Journal of plastic, reconstructive & aesthetic surgery : JPRAS
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J Plast Reconstr Aesthet Surg · Aug 2015
Strategies for customized neck reconstruction based on the pre-expanded superficial cervical artery flap.
It is still highly challenging to restore the esthetic neck contour for postburn deformities. In many patients with burns, the back skin remains intact, which is a useful donor site for extensive contracture release. As the main technique, the refinement of the pre-expanded superficial cervical artery (SCA) flaps may improve its application in diverse neck contractures. ⋯ Pre-expanded SCA flaps are practical and flexible for the reconstruction of diverse scar contractures ranging from unilateral to total neck lesions. Considering the reconstructive efficiency and the reduced donor-site morbidity, this flap may be an ideal option for the reconstruction of severe neck scar contractures.
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J Plast Reconstr Aesthet Surg · Aug 2015
Reconstructive approach to hostile cranioplasty: A review of the University of Chicago experience.
Hostile sites for cranioplasty occur in patients with a history of radiation, infection, failed cranioplasty, CSF leak or acute infection. We review our series of autologous cranioplasties and present an approach to decision-making for reconstructing these complex defects. ⋯ Vascularized, non-vascularized and mixed reconstructive methods can be used successfully in these challenging situations. We offer the CRASSH to aid in aligning patients with the most appropriate autologous reconstruction method for their hostile cranial sites.
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J Plast Reconstr Aesthet Surg · Jul 2015
Case ReportsReconstruction of a large soft-tissue defect in the single finger using the modified cross-finger flap.
Providing soft-tissue coverage for a large defect in the single finger presents marked functional and aesthetic challenges. This article describes the reconstruction of such injuries using a modified cross-finger flap, and it reports the results of the use of the flap. ⋯ Therapeutic IV.
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J Plast Reconstr Aesthet Surg · Jun 2015
One-stage dual latissimus dorsi muscle flap transfer with a pair of vascular anastomoses and double nerve suturing for long-standing facial paralysis.
Various types of neurovascular free-muscle transfers have been reported as surgical treatments for long-standing facial paralysis. Among one-stage methods, two approaches, that is, latissimus dorsi transfer with nerve suturing to the contralateral facial nerve and gracilis transfer with nerve suturing to the ipsilateral masseteric nerve, have recently become popular. The former method has the advantage of making spontaneous smiling possible, but the contraction strength of the transferred muscle varies, whereas the latter approach has the advantage of guaranteeing voluntary contraction of the transferred muscle, but makes spontaneous smiling difficult. Recently, dual innervation methods have also been reported, but uncertainty remains about the utility of such approaches. To overcome these drawbacks, we devised a hybrid method combining the two previously established techniques. ⋯ Our novel one-stage method, which involves a combination of two previously established methods, guarantees early voluntary smiling, and spontaneous smiling becomes possible later. In addition, it is free from the uncertainty associated with double innervation and does not require nerve grafts. So, stable results can be expected in most patients with long-standing facial paralysis.