Abstract:
PURPOSE:Since its description in the 1970s, the radial forearm free flap has earned a clearly defined role in the armamentarium of reconstructive head and neck surgery. Three decades later, the donor site remains an intrinsic drawback primarily due to its esthetic impact, although functional morbidity is significant in a minority. These points do not outweigh significant advantages but are occasionally reasons for the choice of alternative flaps. Modifications evolved in an effort to improve these undesirable features include primary closure, rotation-advancement, proximal paddle placement, full-thickness skin graft (FTSG) and suprafascial dissection. We describe a novel technique of engineering a composite graft of cadaveric acellular dermal matrix and autologous split-thickness skin graft (STSG) for a better donor-site closure. METHODS:From December 1995 to August 2003, 23 patients underwent radial forearm reconstruction of head and neck defects. Control patients (Group I; n = 5) had donor sites closed by conventional STSG technique (0.014-0.016 inch). In 18 patients (Group II), the donor site was closed with a composite technique (dermal allograft, 0.020-0.030 inch, and an ultrathin STSG, 0.0080 inch). Both groups of patients were retrospectively studied for comparative defects. Contralateral upper extremities also served as controls. All patients underwent a standardized functional examination of the donor and contralateral extremities, as well as an outcome questionnaire. All extremities were photographed for visual comparison by the author. RESULTS:Three of the 5 group I patients were available for follow-up, which averaged 64 months (60-72 months). Thirty-three percent had a decrease in functional parameters and 67% complained of paresthesia. Patient satisfaction was 3.5/5. Six of the 18 patients were excluded from Group II due to insufficient follow-up or inability to follow. Follow-up averaged 8 months (1-24 months). Functional parameters in all patients were comparable to the contralateral extremity, except in 1 patient. In this case, a 0.030-inch allograft was used which never revascularized, inhibiting wrist motion. Other patients exhibited excellent range of motion of the wrist and fingers. This was the only patient in this group that exhibited paresthesia of the donor site. Patient satisfaction was 4.6/5. Esthetic results were extremely gratifying as judged by the author. Esthetic results were better than those observed in Group I. CONCLUSIONS/SIGNIFICANCE:Composite grafting with acellular dermal matrix and STSG provides a comparable (trending to superior) result with traditional STSG for the treatment of radial forearm graft donor sites. Even if functionally equivalent, it is esthetically superior and therefore a technique warranting further investigation.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Rowe NM,Morris L,Delacure MDdoi
10.1097/01.sap.0000221622.41450.60subject
Has Abstractpub_date
2006-09-01 00:00:00pages
305-11issue
3eissn
0148-7043issn
1536-3708pii
00000637-200609000-00015journal_volume
57pub_type
杂志文章abstract::Exposure of silicone breast implants usually leads to infection and extrusion. According to the literature, implant extrusion rates are not higher than 2% 1 and removal of the implant is recommended. 2 During the past 3 years, the authors dealt with eight implant exposures (six women: two cases of bilateral exposure a...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.SAP.0000044251.40733.2B
更新日期:2003-05-01 00:00:00
abstract::The author reports primary repair of complete unilateral cleft lip using three flaps: (1) a small triangular flap at the vermilion border; (2) a large triangular flap at the upper lip; and (3) an alar flap. This method has the advantages that the design can be made by any beginner in plastic surgery, reconstruction of...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198006000-00012
更新日期:1980-06-01 00:00:00
abstract:UNLABELLED:When immediate reconstruction is applied to breast conservation therapy (BCT), the benefits extend well beyond the minimization of poor cosmetic results. The purpose of this analysis was to compare literature outcomes between BCT alone and BCT with the oncoplastic approach. METHODS:A meta-analysis was perfo...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,meta分析
doi:10.1097/SAP.0b013e3182605598
更新日期:2014-02-01 00:00:00
abstract::Ever since its introduction, the transverse rectus abdominis myocutaneous flap has become the mainstay of autologous breast reconstruction. However, concerns regarding donor site morbidity due to the breach of abdominal wall musculature integrity soon followed. Muscle-sparing techniques, eventually eliminating the mus...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000664
更新日期:2016-02-01 00:00:00
abstract::Nerve graft procedures require the use of a donor nerve to supply the graft material. This results in an area of numbness in a less critical region. The purpose of this study was to assess donor site recovery using patient subjective evaluation. Thirty-one patients (mean age, 38 years) who were at least 2 years past a...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199912000-00005
更新日期:1999-12-01 00:00:00
