Split Flap Research Articles

A Novel Control Allocation Method for Yaw Control of Tailless Aircraft

Tailless aircraft without vertical stabilisers typically use drag effectors in the form of spoilers or split flaps to generate control moments in yaw. This paper introduces a novel control allocation method by which full three-axis control authority can be achieved by the use of conventional lift effectors only, which reduces system complexity and control deflection required to achieve a given yawing moment. The proposed method is based on synthesis of control allocation modes that generate asymmetric profile and lift induced drag whilst maintaining the lift, pitching moment and rolling moment at the trim state. The method uses low order models for aerodynamic behaviour characterisation based on thin aerofoil theory, lifting surface methodology and ESDU datasheets and is applied to trapezoidal wings of varying sweep and taper. Control allocation modes are derived using the zero-sets of surrogate models for the characterised aerodynamic behaviours. Results are presented in the form of control allocations for a range of trimmed sideslip angles up to 10 degrees optimised for either maximum aerodynamic efficiency (minimum drag for a specific yawing moment) or minimum aggregate control deflection (as a surrogate observability metric). Outcomes for the two optimisation objectives are correlated in that minimum deflection solutions are always consistent with efficient ones. A configuration with conventional drag effector is used as a reference baseline. It is shown that, through appropriate allocation of lift based control effectors, a given yawing moment can be produced with up to a factor of eight less aggregate control deflection and up to 30% less overall drag compared to use of a conventional drag effector.

Influences of trailing edge split flap on the aerodynamic performance of vertical axis wind turbine

AbstractTo improve the performance of a 3.5 kW small H‐type vertical axis wind turbine (VAWT) with the airfoil of NACA0015, a design method for installing split flaps at the trailing edge of a blade is proposed. By solving the two‐dimensional URANS equations, the simulation of VAWTs is carried out. The influences of the length (10% c‐30% c), arrangement positions (90% c‐70% c), and deflection angles (10°‐30°) of the split flaps on the performance of VAWT are determined by orthogonal design when Reynolds number is 2 × 105 and 1 < TSR < 3. In accordance with the influence degrees of these parameters and adopting the maximum wind energy utilization ratio CPmax and the maximum efficient operating range Δλmax as research objectives, the optimum flap length is determined as 22% c, the optimum deflection angle is 10°, and the optimum arrangement position is 92% c. Further studies show that the CPmax is increased by 5.8% and its Δλmax is increased by 25.9% after installing split flaps. Meanwhile, split flaps can change the Kutta‐Joukowsky trailing edge boundary condition, which increases the flow circulation around the airfoil. Also, split flaps can increase the positive pressure difference in the upwind area and reduce the negative pressure difference in the downwind area, which significantly improves the aerodynamic performance of VAWTs.

Full versus split thickness flap to increase soft tissue thickness and keratinization of NO‐keratinized mucosa. A 3‐year split mouth randomized clinical trial

Full versus split thickness flap to increase soft tissue thickness and keratinization of NO‐keratinized mucosa. A 3‐year split mouth randomized clinical trial

Immediate Versus Staged Soft Tissue Reconstruction After Soft Tissue Sarcoma Resection Has Similar Wound and Oncologic Outcomes.

The aim of this study was to compare the wound complication rate and oncologic outcome in patients undergoing immediate versus staged soft tissue reconstruction after soft tissue sarcoma (STS) resection. This is a retrospective analysis of a single sarcoma referral center between 2006 and 2016 which identified a cohort that underwent resection of an extremity or trunk STS with reconstruction surgery (split thickness skin graft or flap coverage). Patients were divided into 2 groups based on the reconstruction timing: immediate (same day) versus staged (later date). Demographic characteristics, wound complications, and oncologic outcomes were compared. Of the 491 patients who underwent resection of an extremity or trunk STS, 81 (16%) received reconstructive surgery, with 26 patients undergoing immediate reconstruction and 55 patients undergoing staged reconstruction. Overall wound complication (58% vs 45%, P = 0.347) and infection rates (35% vs 25%, P = 0.602) were similar between immediate and staged groups, respectively. Likewise, local recurrence (8% vs 7%, P = 1.000), metastasis (19% vs 20%, P = 0.755), and all-cause mortality (27% vs 27%, P = 1.000) rates after reconstruction was similar. Patients in the staged group with positive margins after resection were re-excised before definitive reconstruction, whereas those in the immediate group were not. The staged group required fewer surgical intensive care unit stays after resection surgery (22% vs 58%, P = 0.006). The mean ± SD final follow-up was 38 ± 33 months. Wound complication rates and oncologic outcomes remain similar, regardless of timing for reconstruction. Staged reconstructions were associated with fewer surgical intensive care unit stays, while also affording opportunity for reintervention after positive margins with little additional morbidity.

