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ABSTRACT: Reconstruction of the subtotal upper lip with a columellar defect is still a problem for reconstructive surgeons. Various
techniques have been reported for this purpose. Each technique has its own drawbacks, and few can be performed in one stage.
Although Karapandzic describes the standard procedure that functionally reconstructs large defects in the upper and lower
lip, the Karapandzic flap is not sufficient for the columellar defects. It is a simple and safe technique; results are satisfactory,
functional, and aesthetically well tolerated, sacrifice less tissue, and are effective for repairing defects. We report a
74-year-old male who presented with a large, fungating, pus-discharging ulcerative mass on his upper lip including the columella.
Biopsy results confirmed squamous cell carcinoma. The tumor was excised and defects were reconstructed using a simple modification
of the Karapandzic flap. This modification of the Karapandzic flap provides adequate tissue for the subtotal upper lip defect
including the columellar defect.
European Journal of Plastic Surgery 04/2012; 31(3):147-150.
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ABSTRACT: BackgroundThe purpose of this study was to investigate the morphological, histopathological, and electrophysiological changes of peripheral
nerve after CO2 (carbon dioxide), Er:YAG (erbium:yttrium aluminum garnet), and CO2+Er:YAG laser irradiation. There have been no comparative reports on CO2, Er:YAG, and CO2+Er:YAG laser effects on peripheral nerve.
MethodsThirty Wistar albino rats were randomly assigned to three groups. Group I received CO2, group II Er:YAG, and group III CO2+Er:YAG laser irradiation. Contralateral untreated sciatic nerves from the same animals were used as controls. The effect
of laser on the peripheral nerve was assessed morphologically, histopathologically, and electrophysiologically after 6weeks
of laser irradiation.
ResultsNo significant difference was observed between the treated and the untreated nerves.
ConclusionThe overall findings indicated that CO2, Er:YAG, and CO2+Er:YAG lasers may be used safely in nerve tissue surgery.
KeywordsErbium:yttrium aluminum garnet-Laser-Carbon dioxide-Nerve
Aesthetic Plastic Surgery 04/2012; 34(2):193-199. · 1.41 Impact Factor
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ABSTRACT: The purpose of this study was to investigate the morphological, histopathological, and electrophysiological changes of peripheral nerve after CO(2) (carbon dioxide), Er:YAG (erbium:yttrium aluminum garnet), and CO(2) + Er:YAG laser irradiation. There have been no comparative reports on CO(2), Er:YAG, and CO(2) + Er:YAG laser effects on peripheral nerve.
Thirty Wistar albino rats were randomly assigned to three groups. Group I received CO(2), group II Er:YAG, and group III CO(2) + Er:YAG laser irradiation. Contralateral untreated sciatic nerves from the same animals were used as controls. The effect of laser on the peripheral nerve was assessed morphologically, histopathologically, and electrophysiologically after 6 weeks of laser irradiation.
No significant difference was observed between the treated and the untreated nerves.
The overall findings indicated that CO(2), Er:YAG, and CO(2) + Er:YAG lasers may be used safely in nerve tissue surgery.
Aesthetic Plastic Surgery 09/2009; 34(2):193-9. · 1.41 Impact Factor
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Annals of Plastic Surgery 09/2006; 57(2):241. · 1.32 Impact Factor
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ABSTRACT: The purpose of this report is to introduce the cross-leg anterolateral thigh perforator flap for closure of a defect on the dorsum of the foot, and to show that the anterolateral thigh perforator flap is a safe option for a cross-bridge microvascular anastomosis in defects of the extremity. The free anterolateral thigh perforator flap was used for a patient with an unhealed wound on the dorsum of the foot. The flap was revascularized by end-to-side anastomosis between the flap's artery and the posterior tibial artery of the other leg, since there was no available recipient artery on the same leg. After a 4-week neovascularization period, the pedicle was cut. To the best of our knowledge, this is the first report of the use of a free anterolateral thigh perforator flap for a cross-bridge microvascular anastomosis.
