• Archives of Craniofacial Surgery
• /
• v.12 no.2
• /
• pp.111-115
• /
• 2011

Purpose: Reconstruction of a full thickness defect of the nose is a difficult task for plastic surgeons because the anatomical characteristic, shape, and function of the nose all need to be taken into consideration. Most often, a local flap or a composite graft is used, but for a large defect, reconstruction using free flaps is the most ideal method. In free flap reconstruction, the chondrocutaneous preauricular area can be a suitable donor site. We performed a chondrocutaneous preauricular free flap with an interpositional vascular graft for reconstruction of a nasal ala. Methods: A 46 year-old male presented to the hospital with a right alar deformity induced by a dog bite. During the surgery, the existing scar tissue was removed and thereby a newly formed full thickness defect was reconstructed using the chondrocutaneous preauricular free flap with an interpositional vascular graft harvested from the descending branch of the lateral femoral circumflex vessel between the facial and superficial temporal vessels of the free flap. Results: The flap survived without flap loss and showed symmetry in its overall shape, contour, texture, and color. The patient was satisfied with the results and the surgery yielded no additional scars at the nasolabial fold area. Conclusion: The chondrocutaneous preauricular free flap is a valuable method in reconstruction of full thickness defects of the nose, and using the descending branch of the lateral femoral circumflex vessel as the interpositional vascular graft at the anastomotic site produces reliable results.

• Archives of Reconstructive Microsurgery
• /
• v.9 no.1
• /
• pp.37-43
• /
• 2000

Vascularized tissue coverage is necessary for treatment of soft tissue defect with bone and tendon exposure on hand and foot dorsum, which cannot be successfully covered with simple skin graft or local flap. The temporal fascia is one of the most ideal donor for coverage of soft tissue defect of dorsum of hand or foot in term of ultra-thin, pliable and highly vascular tissue. Also, this flap offers the advantage of a well-concealed donor site in the hair-bearing scalp and smooth tendon gliding. We have experienced 11 cases of reconstruction for soft tissue defect in the hand or foot using temporal fascial flap with skin graft. All cases survived completely and we could gain satisfactory functional results. There were no specific complications except one donor site alopecia We think that the free temporal fascial flap coverage is a highly reliable method for soft tissue defect in hand and foot dorsum. However, the potential pitfalls is secondary alopecia and requirement of skin graft after its transfer.

• Smart Structures and Systems
• /
• v.16 no.3
• /
• pp.555-577
• /
• 2015

In the work at hand, the development of a morphing flap, actuated through shape memory alloy load bearing elements, is described. Moving from aerodynamic specifications, prescribing the morphed shape enhancing the aerodynamic efficiency of the flap, a suitable actuation architecture was identified, able to affect the curvature. Each rib of the flap was split into three elastic elements, namely "cells", connected each others in serial way and providing the bending stiffness to the structure. The edges of each cell are linked to SMA elements, whose contraction induces rotation onto the cell itself with an increase of the local curvature of the flap airfoil. The cells are made of two metallic plates crossing each others to form a characteristic "X" configuration; a good flexibility and an acceptable stress concentration level was obtained non connecting the plates onto the crossing zone. After identifying the main design parameters of the structure (i.e. plates relative angle, thickness and depth, SMA length, cross section and connections to the cell) an optimization was performed, with the scope of enhancing the achievable rotation of the cell, its ability in absorbing the external aerodynamic loads and, at the same time, containing the stress level and the weight. The conceptual scheme of the architecture was then reinterpreted in view of a practical realization of the prototype. Implementation issues (SMA - cells connection and cells relative rotation to compensate the impressed inflection assuring the SMA pre-load) were considered. Through a detailed FE model the prototype morphing performance were investigated in presence of the most severe load conditions.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.22 no.1
• /
• pp.98-104
• /
• 2000

Expansion in the scope and technique of head and neck tumor resection during the past two decades has paralleled precise tumor localization with advanced radiographic imaging and the availability of microvascular free tissue transfer. Especially, the defect reconstruction utilizing free flap results in improvement of patient survival due to decrease of local recurrence by wide resection of cancer. The rectus abdominis free flap has been used widely in reconstruction of the breast and extremities. However, the report of cases on its applications in the head and neck, based on the deep inferior epigastric artery and vein, is rare. This flap is one of the most versatile soft-tissue flaps. The deep inferior epigastric artery and vein are long and large-diameter vessels that are ideal for microvascular anastomosis. The skin area that can be transferred is probably the largest of all flaps presently in use. The versatility of the donor site is due to the ability to transfer large areas of skin with various thickness and amounts of underlying muscle. This article is to report reconstruction of midface defects utilizing the rectus abdominis free flap in 2 patients with maxillary squamous cell carcinoma and discuss briefly considerations in flap design and orbital exenteration, and healing of irradiated recipient site by hyperbaric oxygen therapy with literature review.