Function-Sparing Free Split Latissimus Dorsi Flap for Lower-Extremity Reconstruction: Five-Year Consecutive Single-Surgeon Series.

The free split latissimus dorsi flap for lower-extremity reconstruction has some advantages over the traditional latissimus dorsi flap. The flap is harvested with the patient in the supine position and is associated with minimal morbidity as the function of the remaining latissimus dorsi muscle is preserved through the posterior division of the thoracodorsal nerve. A consecutive single-surgeon 5-year series of free split latissimus dorsi muscle flaps for lower-extremity reconstruction (n = 42) was evaluated. Donor site morbidity was evaluated through assessment of the strength of the remaining latissimus dorsi at least 1 month after surgery. Shoulder function was evaluated postoperatively using the Disabilities of the Arm, Shoulder and Hand (DASH) score, American Shoulder and Elbow Surgeons (ASES) score, and Shoulder Pain and Disability Index (SPADI). The mean age of the 42 patients was 40.7 years. The mean length and width of the flaps were 17.9 cm and 8.6 cm. The majority (71%) of the wounds were due to acute trauma. Of the 42 flap procedures performed, 95% (40) were successful. Assessment of remaining latissimus dorsi strength at least 1 month postoperatively, during 3 activities, showed a Medical Research Council (MRC) grade of 5 in all patients. The mean and median scores were 6.4 and 0 according to the DASH, 6.0/6.4 and 0/0 on the SPADI pain/disability scales, and 90.7 and 100 on the ASES. The free split latissimus dorsi flap is a large reliable muscle flap with negligible donor site morbidity that is particularly advantageous for lower-extremity resurfacing following trauma. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Immediate unilateral breast reconstruction and contralateral breast augmentation with bilateral free deep inferior epigastric perforator flaps.

A 42-year-old woman was referred for consideration of left-sided mastectomy and immediate reconstruction. She previously had a bilateral breast augmentation using silicone implants. She desired to maintain her breast size and natural appearance. Owing to the availability of sufficient abdominal tissue, the option of an immediate unilateral breast reconstruction and contralateral augmentation with a differentially split deep inferior epigastric perforator flaps was offered to the patient. The patient had a successful reconstructive and contralateral symmetrising procedure with an uneventful postoperative recovery. She was satisfied with her breast size, which was achieved without the use of implants. In selected patients the free deep inferior epigastric perforator flap provides an appropriate option for unilateral breast reconstruction and contralateral breast augmentation. It has numerous advantages including making use of available excess abdominal tissue and avoiding implant related complications.

Combined Horizontal Split Gluteus Maximus Muscle Flap and Fasciocutaneous Limberg Flap for Reconstruction of Recurrent Sacrococcygeal Pilonidal Sinus

