Annals of plastic surgery
-
This study compared the combined iliac and ulnar forearm flaps with the osteomusculocutaneous fibular free flap for mandibular reconstruction. A retrospective study of 40 patients who had oromandibular reconstruction was performed, of whom 23 patients had a combined iliac crest without skin and ulnar forearm free flap. Seventeen patients had an osteomusculocutaneous free fibular flap. ⋯ It appears that within this study population the free osteomusculocutaneous fibular flap had fewer local complications and a higher flap survival rate than the combined iliac/ulnar forearm flaps. Overall functional outcome was also improved. The use of the double flap may be appropriate in massive oromandibular defects, but may be less appropriate in more modest functional reconstructions of mandibular defects.
-
Annals of plastic surgery · Jan 2004
Randomized Controlled Trial Clinical TrialThe single-fascicle method of nerve grafting.
In this study a single-fascicle technique for neural deficits repair was evaluated using a rat sciatic nerve model. Twenty-four Lewis rats were divided into 4 groups: group 1, 1.5-cm deficit without repair; group 2, conventional autograft; group 3, large-fascicle autograft; and group 4, small-fascicle autograft. Nerve regeneration was evaluated by pin-prick and toe-spread tests. ⋯ Histology revealed a significantly higher number of axons and myelin thickness in the small-fascicle (2.8 +/- 0.4 x 10(3) axons, 4.22 +/- 0.41 microm) and large-fascicle (5.1 +/- 1.7 x 10(3) axons, 4.62 +/- 0.28 microm) groups compared with the conventional autograft group (2.1 +/- 0.3 x 10(3) axons, 2.93 +/- 0.20 microm). The small-fascicle group had a significantly greater mean axon area (58.59 +/- 15.81 microm2) than the large-fascicle group (29.66 +/- 12.67 microm2) and the conventional group (25.35 +/- 7.52 microm2). In this study, peripheral nerve repair using a single-fascicle graft resulted in faster functional recovery and better morphometric outcome compared with conventional nerve repair.