Objective To explore the clinical effect of different types of free tissue transplantation on repairing tissue defects and reconstructing functions. Methods From November 2001 to September 2004, 14 types of freetissue transplantation and 78 free tissue flaps were applied to repairing tissue defects and reconstructing functions in extremities and maxillofacial region in 69 cases. Of the 69 cases, there were 53 males and 16 females (their ages ranged from 18 to 56, 31 on average). Five cases were repaired because of skin defects in foot, 22 cases were repaired because of skin defects in leg, 36 cases were repaired as the result of skin defects in hand or forearm and finger reconstruction, 3 cases were restored by virtue of ulna or radius defects, and 3 cases were repaired in maxillofacial region. There were 55 cases of open wound, in which 16 cases were infectious wound, 6 cases were osteomyelitis or pyogenic arthritis. There were 14 cases of noninfectious wound. The area of these tissue flaps ranged from 2.0 cm×1.5 cm to 43.0 cm×12.0 cm. The length of bone transplantation ranged from 10 cm to 15 cm. Results Arterial crisis occurred in 2 cases, venous crisis occurred in 2 cases.Seventysix flaps survived completely and 2 flaps survived partially which werelater healed. Fiftytwo cases were healed at stageⅠ, 13 cases were healed at stageⅡ(healing time ranged from 20 to 30 days), purulent infection occurred to 4cases(healing time ranged from 3 to 11 months). Bone healing time ranged from 6 to 8 weeks in finger reconstruction. Bone healing time ranged from 4 to 6 months in fibula transplantation. The function reconstruction and appearance were satisfying. The functions of all regions, where free tissues were supplied, were not disturbed. Conclusion Tissue transplantation and composite tissue transplantation are effective in repairing tissue defects and reconstructing functions.
Eight cases of tissue defect inthe faciomaxillo-neck region weretreated by application of the vascu-larized paraseapular free flap Themain causes of the tissue defects werepostresection of tumor in the faceor neck and cicatrical contractureafter burn. The method of flapdesign was discussed. It was stress-ed that the incision of the flap onthe outer margin should be 2 cmbeyond the lateral border of thescapula, thus the damage to thesuperficial branch of the circumfl-ex seapular artery could be avoided.
Abstract From March, 1987 through May, 1996, a total of 13 cases of severe deep burn and bone defect of hand and wrist were treated by groin skin and iliac bone composite graft with vascular pedicle and had resulted in satisfactory result. The operation was relatively simple. Because thecomposite graft carried its own blood supply in the pedicle, it was not necessary to revascularize the composite graft by anastomosis of blood vessel during operation. Owing to the presence of abundant vascular supply of the iliac bone, the antiinfection potency was high, so its application was suitable for those conditions such as fresh severe deep burn with infection and bone defect. As a result, this technique gave the best chance to save the limb from amputation, and the duration required for treatment could be markedly shortened. This method provided the possibility to solve effectively the difficult problem dealing with the treatment of severe deep burn with infection and bone defect of the hand and wrist.
OBJECTIVE To investigate the repairing method of soft tissue defect of heel, pedicled island myocutaneous flap of flexor digitorum brevis was designed. METHODS From 1984 to 1997, 26 cases with soft tissue defect of heel were adopted in the clinical trial. Among them, the were 18 males, 8 females and the age ranged from 15 to 60 years old. The area of wound ranged from 2.5 cm x 1.5 cm to 8.0 cm x 6.0 cm. RESULTS After operation, all of the flaps survived. They were followed up for 9 to 72 months. All of the flaps had primary healing except in one there was infection of peripheral of the flap. The contour of heel was satisfactory the sensation of flap was good and the weight-bearing function was also successful. CONCLUSION It was concluded that the myocutaneous flap of flexor digitorum brevis could be used to repair the soft tissue defect of heel because of its nearby position, hidden location, good recovery of skin sensation and weight-bearing function, Besides, the procedure of this operation was simple and the anti-inflammatory potential of the flap was high. However, Because of the limited donor area, the pre-operative design was important.