abstract::Combined latissimus dorsi musculocutaneous and scapular fasciocutaneous free flap were successfully used to reconstruct two complex pharyngolaryngectomy defects with no anterior neck skin. The cervical esophagus and hypopharynx were reconstructed with the scapular portion, and the latissimus segment restored the anter...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199409000-00014
更新日期:1994-09-01 00:00:00
abstract::This article describes a model of chronic nerve compression in the rat. The sciatic nerve of adult male Sprague Dawley rats was banded with a 1-cm Silastic tube for varying periods of time. Morphometric analysis, electrodiagnostic studies, and histological evaluation were carried out 3, 5, 8, and 12 months after bandi...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198711000-00008
更新日期:1987-11-01 00:00:00
abstract::High velocity injuries have traditionally been covered with free muscle flaps. We sought to evaluate the utility of the anterolateral thigh flap (ALT) flap as a primary choice in reconstructing traumatic injuries in Western patients.A retrospective chart review was conducted of 122 patients treated at the R Adams Cowl...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181a20ab0
更新日期:2010-02-01 00:00:00
abstract::Surgical correction of chronic mallet finger caused by terminal tendon disruption was carried out in 22 patients. The distal stump of the tendon was fixed to the base of the distal phalanx with a Mitek micro arc bone anchor. In all patients the mallet finger deformity was corrected. There were 15 patients with excelle...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000151464.03967.a2
更新日期:2005-04-01 00:00:00
abstract::In 8 male white Yorkshire pigs weighing approximately 42 kg each, 12 buttock neurovascular island skin flaps were dissected. Baseline recordings were made of blood flow and O2 consumption in the flap. Two series of experiments were carried out. In control animals (5), the flap was dissected and the "cold" aluminum pla...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198607000-00014
更新日期:1986-07-01 00:00:00
abstract::Lipofibromatosis is a slow-growing, childhood soft-tissue neoplasm that is often confused with other conditions. We report a patient with lipofibromatosis causing extremity enlargement at birth. The lesion initially was thought to be a vascular anomaly or lipedema on clinical and MRI examination. When involving the lo...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181a13df6
更新日期:2009-06-01 00:00:00
abstract::The first metatarsophalangeal joint area is a very difficult one to reconstruct, needing skin that is thick, sensitive, and resistant to friction. Although the medial plantar island flap was initially described to resurface heel defects, we have used this flap as a cross-foot flap to recover the first metatarsophalang...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198805000-00012
更新日期:1988-05-01 00:00:00
abstract::Through a transfixion incision, a rhomboidal portion of both the depressor muscle of the nasal septum and the orbicular muscle of the mouth are excised. The remaining columellar tissues are brought nearer to each other by means of a mattress suture tied over a double-foam bolus. This simple procedure yields three adva...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198905000-00001
更新日期:1989-05-01 00:00:00
abstract::Oculopharyngeal muscular dystrophy is a hereditary, autosomal dominant, slowly progressive disorder with onset that occurs during middle age. Major symptoms are ptosis and dysphagia resulting primarily from selectively involved levator palpebrae and the pharyngeal muscles. Progressive, usually symmetrical blepharoptos...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200210000-00015
更新日期:2002-10-01 00:00:00
abstract::Locoregional recurrent and distant metastases from squamous cell carcinomas, despite multimodality therapy, remain troublesome clinical realities. Discrepancies in success rates of various surgery and radiation treatment regimens dealing with these problems are confusing to the clinician attempting to recommend the mo...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199508000-00010
更新日期:1995-08-01 00:00:00
abstract::We present a case of a nail defect, which was reconstructed by free composite nail combined with the palmar pocket method without vascular anastomoses. A 40-year-old man lost his nail of the right middle finger by trauma 1 year ago. A total nail composite graft, composed of germinal and sterile matrices, and proximal ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000164731.99795.fe
更新日期:2005-06-01 00:00:00
abstract::A more direct measurement of implant capsule contracture is needed for the laboratory study of this phenomenon. Most of the previous methods for quantitation of contracture rely on measurements of deformability. Because contraction of an implant capsule is in fact a decrease in the surface area of the capsule, a metho...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198311000-00008
更新日期:1983-11-01 00:00:00
abstract::Anophtalmic socket reconstruction is a challenging problem in plastic surgery. We had described a prefabricated superficial temporal fascia island flap and used this technique in >50 enucleation patients with severe socket contraction ending in excellent or good results for 28 years (Altindas- 1 procedure). However, t...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181c9dd17
