Objective To introduce the myocutaneous flap in blepharoplasty and summarize its clinical efficacy. Methods Between January 2013 and March 2016, 1 560 patients underwent blepharoplasty with myocutaneous flap. Of them, 158 patients were followed up over 6 months and included in the study. There were 18 males and 140 females with the average age of 23.4 years (range, 18-35 years). The unilateral side was involved in 13 cases and bilateral sides in 145 cases. The patients had narrow double eyelid, shallow double eyelid, single eyelid, bloated upper eyelid, and upper eyelid skin relaxation. During operation, the tissue between the orbicular muscle of eye and the tarsus was trimmed layer by layer; the orbicularis oculi muscle, capillary network, and the front fascia of tarsus were retained, and the full-thickness skin, muscle, and the front fascia of tarsus were sutured by anatomical apposition. Results Incision healed at stage I. All patients were followed up 6 months to 2 years (mean, 8.3 months). During follow-up period, shallow or extinctive double-eyelid line was observed in 9 cases (12 eyes), and satisfactory results were achieved after trimming front fascia of tarsus and suturing. Good clinical results were obtained in the other patients, who had natural and coherent double eyelid without obvious scar or depression at resection margin. Conclusion Myocutaneous flap for blepharoplasty has many advantages of fast recovery, little wound, light swelling, permanent effects, and good appearance.
OBJECTIVE To introduce the method using the gracilis myocutaneous flaps to repair of vulvar defect after radical vulvectomy. METHODS The gracilis myocutaneous flaps were applied in 4 cases with vulvar carcinoma which located vestibule of vulva and bulk, and the carcinoma was large after radical resection to repair vulvar defect simultaneously. RESULTS The incision of 3 cases was healing by first intention, and 1 case with type II diabetes mellitus was healing by second intention. After followed up 3-6 years, 1 case was recurrent in 2 years after operation, 3 cases were survival without complication. CONCLUSION Vulvar reconstruction with the use of gracilis myocutaneous flaps in radical vulvectomy could markedly decrease the rate of complication.
Objective To introduce the experience about thereconstruction of median sternotomy wound dehiscence. Methods From February 2002 to October 2004, 10 patients with median sternotomy wound dehiscence due to coronary artery revascularization were treated. There were 7 males and 3 females, aging from 68 to 76 years. The sizes of defects ranged from3 cm×5 cm to 5 cm×15 cm. After debridement of necrotic soft tissue, sternum and rib, infected median sternotomy wound was reconstructed with rectus abdominis myocutanous flap, pectoralis major myocutanous flap and latissimus dorsi flap or single muscle flap. The sizes of flaps ranged from 3 cm×5 cm to 5 cm×16 cm.Results Allpatients were followed up from 3 to 11 months with anaverage of 6 months. All the patients achieved healing by first intention with normal respiration and normal function of upper limbs. The wound of donor site healed well.No abdominal hernia and other complications occurred. The wound of donor site healed well.The results were satisfactory.Conclusion According to different stages of the disease and different conditions of an operation, the surgical management should vary with each individual.
OBJECTIVE: To explore the anatomical basis of blood supply and heel reconstruction by reversed island fibular musculocutaneous flap. METHODS: The blood supply of fibular musculocutaneous flap and the biomechanical characteristics of heel were studied by anatomical examination. One case with right heel full defect because of explosion injury was repaired by transfer of reversed island fibular vessels. The fibular flap was 14 cm in length with part of peroneus muscle and long flexor muscle of great toe. RESULTS: The lower part of fibular artery had plentiful anastomosis with anterior tibial artery and posterior tibial artery, which could provide ideal reversed blood supply. The rotatory point of vessel pedicle could be chosen according to the need of operation. The lowest site might be above 6 cm to lateral malleolus, and the vessel pedicle was 20 cm in length. The morphological feature of the reversed island fibular musculocutaneous flap was suitable to the biomechanical character of heel. The patient achieved satisfactory clinical result, the musculocutaneous flap survived well for 10 months of follow-up. CONCLUSION: The reversed island fibular musculocutaneous flap provide a new method for repairing the severe heel defect, especially in full defect of calcaneus and cuboid bone.