• Title/Summary/Keyword: Skin defects

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Through-and-through Nasal Reconstruction with the Bi-Pedicled Forehead Flap

  • Agostini, Tommaso;Perello, Raffaella;Russo, Giulia Lo;Spinelli, Giuseppe
    • Archives of Plastic Surgery
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    • v.40 no.6
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    • pp.748-753
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    • 2013
  • Background Nasal reconstruction is one of the most difficult challenges for the head and neck surgeon, especially in the case of complex full thickness defects following malignant skin tumor resection. Full-thickness defects require demanding multi-step reconstruction. Methods Seven patients underwent surgical reconstruction of full-thickness nasal defects with a bi-pedicled forehead flap shaped appropriately to the defect. Patients were aged between 58 and 86 years, with a mean age of 63.4 years. All of the tumors were excised using traditional surgery, and in 4 of the patients, reconstruction was performed simultaneously following negativity of fresh frozen sections of the margins under general anesthesia. Results Nasal reconstruction was well accepted by all of the patients suffering non-melanoma skin tumors with acceptable cosmetic outcomes. The heart-shaped forehead flap was harvested in cases of subtotal involvement of the nasal pyramid, while smaller defects were reconstructed with a wing-shaped flap. No cartilaginous or osseous support was necessary. Conclusions This bi-pedicled forehead flap was a valid, versatile, and easy-to-implement alternative to microsurgery or multi-step reconstruction. The flap is the best indication for full-thickness nasal defects but can also be indicated for other complex facial defects in the orbital (exenteratio orbitae), zygomatic, and cheek area, for which the availability of a flap equipped with two thick and hairless lobes can be a valuable resource.

Cutaneous asthenia associated with Ehlers-Danlos syndrome in a Yorkshire terrier

  • Cho, Sung-Jin;Kim, Okjin
    • Korean Journal of Veterinary Research
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    • v.47 no.1
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    • pp.91-94
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    • 2007
  • tisue disease of dog and cat, resembling Ehlers-Danlos syndrome (EDS) in man. EDS is characterizedby loose, hyperextensible and, fragile skin, it is attributed to mutations in connective tisue gene. Thesemutations cause defects in type I or II collagen synthesis and as a result lack of strength or elasticityto skin, joint, ligament and vessels. EDS-affected animals often experience subcutaneous hematomas thathave long bleeding times. The 4-years old male Yorkshire terrier was evaluated because of subcutaneoushematoma after stifle surgery. Clinical examination revealed a thin and hyperextensible skin and jointlaxity. The degree of skin extensibility index was 23.4%, marked skin stretchy. Clinical diagnosis wasconfirmed by histophathological examination of a skin biopsy revealing reduced packing density ofcollagen fiber of skin.

The Management Method for Preventing Frequent Defect about Each Inspection Part from The Data Analysis of Pre-qualification of Residential Building Reconstruction (주택 재건축 예비평가 자료분석을 통한 분야별 주요결함의 예방·조치방안)

  • Kim, chun hag;Bae, cheol hak
    • Proceedings of the Korean Institute of Building Construction Conference
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    • 2008.11a
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    • pp.181-186
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    • 2008
  • The purpose of this study is analyzing the frequent defect about each inspection part of Pre-qualification of residential building reconstruction and finding the cause of occurrence so that can supply a solution of the problem during the plalnning and constructure. The frequent defects are naturally following the deterioration and more occur in the structure body than a skin. The meaning that supply the cause and the managing method for preventing frequent defects about each inspection part is as follows. To prevent the defects, it is needed that the choice of the appropriate materials, giving a sufficient space for facilities, reliable constructure for the part of expecting the defects. The quality of life will go up due to making a good dwelling environment and extending the life cycle of structures from the inspection and managing the part of expecting defects.

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Reconstruction of large oroantral defects using a pedicled buccal fat pad

  • Yang, Sunin;Jee, Yu-Jin;Ryu, Dong-mok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.7.1-7.5
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    • 2018
  • Background: Oroantral communicating defects, characterized by a connection between the maxillary sinus and the oral cavity, are often induced by tooth extraction, removal of cysts and benign tumors, and resection of malignant tumors. The surgical defect may develop into an oroantral fistula, with resultant patient discomfort and chronic maxillary sinusitis. Small defects may close spontaneously; however, large oroantral defects generally require reconstruction. These large defects can be reconstructed with skin grafts and vascularized free flaps with or without bone graft. However, such surgical techniques are complex and technically difficult. A buccal fat pad is an effective, reliable, and straightforward material for reconstruction. Case presentation: This report describes three cases of reconstruction of large oroantral defects, all of which were covered by a pedicled buccal fat pad. Follow-up photography and radiologic imaging showed successful closure of the oroantral defects. Furthermore, there were no operative site complications, and no patient reported postsurgical discomfort. Conclusion: In conclusion, the use of the pedicled buccal fat pad is a reliable, safe, and successful method for the reconstruction of large oroantral defects.