更新日期:2010-08-01 00:00:00
abstract::The relative merit of cartilage scoring versus suturing in otoplasty remains a subject of debate among leading plastic surgeons. We compared a variety of otoplasty techniques in 42 rabbit ears using anterior or posterior scoring, horizontal or vertical mattress sutures, and combinations of scoring and suturing. The ea...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199501000-00009
更新日期:1995-01-01 00:00:00
abstract::The most common cause of nasal obstruction is chronic enlargement of the inferior turbinate bones. The variety of medical and surgical treatments available for this condition bears testimony to their frequent ineffectiveness and the frustration of the physician or surgeon caring for these patients. Removal or destruct...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-197909000-00009
更新日期:1979-09-01 00:00:00
abstract:BACKGROUND:Management of posttraumatic large soft tissue defects and bone loss remains a therapeutic and surgical challenge for orthopedic surgeons. We assessed the use of a neurocutaneous flap and the Ilizarov technique in the reconstruction of severe composite defects in the tibia. METHODS:We retrospectively reviewe...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000921
更新日期:2017-05-01 00:00:00
abstract::Traumatic hemipelvectomy is an uncommon and devastating injury with few patients alive when they reach the hospital. There are only 19 reported survivors of this injury. This group includes 17 males and 2 females. All had severe, associated injuries. The mechanism of injury involved motorcycle, automobile, pedestrian/...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/00000637-199108000-00011
更新日期:1991-08-01 00:00:00
abstract::The authors present a case where a cross-leg fillet flap from an amputated limb allowed reconstruction of the contralateral disrupted Achilles tendon and provided neurotized soft tissue. Achilles tendon reconstruction of the left leg was achieved by utilizing vascularized extensor tendons from the dorsum of the right ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31802e32d1
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:The purpose of this study is to examine the effect of various risk factors on complications in patients undergoing pedicled transverse rectus abdominis musculocutaneous (TRAM) flap breast reconstruction. METHODS:A retrospective review of 224 pedicled TRAMs in 200 patients over a 10-year period was carried o...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000184463.90172.04
更新日期:2005-12-01 00:00:00
abstract::Liquid silicone injection for soft-tissue augmentation remains a controversial procedure despite 30 years of clinical use which has demonstrated exceptional results in patients with severe facial atrophies. This article describes a case in which massive silicone injection was used to treat hemifacial atrophy. Over a 9...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:1988-02-01 00:00:00
abstract::Dermatofibrosarcoma protuberans is an unusual soft-tissue tumor with a propensity for local recurrence and occasional metastatic spread. Given its indolent course, it may be mistaken for atypical scarring or a keloid growth. Most lesions are trunkal or on the proximal extremities with digital lesions being extremely r...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/00000637-199010000-00009
更新日期:1990-10-01 00:00:00
abstract::Although combined suction-assisted lipectomy (SAL) and surgical abdominoplasties have been described, the surgical excisions have in general been small and limited to the lower portion of the lower abdomen (i.e., just above the pubis). For the obese patient this is an insufficient lipectomy. SAL alone is unsatisfactor...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:1990-02-01 00:00:00
abstract::Pilar leiomyoma is a benign smooth muscle tumor arising from the arrectores pili muscles associated with the hair follicles of the skin. The multiple biopsies and pathological consultations needed to obtain a diagnosis attest to the rarity of the disease and the difficult histological picture, which often requires an ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/00000637-200045060-00018
更新日期:2000-12-01 00:00:00
abstract::A comparison study of donor site care using 5 common modalities was undertaken. A total of 210 treated donor areas were examined for healing differences, comfort, complications, and cost. At the conclusion of the study we were able to recommend certain treatment methods depending on the nature of the donor wound. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198009000-00013
更新日期:1980-09-01 00:00:00
abstract:INTRODUCTION:Hand photography is effective and advantageous for assessing functional deficits and improvements related to surgery. In this study, it is aimed to investigate whether the correct active range of motion (ROM) is masked by the passive ROM in a wrist joint. METHOD:Eleven patients who were treated for unilat...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001845
更新日期:2019-06-01 00:00:00