Microsurgery 02/2006; 26(3):190-2. · 1.61 Impact Factor
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Journal of Oral and Maxillofacial Surgery 04/2005; 63(3):396-9. · 1.64 Impact Factor
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ABSTRACT: We investigated the appropriateness of the implant to be used in free-tissue transfers in a rabbit model in which a full-thickness skin graft was wrapped around a prefabricated high-density porous polyethylene implant.
In ten New Zealand white rabbits, high-density porous polyethylene implants (Medpor), 10x15x3 mm in size, were bilaterally placed and anchored underneath the superficial inferior epigastric artery and vein pedicle under anesthesia. The flaps were prefabricated through vascular induction. Eight weeks later, the flaps were wrapped by a full-thickness postauricular skin graft, following orthotopic transplantation. Two weeks after grafting, full-thickness biopsy samples were obtained from the distal one-third of the implants and stained with hematoxylin-eosin and Masson trichrome for histologic examination.
Graft compliance was observed in all the implants. Histologic sections showed rich fibro-neovascular tissue, neovascularization, and development of connective tissue cells. There were very few polymorphonuclear cells. No signs of inflammation were observed.
Prefabrication of the high-density porous polyethylene implant under the superficial inferior epigastric artery and vein results in sufficient conditions for its use in free transfers.
Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery: TJTES 05/2004; 10(2):75-82. · 0.33 Impact Factor
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ABSTRACT: Reconstruction of soft-tissue defects of the calcaneal region and the heel is very demanding and necessitates, as a rule, a sensate and thin flap. The ideal characteristics of a sensate and thin layer of flap should be combined with a reliable blood supply and minimal morbidity at the donor site. The authors report an updated review of their experience with the use of island modifications of the lateral calcaneal artery skin flap-the lateral calcaneal island flap, the lateral calcaneal V-Y advancement flap, and the bilobed-shaped lateral calcaneal island advancement flap-for the reconstruction of small and medium-sized tissue defects over the exposed calcaneal tendons and calcaneal bones of 18 patients. All of the procedures were performed under spinal or epidural anesthesia. There were no problems associated with flap viability, but the authors have seen necrosis of undermined skin between the lateral malleolus and calcaneal tendon in two cases and a partial loss of skin graft in one case. In this article, the authors discuss some advantages and disadvantages of the use of a lateral calcaneal island flap and its modifications.
Plastic & Reconstructive Surgery 05/2004; 113(4):1167-74. · 3.38 Impact Factor
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ABSTRACT: The tensor fascia lata flap is one of the appropriate choices for the coverage of trochanteric pressure sores. The authors designed a new, hatched-shaped tensor fascia lata musculocutaneous flap with distal Z-plasty closure and applied it to four trochanteric defects in 4 patients. Satisfactory results were obtained in all patients. The hatchet-shaped tensor fascia lata musculocutaneous flap is very safe, reliable, and practical. Designing the flap in a hatchet shape allows one to use the proximal and well-vascularized portion of the flap in the trochanteric pressure sore area. Another important advantage is the possibility of reuse resulting from recurrence. Prevention of a "dog-ear" deformity at the recipient site provides a smooth contour on the lateral aspect of the thigh. Another advantage is the tension-free Z-plasty closure of the donor site without need of grafting.
Annals of Plastic Surgery 11/2003; 51(4):419-22. · 1.32 Impact Factor
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Plastic & Reconstructive Surgery 09/2003; 112(2):712; author reply 712. · 3.38 Impact Factor
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ABSTRACT: Thermal anterior chest-wall burns including the breasts causes absent, hypoplastic or flattened breast deformities. There are many methods for secondary reconstruction of those deformities. In this report we present a mild breast burn contracture case treated with a technique which we have called "V-Y-Z plasty".
