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Fu-chan Wei - One of the best experts on this subject based on the ideXlab platform.
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free fibula Osteocutaneous Flap with soleus muscle as a chimeric Flap for reconstructing mandibular segmental defect after oral cancer ablation
Annals of Plastic Surgery, 2010Co-Authors: Yurren Kuo, Hsiangshun Shih, Chienchang Chen, Radovan Boca, Yaochung Hsu, Sengfeng Jeng, Fu-chan WeiAbstract:Abstract:In some cases, the fibula Osteocutaneous Flap may not provide sufficient soft tissue for obliterating dead space after tumor ablation. This report describes a modified fibula Osteocutaneous Flap using a portion of soleus muscle to reduce postoperative complications.This study analyzed 20 pa
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Reverse venous outflow of a free fibular Osteocutaneous Flap: a salvage procedure.
Annals of Plastic Surgery, 1999Co-Authors: Yurren Kuo, Sengfeng Jeng, Fu-chan WeiAbstract:The authors report 2 patients with a massive bony defect of the tibia due to chronic osteomyelitis. They reconstructed the defect using a free vascularized fibular Osteocutaneous Flap. Unfortunately, venous insufficiency was diagnosed 24 hours postoperatively. The previous anastomosed veins were promptly explored. The peroneal veins of the vascularized fibular bone graft were noted to be full of thrombi. After thrombectomy, the vessels became very fragile and broke down easily. It was impossible to achieve normal antegrade venous outflow from the previous vein of the donor graft; however, they found that distal runoff of the peroneal vein achieved a reverse venous outflow from the donor graft. The great saphenous vein was dissected and reanastomosed to achieve adequate venous drainage. This procedure may offer an alternative treatment for a Flap with venous insufficiency.
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Functional and esthetic reconstruction of a mutilated hand using multiple toe transfers and iliac Osteocutaneous Flap: a case report.
Microsurgery, 1993Co-Authors: Fu-chan Wei, Hung-chi Chen, Chee-seng Seah, Chwei-chin ChuangAbstract:With reconstructive microsurgical techniques, some previously hopelessly mutilated hands have become reconstructable. The functional and esthetic results of such hands can be improved to an acceptable degree with thorough prereconstruction evaluation and planning. This case report demonstrates the approach to reconstruction of a mutilated hand using the following: a pedicle groin Flap for soft tissue reconstruction of the first web space and the amputation stump of the thumb; a combined second and third toe transfer for reconstruction of opposable fingers at the amputated index and middle finger stumps; a single second toe for reconstruction of the thumb, and an iliac Osteocutaneous Flap for reconstruction of the ulnar border of the palm. © 1993 Wiley-Liss Inc.
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Technique of foot lengthening and shaping with free vascularized iliac Osteocutaneous Flap.
Plastic and Reconstructive Surgery, 1992Co-Authors: David Chwei-chin Chuang, Hung-chi Chen, Fu-chan WeiAbstract:The iliac Osteocutaneous Flap has been used widely to replace bony defects of the mandible and the extremities. We report a further application of this Flap in foot reconstruction. The iliac Osteocutaneous Flap proved to be of value to augment both soft tissue and bone in a transmetatarsally amputated foot. This resulted in satisfactory function and an appealing cosmetic result, allowing the patient to wear normal shoes. Flap design and secondary contouring procedures are described for the success of this reconstruction.
Hung-chi Chen - One of the best experts on this subject based on the ideXlab platform.
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Treatment of dyspareunia by creation of a pseudojoint in rigid bone following total penile reconstruction with fibular Osteocutaneous Flap.
