Subcutaneous Pedicle Limberg Flap for Facial Reconstruction

Background. A residual dog-ear arising from the traditional Limberg flap transposition sometimes influences the cosmetic outcomes, and the Limberg flap with a subcutaneous pedicle is an innovation applicable to a variety of facial defects and free from the dog-ear.
Objective. To investigate the outcome of the subcutaneous pedicle Limberg flap for the reconstruction of medium-sized facial skin defects.
Materials and Methods. From August 2002 to June 2004, the subcutaneous pedicle Limberg flap was designed to repair facial skin defects in 17 patients (19 flaps), and the size of the lesions ranged from 2.0 × 1.9 cm to 5.0 × 4.5 cm.
Results. All flaps survived with primary healing postoperatively. The patients were followed up from 1 to 22 months, and functionally and cosmetically satisfactory outcomes were achieved.
Conclusions. This subcutaneous pedicle Limberg flap provides a competitive repair alternative for the treatment of medium-sized skin defects in the face.     

The Versatile V-Y Flap for Facial Reconstruction

BACKGROUND: There are many acceptable treatments for facial skin cancer, but some form of surgical excision is by far the most widely accepted. After surgical excision, there will necessarily be a defect that has to be managed. The V-Y flap is a very useful modality for repair of such defects in all zones of the face. OBJECTIVE: This article reviews the indications for V-Y flaps and the surgical technique that should result in a successful reconstruction. Each zone of the face is independently discussed, along with the appropriate variations in technique for each area. METHODS: An evaluation of the literature as well as the extensive experience of the senior author in performing this procedure provides the basis for this review. CONCLUSION: V-Y flaps are extremely versatile and relatively easy to perform. All areas of the face can be successfully reconstructed after skin cancer removal with V-Y flaps if they are properly designed and executed.     

Innovations in the Island Pedicle Flap for Cutaneous Facial Reconstruction

BACKGROUND: The island pedicle flap is a useful method of reconstruction in dermatologic surgery. Traditionally, the pedicle has been centrally and inferiorly based, with flap movements by rotation or advancement. With innovations, however, the flap is remarkably applicable to a variety of facial defects. OBJECTIVE: Our purpose is to introduce modifications of the island pedicle flap, including (1) single lateral pedicle, (2) transposition, and (3) interpolation movements. METHODS: Modifications of the island pedicle flap were applied in nine cases of cutaneous repair after Mohs micrographic surgery. Patient records and postoperative photographs were reviewed retrospectively. Both patients and other surgeons were asked to assess outcome variables. RESULTS: Patients and physicians judged overall outcome as "excellent" or "good" in 100% and 90.7% of evaluated cases, respectively. CONCLUSIONS: Variations of the island pedicle flap, including (1) single lateral pedicle, (2) transposition, and (3) interpolation movements, are viable options in the reconstruction of facial defects after Mohs micrographic surgery.     

Reverse-Flow Retroauricular Island Flap in Facial Reconstruction

BACKGROUND Reconstruction of facial skin defects requires good-quality skin cover to satisfy aesthetic expectations of patient, especially when the skin defect is on the uncovered area of the face. Limitations in the available local tissue and donor-site morbidity restrict the options.
OBJECTIVE In an effort to solve these problems, we have begun to use a subcutaneous pedicled retroauricular reverse-flow flap.
METHODS Between January 1997 and December 2005, reverse-flow subcutaneous pedicled retroauricular island flap was used to cover facial defects in 12 patients who underwent surgical excision of skin tumor. The patients ranged in age from 44 to 81 years with a mean age of 58 years.
RESULTS Only one case experienced a superficial necrosis in the distal one-quarter part of the flap. The functional and aesthetic results were satisfactory for both patients and surgeons, and no tumor recurrence was observed during the 12 to 28 months (mean, 18.8 months) follow-up period.
CONCLUSIONS This flap can be used reliably for the reconstruction of facial skin defects of small and medium size. The preference of frontal branch pedicled flap enables more distal facial area defects to be covered, such as dorsal nasal, nasolabial, and upper lip, than flaps based on parietal branch.     

