Nose resurfacing with free fasciocutaneous flaps in burns patients

Yen, Cheng-I; Yang, Jui-Yung; Chang, Chun‐Shin; Huang, Jung‐Ju; Wu, Chia‐Chen; Chen, Hung-Chang; Yang, Shih-Yi; Chang, Shu-Yin; Chuang, Shiow-Shuh; Hsiao, Yen-Chang

doi:10.1002/micr.30305

Cited by 9 publications

(12 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Introductionmentioning

confidence: 99%

“…The reconstruction of total or near-total nasal defects is challenging and requires the recreation of three nasal layers, including the nasal lining, cartilaginous framework, and external skin covering (Burget & Walton, 2007;Correa et al, 2013;Hsiao et al, 2016Hsiao et al, , 2017Menick, 2002;Menick, 2009Menick, , 2010Menick & Salibian, 2011;Moolenburgh et al, 2010;Ribuffo et al, 2012;Seth et al, 2013;Yen et al, 2018). Fasciocutaneous free flaps have been effectively used to restore the vascularized nasal lining when local flaps cannot provide adequate coverage (Burget & Walton, 2007;Hsiao et al, 2016;Menick, 2010;Menick & Salibian, 2011;Seth et al, 2013;Yen et al, 2018). There are many options for nasal lining reconstruction, including the radial forearm free flap which is the most frequently used, and other flaps includes the ulnar forearm flap, the temporoparietal flap, the dorsal metacarpal flap, the dorsalis pedis, the preauricular skin flap, and the traditional or super-thin anterolateral thigh flap (Ramji et al, 2019;Swartz, 1988).…”

Section: Introductionmentioning

confidence: 99%

“…In general, major nasal reconstruction requires a preliminary stage in which the nasal lining is restored with free tissue transfer to provide a vascularized platform for further graft nourishment and survival (Burget & Walton, 2007; Hsiao et al, 2016; Menick, 2010; Menick & Salibian, 2011; Seth et al, 2013; Yen et al, 2018). No matter which free flap was utilized, the raw surface is often covered with skin grafts or artificial dressing materials to prevent pedicle exposure.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Simultaneous free flap and forehead flap for nasal reconstruction

et al. 2023

Self Cite

View full text Add to dashboard Cite

Background Reconstruction of total or near‐total nasal defects is challenging and requires the re‐creation of three nasal layers. Fasciocutaneous free flaps have been used effectively for restoring the vascularized nasal lining and staged forehead flap for nasal skin replacement, which is a long process. The aim of this study is to share our experience of combination of preliminary free tissue transfer with paramedian forehead flap reconstruction in the same stage of complex nasal reconstruction. Methods From December 2015 to July 2021, 10 patients underwent nasal reconstruction with free flaps including 4 medial sural artery perforator (MSAP) flaps, 5 anterolateral thigh (ALT) flaps and 1 radial forearm flap for lining and forehead flaps for skin coverage simultaneously for total or subtotal nasal defects. Nasal obstruction symptoms evaluation (NOSE) score was utilized to evaluate the functional outcome and the aesthetic results were evaluated with the last follow‐up photos with score 1–5 by 5 plastic surgeon and 5 laypersons. Results The size of the free flaps ranged from 3 cm x 6 cm to 6 cm x 13 cm. After excluding one patient who expired before forehead flap division due to comorbidities, the average duration between combination surgery and the division of the forehead flap pedicle of the remaining patients was 5.7 months (range, 2–12). For patients without any postoperative events, the duration was 2.2 months (range, 2–3). One free flap had partial necrosis due to infection. The average follow‐up duration was 29.6 months (range, 12–64). The NOSE score was 5.9 (range, 0–10) and the aesthetic score is 4.1 (range, 3–5) in average. Conclusions The combination of preliminary free tissue transfer for nasal lining restoration with a paramedian forehead flap for nasal skin replacement in the same stage may shorten the long process and achieve satisfactory reconstruction in complex nasal reconstruction.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Simultaneous free flap and forehead flap for nasal reconstruction

et al. 2023

Self Cite

View full text Add to dashboard Cite

show abstract

“…2 The forehead flap is widely used for nasal reconstruction because it provides the best color and texture match with relatively inconspicuous scars located at the forehead instead of the central face. [1][2][3][4][5][6][7][8] The robust nature of the forehead flap has proven to be a workhorse for major nasal resurfacing. 3,4 The nasal subunit principle, as Burget and Menick suggested in 1985, is a well-accepted technique for achieving optimal cosmetic results in nasal reconstruction.…”