disease. The exact etiology of the disease is still unknownbut the most accepted theory is an acquired condition characterizedby infected sinus in the natal cleft area contains lifelesshair tuft. Multiple techniques were prescribed for its treatmenthowever the ideal method still not yet defined.Patients and Methods: Fifty eight male patients whounderwent excision of their recurrent pilonidal sinus diseaseand the resulting defects were reconstructed using combinedhorizontal split gluteus maximus flaps and rhomboid flaps.Outcomes were revised from patient's files case and followedup in outpatient clinic and via questionnaires.Results: The mean hospital stay was three days. The meantime to return to work was 16 days. Partial wound dehiscence'soccurred in two patients. Distal end flap necrosis occurred inone patient. There were no flap losses, no recurrences, noinfections, no loss of function and no seromas during a meanfollow-up period of 24 months. All patients were satisfiedwith the results.Conclusion: In comparison with other techniques, it hasa comparable operative time and hospital stays. It has minimaland acceptable complication rates and no recurrences. We canconclude that this procedure of combined split gluteus maximusmuscle flap and rhomboid flap provides an excellent, effective,easy and feasible method of choice for reconstructing defectsof recurrent pilonidal sinus disease.

Comparison of Split Thickness Skin Grafts and Flaps in Bilateral Chronic Axillary Hidradenitis Suppurativa.

BACKGROUNDHidradenitis suppurativa is a chronic inflammatory disease with multiple inflammatory nodules and abscesses. We aimed to compare split thickness skin graft (STSG) and flaps in bilateral chronic refractory axillary hidradenitis suppurativa. METHODSThirty patients were investigated from March 21, 2010 to March 20, 2015. Debridement of involved skin and subcutaneous fat was done until deep fascia. The second operation was a reconstructive procedure to cover bilateral axillary wounds with STSG in left side and random fasciocutaneous flaps in the right side. RESULTSMean age of patients was 35.2±9.3 years. There were 16 men (53.3%) and 14 women (46.7%). Duration of the disease before trial was 6.5±2.1 years. The association between pain at one-month follow-up for graft or flap sites was not significant. The patients did not have pain at flap and graft sites at three-month, six-month and one-year follow-ups. Twenty-four patients (80.0%) had normal ranges of motion at one-month follow-up. At six-month and one-year follow-ups, all patients had bilateral normal ranges of motion. All patients were satisfied from symmetry of flap and graft sites at six-month and one-year follow-ups. All patients were satisfied from graft and flap donor sites at six-month and one-year follow-ups. At one-month, three-month, six-month and one-year follow-ups, recurrence of hidradenitis suppurativa was not seen.CONCLUSIONBoth STSGs and fasciocutaneous flaps were successful and satisfactory for tissue coverage in patients with axillary hidradenitis suppurativa. We recommend this technique in cases of bilateral axillary hidradenitis suppurativa.

Medial canthal and eyelid reconstruction using the split paramedian forehead flap: a case report.

espanolLos defectos que comprometen el canto interno son dificiles de reconstruir. Esta region tiene importancia funcional y estetica en la armonia facial. El aparato lagrimal drena en el area del canto interno y ambos parpados protegen el ojo de la sequedad y la exposicion, de tal forma que el danar estas estructuras puede tener consecuencias oftalmologicas severas. Ademas, el canto medial es un area con una superficie concava y compleja, dificil de reconstruir de manera satisfactoria. Es importante realizar una buena tecnica de reconstruccion para evitar resultados cosmeticos indeseables. El colgajo frontal se utiliza principalmente en la reconstruccion nasal. Tiene una buena vascularizacion y permite un amplio arco de rotacion. Ademas, se puede remodelar y adelgazar de manera que ofrezca mejores resultados esteticos. Se han descrito diferentes modificaciones en la literatura. El colgajo frontal puede ser una buena opcion para la reconstruccion del area del canto medial dadas las caracteristicas mencionadas previamente. Presentamos el caso de una paciente de 88 anos de edad que presento un defecto del area del canto medial tras la reseccion de un carcinoma escamoso. Se realizo la reconstruccion con un colgajo frontal contralateral. Concluimos que el colgajo frontal puede ser una opcion segura y sencilla como alternativa en la reconstruccion del canto medial. Permite preservar la funcion del parpado y ofrece resultados esteticos aceptables con minima morbilidad de la zona donante. EnglishMedial eyelid/canthal defects are difficult to reconstruct. This region has both functional an cosmetic importance in facial esthetics. The lacrimal apparatus drains in the medial canthal area and both eyelids protect the eye from dryness and exposure, so damage to this organs may have severe ophthalmic consequences. Furthermore, the medial canthal area owns a complex concave surface difficult to replace satisfactorily. Poor reconstruction techniques may have undesirable cosmetic outcomes, which may be easily noticeable. The paramedian forehead flap is a mainly used in nasal reconstruction. It has a reliable vascularity and allows a wide arc of rotation. Plus, trimming and recontouring of the flap may be done to offer the best results. Several modifications of the flap have been purposed in the literature. The paramedian forehead flap may be a good choice for medial canthal/eyelid reconstruction as well, given the characteristics aforementioned. We present a case of an 88 year old woman who presented with a medial eyelid/canthal defect following resection of a squamous cell carcinoma. Reconstruction with a contralateral split paramedian forehead flap was achieved. We conclude that the paramedian forehead flap may represent a safe and simple alternative in medial eyelid/canthal reconstruction, preserving eyelid function and offering acceptable cosmetic results with minor donor site morbidity.