• Proceedings of the KSME Conference
• /
• 2001.06d
• /
• pp.1014-1019
• /
• 2001

A numerical investigation was performed to determine the effect of airfoil on the optimum flap height using NACA 00XX and 44XX airfoils. The six flaps which have 0.5% chord height difference were selected. A Navier-Stokes code, FLUENT, was used to calculate the flow field of the airfoil. The code was first tested as a benchmark by modelling flow around a NACA 4412 airfoil. Predictions of local pressure coefficients are found to be in good agreement with the result of the experimental result. For every NACA 00XX and 44XX airfoil, flap heights ranging from 0.0% to 2.5% chord were changed by 0.5% chord interval and their effects were also studied. Representative results from each case are presented graphically and discussed. It is concluded that this initial approach gives an idea for the future development of the wind turbine optimum design.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.39 no.1
• /
• pp.3-8
• /
• 2013

Reconstruction of oral soft-tissue defects following resection of oral carcinomas can be achieved using various techniques including microsurgical tissue transfer. However, there seems to be a role for regional or local flaps. Small to medium-size defects can be functionally reconstructed with the platysma myocutaneous flap as an excellent choice particularly in medically compromised patients not being eligible for free tissue transfer. The present paper reviews the indication, surgical technique, and complications following reconstruction of defects of the oral cavity with the platysma myocutaneous flap.

• Proceedings of the Korean Society of Marine Engineers Conference
• /
• 2001.05a
• /
• pp.58-62
• /
• 2001

A numerical investigation was performed to determine the effect of airfoil on the optimum flap. height using NACA 0006, 0009, 0012, 0015, 0018, 0021 and 0024 airfoils. The six flaps which have 0.5% chord height difference were used. A Navier-Stokes code, FLUENT, was used to calculate the flow field of the airfoil. The code was first tested as a benchmark by modelling flow around a NACA 4412 airfoil. Predictions of local pressure coefficients are found to be in good agreement with the result of the experimental result. For every NACA 00XX airfoil, flap heights ranging from 0.0% to 2.5% chord were changed by 0.5% chord interval and their effects were also studied. Representative results from each case are presented graphically and discussed. It is concluded that this initial approach gives a promise for the future development of wind turbine optimum design.

• Archives of Craniofacial Surgery
• /
• v.24 no.3
• /
• pp.129-132
• /
• 2023

Scalp defects necessitate diverse approaches for successful reconstruction, taking into account factors such as defect size, surrounding tissue, and recipient vessel quality. This case report presents a challenging scenario involving a temporal scalp defect where ipsilateral recipient vessels were unavailable. The defect was effectively reconstructed utilizing a transposition flap and a latissimus dorsi free flap, which was anastomosed to the contralateral recipient vessels. Our report underscores the successful reconstruction of a scalp defect in the absence of ipsilateral recipient vessels, emphasizing the importance of employing appropriate surgical interventions without necessitating vessel grafts.

• Archives of Plastic Surgery
• /
• v.37 no.6
• /
• pp.835-838
• /
• 2010

Purpose: Reconstruction of soft tissue defects in the distal lower leg, especially in the distal third, largely depends on free tissue transfer and local fasciocutaneous flaps. But several local muscle flaps have also been proposed as useful alternative reconstructive manner. In this report, the authors present the successful use of the flexor digitorum longus muscle flaps in the distal lower leg reconstruction. Methods: Case 1: An 81-year-old woman with a dog bite wound in the left distal lower leg was admitted. She had a $10{\times}8\;cm$ wound with tibial exposure along the medial aspect of the leg. Soft tissue reconstruction with a flexor digitorum longus muscle flap and a split-thickness skin graft was performed. Case 2: A 77-year-old woman had a squamous cell carcinoma in the right distal lower leg. After wide excision, a $5{\times}4\;cm$ wound was developed with exposure of the tibia. The flexor digitorum longus muscle flap was transposed and covered with a split-thickness skin graft. Results: The flexor digitorum longus muscle flaps were shown to be useful to cover tibial defects in the distal lower leg. During the follow-up period, no significant donor site morbidity was found. Conclusion: The flexor digitorum longus muscle flap can be used to cover the exposed distal tibia, especially when a free tissue transfer is not an option. The relative ease of dissection and minimal functional deficits were the major advantages of this flap, while the extent of reach into the lower third has a limitation.

• The Journal of the Korean bone and joint tumor society
• /
• v.14 no.1
• /
• pp.33-43
• /
• 2008

Purpose: To evaluate the clinical usability of reconstructive methods, and how to select flap after wide excision of malignant soft tissue tumor in ankle and foot. Materials and Methods: The 15 cases shown in the 14 patients (In case of a male patient, reconstruction was performed two times due to local recurrence.) with malignant soft tissue tumor in ankle and foot, who underwent reconstruction after wide excision from March 2000 until March 2007. Oncologic, surgical and functional results were evaluated. Results: The method of reconstruction used were anterolateral thigh perforator flap (5cases), Reversed superficial sural artery flap (4 cases), dorsalis pedis flap (3 cases), local flap (3cases). The defect, mean size was $5.5{\times}5.7\;cm$, was reconstructed with rotation flap or free flap, mean size was $5.9{\times}6.0\;cm$, skin graft for remnant. The mean operation time was 310 minutes (120~540 minutes); it took 256 minutes to reconstruct by rotation flap, and 420 minutes by free flap. As oncologic results, 7 patients were no evidence of disease, 6 patients were alive with disease and 1 patient was expired by pulmonary metastasis at the time of the last follow-up. 4 patients had local recurrence and 4 pateints had distant metastases. As functional results, 14 patients were evaluated with average score of 68.8% using the system of the Musculoskeletal Tumor Society. Conclusion: The dorsalis pedis and reverse superficial sural artery rotation flap which is easy procedure, has less complication and takes short operation time, can be primarily considered to reconstruct a small defect. And the anterolateral thigh perforator flap is suitable for coverage of a large defects after wide excision of malignant soft tissue tumor in ankle and foot.