Flap Design (flap + design)

Distribution by Scientific Domains


Selected Abstracts


A Simple Tool for Teaching Flap Design with Digital Images

DERMATOLOGIC SURGERY, Issue 12 2001
Daniel Berg MD
Background. Defects created by excision or Mohs micrographic surgery must be analyzed and surgical options including flaps must be considered. Teaching flap design to dermatology trainees is often done at the bedside of the patient with the trainee describing or marking a proposed flap. Open discussion of the options in this way is sometimes unnerving for the patient. Blackboard discussions or drawings are limited in their realism. Objective. To describe a rapid, simple method using commonly available software to allow a trainee to draw and redraw a proposed flap on a digital image of the defect without the time and cost of printing. Methods. We describe a feature in the widely used presentation program Microsoft PowerPoint which can be used to draw on an imported digital image in various colors. Results. A digital photograph taken at the bedside can quickly be loaded into PowerPoint and viewed as a full-screen picture on a computer. Using an electronic pen, multiple lines can be drawn and erased on the picture, allowing surgical planning and teaching away from the bedside. Conclusion. Design and analysis of potential incision lines for a flap can be done quickly using a digital image and commonly available software, allowing a new option for teaching flap design. [source]


Modifying techniques in deep inferior epigastric artery perforator flap harvest with the use of preoperative imaging

ANZ JOURNAL OF SURGERY, Issue 9 2009
Warren M. Rozen
Abstract New techniques in the harvest of deep inferior epigastric artery perforator (DIEP) flaps have become introduced as a result of modern imaging technologies that can allow virtual surgery to be achieved preoperatively. With computed tomographic angiography, individual anatomy can be appreciated in detail to a level not previously appreciated. These imaging techniques can be successfully used to guide DIEP flap surgery. ,Optimal' perforators can be selected based on size, location, intramuscular and subcutaneous course, and their association with motor nerves. Flap design can be safely achieved based on the cutaneous distribution of perforators. Abdominal wall closure can be improved based on the abdominal contour seen with imaging. Preoperative planning can aid patient selection, plan all aspects of the operative technique, reduce operating time and improve operative outcomes. [source]


"Reading Man Flap" Design for Reconstruction of Circular Infraorbital and Malar Skin Defects

DERMATOLOGIC SURGERY, Issue 11 2008
TAMER SEYHAN MD
BACKGROUND Surgical complications such as lid retraction and ectropion from graft or flap scar contracture make reconstruction of skin defects in the malar and infraorbital regions challenging. OBJECTIVE A new flap design, the reading man flap, was used to overcome these problems. The Limberg and bilobed flap were compared with the reading man flap. METHODS The reading man flap consists mainly of a superiorly based quadrangular flap and an inferiorly based triangular flap. Malar and infraorbital circular skin defects measuring 14 14 to 40 40 mm were reconstructed with a reading man flap in 13 patients. The defects occurred after basal cell carcinoma in all patients. The Limberg flap, bilobed flap, and reading man flap were planned for same-sized defects on the abdominoplasty resection material. The results were compared in terms of total scar area, scar length, and total healthy skin area discarded. RESULTS When comparing the 3 flap designs, the reading man flap was the most suitable flap in terms of total scar area and length. CONCLUSION The reading man flap can be used to reconstruct malar and infraorbital circular defects with good cosmetic results and without creating any tractional forces to the eyelids. [source]


Introduction to Flap Movement: Reconstruction of Five Similar Nasal Defects Using Different Flaps

DERMATOLOGIC SURGERY, Issue 2005
Elbert H. Chen MD
Background. There are several options for closure of a given surgical defect after tumor extirpation is confirmed. Flap reconstruction is one of these options. Objective. The purpose of this article is to introduce the three basic types of flap movement: advancement, rotation, and transposition. Methods. Five similar defects located on the nasal sidewall were repaired, each using a different flap design. Results. The optimal flap design for a given defect on a particular patient is based on the answers to a series of questions: Where is the available tissue reservoir? How can tissue be mobilized from the reservoir to cover the defect? How do the resulting tension vectors affect critical structures? Where are the final incision lines? Conclusion. Many factors must be evaluated before determining a method of reconstruction. Flap reconstruction requires a thorough understanding of anatomy and tissue movement. [source]


A Simple Tool for Teaching Flap Design with Digital Images

DERMATOLOGIC SURGERY, Issue 12 2001
Daniel Berg MD
Background. Defects created by excision or Mohs micrographic surgery must be analyzed and surgical options including flaps must be considered. Teaching flap design to dermatology trainees is often done at the bedside of the patient with the trainee describing or marking a proposed flap. Open discussion of the options in this way is sometimes unnerving for the patient. Blackboard discussions or drawings are limited in their realism. Objective. To describe a rapid, simple method using commonly available software to allow a trainee to draw and redraw a proposed flap on a digital image of the defect without the time and cost of printing. Methods. We describe a feature in the widely used presentation program Microsoft PowerPoint which can be used to draw on an imported digital image in various colors. Results. A digital photograph taken at the bedside can quickly be loaded into PowerPoint and viewed as a full-screen picture on a computer. Using an electronic pen, multiple lines can be drawn and erased on the picture, allowing surgical planning and teaching away from the bedside. Conclusion. Design and analysis of potential incision lines for a flap can be done quickly using a digital image and commonly available software, allowing a new option for teaching flap design. [source]


