Repair of necrosis and defects of penile skin with autologous free skin flap

We described a 27-year-old case of avulsion and traumatic degloving of penile with extensive penis skin necrosis. Under general anesthesia, donor skin was partially resected from lower limbs according to defect area of penile skin. Then shear the shape of graft was sheared, sutured to hostage skin defect and enswathed with tension. The postoperative appearance and function of the penis were satisfactory. It is suggest the homologous free skin flap from lower limbs is suitable for penile skin repair and beneficial to patient resulting in satisfactory erection and shape.

Repair of facial skin defect with a skin flap of SMAS pedicle

To report a method of repair facial skin defects with a skin flap of SMAS pedicle.Methods According to the size of defect of skin,design a skin flap with SMAS pedicle for repair of defect.Results The method has been successfully applied for skin defects of eyelid and lip in 14 cases with satisfied results.The area of the largest flap was 5 cm×3 cm.Conclusion Repairing facial defects such as eyelid skin defect or lip skin defect with skin flap of SMAS pedicle is a very good method.The flap has a good blood supporting and satisfactory color and flexibility.5 refs,6 figs.

Study on Different Types of Skin Flap Transplantation to Repair Forefoot Damaged Injury

Objective To investigate the clinical effect of different types of skin flap transplantation in repairing forefoot lesion.Methods From January 2016 to June 2019,62 patients with forefoot damage were selected and their clinical data were retrospectively analyzed.All the selected patients received skin flap transplantation and repair,of which 26 patients received free myocutaneous flap transplantation and repair,and were treated as group A.The other 36 patients underwent retrograde foot flap transplantation and repair.They were taken as group B,and the clinical treatment methods and curative effects were summarized.Results Among the 26 patients in group A,the skin flaps of 21 patients survived completely,while those of the other 5 patients showed partial necrosis at the edge of the skin flaps.They were treated with free skin grafting and healed after regular dressing change.All the skin flaps survived.Follow-up for at least 6 months showed that 11 patients had mild claudication and skin flap sensation was slightly poor.Among the 36 patients in group B,only 2 cases suffered from distal partial necrosis after the operation,which was caused by large tension after dorsum pedis flap transplantation.After systematic treatment and regular dressing change by doctors,the flaps of 2 patients healed.In addition,venous reflux disorder occurred in 3 patients with medial saphenous nerve nutrient vessel flap of the foot,which was related to swelling factors.The flaps of other patients survived,healed well and did not show infection symptoms.Conclusion According to the actual condition of patients with forefoot damage,the flap repair method is formulated,which has good short-term and long-term therapeutic effects and plays an important role in repairing forefoot damage.

Subcutaneous pedicle Limberg flap for repairing skin defects in the face

Objective:To investigate the effect of a subcutaneous pedicle Limberg flap for the reconstruction of medium-sized skin defects in the face following skin tumor or scar excision. Methods: From August 2002 to June 2004,the subcutaneous pedicle Limberg flap was designed to repair facial skin defects in 17 patients(19 flaps),and the size of the lesions ranged from 2.0 cm×1.9 cm to 5.0 cm×4.5 cm.The operation was performed under general anesthesia in 2 children,and under local anesthesia in the remaining 15 patients. Results: All flaps survived with primary healing postoperatively.With a follow-up from 1 to 22 months,neither short-term nor long-term postoperative complications such as flap necrosis,hematoma,infection,visible dog-ear and trap door deformity were found,and functionally and cosmetically satisfactory outcomes were achieved. Conclusion: This subcutaneous pedicle Limberg flap provides a competitive repair alternative for the treatment of medium-sized skin defects in the face.