Structural design and experimental verification of a novel split aileron wing

Many unmanned aerial vehicles (UAVs) such as solar powered ones require their top surfaces of the wings to be integral and gap free. To enable rolling movement and improve aerodynamic performance of such UAVs, a novel design scheme of split aileron is proposed that is similar to the concept of split flap. The function of the separated aileron is implemented utilizing an electro-servo system actuated by a brushless direct current motor (BLDCM). The design of three conceptual configurations, including the upper, middle, and bottom positions with deflection angle of 31° and 15° downwards, are studied numerically. Based on the optimal design of the bottom position of the split aileron structure, its aerodynamic characteristics, maneuverability and structural weight are evaluated by comparing with a traditional hinged aileron. The results indicate that the proposed design of the detached aileron can enhance the average aerodynamic efficiency of the wing by 16.3% and reduce the weight by 58.3%. A functional prototype of the split aileron wing airplane is established and manufactured based on the proposed design. The flight test results confirm the applicability of the clam-shell aileron to control the rolling motion of aircraft, which is of high potential for solar-powered fixed-wing UAVs.

A dual padding method for ischial pressure sore reconstruction with an inferior gluteal artery perforator fasciocutaneous flap and a split inferior gluteus maximus muscle flap.

BackgroundVarious surgical management methods have been proposed for ischial sore reconstruction, yet it has the highest recurrence rate of all pressure ulcer types. A novel approach combining the advantages of a perforator-based fasciocutaneous flap and a muscle flap is expected to resolve the disadvantages of previously introduced surgical methods.MethodsFifteen patients with ischial pressure ulcers with chronic osteomyelitis or bursitis, who underwent reconstructive procedures with an inferior gluteal artery perforator (IGAP) fasciocutaneous flap and a split inferior gluteus maximus muscle flap from January 2011 to June 2016, were analyzed retrospectively. The split muscle flap was rotated to obliterate the deep ischial defect, managing the osteomyelitis or bursitis, and the IGAP fasciocutaneous flap was rotated or advanced to cover the superficial layer. The patients’ age, sex, presence of bursitis or osteomyelitis, surgical details, complications, follow-up period, and ischial sore recurrence were reviewed.ResultsAll ischial pressure ulcers were successfully reconstructed without any flap loss. The mean duration of follow-up was 12.9 months (range, 3–35 months). Of 15 patients, one had a recurrent ulcer 10 months postoperatively, which was repaired by re-advancing the previously elevated fasciocutaneous flap.ConclusionsThe dual-flap procedure with an IGAP fasciocutaneous flap and split inferior gluteus maximus muscle flap for ischial pressure ulcer reconstruction is a useful method that combines the useful characteristics of perforator and muscle flaps, providing thick dual padding with sufficient vascularization while minimizing donor morbidity and vascular pedicle injury.

