient Jewish Eyes (New York: Image Books, 2014). 3 See Fergus Kerr, O.P., Twentieth-Century Catholic Theologians: From Neoscholasticism to Nuptial Mysticism (Malden MA: Blackwell Publishing , 2007) viii, 201. Kerr is clearly not happy about this, pointing out numerous concerns with this state of affairs. 71 The Nuptial Mystery, the Sacrament of Marriage and John Paul II’s Man and Woman He Created Them...

Outcomes of Wound Closure with the Reading Man Flap Technique

In dermatologic surgery, numerous flap types have been described for wound closure after skin cancer surgery. The reading man flap was first published in 2008 for the closure of skin defects of the face, trunk, and extremities. Technically, this flap is based on an asymmetrical Z-plasty. To investigate the feasibility, clinical outcomes, and postoperative complications for wound closure with the reading man flap technique. We treated seven patients (facial and extremity defects) after microscopically controlled surgery using the reading man flap technique. The median defect size was 491.71 mm2. All of the patients were treated under tumescent local anesthesia. A tension-free defect closure was created in all patients. One minor complication, a wound infection on one leg, was observed. The described technique is an easy and safe dermatologic surgery procedure that can be performed under local anesthesia.

Reading Man Flap: Application to Plantar Defects

The plantar surface of the foot has highly specialized, densely adherent, glabrous skin, making functional replacement difficult. Glabrous skin defects should be replaced with similar skin to restore function and aesthetics. An innovative technique, the “reading man flap,” was developed for closure of circular skin defects. At locations such as the face, trunk, thigh, and calf, the “reading man” procedure provides tension-free closure with minimal additional healthy skin excision, and it does not cause “dog ear” formation. The potential exists for replacement of plantar defects with skin of the same quality using this procedure. In the present study, we report on 2 clinical cases in which intermediate-size plantar defects were reconstructed using the reading man flap. This method can provide tissue as durable, yet as sensitive, as skin that matches the unique characteristics of the plantar skin.