Objective To introduce a method for total nasal defect reconstruction with a double forehead expanded flap.Case presentation A 55-year-old man underwent three-stage total nasal reconstruction for a complete nasal defe...Objective To introduce a method for total nasal defect reconstruction with a double forehead expanded flap.Case presentation A 55-year-old man underwent three-stage total nasal reconstruction for a complete nasal defect due to electrical injury.The skin expander was implanted during the 1st stage.Total nasal reconstruction was performed with double expanded forehead flap transfer during the 2nd stage.The unilateral forehead flap was used for lining and the contralateral forehead flap,together with the autologous cartilage and titanium mesh framework,were used for skin replacement.The forehead donor defect was covered with a skin graft.Pedicle division and inset were performed in the 3rd stage.Results There was no flap loss,infection,hematoma,rhinostenosis,or implant exposure over the 2-year follow-up,and satisfactory aesthetic results were achieved.Conclusion The double forehead expanded flap method is useful for the reconstruction of large composite nasal defects in patients who are not suitable for nasolabial flaps and those who may not tolerate free tissue transfer.The operation has fewer complications and is uncomplicated.展开更多
Introduction: In the last two decades, chest wall perforator flaps (CWPF) have become a versatile tissue replacement technique for partial breast reconstruction following breast-conserving surgery (BCS) in well-select...Introduction: In the last two decades, chest wall perforator flaps (CWPF) have become a versatile tissue replacement technique for partial breast reconstruction following breast-conserving surgery (BCS) in well-selected cases. We present the surgical outcome of 81 patients with chest wall perforator flaps used for breast-conserving surgery. Methods: We recorded the outcomes of three oncoplastic breast surgeons who performed partial breast reconstruction with chest wall perforator flaps from 1<sup>st</sup> January 2018 to 30<sup>th</sup> June 2022 at Sherwood Forest Hospitals NHS Foundation Trust. Data were collected on patient demographics, including age, BMI, smoking status, bra size, previous treatments, type of CWPF procedure, tumor size (measured clinically, via imaging and histologically), biopsy results, specimen weight, margins involvement, re-operation rate, surgical site infection (SSI), flap loss, flap shrinkage, hematoma, and seroma rates. Results: A total of 81 patients were included in this study, with an average age of 55.7 years and a body mass index (BMI) of 26.7 kg/m<sup>2</sup>. The bra size varied between A to FF with A (7.4%), B (28.3%), C (38.2%), D (13.6%), DD (11.1%), and FF (1.2%). 14.8% of the patients had neoadjuvant chemotherapy (NACT). For 45 patients, LICAP (lateral intercostal artery perforator), 16 AICAP (anterior intercostal artery perforator), 13 MICAP (medial intercostal artery perforator), and for seven patients, LTAP (lateral thoracic artery perforator) flaps were used. The average tumor was measured at 15.75 mm clinically, 19.1 mm via imaging, and 19.6 mm histologically. Biopsy showed that 16% of the tumors were ductal carcinoma in situ (DCIS), and 84% were invasive. 16% of patients had involved margins, and re-excision was required in 10 patients, and completion mastectomy was performed in 2 patients. A thirty-day SSI rate was 6.2%, with flap-related complications, including flap loss and shrinkage, at 3.7% and 4.9%, respectively. In addition, 3.7% had a hematoma, and 17.3% had other complications. Conclusion: Partial breast reconstruction with perforator flaps is an excellent volume replacement technique in breast-conserving surgery with acceptable complications in well-selected cases.展开更多
Background Skin lesions on the nose are common.Multiple surgical techniques have been used for nasal reconstruction.These options may be autogenous or alloplastic and can be performed in single or multiple stages.The ...Background Skin lesions on the nose are common.Multiple surgical techniques have been used for nasal reconstruction.These options may be autogenous or alloplastic and can be performed in single or multiple stages.The choice of coverage depends on the nature of the lesion,location on the nose,and available donor sites.This study aimed to evaluate the surgical outcomes of using locoregional flaps for nasal reconstruction.Methods A total of 27 patients underwent surgery.There were 9 men and 18 women,aged 7 months to 93 years.Four patients presented with involuting hemangioma,five patients with ischemic necrosis of the columella,and five patients with congenital nevus;the remaining 13 patients were previously diagnosed with basal cell carcinoma.Six techniques have been described for nasal reconstruction at our institution from 2016 to 2020.Most patients had basal cell carcinoma(n=13).Locoregional flaps and primary sutures were used for nasal reconstruction.Results The complications were minimal.One patient had a superficial infection and one experienced postoperative bleeding.No recurrence was observed,and none of the patients asked for a second opinion.Conclusion Radical excision of tumors combined with analysis of nasal defects and nearby donor sites is essential for nasal reconstruction.The use of locoregional flaps leads to consistent and good aesthetic outcomes.展开更多
基金This study was supported by project grants(Y20008)from the postgraduate educational reform of Fujian Medical University.