Control device effectiveness studies of a 53∘ swept flying wing configuration. Experimental, computational, and modeling considerations

The present investigation covers studies of different control devices on several 53∘ swept flying wing configurations without a vertical tail plane. The wings considered share the same planform but differ in their spanwise profile shapes. The planform, developed under the NATO AVT-251 Task Group, is referred to as the MULDICON (or MULti-DIsciplinary CONfiguration). The objectives of this article are twofold: (1) to design yaw control surfaces for the MULDICON wing using an experimental/computational approach and (2) to develop aerodynamic models that rapidly and accurately predict the effectiveness of control surfaces over a wide range of flight conditions. The yaw control surface design (position and size) should provide sufficient yaw moment with almost no contribution in roll and pitch moment. To identify such concepts, a number of preliminary experiments on a generic flying wing configuration have been conducted. Two promising concepts from wind tunnel tests were then numerically examined for being implemented in the MULDICON baseline wing. Concepts with spoilers and a split flap were specifically considered. For medium to high angles of attack, the flow topology of the baseline wing is dominated by a vortical flow field on the upper outer wing. This leads to interactions between vortex and the control device which influences the flow and the attitude of the control device on the upper wing side. Furthermore, this work considers developing aerodynamic models for predicting stability derivatives of several MULDICON designs over a wide range of flight conditions. Aerodynamic loads models are only developed for normal force and pitch moment coefficients, however, the developed approach can easily being extended to include lateral aerodynamic coefficients as well. Quasi-steady models of this work are power series expansions of traditional linear aerodynamic models to capture nonlinear effects. Additionally, the models can estimate static and dynamic stability derivatives and the control surface powers.

Outcomes after Split Abdominal Wall Muscle Flap Repair for Large Congenital Diaphragmatic Hernias.

Repair of large congenital diaphragmatic hernias (CDHs) is challenging. As primary repair is not always feasible, patches are commonly used. An alternative treatment is split abdominal wall muscle flap repair, which uses vascularized autologous tissue. The aim of this study was to analyze the long-term outcome of large CDH defects undergoing split abdominal wall muscle repair. This is a retrospective review (2003-2016) of large CDH treated by split abdominal wall muscle flap repair. In a total of 107 CDH patients, the abdominal muscle flap technique was used in 10 (9.3%); 7 had been prenatally treated with tracheal occlusion. Two patients experienced recurrence at 2 months and 6 years, respectively. Only one patient required abdominoplasty due to abdominal wall muscle weakness. Two patients developed progressive scoliosis; one of them required orthopaedic treatment. Minor chest wall deformities were detected in seven, but only one required orthopaedic treatment. The lung-to-head ratio was 0.79 in patients developing musculoskeletal deformities, and 1.5 in those without this complication (p < 0.05). Median follow-up was 11.2 years (3.5-14.2), and all patients were alive at the time of writing this article. The split abdominal wall muscle flap technique is a valid option for repair of large CDH. Associated musculoskeletal deformities seem to be influenced not only by the repair technique used but also by the degree of pulmonary hypoplasia and inherent pathophysiological changes.

A Novel Approach to Monitoring Graft Neovascularization in the Human Gingiva.

Laser speckle contrast imaging (LSCI) is a novel method for measuring superficial blood perfusion over large areas. Since it is non-invasive and avoids direct contact with the measured area, it is suitable for monitoring blood flow changes during wound healing in human patients. Vestibuloplasty is periodontal surgery to the oral vestibule, aiming to restore vestibular depth with simultaneous enlargement of the keratinized gingiva. In this special clinical case, a split thickness flap was elevated at the first upper premolar and a xenogenic collagen matrix was adapted to the resulting recipient bed. LSCI was used to monitor the re- and neovascularization of the graft and the surrounding mucosa for one year. A protocol is introduced for the correct adjustment of microcirculation measurement in the oral mucosa, highlighting difficulties and possible failures. The clinical case study presented demonstrated that - following the appropriate protocol - LSCI is a suitable and reliable method for following up microcirculation in a healing wound in the human oral mucosa and gives useful information on graft integration.

