• Title/Summary/Keyword: forearm skin

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Comparison Study Between Coverage Choices for Radial Forearm Free Flap Donor Site (전완유리피판 공여부 재건에서 전층 피부이식술과 부분층 피부이식술의 비교)

  • Jeong, Woo Shik;Choi, Jong Woo;Oh, Tae Suk
    • Korean Journal of Head & Neck Oncology
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    • v.31 no.1
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    • pp.5-8
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    • 2015
  • Backgrounds: The purpose of this study was to compare full thickness skin graft with inguinal skin to split thickness skin graft for coverage of the radial forearm free flap donor site. Patients and Methods: 25 patients who was reconstructed with radial forearm free flap for head and neck cancer were reviewed retrospectively. Results: The graft loss rates of full thickness skin graft were less than split thickness skin graft or split thickness skin graft with dermal substitutes. The recovery times of donor site and skin graft donor site of full thickness skin graft were also shorter than split thickness skin graft or split thickness skin graft with dermal substitutes. Skin texture and aesthetic results of donor site were improved and complications as itching and pain sensation were decreased. Conclusion: Full thickness skin grafts with inguinal skin should be considered for patients requiring a radial forearm free flap.

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Study on the Surface Properties of Corneocyte between Face and Forearm Using Atomic Force microscopy (AFM) (AFM을 이용한 얼굴과 하박내측 각질세포 표면 특성 비교연구)

  • Chang, Minyoul
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.45 no.4
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    • pp.373-380
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    • 2019
  • There are many differences in tran-epidermal water loss (TEWL), skin water contents, and skin elasticity, etc between face and forearm skin. In particular, our previous studies showed that elasticity of face skin was significantly differed from forearm depending on full hydration. So, we have studied the surface properties of corneocyte using atomic force microscopy (AFM), assuming that the differences between face and forearm skin would be associated with the surface properties of corneocyte. The surface roughness of corneocyte and villus-like projections (VPs) were measured. Furthermore, qualitative comparison among the surface of face, forearm, and lip corneocyte was performed. Corneocytes were collected by tape-stripping on both face and forearm of 8 volunteers, and the bottom surface of corneocytes were measured at 40 ㎛ × 40 ㎛ using AFM. Results showed that the lower surface roughness of face corneocytes was 388.34 ± 86.189 nm, and that of forearm corneocytes was 662.27 ± 224.257 nm, which confirmed that the lower surface of forearm corneocytes was more rough than that of face corneocytes (p < 0.001). Compared with the amount of VPs, lip corneocytes were the highest followed by face corneocytes, and forearm corneocytes were the lowest. From these results, it is conclued that the surface properties of corneocytes are somewhat involved in the property differences between the face and the forearm skin and VPs can be a useful parameter for the study of corneocyte by site. In addition, AFM is a very useful device for the comparative study of nano-structural differences on the surface of corneocytes. More studies can lead to develop a new evaluation method of corneocytes.

Reconstruction of the Finger Defect with Free Vascularized Reversed Radial Forearm Flap (유리 반전 전완피판술을 이용한 수지부 결손의 치료)

  • Chung, Duke-Whan
    • Archives of Reconstructive Microsurgery
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    • v.7 no.2
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    • pp.122-128
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    • 1998
  • Radial forearm flap is one of the most useful skin flap in hand reconstructuion with distally based reverse pedicled or free vascularized fashion. Athors modified that flap into reverse pedicled and free vascularized flap which has advantages of both methods. The modification composed with harvesting flap on recipient side distal forearm just as free flap, than apply it as reverse distal pedicled flap fashion with microvascular anastomosis with distal vascular stump of donor radial vessels. We underwent this method in 5 cases in finger reconstruction from 1996, all of the cases had sucessful results. The advantages of this method are: 1. Thin flap which is compatible to finger skin can harvest from distal forearm with very long vascular pedicle that can be passed under the subcutaneous tunnel which avoid additional skin incisions on the hand. 2. The vessels of donor site and recipient site are same vessel in effected side of forearm, which can preserve contralateral side forearm and hand keep intact. 3. The flap can cover the defects on distal portion of the fingers which is difficult in conventional reversed radial forearm pedicled flap because of limited mobilization of flap due to limitation of pedicle length reach to tip of the fingers.

