Reconstruction of soft tissue defect with exposed bone over the forehead is a technical challenge in pediatric population. The options vary from skin grafting, local flaps to complex microvascular tissue transfer. The local flaps leave unsightly scar in the neighboring area and may violate the hair bearing scalp, hair line and the direction of hair. Skin grafting requires a vascular bed for its take and the aesthetic appearance is inferior. The tissue expansion in an acute stage may not be an option. Here we present our experience of soft tissue reconstruction of a forehead defect in a 2-year-old child with free radial forearm flap (RAFF). To best of our knowledge free radial forearm flap has rarely been reported for usage in reconstruction of forehead defect in pediatric population.
A perfect microsurgical anastomosis is crucial for the survival of a free flap. One needs to have special micro instruments, microsutures, and operating microscope for the successful anas-An anastomosis is done after clamping the vessels or under tourniquet. A bloodless field in the microscope helps the surgeon to tackle the microsutures and see the lumen. Clamp removal for checking the functional status of the anastomosis often leads to a blood-filled field in the working area. Heparin saline irrigation is also an important step during the vessel anastomosis, which will flood the field. The normal suction cannulas are not suitable to use here because they may endanger the anastomosis through its powerful suction. In this manuscript, we would like to introduce a simple technique to make a microsuction cannula.The materials needed for making this are a suction tube, a 2 ml syringe, and a cannula sheath. The suction tube end is telescoped into the 2 ml syringe and the cannula sheath is attached to the syringe (Figure1 and Figure 2). Although commercial metallic suction tips are available in some countries, this technique can be helpful for surgeons in the developing or poor countries.
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AbstractOptimum operating conditions are an integral part of a successful microvascular surgery. We hereby introduce a new technique to make a lowcost microsuction cannula, which will be helpful for microvascular surgeons.
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