One-stitch anastomosis through the skin with bicanalicular intubation:a modified approach for repair of bicanalicular laceration

AIM:To evaluate the efficacy and safety of one-stitch anastomosis through the skin with bicanalicular silicone tube intubation in repairing of bicanalicular laceration.METHODS:The clinical data of 15 consecutive patients with both superior and inferior canalicular laceration in one eye who underwent surgical repair using one-stitch anastomosis through the skin and bicanalicular stent were retrospective studied.All the operations were performed under surgical microscope,5-0 silk sutures were used and were with bicanalicular silicone tube(diameter was 8mm) intubation,for one lacerated canaliculi one-stitch anastomosis through the skin.The stents were left in place for 3 months postoperatively and then removed.The follow-up period was 3-36 months(average 14 months). RESULTS:In 15 patients,13 patients were cured entirely,1 patient was meliorated,1 patient with no effects.All patients had got good recovery of eyelid laceration with no traumatic deformity in eyelid and canthus.Complication was seen in one case,for not followed the doctor’s guidance to come back to hospital to had the suture removed on the 7thday after operation,when he came at the 15thday,the inferior canalicular wall and eyelid skin were corroded by the suture caused 2mm wound,and the inside silicone tube was exposed,a promptly repair with 10-0 nylon suture was done,the wound healed in a week.There were no early tube protrusions and punctal slits in the patients.CONCLUSION:One-stitch anastomosis through the skin with bicanalicular silicone tube intubation is a good method in repair of bicanalicular laceration in one eye,the cut ends can be anastomosed directly,and with excellent cosmetic results,it is acceptable for the patients.For there is no suture remained in the wound permanently,so there is no suture-related granuloma which may cause obstruction or stenosis of canaliculi.It is simple,economical,effective and safe.

Skin-Adhesive Tape versus Interrupted Suture in Episiotomy Skin Repair: Randomized Control Trial

Introduction: The ideal method for perineal repair should be quick, easy to perform and preferably, with minimal pain. Aim: To compare skin adhesive tape and interrupted?absorbable subcuticular suture for episiotomy repair after birth as regard postoperative pain, skin closure time and wound infection. Design: Prospective double-blinded randomized controlled trial. Methods: Three-hundred qualified patients were equally distributed between two groups. Group 1 underwent skin repair with skin adhesive tape, while group 2 underwent the currently traditional method for perineal repair by interrupted suture. Pain was evaluated at 2, 4, 6 and 12 hours after birth then daily until one week using Wong-Baker faces pain rating scale with verbal expression for pain intensity as primary outcome. Skin closure time and wound infection were also evaluated as secondary outcomes. Results: Statistically significant difference in pain was?found at 4 and 6 hours, and 3,?4,?5 and 7 days after perineal repair in favor of the adhesive tape group (p = 0.04 and 0.02 respectively) (p = 0.002, 0.002, 0.003 and 0.001 respectively). No statistically significant difference was found in skin closure time between both groups, and no cases of wound infection occurred in both groups (p = 0.3). Conclusion: Skin adhesive tape may be superior to skin suturing in decreasing pain resulting from perineal repair after birth;however, further studies are needed to assess long-term effects, calculate costs and accurately measure patients’ satisfaction, which were not addressed in this study.

Study on the Repairing Effect of Cosmetics Containing <i>Artemisia annua</i>on Sensitive Skin

In view of the increasing sensitivity of consumer skin in recent years, cosmetics containing Artemisia annua extract was tested to evaluate its effectiveness in repairing sensitive skin. Through the experiment of xylene-induced ear swelling in mice, it was found that the inhibition rates of ear swelling in mice induced by xylene in three groups of cosmetics containing Artemisia annua extract reached 60.40%, 73.36% and 74.01%, respectively, close to the positive drug group. Twenty-five sensitive skin volunteers were selected for human clinical trial, and the skin TEWL value, cuticle hydration degree and skin heme (ultra-high concentration) were tested. The results showed that using cosmetics containing Artemisia annua extract for four weeks could effectively increase the hydration degree of cheek cuticle by 63.90% and reduce transepidermal waterloss (TEWL) by 21.51%. The skin heme (ultra-high concentration) decreased by 69.14% and the affected area decreased by 77.47%. The results show that the cosmetics containing Artemisia annua extract can inhibit inflammation, repair skin barrier, improve damaged skin, and reduce redness and other sensitive skin symptoms.

