Journal of plastic, reconstructive & aesthetic surgery : JPRAS
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J Plast Reconstr Aesthet Surg · Dec 2016
The pre-expanded subclavicular island flap: A new tool for facial reconstruction.
The anterior chest is an excellent donor site for cervicofacial reconstruction. Studies of chest flaps began as early as 1988 at our institution. We identified a new branch of the supraclavicular artery that nourishes the anterior chest, and on the basis of this finding, we created a new flap called the subclavicular flap. Unlike the supraclavicular flap, which is pedicled by the deltoid branch, this flap is primarily pedicled by the thoracic branch, and it shares similar vascular territory with the deltopectoral flap. In China, this flap has been widely used for neck reconstruction since our first publications on it in 1993. However, reports of its application are limited. To popularize the use of this flap, we present our experiences with pre-expanded subclavicular island flaps for the repair of facial scars. ⋯ Pre-expanded subclavicular island flaps have similar benefits to supraclavicular and deltopectoral flaps, and they may emerge as one of the best choices for cervicofacial reconstruction globally.
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J Plast Reconstr Aesthet Surg · Dec 2016
Endoscopy-assisted subfascial anterior transposition of the ulnar nerve for the treatment of cubital tunnel syndrome.
Many techniques have been described to relieve the compression and reduce subluxation of the ulnar nerve following surgery. The subfascial anterior transposition of the ulnar nerve (SfATUN) is one described technique, but involves a long scar, risk of injury to the medial antebrachial cutaneous nerve, and possible nerve ischemia from anterior transposition. We assessed a more refined approach of endoscopy-assisted SfATUN for the treatment of cubital tunnel syndrome. ⋯ A combination of endoscopy-assisted SfATUN allows for decompression transposition and reduced strain on the ulnar nerve through a small scar. This is now our standard approach for cubital tunnel syndrome and the "unstable" nerve.
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J Plast Reconstr Aesthet Surg · Dec 2016
Adipofascial fold-down flaps based on the posterior tibial artery perforator to cover the medial foot and ankle defects.
We report the clinical outcome after coverage for soft-tissue defect on the medial foot and ankle with an adipofascial fold-down flap based on the posterior tibial artery perforator branch proximal to the defect. ⋯ For the medial foot and ankle soft-tissue defect, the fold-down adipofascial flaps based on the posterior tibial artery perforator branch proximal to the defect could be a good option to cover it.
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J Plast Reconstr Aesthet Surg · Dec 2016
Replantation or revascularization for the treatment of hand degloving injuries.
The purpose of this study was to explore effective strategies of replantation or revascularization for the treatment of hand degloving injuries. ⋯ Midlateral incision to reduce the secondary damage to the capillaries, repair of more vessels for circulation, application of full-thickness skin grafts to enlarge the survival area, and use of anticoagulation protocols during and postsurgery may be beneficial to improve the replantation survival of the degloved skin.