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Reconstruction of Suborbital area using Composite Radial Forearm Free Flap with Palmaris Longus Tendon immediately after Wide Excision of Skin Cancer (피부 악성 종양 절제 후 장장근건을 포함한 복합 요골 전완 유리 피판술을 이용한 중안면부의 재건)

  • Lee, Hyun-Taek;Minn, Kyoung-Won
    • Archives of Reconstructive Microsurgery
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    • v.10 no.1
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    • pp.60-63
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    • 2001
  • The reconstruction of the suborbital area followed by resection of skin cancer has been used many methods including skin graft, local flaps, free flaps, and skin expansion. The radial forearm free flap has become a workhorse flap in this area because of its lack of bulk, ease of dissection, malleability, and hairlessness. When the suborbital defect especially including full-thickness defect of lower lid was reconstructed with many free flaps, the ectropion and the deformity of medial and lateral canthal area were common problems encountered as late complication due to gravitational descent. To improve the final aesthetic result in patients with suborbital defect, the radial forearm free flap was elevated as a composite radial forearm - palmaris longus free flap, in which the vascularized palmaris longus london was included and anchored to the periorbital bone with $mitek^{(R)}$ as sling, to suspend the flap against gravity and inferior descent, and thereby creating a more natural cheek contour. Two clinical cases were presented as an example of this procedure. Postoperative results emphasize the importance of suspension sling with palmaris longus tendon using $mitek^{(R)}$ in reconstruction of the suborbital defect with radial forearm free flap.

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Effects of Somatotype Characteristics on Body Temperature Control Reaction & Thermal Sensation (체형특성(體型特性)이 체온조절반응(體溫調節反應) 및 온열쾌적감(溫熱快適感)에 미치는 영향(影響))

  • Shim, Boo-Ja;Yoo, Hyun
    • Journal of Fashion Business
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    • v.7 no.1
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    • pp.27-37
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    • 2003
  • This study is the first part of the research to reveal the effects of somatotype characteristics on body temperature control reaction as well as thermal sensation. Nine healthy female collegians (classified into 3 body types of thin, normal, and obese according to Rohrer index) living in Busan were chosen as the subjects. The following are the results: Significant differences of skin temperature appeared in the parts of epigastrium (thin/normal>obese), anterior forearm (normal>thin/obese), and anterior leg (obese > thin/normal) as well as mean skin temperature. Mean skin temperature temporarily dropped owing to the exercise but tended to recover as time went by. Skin temperature of normal/thin shows higher than obese type. The change of skin temperature was noticed in the order of forehead > epigastrium > anterior forearm > anterior leg > anterior thigh (obese type) ; epigastrium > forehead > anterior forearm > anterior thigh > anterior leg (normal type) ; epigastrium > forehead > anterior forearm > anterior thigh > anterior leg (thin type, before and after exercise); epigastrium > forehead > anterior forearm > anterior leg > anterior thigh (thin type, during exercise). Significant differences were shown in the temperature change inside clothes according to somatotypes. No significant differences were revealed in thermal sensation, moisture sensation, and comfortable sensation according to body types and time.

The Effect of Electrical Stimulation Applied in Dominant Forearm on Autonomic Nervous System Response of Both Hands (우세측 전완에 적용한 전기자극이 양쪽 손 자율신경계 반응에 미치는 효과)

  • Lee, Dong-Geol;Seo, Sam-Ki;Lee, Jeong-Woo
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.7 no.1
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    • pp.7-10
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    • 2009
  • Purpose : The purpose of this study was to investigate the effect of electrical stimulation applied in dominant forearm on autonomic nervous system response of both hands. Methods : Fourteen healthy subjects (women) received low frequency-high intensity electrical stimulation to one forearm. The subjects assigned to two groups; a ipsilateral stimulation group (n=7) and a contralateral stimulation group (n=7). The electrode attachment was arranged on the forearm of the dominant arm and the electricity stimulus time was set as 15 minutes. Measuring items were the skin conduction velocity, the blood flow, and the pulse rate, which were measured total 3 times (pre, post, and post 10 min.). Results : The skin conduction velocity showed a significant difference according to the change of the time in both hands, but there was no significant difference according to time in the blood flow, and the change of the pulse frequency regardless of stimulus side. Conclusion : These results demonstrate that the low frequency-high intensity electrical stimulation applied dominant forearm can increase selectively only with the skin conduction velocity, which may be helpful for the activation of the sudomotor function of both hands by the activation of sympathetic nerve.

A Case Report of Hypospadias Repaired by Radial Forearm Free Flap (요측전완유리피판을 이용한 요도하열의 교정 1례 보고)

  • Park, Sung Ho;Chung, Chul Hoon;Lee, Jong wook
    • Archives of Plastic Surgery
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    • v.36 no.2
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    • pp.225-228
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    • 2009
  • Purpose: Urethral reconstruction following failed hypospadias repair is difficult because of a severe shortage of the skin on ventral surface of the penis. We experienced a successful reconstruction of a failed hypospadias repair using the radial forearm free flap. So we present our case. Methods: A 16 - year - old boy had a proximal shaft hypospadias and had been taken a transverse preputial island flap but it completely broke down. There was no spare skin on the shaft of the penis. So we reconstructed a neo - urethra and the ventral skin of the penis with the radial forearm free flap. Results: Postoperatively he made relatively good process. The urethral catheter was maintained for 10 days and self - voiding was started. The suprapubic catheter was removed at the postoperative 30th day after control of cystitis. The postoperative appearance of the penis is acceptable and a straight erection is achieved. Conclusion: In the scarred penis with hypospadias, the radial forearm free flap transfer is a reliable reconstructive method for the neo - urethra and the ventral skin of the penis.

