Search PubMed⌕ Search

Biomedical subjects

C Le-Quang

Publications and source records attributed to C Le-Quang.

16 recordsLinked to original sources
PubMed1994

[Reversed vascular full-thickness nasolabial flap].

The author describes a vascular island full-thickness nasolabial flap, which is superior pedicled and is nourished by the distal portion of axial vessels, the facial artery and vein, by means of a reverse blood flow. When the vein is not available, a muscular pedicle can provide the venous drainage. This composite musculo-mucocutaneous flap was used in a single stage procedure for external cover and internal lining repair in 32 cases of full-thickness defect of the alar lobule (18 cases) or of the lower half of the nasal sidewall (14 cases). Some cases needed a secondary defatting (37.5 per cent). The final result was good in all cases, with minimal sequelae on the donor site.

Arteries↗
PubMed1993

[Forum: reconstruction of the traumatic thumb. The thumb in hand mutilations. Indications for reconstructive surgery].

The indications for reconstruction of the thumb in traumatic mutilations of the hand are presented in relation to the various conventional and microsurgical techniques. Several clinical situations are distinguished according to the severity of the hand mutilation and the number of severed fingers. Paucidigital amputations (one or two fingers including the thumb) should be treated by pollicisation or other techniques (Matev, osteoplastic reconstruction, second toe or "custom-made" transfers) depending on whether or not the other fingers need to be preserved. Pluridigital amputations (the thumb and two or three long fingers) require transfer of the 2nd toe or "custom-made" transfers avoiding a further reduction of the digital capital of the hand. Amputations of the five fingers create oblique, transverse or convex sections which, when they are proximal, require elongation of one, two or three digits depending on whether surgery is designed to restore a bipod or tripod pinch grip. Lastly, complex mutilations require a combination of digital reconstruction and palmo-commissural skin repair by neurovascular free flaps from the foot. Nonsurgical management should also be discussed in every case.

Amputation, Traumatic↗
PubMed1993

[Forum: reconstruction of the traumatic thumb in practice...the surgeon passes!].

The aim of thumb reconstruction is to obtain, within a reasonable time, a thumb with an aesthetic appearance and function as close as possible to those of a normal thumb, leaving a minimum of sequelae at the donor site. The author reviews the various modalities of reconstruction, according to the severity of mutilation of the thumb. In pulp amputations, partial lesions are repaired by a homodigital island pulp flap (subcutaneous or unilateral or bilateral neurovascular pedicle advancement flap); total pulp defects should be treated by toe pulp transfer rather than the neurovascular pedicle conventional heterodigital pulp flap (with nerve anastomosis): hemipulp of the great toe or pulp of the 2nd toe. Several thumb reconstruction procedures can be proposed in digital amputations and the surgeon must be aware of their precise indications: up-to-date osteoplastic reconstruction by osteocutaneous forearm retrograde flaps (radial flap or anterior interosseous flap), progressive elongation of the 1st metacarpal, pollicisation (of the ring finger), microsurgical transfer of a toe (not the great toe because of the sequelae to the foot, but the 2nd toe), exceptionally microsurgical transfer of a (damaged) finger from the other hand. Lastly, with minimal sequelae to the foot, "custom-made" reconstructions allow repair of partial amputations (partial great toe transfers) and complete amputations of the thumb (great toe "wrap-around" flap, "twisted two toes" flap of great toe and 2nd toe) or even complex and multidigital mutilations of the hand (dorso-commissuro-bipulpar foot flap).

Amputation, Traumatic↗
PubMed1992

[Forum: dermopigmentation or medical tattooing. In practice ... how to perform medical tattooing?].

Dermopigmentation is now part of the therapeutic armamentarium of plastic surgeons. In good indications and when applied according to a few simple rules, every surgeon can obtained reliable and reproducible results with medical dermography. This therapeutic procedure is performed on an outpatient basis, usually in several sessions; subsequent revisions are always possible provided certain basic errors are avoided. The authors describe each step of this technique.

Alopecia↗
PubMed1992

[Secondary microsurgical reconstruction of the breast and free inferior gluteal flap].

A technique of secondary breast reconstruction by microsurgical transfer of an inferior gluteal flap is presented. The principal characteristics of the inferior gluteal myocutaneous flap, described for the first time by the author in 1978, are presented: anatomical bases, harvesting technique. Breast reconstruction with this flap is performed in three operative steps. Step 1: application of a skin expander in the breast region in order to re-create the mammary space. Step 2: microsurgical transfer of the de-epithelialized flap, rolled up to create a pseudo-mammary gland, then insertion into the expanded mammary space. Step 3: reconstruction of the areola-nipple complex from the contralateral side and restoration of breast symmetry. The results of breast reconstruction according to this technique were evaluated in a series of 14 cases operated between 1987 and 1991, while the sequelae of the gluteal donor site were evaluated on a series of 65 free inferior gluteal flaps performed between 1977 and 1991. The advantages of this procedure are the natural curvature and softness of the reconstructed breast, the moderate sequelae at the donor site, leaving a scar dissimulated in the gluteal fold. This technique was compared with other reconstruction techniques: microsurgical procedures (non de-epithelialized inferior gluteal flap, superior gluteal flap, lateral mammary flap, etc.) and conventional procedures (breast expansion+prosthesis, latissimus dorsi flap, rectus abdominis flap). In conclusion, another technique is described, which appears to offer the advantages of the de-epithelialized inferior gluteal flap without the disadvantage of microsurgical transfer: reconstruction with a de-epithelialized rectus abdominis pedicle flap after expansion of the mammary space.

Abdominal Muscles↗
PubMed1991

[Improvement in the prognosis of severe mediastinitis by the use of muscle flaps].

Between 1984 and 1988, 12 mediastinitis were observed in a series of 1.724 cases of cardiac surgical procedures by sternotomy (0.7%). These 12 patients were retrospectively separated in 2 groups in terms of surgical management. In group I (5 patients in 1984 and 1985) the treatment was mediastinal irrigation and in case of failure, an omental transposition. In group II (7 patients in 1986, 86 and 88) the treatment was mediastinal irrigation and in case of failure, a mobilization of muscle flaps. Four patients died in group I of poly-visceral failure with a persistent severe sepsis. In group II, there was no death and the cicatrization was quickly obtained with an average length of stay in intensive care unit of 62 days. The mediastinal irrigation is the treatment of choice for benign mediastinitis, but the prognosis of severe mediastinitis was in our series greatly improved by muscle flap procedures realized with plastic and reconstructive surgical techniques.

Cardiac Surgical Procedures↗
PubMedDate not supplied

[Post-radiotherapy lesions of the brachial plexus. Classification and results of surgical treatment].

A series of 60 cases with a follow-up of 3 to 13 years among 118 operations for post-radiation lesions of the brachial plexus performed between 1978 and 1990 was investigated as a function of three features: 1) anatomic classification according to 3 stages for per-operatory observations of extrinsic and intrinsic compression, 2) clinical classification according to 4 types of sensoro-motor neurological symptoms and 3) the different operative procedures used for decompression. It was concluded that post-radiation plexuses should be operated as early as possible as soon as paraesthesia appears and before the onset of pain since the aim of the operation is to stabilize the clinical course and not achieve cure. It was also found that the best operative procedure is a selective neurolysis of the plexus completed by a pedicled omentoplasty.

Brachial Plexus↗