The Experts below are selected from a list of 234 Experts worldwide ranked by ideXlab platform
Huifeng Song - One of the best experts on this subject based on the ideXlab platform.
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surgical treatment of severe or moderate axillary Burn Scar Contracture with transverse island scapular flap and expanded transverse island scapular flap in adult and pediatric patients a clinical experience of 15 cases
Burns, 2015Co-Authors: Baoguo Chen, Minghuo Xu, Jiake Chai, Huifeng SongAbstract:Abstract Background Axillary Burn Scar Contracture is common and troublesome. With the aim of restoring the function of the upper extremities, a proper local flap with minor damage and preclusion from recurrence should be developed to guarantee satisfactory results. A minor webbed Scar Contracture was rectified by Z-plasty. However, severe or moderate Contracture must be constructed by a local flap. An island scapular flap has been used in pediatric patients for repairing axillary Contracture. However, no detailed description of the use of a transverse island scapular flap (TISF) was reported to correct the deformity. Moreover, an expanded transverse island scapular flap (ETISF) used for increasing the volume of skin for severe axillary Contracture in adults and developing children was also not presented. Methods From 2006 to 2013, TISFs were harvested for 12 pediatric patients (5–12 years of age) with 15 sides of severe or moderate axillary Burn Scar Contractures. Four ETISFs were designed for two adult patients (38 and 32 years of age). The flap size was between 10 cm × 5 cm and 20 cm × 10 cm. In one pediatric patient, a cicatrix was observed on the surface of the flap's donor site. Handheld Doppler was applied to detect the pedicle. Results The patients were required to lift their upper arms regularly each day after the operation. All 19 flaps survived completely. Axillary Burn Scar Contractures were corrected successfully in 11 patients with no expander implantation. The lifting angle was enhanced considerably with 1–3 years of follow-up in the 11 patients. Only one pediatric patient with cicatrix on the donor site displayed tight skin on the back and a little restraint on the shoulder. The patient's parents were told to intensify the chin-up movement on the horizontal bar. She was in the process of a 3-month follow-up. The lifting angle was also improved significantly in the latter three cases of expander implantation although they were followed up for a short duration of 3 months. Due to poor flap design, the donor site of one adult patient was not closed directly with the help of skin grafting on the left side of her back. Conclusions Considering the flap's negligible level of later Contracture and minimal trauma, local TISF based on the transverse branch of the circumflex scapular artery is a good choice for reconstruction of axillary Burn Scar Contractures. If the TISF is not able to meet the demand, the expander implanted in advance can be more beneficial.
Yen Chang Hsiao - One of the best experts on this subject based on the ideXlab platform.
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chin projection creation in patients with facial and cervical Burn Scar Contracture
Burns, 2013Co-Authors: Chun Yuan Huang, Jui Yung Yang, Yen Chang HsiaoAbstract:Abstract Background Loss of cervicomental angle is characteristic of severe facial and cervical Burned patients due to Scar Contracture. This micrognathia-like deformity is also seen in patients following chin and neck reconstruction using skin expanded flaps. The aim of modern plastic surgery is to restore a harmonious and symmetrical facial appearance for Burn survivors. Methods Six facial and cervical Burned patients with micrognathia-like deformity after neck reconstructions were reported. Chin augmentation with Medpor implant through submental approach was performed in 4 patients and intraoral access in 2 cases to restore their favorable chin projections. Five of them received cervicomental contour reconstruction simultaneously. Results Patient follow-up ranged from 12 to 18 months. No implants became exposed nor infected. All patients had satisfactory results. We reviewed our experience with the use of the Medpor implant in Burn chin reconstruction including preoperative and postoperative radiograph analysis. Conclusions With proper patient selection, pre-operative planning, and taking care of details during operation, augmentation genioplasty with Medpor implant offers a reliable, simple and satisfactory solution for improving micrognathia-like facial configurations in patients with Scar Contracture following severe Burns.
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free medial thigh perforator flap for reconstruction of the dynamic and static complex Burn Scar Contracture
Burns, 2010Co-Authors: Chung Ho Feng, Chun Yuan Huang, Jui Yung Yang, Shiow Shuh Chuang, Yen Chang HsiaoAbstract:Abstract Introduction Dynamic and static complex Scar Contractures after Burn commonly cause tendon adhesion, deep adipose tissue stiffness and further limitation of major joints motion. Skin autografting or locoregional flaps are not adequate reconstructive options, because of the easy recurrence and limitation of donor sites. Therefore, free perforator flaps are playing increasing role in reconstruction of complex Scar Contractures. Patients and methods The free medial thigh perforator (MTP) flap is an addition to the reconstructive armamentarium and is particularly useful since the medial thigh is commonly spared in Burn injury. Between December 2001 and October 2005, eight patients with severe post-Burn Scar Contractures received free MTP flaps treatment in the Linkou Burn Center. The free MTP flap harvest was modified to enhance its reliability and versatility. Flap sizes ranged from 5 × 15 cm to 8 × 24 cm. The follow-up period was from 12 to 26 months. Flap harvest is rapid, averaging 37.8 min. Results The significantly improved range of motion of the Contracture joints approximated to normal activity at 6–22-month follow-up ( p Conclusion The free MTP flap with new modified harvest is a good choice for dynamic an static complex Scar Contractures of major joints, due to short harvesting time and few variations of the pedicle. However, thick skin paddle was considered in secondary hand reconstruction.
