Prevention of Necrosis of Adjacent Expanded Flaps by Surgical Delay

Zhu, Heng; Xie, Yun; Xie, Feng; Gu, Bin; Li, Kai; Zan, Tao; Li, Qingfeng

doi:10.1097/sap.0b013e31827fafce

Cited by 9 publications

(7 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Applying this kind of skin flap can exceed the normal ratio ( 11 , 12 ) and evaluate vascular redistribution ( 13 ). Yet, Hainan et al ( 14 ) reported on using prefabricated expanded skin flaps, revealing a significantly lower rate of necrosis after flap rotation surgery. This provided a new approach for preventing the expended flap from necrosis; however, further research on axial pattern skin flaps is still urgently needed.…”

Section: Discussionmentioning

confidence: 99%

Testing the circulation of expanded flaps—prevention of necrosis of expanded flaps (a clinic study)

Han

Chen

et al. 2023

Front. Pediatr.

View full text Add to dashboard Cite

BackgroundExpanded flaps are commonly used in plastic surgery. Although expanded flaps are more resistant to hypoxia than unexpanded flaps, flap necrosis can sometimes occur, particularly with skin incisions of regular proportion. Distal skin necrosis of the expansion flap can be avoided by careful design; however, the utilization rate of the expansion flap decreases. Consequently, successfully avoiding distal skin flap necrosis remains a challenge. In this study, we designed a device for testing the circulation of the expanded flap that can decrease the risk of expanded flap necrosis, thus maximizing the use of an expanded flap.MethodsA total of 128 patients who underwent surgical repair between 2011 and 2019 and were retrospectively examined with the device for testing the circulation of the expanded flap were included in the study. The procedure included (1) making a device for testing the circulation, (2) implanting a skin expander, (3) injecting normal saline into the skin expander, (4) testing the circulation of the expanded flap, and (5) transferring the expanded flap to repair the defect.ResultsOne hundred forty-eight expanded flaps were implanted in 128 patients. The expanded flap that was transferred to repair the defect had no necrosis or infection. None of the expanded flaps with separated blood supply, which could be observed during operations, revealed complications. The survival rates of the expanded flap were increased by testing the circulation of the expanded flap. Expanded flaps designed by this method showed no swelling or paleness and no obvious temperature changes. In addition, the length-to-width ratio could be extended to 3:1.ConclusionsOur proposed method resulted in an effective surgical procedure for the repair of tissue defects. This approach could effectively change the direction of the blood vessel of the expanded skin flap and prevent necrosis of the expanded flap, thus representing a practical way to increase the use of expanded flaps and the flap survival rate, making the whole expanded flap transfer procedure more convenient.

show abstract

Section: Discussionmentioning

confidence: 99%

Testing the circulation of expanded flaps—prevention of necrosis of expanded flaps (a clinic study)

Han

Chen

et al. 2023

Front. Pediatr.

View full text Add to dashboard Cite

show abstract

“…Due to the instability of blood supply in the cervicofacial flap and demand for a deep back cut to unfold along the cubic expanded flap, partial flap necrosis can still occur even without surgical delay. Therefore, we developed a“4 zone design” method to facilitate the design of the delayed incision and the detailed technique was published in a previous report 6 …”

Section: Discussionmentioning

confidence: 99%

“…Stage 5: after 3 months of tissue expansion, the expansion of the cervicofacial flap was surgically delayed to prevent flap necrosis. An incision was made according to the “4 zone design” method that was reported in our previous article 6 …”

Section: Clinical Reportmentioning

confidence: 99%

Surgical Treatment for Extensive Postburn Facial Deformity Using Tube Flap and Cervicofacial Flap

Duan,

Liu,

Gao

2023

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

The current concept of facial unit reconstruction has evolved from simple coverage of defects to the reconstruction of the 3-dimensional structure and delicate features. The reshaping of the middle third of the face, including the nose and cheek, remains a challenge for plastic surgeons due to its complex structure and the dynamic relationship between each part. In this article, the authors describe a clinical report of extensive facial burns with skin lesions in the middle third of the face. The 30-year-old female patient sustained burns throughout the full thickness of the skin burns on the entire nose and left cheek with hypertrophic scar. The authors performed an expanded cervical-facial flap and tube flap of the upper extremity to reconstruct the entire nasal and cheek region. The patient underwent 8 stages of the operation successively resulting in a satisfactory level of appearance and function.

show abstract

“…Tissue necrosis may be susceptible to the appreciate treatment of omentum flap. [ 24 ] Besides, free transplantation of omentum could easily result in thrombosis than conventional transplantation. Hypertonic citrate adenine (HC-A) solution containing citrate and adenine, widely used in isolated kidney preservation, has been proved to achieve ideal efficacy and safety.…”

Section: Discussionmentioning

confidence: 99%

Immediate breast reconstruction with omental flap for luminal breast cancer patients

Zhi

et al. 2017

Medicine

View full text Add to dashboard Cite

Rationale:Luminal subtype breast cancer, accounting for 70 to 80% of all breast cancers, has been reported to be associated with good prognosis. However, for the patients with large mass or worse mass position, omental flap transplantation may provide a new option for breast reconstruction.Patient concerns:Ten patients (6 luminal B1, 2 luminal B2, 2 luminal A), were enrolled into the study, between January 23, 2015 and August 22, 2016. The mean age was 34.6 ± 6.96 (24-44) years old. Immunohistochemistry demonstrated that the tumor cells were positive for estrogen receptor and progestrone receptor.Diagnoses:According to the clinicopathological features, diagnosis of breast cancer patients were made.Interventions:Breast-conserving surgery, laparoscopic greater omentum harvest and vascular anas-tomosis were carried out orderly. Postoperative operative results, cosmetic outcomes, complications, as well as blood supply were investigated for surgery evaluation. Reasonable chemotherapy and irradia-tion were adopted to patients according to the pathological condition.Outcomes:We successfully accomplished breast reconstruction by omental flap transplantation, ex-cept one failed case because of the necrosis of omentum and changed to fat transplantation. The volumes and symmetry of breasts were all satisfied. The blood supply was detected to be fluent. Only one case of slight hematoma and another case of one distant metastasis were observed during fol-low-up period. No arm mordities or arm movement restriction occurred after surgery. Moreover, radia-tion therapy and chemotherapy had no clear effects on the reconstructed breast.Lessons:Immediate breast reconstruction surgery by transplanting omental flap for luminal breast cancer patients can be considered successful based on the excellent clinic outcome.

show abstract

Prevention of Necrosis of Adjacent Expanded Flaps by Surgical Delay

Cited by 9 publications

References 20 publications

Testing the circulation of expanded flaps—prevention of necrosis of expanded flaps (a clinic study)

Testing the circulation of expanded flaps—prevention of necrosis of expanded flaps (a clinic study)

Surgical Treatment for Extensive Postburn Facial Deformity Using Tube Flap and Cervicofacial Flap

Immediate breast reconstruction with omental flap for luminal breast cancer patients

Contact Info

Product

Resources

About