APPLICATION OF ARTIFICIAL DERMIS($Terudermis^{(R)}$) AND SPLIT THICKNESS SKIN GRAFT ON THE DONOR SITE OF RADIAL FOREARM FLAP (인공진피($Terudermis^{(R)}$)와 부분층 피부이식을 이용한 전완피판 공여부 수복)

  • Oh, Jung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.3
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    • pp.227-232
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    • 2007
  • The radial forearm fasciocutaneous flap(RFFF) is a well-known flap for the reconstruction of oral and maxillofacial defects. It was first described by Yang et al. in 1981 and Soutar et al. developed it for the reconstruction of intraoral defect. RFFF provides a reliable, thin, and pliable soft tissue/skin paddle that is amenable to sensate reconstruction. It also has a long vascular pedicle that can be anastomosed to any vessel in either the ipsilateral or contralateral neck. However, split thickness skin graft(STSG) is most commonly used to cover the donor site, and a variety of donor site complications have been reported, including delayed healing, swelling of the hand, persistent wrist stiffness, reduced hand strength, and partial loss of the graft with exposure of the forearm flexor tendon. Various methods for donor site repair in addition to STSG have been developed and practiced to minimize both functional and esthetic morbidity, such as direct closure, V-Y closure, full thickness skin graft, tissue expansion, acellular dermal graft. We got a good result of using artificial dermis($Terudermis^{(R)}$) and secondary STSG for the repair of RFFF donor site defect esthetically and report with a review of literature.

Double-layered collagen graft to the radial forearm free flap donor sites without skin graft

  • Park, Tae-Jun;Kim, Hong-Joon;Ahn, Kang-Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.45.1-45.8
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    • 2015
  • Background: Radial forearm free flap is the most reliable flap for intraoral soft tissue reconstruction after cancer ablation surgery. However, unesthetic scar of the donor site and the need for a second donor site for skin graft are major disadvantages of the forearm flap. The purpose of this study was to report the clinical results of double-layered collagen graft to the donor site of the forearm free flap without skin graft. Methods: Twenty-two consecutive patients who underwent oral cancer ablation and forearm reconstruction between April 2010 and November 2013 were included in this study. Male to female ratio was 12:10, and average age was 61.0 years old (27-84). Double-layered collagen was grafted to the donor site of the forearm free flap and healed for secondary intention. Upper silicone had been trimmed at the periphery during secondary intention, and dry dressing was used. Postoperative scar healing and esthetic results and function were evaluated. Results: An average follow-up period was 34.9 months. The scar area was decreased to 63.9 % in average. The complete healing was obtained between 1.5 and 3 months according to the defect size. There was no functional defect or impairment 3 months after operation. All patients were satisfied with the esthetic results. Three patients died of recurred cancer. Conclusions: Double-layered collagen graft was successfully performed in this study. Without the thigh skin graft, patients had experienced less painful postoperative healing periods and discomfort.

Analysis of Color Difference in Facial Reconstruction used Various Flaps (안면부 재건술에서 사용되는 다양한 피판의 색조 비교)

  • Park, Jang Wan;Kim, Eui Sik;Hwang, Jae Ha;Kim, Kwang Seog;Lee, Sam Yong
    • Archives of Plastic Surgery
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    • v.36 no.4
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    • pp.365-371
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    • 2009
  • Purpose: Good color match holds a key position in facial reconstruction for good aesthetic result. To correct the wide facial soft tissue defect were usually used the tissue expanded cheek flap, deltopectoral flap or radial forearm free flap. This study is aimed to analyse the color difference after flap surgery by using chromameter. Method: From August 1995 to December 2006, 30 patients underwent flap operations were chosen randomly and evaluated color differences between flap site and adjacent skin. Reconstructive procedures included tissue expanded cheek flap(n = 10), deltopectoral flap(n = 10), and radial forearm free flap(n = 10). The measured sites were flap center within a radius of 1 ㎝ and four points of adjacent skin along the flap margin. The color was quantified in a three dimensional coordinate system $L^*$ (brightness), $a^*$ (redness), $b^*$ (yellowness). Results: There was no significant color difference between the pedicled flaps(tissue expanded cheek flap and deltopectoral flap) and adjacent skin area. On the other hand, color values of the radial forearm free flap were statistically different from those of adjacent skin area. Total color difference(${\Delta}E$) of tissue expanded cheek flap and deltopectoral flap were $7.45{\pm}5.78$ versus $9.41{\pm}7.09$, and that of radial forearm free flap was $11.74{\pm}3.85$. They suggest that pedicled flaps have a potential of better color match than radial forearm free flap. Conclusion: Thus, better esthetic result and satisfaction is more likely to be expected in pedicled flaps as long as it could be applied comparing radial forearm free flap.