Abstract:
:Reconstruction of the nose after severe burn injury is a challenging problem. There are usually associated facial burns, which limits the availability of local flaps. Reconstruction with unburned distant tissue is often not appropriate because of the resulting mismatch in color and texture. Successful nasal reconstruction can be accomplished in this group of challenging patients using a simple, inferiorly based flap from the nasal dorsum with subsequent skin grafting to the resulting defect. We have used an inferiorly based nasal turndown flap to reconstruct severe nasal deformities after burn injury in 28 patients. The flap tissue consists of the dorsal surface of the nose, which is usually made up of skin graft and scar. The flap base is the scar transition zone between the dorsum of the nose and the lining mucosa. This is turned over to provide nasal length, projection, and to stimulate alar lobules. The resulting defect on the dorsum of the nose is then skin grafted. If further length or refinement is required, the procedure may be repeated. The records of all patients who underwent this procedure were reviewed for demographics, age at burn, percentage of total body surface area burned (%TBSA), availability of the forehead, number of procedures, and complications. Twenty-eight patients underwent nasal reconstruction in our series using this local turndown flap. Most of these patients had severe burns, with an average %TBSA of 46%. The procedure was initially applied to patients with devastating injuries and %TBSA of 80%-95%, with extremely limited donor sites. As the success of the procedure was established, less severely burned patients were included in the series, thereby lowering the mean %TBSA. All patients had partial or complete destruction of their forehead donor site. All patients presented for multiple hospitalizations, with an average of 17 hospital admissions. Using this local turndown flap, adequate nasal length and projection could be achieved. There were few complications. All of the flaps survived, although there were 2 cases of necrosis of the distal edge of the flaps (0.7%). This resulted in decreased length and projection but this problem was successfully addressed with additional staged procedures. Contraction of local scar tissue created bulk and support, eliminating the need for distant tissue transfer or cartilage grafting. Twelve of the 28 patients required repeat turndown flaps to achieve sufficient nasal length and projection. These results were durable over a follow-up period of up to several decades. A simple, multistaged dorsal nasal flap can be used to reconstruct severe nasal deformities after facial burn injury. This can obviate the need for distant tissue transfer. Even in patients with subtotal nasal amputation and complete absence of cartilaginous support, the opportunistic use of scar tissue can restore nasal tip projection and alar lobule architecture without cartilage grafting. The resulting nasal reconstruction blends well into the surrounding facial appearance. This simple technique has been remarkably successful in this selected group of patients with challenging nasal deformities.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Taylor HO,Carty M,Driscoll D,Lewis M,Donelan MBdoi
10.1097/SAP.0b013e31817d87edsubject
Has Abstractpub_date
2009-02-01 00:00:00pages
175-9issue
2eissn
0148-7043issn
1536-3708pii
00000637-200902000-00018journal_volume
62pub_type
杂志文章abstract::Angiogenesis was examined by a three-dimensional model in vitro, using human umbilical vein endothelial cells (HUVECs) cultured in a collagen gel. An abundant capillary-like network with a lumen structure was identified histologically and shown to have formed at a collagen density of 0.05% or 0.10% instead of 0.15%, f...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199303000-00008
更新日期:1993-03-01 00:00:00
abstract::A case of a closed rupture of a single slip of flexor digitorum superficialis to the little finger is described. Closed rupture injuries of the flexor digitorum profundus tendon are quite common, but closed injuries to the superficialis tendon have been rarely reported. A single slip avulsion rupture of this tendon wo...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200110000-00012
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND AND AIM:To date, clinically relevant selection criteria have not been established for the use of the gluteal fold flap after oncological vulvoperineal resection. We prospectively assessed the surgical risk factors of this reconstructive technique in a large series. METHODOLOGY:From April of 2000 through Dec...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000964
更新日期:2017-07-01 00:00:00
