The clinic application of thoracodorsal artery perforator flap: a report of 16 cases / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the effects of free and pedicled thoracodorsal artery perforator (TDAP) flaps for repairing skin and soft tissue defects in limbs, neck, axillary and shoulder.</p><p><b>METHODS</b>From October 2009 to Auguest 2011, 16 TDAP flaps were used to repair skin and tissue defects. Among them, five ipsilateral pedicled flaps were used to repair wounds in neck, axillary and shoulder. 11 free TDAP flaps were used to repair the wounds with bone or tendon exposure. In 12 cases, the flaps were pedicled with thoracodorsal artery and vein-lateral branches-perforators, in 4 cases, pedicled with thoracodorsal artery and vein-serratus anterior muscular branches-perforators. The deep fascia, the latissimus dorsi and thoracodorsal nerve were not included in all flaps. The flaps size ranged from 10 cm x 5 cm to 26 cm x 10 cm.</p><p><b>RESULTS</b>All 16 flaps survived completely with primary healing both at donor site and recipent area. After a follow-up of 3 to 24 months, all flaps gained good texture and appearance. Only linear scar was left at donor area. The shoulder could move freely.</p><p><b>CONCLUSIONS</b>TDAP flap has good texture, long vascular pedicle,and reliable blood supply, leaving less morbidity at donor site. The latissimus dorsi and thoracodorsal nerve are also preserved. The pedicled TDAP flap is an ideal flap for repairing the ipsilateral skin and soft tissue defects of the neck, shoulder, axillary. The free TDAP flap is suited for repairing skin and soft tissue defects of the extremities.</p>

Free dorsum flap lobule grafting for repair of third degree electric burn in two or three fingers / 中华显微外科杂志

Objective To report the therapeutic effect of free dursum flap lnbule grafting to repair soft tissue defects in two or three fingers result from electric bum in just one operation.Methods Seven patients with electric injuries in two or three fingers were treated by the dorsum flap (or composite flap) lohule graft- ing.The procedure is followed:after dehridement,a trifoliated flap composed of medial pedal,first dorsal met- atarsal and lateral pedal flaps or a bifoliated flap composed of first dorsal metatarsal and lateral pedal flaps was designed.The combined flap contained anterior tihial artery and dorsal pedal artery as the stem vessel for anas- tomosing with the supplying vessel.The three tributaries of dorsal pedal artery:medial tarsal artery,first dor- sal metatarsal artery and lateral tarsal artery were enntained in the three leaves respectively.They could contain extensor digitorum longus tendons and cutaneous nerves and be used to cover the skin defect of two or three fin- gers,reconstruct the flexor tendons and finger arteries and nerves at the same time.Results All the flaps were survived completely,the wounds in all fingers healed primarily,however,skin graft in two feet necrosised partly,one got to healing required wound dressing for three weeks,another required further operation of trans- ferring medial supramalleolar flap due to tendon exposure.The patients were followed up from 3 to 24 months, all the flaps were of appropriate thickness,good texture and satisfactory sensation,all the fingers recovered good function of flection and extension except two fingers existing little limitation.Conclusion Free dorsum flap lohule grafting is an ideal way to treat electric injuries of multiple fingers because it can recnnstruct the skin,tendons,blood vessels and nerves in two or three fingers in just one operation.

Microvascular anastomotic anterolateral thigh flaps for reconstruction of traumatic widespread defects of soft tissue in heel / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the results of repairing widespread defects of traumatic soft tissue in heel by microvascular anastomotic anterolateral thigh flaps.</p><p><b>METHODS</b>Twenty-six consecutive free anterolateral thigh flaps in 26 patients were transplanted for repairing widespread defects of traumatic soft tissue in heel from October 1997 to March 2005, suturing the descending branch of the lateral circumflex femoral vascular and posterior tibial vascular to reconstruct the blood supply of transplanted flaps, repairing lateral femoral cutaneous nerve to recover their sensation, fixing tensor fasciae in the calcaneum to add their stabilization.</p><p><b>RESULTS</b>All flaps survived completely,the wounds healed in the initial treatment, follow up 3 to 48 months, twenty-six cases achieved partial sensation, good contour and stabilization.</p><p><b>CONCLUSIONS</b>The anterolateral thigh flap is an ideal flap for repairing widespread defects of traumatic soft tissue in heel, because it has such advantages as adequate blood supply, big dermatosis area and covert donor site, furthermore, nervi cutaneous femoris lateralis and tensor fasciae offer the good sensation and adequate stabilization.</p>

Transplantation of free latissimus dorsi myocutaneous flaps for craniomaxillofacial reconstruction / 中华整形外科杂志

<p><b>OBJECTIVE</b>This clinical study was to improve the surgical treatment to craniomaxillofacial tissue defects.</p><p><b>METHODS</b>Since 1997, eight cases with severe craniomaxillofacial defects were treated using free latissimus dorsi myocutaneous flaps. In the operation, nerve anastomosis was performed. Of the 8 cases, 7 were treated in one stage, 1 was treated in 3 steps. The craniomaxillofacial defects ranged from 10 cm x 8 cm to 30 cm x 12 cm. The flaps was 12 cm x 10 cm to 32 cm x 16 cm in size.</p><p><b>RESULTS</b>Postoperative follow-up for 6 months to 4 years demonstrated satisfactory results in all the cases. There was neither necrosis nor ulcer after the operation. The sensation recovery of the flap was also satisfactory.</p><p><b>CONCLUSION</b>Free transfer of the latissimus dorsi myocutaneous flap is an ideal treatment to severe craniomaxillofacial defects as it possesses the advantages of reliable blood supply, ability against infections, large size, concealed donor site, and functional restoration of sensation and movement.</p>