Use Of Skin Flaps Research Articles

A re-look at pollicization

One of the most difficult and intricate surgeries in the field of hand surgery is that of Pollicization. It involves transfer of one of the fingers to create a new functioning thumb when it is absent. This elegant surgical technique has evolved over the 100 years from a simple, though unaesthetic transposition of digits to a complex procedure which demands an intelligent use of skin flaps, osteotomy and muscle balancing to create an almost normal looking aesthetic thumb. We present a review of this procedure briefly touching on its historical development, indications, and refinements in the critical steps of the technique, long term results and complications.Pollicization continues to be one of the most useful surgeries in improving the function of the hand and has stood the test of time.

Effect of Eletroacupuncture on DU-14 (Dazhui), DU-2 (Yaoshu), and Liv-13 (Zhangmen) on the Survival of Wistar Ratsʼ Dorsal Skin Flaps

The survival of skin flaps has great interest in many areas of Medicine. In practice, one of the most important complications in the use of skin flaps is the tissue ischemia, which frequently results in widespread necrosis and failure of the proposed treatments. The objective of this study was to evaluate the possible benefits of eletroacupuncture stimulation of the points DU-14 (Dazhui), DU-2 (Yaoshu), and Liv-13 (Zhangmen) over the skin flap survival of Wistar rats after 8 days of treatment. Forty male Wistar rats were allocated into four groups with 10 animals each. They were submitted to a surgical procedure in which a dorsal skin flap measuring 10 x 4 cm was elevated and then sutured back with a plastic barrier between the flap and the donor site. During the following 8 days, one group received electro stimulation in two "nonaccupoints" whereas the other one had the accupoints DU-14 (Dazhui), DU-2 (Yaoshu), and Liv-13 (Zhangmen) stimulated. After this period, the rats were killed and flaps were appraised qualitative and quantitatively. Data were evaluated with analysis of variance and to establish significance Fisher's PLSD test was used when analysis of variance showed P < .05. It was observed that electroacupuncture group presented a skin flap survival index remarkably larger than the others. It has also shown a better evolution during the 8 days PO, confirmed by the lowest rate of necrosis and absent area. In this experimental model, eletroacupuncture was an efficient method to preserve vitality and decrease dorsal skin flap necrosis on Wistar rats.

Relation between the area affected by Fournier's gangrene and the type of reconstructive surgery used: a study with 80 patients

To assess the affected skin area and the reconstructive techniques used in 80 patients affected by Fournier's gangrene. Eighty patients ranging in age from 19 to 85 years (mean = 51) affected by Fournier's gangrene were studied. When admitted to the emergency room the patients were submitted to clinical and laboratory examinations to analyze the gravity of the case. All patients were submitted to an extensive debridement of the lesion, urinary derivation by cystostomy and colostomy whenever necessary. Only 13 patients (16.25%) died. From the 67 remaining patients, in 44 (65.6%) debridement was restricted to the scrotum, in 10 (14.9%) there has been scrotum and penile lesions and in 13 (19.3%) there has been a debridement of the scrotum and the perineal region. In 11 cases (16.4%) there was no need for reconstructive surgery with wound closing by second intention, in 16 cases (23.8%) reconstructive surgery was performed with mobilization of local skin, in 19 (28.3%) we have used skin grafts, 20 patients (29.8%) needed reconstructive surgery with the use of skin flaps and in 1 case (1.4%) there has been the use of skin flaps and grafts simultaneously. Fournier's gangrene is a serious pathology and should be treated aggressively with an extensive debridement of the area with necrosis. The use of precocious reconstructive surgery of the genitals present good results and tends to greatly reduce the length of hospital stay and improve the psychological conditions of these patients.

The Use of Skin Flaps and Grafts for Wound Management in Raptors

Managing large open wounds in birds is challenging because of the limited amount of skin and the difficulties associated with bandaging. New techniques involving the use of skin flaps, autografts, and extracellular matrix grafts are emerging to the forefront of wound management as viable options in avian patients. Understanding the anatomy of the avian integument is important when considering the use of one of these forms of reconstruction as a wound management technique in birds. Here we review the use of skin grafts and flaps in avian patients in relation to the anatomy of the avian integumentary.

Basic Skin Flaps for the General Surgeon

Teaching residents the design and creation of skin flaps is challenging because the use of skin flaps is not common enough during the course of a typical residency to provide a broad experience base. A 12 x 12-inch board with a 1/8-inch foam rubber covering was designed to provide for the creation of four flaps and one Z-plasty. A lecture and practical exercise were used to teach basic techniques. Performance was measured by preexamination and postexamination, as well as by a resident satisfaction survey. Mean scores improved by 45%. The resident survey revealed an average subjective rating was 4.7 on a scale of 1 to 5. All residents rated this format superior to traditional lecture instruction. Total cost to provide laboratory experience for 16 residents was $50. Materials can be recovered and reused at a cost of $0.40 each. The materials developed provided an effective, inexpensive nonbiologic model for teaching preoperative skills.

The use of transpositional skin flaps in closing plantar defects: A case report

Large defects on the plantar aspect of the foot can be too extensive to permit primary repair by suturing alone. Such defects can be closed through the use of skin flaps. The authors present an overview of skin flaps and suggest a transpositional skin flap as one type of reconstructive treatment for this problem.