Reconstruction of Facial Gunshot Wound by the Cervicopectoral Flap

Background: Reconstruction of large facial defects secondary to shotgun blast to the face is a very difficult task in surgery. Case Study: We report on a 34-year-old female patient with suicidal shotgun injury to her face delivered by a hunting rifle at close range into her mouth. She showed a large right cheek defect and a mandibular fracture. The defect was closed by a cervicopectoral fasciocutaneous flap; the mandibular fracture was managed with a titanium reconstruction plate. Good aesthetic and functional results were achieved 1 year after reconstruction. Conclusion: Early definitive reconstruction of shotgun injuries is still controversial. The cervicopectoral flap has many advantages. It is easy and secure to harvest and possesses skin properties similar to the face. The flap is quite thin allowing soft tissue coverage without a bulky view. This is the first study in the literature using a cervicopectoral flap for closure of a facial gunshot wound. We conclude that in patients with facial gunshot wounds, early reconstruction with a cervicopectoral flap offers a very important alternative.     

Local Hatchet Flap for Facial Skin Defects Reconstruction in Special Areas

BACKGROUND: The local hatchet flap has been used to reconstruct skin defects of the face with satisfactory results. Cosmetically, it has advantages over other local flaps when skin defects are located in special areas such as the eyelid. OBJECTIVE: The purpose of this study was to examine the application of local hatchet flaps for facial defect reconstruction, especially in cases where reconstruction is classically difficult for cosmetic and functional rehabilitation. METHODS: We report an illustrated case series. Results. In this study, all four cases achieved satisfactory functional and cosmetic results using the local hatchet flap. CONCLUSIONS: The local hatchet flap is an effective and simple alternative for reconstructing facial defects in special areas of the face, offering good cosmetic results and satisfactory function.     

Superficial Temporal Fascial Flap Plus Lipofilling for Facial Contour Reconstruction in Bilateral Progressive Facial Hemiatrophy

Progressive facial hemiatrophy (PFH) was first described by Parry in 1825 and later by Romberg in 1846 and was also known as Parry-Romberg syndrome. Progressive facial hemiatrophy, as the name suggests, usually has unilateral presentation. However, bilateral manifestation has been reported in 5–10% of the cases. It is a rare disorder with few cases reported. Treatment involves augmentation of the atrophic region and restoration of symmetry of the face. Because many tissues are needed, it is very difficult to treat. In this article we report the use of a superficial temporal fascial flap plus lipofilling to treat bilateral progressive facial hemiatrophy. We obtained good facial volume, smooth contour, and soft palpation. It is safer, simple to perform, and more cost effective than free tissue transfer. It is a suitable technique of choice in the treatment of bilateral progressive facial hemiatrophy.     

皮下组织蒂岛状皮瓣在面部皮肤缺损修复中的应用

目的介绍皮下组织蒂岛状皮瓣在面部皮肤缺损中的应用。方法以面部皮下组织作为皮瓣的供血蒂,转移皮瓣修复面部缺损。皮瓣面积为1.0cm×1.0cm至3.0cm×4.0cm。结果本组25例患者,切口均Ⅰ期愈合,皮瓣全部成活,术后面部形态满意,术区平整,无"猫耳"畸形,切口瘢痕不明显。结论皮下组织蒂岛状皮瓣修复面部皮肤缺损可以达到良好的美学效果。     

精细缝合与局部皮瓣在面部外伤修复中的应用

目的 探究精细缝合与局部皮瓣在面部外伤修复中的应用效果。方法 选取2021年1月-2023年1月 丹阳市人民医院烧伤整形外科收治的面部外伤患者50例,随机分为对照组和观察组,各25例。对照组行传 统缝合方式修复,观察组则采用精细缝合与局部皮瓣方式修复,比较两组临床症状情况,治疗前、后瘢 痕美观度评分、瘢痕程度评分、并发症发生率以及炎性因子水平。结果 观察组并发症发生率低于对照组 （P＜0.05）;两组治疗后IL-1、IL-6以及TNF-α水平均低于治疗前,且观察组低于对照组（P＜0.05）; 两组治疗后VSS各项评分均低于治疗前,且观察组低于对照组（P＜0.05）;两组治疗后PSAS、OSAS以 及POSAS评分均低于治疗前,且观察组低于对照组（P＜0.05）;观察组瘢痕长度、水肿持续及切口愈合 时间均短于对照组（P＜0.05）;观察组治疗总有效率高于对照组（P＜0.05）。结论 在面部外伤修复中 应用精细缝合与局部皮瓣,可提高美容效果和创口修复质量,降低瘢痕增生及炎症反应,有效且安全。 【关键词】面部外伤;精细缝合;局部皮瓣;瘢痕     