The Journal of Sexual Medicine, 2008Co-Authors: Christopher J. Salgado, Antonio Rampazzo, Hung-chi ChenAbstract:ABSTRACT Introduction Gender reassignment requires total penile reconstruction, which is commonly performed with autologous tissue. One option for reconstruction is the free fibula Osteocutaneous Flap, which provides a long segment of vascularized bone that is less susceptible to infection and allows for deep penetration into the vagina during sexual intercourse. One problem, however, is that their sexual partner may suffer from pain (dyspareunia) because of the long and rigid bone. Aims Our intent is to elucidate the treatment of female dyspareunia by surgically modifying the reconstructed penis with segmental osteotomies and fascia interposition within the rigid bone stock resulting from gender reassignment with a free fibula Osteocutaneous Flap. Methods In order to improve their sexual relations and alleviate dyspareunia, a semirigid penis was created by forming a pseudojoint at the junction of the proximal and distal third of the fibula bone stock with osteotomies and fascia interposition. Main Outcome Measures Alleviation of dyspareunia by surgical modification of a previously reconstructed penis for the couple to continue to have sexual relations. Results The created pseudojoints in the reconstructed penis allowed for pain‐free vaginal intercourse between the patient and his wife because of its now semirigid structure. Conclusion The surgical modification presented in this case report addresses the treatment of dyspareunia by creating a more malleable penile reconstruction, which will now allow for a pain‐free vaginal intercourse. Salgado C, Rampazzo A, Xu E, and Chen H‐C. Treatment of dyspareunia by creation of a pseudojoint in rigid bone following total penile reconstruction with fibular Osteocutaneous Flap. J Sex Med **; **:**–**.
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Prefabrication of the free fibula Osteocutaneous Flap to create a functional human penis using a controlled fistula method.
Journal of Reconstructive Microsurgery, 2007Co-Authors: Hung-chi Chen, Tewodros M. Gedebou, Sukru Yazar, Yueh-bih TangAbstract:Neophalloplasty remains one of the most challenging efforts in plastic and reconstructive surgery. The complex functional and aesthetic requirements are difficult to attain with consistency and safety. The current gold standard technique involves the use of a radial forearm tube-in-tube free Flap, which also requires the placement of a stiffening prosthetic device for dual function. We report the safe use of the free fibula Osteocutaneous Flap to create a functional, cosmetically-acceptable penis utilizing the principles of prefabrication and controlled fistula method in one case of gender dysphoria.
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Functional and esthetic reconstruction of a mutilated hand using multiple toe transfers and iliac Osteocutaneous Flap: a case report.
Microsurgery, 1993Co-Authors: Fu-chan Wei, Hung-chi Chen, Chee-seng Seah, Chwei-chin ChuangAbstract:With reconstructive microsurgical techniques, some previously hopelessly mutilated hands have become reconstructable. The functional and esthetic results of such hands can be improved to an acceptable degree with thorough prereconstruction evaluation and planning. This case report demonstrates the approach to reconstruction of a mutilated hand using the following: a pedicle groin Flap for soft tissue reconstruction of the first web space and the amputation stump of the thumb; a combined second and third toe transfer for reconstruction of opposable fingers at the amputated index and middle finger stumps; a single second toe for reconstruction of the thumb, and an iliac Osteocutaneous Flap for reconstruction of the ulnar border of the palm. © 1993 Wiley-Liss Inc.
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Technique of foot lengthening and shaping with free vascularized iliac Osteocutaneous Flap.
Plastic and Reconstructive Surgery, 1992Co-Authors: David Chwei-chin Chuang, Hung-chi Chen, Fu-chan WeiAbstract:The iliac Osteocutaneous Flap has been used widely to replace bony defects of the mandible and the extremities. We report a further application of this Flap in foot reconstruction. The iliac Osteocutaneous Flap proved to be of value to augment both soft tissue and bone in a transmetatarsally amputated foot. This resulted in satisfactory function and an appealing cosmetic result, allowing the patient to wear normal shoes. Flap design and secondary contouring procedures are described for the success of this reconstruction.
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Bone marrow as a means of venous drainage for a microvascular Osteocutaneous Flap.