Necrotising fasciitis Use of skin flaps needs experience

EDITOR, — H Cox and colleagues seem to misunderstand the circulation of the skin.1 The primary problem in necrotising fasciitis relates not just to the underlying fascia but also to the subcutaneous tissues. Any plastic surgeon will have seen cases in which the underlying subcutaneous tissues become necrotic. When this dead tissue is excised the skin above becomes necrotic because the feeding blood supply based on the fasciocutaneous perforated system has been removed. If excision of …

Recent Modifications in the Treatment of lnvasive Squamous Cell Carcinoma of the Vulva

The curative potential of therapy should not be sacrificed. However, an effort must be made to determine methods that will reduce the morbidity while at least retaining the curative potential. Modifications which potentially may reduce the morbidity of regional nodal management include deletion of the inguinal lymphadenectomy or use of superficial inguinal lymphadenectomy in selected early lesions, the use of separate groin incisions, the selected use of unilateral inguinal lymphadenectomy, and the use of primary radiation therapy to the inguinal and/or pelvic nodal areas. Modifications which potentially may reduce the morbidity of the primary tumor management include wide local excision for superficial lesions, modified radical vulvectomy for regionalized lesions, the use of skin flaps in selected cases, the development of more sophisticated plastic surgical procedures for the management of posterior lesions, and the use of combined treatment modalities in the management of locally advanced disease.

Comparison between the Early Use of Skin Flap and Skin Graft for the Correction of Large Tissue Loss at the Elbow

Six patients with soft and hard tissue injuries of the elbow region during the 1973 Yom-Kippur war are discussed. These six patients were treated with two types of procedures. One group was initially treated with application of a split-thickness skin graft followed by a thoracoabdominal, abdominal, or chest skin flap. The second group was initially treated with the application of a thoracoabdominal flap. There are few descriptions in the literature or in textbooks of the plan design method, nor are there comparisons of two types of procedures. In both groups the end results were the same. The differences were the time of hospitalization and the cooperation of the patients during treatment. In both groups the flap was transferred before further surgical reconstruction of bones and joints.

Some factors involved in the skin flap delay phenomenon.

The use of skin flaps for reconstruction following extensive ablative surgery in the head and neck area has played a major role on the improvement of the results being attained. Using the pig as an experimental animal various factors of flap orientation, skin incisions and flap undermining were investigated. Results confirmed the ineffectiveness of incision alone as a delay maneurver and suggested that anatomical orientation of cutaneous skin flaps was not of crucial significance. The complete mechanism of the positive effects of delay remains undefined.

Use of skin flaps in dermatologic surgery of the face.

Different flap techniques for plastic repair of defects are described, namely, local flaps (advancement, transposition and rotation flaps) and regional flaps. Such use of skin of similar structure and pigmentation gives excellent cosmetic results. The indications for using local or regional flaps depends on size and location of the defect. Total extirpation of cutaneous malignancy particularly by microscopically monitored serial excision is a prerequisite to reconstruction.

The use of skin flaps in hand injuries

The use of skin flaps in hand injuries

Haemorrhoidectomy: low ligation and the use of skin-flaps.

Journal Article Haemorrhoidectomy: Low ligation and the use of skin-flaps Get access R E B Tagart R E B Tagart Surgeon Newmarket and West Suffolk General Hospitals Search for other works by this author on: Oxford Academic Google Scholar British Journal of Surgery, Volume 53, Issue 1, January 1966, Pages 53–56, https://doi.org/10.1002/bjs.1800530113 Published: 08 December 2005

The preservation of tendon function by the use of skin flaps

It is evident that tendons can be saved by the use of flaps even after they have begun to slough. Skin grafts will not take over exposed tendons and should not be attempted. In cases where the skin has been injured by pressure, the chances of survival are so remote that valuable time will be saved if no attempt is made to preserve it. The surgeon must select the type of flap which can be easily used in a given case. In Case I an immediate transfer was possible because a gauntlet flap could be used. In Case II, the flap was delayed because a single pedicle flap was desirable and this type could not be used immediately under the given conditions. In Cases III and IV, a tubed flap was used to avoid exposed granulations and because it insured the best take in the most comfortable position. Flaps from the back are not desirable because of the thickness of the skin and the uncomfortable position into which a patient with a hand injury would have to be placed. Three cases are presented in which the function of the hands was saved to a degree sufficient to justify the time and trouble required. In an industrial age in which competition is so great, these patients were re-established sufficiently to permit them to return to employment of some form and to keep them off of the long list of unemployed.

Congenital absence of the vagina and its treatment

Congenital absence of the vagina is a rare condition, but is common enough to warrant serious consideration.Handling of cases from the psychologic standpoint is important, and operation should never be urged.Operation should not be advised until marriage is contemplated unless hematometra develops as the result of retained menses in a more or less normal uterus. If patients insist, operative correction is justifiable at any time.Two types of operation, the use of skin flaps or sections of the bowel may be employed. I believe that a section of small bowel used as advised by Baldwin gives the best functional results, and although a more dangerous operation, it is relatively safe when properly done. It is, moreover, justifiable.A dilator should be used until healing is satisfactory.