European Journal of Plastic Surgery 08/2003; 26(5):255-257.
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ABSTRACT: Pressure sores are very prevalent among hospitalized patients and those in long-term medical care facilities. The ischial region is the most common site for pressure sores in paraplegics capable of sitting. Perineal pressure sores are rarely seen and possess distinct features such as increased risk after bilateral ischiectomy, and development of urethrocutaneous fistulae and exposure of the testicles. A case of perineal pressure sore which occurred in a man in the absence of bilateral ischiectomy is presented.
European Journal of Plastic Surgery 05/2003; 26(3):150-152.
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ABSTRACT: The use of perioperative erythropoietin (EPO) therapy is gaining popularity to avoid blood transfusion and correct anemia in head and neck cancer surgery. The purpose of the study was to determine the effect of various doses and durations of EPO treatment on random flap survival.
A McFarlane type random and musculocutaneous (3 x 10 cm) flap were elevated on the dorsum of each rat.
Eighty-four male Albino rats were randomly assigned into seven groups (2 animals in each group): group I, control animals receiving placebo; group II, chronic EPO injections (50 U/kg); group III, chronic EPO injections (100 mg/kg); group IV, chronic EPO injections (150 mg/kg); group V, short-term EPO injections (50 mg/kg); group VI, short-term EPO injections (100 mg/kg); and group VII, short-term EPO injections (150 mg/kg). Rats in groups II to IV began to receive EPO 3 weeks (thrice weekly) before the construction of flaps, and rats in groups V to VII received EPO after flap elevation for 1 week (thrice) subcutaneously. Following 7 days of recovery, the area of flap survival was measured. Hematocrit and systolic blood pressure were followed weekly in all groups.
Erythropoietin increased the hematocrit levels and systolic blood pressure in all groups, but significant increases were noted only in the long-term treatment groups. There was a significant increase in distal necrosis of random skin flaps after long-term EPO treatment (P <.05). However, short-term low and therapeutic doses of EPO improved flap survival significantly (P <.05).
Long-term EPO treatment might have impaired flap survival because of direct or prostaglandin-mediated vasoconstriction, endothelin-induced hypertension, increased peripheral vascular resistance, hyperviscosity, and increased thrombosis. However, EPO might have enhanced flap survival because of its antioxidant effect and modulation of nitric oxide levels. Effects of EPO are controversial, and further research is necessary to delineate the dose and duration relationship and the exact mechanism of action on flap viability.
The Laryngoscope 01/2003; 113(1):85-9. · 1.75 Impact Factor
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ABSTRACT: The dorsal nasal flap and its modifications have proved reliable in the coverage of defects on or adjacent to the tip of the nose. However, the problems inherent in the nature of the flap are limited rotational movement afforded by the pedicle, visible scars crossing the dorsum and the natural concavity of the alar crease, skin thickness discrepancy between the flap and the skin, and dog-ear deformity created by the rotation. The purpose of this study was to design a new modification of the dorsal nasal flap, in the highlight of a cadaveric study, that can overcome the traditional drawbacks. Ten adult human cadavers were used to study the vascular basis of the flap and to simulate application of the flap. Cadaveric dissections demonstrated that a skin island over the nasal dorsum and glabellar area can be elevated safely based on a dual axial supply (i.e., the terminal branches of the angular artery and vein bilaterally), and can be advanced easily in a V-Y manner to cover the nasal tip defect. The result obtained in the clinical case showed that the V-Y island dorsal nasal flap provided a sizable amount of skin with more appropriate texture and color for coverage of the nasal tip defect without tension or secondary deformity.
Annals of Plastic Surgery 02/2002; 48(1):75-82. · 1.32 Impact Factor
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ABSTRACT: The development of malignancy in burn sears is a well known entity. However, burn sear sarcomas are rarely seen. This report presents the first case of a leiomyosarcoma arising in a burn scar of scalp in the English literature.
Burns.
