Mechanics of movement for rotation flaps and a local flap template.
ABSTRACT After studying the mechanics of rotational movement, it has become apparent that there exists a local flap template for triangulated defects. Predominant rotation and transposition movements lie at extreme ends of its spectrum. This concept offers a design improvement by which these flaps can be executed with ease and confidence in all areas of the body. Several design variations are available from the template, making the hypothesis versatile and flexible. Underlying this success is the strategic placement of the triangulated defect within an imaginary circle of skin tissue around it. The concept also provides a logical and comprehensive teaching model.
- Indian Journal of Plastic Surgery 07/2010; 43(2):148-50.
- [Show abstract] [Hide abstract]
ABSTRACT: Treatment of anal fissures has changed dramatically in the past decade. Only a few fail to respond to medical therapy. Sphincterotomy and anal dilatation have fallen out of favour due to the risk of incontinence. Island flaps have been proposed to address this, but 60--70% of flap donor sites break down with complications. We proposed that using a rotational flap would overcome this problem. Twenty-one patients (14 women,7 men) with chronic anal fissures were treated with rotation flap from perianal skin. The median age was 43 (range 21--76) years. All patients had failed chemical sphincterotomy and showed no signs of improvement following at least a 3-month course of topical GTN 0.2% ointment. The median hospital stay was 2 days. Seventeen patients had complete resolution of symptoms. Only one patient continued to have severe pain. Two developed a recurrent fissure. One patient had a combined fistula-fissure complex at diagnosis and suffered from a breakdown of the flap and donor site. Another patient had had haemorrhoidectomy and an advancement flap in the past. He developed problems with the donor site, which was successfully managed conservatively. One patient had persistent mild pain after surgery, but the cause could not be found. None of the patients suffered continence defects after surgery. Use of a rotational flap is a simple, safe and successful treatment for anal fissures. Donor site problems are minimised using this approach. It should be a treatment of choice when surgery is required for chronic anal fissures, particularly in patients in whom there is a risk of incontinence.International Journal of Colorectal Disease 08/2005; 20(4):339-42. · 2.24 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Our goal was to evaluate 2 design properties, pivot point and secondary defect, that affect the results of rotation flaps used to treat skin cancer defects of the head and neck. We conducted a retrospective review of the last 50 patients who underwent rotation flaps for closure of skin cancer defects on the head and neck with regard to postoperative complications. Four patients experienced complications, all of which were managed to an acceptable conclusion. These complications included tip necrosis and ectropion. Rotation flaps, although simple in design, are often modified during their execution. Understanding the basic design and possible modifications of pivot point and secondary defect will yield a successful outcome.Journal of Oral and Maxillofacial Surgery 10/2004; 62(9):1069-75. · 1.28 Impact Factor