abstract::Avoidance of complications in tissue expansion requires careful outpatient observation and consistent follow-up-two factors that are difficult to manage in a city hospital-based population. To determine the complication rate of tissue expanders in a given population, the authors reviewed retrospectively 34 tissue expa...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199904000-00008
更新日期:1999-04-01 00:00:00
abstract:INTRODUCTION:Currently, only a few large animal models, including swine, dog, and nonhuman primate, are described for composite face transplantation studies and the literature lacks reports on the large animal model of composite auricular transplantation. Large animal models offer better understanding of the immunologi...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000122
更新日期:2014-04-01 00:00:00
abstract::Excessive scar contracture by wound fibroblasts can have devastating consequences, ranging from body disfigurement to joint immobility. The ability of fibroblasts isolated from lesions of hypertrophic scars, keloids, normal skin, or normal scars in contracting the provisional wound matrix (i.e., fibrin clot) was compa...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199605000-00011
更新日期:1996-05-01 00:00:00
abstract::Craniofacial surgical techniques have yielded better methods of treating severe craniofacial trauma. In this paper surgical techniques are discussed in principle and specifically presented through case reports. We conclude that the most important factors for successful reconstruction after craniofacial trauma are to d...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198612000-00012
更新日期:1986-12-01 00:00:00
abstract::Dynamic reconstruction of the abdominal wall using a free reinnervated rectus femoris muscle and an island tensor fascia lata transfer was performed for a large herniation with loss of the bilateral rectus abdominis muscles of the abdominal wall. The tensor fascia lata transfer was used to close an inner side of the a...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:Data regarding donor-site morbidity, postoperative clinical course, and functional outcome after hemisoleus muscle flap reconstruction are rare. The aim of this study was to determine the clinical and functional outcome of distally based medial hemisoleus flaps used for the reconstruction of defects in the l...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001539
更新日期:2018-10-01 00:00:00
abstract::Reconstruction of intraoral defects is one of the main aspects of head and neck cancer treatment. Since the advent of microvascular surgery in this field, free flap tissue transfer has become a common procedure, and various flaps have been described for soft tissue reconstruction. The lateral upper arm free flap is on...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001876
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Since obtaining FDA approval for postsurgical pain management in 2011, a number of well-designed studies have reported favorably on the safety and efficacy of liposomal bupivacaine (LB). However, the literature lacks adequate reports of patient perception of postoperative pain and subjective satisfaction. M...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000444
更新日期:2015-06-01 00:00:00
abstract::To determine the incidence of finger amputation and replantation in North Carolina (NC) and to identify patterns of injury by race and immigration status. Finger amputation injury data were obtained from the NC hospital discharge database. Hospital discharge data were linked to 2000 US Census data by zip code of resid...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181bffcaf
更新日期:2010-05-01 00:00:00
abstract::Skin grafting is a modern addition to surgery but with ancient roots. Its biology has come to light only within the last 50 years, and research continues into its basic mechanisms. A brief history of skin grafting from Susruta to Reverdin and Ollier and the mechanisms of skin grafting featuring recent research effects...
journal_title:Annals of plastic surgery
pub_type: 历史文章,杂志文章,评审
doi:10.1097/00000637-198810000-00011
更新日期:1988-10-01 00:00:00
abstract::The use of a Keith needle is described to secure a cartilage graft during rhinoplasty. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND:International adoptees with cleft lip and palate (CLP) are a growing population in the United States. They represent a clinical challenge, presenting at various ages and stages of cleft repair. METHODS:A retrospective review of patients seen at the CLP Program at the Children's Hospital of Philadelphia (CHO...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000863
更新日期:2016-10-01 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:OBJECTIVE:This study evaluated the impact of a newly implemented protocol for superficial to mid-dermal partial thickness burns which involves early surgery and rapid coverage with biosynthetic dressing in a specialized national burns center in Singapore. METHODS:Consecutive patients with 5% or greater total body surf...
