ABSTRACT: To investigate the feasibility and significance of modified paramedian forehead flap for nasal defect and reconstruction.
Modified paramedian forehead flaps with forehead muscle in the pedicle were used in 2 patients with nasal reconstruction and 7 patients with nasal defects. The flaps were elevated subcutaneously with only forehead muscle in the pedicle at the supraorbital site. The degree of flap axis ranged from 90 degrees to 50 degrees. Inverted L-shape design was used for 3 cases with low hair line.
Skin branch of supratrochlear vessel was observed running at the subcutaneous layer during the operation. 8 flaps all survived successfully with good texture and color. Partial necrosis happened in the distal end of one flap with subcutaneous pedicle, which healed through dressing.
Modified paramedian forehead flap, which includes muscle just in the pedicle, is based on the skin branch of supratrochlear vessel. The flap is very flexible and has reliable blood supply, leaving less morbidity in donor site. It also has good texture and skin color.
Zhonghua zheng xing wai ke za zhi = Zhonghua zhengxing waike zazhi = Chinese journal of plastic surgery 01/2010; 26(1):1-4.
ABSTRACT: To study the effects of negative-pressure wound therapy (NPWT) on the treatment of complicated and refractory wounds.
Sixty-seven patients with complicated or refractory wounds admitted to our hospital from September 2005 to November 2008 were randomly divided into NPWT group (n = 35) and conventional treatment (CT) group (n = 32). Wounds of patients in NPWT group were treated with interrupted suction under a pressure of -16.63 kPa for 24 hs, or continuous suction under a pressure of -10.64 kPa for 24 hs. Wounds of patients in CT group were covered with petrolatum gauze overlaid with isotonic saline gauze and dry gauze. Duration of treatment, times of operation, treatment cost, and the process of healing were compared between two groups.
The duration of treatment, treatment cost and times of operation of patients in NPWT group were obviously less or fewer than those of CT group (P < 0.05). Wounds of patients in NPWT group were mainly healed by themselves (40.0%) or healed after free skin grafting (40.0%). While wounds in patients in CT group healed mainly after tissue flap transplantation (66.7%) or free skin grafting (23.3%).
Compared with CT, NPWT can shorten the length of hospital stay, reduce operation frequency and treatment cost, and it is easier to carry out in the surgery of treating complicated and refractory wounds, which is worth generalization.
Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns 08/2009; 25(4):249-52.
ABSTRACT: To compare the differences of the clinical effects, side effects and treatment-related cost between two kinds of negative-pressure wound therapy (NPWT).
Forty-four inpatients with acute, subacute, and chronic wounds were divided into simplified NPWT group (A group) and conventional NPWT group (B group) according to the random number table. Wounds of patients in A group were treated with gauze + continuous suction with hospital central negative pressure (-10.64 kPa) for 24 hs; wounds of patients in B group were treated with sponge + interrupted suction with a purpose-designed suction appliance (-16.63 kPa) for 24 hs. Gross wound condition, treatment time, survival rates of skin graft and flap, changes of bacterial species on wound, treatment cost, and ratio of side effects between two groups were compared.
There was no significant difference between A and B groups in respect of gross wound condition, treatment time [A group (29 +/- 12) d, B group (26 +/- 13) d, P > 0.05], changes of bacterial species, survival rates of skin graft [A group (98 +/- 4)%, B group (98 +/- 4)%, P > 0.05] and flap (A group 98%, B group 100%, P > 0.05). Treatment cost of A group yen(374 +/- 134) was obviously lower than that of B group yen(9825 +/- 4956) (P < 0. 01), while more side effects were observed in A group (33.3%) than that in B group (5.0%) (P < 0.05).
Both simplified NPWT and NPWT with purpose-designed appliance can effectively improve wound healing. The simplified method may cause many side effects and has a potential risk of inciting nosocomial infection, but it can be conveniently employed with a low cost. In contrast, the cost of using purpose-designed appliance should be cut down to meet the aim of generalization.
Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns 08/2009; 25(4):253-7.