上臂内侧扩张皮瓣修复面部瘢痕挛缩

目的探讨上臂内侧扩张皮瓣面部瘢痕挛缩的方法及效果。方法采用上臂内侧扩张皮瓣修复面部瘢痕挛缩17例。结果本组皮瓣面积(10 cm×8 cm)~(15 cm×9 cm),移植皮瓣全部成活。7例随访3个月~5年,皮瓣外形良好,色泽与面部皮肤相近,供瓣区遗留瘢痕较小。结论上臂内侧扩张皮瓣修复面部瘢痕挛缩效果良好,虽所需时间长,且需强迫体位固定,但仍不失为面部整形修复的可选之法。     

高氧液在颌面部组织缺损移植修复术中的应用

目的 探讨静脉输注高氧液在颌面部组织缺损移植修复术中的应用效果.方法 对21例颌面部组织缺损患者采用组织移植的方法修复缺损;术后给予静脉输注高氧葡萄糖液治疗,监测患者血氧饱和度(SaO2),分析动脉血氧分压(PaO2),并比较输注高氧液前后各指标的变化情况.结果 输注高氧液30 min、60 min后患者SaO2、PaO2显著上升(均P＜0.05),皮瓣愈合良好.结论 静脉输注高氧液可以明显改善缺损修复区组织的血氧供应,对皮瓣移植患者有一定的治疗作用.     

高氧液在颌面部组织缺损移植修复术中的应用

目的探讨静脉输注高氧液在颌面部组织缺损移植修复术中的应用效果。方法对21例颌面部组织缺损患者采用组织移植的方法修复缺损；术后给予静脉输注高氧葡萄糖液治疗，监测患者血氧饱和度（SaO2），分析动脉血氧分压（PaO2），并比较输注高氧液前后各指标的变化情况。结果输注高氧液30min、60min后患者SaO2、PaO2显著上升（均P〈0．05），皮瓣愈合良好。结论静脉输注高氧液可以明显改善缺损修复区组织的血氧供应，对皮瓣移植患者有一定的治疗作用。     

皮下组织蒂岛状皮瓣在面部皮肤肿瘤切除术后创面修复中的应用效果

探究在面部皮肤肿瘤切除术后创面修复中应用皮下组织蒂岛状皮瓣的效果。方法 选取2019年1月-2023年1月于本院行面部皮肤肿瘤切除术的60例患者作为研究对象,根据应用皮瓣差异分为对照组和观察组,每组30例。对照组于面部皮肤肿瘤切除术后应用传统皮瓣修复创面,观察组于面部皮肤肿瘤切除术后应用皮下组织蒂岛状皮瓣修复创面,比较两组修复效果、并发症发生情况、疼痛程度及生活质量。结果 观察组修复总有效率为93.33%,高于对照组的66.67%（P ＜0.05）;观察组并发症发生率为3.33%,低于对照组的20.00%（P ＜0.05）;观察组术后1、7、14 d VAS评分均低于对照组（P ＜0.05）;观察组躯体功能、心理功能、社会功能、物质生活评分均高于对照组（P ＜0.05）。结论 皮下组织蒂岛状皮瓣在面部皮肤肿瘤切除术后创面修复中的应用效果理想,术后并发症较少,疼痛程度较轻,可提高患者生活质量,促进恢复。     

颞浅筋膜预置耳后扩张皮瓣在面部较大面积创面修复中的应用

目的 探索颞浅筋膜预置耳后扩张皮瓣,在修复面部较大面积组织缺损中的应用.方法 自2007年,对10例较大面部浅表性组织缺损患者,采用颞浅筋膜预置耳后扩张皮瓣进行修复.Ⅰ期手术形成由颞浅动脉顶支供血的筋膜岛状瓣,预置于耳后乳突区皮下,同时在筋膜瓣下埋置皮肤扩张器.注水完成并保持3～5个月,动脉造影观察颞浅动脉分支在耳后的区分布.Ⅱ期手术取出扩张器,形成以颞浅动脉直接供血的耳后岛状皮瓣,经皮下隧道转移覆盖面部创面.结果 本组患者术后随访6～18个月.2例术后24h出现皮瓣远端静脉回流受阻,致浅表组织坏死,于2周内创面愈合.其余皮瓣存活良好.皮瓣切取最大面积7 cm×3.5 cm.结论 颞浅筋膜岛状瓣预置耳后扩张皮瓣,皮瓣薄,供皮区无需植皮,面部不增加额外切口,适合于面部较大面积创面的修复.