ABSTRACT
BACKGROUND: The superiorly based nasolabial flap is a well-known procedure. However, random pattern or subcutaneous pedicle flaps are insufficient for reconstruction of large defects. Artery pedicle flaps have a satisfactory blood supply, and for that reason, the required tissue can be raised for reconstruction of large defects of the nose. METHODS: Twelve cases were operated on with this technique. Reconstruction was performed with a lateral nasal artery pedicle island flap. The mean age of the patients was 68.4 years. Three patients required cartilage grafts for alar rim support. The cartilage grafts were harvested from the auricular conchal bowl. The follow-up period ranged from 15 to 33 months. RESULTS: There was no partial or total loss of the flap. There was no distortion on the face caused by smiling and pursing of the lips observed. Donor and reconstructed areas have an excellent appearance in all cases. The aesthetic results were satisfying for all patients as well. CONCLUSIONS: The authors' flap can be used for reconstructing large defects of the lower half of the nose, and reconstruction with a single stage yields a fast and satisfactory result. The authors advocate that the lateral nasal artery pedicle nasolabial island flap is an excellent choice for reconstruction of large defects in the lower half of the nose.
Subject(s)
Nose Deformities, Acquired/surgery , Rhinoplasty/methods , Surgical Flaps/blood supply , Aged , Carcinoma, Basal Cell/pathology , Carcinoma, Basal Cell/surgery , Cohort Studies , Ear Cartilage/transplantation , Esthetics , Female , Follow-Up Studies , Graft Rejection , Graft Survival , Humans , Male , Middle Aged , Nose Deformities, Acquired/etiology , Nose Neoplasms/pathology , Nose Neoplasms/surgery , Plastic Surgery Procedures/adverse effects , Plastic Surgery Procedures/methods , Retrospective Studies , Rhinoplasty/adverse effects , Risk Assessment , Skin Transplantation/methods , Wound Healing/physiologyABSTRACT
Advances in reconstructive microsurgery have enabled us to make use of many flap alternatives in severe lower-extremity trauma, and traditional cross-leg flaps for wound coverage have been replaced in most centers by free-tissue transfers. But free-flap surgery is still a challenging area in very young pediatric populations because of technical difficulties with considerable drawbacks. Six children with severe foot and ankle trauma were presented. Distally based sural fasciocutaneous cross-leg flaps were carried out to cover the defects, with no complications. Because of its easy dissection and reliable pedicle without compromising the major vessels, this procedure may be a safe choice among the other cross-leg flap alternatives when microsurgery is not considered.