The application of anterolateral thigh flap in post-operative repairing of vulva tumor

Objective： The aim of this study was to evaluate the value of the application of anterolateral thigh flap in postoperative repairing of vulva tumor. Methods： Anterolateral thigh flap with the descending branch of the lateral circumflex femoral artery and the pedicle of anterolaterat thigh cutaneous nerve was used in primary repairing of the defect from postoperative vulva tumor, the sizes of the flaps ranged from 10 cm ×14 cm-14 cm× 20 cm. Results： All flaps survived, during a follow-up of 2 to 12 months, the appearance of the flaps was satisfactory with sensitive function without local recurrences. Conclusion： Anterelateral thigh flap has fairly long vessel pedicle, wider vessel diameter, and is in the covert area. Anterolateral thigh flap with sensory nerve is the ideal choice for postoperative repairing of vulva tumor.

Primary Observations on the Influence of ^(60)Co Local Irradiation on Free Skin Flaps

Objective To study the effect of postoperative radiation on free skin flaps. Methods Twenty-nine patients with free skin flaps applied to the plerosis of the postoperative defect were followed up. Twenty-eight out of 29 patients received forearm free flaps while 1 had anterolater-al femoris skin flaps in a size ranging from 14cm×6cm to 8cm×4cm. These flaps were exposed to 60Co radiation ranging 40-69 Gy. Results Observation during irradiation, no visible changes of skin flaps and oral mucous membrane were detected, when irradiation dose was within 40 Gy; some changes may be detected over 40 Gy. Observation 1 - 4 months after irradiation: pigmentations were found in areas of erosion epidermis; skin flaps got dark but without evidence of necrosis. Observation 2 years after irradiation, rib necrosis happened in 29 skin flaps. Hairs were found on 15 of 29 flaps. Sensation occurred within the margin of 1 cm. Conclusion Free skin flap can endure irradiation at the dose of 60 Gy.

Use of Acellular Fish Skin for Dura Repair in an Ovine Model: A Pilot Study

Recently the use of biologic materials as dura mater repair patches has been increasing. The purpose of this study is to assess the basis for efficacy and safety of using a novel fish derived acellular dermis (Kerecis Omega3 DuraTM). In an ovine model a craniotomy under general anaesthesia was performed. A defect was produced in the dural covering of approximately 1 × 2 cm and closed with an onlay technique, with Kerecis Omega3 Dura. The bone defect was covered with the bony flap and the overlying tissues closed in layers. At 2, 5, 8 and 11 weeks the sheep underwent MRI scanning followed by euthanasia, necropsy and histological assessment. MRI images taken at 2, 5, 8 and 11 weeks showed initially moderate inflammatory response, which diminished over time, and at 11 weeks no evidence of inflammation existed. There was evidence of cerebrospinal fluid leakage at no time point. Necropsy revealed some adhesions at 5 and 8 weeks, in particular at 5 weeks, but at 11 weeks there were no adhesions found. From 2 - 11 weeks, there was evidence of initially an inflammatory reaction followed by neodura formation at the defect site through cellular ingrowth and remodeling of the acellular fish skin. Histology showed a histiocytic foreign body reaction initially that subsided over time. As early as 8 weeks there was evidence of neodura formation and by 11 weeks there was a minimal inflammatory response with an intact neodura formed. In this pilot study the Kerecis Omega3 Dura patches performed in a safe and efficacious manner. This new material needs to be fully assessed and compared with other products that are currently on the market in a larger scale animal study.

The application of thin flap repairing method after reascularization in femoral anterolateral free flap