S Y Li - One of the best experts on this subject based on the ideXlab platform.
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superior extension of the parascapular free flap for cervical Burn Scar Contracture
Plastic and Reconstructive Surgery, 1995Co-Authors: Jia Xu, Senkai Li, Yangqun Li, X B, S Y LiAbstract:A newly designed superior extension of the parascapular free flap and its free transfer clinically for the repair of 11 cases of cervical Burn Scar Contracture without any loss are presented. The flap sizes ranged from 16 X 7 cm to 32 X 11 cm. Based on the anatomic distribution of the circumflex scapular vessels, the flap in the scapular territory can be taken much longer and wider than before. There is less tension in this vertically oriented flap than in the horizontally oriented flap in obtaining primary closure. This method extends the application of the scapular territory as a donor site for free flaps. (Plast. Reconstr Surg. 96 : 58, 1995.)
Suk Joon Oh - One of the best experts on this subject based on the ideXlab platform.
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acceleration of integra incorporation in reconstruction of Burn Scar Contracture with the vacuum assisted closure vac
Archives of Plastic Surgery, 2009Co-Authors: Suk Joon Oh, Man Kyung Jeon, Sung Hoon KoAbstract:Purpose: Negative pressure therapy has been used in various conditions to promote wound healing. It has also been used to secure a skin graft by improving microcirculation and improving tight adhesion between the graft and the recipient bed. To reduce post Burn Scar Contracture and improve aesthetical result, many types of dermal substitutes have been invented and used widely. The goal of this study is to evaluate usefulness of the VAC(Kinetic concepts Inc., San Antonio, TX) in improving the take rate and time to incorporation of Integra in reconstruction of Burn Scar Contracture. Methods: A retrospective study was performed from October, 2006 to December, 2008. The VAC was utilized for 11 patients. The patient’s ages ranged from 5 to 27 with an average of 19.7 years. The surface area ranged from 24 to 1,600cm2 with an average of 785cm2. The Burn Scars were excised deep into normal subcutaneous tissue to achieve complete release of the Scar, Integra was sutured in place with skin staple and Steri-strip . Then slit incisions were made on silicone sheet only with No.11 blade for effective drainage. The VAC was used as a bolster dressing over Integra . Negative-Pressure ranging from 100 to 125mm Hg was applied to black polyurethane foam sponge trimmed to the appropriate wound size. An occlusive seal over the black polyurethane foam sponge was maintained by a combination of the occlusive dressing, OP-site . The VAC dressing changes were performed every 3 or 4 days until adequate incorporation was obtained. The neodermis appeared slightly yellow to orange color. When the Integra deemed clinically incorporated, The VAC was removed and take was estimated with visual inspection. Very thin STSG(0.006-0.008 inches) was performed after silicone sheet removal. Result: The mean time for clinically assessed incorporation of Integra was 10.00 days(range 9-12). The mean dressing change was 3.5 times until take was obtained. In All patients, Integra had successful incorporation in tissue without serious complications. Conclusion: Integra in combination with Vacuum- Assisted Closure(VAC) may be incorporated earlier than conventional dressing method.
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correction of Burn Scar Contracture indication and choice of free flap
Archives of Plastic Surgery, 2008Co-Authors: Jai Koo Choi, Young Chul Jang, Suk Joon OhAbstract:Purpose: Most Burn Scar Contractures are curable with skin grafts, but free flaps may be needed in some cases. Due to the adjacent tissue Scarring, local flap is rarely used, and thus we may consider free flap which gives us more options than local flap. However, inappropriate performance of free flap may lead to unsatisfactory results despite technical complexity and enormous amount of effort. The author will discuss the points we should consider when using free flaps in treating Burn Scar Contractures Methods: We surveyed patients who underwent free flaps to correct Burn Scar Contractures from 2000 to 2007. We divided patients into two groups. The first group was those in which free flaps were inevitable due to exposure of deep structures such as bones and tendons. The second group was those in which free flap was used to minimize Scar Contracture and to achieve aesthetic result. Results: We performed 44 free flap on 42 patients. All of the flaps were taken well except one case of partial necrosis and wound dehiscence. Forearm free flap was the most common with 21 cases. Most of the cases(28 cases) in which free flaps were inevitable were on the wrist and lower limbs. These were cases of soft tissue defect due to wide and extensive Burns. Free flaps were done in 16 cases to minimize Scar Contracture and to obtain aesthetic outcome, recipient sites were mostly face and upper extremities. Conclusion: When using free flaps for correction of Burn Scar Contractures, proper release and full resurfacing of the Contracture should be carried out in advance. If inadequate free flap is performed, secondary correction is more challenging than in skin grafts. In order to optimize the result of reconstruction, flap thickness, size and Scar of the recipient site should be considered, then we can achieve natural shape, and minimize additional correction.