Yaw-control efficiency analysis for a diamond wing configuration with outboard split flaps

The yaw-control device of a low-aspect ratio flying wing with diamond-shaped wing planform is investigated. Extensive low-speed wind tunnel experiments have been carried out to obtain surface pressure data and the aerodynamic forces and moments of the configuration for six different flap deflection angles at varying angles of attack and sideslip. Complementary unsteady Reynolds-averaged Navier–Stokes simulations are performed for selected configurations. The experimental data is used to examine the validity of the numerical results. The analysis is focused on the aerodynamic coefficients and derivatives. Yaw-control effectiveness, yaw-control efficiency, crosswind landing capabilities and coupling effects are discussed. The results show sufficient yaw-control effectiveness and efficiency for a wide range of considered freestream conditions. The outboard flap exhibits a non-linear characteristic with respect to the flap deflection angle and freestream conditions. The efficiency is considerably reduced at high angles of attack due to large-scale flow separation in the wing outboard section. Non-linear coupling effects with the rolling moment become obvious for moderate to large flap deflections over the whole angle of attack polar. The numerical results show good agreement with the experimental data in the surface pressure distributions and longitudinal aerodynamic coefficients. The yawing moment is overpredicted by numerical simulations for large flap deflection angles.

Kinetics of wound process with various methods of stimulation of regeneration in wounds

Urgency. Objective indicators of the dynamics of the wound process are planimetric methods, including the determination of the area of ulcerative defects and the rate of their epithelialization.&#x0D; The aim of the work is to assess the kinetics of the wound process in venous, ischemic and neurotrophic ulcers of the lower extremities using various methods of stimulating regeneration in wounds.&#x0D; Materials and methods. 4 blocks of studies were carried out: in the first block, the healing of venous trophic ulcers up to 20 cm2 was evaluated; in the second - more than 20 cm2; in the third block, the course of the wound process was studied in patients with ischemic trophic ulcers of the lower extremities on; in the fourth - with neurotrophic ulcers of the lower extremities. In each block, patients were divided into 4 groups according to the methods of stimulation of regeneration: combination of platelet-rich donor plasma and collagen preparations was used; interactive bandages; collagen preparations; platelet-rich donor plasma. To assess changes in the area of wounds in time used the exponential function and the parameter τ (the characteristic time of wound healing), allowing a single number to characterize the kinetics of healing and to measure the period of wound healing.&#x0D; Results and their discussion. For venous trophic ulcers up to 20 cm2 complex use of collagen preparations and platelet-rich donor plasma provides the shortest reduction of the wound area in comparison with other considered methods.&#x0D; For venous trophic ulcers of large and giant size (more than 20 cm2), stimulation of regeneration before autodermoplasty with a split skin flap only using collagen-containing preparations (14.4 days) or platelet-rich donor plasma (11.6 days) provided a greater percentage of survival of the autodermograft.&#x0D; The complex use of collagen preparations and platelet-rich donor plasma is most effective among other methods in reducing the area of neurotrophic ulcers, the characteristic time of reducing the wound area is 48.9 days, which is faster than other methods by 1.25 - 2, 93 times.&#x0D; The healing process of ischemic trophic ulcers is more difficult to Express by mathematical formulas. However, among the compared methods, the use of the complex of drugs leads to a statistically faster decrease in the area of wounds - 24.3 days against 31.6, 29.3 and 88 days.&#x0D; Summary. The complex of preparations provides in General the best kinetics of healing of venous, ischemic and neurotrophic ulcers in comparison with the use of modern dressings and separate use of collagen-containing preparations and platelet-rich donor plasma.

