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Biomedical subjects

F Nahai

Publications and source records attributed to F Nahai.

At least 73 records · Page 4Linked to original sources
PubMed1982

Platysma musculocutaneous flap: clinical and anatomic considerations in head and neck reconstruction.

The platysma musculocutaneous flap was used in 14 patients for reconstruction of the oral lining and external skin coverage in the head and neck area. Complications occurred in five patients. Only one patient, however, required further surgery and this was for correction of a poor cosmetic result. The skin and subjacent muscle are supplied by a major vascular pedicle from the facial artery and vein and a minor pedicle from the transverse cervical artery and vein. Either pedicle can be used as the pivot for the flap's arc of rotation. The donor defect can be closed primarily and did not present any problems. The flap can be raised with both its motor and sensory supply intact. The thinness and pliability, color match, and proximity make this flap a useful adjunct in head and neck surgery.

Aged↗
PubMed1982

Chest wall reconstruction--management of the difficult chest wound.

Full-thickness chest wall defects after ablative surgery for metastatic cancer, trauma, infection, or irradiation injury have posed major and often impossible dilemmas for reconstruction. At times, resection has had to be abandoned because reconstruction was deemed infeasible. However, recent knowledge of the multicentric blood supply and anatomy of the latissimus dorsi and pectoralis major muscle make it possible to use these muscles and myocutaneous units (even following division of their major blood supply) for reconstruction of the chest wall. The reconstruction of difficult anterolateral chest wall defects is discussed and the options available to the surgeon before and after interruption of the major blood supply to these flaps are presented.

Adult↗
PubMed1982

The omentum: its use as a free vascularized graft for reconstruction of the head and neck.

The experience at Emory University Affiliated Hospitals with transplantation of the greater omentum as a free revascularized graft in 18 patients is presented. In each instance, there was realization of the therapeutic objective, either 1) the amelioration of congenital or acquired somatic deformity (14 patients) or 2) the control of infection (4 patients). Because the omentum is a syncytium of blood vessels and a variable amount of fat within redundant leaves of peritoneal membrane laden with macrophages, it is a tissue that serves admirably its extended role as an extracelomic free transplant. The greater omentum has been used for this purpose in five patients with hemifacial atrophy (Romberg's disease); three patients with hemifacial microsomia (first and second branchial arch syndrome); two patients with extensive losses of the maxilla, palate, and face due to a shotgun blast; two patients with atrophy and facial growth arrest due to x-irradiation; and two patients with deformity of the jaw and neck following tumor resection. In three additional patients, the omentum was used to obliterate the dead space after debridement of an infected open frontal sinus following failure of conventional therapy. In one instance, a revascularized free graft of omentum was used to salvage a patient with an exposed irradiated carotid artery graft and skin flap failure following radical neck dissection. In these 18 patients, there were no intra-abdominal complications consequent to harvest of the omentum. In one patient afflicted with hemifacial atrophy, there was spotty necrosis of the overlying attenuated facial skin flap and limited fat necrosis. In the follow-up period of four months to seven years, there has been no instance of late resorption. The method is reliable and has considerable promise in reconstructive surgery.

Face↗
PubMed1981

Free jejunal grafts for reconstruction of pharynx and cervical esophagus.

Reconstruction of the pharynx and cervical esophagus is a surgical challenge associated with high complications, multiple-staged procedures, and prolonged hospitalizations. In a series of cases, single-stage transfer-free jejunal graft reconstructions had a 85% success rate with low complications in a series of patients who received preoperative, postoperative, and curative radiation treatment. There are advantages to this reconstruction procedure; however, there can also be complications.

Aged↗
PubMed1981

Evaluation of strategic nerve section in myocutaneous flaps.

Manipulation of the muscle blood supply by denervation was undertaken to see if it affected the amount of the myocutaneous unit that survived. Nineteen dogs were studied, using the gracilis muscle as a model. The gracilis muscle was denervated on one side, with the other, innervated muscle serving as a control. No difference was noted in how much of the myocutaneous unit survived. It was concluded that denervating a myocutaneous unit does not increase survival.

Animals↗
PubMed1981

Surgical management of heel ulcers--a comprehensive approach.

Reconstruction of the ankle, heel, and foot remains a challenging, often frustrating problem for surgeon and patient alike. Little local soft tissue is available for the reconstruction, and often the underlying disorder precludes use of some procedures. The ankle and the heel are vital musculoskeletal structures, responsible for shock absorption, weight-bearing, and locomotion, and their dysfunction inflicts discomfort and disability on the individual that commonly lasts many months or even over a year. Soft tissue defects on the weight-bearing versus the nonweight-bearing surfaces present two quite different problems. Many surgical modalities, beginning with a skin graft and ending with microvascular transplantation of sensile tissues, are now available to the reconstructive surgeon for resurfacing the sole of the foot. We present a classification of heel ulcers based on their etiology, location, size, and the status of the peripheral circulation; offer new operative modalities and update the operations already available; and suggest an orderly approach to selecting an operation for reconstructing the foot.

Adolescent↗
PubMed1981

Classification of the vascular anatomy of muscles: experimental and clinical correlation.

Five patterns of muscle circulation, based on studies of the vascular anatomy of muscle, are described. Clinical and experimental correlation of this classification is determined by the predictive value of the vascular pattern of each muscle currently useful in reconstructive surgery in regard to the following parameters: arc of rotation, skin territory, distally based flaps, microvascular composite tissue transplantation, and design of muscle-delay experimental models. This classification is designed to assist the surgeon both in choice and design of the muscle and musculocutaneous flap for its use in reconstructive surgery.

Aged↗
PubMed1980

Persistent tracheostomy stoma.

Prolonged presence of a tracheostomy tube or prolonged tracheostomy stoma can result in a failure of spontaneous closure. The stoma may remain open until surgically closed. Muscle flaps as well as skin flaps can be used to close the persistent tracheostomy stoma. These flaps seal the stoma, provide soft tissue between the trachea and the skin, and allow a satisfactory cosmetic result. The sternohyoid muscle is readily accessible for this purpose. This procedure was used in five patients with a satisfactory result in each.

Fistula↗
PubMed1980

Avoiding the flat breast in reduction mammaplasty.

The reliance on retained superior breast tissue beneath the reduced skin envelope may not provide adequate breast projection in reduction mammaplasty. Placement of preserved inferior dermal-breast pedicle beneath the tailored skin envelope in this group of patients has allowed control of both breast projection and size, but there are alternatives in the management of the nipple--areola complex with the use of this technique.

Breast↗