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Fist position for skin grafting on the dorsal hand : II. Clinical use in deep Burns and Burn Scar Contractures
Plastic and Reconstructive Surgery, 2000Co-Authors: Jin Sik Burm, Suk Joon OhAbstract:The fundamental problem in all types of hand Burns is a loss of skin and subsequent deformities. The goal of skin grafting on the dorsal hand is to graft a sufficient amount of skin, as much as the original amount, and to restore normal hand function without secondary deformities. The safe, or Michigan, position commonly has been used for immobilizing the hand. However, this position is to protect hand function rather than to provide for adequate skin grafting. This institution has developed a new hand position (the fist position) for grafting the greatest amount of skin on the dorsal side of the hand. In the fist position, the hand is positioned flexing all joints of the wrist and the fingers and maximally stretching the dorsal surface of the hand before skin grafting. Ten hands with deep second- or third-degree Burn ( n = 6) and Burn Scar Contracture (n = 4) of the dorsal hand in eight patients were treated with split-thickness skin grafting after immobilizing in the fist position. The Burns and Contractures involved nearly the total area of the dorsal hand. The hand was kept in the fist position for 7 to 9 days after skin grafting. Excellent functional and cosmetic results were observed in all cases during the follow-up period of 6 months to 2 years. Complications resulting from hand immobilization for a short period did not occur. The fist position may be a proper hand position for skin grafting to reconstruct the dorsal hand.
Baoguo Chen - One of the best experts on this subject based on the ideXlab platform.
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surgical treatment of severe or moderate axillary Burn Scar Contracture with transverse island scapular flap and expanded transverse island scapular flap in adult and pediatric patients a clinical experience of 15 cases
Burns, 2015Co-Authors: Baoguo Chen, Minghuo Xu, Jiake Chai, Huifeng SongAbstract:Abstract Background Axillary Burn Scar Contracture is common and troublesome. With the aim of restoring the function of the upper extremities, a proper local flap with minor damage and preclusion from recurrence should be developed to guarantee satisfactory results. A minor webbed Scar Contracture was rectified by Z-plasty. However, severe or moderate Contracture must be constructed by a local flap. An island scapular flap has been used in pediatric patients for repairing axillary Contracture. However, no detailed description of the use of a transverse island scapular flap (TISF) was reported to correct the deformity. Moreover, an expanded transverse island scapular flap (ETISF) used for increasing the volume of skin for severe axillary Contracture in adults and developing children was also not presented. Methods From 2006 to 2013, TISFs were harvested for 12 pediatric patients (5–12 years of age) with 15 sides of severe or moderate axillary Burn Scar Contractures. Four ETISFs were designed for two adult patients (38 and 32 years of age). The flap size was between 10 cm × 5 cm and 20 cm × 10 cm. In one pediatric patient, a cicatrix was observed on the surface of the flap's donor site. Handheld Doppler was applied to detect the pedicle. Results The patients were required to lift their upper arms regularly each day after the operation. All 19 flaps survived completely. Axillary Burn Scar Contractures were corrected successfully in 11 patients with no expander implantation. The lifting angle was enhanced considerably with 1–3 years of follow-up in the 11 patients. Only one pediatric patient with cicatrix on the donor site displayed tight skin on the back and a little restraint on the shoulder. The patient's parents were told to intensify the chin-up movement on the horizontal bar. She was in the process of a 3-month follow-up. The lifting angle was also improved significantly in the latter three cases of expander implantation although they were followed up for a short duration of 3 months. Due to poor flap design, the donor site of one adult patient was not closed directly with the help of skin grafting on the left side of her back. Conclusions Considering the flap's negligible level of later Contracture and minimal trauma, local TISF based on the transverse branch of the circumflex scapular artery is a good choice for reconstruction of axillary Burn Scar Contractures. If the TISF is not able to meet the demand, the expander implanted in advance can be more beneficial.
