The ‘RITE’ use of the Fricke flap in periorbital reconstruction

Abstract

Purpose To revisit an important but outmoded periorbital reconstructive technique.We present cases to illustrate the usefulness of the Fricke flap and describe a method of rapid intraoperative tissue expansion (RITE), which can enhance the applicability and effectiveness of the Fricke flap. A comparison between those cases performed with and without adjunctive RITE was not made due to the low numbers available. Methods A retrospective review of clinical cases. Results A total of 20 cases in which the Fricke flap was used for periorbital reconstruction were reviewed. The mean patient age was 64.7 years; the male-to-female ratio was 1 : 1. The patient follow-up ranged from 1 to 8 years with a mean of 4.2 years. The most common cause (65%) of periorbital defect was excision of eyelid malignancy. Necrosis of the terminal segment of the flap requiring further surgical intervention occurred in 10%

Activated hypoxia‐inducible factor‐1α pathway modulates early events in stretch‐induced skin neovascularization via stromal cell‐derived factor‐1 and vascular endothelial growth factor

“…The mean patient age was 39·8 years (range 16–49) and there were 16 women and nine men in the group. During the operation, a Foley's catheter (20Fr) was used as an expander as previously described . The catheter was inflated with saline until the overlying skin became blanched to 60 mmHg intraluminal pressure.…”

Total reconstruction of lower eyelid in a post-traumatic patient using modified fricke′s cheek flap

“…In his case series on reconstruction of lower eyelids, Barba-Gómez et al .,[3] have considered many such techniques like the method described by Mustarde,[2] the Hughes[4] transposition flap with its modifications,[5] the eyelid[6] cutaneous rim graft, the hard palate graft covered by an orbicularis oculi myocutaneous advancement flap,[7] the Tripier[8] flap, and more complex approaches such as the pre-expansion mucosa-lined tongue flap,[9] the use of acellular human dermis,[1011] the cheek flap supported by fascia lata,[12] the island tarsoconjuctival mucochondrocutaneous flap,[1314] and the use of an expanded forehead Fricke flap. [151617] All of these techniques are useful when reconstruction of the lower eyelid is required; however, some of these procedures are complex and expensive.…”

“…[15] It can be used in the reconstruction of large lower lid, upper lid, and lateral canthal defects or to bring vascularized tissue to anterior orbital defects. [16] A laterally based skin flap above the eyebrow is raised and rotated to bring to the defect. The donor area is usually primarily closed or can be closed by skin graft.…”

“…It is particularly useful in lower lid defects involving the entire length of the lower lid, but which are relatively short in their vertical dimension. [16]…”

Pedicled lower lid-sharing flap for full-thickness reconstruction of the upper eyelid

“…Its limitations include secondary lesions, no symmetry of eyelid height and contour, and it may affect the function of the eyelid closure. [8][9][10] The horizontal V-Y myotarsocutaneous advancement flap has a better aesthetic result compared with full-thickness skin grafts for anterior lamellar reconstruction, but this method requires posterior lamella coverage. 11 Its limitations are that there is no lash eyelid margin or eyelashes.…”