• Title/Summary/Keyword: Pedicled graft

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THE USE OF BUCCAL FAT PAD AS A PEDICLED GRAFT FOR THE RECONSTRUCTION OF ORAL MUCOSAL DEFECT (구강점막 결손 재건시 유경협지방대이식술의 임상적 적용)

  • Lee, Dong-Soo;Kim, Chin-Soo;Lee, Sang-Han;Jang, Hyun-Jung;Choi, Jae-Kab;Ki, Woo-Cheon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.3
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    • pp.185-190
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    • 1998
  • Various local flaps and distant flaps including tongue flap, palatal island flap, and buccal flap as well as skin grafts have been used for the reconstruction of oral mucosal defect. In the posterior region of oral cavity and the buccal cheek area, buccal fat pad can be used as a pedicled graft. The buccal fat pad is different from other subcutaneous fat tissue and it is easily accessible. There are many advantages in pedicled buccal fat pad graft for the closure of oral mucosal defect. The procedure is easy, there is no visible scar in the donor site, it is capable of reconstruction of various contour, and it has good viability. We had used buccal fat pad as a pedicled graft for the closure of oral mucosal defect after the excision of tumor and the oroantral fistula. From the results of these cases, we concluded that the use of the buccal fat pad flaps was worth of the consideration for the reconstruction of oral mucosal defect in the regions of the buccal cheek, and posterior oral cavity.

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CLOSURE OF LARGE OROANTRAL FISTULA WITH PEDICLED BUCCAL FAT GRAFT;A CASE REPORT (협지방대유경이식술을 통한 구강상악동루의 외과적 치험례)

  • Cho, Se-In;Yeo, Hwan-Ho;Kim, Young-Kyun;Lee, Hyo-Bin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.1
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    • pp.29-32
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    • 1994
  • IN 1956, Peer presented a very comprehensive account of free fatty tissue transplantation. The use of buccal fat pad had been usually used to reconstruct the perioral defects. The buccal fat pad is a special fatty tissue which is markedly different from subcutaneous fat. And it is a easily accessible fat tissue in oral and maxillofacial region. The buccal fat pad can be used as a free graft or pedicled flap. Recently, buccal fat pad is interested in cosmetic surgery because its' removal for cosmetic purpose has been favorable result. We used the buccal fat as an unlined, pedicled graft for closure of large oroantral fistula. We present a case of report and review of literature.

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The 4+5th Extensor Compartmental Artery- Pedicled Vascularized Bone Graft in Lichtman Stage III Kienbock's Disease (Lichtman 제 III기 Kienbock 병에서 시행한 제 4+5 신전구획동맥 유경 생골 이식술)

  • Kang, Soo-Hwan;Kim, Chol-Jin;Chung, Yang-Guk;Ryu, Ji-Hyun
    • Archives of Reconstructive Microsurgery
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    • v.21 no.1
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    • pp.68-75
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    • 2012
  • Purpose: The purpose of this study was to evaluate the clinical results of the 4+5th extensor compartmental artery pedicled vascularized bone graft in advanced Lichtman stage III Kienbock's disease. Materials and Methods: Eight patients with advanced Lichtman stage III Kienbock's disease who underwent the 4+5th extensor compartmental artery pedicled vascularized bone graft and followed up more than 1 year were analyzed retrospectively. There were 3 men and 5 women. The mean age was 43.6 years old. Two patients were Lichtman stage IIIA and six patients were IIIB. The clinical outcomes were evaluated with radiocarpal joint pain, range of motion, grip strength, carpal-height ratio, radioscaphoid angle, return to daily living activity and/or work. The mean follow up period was 38.5 months (range from 12 to 86 months). Results: On last follow up, the pain was disappeared in 6 patients, and mild occasional pain was remained in 2 patients. Mean radiocarpal joint flexion and extension were 55 degrees and 60 degrees, 87% and 88% of the normal side, respectively. The carpal-height ratio was maintained or improved in 6 patients and slightly decreased in 2 patients. Radioscaphoid angle were improved or maintained in 7 patients. Mean grip strength was 67 lb, 93% of the normal side. All 8 patients returned to daily living activities and/or their previous works. Conclusion: The 4+5th extensor compartmental artery pedicled vascularized bone graft prevented the progression of disease and provided clinical improvement even in advanced Lichtman stage III Kienbock's disease.