Cutaneous asthenia (Ehlers-Danlos syndrome) in a Korean short-haired cat

  • Seo, Sang-Hyuk;Choi, Miru;Hyun, Changbaig
    • Korean Journal of Veterinary Research
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    • v.56 no.1
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    • pp.53-55
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    • 2016
  • A 1-year-old Korean domestic short-haired cat presented with skin hyperextensibility and a severely macerated wound on the skin of the dorsal part of the neck. Diagnostic studies including histopathology and skin extensibility index revealed congenital cutaneous asthenia (Ehlers-Danlos syndrome). In this cat, the skin wounds and defects were successfully managed with standard wound management and cosmetic surgery. Although skin hyperextensibility is persistent, the cat has lived well without other complications to date. To the best of our knowledge, this is the first report of cutaneous asthenia in a cat in Korea.

MAXILLARY GROWTH FOLLOWING CULTURED EPIDERMAL TISSUE GRAFT AND THE ADMINISTRATION OF TGF-${\beta}_3$ ON SURGICALLY CREATED PALATAL DEFECTS IN RAT (백서 구개의 외과적 결손부에 자가배양상피조직 이식 및 TGF-${\beta}_3$ 투여가 상악골의 성장에 미치는 영향)

  • Park, Jung-Hyun;Choi, Byung-Ho;Kang, Jung-Wan;Yook, Jong-In;Kim, Jin;Yi, Choong-Kook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.6
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    • pp.565-580
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    • 2000
  • This study was designed to evaluate the influence of cultured epidermal tissue graft and the administration of transforming growth factor(TGF)-${\beta}_3$ on maxillary growth in surgically created palatal defects. A total of 155 rats were divided into 2 groups according to surgical timing : postnatal 2 weeks(n=95), 4 weeks(n=40) and control(unoperated) group(n=20). The postnatal 2-week surgical group was subdivided into 3 groups according to repair methods: conventional surgery(Von Langenbeck technique)group(n=23); cultured tissue graft group(n=25); and full thickness skin graft group(n=25). Additionally, recombinant human TGF-${\beta}_3$ was administered(30ng or 150ng) on collagen matrix in surgically created palatal defects during surgery(9 conventional surgeries, 9 cultured tissue grafts) in 2-week-old rats. The results showed that all types of surgical treatment decreased maxillary growth compared with the control(unoperated) group(p<0.0001). On the other hand, the tissue graft group, whether cultured tissue or grafted skin, contributed to increased maxillary growth(p<0.0001).And exogenous TGF-${\beta}_3$ might play a role in connective tissue proliferation and new bone generation during wound healing on palatal defects. Our results suggest that grafting cultured epidermis with collagen matrix decreases the scar tension on maxillary growth more than conventional palatal surgery does. Therefore, exogenous TGF-${\beta}_3$ may contribute to accelerate wound healing on palatal defects.

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Reconstruction of large facial defects using a combination of forehead flap and other procedures

  • Kim, Ryuck Seong;Yi, Changryul;Kim, Hoon Soo;Jeong, Ho Yoon;Bae, Yong Chan
    • Archives of Craniofacial Surgery
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    • v.23 no.1
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    • pp.17-22
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    • 2022
  • Background: Reconstruction of large facial defects is challenging as both functional and cosmetic results must be considered. Reconstruction with forehead flaps on the face is advantageous; nonetheless, reconstruction of large defects with forehead flaps alone results in extensive scarring on the donor site. In our study, the results of reconstruction using a combination of forehead flaps and other techniques for large facial defects were evaluated. Methods: A total of 63 patients underwent reconstructive surgery using forehead flaps between February 2005 and June 2020 at our institution. Reconstruction of a large defect with forehead flaps alone has limitations; because of this, 22 patients underwent a combination of procedures and were selected as the subjects of this study. This study was retrospectively conducted by reviewing the patients' medical records. Additional procedures included orbicularis oculi musculocutaneous (OOMC) V-Y advancement flap, cheek advancement flap, nasolabial V-Y advancement flap, grafting, and simultaneous application of two different techniques. Flap survival, complications, and recurrence of skin cancer were analyzed. Patient satisfaction was evaluated using questionnaires. Results: Along with reconstructive surgery using forehead flaps, nasolabial V-Y advancement flap was performed in nine patients, local advancement flap in three, OOMC V-Y advancement flap in two, grafting in five, and two different techniques in three patients. No patient developed flap loss; however, cancer recurred in two patients. The overall patient satisfaction was high. Conclusion: Reconstruction with a combination of forehead flaps and other techniques for large facial defects can be considered as both functionally and cosmetically reliable.