Surgery, 1991Co-Authors: Hung-chi Chen, Yueh-bih Tang, M. S. NoordhoffAbstract:Intraosseous infusion of fluid had been used in traumatology. Here we describe a clinical situation in which bone marrow is first used for drainage of venous blood in a free Osteocutaneous Flap. Two factors account for the survival of the large Osteocutaneous Flap in which venous anastomosis was impossible. (1) In the design of the arterial circuit and the major route of venous drainage, there were two ends of the peroneal artery of the Osteocutaneous Flap. Both its upper and lower ends were anastomosed to the anterior tibial artery of the recipient site to constitute an uninterrupted arterial circulation. This prevented stagnation of arterial flow and thrombosis of the arterial anastomosis. (2) The major route of venous drainage was through bone marrow. The initial congestion was finally overcome by the development of neovascularization. Bone scan showed good survival of bone with increased uptake of radioactivity. At 3 years follow-up, roentgenogram showed bone union, and the patient had no trouble walking. The continuity of the anterior tibial artery, which had been interrupted by trauma, was restored by this Flap.
Lizheng Qin - One of the best experts on this subject based on the ideXlab platform.
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single versus dual venous anastomoses of the free fibula Osteocutaneous Flap in mandibular reconstruction a retrospective study
Microsurgery, 2013Co-Authors: Zhengxue Han, Lizheng QinAbstract:Objective The present study was to compare the success rates of single venous anastomosis with dual venous anastomoses of the free fibula Osteocutaneous Flap in mandibular reconstruction. Patients and Methods Retrospective review of all cases of mandibular reconstruction using free fibula Osteocutaneous Flaps performed by a single surgeon in our department during the period January 2005 to April 2012. All the Flaps were harvested and transplanted by the standard protocols. Microvascular anastomosis of either one or two veins was performed. In addition to routine clinical evaluation, the viability of the Flap was evaluated by a portable Doppler at the tenth day after surgery. Results Two hundred and one free fibula Osteocutaneous Flaps were performed during this time period. Single venous anastomosis was performed in 112 Flaps and dual venous anastomoses were performed in 89 Flaps. The overall incidence of vascular thrombosis was 3%, and the success rate of the transplantation was 98.5%. Six cases developed vascular thrombosis postoperatively. One was arterial thrombosis that occurred 12 hours after initial operation in the dual venous anastomoses group. Three venous thrombosis occurred 24 hr after the operation in the single venous anastomosis group. In dual venous anastomoses group, two venous thrombosis occurred 3–4 days after initial operation and attempt to salvage failed in both the cases. Fisher's exact test showed that there was no significant difference of the success rate between single and dual anastomoses groups (P = 0.59). Conclusions There is no difference in success rates between single venous anastomosis and dual venous anastomoses for mandibular reconstruction with free fibula Osteocutaneous Flap. © 2013 Wiley Periodicals, Inc. Microsurgery 33:652–655, 2013.
F Yurren A C S Kuo - One of the best experts on this subject based on the ideXlab platform.
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functional assessment of donor site morbidity after harvest of a fibula chimeric Flap with a sheet of soleus muscle for mandibular composite defect reconstruction
Microsurgery, 2012Co-Authors: M Yuchi D Huang, M Chaupeng D Leong, M Yaping D Pong, M Tingyuan D Liu, F Yurren A C S KuoAbstract:This study aims to compare donor-site morbidity between the traditional fibula Osteocutaneous and chimeric fibula Flaps for mandibular reconstruction. Twenty-three patients with head and neck cancer were recruited. Fifteen patients underwent the traditional fibula Osteocutaneous Flap. Eight patients received a chimeric fibula Osteocutaneous Flap with a sheet of soleus muscle. Subjective donor-site morbidities were evaluated by questionnaire. Objective isokinetic testing and 6-minute walking test (6MWT) were used to evaluate ankle strength and walking ability. The results revealed no significant difference was found in total average score of the questionnaire between the traditional (2.57) and the chimeric (2.75) groups (P > 0.05). There were no significant differences in peak torque/total work of ankle motions and in walking ability at 6MWT between the traditional and chimeric groups (P > 0.05). In conclusion, compared with the traditional fibula Osteocutaneous Flap, the chimeric fibula Flap does not increase donor-site morbidity for reconstructive surgery. © 2011 Wiley Periodicals, Inc. Microsurgery, 2012.
