Trapezoid Adipose-Scar Local Flap: Postburn Lateral Truncal Contracture Elimination With Trapeze-Flap Plasty.
Summary of "Trapezoid Adipose-Scar Local Flap: Postburn Lateral Truncal Contracture Elimination With Trapeze-Flap Plasty."
Trunk burns result in various complications, deformities, and contractures. Contracture of the lateral surface of the trunk is one of the serious complications that limits movements of the spine; children experience structural changes in the form of scoliosis. Therefore, the lateral truncal contracture should be the subject of early surgical treatment. The currently used method has been the stage-by-stage incisions on the contracture scars and skin grafting or Z-plasty. Skin grafts have a tendency to shrink; thus, compression garments are recommended for an extended period of time after surgery. Triangular flaps are small to complete contracture elimination. The need for development of a more effective surgical technique is apparent. Lateral truncal contracture is caused by a crescent-shaped fold; both sheets of the fold are scars. The sheets have a trapeze-shaped surface deficit in length, which causes the contracture and creates the skin surplus in width. The contracture is of medial type; therefore, it is subject to treatment with local tissues using trapeze-flap plasty. The fold and the adjacent contracted scars are converted into trapezoid flaps by radial incisions. The distance among incisions ranges from 4 to 5 cm, which determines the width of the flap's top. One or several trapezoid flap pairs are planned. The scar flaps are elevated with the subcutaneous fat layer and transposed one toward another with tension, so that the end of one flap reaches the base of the counter flap. As a result, the zone of the plasty is elongated by 100 to 150%. Twelve patients with lateral truncal contractures were operated using trapeze-flap plasty. Good immediate and late results have been achieved. It is the author's belief that trapeze-flap plasty is the most effective technique in light of today's proposed methodology.
Affiliation
From the Department of Reconstructive and Plastic Surgery, A.V. Vishnevsky Institute of Surgery of the Russian Academy of Medical Sciences, Moscow, Russia.
Journal Details
This article was published in the following journal.
Name: Journal of burn care & research : official publication of the American Burn Association
ISSN: 1559-0488
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20861744
- DOI: http://dx.doi.org/10.1097/BCR.0b013e3181f93957
Medical and Biotech [MESH] Definitions
Flap Endonucleases
Endonucleases that remove 5' DNA sequences from a DNA structure called a DNA flap. The DNA flap structure occurs in double-stranded DNA containing a single-stranded break where the 5' portion of the downstream strand is too long and overlaps the 3' end of the upstream strand. Flap endonucleases cleave the downstream strand of the overlap flap structure precisely after the first base-paired nucleotide, creating a ligatable nick.
Keratomileusis, Laser In Situ
A surgical procedure to correct MYOPIA by CORNEAL STROMA subtraction. It involves the use of a microkeratome to make a lamellar dissection of the CORNEA creating a flap with intact CORNEAL EPITHELIUM. After the flap is lifted, the underlying midstroma is reshaped with an EXCIMER LASER and the flap is returned to its original position.
Keratectomy, Subepithelial, Laser-assisted
A surgical technique to correct REFRACTIVE ERRORS of the EYE, such as MYOPIA and ASTIGMATISM. In this method, a flap of CORNEAL EPITHELIUM is created by exposure of the area to dilute alcohol. The flap is lifted and then replaced after laser ablation of the subepithelial CORNEA.
Keloid
A sharply elevated, irregularly shaped, progressively enlarging scar resulting from formation of excessive amounts of collagen in the dermis during connective tissue repair. It is differentiated from a hypertrophic scar (CICATRIX, HYPERTROPHIC) in that the former does not spread to surrounding tissues.
Adipose Tissue
Specialized connective tissue composed of fat cells (ADIPOCYTES). It is the site of stored FATS, usually in the form of TRIGLYCERIDES. In mammals, there are two types of adipose tissue, the WHITE FAT and the BROWN FAT. Their relative distributions vary in different species with most adipose tissue being white.
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