Using the Helical Free Flap Based on the Retrograde Flow From Frontal Branch of Superficial Temporal Vessels in Lower Third Nasal Reconstruction.

ABSTRACT: Although the helical free flap is 1 of the most effective option for the lower third nasal reconstruction, the main limitation is still related to having a short pedicle length. In this report, the authors presented our experience in using the long pedicle helical free flap based on the frontal branch of the superficial temporal vessels in nasal reconstruction. Five patients, 3 alar full-thickness defects, 1 columellar defect, and 1 multiple subunit defect, underwent reconstruction using this technique. The pedicle length ranged from 4 to 6 cm. All the flaps were survived completely. However, vein congestion was seen post-operation in 1 case. This flap was saved by using medical leech. No vascular graft was needed. The helical free flap based on the retrograde flow of the frontal branch of the superficial temporal artery offers an option to overcome the limitation of short pedicle length. This composite flap is valuable for nasal alar and columellar reconstruction or even the larger defects, which involve multiple subunits.

The role of rapid tissue expansion in separating xipho-omphalopagus conjoined twins in Vietnam

Conjoined twins are rare, and each set of conjoined twins has a unique conjoined anatomy. It is necessary to perform separation to increase the chance of patient survival. Tissue expansion is an advanced technique for providing sufficient soft tissue and skin for wound closure. We report the successful application of rapid tissue expansion in 10-month-old xipho-omphalopagus conjoined twins in Vietnam. A tissue expander was placed on the anterior body between the sternum and umbilicus with a baseline of 70 mL sterile saline (0.9% NaCl). The first injection into the tissue expander began on the 6th day after expander insertion, and injections continued every 2 days with approximately 30–70 mL per injection according to the expansion of the skin. The expander reached 335 mL after six injections and within 10 days. In order to prepare for surgical separation, expansion was completed on the 15th day after insertion. The expanded skin area was estimated to be 180 cm2, which was sufficient to cover both patients’ skin deficiencies. The twins presented for surgical separation 6 days following the completion of tissue expansion. Both babies were discharged in good health 1 month after separation.

The role of rapid tissue expansion in separating xipho-omphalopagus conjoined twins in Vietnam

Conjoined twins are rare, and each set of conjoined twins has a unique conjoined anatomy. It is necessary to perform separation to increase the chance of patient survival. Tissue expansion is an advanced technique for providing sufficient soft tissue and skin for wound closure. We report the successful application of rapid tissue expansion in 10-month-old xipho-omphalopagus conjoined twins in Vietnam. A tissue expander was placed on the anterior body between the sternum and umbilicus with a baseline of 70 mL sterile saline (0.9% NaCl). The first injection into the tissue expander began on the 6th day after expander insertion, and injections continued every 2 days with approximately 30–70 mL per injection according to the expansion of the skin. The expander reached 335 mL after six injections and within 10 days. In order to prepare for surgical separation, expansion was completed on the 15th day after insertion. The expanded skin area was estimated to be 180 cm2, which was sufficient to cover both patients’ skin deficiencies. The twins presented for surgical separation 6 days following the completion of tissue expansion. Both babies were discharged in good health 1 month after separation.