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Vascularized Bone Graft Reconstruction for Upper Extremity Defects: A Review

  • Ava G. Chappell;Matthew D. Ramsey;Parinaz J. Dabestani;Jason H. Ko
    • Archives of Plastic Surgery
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    • v.50 no.1
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    • pp.82-95
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    • 2023
  • Upper extremity reconstruction may pose clinical challenges for surgeons due to the often-critical, complex functional demands of the damaged and/or missing structures. The advent of vascularized bone grafts (VBGs) has aided in reconstruction of upper extremity (UE) defects due to their superior regenerative properties compared with nonvascularized bone grafts, ability to reconstruct large bony defects, and multiple donor site options. VBGs may be pedicled or free transfers and have the potential for composite tissue transfers when bone and soft tissue are needed. This article provides a comprehensive up-to-date review of VBGs, the commonly reported donor sites, and their indications for the treatment of specific UE defects.

Versatility of the pedicled buccal fat pad flap for the management of oroantral fistula: a retrospective study of 25 cases

  • Park, Jinyoung;Chun, Byung-do;Kim, Uk-Kyu;Choi, Na-Rae;Choi, Hong-Seok;Hwang, Dae-Seok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.50.1-50.6
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    • 2019
  • Purpose: Maxillary bone grafts and implantations have increased over recent years despite a lack of maxillary bone quality and quantity. The number of patients referred for oroantral fistula (OAF) due to implant or bone graft failure has increased, and in patients with an oroantral fistula, the pedicled buccal fat pad is viewed as a robust, reliable option. This study was conducted to document the usefulness of buccal fat pad grafts for oroantral fistula closure. Materials and methods: We retrospectively studied 25 patients with OAF treated with a buccal fat pad graft from 2015 to 2018. Sex, age, OAF location, cause, duration, presence of systemic disease, smoking, previous dental surgery, and side effects were investigated. Results: A total of 25 patients were studied. Mean patient age was 54.8 years, and the male to female ratio was 19: 6. Causes of oroantral fistula were cyst enucleation, tumor resection, implant removal, bone graft failure, and extraction. Excellent results were obtained in 23 (92%) of the 25 patients. In the other two patients that both smoked, a small fistula was observed during follow-up. No recurrence of oroantral fistula was observed after 2 months to 1 year of follow-up. Conclusions: The incidence of oroantral fistula is increasing due to implant and bone graft failures. Oroantral fistula closure using a pedicled buccal fat pad was found to have a high success rate.

Reconstruction of Post Burn Ala Defect Using Adiposocutaneous Graft (지방피부복합조직 이식을 이용한 화상 후 콧방울 결손의 재건)

  • Kwon, Min-Joo;Lee, Jong-Wook;Koh, Jang-Hyu;Seo, Dong-Kook;Choi, Jai-Ku;Jang, Young-Chul
    • Archives of Plastic Surgery
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    • v.38 no.4
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    • pp.451-457
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    • 2011
  • Purpose: As a central feature of the face, the nose has considerable significance in appearance and expression. Reconstruction of full thickness defects of the nasal ala has always been a challenge because of the 3-dimensional structure. For reconstruction of post burn defects of ala, skin graft, local or pedicled flap and composite graft are optionally available. We have reconstructed the ala defects using adiposocutaneous graft and observed the outcome. Methods: From March 2003 to December 2010, 19 cases in 11 patients with scar contracture and defect on ala portion were performed operation using adiposocutaneous graft. As a donor site, we used the inguinal crease and posterior auricular area and the donor site was primarily closed. We made incision through the superior rim of ala and released fully. A graft is applied to recipient site with larger size than recipient volume. Results: The mean age of the patient was 38.6 years (16~51), males are seven patients and females are four patients. The operation was performed bilaterally in 5 patients and unilaterally in 6 patients. Composite grafts were harvested from inguinal area in 13 cases and posterior auricular area in 6 cases. In one case, we did 4 times of operation to get enough volume. All the grafts were well taken. The mean size of the graft was 3.63 $cm^2$. Conclusion: For reconstruction of post burn defects of ala, it's not easy to use local flap or pedicled flap because of hardness and fibrosis of surrounding tissue. So, we choose adiposocutaneous graft for ala deformity reconstruction, got satisfactory outcome in color matching and texture.

