• Archives of Plastic Surgery
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• v.38 no.5
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• pp.674-678
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• 2011

Purpose: Straight closure line of classic Weir excision leaves visible scars and makes it difficult to precisely approximate resection margins. Hence this study introduces Park-Weir excision that effectively reduces alar width with minimal alar rim scar by 3-dimensional zigzag incision and properly controls the approximation of edges. Methods: From 2008 to 2010, 14 patients underwent Park-Weir excision, crossed wedge excision on alar rim not exceeding 5 mm in width. Each patient was photographed in the same position. Alar width and columellar height against intercanthal distance was compared preoperatively and postoperatively, using image analysis software. Results: Five patients were female and nine were male. Average follow up period was 8 month. Alar width was reduced by 50.50% to 45.96%, original alar width reduced by 8.98% without significant changes in columellar height which was reduced by 0.39%. No visible scar was reported during outpatient follow-up. Conclusion: Park-Weir excision effectively reduces alar width and corrects the flaring of alar without affecting the columellar height. Zigzag incision of Park-Weir excision leaves aesthetically more pleasant scar than straight single incision of classical Weir excision.

• Archives of Reconstructive Microsurgery
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• v.14 no.2
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• pp.131-137
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• 2005

The extensor digitorum brevis (EDB) muscle island flap is a reliable, safe method for coverage of foot and ankle. There are many variation in approach such as curvilinear, zigzag, L-shaped or vertical longitudinal incision for exposure of the EDB muscle. These approaches use only single incision excluding the distal incision for exposure of the distal tendon. Since dorsalis pedis artery vascular bundle and sinus tarsi branch of the lateral tarsal artery both requires careful dissection, single incision alone may cause not only difficulty in exposure but also skin sloughing at donor site. So we tried to modify the approach into two parallel longitudinal incision, one for dorsalis pedis vascular bundle and the other for sinus tarsi branch exposure. The author treated 9 patient with EDB muscle flap. We used single incision in six patients, and two parallel incision in three patients. All the flap survived. In two parallel incision group, dissection was more easy and rapid. So we would like to suggest that two parallel longitudinal incision approach is better method than the single incision technique for exposure of the EDB muscle flap.

• Archives of Plastic Surgery
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• v.42 no.2
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• pp.207-213
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• 2015

Background Pincer nail deformity is a transverse overcurvature of the nail. This study aimed to define the anatomical characteristics of pincer nail deformity and to evaluate the surgical outcomes. Methods A retrospective review was conducted on 20 cases of pincer nail deformity of the great toe. Thirty subjects without pincer nail deformity or history of trauma of the feet were selected as the control group. Width and height indices were calculated, and interphalangeal angles and base widths of the distal phalanx were measured with radiography. We chose the surgical treatment methods considering perfusion-related factors such as age, diabetes mellitus, kidney disease, and peripheral vascular disease. The zigzag nail bed flap method (n=9) and the inverted T incision method (n=11) were used to repair deformities. The outcomes were evaluated 6 months after surgery. Results The interphalangeal angle was significantly greater in the preoperative patient group ($14.0^{\circ}{\pm}3.6^{\circ}$) than in the control group ($7.9^{\circ}{\pm}3.0^{\circ}$) (P<0.05). The postoperative width and height indices were very close to the measurements in the control group, and most patients were satisfied with the outcomes. Conclusions We believe that the width and height indices are useful for evaluating the deformity and outcomes of surgical treatments. We used two different surgical methods for the two patient groups with respect to the perfusion-related factors and found that the outcomes were all satisfactory. Consequently, we recommend taking into consideration the circulatory condition of the foot when deciding upon the surgical method for pincer nail deformity.