文摘Objective To introduce a method for total nasal defect reconstruction with a double forehead expanded flap.Case presentation A 55-year-old man underwent three-stage total nasal reconstruction for a complete nasal defect due to electrical injury.The skin expander was implanted during the 1st stage.Total nasal reconstruction was performed with double expanded forehead flap transfer during the 2nd stage.The unilateral forehead flap was used for lining and the contralateral forehead flap,together with the autologous cartilage and titanium mesh framework,were used for skin replacement.The forehead donor defect was covered with a skin graft.Pedicle division and inset were performed in the 3rd stage.Results There was no flap loss,infection,hematoma,rhinostenosis,or implant exposure over the 2-year follow-up,and satisfactory aesthetic results were achieved.Conclusion The double forehead expanded flap method is useful for the reconstruction of large composite nasal defects in patients who are not suitable for nasolabial flaps and those who may not tolerate free tissue transfer.The operation has fewer complications and is uncomplicated.
文摘Introduction: In the last two decades, chest wall perforator flaps (CWPF) have become a versatile tissue replacement technique for partial breast reconstruction following breast-conserving surgery (BCS) in well-selected cases. We present the surgical outcome of 81 patients with chest wall perforator flaps used for breast-conserving surgery. Methods: We recorded the outcomes of three oncoplastic breast surgeons who performed partial breast reconstruction with chest wall perforator flaps from 1<sup>st</sup> January 2018 to 30<sup>th</sup> June 2022 at Sherwood Forest Hospitals NHS Foundation Trust. Data were collected on patient demographics, including age, BMI, smoking status, bra size, previous treatments, type of CWPF procedure, tumor size (measured clinically, via imaging and histologically), biopsy results, specimen weight, margins involvement, re-operation rate, surgical site infection (SSI), flap loss, flap shrinkage, hematoma, and seroma rates. Results: A total of 81 patients were included in this study, with an average age of 55.7 years and a body mass index (BMI) of 26.7 kg/m<sup>2</sup>. The bra size varied between A to FF with A (7.4%), B (28.3%), C (38.2%), D (13.6%), DD (11.1%), and FF (1.2%). 14.8% of the patients had neoadjuvant chemotherapy (NACT). For 45 patients, LICAP (lateral intercostal artery perforator), 16 AICAP (anterior intercostal artery perforator), 13 MICAP (medial intercostal artery perforator), and for seven patients, LTAP (lateral thoracic artery perforator) flaps were used. The average tumor was measured at 15.75 mm clinically, 19.1 mm via imaging, and 19.6 mm histologically. Biopsy showed that 16% of the tumors were ductal carcinoma in situ (DCIS), and 84% were invasive. 16% of patients had involved margins, and re-excision was required in 10 patients, and completion mastectomy was performed in 2 patients. A thirty-day SSI rate was 6.2%, with flap-related complications, including flap loss and shrinkage, at 3.7% and 4.9%, respectively. In addition, 3.7% had a hematoma, and 17.3% had other complications. Conclusion: Partial breast reconstruction with perforator flaps is an excellent volume replacement technique in breast-conserving surgery with acceptable complications in well-selected cases.
文摘Background Skin lesions on the nose are common.Multiple surgical techniques have been used for nasal reconstruction.These options may be autogenous or alloplastic and can be performed in single or multiple stages.The choice of coverage depends on the nature of the lesion,location on the nose,and available donor sites.This study aimed to evaluate the surgical outcomes of using locoregional flaps for nasal reconstruction.Methods A total of 27 patients underwent surgery.There were 9 men and 18 women,aged 7 months to 93 years.Four patients presented with involuting hemangioma,five patients with ischemic necrosis of the columella,and five patients with congenital nevus;the remaining 13 patients were previously diagnosed with basal cell carcinoma.Six techniques have been described for nasal reconstruction at our institution from 2016 to 2020.Most patients had basal cell carcinoma(n=13).Locoregional flaps and primary sutures were used for nasal reconstruction.Results The complications were minimal.One patient had a superficial infection and one experienced postoperative bleeding.No recurrence was observed,and none of the patients asked for a second opinion.Conclusion Radical excision of tumors combined with analysis of nasal defects and nearby donor sites is essential for nasal reconstruction.The use of locoregional flaps leads to consistent and good aesthetic outcomes.