Chun-ta Liao - One of the best experts on this subject based on the ideXlab platform.
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Ulnar forearm Osteocutaneous Flap harvesting using Kapandji procedure for pre-existing complicated fibular Flap on mandible reconstruction--cadaveric and clinical study.
Annals of Plastic Surgery, 2015Co-Authors: Chun-ta LiaoAbstract:UNLABELLED: It is not uncommon that after using a fibular Flap for lower gum cancer reconstruction, nonunion, chronic osteomyelitis, or fibular bone exposure occurs, which requires a composite bone and soft tissue reconstruction. Radial forearm Osteocutaneous Flap possesses the risk of stress fracture. Ulnar forearm Osteocutaneous Flap can be another option for small bone defect reconstruction. PATIENTS AND METHOD: Six patients who had undergone fibular Flap for mandible reconstructions and sustained either bone exposure (3 patients), chronic osteomyelitis (1 patient), malocclusion (1 patient), or osteoradionecrosis (1 patient) underwent ulnar forearm Osteocutaneous Flap with 3-cm ulnar bone for touch-up procedure. The distal radioulnar joints were fused with a screw. Six ulnar forearm Osteocutaneous Flap dissections were also performed on 4 fresh frozen cadavers to clarify the anatomic distribution of the distal ulnar artery. RESULT: All 6 ulnar forearm Osteocutaneous Flaps survived with one re-exploration for venous occlusion. All presented bone union. Comparable to the clinical dissection, the cadaveric distal ulnar artery demonstrates a periosteal branch that runs between the proper ulnar nerve and dorsal sensory nerve. This periosteal branch comes out of an ulnar artery approximately 3 cm proximal to the wrist joint. CONCLUSION: Ulnar forearm Osteocutaneous Flap can provide a secondary Flap of wide skin paddle and small segment bone for specific mandibular defect after a fibular Flap transfer.
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Ulnar forearm Osteocutaneous Flap harvesting using Kapandji procedure for pre-existing complicated fibular Flap on mandible reconstruction--cadaveric and clinical study.
Annals of plastic surgery, 2015Co-Authors: Chih-hung Lin, Chun-ta Liao, Cheng-hung Lin, Bien-keem Tan, Chun-ta LeeAbstract:It is not uncommon that after using a fibular Flap for lower gum cancer reconstruction, nonunion, chronic osteomyelitis, or fibular bone exposure occurs, which requires a composite bone and soft tissue reconstruction. Radial forearm Osteocutaneous Flap possesses the risk of stress fracture. Ulnar forearm Osteocutaneous Flap can be another option for small bone defect reconstruction. Six patients who had undergone fibular Flap for mandible reconstructions and sustained either bone exposure (3 patients), chronic osteomyelitis (1 patient), malocclusion (1 patient), or osteoradionecrosis (1 patient) underwent ulnar forearm Osteocutaneous Flap with 3-cm ulnar bone for touch-up procedure. The distal radioulnar joints were fused with a screw. Six ulnar forearm Osteocutaneous Flap dissections were also performed on 4 fresh frozen cadavers to clarify the anatomic distribution of the distal ulnar artery. All 6 ulnar forearm Osteocutaneous Flaps survived with one re-exploration for venous occlusion. All presented bone union. Comparable to the clinical dissection, the cadaveric distal ulnar artery demonstrates a periosteal branch that runs between the proper ulnar nerve and dorsal sensory nerve. This periosteal branch comes out of an ulnar artery approximately 3 cm proximal to the wrist joint. Ulnar forearm Osteocutaneous Flap can provide a secondary Flap of wide skin paddle and small segment bone for specific mandibular defect after a fibular Flap transfer.
