[Distribution of deep inferior epigastric perforator vessel and application of the expanded perforator flaps].

OBJECTIVE: To explore the distribution of deep inferior epigastric perforator vessel and application of the expanded perforator flap for large scar on hand and forearm. METHODS: 20 healthy adults were selected to detect the distribution of deep inferior epigastric perforator vessel. 10 cases with cicatricial constriction on hand and forearm were treated with expanded perforator flap. RESULTS: 425 perforator points were detected on the skin surface of abdomen in 20 adults. 80% of the points are located within the area which is 1.1 -5.8 cm far from the mid-line of abdomen. According to the Rand method, the percentage of the points in zone I , II , III were 26%, 43%, and 30%, respectively. There were few points in zone IV. The area around navel had a high density of points. The points were distributed asymmetrically at the two sides of abdomen. 10 cases were treated. Vascular deficiency happened at the distal end of one flap. All the other 9 flaps survived. CONCLUSIONS: The expanded deep inferior epigastric perforator flap is thin and has a large size. It is very suitable for large scar on forearm or hand.

[Repair of the severe cleft palate in patients over 10 years old by soft palate plasty combined with buccal musculomucosal flap].

OBJECTIVE: To investigate the repair of the severe cleft palate in patients over 10 years old. METHODS: First, the horizontal palate of the palatine bone was broken and the greater palatine foramen was enlarged by chisel. Then the great palatine neurovascular bundle was released. The soft palate was pushed back and lifted as described by Pro. Ruyao Song. Finally, a buccal musculomucosal flap was transferred to repair the frontal wound after pushing back the soft palate. RESULTS: 13 patients aged 10 - 25 years old were treated by this method. All the flaps survived completely. Both the hard and soft palate were lengthened. Velopharyngeal incompetence was corrected very well and the pronunciation improved markedly. CONCLUSIONS: This method can close the severe cleft palate without tension and lengthen the soft palate. It can correct velopharyngeal incompetence very well and improve pronunciation dramatically. It is especially useful for severe cleft palate in older patients.