• Title/Summary/Keyword: Double flap

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Total Urethra and Penile Shaft Reconstruction with Combined Pedicled Anterolateral Thigh Flap and Radial Forearm Free Flap after Total Penectomy

  • di Summa, Pietro Giovanni;Sapino, Gianluca;Bauquis, Olivier
    • Archives of Plastic Surgery
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    • v.49 no.3
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    • pp.448-452
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    • 2022
  • Total reconstruction of the penis (TPR) represents a challenge for urologists and plastic surgeons, especially when urethral length is severely reduced. We here describe, for the first time in an oncologic scenario, a double flap phalloplasty using a pedicled anterolateral thigh (ALT) flap for penile reconstruction and a radial forearm free flap (RFFF) for complete neourethra and glans reconstruction following penile amputation. A 48-year-old patient came to our department following a total penectomy with inferior urethral derivation. The indication for a double flap phalloplasty was posed as only way to fully reconstruct the urethra on its length avoiding possible complications of single flap reconstruction using tube-into-tube technique. Both flaps healed uneventfully with no neourethral strictures or fistulas described. At 18 months follow-up, the patient was extremely satisfied with the aesthetic result and was able to void in standing position. We think that a double free tissue transfer for TPR should be considered, particularly when a urethral length > 14 cm needs to be reconstructed. While the pedicled ALT can be used to reconstruct a proper penile shaft with an easily concealed scar, the RFFF can provide adequate neourethra length with satisfactory sensory recovery at the neoglans.

Optimum Draft and Phasing of Double-Flap Wavemaker (Double-Flap 조파기의 설계 및 조파판의 최적 위상관계)

  • Shin-Hyoung,Kang
    • Bulletin of the Society of Naval Architects of Korea
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    • v.16 no.1
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    • pp.1-6
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    • 1979
  • A method to determine the optimum drafts of waveboards of single and double-flap wavemaker is presented by using a linearized first-order wave theory and a linear regression method. A linear regression is verified to be quite simpler than the local disturbance consideration or regular-wave forming distance. It is pointed out that lower hinge should be deep enough to keep the upper flap vertical for a long wave length.

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Reconstruction of Hand Dorsum Defect Using Double Perforators-Based Anterior Interosseous Artery Island Flap: A Case Report and Description of a New Anterior Interosseous Artery Perforator

  • Inho Kang;Hyun Rok Lee;Gyu Yong Jung;Joon Ho Lee
    • Archives of Plastic Surgery
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    • v.50 no.4
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    • pp.409-414
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    • 2023
  • The anterior interosseous artery (AIA) perforator flap is not commonly used in hand dorsum reconstruction compared with alternatives. However, it is a versatile flap with several advantages. Literature on the AIA perforator flap is based on the dorsal septocutaneous branch (DSB), which branches from the AIA and passes through fascia between the extensor pollicis longus (EPL) and extensor pollicis brevis muscles. In the described case, the authors reconstructed a hand dorsum defect in a 78-year-old man using an AIA perforator flap with double perforators supplied by the DSB and a new perforator branching from the distal than DSB. No complication was encountered, and the flap survived completely. A retrospective computed tomography review revealed the presence of the new perforator in 14 of 21 patients. Two types of new perforator were observed. One passed through the ulnar side of the extensor indicis proprius (EIP) muscle and penetrated fascia between the extensor digitorum minimi and extensor digitorum communis tendons, whereas the other passed between the EPL and EIP muscles. This report describes the anatomical location and clinical application of the new AIA perforators. The double perforators-based AIA flap provides a straightforward, reliable means of reconstructing hand dorsum defects.

Double Paddle Pectoralis Major Myocutaneous Flap for Simultaneous Reconstruction of Oro-or Pharyngocutaneous Fistula (구강 혹은 인두피부루의 동시재건을 위한 양면 대흉근피판술)

  • Lim Young-Chang;Son Eun-Jin;Shin Woo-Chul;Kim Sang-Cheol;Lee Wook-Jin;Choi Eun-Chang
    • Korean Journal of Head & Neck Oncology
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    • v.19 no.1
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    • pp.47-51
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    • 2003
  • Background and Objectives: Oro-and pharyngocutaneous fistula after irradiation can lead to extensive wound necrosis and fetal complication such as carotid rutpure. So, there is a need to clean and cover the wound rapidly in these compromised patients. Pectoralis major myocutaneous (PMMC) flap has been presented for reconstruction of complex defects in these irradiated patients. We applied the double paddle PMMC flap for the simultaneous reconstruction of above complex defects and evaluated the it's clinical efficacy. Material and Methods: Retrospective chart review of three cases of simultaneous head and neck reconstruction after irradiation with double paddle PMMC. All patients received prior radiotherpy before development of complications. The double paddle PMMC flap was used for mucosal lining of the oral cavity and epithelial lining of external skin in 2 cases, for mucosal lining of the pharynx and epithelial lining of external skin in 1 case. Results: Considerable complications such as major flap necrosis or fistula did not occur in any of the cases, and simultaneous reconstruction was achieved in all cases without reoperations. Conclusion: Many extended defects such as oro-and pharyngocutaneous fistula involving cover and lining about the head and neck after irradiation can be rehabilitated by the double paddle pectoralis major myocutaneous flap.

