Annals of plastic surgery
-
Annals of plastic surgery · Jul 2010
Case Reports Comparative StudyVersatility of free SCIA/SIEA flaps in head and neck defects.
Reconstruction of head and neck defects may require replacement of the bony structures, external soft tissue, and intraoral mucosa. Most cases, including maxillary defects, often require repair using only soft tissue flaps. Recently, the authors used free superficial circumflex iliac artery/superficial inferior epigastric (SCIA/SIEA) flaps for head and neck reconstruction. ⋯ The functional and aesthetic results were deemed as acceptable in all patients. Based on our results, we believe that the free SCIA/SIEA flap is useful for soft tissue defect reconstruction in the head and neck. It has the following advantages: (1) Large flap elevation is possible for reaching distant recipient vessels, (2) Two surgical teams may work at the same time preparing the donor and recipient regions, and (3) The flap design uses an abdominoplasty incision, which has minimal donor site morbidity.
-
Annals of plastic surgery · Jul 2010
Case ReportsIn vivo tissue engineering over wounds with exposed bone and tendon: Autologous dermal grafting and vacuum-assisted closure.
Flap coverage is ideal for wounds exposing bone and tendon, but technically less demanding and speedier options might be considered for small shallow wounds and for wounds with adjacent tissue loss precluding local flaps. We revisited the use of autologous dermal grafting-in combination with vacuum-assisted closure (VAC)-for such wounds. Five small- to medium-sized wounds exposing bone, joint, and/or tendon were each covered using an autologous meshed dermal graft followed by VAC application to induce granulation. ⋯ All healed wounds had a nearly flush profile with no bulkiness in the foot and toe region. Autologous dermal grafting with VAC is an integrated in vivo tissue engineering system in which the meshed dermis acts as an attractive scaffold for granulation within the conducive VAC-medium. As an alternative to flap surgery or dermal substitutes, the technique is simple, swift, and cost-effective for immediate closure of small shallow wounds and even multiple small wounds, exposing bone and tendon particularly in the lower legs, feet, and toes.