Principles of hatchet-skin flap for repair of tissue defects on the cheek.

BACKGROUND: To date, cheek reconstruction remains a challenge for plastic surgeons. This report presents the authors' cheek reconstruction technique with different types of hatchet-skin flaps, which provides satisfactory results. METHODS: The cheek area was divided into three parts (P1, P2, and P3), with vertical lines passing through the medial and lateral canthus. Different types of hatchet-skin flaps were used to repair the tissue defects in each part. The study population consisted of 29 patients divided into three groups according to the location of the defect (G1, G2, and G3). Patient satisfaction was evaluated 1 year after the operation using a questionnaire concerning five important aspects: color match, texture match, scar visibility, morbidity, and function. RESULTS: The 29 patients (17 men and 12 women) ranged in age from 19 to 81 years. The sizes of the defects ranged from 1.5×1.5 to 2.5×3.5 cm. All the flaps survived. The patients' ages and defect sizes did not differ between the three groups. The mean rating of each evaluation was high in all three groups. The mean rating for scar visibility on a 5-point scale was significantly lower for G1 than for G3. CONCLUSION: The hatchet-skin flap procedure is a versatile technique for the repair of medium defects in the three parts of the cheek. The defects in each part of the cheek should be repaired separately depending on the characteristics of the natural lines.

Application principles of hatchet skin flap for repairing tissue defect of cheek / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the design principles, clinical results and significance of hatchet skin flaps for repairing tissue defects in different parts of cheek.</p><p><b>METHODS</b>The area of cheek was divided into three parts, P(I), P(II) and P(III), with vertical lines through the medial canthus and lateral canthus. Different kinds of hatchet skin flaps were designed to repair tissue defects in different part of cheek. The hatchet skin flaps were performed in 29 cases with tissue defects in different part of cheek from August 2005 to August 2009. There were 17 male and 12 female, aged from 19 to 81 years, with a mean age of (45 ± 16) years. The size of tissue defect ranged from 1.5 cm × 1.5 cm to 2.5 cm × 3.5 cm. Patients' satisfactions were evaluated with a questionnaire in 5 aspects:color and texture match, scar, morbidity, and function after 6 months operatively.</p><p><b>RESULTS</b>All the flaps survived completely with good color and tissue match. The facial contour was not altered obviously. Six to eighteen months later, all scars were almost invisible. All 29 patients were satisfied with their results.</p><p><b>CONCLUSIONS</b>The hatchet skin flap is one of the versatile reconstructive methods for repairing of medium and small defects in the three parts of cheek. Defects in different part of cheek should be repaired individually with hatchet flap based on characters of natural lines.</p>

Effect of the tumescent infiltration solution temperature on body temperature / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of tumescent infiltration solution temperature on core body temperature after liposuction.</p><p><b>METHODS</b>15 healthy female subjects were randomly divided into 2 groups to receive tumescent infiltration solution at 25 degrees C as group A, or at 37 degrees C as group B. All subjects were under epidural anesthesia. Vital signs, including core temperature, heart rate, respiratory rate and blood pressure, were monitored immediately, 1 hour, 2 hours, 3 hours, 4 hours and 8 hours after operation.</p><p><b>RESULTS</b>The core body temperature immediately, 1 hour, 2 hours and 3 hours after operation were (35.8 +/- 0.5) degrees C, (35.8 +/- 0.5) degrees C, (36.0 +/- 0.5) degrees C, (36.1 +/- 0.5) degrees C in group A, and (36.5 +/- 0.4) degrees C, (36.5 +/- 0.3) degrees C, (36.5 +/- 0.3) degrees C, (36.6 +/- 0.4) degrees C in group B, showing a significant difference between the two groups (P = 0.008, P = 0.008, P = 0.03, P = 0.033, respectively). There was no difference in body temperature 4 hours and 8 hours after operation and in heart rate, respiratory rate and blood pressure between the two groups (P > 0. 05).</p><p><b>CONCLUSIONS</b>The tumescent infiltration solutions at room temperature (25 degrees C) can decrease the core body temperature and increase surgical risk. It might not be good for rehabilitation. It is recommended to use tumescent infiltration solution at body temperature (37 degrees C) in liposuction.</p>

Application of hatchet flap for buccal tissue defect / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate the therapeutic effect of hatchet flap for buccal tissue defect.</p><p><b>METHODS</b>The hatchet flap was designed beside the tissue defect and advanced to cover the defect.</p><p><b>RESULTS</b>Since 2006, 13 cases were treated with primary healing and no flap loss. The size of the flaps ranged from 1.8 cm x 2.0 cm to 2.5 cm x 3.5 cm. All the cases were followed up for 3 months to 1.5 years. The postoperative appearance was satisfactory with inconspicuous scar.</p><p><b>CONCLUSIONS</b>Hatchet flap is very suitable for the buccal tissue defect with satisfactory cosmetic result. The facial natural figure is protected very well.</p>