Three disadvantages are frequent after parotidectomy: a scar affecting the neck, a deep hollow between the sternocleidomastoid muscle and the mandible (the larger the resection is, the deeper is the hollow), and a sweat secretion. These disadvantages can be prevented or reduced by using four simple procedures: (1) using a facelift incision; (2) using a very simple and original "trick," by displacing outward the posterior belly of the digastric muscle; (3) using a flap with an upper pedicle taken from the sternocleidomastoid muscle; and (4) using a double free graft, taken from the superficial and deep temporal fascias. These two grafts lay down on the net constituted by the preceding flaps. They line the skin, thus blocking the wrong innervation.
Introduction: The vacuum-assisted closure (VAC) has proved to be very promising in the management of difficult to heal wounds. However, the first reports about the use of negative pressure wound device came from Argenta and Morykwas in the year 1997. Though there are various commercially prepared and manufactured vacuum assisted closure dressing materials, these are often unavailable or unaffordable to patients in third world countries. Our “homemade” vacuum dressing has been found to be, affordable for our patients and most importantly effective in wound management. Materials and methods : The homemade Vacuum Assisted closure dressing was used for the management of some wounds which presented at our centre. These wounds were irrigated and thoroughly debrided. Our homemade vacuum assisted closure dressings were subsequently applied. Results: The wounds healed well with good granulation tissue. Subsequent split thickness skin graft (SSG) done had very good take. The VAC dressing often resulted in good wound contraction with no need for SSG. Conclusion: In our practice our “home made” vacuum which was affordable and customized proved to be effective in wound management.
Introduction: Several Local flaps can be used for the reconstruction of digital soft tissue defects with exposure of tendons and/or phalanges. The homodigital flap is a versatile option. This article discusses the use of the homodigital reverse vascular island flap-a regional, axial-patterned skin flap in the reconstruction of distal digital defects.Methods: 6patients with a soft-tissue defect at the distal part of the finger were treated by homodigital island flaps for reconstruction. We evaluated the active range of motion of the involved finger, and the patient's satisfaction with the appearance of the finger after reconstruction.Results: All patients admitted to a good functional outcome. The donor site morbidity was minimal. The take of the split-thickness skin graft to the flap donor site was generally good. However one patient complained of numbness of the finger over the donor site. Conclusion:The Homodigital flap is a handy multipurpose flap that can be used. Notwithstanding its limitation, it is easy to raise and it can be used to a variety of defects.
Introduction. One of the most challenging regions of the body to cover is the lower part of the leg, the ankle, and the foot, especially with the exposure of bones or tendons. Many options for covering soft tissue defects in this area have been proposed. This article describes the lateral supramalleolar flap, which is used for the reconstruction of defects of the lower leg, ankle, heel, and foot. This flap is a surgical technique to salvage the lower extremity due to its large skin paddle and a wide rotation arc. In this case series, patients with lower leg and ankle defects requiring flaps had the lateral supramalleolar flaps performed. This article discusses the overview, technique, and outcomes.Methods. These flaps were performed under spinal anesthesia and tourniquet control. The upper limit of the flap was about 8 cm from the popliteal crease, and the lower border was 5 cm from the axis of the ankle joint. The lateral extent of the flap was up to the fibula, contrary to mid-calf. The flap was harvested in the sub-facial plane, and the donor site was grafted.Results. The Flap was generally easy to raise and secure in place at the donor site. Partial necrosis of the flap was reported in one case. The overall donor site morbidity was minimal.Conclusion. The lateral supramalleolar flap is a reliable and useful flap for coverage of the lower third of the leg, ankle, and dorsal foot defects. It is a viable option available to the reconstructive surgeon, especially with the exposure of bones or tendons.Â
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