The Experts below are selected from a list of 387 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.
Claudio Angrigiani - One of the best experts on this subject based on the ideXlab platform.
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refining the extended circumflex Scapular Flap for neck burn reconstruction a 30 year experience
Journal of Plastic Reconstructive and Aesthetic Surgery, 2017Co-Authors: Claudio Angrigiani, Guillermo Artero, Carlos Sereday, Roger K Khouri, Zachary P FrenchAbstract:Summary Introduction Neck burn sequelae remain a major challenge for the reconstructive surgeon. To achieve satisfactory functional and aesthetic results, the anterior neck aesthetic unit must be covered as a single unit. In cases where free Flaps are required, harvesting a Flap of sufficient size can cause major donor site morbidity. In 1994, we published our favorable 6-year experience of reconstructing neck burn sequelae with an extended circumflex Scapular Flap (ECSF). Since then, we have made several modifications to the technique, resulting in improved long-term functional and aesthetic results. Herein, we present our 30-year, 150-patient experience with the ECSF Flap for the treatment of anterior neck burn sequelae. Methods We retrospectively reviewed the records of 150 consecutive patients who underwent ECSF procedure for neck resurfacing performed or supervised by the senior author from 1986 to 2015. All cases were assessed for function, aesthetics, satisfaction, and complications. Results A total of 160 ECSFs were used in 150 patients. Ninety-nine patients were available for updated follow-up [1–30 years (mean, 15.3)]. At the last follow-up, 92 patients regained full range of motion, and 90 patients had acceptable cervicomental angle ( Nine Flaps (5.6%) failed completely and were successfully replaced. Twenty-two patients (15%) had distal necrosis of the Flap. Fifteen of these 22 patients underwent complementary Flaps to replace the necrotic area, and all 15 patients regained full range of motion. Conclusions For neck burn sequelae, the ECSF provides safe and effective long-term functional and aesthetic results with minimal donor site morbidity.
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The inframammary extended circumflex Scapular Flap: an aesthetic improvement of the paraScapular Flap.
Plastic and reconstructive surgery, 1997Co-Authors: John W. Siebert, Michael T. Longaker, Claudio AngrigianiAbstract:ParaScapular free Flaps traditionally have been designed obliquely across the back, corresponding to the descending branch of the circumflex Scapular artery. The donor site of this workhorse Flap has the drawback of a widened and frequently hypertrophic scar. In searching for aesthetic improvements in the donor site, we have progressively rotated the axis of this Flap in an anterior direction. The end result of this modification is the Flap we report here : the inframammary extended circumflex Scapular Flap. This Flap has a longitudinal axis of rotation lying curvilinearly from the inframammary fold to the circumflex Scapular artery within the triangular anatomic space. We have used this Flap in 20 patients over the past 2 years. The vast majority of these cases were deepithelialized Flaps with customized extensions of dorsal thoracic fascia to correct facial asymmetry. We feel that the inframammary extended circumflex Scapular artery Flap donor-site scar is well hidden within the inframammary fold, and that the unavoidable widening and hypertrophy of paraScapular and Scapular Flap donor-site scars were minimized compared with traditional Flap designs.
Kitaro Ohmori - One of the best experts on this subject based on the ideXlab platform.
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use of the osteocutaneous free Scapular Flap on the lower extremities
Plastic and Reconstructive Surgery, 1993Co-Authors: Junsuke Sekiguchi, Seiichiro Kobayashi, Kitaro OhmoriAbstract:Reports on the use of osteocutaneous free Scapular Flap transfers have focused primarily on mandible reconstruction. Yet the scapula is a nearly straight bone, and it is also useful in the reconstruction of long bones. We would like to report on 23 patients undergoing osteocutaneous free Scapular Flap transfers to the lower extremities in whom we obtained extremely satisfactory results. These 23 surgical patients included 10 with pseudoarthrosis with osteomyelitis, 3 with pseudoarthrosis due to trauma, and 5 with osteomyelitis of the lower extremities, as well as 5 with other miscellaneous problems. Surgery was successful in all patients. There was a recurrence of osteomyelitis in 2 patients. In 1 patient, the problem was minor and was treated on an outpatient basis. In the other patient, an infection arose in surgical dead space, and a second operation was required. The level of weight bearing achieved with the osteocutaneous free Scapular Flap is the same as obtained with a vascularized free fibular graft used for the treatment of pseudoarthrosis. We therefore believe that the osteocutaneous free Scapular Flap is extremely effective in the treatment of chronic and severe lower leg problems.
Hugh F Biller - One of the best experts on this subject based on the ideXlab platform.
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the combined latissimus dorsi Scapular free Flap in head and neck reconstruction
Archives of Otolaryngology-head & Neck Surgery, 1991Co-Authors: Jonathan E Aviv, Mark L Urken, Carlin Vickery, Hubert Weinberg, Daniel Buchbinder, Hugh F BillerAbstract:• Microvascular free tissue transfer techniques offer great versatility in the selection of tissue for reconstruction of head and neck defects. The system of Flaps based on the subScapular artery and vein provides the widest array of composite free Flaps. The possible Flaps that can be harvested based on this single vascular pedicle include the Scapular and paraScapular skin Flaps, the serratus anterior and latissimus dorsi muscle Flaps, and the lateral Scapular bone Flap. In addition, a segment of vascularized rib can be transferred with the serratus anterior and latissimus dorsi muscles. Large cutaneous defects can be resurfaced by combining the latissimus dorsi and Scapular Flaps. Another advantage of this combined Flap is the independent vascular pedicles of its components, which allow freedom in orientation of the various tissue segments. Thus, the combined Flap can be helpful in reconstructing complex threedimensional composite defects of the head and neck. In addition, by reinnervating the muscle portions of this Flap, bulk can be preserved and an improved functional reconstruction of the oral cavity achieved. A review of the literature shows three previous reports utilizing this combination of Flaps in five patients. We report the use of the combined latissimus dorsi—Scapular free Flap in six patients to reconstruct massive composite defects of the oral cavity, midface, and scalp. There was one Flap failure, which was successfully reconstructed with the contralateral latissimus dorsi—Scapular Flap. The anatomy of this Flap is reviewed, and the indications for its application are discussed. ( Arch Otolaryngol Head Neck Surg . 1991;117:1242-1250)
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.