mentioning

confidence: 99%

Upper Margin of the Forehead Flap and Its Correlation With Aesthetic Results in Nasal Reconstruction in Fitzpatrick Skin Type III and IV Chinese

et al. 2021

Self Cite

View full text Add to dashboard Cite

BACKGROUNDThe forehead flap is one of the most commonly used methods for nose reconstruction. OBJECTIVE To determine the ideal upper margin of the flap in nasal reconstruction and its correlation with aesthetic results. METHODS From April 2013 to September 2017, 40 patients underwent nasal reconstruction involving the dorsum with a forehead flap. The authors hypothesized 5fdifferent levels as the position to place the upper margin of the forehead flap: (1) glabella, (2) level of the upper eyelid, (3) intercanthal line, (4) horizontal line between the keystone and intercanthal line, and (5) the keystone. Then they photoshopped the upper margins of the forehead flap at 5 different levels and designed a questionnaire. Nasal reconstructive plastic surgeons, medical practitioners, and people without medical backgrounds chose the most aesthetically pleasing photograph for every patient. RESULTS The questionnaire showed that the most aesthetically pleasing positions were located at glabella (n 5 0), level of upper eyelid (n 5 9), intercanthal line (n 5 24), the line between keystone and intercanthal line (n 5 6), and keystone (n 5 1). CONCLUSION The authors suggest placing the upper margin of the forehead flap at the level of the intercanthal line in nasal reconstruction involving the dorsum to achieve the best aesthetic results.

show abstract

“…Restoring the nasal lining or columella is a great challenge in the reconstruction of nasal defects. Options for nasal lining reconstruction include skin grafting, mucosal grafting, perinasal local flap, turn-over flap, folded forehead flap, or finally free flap surgery 1,2 . However, for people who have undergone multiple nasal surgeries, the perinasal tissue is usually limited, and the wound bed over the lining or columella is often chronically inflamed, friable, and not healthy enough for either skin grafting or composite grafting 3 .…”

mentioning

confidence: 99%

The Upper Buccal Musculomucosal Flap for Nasal Lining and Columellar Defect Reconstruction

Yen

Chang²,

Chen³

et al. 2020

Journal of Craniofacial Surgery

Self Cite

View full text Add to dashboard Cite

Restoring the nasal lining is a great challenge in the reconstruction of nasal defects. In this series, the authors present our experience in using the upper buccal musculomucosal (UBMM) flap for the reconstruction of full thickness columellar or nasal lining defects. Ten patients who underwent UBMM flap reconstruction of columellar or nasal lining defects, with or without composite grafting, were identified between December of 2014 and February of 2017. The records were retrospectively reviewed to determine the demographics, nasal deformity etiology, surgical technique, complications, flap survival rate and duration of follow-up. Of these ten patients, three were men, and seven were women; the average age was 48.1 years (range, 34-66 years). Four patients underwent bilateral UBMM flaps, and 6 patients underwent unilateral UBMM flap reconstruction. All of the donor sites were closed without complications, except for one small granuloma that occurred 8 months later. Of the total 14 flaps, 7 healed well, 6 healed well after minimal debridement in the clinic, and one failed and was replaced with a contralateral UBMM flap. The average follow-up time was 20.1 months (range, 8-38 months). All patients had satisfactory aesthetic and functional outcomes. Due to the limited availability of healthy local tissue for nasal lining reconstruction after multiple surgeries, the UBMM flap serves as an applicable choice to restore columellar or nasal lining defects, with minimal donor site morbidity and no visible external scarring.

show abstract

Nose resurfacing with free fasciocutaneous flaps in burns patients

Abstract: Free flap is an applicable alternative to restore nasal skin envelope, with rebuilding the nasal framework performed in the same stage after severe facial burn injury. Through thoughtful planning and sufficient refinement, satisfactory aesthetic, and functional results are achievable.

Cited by 9 publications

References 26 publications

Simultaneous free flap and forehead flap for nasal reconstruction

Simultaneous free flap and forehead flap for nasal reconstruction

Upper Margin of the Forehead Flap and Its Correlation With Aesthetic Results in Nasal Reconstruction in Fitzpatrick Skin Type III and IV Chinese

The Upper Buccal Musculomucosal Flap for Nasal Lining and Columellar Defect Reconstruction

Contact Info

Product

Resources

About