A Comparison of the Local Flap and Skin Graft by Location of Face in Reconstruction after Resection of Facial Skin Cancer

  • Lee, Kyung Suk;Kim, Jun Oh;Kim, Nam Gyun;Lee, Yoon Jung;Park, Young Ji;Kim, Jun Sik
    • Archives of Craniofacial Surgery
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    • v.18 no.4
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    • pp.255-260
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    • 2017
  • Background: Surgery for reconstruction of defects after surgery should be performed selectively and the many points must be considered. The authors conducted this study to compare the local flap and skin graft by facial location in the reconstruction after resection of facial skin cancer. Methods: The authors performed the study in patients that had received treatment in Department of Plastic Surgery, Gyeongsang National University. The cases were analyzed according to the reconstruction methods for the defects after surgery, sex, age, tumor site, and tumor size. Additionally, the authors compared differences of aesthetic satisfaction (out of 5 points) of patients in the local flap and skin graft by facial location after resection of facial skin cancer by dividing the face into eight areas. Results: A total of 153 cases were confirmed. The most common facial skin cancer was basal cell carcinoma (56.8%, 87 cases), followed by squamous cell carcinoma (37.2%, 57 cases) and bowen's disease (5.8%, 9 cases). The most common reconstruction method was local flap 119 cases (77.7%), followed by skin graft 34 cases (22.3%). 86 patients answered the questionnaire and mean satisfaction of the local flap and skin graft were 4.3 and 3.5 (p=0.04), respectively, indicating that satisfaction of local flap was significantly high. Conclusion: When comparing satisfaction of patients according to results, local flap shows excellent effects in functional and cosmetic aspects would be able to provide excellent results rather than using a skin graft with poor touch and tone compared to the surrounding normal skin.

USAGE OF NASOLABIAL SKIN FLAPS FOR THE RECONSTRUCTION OF VARIOUS INTRAORAL DEFECTS (다양한 구강내 결손부 재건을 위한 비순피판의 활용)

  • Kim, Kyoung-Won;Lee, Eun-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.1
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    • pp.71-78
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    • 2007
  • The nasolabial flap has been used for reconstruction of moderate size intraoral defects. The nasolabial fold area provides an ample supply of tissue with a good color and texture match. The nasolabial flap classified advancement flap, inferiorly-based flap, superiorly-based flap. The flap is based inferiorly, so that it can easily be rotated to the intraoral defects. The nasolabial flap is chosen for the repair of various intraoral defects because of its simple elevation, proximity to the defect and its rich subcutaneous blood supply of a island flap. The subjects were 6 patients with nasolabial flap, who had reconstruction of moderate size intraoral defects. We have found the inferiorly-based nasolabial flap with a subcutaneous pedicle useful in the primary repair of surgical defects of the buccal mucosa, edentulous mandibular ridge, maxillary alveolus area and soft palate in these patients. There was no complication except one case. Intraoral hair growth was a minor problem of this patient. We thought that the inferiorly-based nasolabial flap is a useful technique for reconstruction of various intraoral defects.

Treatment of Aplasia Cuti Congenita Using Allogenic Dermal matrix and Cultured Epithelial Autograft: A Case Report (동종사체진피와 배양한 자가상피세포를 이용한 선천성 피부 형성 부전증 환자의 치험례)

  • Lee, Jin Hwa;Kim, Yong Kyu;Lee, Sang Joon
    • Archives of Plastic Surgery
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    • v.33 no.5
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    • pp.672-675
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    • 2006
  • Purpose: The purpose of this study is to document the surgical methods used in infants with aplasia cutis congenita treated with allogenic dermal matrix and cultured epithelial autografts. Methods: The large defects in both lower legs were replaced with allogenic dermal matrix to avoid the postoperative hypertrophic scar contracture and a full-thickness skin biopsy was taken from right groin area simultaneously. We sent the specimen to a commercial laboratory for culture and obtained cultured epithelial autografts($Holoderm^{(R)}$) after 2 weeks, placed it over the allogenic dermal matrix. Results: The skin-defected area were nearly epithelialized after 2 weeks and there were no significant problem on during 6 months follow-up. Conclusion: The surgical method using allogenic dermal matrix and cultured epithelial autograft provided an excellent coverage of large skin defects of infant with aplasia cutis congenita.