Application of rhomboid skin flap in expanded skin flap transfer / 中华医学美学美容杂志

Objective To explore the use of rhomboid skin flap in expanded skin flap transfer. Methods A rhomboid skin flap was designed if the top soft part could not be fully utilized after expanded in a rotation skin flap. The flap pedicels were designed near the incision side. It should be ensured that ra-tio of the length to the width of the composite flap, which was composed of the rhomboid skin flap and the rotation skin flap, was 2.5∶1.0. Results Among these 11 patients with re-designed rhomboid skin flaps in the rotation skin flaps, the ratio of the length to the width reached to 3∶1 in some cases, but 2. 5∶1.0 in most cases. All the skin flaps survived, except one patient with disturbance of blood circulation in a small area and one with mild congestion. Conclusion The expanded soft tissue can be fully and rationally utilized to repair the skin defect in this design. Attention should be paid to the ratio of the length to the width of the composited flap, and it is better to select axial flap as the composite flap for safety. This method is safe, and worthy of recommendation.

Clinical application of skin expansion with easily self-controlled and continuous constant pressure / 中华医学美学美容杂志

Objective To study the effects of a self-controlled and totally-enclosed type perfusion skin and tissue expansion in which pressure was continuous and constant. Methods Totally-enclosed type perfusion system included single-used infusion apparatus, triplet, soft water storage bag, catheter, and common expander. Continuous pressure-constant system included inflatable infusion apparatus and common spring sphygmomanometer. Expander was filled from soft water storage bag which was put in inflatable infusion apparatus by crushed ball. The pressure of expander was controlled by patients according to pain threshold. 26 expanders were used in 20 patients in clinical practice. The volume of expander was about 100 ~ 400 ml. After 3~5 days from operation, water began to fill in the expander and stopped when the expansion area reached. Results The volume of expander was 120~640 ml and the duration of expansion was 10~16 days, average (13.6? 2.1) days, without any complication. Conclusions The tissue expansion with continuous and constant pressure and totally-enclosed perfusion is worth popularizing because of its easy preparation, simply operation, rapid expansion, safety and comfort.