PS02.244: PEDICLED FLAPS IN ESOPHAGEAL SURGERY: WHERE THORACIC-, PLASTIC- AND ENT- SURGEONS MEET

Abstract Background Esophageal, esophago-hypopharyngeal and esophago-tracheobronchial fistulae or strictures arising either de novo or following therapeutic interventions constitute serious therapeutic challenges. If conservative measures fail, pedicled muscular or myocutaneous flaps are life-saving assets. Methods During the last 10 years we treated 13 patients (11 males, 2 females; mean age: 59; range: 44–82y) with complex esophageal/hypopharyngeal problems by using pedicled muscle flaps. Results All had but one case of lye ingestion had underlying malignant disease, all but two of the latter had had chemo- and or radiotherapy. At the time of the intervention eight patients were in a critical, septic condition. There were 5 esophago-tracheal, 2 esophago-bifurcational, one esophago-colo-bronchial, and one hypopharyngo-tracheal fistula, as well as one pharyngo-cutaneous fistula all following resection/reconstruction and/or attempts of surgical closure. One patient had stricture following external irradiation, another one anastomotic stricture. We applied a total of 17 pedicled flaps: 10 pectoralis major flaps (7 of them myocutaneous, three split flaps), 5 deltoideo-pectoral myocutaneous flaps and 2 sternocleidomastoideus flaps. In 11 patients additional intermittent stenting was used. In 6 patients the respective condition healed, 4 patients could be discharged but had minor recurrent fistulae that could be handled conservatively, in three cases persisting sepsis and multiorgan failure could not be overcome. Conclusion Muscle flaps can be life-saving in large fistulae of the esophagus and the hypopharynx and are useful for refractory cervical stenosis. In presence of multiorgan dysfunction, however, healing of flaps however initially vital, is often impaired. Disclosure All authors have declared no conflicts of interest.

Lip reconstruction by new split cheek flap.

Lip reconstruction by new split cheek flap.

Does postauricular fascial flap reduce suture complications in otoplasty?

Numerous suture techniques and covering flaps have been described to minimize complications related to sutures in otoplasty. The split postauricular fascial flap is one of such techniques, and it has been used to pad otoplasty suture. The aim of this study was to evaluate complications related to nonabsorbable cartilage sutures in otoplasty, using a variation of the split postauricular fascial flap. In this retrospective case series, we analyzed otoplasty patients in whom simplified split postauricular fascial flap was utilized. A postauricular skin ellipse was de-epithelialized (preserving dermis) and a longitudinally split in half. Flaps were dissected, and they were positioned on the cartilage to promote additional soft tissue coverage to the sutures. The lateral flap covered conchoscaphal sutures while the medial flap covered the conchomastoid sutures. Both the flaps were not sutured to cartilage. Early and late postoperative complications were evaluated. A total of 142 patients were included. Twenty-four (16.9%) patients developed late complications: 13 (9.1%) patients had palpable and visible sutures, nine (6.3%) had suture extrusion and two (1.4%) had hypertrophic scars. In this case series, the simplified split postauricular flap did not prevent or reduce late complications related to suture extrusion in otoplasty. It is possible that suturing the entire length of the flaps may play a role in our results. So, anchoring the flap and possibly tightening it a little may be an important technical step to prevent extrusion of sutures whenever the postauricular flap is used.

Reconstruction of traumatic finger defects with split groin flap

Pedicled groin flap is a treatment option in use for hand defects caused by trauma or other etiologic factors. It gains particular significance in multiple finger defects, especially in those with one intact digital artery or in hand defects that cannot be reconstructed with regional flaps. Although several studies have reported the use of split groin flap in the reconstruction of such defects, no previous study has reported cases where specifically complex volar defects of two adjacent fingers. We present the reconstruction of two adjacent fingers with a split groin flap. A 22-year-old male patient, active smoker, admitted to our clinic for second and third finger volar complex defects in his right hand due to traffic accident. It was contaminated with asphalt tar, and bone and flexor tendons were exposed. After initial debridement, the patient was followed up by outpatient treatment until an appropriate wound surface was obtained. Then, split groin flap was planned. The flap was divided in the 3^rd postoperative week and adapted to the wounds. In the follow-up period, no flap loss occurred, and the patient did not require any flap revision or additional surgery. Split groin flap is a reliable flap option for complex volar finger defects.