A random pattern flap borne on an axial pattern flap: experimental study in rats.
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Abdominal Muscles↗
Biomedical subjects
R M Zuker
Publications and source records attributed to R M Zuker.
Prefabrication of skin flaps using vein grafts: an experimental study in rabbits.
Prefabrication provides a new method for creating donor sites which are not limited by natural vascular territories. There are several methods for prefabrication, and these include implantation of greater omentum, blood vessels or muscle flaps. Based on the concept that an arterio-venous (A-V) shunt results in sufficient neovascularisation to support a free flap, we used a rabbit model to investigate the characteristics of these flaps. Prefabrication of an abdominal wall donor site was performed using the left epigastric vein in 20 male New Zealand white rabbits. An 8 x 10 cm skin flap was elevated 10 days after prefabrication, either as an island or a free flap. Survival of the skin flaps exceeded 93% and was independent of position of the vascular pedicle, direction of blood flow, or nature of the flap (island or free flap). Angiograms showed a very rich neovascularisation within the prefabricated flap.
Animals↗
The use of tissue expansion in pediatric scalp burn reconstruction.
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Adolescent↗
Tissue expansion in pediatric burn reconstruction.
Tissue expansion has gained increased acceptance in postburn reconstruction. In this study, the clinical outcomes for 17 pediatric patients with burns are outlined. A total of 46 tissue expanders were inserted for the reconstruction of postburn scalp alopecia and burn scars. The average size of the soft-tissue defect was 124 cm2, and the mean time to follow-up was 19 months. Overall outcome in most cases was excellent; however, complications were common (37%) and included infection, exposure, port loss, and partial flap necrosis. Five patients in the scalp reconstruction group required transfusions (45%). Tissue expansion in pediatric burn reconstruction is a useful technique, which may yield superb results; however, careful surgical planning is essential to avoid complications.
Adolescent↗
The relative risk of tissue expansion in the pediatric patient with burns.
Tissue expansion has been successfully used for reconstruction after burn injury. The purpose of this study was to investigate the relative risk of complications of tissue expansion in the pediatric population. Children with burns who underwent reconstruction with tissue expansion were studied (37 expanders in 14 patients). Patients without burns who were also treated with tissue expansion served as a comparative group. The patients without burns included children with congenital anomalies (70 expanders in 37 patients) and acquired problems (40 expanders in 25 patients). Complications occurred in 10.8% of the expanders in the burn group, in 11.2% of the expanders in the congenital anomalies group, and in 7.5% of the expanders in the acquired problems group. No significant difference between the groups was noted. We conclude, therefore, that the child with burns is at no greater risk of complications from tissue expansion than are other children.
Adolescent↗
Free gracilis muscle transfer for coverage of severe foot deformities.
The purpose of this study was to describe the gracilis free-tissue transfer for soft-tissue coverage after surgical correction of severe clubfoot and other complex foot deformities in children older than 4 years. Requirements for success include complete correction of deformity, temporary Kirschner-wire fixation to maintain correction, experience in microvascular surgery, and close postoperative monitoring of the tissue transfer. Atrophy of the muscle transfer over the first year precludes the need for debulking procedures. This procedure was used in three children aged 4.5, 7, and 7.3 years with untreated or recurrent equinovarus foot deformities. Postoperatively, these children had flexible, pain-free, plantigrade feet with no donor-site complications. In conclusion, the gracilis free transfer appears to be a safe, effective, and reliable option to cover soft-tissue defects after the treatment of severe clubfeet in older children.
Child↗