Prognosis of closure of large sinus membrane perforations using pedicled buccal fat pads and a resorbable collagen membrane: case series study

  • Kim, Young-Kyun;Yun, Pil-Young;Oh, Ji-Su;Kim, Su-Gwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.4
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    • pp.188-194
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    • 2014
  • For large membrane perforations that develop during sinus-bone grafting, we performed repairs using a pedicled buccal fat pad and a resorbable collagen membrane simultaneously with the bone graft. This study included eight patients. Postoperative maxillary sinusitis developed in two patients, which we managed with incision and drainage, and antibiotics. Ultimately, six patients received 12 implants, three of which failed (75% success). Implant replacement was performed after the removal of the failed replacement, at which point the prosthetic treatment was considered complete. In all of the six cases that we were able to follow-up with, the sinus-bone graft was healing favorably. We observed that the sinus bone height decreased gradually with time. Based on these case series, we conclude that our procedure of repairing large sinus-membrane perforations with a pedicled buccal fat pad and a collagen membrane is a reliable technique.

Treatment of Syndactyly Using Small Subcutaneous Pedicled Flap (Small Subcutaneous Pedicled Flap을 이용한 합지증의 치험례)

  • Park, Sang Woo;Kang, Dae Il;Choi, Tae Hyun;Lee, Kyung Suk;Kim, Nam Gyun;Kim, Jun Sik
    • Archives of Plastic Surgery
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    • v.32 no.6
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    • pp.777-781
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    • 2005
  • Syndactyly and polysyndactyly are one of the most common congenital anomalies of upper limb. Although there are many surgical approaches, most of them require skin graft for covering the raw surfaces. Therefore these methods involve many disadvantages such as grafted skin contracture, web recurrence, skin graft loss and long operation time, and the grafted hyperpigmented skin and donor site of skin graft, which lead to poor results aesthetically. The authors treated seven cases with a Hayashi's new method in four patients. In this method, tissue of interdigital space are regarded as forming 4 facets of a two piled cube. A dorsal rectangular flap on dorsum of interdigital web makes a new interdigital space. One side of divided digit is coverd with lateral based plantar flap and the other side of divided digit is covered with subcutaneous pedicled flap and remnant web skin. The authors could obtain natural deep interdigital space without web recurrence and scar contracture in 7 cases. Moreover this method does not require skin grafting, accordingly produces better aesthetic results without hyperpigmentation and donor site scaring. Therefore we report this operation technique, which might be used as one of the standard in surgical correction of syndactyly and polysyndactyly.

The Use of Pedicled Buccal Fat Pad Graft in Dental Surgery: Case Reports (치과 수술에서 유경 협지방대의 이용: 증례보고)

  • Kim, Young-Kyun;Yun, Pil-Young;Lee, Chang-Su
    • The Journal of the Korean dental association
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    • v.41 no.9 s.412
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    • pp.637-646
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    • 2003
  • Euccal fat pad is special fat tissue which is different from subdermal fat. Anatomically, buccal fat pad is easy to harvest in the course of dental surgery procedure. In 1802, it was introduced by Bichat, Since Egyedi used buccal fat pad flap for the closure of oro-antral fistula and oro-nasal fistula, it has been widely used as an alternative method for the reconstruction of small to medium-sized intraoral defects in oral and mzxillofacial surgery. Kim et al. reported successful results in the all cases they applied buccal fat pad for the reconstruction of intraoral defect from their 31 months follow-up data. Because intraonal wounds are difficult to complete the layered suture and there are high risks of infection related with wound dental implant surgery, double layer closure using some kind of local flaps or other procedure is recommended. So we are to introduce the useful applications of the pedicled buccal fat pad in the dental surgery procedure from the various case presentations.

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