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Objective To investigate the clinical results of microsurgical free tissue transfers in pediatric reconstruction.Methods Between Janua~ 2004 and December 2010,twenty-seven free tissue transfers for reconstruction of various defects in 27 pediatric patients were performed.The average age at the time of reconstruction was 10.8 years(range:5-14 years).Fourteen patients were boys and 13 were girls.There were 5 tumor resection defects,sixteen posttraumatic defects and 6 burn contractures which consist of 19 fasciocutaneous flaps,six osteoseptocutaneous flaps and 2 muscle flaps.The mean operative time was 4 hours and 20 minutes.Results All flaps survived except 1 partial necrosis,with 96.3％ success rate.All patients were followed up 3 months to 4 years (mean,one and a half years).The appearance of the flaps was slightly overstaffed,but the color and texture were satisfactory.Conclusion Free tissue flap transfer is a safe,reliable,cost-and time-effective method for the reconstruction of various defects in children.
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Objective To provide the applied anatomy of the posterior intercostal artery perforator flap and the clinical results of repairing the soft tissue defects with lateral perforator flap. Methods Six fresh adult cadavers were injected with a lead oxide-gelatin mixture for three-dimensional visualization reconstruction using a 64-slice spiral computed tomography scanner and specialized software (Materiaise's interactive medical image control system,MIMICS).The origin,course,diameter,and distribution of the the 6-10th posterior intercostal artery perforators in the thoroax region were observed and measured.Clinically,nine cases were treated with the lateral perforator flap supplied by 7-10th posterior intercostal artery transplantation for repairing wounds in upper limbs.The flap size was 9 cm × 7 cm-16 cm × 12 cm. Results The 6-10th posterior intercostal artery perforator (outer diameter 1.70 ± 0.14 mm) were from the artery in the chest region, which pierce in deep fascia near midaxillary line. The average pedicle length from the deep fascia was (87.56 ± 6.48) mm.All of 9 cases were repaired successfully,the clinical results were satisfactory.Conclusion The posterior intercostal artery perforator flap can be used to form many kinds of axial skin flaps,it is a good option for repairing soft-tissue defect.
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Objective To report the improved operative technique and clinical results of reversed saphenous neurocutaneous vascular flap. Method Under the guidance of Doppler flowmeter,a reversed saphenous neurocutaneous vascular flap pedicle with the perforating branches of the tibialis posterior artery were designed to repair the skin defects of the middle and lower leg,the ankle and the foot. Results The modified flaps were applied in 7 cases,all flaps survived completely. The size of the flaps ranged from 15cm?8cm to 5cm?4cm,the location of the perforating branches were 8～20 cm above the medial malleolus. The colour and texture of the flaps were excellent,the outline and functional results were satisfactory after 6～18 months follow up. Conclusions The flap is easy to design and dissect,blood supply is reliable,it is suitable for repairing the soft tissue defects of the middle and lower leg,the ankle and the foot. It is a new type of flap combining the neurocutaneous vascular flap with the perforator flap.
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Objective To investigate the operative methods and treatment outcomes of replantation of amputated complex mini tissue mass of the fingers Methods Seventeen severed complex mini mass in 16 cases were replanted with microsurgery technique using different revascularization procedures Results Fifteen replanted masses were survived completely,proximal partial skin margin necrosis in 1 case,only one case was failure Both function and appearance in surviving replantations were excellent after 6～24 months follow up Conclusions Replantation of amputated complex mini tissue mass of the fingers is rewarding as long as the mass remained intact and the vessels for anastomosis could be found