journal_title:Annals of plastic surgery
pub_type: 临床试验,杂志文章
doi:10.1097/SAP.0000000000000682
更新日期:2016-03-01 00:00:00
abstract::Good mammography in the augmented patient is often difficult to achieve. A case is described that illustrates that posterior breast tissue is generally better seen with standard compression mammography and that physical examination by the radiologist must accompany mammography. Implant displacement mammography, while ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199009000-00012
更新日期:1990-09-01 00:00:00
abstract::Lipedema is a condition characterized by abnormal deposition of adipose tissue in the lower extremities leading to circumferential bilateral lower extremity enlargement typically seen extending from the hips to the ankles. Diagnosis of the condition is often challenging, and patients frequently undergo a variety of un...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318215791e
更新日期:2012-03-01 00:00:00
abstract::Several clinical studies promulgate the concept that some degree of crossover innervation occurs after digital nerve injuries are sustained and that the intact digital nerve might even substitute for the loss of nerve function on the injured side. Other studies strongly dispute the existence of this phenomenon. An exc...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200045050-00007
更新日期:2000-11-01 00:00:00
abstract::We present a new concept of vascular anatomy, proposing that a complex subcutaneous vascular network, located between the dense and loose adipose tissue, connects the larger subcutaneous vessels, the vertical perforators, and the subdermal plexus. Knowledge of the location of these vessels helps determine optimal flap...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198308000-00002
更新日期:1983-08-01 00:00:00
abstract::Keloid disease is known to have variable clinical behavior in response to therapy and there is no clinicopathologic classification that predicts such varied behavior. The aim of this study was to study the effect of excision margins and other histopathologic characteristics on keloid prognosis.Seventy-five multiethnic...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31819b6c3a
更新日期:2010-01-01 00:00:00
abstract::Free flaps have become a popular option for the reconstruction of intraoral defects. The radial forearm flap used to be the workhorse flap for small and thin defects, but was associated with numerous donor-site morbidities. The proximal lateral leg flap can provide a thin and pliable tissue similar to the radial forea...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000047
更新日期:2013-12-01 00:00:00
abstract:INTRODUCTION:The aim of this study is to present an anatomic study and a dissection technique to prepare maxilla graft for transplantation. METHODS:Six fixed adult human cadavers were used for dissection of the maxilla grafts. Retrospective reviews of archives of 10 MRI and 5 angiographies of the maxillary region were...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318095a7a1
更新日期:2008-07-01 00:00:00
abstract:OBJECTIVE:Our objective in this study was to extend diaphragmatic pacing therapy to include paraplegic patients with high cervical spinal cord injuries between C3 and C5. INTRODUCTION:Diaphragmatic pacing has been used in patients experiencing ventilator-dependent respiratory failure due to spinal cord injury as a mea...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001105
更新日期:2017-08-01 00:00:00
abstract::Six patients underwent percutaneous pin placement, 17 intraoral corticotomies, and application of an Orthofix lengthening device to facilitate complex multiplanar distraction as mandated by the patient's specific deformity. The patients underwent gradual bony and soft-tissue distraction at the rate of .25 mm four time...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199502000-00004
更新日期:1995-02-01 00:00:00
abstract::Malignant melanoma of the head and neck can metastasize to lymph nodes within the parotid gland. Selective lymphadenectomy is the modern method of staging regional lymph node basins in clinically localized melanoma. This procedure involves intraoperative lymphatic mapping and directed, selective removal of the first d...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199907000-00001
更新日期:1999-07-01 00:00:00
abstract::The transverse rectus abdominis musculocutaneous flap and deep inferior epigastric perforator flap are the flaps of choice for autologous breast reconstruction. The better understanding of the vascular anatomy of these flaps has reduced the incidence of flap loss and fat necrosis, and positioning the flap's least vasc...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000162509.32962.9c
更新日期:2005-06-01 00:00:00
abstract::Cryopreservation has the potential to improve availability of donor parts for composite tissue allotransplantation and may reduce their antigenicity. This study investigates whether the component tissues of composite flaps remain viable after cryopreservation. Forty-one epigastric flaps were harvested from Lewis rats....
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000245114.96202.62
更新日期:2007-06-01 00:00:00
abstract::The gastrocnemius muscle flap has gained wide acceptance as a reconstructive technique for management of wounds of the knee and proximal tibia. The use of the muscle as a pedicle flap to the distal and middle femur has not been well quantified, and the proximal rotation arc has been underestimated. We report the use o...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199504000-00014
更新日期:1995-04-01 00:00:00