Reconstruction Of Full-thickness Defects Research Articles

Radiation-Related Wounds Of The Chest Wall

Irradiation-associated chest wall lesions pose a significant health hazard to the patient. The principles of management include (1) biopsy of any open wounds to rule out the recurrence or persistence of tumor, (2) aggressive debridement of all offending tissues, and (3) reconstruction with well-vascularized flap tissue. Numerous questions arise regarding the practical management of these patients. The controversies that have arisen during our management of more than 100 of these patients have been discussed. It is appropriate to perform reconstruction following nonhealing of a superficial ulcer or immediately following the excision of a full-thickness chest wall defect. Hyperbaric oxygen can serve as a useful adjunct. It is rarely necessary to use a prosthetic material for the purpose of chest wall stabilization during the reconstruction of full-thickness defects. Paradoxic chest wall movement in the postoperative period does not significantly affect pulmonary function tests and is generally a transient problem. Subtotal excisions are frequently necessary. As long as all of the necrotic or tumor-bearing tissue has been fully removed, these wounds can be expected to heal in most instances by placing vascularized tissue into the defect. Operative sites in previously irradiated chest wall tissue can be expected to heal if proper and careful surgical technique is employed. Nevertheless, there is a risk of wound breakdown following any surgery in irradiated tissue. Finally, we believe it is appropriate to proceed with aesthetic recontouring of chest wall deformities associated with irradiation exposure.

Cheek Flaps for Reconstruction of Full-Thickness Lip Defects

Two patients with full-thickness defect of the lip reconstructed by a cheek flap are presented. The cheek flap was split into two flaps preserving subcutaneous vascular networks, one for external skin cover and the other for coverage of the oral lining. With this flap, an adequate intraoral vestibulum and easy denture-fitting could be maintained. Disadvantages of the flap described here are that whiskered men cannot use this flap for coverage of the oral lining, and that this cheek flap cannot be used for the reconstruction of full-thickness defects of the lower lip due to potential postoperative downward tendency, unless a simultaneous sling procedure or sphincter reconstruction is performed.

Buccal mucosal flaps in nasal reconstruction

Buccal mucosal flaps provide a simple and effective method of replacing nasal mucosal lining. This technique has been used in 15 patients requiring reconstruction of full thickness defects of the lateral nasal wall and tip of nose, in combination with a variety of local flaps for skin cover. The buccal mucosal flap is of particular value in reconstructing the common defect of the lower lateral nasal wall and alar rim where more bulky reconstructions often distort the airway.

Tarsal Rotational Flap for Upper Eyelid Reconstruction

Reconstruction of full-thickness defects in the upper eyelid presents a special challenge to the oculoplastic surgeon. We present and discuss a new, surgically simple technique for posterior lamella reconstruction of the upper eyelid, which can also be used with other procedures. The surgical technique calls for a vertical strip of tarsus (tarsal flap) to be rotated horizontally and sutured to canthal tendon remnants or periosteum at the orbital rim. This procedure has produced satisfactory to excellent results in our test group, and presents the reconstructive surgeon with several advantages over other techniques.

Reconstruction of full thickness defects of both eyelids

Reconstruction of full thickness defects of both eyelids

Midline Forehead Flap Rhinoplasty in Patients With Low Hairline

SummaryThe classicel midline forehead flep rhinoplasty is an ideal procedure for reconstruction of full thickness defect of the lower part of the nose. But the surgeon may be handicapped in 2 patient with a low hairline. A modified procedure is described in which the forehead flap is caterpillared to obviate this difficulty.

Reconstruction of full thickness defects of both eyelids

Full thickness defects of the upper eyelids are most often the result of mutilating surgery for cancer. In most cases, immediate reconstruction should be performed in order to insure protection of the cornea. In the past, many techniques have been proposed for the repair of such defects. In this article, the author reviews the most commonly used methods of reconstruction. Using several case examples, he then shows how these techniques can be modified or combined in order to obtain the best functional and cosmetic results even in defects involving the whole of the upper lid and part of the lower eyelid.

Reconstruction of Full Thickness Defects of Nose

Reconstruction of Full Thickness Defects of Nose

Cervical Tube Pedicle Graft in the Reconstruction of Full Thickness Defect of the Lower Lip

Cervical Tube Pedicle Graft in the Reconstruction of Full Thickness Defect of the Lower Lip