Objective: To summarize the application and effect of thin flap repairing method after reascularization in femoral anterolateral free flap. Methods: From May 2013 to October 2015, 20 cases of patients received femoral anterolateral free flap transplantation, with the flap transported to the recipient site. After reascularization, the phase I of thin flap repairing was performed in each 'vein type'area. Among those, there existed 8 cases of direct suture in the donor site, and 12 cases of skin transplantation by intermediate split thickness skin graft. Results: All the postoperative flaps survived, with 2 cases of vascular crisis and 2 cases of poor venous return at the edge of flap. No complications such as flap infection and necrosis occurred. Wounds and incisions in donor and recipient sites were healed in phase I. 20 cases of patients had been followed up for 5-24 months, and the average follow-up time was 15 months. The skin texture of flap was similar to the surrounding skin, with good abrasion resistance, no ulceration and no phase II flap repairing;the sensation of flap recovered to S3-S4 level;the two-point discrimination was 3.5-6.0 mm, with the average value of 5.0 mm. The function of patients' fingers recovered well without any complications such as contracture and deformity etc. In the last follow-up, Testative Evaluation Standard of Upper Limb Function, which was established by Chinese Medical Society for Surgery of Hand, was used to assess efficacy, and the evaluation results were as follows: excellent in 9 cases, good in 5 cases, fair in 6 cases;in accordance with the evaluation criteria listed in Michigan Hand Outcome Questionnaire (used to assess patients' satisfaction with the appearance of flaps after operation, and the results were as follows: very satisfactory in 9 cases, satisfactory in 9 cases, and moderate in 2 cases. Conclusions: After reascularization in femoral anterolateral free flap grafting, phase I of thin repairing has small effects on flap vascularization, with a satisfactory appearance of the flap.

The First Case of Free Radial Forearm Skin Flap:A 40-Year Follow-Up Study

Background The radial forearm skin flap(RFSF)was first introduced by the Chinese scholar Guofan Yang and has since been used for nearly 40 years.The many advantages of RFSF have been investigated in this study.Case presentation In this case,a female patient underwent RFSF surgery in 1979.In 2016 and 2018,two interviews were held to evaluate her subjective postoperative experience.In addition,overall donor site evaluation was conducted based on general health checkups and tests;tests for appearance,tactile sensitivity,muscle strength,and motor function;and CTA.Results The flap survived well,and the donor site recovered without hand necrosis in the 1970s.In 2018,the patient was in good health condition and expressed her satisfaction with the surgery.The patient did not suffer from any postoperative complications such as diminished sensation of the donor site or donor site dysfunction;in the evaluation of hand and finger function,there was no point where functional reduction of the donor site was noted.CTA revealed compensatory blood supply with enlargement in the diameter of the ulnar and interosseous artery.Conclusion After a nearly 40-year follow-up,the patient who underwent the first free radial forearm flap transplantation expressed satisfaction with the operative outcomes.The examination showed good results at the recipient site with little donor site deformities and good compensatory blood supply.

Application of Frontotemporal Expanded Flap with Bilateral Superficial temporal vessels in Repair of Large Area Scar Contracture in Face and Neck

Objective To summarize the clinical experience of frontotemporal expanded flap with bilateral superficial temporal vessels in repairing large area scar contracture in face and neck.Methods 14 patients with facial and Cervical scar contracture in our hospital were taken as the research object.With bilateral superficial temporal vessels as pedicles,a 400-600 ml skin dilator was inserted into the forehead and 50-100 ml skin dilator was inserted into the two temporal parts respectively.Within 3-4 months,the water injection volume reaches 2 times of the dilator volume.After maintaining for one month,skin flap transplantation was performed.The frontal flap was reserved for hairline reconstruction,and the flap was cut to cover the area after facial and Cervical scar release to reconstruct the jaw-neck angle.The pedicle division and pedicle trimming were performed 3-4 weeks after operation.Results All the 14 patients completed the operation successfully.The flap expansion time is 5-6 months.The expanded skin flap covers an area of 26 cm×9 cm-42 cm×16 cm,and all the skin flaps survived after operation.Among them,2 patients suffered from flap congestion after flap transplantation.Follow-up for 6-12 months showed that the color and texture of the skin flap were similar to those of facial skin,with natural transition and no obvious bloating.The angle between the lower jaw and the neck is about 90.The anterior flexion,posterior extension,lateral flexion and rotation of the neck are obviously improved compared with the anterior,and the posterior extension is close to normal.Conclusion Frontotemporal expanded flap with bilateral superficial temporal vessels is suitable for patients with large-area scar contracture in face and neck that cannot be repaired after expansion of adjacent local normal tissues.