A Study on the Flow characteristics of Wells Turbine for Wave Power Conversion by Various Flap Shape (파력발전용 웰즈터빈의 Flap형상변화에 따른 유동 특성에 관한 연구)

  • Kim, Dong-Kyun;Choi, Gab-Song;Kim, Jeong-Hwan
    • Journal of the Korean Solar Energy Society
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    • v.26 no.2
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    • pp.1-7
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    • 2006
  • A numerical investigation was performed to determine the effect of airfoil on the optimum flap height using NACA0015 Wells turbine. The five double flaps which have 0.5% difference were selected. A Navier-Stokes code, CFX-TASCflow, was used to calculate the flow field of the Wells turbine. The basic feature of the Wells turbine is that even though the cyclic airflow produces oscillating axial forces on the airfoil blades, the tangential force on the rotor is always in the same direction. Geometry used to define the three dimension numerical grid is based upon that of an experimental test rig. This paper tries to disign the double flap of Wells turbine with the numerical analysis.

Forehead reconstruction using modified double-opposing rotation-advancement flaps for severe skin necrosis after filler injection

  • Kim, Jinwoo;Hwang, Woosuk
    • Archives of Craniofacial Surgery
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    • v.19 no.1
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    • pp.64-67
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    • 2018
  • Varying degrees of complications can occur after hyaluronic acid filler injections. Tissue necrosis due to interruption of the vascular supply is an early complication that can be severe. If the site of tissue necrosis due to the filler injection is the forehead, successfully reconstructing the region without distorting the key landmarks is challenging. We describe the case of a 50-year-old man who experienced widespread forehead skin necrosis after hyaluronic acid filler injection in the glabellar area. We successfully covered the forehead area with a $3{\times}4-cm^2$ midline necrotic tissue using the modified double-opposing rotation-advancement flap method. Although modified double-opposing rotation-advancement flap closure has the disadvantage of leaving a longer scar compared to conventional double-opposing rotation-advancement flap closure, the additional incision line made along the superior border of the eyebrow aids in camouflaging the scar and decreases eyebrow distortion. Therefore, it is believed that the modified double-opposing rotation-advancement flap technique is an excellent tool for providing adequate soft tissue coverage and minimal free margin distortion when reconstructing widespread skin necrosis in the central mid-lower forehead that can occur after filler injection in the glabellar area.

A Study on the Design of Wells Turbine for Wave Power Conversion by Various Flap Shape (1) (플랩현상 변화에 따른 파력발전용 웰즈터빈의 형상설계에 관한 연구(1))

  • Kim D.K.;Kim J.H.;Choi Y,H.;Bae S.T.;Lee Y.W.;Lee Y.H.
    • Korean Journal of Computational Design and Engineering
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    • v.9 no.3
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    • pp.253-259
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    • 2004
  • A numerical investigation was performed to determine the effect of airfoil on the optimum flap height using NACA0015 Wells turbine. The five double flaps which have 0.5% difference were selected. A Navier-Stokes code, CFX-TASCflow, was used to calculate the flow field of the Wells turbine. The basic feature of the Wells turbine is that even though the cyclic airflow produces oscillating axial forces on the airfoil blades, the tangential force on the rotor is always in the same direction. Geometry used to define the three dimension numerical grid is based upon that of an experimental test rig. This paper tries In optimized disign the double flap of Wells turbine with the numerical analysis.

A CFD Study on Wells Turbine Flap for Wave Power Generation (CFD에 의한 파력발전용 웰즈터빈의 플랩에 관한 연구)

  • Kim, J.H.;Kim, B.S.;Choi, M.S.;Lee, Y.W.;Lee, Y.H.
    • 유체기계공업학회:학술대회논문집
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    • 2003.12a
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    • pp.520-525
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    • 2003
  • A numerical investigation was performed to determine the effect of airfoil on the optimum flap height using NACA0015 Wells turbine. The five double flaps which have 0.5% chord height difference were selected. A Wavier-Stokes code, CFX-TASCflow, was used to calculate the flow field of the Wells turbine. The basic feature of the Wells turbine is that even though the cyclic airflow produces oscillating axial forces on the airfoil blades, the tangential force on the rotor is always in the same direction. Geometry used to define the 3-D numerical grid is based upon that of an experimental test rig. This paper tries to analyze the optimum double flap of Wells turbine with the numerical analysis.

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A Study on Double Flan of Wells Turbine for Wave Power Conversion (파력발전용 웰즈터빈의 더블플랩에 관한 연구)

  • Kim, J.H.;Kim, B.S.;Yoon, S.H.;Lee, Y.W.;Lee, Y.H.
    • Proceedings of the KSME Conference
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    • 2001.11b
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    • pp.616-621
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    • 2001
  • A numerical investigation was performed to determine the effect of airfoil on the optimum flap height using NACA 0021 Wells turbine. The five double flaps which have 0.5% chord height difference were selected. A Navier-Stokes code, FLUENT, was used to calculate the flow field of the Wells turbine. The basic feature of the Wells turbine is that even though the cyclic airflow produces oscillating axial forces on the airfoil blades, the tangential force on the rotor is always in the same direction. Geometry used to define the 3-D numerical grid is based upon that of an experimental test rig. This paper tries to analyze the optimum double flap of Wells turbine with the numerical analysis.

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Total Maxillary Reconstruction Using a Double-Barreled and Double Skin Paddle Fibular Flap after Total Maxillectomy

  • de la Parra, Miguel;Sanchez, Gerardo;Lopez, Jaime;Perez, Adrian;Naal, Norberto
    • Archives of Plastic Surgery
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    • v.40 no.6
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    • pp.779-782
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    • 2013
  • Chondroblastomas are rare entities accounting for approximately 1% of all primary bone tumors. We describe a case of a 7-year-old girl with a giant chondroblastoma of the maxilla, treated with bilateral class III maxillectomy and reconstruction with a double-barreled and double skin paddle fibular free flap. We show evidence of an excellent aesthetic outcome at 6 months' follow up with no evidence of tumor recurrence.