Undermining subcutaneous island flaps.
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Biomedical subjects
Publications and source records attributed to L M Field.
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A U-shaped flap, hinged proximally and incised distally, adapts well on digits. When incising over joint skin, dual-running W-plasties are mandatory to prevent cicatricial bridging and functional compromise. In a series of 18 cases, no untoward difficulties have been noted.
Utilization of the office setting for frozen section evaluation of tumor removal in the treatment of skin cancer is of considerable value. The impact of such surgery includes (1) enhanced quality of surgery by reducing the possibility of incomplete removal of tumor, (2) decreased financial cost to the patient when compared to hospital treatment, (3) better utilization of the doctor's time and facilities, (4) decreased disruption in the life of the patient and his family in terms of time off from work, surgery schedule flexibility, and a decrease in patient anxiety.
Several cases with serial photographs and commentary summarize experiences with well over 200 transposition "banner" flaps on the torso. The technique allows aesthetically acceptable reconstructions on the trunk by attention to detailed planning.
After Mohs micrographically controlled removal of a recurrent squamous cell carcinoma, a 6 X 7-cm defect of the temple was closed with a large cheek and neck flap elevated and mobilized by blunt liposuction cannula dissection techniques and rotated into the defect. An excellent cosmetic and functional result was obtained.
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The midline forehead island flap exemplifies pedicled island flaps based on random circulation. The use of this flap for medial canthal reconstruction is set forth by photographs, diagrams, and appropriate commentary.
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The crus of the helix may be the best source for alar rim reconstruction in certain patients. Chances of survival of that composite graft are increased when the nasal mucosal surface can be spared by stringent efforts. A case demonstrating the success of these principles is presented, along with several alternative methods of donor site closure.
The principles of the V-to-T plasty (Dieffenbach's winged V-plasty) are adaptable to many regions of the forehead. This paper demonstrates the use of the V-to-T plasty to reconstruct an extensive area of the lower central forehead and glabella following excision for basal cell carcinomatosis. Dual hemi-forehead advancement-rotation flaps were used in a single-stage reconstruction. The same technique adapts to other forehead and facial areas as well.