Clinical Application of Direct Skin Grafting Repair in Popliteal Scar Contracture after Burn in Children

Objective To observe the clinical application of direct skin grafting in repairing popliteal scar contracture after burn in children.Methods From April 2017 to January 2019,30 children with popliteal scar contracture after burn were selected as the research objects.The scar status,knee joint function and quality of life of the patients before and after the operation were compared by direct skin grafting after medium thickness skin removal.Results 30 patients were treated with skin grafting to repair popliteal scar contracture,27 patients healed well,and the survival rate of skin grafting reached 90.00%.The scores of postoperative scar and knee joint function scale(WOMAC)were lower than those before the operation,and the scores of concise health status scale(SF-36)were higher than those before the operation,with statistical significance(P<0.05).Conclusion Scar contracture of popliteal fossa after burn in children can be repaired by direct skin grafting in the skin extraction area after medium thickness skin cutting,which can effectively improve scar condition,restore knee joint function and significantly improve quality of life.

Repair of oral mandibular defects with rib composite flap pedicled with internal thoracic

Objective To study feasibility and value of repair of oral mandibular defects with rib composite flap pedicled with internal thoracic vessels in basic level hospitals. Methods The clinical materials in 13 cases uith mandibular defects which were repaired with rib compos-

Application of free vein skin flap on the anterior aspect of wrist in the case of finger injury with vessel and skin defect

Objective To introduce an effective reconstruction method for the finger injured with vessel and skin defect. Methods Free skin flap with skin vein was transplanted on the site of tissue defect, connecting by anastomosis the vein with artery or vein of the finger. Results Seven cases were treated with this method,among which 5 cases have sikin defect on the palm aspect of fingers, the rest have skin defect on the dorsal aspect skin of finger. All fingers survived with good shape and function. Conclusion This is a simple and effective method of finger reconstruction for the patients with defect of vessels and skin. 6 refs.

Application of fascial flaps of supraclavicular artery in repair of neck scar contracture

Objective To observe eflect uf fascial flaps of supraclavicular artery on treatment of neck scar contracture. Methods The supraclavicular flaps were designed according to direction of supraclavicular arteries and transferred into detective areas caused by scar releasing.

Repair of infectious scalp defects with titanium mesh exposure by scalp rotation flap

Objective To explore the application of scalp rotation flap in reconstruction of infectious scalp defect with titanium mesh exposure. Methods Twelve patients were treated in this group including 4 males and 8 female. S The defective size ranged from 2. 0 cm × 5. 0 cm to 0.

Role of adipose-derived stromal cells in pedicle skin flap survival in experimental animal models

The use of skin flaps in reconstructive surgery is the first-line surgical treatment for the reconstruction of skin defects and is essentially considered the starting point of plastic surgery. Despite their excellent usability, their application includes general surgical risks or possible complications, the primary and most common is necrosis of the flap. To improve flap survival, researchers have used different methods, including the use of adiposederived stem cells, with significant positive results. In our research we will report the use of adipose-derived stem cells in pedicle skin flap survival based on current literature on various experimental models in animals.

Design of axial flaps with color Doppler flow imaging technique for repairing deep wounds of heels

To report the methods and effect of axial pattern flap on lower limb in repairing deep wounds of heels by using color Doppler flow imaging (CDFI) technique so as to solve the ever before problems that the vessel can not be displayed in designing axial flap.Methods Suitable axial flaps on lower limbs were selected according to the character of the wounds.There were 25 flaps including 10 cases of the distal-based sural neurovascular flap,nine medial sole flap and six medial leg flap.All the axial pattern flaps were designed on the basis of traditional design ways before operation;then,CDFI appliance with high resolution was used to examine the starting spot,exterior diameter,trail and length of the flap’s major artery.The flaps were redesigned according to the results of CDFI and transferred to cover the wounds.In the meantime,both the results of operation and examination were compared.Results The major artery’s starting spot,exterior diameter,trail and anatomic layers were displayed clearly,in consistency with the results of operation.The flaps survived completely and recovered well,with perfect appearance,color and arthral function.Conclusion CDFI is a simple,macroscopic and atraumatic method for designing the axial pattern flap on lower limb,can provide more scientific and accurate evidence for preoperative determination of flap transplantation and is worthy of clinical application.10 refs,4 figs,2 tabs.