Perforator-Supercharged Occipitocervicopectoral Flaps for Lower Face and Neck Reconstruction

Ono, Shimpei; Chung, Kevin C.; Takami, Yoshihiro; Chin, Takafumi; Ogawa, Rei; Gao, Jian

doi:10.1097/prs.0b013e318244230b

Cited by 18 publications

(13 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…From the late 1980s to the 1990s, Koshima and Soeda (1989) introduced perforator flaps based on musculocutaneous perforating arteries (Kim & Kim, 2015). Since then, perforator flaps have become increasingly popular in microsurgery and plastic surgery (Ono et al, 2012; Sinna et al, 2010). With the concepts of angiosome theory and choke vessel, the perforasome concept identifies three areas surrounding the intact perforator.…”

Section: Discussionmentioning

confidence: 99%

Differences between novel hybrid mode flaps and traditional perforator flaps at the level of metabolites using LC–MS

Luo

Zhang

et al. 2022

Biomedical Chromatography

View full text Add to dashboard Cite

The multi-territory perforator flaps are widely used in plastic surgery. However, partial necrosis flap in the potential territory remains a challenge to plastic surgeons. We raised a novel "hybrid nourished mode" (HNM) flap based on the multi-territory deep inferior epigastric perforator (DIEP) flap to improve flap survival. Thirty-two rabbits were randomly divided into DIEP and HNM groups. Untargeted metabolic mechanisms between the DIEP and HNM groups were performed using LC-MS under the filter criteria of fold change >20.0 times or <0.05, and variable importance in projection (VIP) value was set at ≥1, P < 0.05. Between the two groups, flap survival, perfusion, microvasculature, histopathology, and immunohistochemistry of CD31 were assessed on post-operative day 7. We screened 16 different metabolites that mainly participated in biosynthesis of secondary metabolites, aminoacyl transfer RNA biosynthesis, phenylalanine metabolism, arginine and proline metabolism, among others.The results of the HNM flaps were higher than those of the DIEP flaps (P < 0.05) in the aspects of flap survival, flap perfusion, and microvasculature. Compared with the DIEP flaps, HNM has a stronger advantage in tissue metabolism. This study provided us with a better understanding and strong evidence in terms of metabolites on how HNM achieves the survival of large multi-territory perforator flaps.

show abstract

Section: Discussionmentioning

confidence: 99%

Differences between novel hybrid mode flaps and traditional perforator flaps at the level of metabolites using LC–MS

Luo

Zhang

et al. 2022

Biomedical Chromatography

View full text Add to dashboard Cite

show abstract

“…Kinds of skin flap were used for cervical contracture reconstruction. Axial flaps can be harvested from neighboring regions with a similar texture match, including transverse cervical artery-based flaps such as supraclavicular (island) skin flaps [ 3 , 15 ], and internal mammary artery-based flaps such as deltopectoral flaps [ 4 , 16 ]. In severe cases their sizes are often limited and can not be used for the extensive defects after release.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment of severe contracture is always challenging for the reconstructive surgeon [ 1 , 2 ]. Although various surgical techniques have been described [ 3 , 4 , 5 , 6 ], no definitive consensus was formed to guide the treatment. Upon the choice of tissue type for covering the wound after release of cervical contracture, should skin graft or skin flap be used?…”

Section: Introductionmentioning

confidence: 99%

Region-Oriented and Staged Treatment Strategy in Reconstruction of Severe Cervical Contracture

et al. 2015

View full text Add to dashboard Cite

IntroductionSevere cervical contracture after burns causes obvious impairment of neck movement and the aesthetic silhouette. Although various surgical techniques for treatment have been described, there is not a definitive strategy to guide treatment. Over the past 6 years, we have been utilizing a region-oriented and staged treatment strategy to guide reconstruction of severe cervical contracture. Satisfactory results have been achieved with this strategy.MethodsThe first stage of treatment focuses on the anterior cervical region and submental region. Procedures include cicatrix resection, contracture release, division and elevation of the platysma to form two platysma flaps, and skin grafting. Three to six months later, the second stage treatment is performed, which localize to the mental region. This includes scar resection, correction of the lower lip eversion, and reconstruction with free (para)scapular skin flap. Three subtypes of cervicomental angle that we proposed were measured as quantitative tool for evaluation of the reconstruction.Results24 patients who completed the treatment were reviewed. By the 3rd postoperative month, their CM angles changed significantly: the soft tissue CM angle was reduced from 135.0° ± 17.3° to 111.1° ± 11.3°, the osseous CM angle increased from 67.1° ± 9.0° to 90.5° ± 11.6° and the dynamic CM angle increased from 21.9° ± 8.7° to 67.4° ± 13.1°. 22 in 24 (91.7%) of these patients gained notable improvement of cervical motion and aesthetic contour.ConclusionsOur results suggest that the region-oriented and staged treatment strategy can achieve satisfactory functional and aesthetic results, combining usage of both skin graft and skin flap while minimizing the donor site morbidity.

show abstract

“…Many methods, such as full-thickness skin grafting, local or free flap, and expanded flap, have been used to reface the defect of lower part of the face and neck. [1][2][3] The cervical area is considered as the best donor site for the face reconstruction. But with scar contracture or tumor invasion, cervical area might be compromised and no longer available.…”

mentioning

confidence: 99%

“…Patients’ appearance and function can be severely undermined due to these injuries or lesions. Many methods, such as full-thickness skin grafting, local or free flap, and expanded flap, have been used to reface the defect of lower part of the face and neck 1–3 . The cervical area is considered as the best donor site for the face reconstruction.…”

mentioning

confidence: 99%

“Zipper” Concept for Designing Expanded Forehead Flap in Facial-Cervical Reconstruction

Chen

Tian

2021

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

Background: Skin defect of the lower part of the face and neck is a severe condition for many patients with burn and traumatic injuries or skin lesions. The expanded forehead flap with anterofrontal temporal vessel pedicles has been widely used in lower cheeks, chin, and neck reconstruction. (In this study, we introduce a new concept-''Zipper concept'' of the flap design.) The aim of this study is to evaluate the feasibility and outcome of using expanded forehead flap with a vertical incision with or without a small transverse incision in the central part. Methods: From March 2010 to September 2016, 27 patients who suffered from lower cheeks and chin skin defects were reconstructed by expanded forehead flap with anterofrontal temporal vessel pedicles. After the lesion was excised, the upper or the lower part of the flap was cut in half with a vertical incision with or without a small transverse incision in the middle part as needed for cheeks, upper lip or neck reconstruction, and the other part of the flap was remained to be one piece for chin reconstruction. Results: All flaps survived completely without any congestion or necrosis. All patients achieved satisfactory results both functionally and aesthetically. Conclusions: A vertical incision with or without a small transverse incision in the central part of the expanded forehead flap with anterofrontal temporal vessel pedicles is a safe modification of the flap design. It is practical and could bring the expanded forehead flap to more indications.

show abstract

Perforator-Supercharged Occipitocervicopectoral Flaps for Lower Face and Neck Reconstruction

Abstract: Therapeutic, IV.

Cited by 18 publications

References 0 publications

Differences between novel hybrid mode flaps and traditional perforator flaps at the level of metabolites using LC–MS

Differences between novel hybrid mode flaps and traditional perforator flaps at the level of metabolites using LC–MS

Region-Oriented and Staged Treatment Strategy in Reconstruction of Severe Cervical Contracture

“Zipper” Concept for Designing Expanded Forehead Flap in Facial-Cervical Reconstruction

Contact Info

Product

Resources

About