• Archives of Plastic Surgery
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• 제32권3호
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• pp.319-326
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• 2005

This study was designed to investigate the optimal period of pedicles implantation in the prefabricated periosteofascial flap using a vascular tissue transfer. Flap prefabrication was prepared with a transposition of the central pedicles of right auricle on the calvarium of the New Zealand white rabbit. Thirty flaps were divided into five groups of six flaps, including control group (group I) of the conventional periosteofascial flap based on the right lateral border of parietal bone. The prefabricated flap was elevated as a $2{\times}2cm$ sized island flap and reposed in place in 1, 2, 3, and 4 weeks after the pedicles transfer in groups II, III, IV, and V, respectively. Five days after flap repositioning, the flap viability and vascularity were evaluated with microangiography and histological study quantitatively. The flap survival was increased in accordance with the implanted period of the pedicle. New vessels developed around the implanted pedicle in the 2nd week, and overall vascularization of the flap was accomplished in the 3rd week. The flap with 4 weeks of implantation period, however, showed the same survival rate as the control group. In conclusion, prefabricated periosteo- fascial flap can be created with a vascular tissue transfer, and the optimal duration of the pedicle implantation is more than 4 weeks to obtain adequate flap survival.

• Archives of Reconstructive Microsurgery
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• 제13권2호
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• pp.93-100
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• 2004

This study was designed to investigate the optimal period of pedicles implantation in the prefabricated periosteofascial flap with a vascular tissue transfer. The flap prefabrication was prepared with a transposition of left occipital pedicles on the calvarial fascia of male Sprague-Dawley rats. Thirty flaps were divided into five groups of six flaps, including control group (group I) of the conventional periosteofascial flap based on the lateral border of the rat calvarium. The prefabricated flap was elevated as an $1{\times}1cm$ sized island flap based on the implanted pedicle at 1, 2, 3, and 4 weeks after the pedicles transfer in groups II, III, IV, and V, respectively. After the completion of creating a critical-sized calvarial defect and implanting with hydroxyapatite granules, the flap was sutured back for covering the defect and kept isolated from surrounding tissues. Six weeks after flap repositioning, the osseous changes of the defect were examined with simple radiographic findings, radiodensitometric analysis, and histological studies. By simple radiographic findings, specimens of the control, groups IV and V showed homogeneous radioopacity within the defect. But in groups II and III, focal radiolucency was observed in the defect. In the radiodensitometric analysis, the control group and the group V showed significant increased radiodensites statistically. Histologically, the implanted hydroxyapatite was absorbed partly in the defect in groups II, III, and IV. In the defects of the control group and the group V, the implanted hydroxyapatite was kept in its volume and the deposition of the bone cells was observed sparsely. In conclusion, the prefabricated periosteofascial flap can be created with a vascular tissue transfer and the pedicles should be implanted at least for 4 weeks to bring out positive osseous changes in the calvarial defect.

• Archives of Reconstructive Microsurgery
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• 제7권1호
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• pp.41-46
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• 1998

Microvascular free tissue transfer technique is widely accepted for reconstruction of extensive soft tissue defects on the extremities. The system of flap based on the subscapular artery and vein provides the widest ways of composite free flaps. The possible flaps that can be harvested based on this single vascular pedicle include the scapular and parascapular skin flaps, the serratus anterior and latissimus dorsi muscular flaps, the lateral scapular bone flap, the latissimus dorsi-rib flap, and the serratus anterior-rib flap. This combined flap is available to mutiple tissue defects or complex defects because it can incorporated with skin, muscle and bone flaps. A strikig advantage is the independent vascular pedicles of each components, which allow freedom in orientation of each components. So, it can be freely applied to any forms of three demensional defects on the upper and lower extremities. The combination of scapular cutaneous flap and latissimus dorsi musculocutaneous flap can be resurfaced for massive cutaneous defects on the extremities. We report the use of the combined scapular and latissimus dorsi free flap in seven patients to reconstruct massive deefcts on the extremities. There was no flap failure and little complications and disadvantages. The anatomy of this flap is reviewed and the indication and advantages are discussed.

• Archives of Plastic Surgery
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• 제49권6호
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• pp.782-784
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• 2022

Diabetic foot ulcers are a severe complication of diabetes, and their management requires a multidisciplinary approach for optimal management. When treating these ulcers, limb salvage remains the ultimate goal. In this article, we present the "hanging" free flap for the reconstruction of chronic lower extremity diabetic ulcers. This two-staged approach involves standard free flap harvest and inset; however, following inset the "hanging" pedicle is covered within a skin graft instead of making extraneous incisions within the undisturbed soft tissues or tunnels that can compress the vessels. After incorporation, a second-stage surgery is performed in 4 to 6 weeks which entails pedicle division, flap inset revision, and end-to-end reconstruction of the recipient vessel. Besides decreasing the number of incisions on diabetic patients, our novel technique utilizing the "hanging" pedicle simplifies flap monitoring and inset and allows reconstruction of recipient vessels to reestablish distal blood flow.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제14권1_2호
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• pp.105-116
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• 1992

저자들은 악안면부에 발생한 종양 절제 후 광배근피판(유정 피판, 5례 : 유리 피판, 1례)으로 재건하여 5례에서 성공하였다. 큰 피판 형성의 잠재성은 두경부에서 충분한 종물제거와 재건을 가능하게 하였으며, 피판 형성이 빠르고 용이하며 긴 혈판경(약 45cm)을 채득할 수 있었다. 공여부 합병증과 기능 상실이 적어 두경부의 커다란 결손부 재건에 매우 유용한 피판으로 판단되었으며, 경부곽청술 후 노출되는 심부 조직에 대해 심미적이며 기능적인 보호를 제공할 수 있었다.