ABSTRACT
Results of operative treatment of 8 patients with cellular basal cancer of the hairy part of the head are presented. The patients were operated by an original worked out method of plastic reconstruction of skin defects of the head hairy part after tumor excision. The mathematical substantiation of the surgical method was stated. The technique of operative intervention is described. The clinical course and illustration of the long-term results are given.
Subject(s)
Carcinoma, Basal Cell , Dissection/methods , Head and Neck Neoplasms , Plastic Surgery Procedures/methods , Skin Neoplasms , Wound Closure Techniques , Adult , Aged , Carcinoma, Basal Cell/pathology , Carcinoma, Basal Cell/surgery , Female , Hair , Head and Neck Neoplasms/pathology , Head and Neck Neoplasms/surgery , Humans , Male , Middle Aged , Neoplasm Invasiveness , Scalp/pathology , Scalp/surgery , Skin Neoplasms/pathology , Skin Neoplasms/surgery , Surgical Flaps , Treatment OutcomeABSTRACT
The aim of the study is to assess our results with free flap transfer. Since October, 2005 till December, 2011 51 operations were performed. Mucosa of upper digestive tract was reconstructed in 40 cases, soft tissues and skin of the head and neck region-in 11 cases. Reconstruction was primary in all but 2 cases. 18 first cases were performed with 2,5x and 4x binocular loupes magnification. Operating microscope was used in another 33 cases. 37 radial forearm fasciocutaneous flaps, 5 latissimus dorsi musculocutaneous flaps, 7 anterolateral thigh flaps, 1 scapular osteocutaneous were used with the single case of visceral flap--jejunal free flap. Death in early postoperative period occurred once. Complete flap loss occurred six times. Five radial and one latissimus dorsi free flaps were lost. Arterial thrombosis is considered as a primary cause of failure in one case, venous thrombosis-in two cases. Severe postoperative infection was considered as a primary cause of failure in one case. In remaining 2 cases the cause of flap loss could not be determined exactly. There were three cases of revision surgery with attempts to reperform venous anastomosis, one of them was successful. Overall success rate in this series is 86,3 %. The main cause of such a low rate of success is a lack of experience.
Subject(s)
Free Tissue Flaps/blood supply , Free Tissue Flaps/statistics & numerical data , Head and Neck Neoplasms/surgery , Plastic Surgery Procedures/methods , Aged , Back/surgery , Female , Forearm/surgery , Free Tissue Flaps/adverse effects , Head and Neck Neoplasms/pathology , Humans , Jejunum/surgery , Male , Middle Aged , Plastic Surgery Procedures/adverse effects , Reoperation , Scapula/surgery , Surgical Wound Infection/etiology , Thigh/surgery , Thrombosis/etiology , Treatment Failure , Treatment OutcomeABSTRACT
Oncological Dispensary of Leningrad Region, St.Petersburg Our paper deals with evaluation of the results of using distal pectoralis major myocutaneous flap (38) in 37 patients; bilateral dissection of tissue--1. Plastic reconstruction of surgical effects of the oral cavity and pharynx was performed in 27 (skin cancer--8, parotid salivary gland tumor--1). Flap was used to both shield the parotid artery and prevent erosive bleeding following radical cervical dissection, urgent plastic surgery--30, postponed--8. Complication, chiefly slight was reported in 60.5% and treated conservatively. Total necrosis was identified in 2 (5.3%), partial--4 (10.8%), salivary fistula--10 out of 27 reconstructions of the upper intestinal tract (18.4%), cervical suture failure--7 (18.4%), flap avulsion from wound edges--6 (15.8%), wound edge avulsion--2 (5.3%). Nasogastric probe for feeding was used for approx. 23.7 days. Feeding per os after the first operation was restored in 23 (85.2%). Repeat reconstruction using pectoralis major myocutaneous flap has proved effective in patients with surgical effects of head and neck.