Fibre retention osseous resective surgery: a novel conservative approach for pocket elimination

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2007
Gianfranco Carnevale
Abstract Aim and Background: The position of the most apical inter-dental portion of the alveolar crest is classically used in osseous resective surgery (ORS) to establish the amount of the inter-proximal and buccal/lingual bone resection. Supracrestal fibres connected to the root cementum are always present coronal to the alveolar crest both in healthy and diseased sites. The aim of this paper is to report a novel surgical approach that combines the classical method of osseous resection with the gingival fibre retention technique. Material and Methods: A description of the surgical procedure in four steps is provided (flap design, marginal soft tissue removal and fibre retention, ORS, suture of the flap). Results and Conclusion: The proposed technique shifts the bottom of the defect in a more coronal position at the level of the connective tissue fibre attachment, establishing a more conservative supporting bone resection. [source]


Penile resurfacing with vascularized fascia lata

MICROSURGERY, Issue 6 2005
Andreas I. Gravvanis M.D., Ph.D.
Penis resurfacing is a challenging procedure, and should simultaneously ensure erectile function, tactile sensibility, sexual satisfaction, and aesthetic integrity. This article presents three cases with penile skin defects treated by means of a pedicled fascia lata attached either to the tensor fascia lata (one case) or an anterolateral thigh flap (two cases). The cause of the wounds included electrical burn, Fournier's gangrene, and self-mutilation. The size of flaps ranged from 10,13 cm in width and 15,30 cm in length. All flaps included vascularized fascia lata, which covered part or the circumference of the penis. All flaps survived completely. The lateral cutaneous nerve of the thigh was included in the designed flaps in all instances, and normal protective sensation was recorded postoperatively. The patients reported normal erectile function and ability to perform intercourse. The flaps, though relatively bulky and hairy, had a good color and texture match with the penis and suprapubic region. Based on our limited experience, we believe that the anterolateral thigh flap has greater dimensions with a longer pedicle, and allows for greater flexibility in flap design compared to the tensor fascia lata flap. An anterolateral thigh flap can be safely thinned in a second stage, and it is our flap of choice for penis resurfacing. 2005 Wiley-Liss, Inc. Microsurgery 25:462,468, 2005 [source]


The Platysma Myocutaneous Flap: Underused Alternative for Head and Neck Reconstruction,

THE LARYNGOSCOPE, Issue 7 2002
Wayne M. Koch MD
Abstract Objectives The use, advantages, and disadvantages of the platysma flap were assessed. Study Design Retrospective review of the medical records of patients undergoing platysma flap reconstruction of the upper aerodigestive tract from 1987 to 2001. Methods Information regarding the tumor, surgical procedure, flap design, and outcome emphasizing complications and function was extracted. Associations between putative risk factors for flap failure and outcome were assessed using the ,2 test. Results Thirty-four patients underwent reconstruction with platysma flaps. Surgical defects included the oropharynx, oral cavity, and hypopharynx. Nine patients had had prior radiation therapy and all had some dissection of the ipsilateral neck. There were 5 postoperative fistulas (15%), flap desquamation was noted in 6 cases (18%), and 2 patients experienced loss of the distal skin closing the donor site. Complications were not associated with prior radiation. Hospital stay ranged from 5 to 21 days (mean, 10 d). There were no returns to the operating room or need for additional reconstruction. All but 1 patient resumed a normal diet within 3 months of surgery. There were no recurrences of cancer in the dissected neck regions. Conclusions The platysma flap is simple and versatile with properties similar to the radial forearm free flap. The rate of complications is similar to other published series, and problems encountered were manageable using conservative methods with excellent functional and cosmetic outcomes. These facts support the contention that the platysma myocutaneous flap can serve as a viable alternative to free tissue transfer and has advantages over pectoralis major pedicled flaps for reconstruction of many head and neck defects. [source]


"Reading Man Flap" Design for Reconstruction of Circular Infraorbital and Malar Skin Defects

DERMATOLOGIC SURGERY, Issue 11 2008
TAMER SEYHAN MD
BACKGROUND Surgical complications such as lid retraction and ectropion from graft or flap scar contracture make reconstruction of skin defects in the malar and infraorbital regions challenging. OBJECTIVE A new flap design, the reading man flap, was used to overcome these problems. The Limberg and bilobed flap were compared with the reading man flap. METHODS The reading man flap consists mainly of a superiorly based quadrangular flap and an inferiorly based triangular flap. Malar and infraorbital circular skin defects measuring 14 14 to 40 40 mm were reconstructed with a reading man flap in 13 patients. The defects occurred after basal cell carcinoma in all patients. The Limberg flap, bilobed flap, and reading man flap were planned for same-sized defects on the abdominoplasty resection material. The results were compared in terms of total scar area, scar length, and total healthy skin area discarded. RESULTS When comparing the 3 flap designs, the reading man flap was the most suitable flap in terms of total scar area and length. CONCLUSION The reading man flap can be used to reconstruct malar and infraorbital circular defects with good cosmetic results and without creating any tractional forces to the eyelids. [source]