Abstract:
BACKGROUND:Combined defects of the skin, larynx, pharynx, and esophagus after central compartment exenteration of the neck can be extremely difficult to reconstruct. The objective of this article is to evaluate reconstruction of the central compartment using a combination of free jejunal transfer for pharyngoesophageal reconstruction, together with regional deltopectoral flaps for tracheostomal reconstruction and cutaneous resurfacing. Myocutaneous flaps, such as pectoralis major and latissimus dorsi flaps, have been used previously for external coverage but can be bulky, causing obstruction of the tracheostoma. METHODS:From 1995 to 2002, seven patients underwent reconstruction of the central compartment with seven jejunal and nine deltopectoral flaps. Five patients required resection for tracheostomal recurrence of squamous cell carcinoma, and two patients required resection for massive pharyngocutaneous fistulas. Flap survival, complications, and outcomes were evaluated retrospectively. RESULTS:The mean age of the patients was 68.7 years and the mean length of follow-up was 1.9 years. Overall free jejunal and deltopectoral flap survival was 100 percent, with no partial loss. All patients maintained an adequate airway with stomal patency. CONCLUSIONS:These complicated defects can be effectively repaired with free jejunal transfers to restore continuity of the alimentary tract and deltopectoral flaps to reconstruct the tracheostoma and surrounding cutaneous defects. The deltopectoral flap provides a large volume of well-vascularized tissue that provides reliable coverage of the newly reconstructed cervical esophagus and exposed major vessels following exenteration of the central compartment. Its thin, pliable nature allows suturing of the tracheal remnants to skin edges without tension and avoids intraluminal prolapse of excess soft tissues, thus maintaining stomal patency.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
McCarthy CM,Kraus DH,Cordeiro PGdoi
10.1097/01.prs.0000156916.82294.98subject
Has Abstractpub_date
2005-04-15 00:00:00pages
1304-10; discussion 1311-3issue
5eissn
0032-1052issn
1529-4242pii
00006534-200504150-00013journal_volume
115pub_type
杂志文章abstract:BACKGROUND:Microvascular reconstruction of the nose was pioneered in China in the early 1970s using the radial forearm flap. Since then, different flaps, methods, and flap designs have been used to improve outcomes. Microvascular tissue transfer has become the first step of multistage reconstruction, which includes reb...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000005777
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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abstract::A method to measure gel bleed from intact silicone gel-filled breast implants was developed. This nondestructive technique permits accurate and reproducible serial measurements of silicone bleed from smooth wall breast implants (n=10) under simulated physiologic conditions in vitro. Gel bleed rates from new low bleed ...
journal_title:Plastic and reconstructive surgery
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doi:10.1097/00006534-199604000-00011
更新日期:1996-04-01 00:00:00
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
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pub_type: 杂志文章,随机对照试验
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journal_title:Plastic and reconstructive surgery
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journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
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journal_title:Plastic and reconstructive surgery
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更新日期:2017-07-01 00:00:00
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journal_title:Plastic and reconstructive surgery
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更新日期:1993-02-01 00:00:00
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更新日期:1995-07-01 00:00:00
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更新日期:2020-08-01 00:00:00
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更新日期:2008-01-01 00:00:00
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更新日期:2013-10-01 00:00:00
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