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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    European journal of plastic surgery 23 (2000), S. 132-134 
    ISSN: 1435-0130
    Keywords: Key words Ischial pressure sores ; Innervated flaps ; Sensible gracilis myocutaneous flap
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  There are problems in finding a definitive treatment of ischial pressure sores because recurrence is frequently observed. The aim of surgical procedures is to cover the ischial region with stable and durable tissue, which has a good neurovascular supply. If the patient with ischial pressure sores has sensation above L3 level, the sensate gracilis musculocutaneous flap can be used to treat the defect after resection of the decubitis. This treatment was performed in 12 paraplegic patients in whom sensation was absent below the L3 level. The median age of the patients was 32.5 years, with ten males and two females. Four patients had recurrent pressure sores. The average time of follow-up was 8 months. Sensation was assessed with moving finger tip pressure, warm and cold cylinders, two point discrimination and dermal cortical somatosensory-evoked potential tests. Sensation was present in the transferred flap. Although the gracilis myocutaneous flap can also be used as a nonsensory flap for the reconstruction of ischial pressure sores in paraplegic patients under L3 level, the sensate gracilis myocutaneous flap should be chosen primarily when there is sensation over the gracilis region.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    European journal of plastic surgery 19 (1996), S. 234-239 
    ISSN: 1435-0130
    Keywords: Composite calvarial flap ; Complex defect ; Reconstruction ; Face ; Hand
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Over the past four years, composite calvarial flaps have been used to reconstruct complex defects in 14 patients. In three of the patients they were free flaps for hand reconstruction. Clinical application (technical details) and complications are also discussed.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    European journal of plastic surgery 22 (1999), S. 144-144 
    ISSN: 1435-0130
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    European journal of plastic surgery 22 (1999), S. 244-250 
    ISSN: 1435-0130
    Keywords: Key words Mandible reconstruction ; Maxilla reconstruction ; Vascularized calvarial bone graft
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Defects of the maxilla and mandible can cause significant functional and aesthetic problems for patients. Vascularized calvarium was used to reconstruct six mandible and four maxillary defects between 1991 and 1998. The ages of patients ranged from 15 to 68 years.Full thickness calvarial bone was preferred for the repair of segmental mandibular defects but split thickness calvarial bone onlay was used to reconstruct contour deformities. When full thickness calvarial bone was used, the donor site defect was covered with split thickness cranial bone. In small defects, a bipedicled galea pericranial flap was used for reconstruction. The bone was supplied by the superficial temporal vessels in all cases. A tunnel in the subcutaneous plane was used for the flap transfer to avoid facial nerve branches. Immediate expansion was performed during the preparation of the tunnel to prevent pedicle compression. Bone vascularization was checked with bone scan and serial X-rays and clinical examinations were also performed in the postoperative period. Flap necrosis was observed in one case, satisfactory functional and aesthetic results were achieved in all other patients. Vascularized cranial bone has not only the same structural features as facial bones but also a reliable vascular supply. The superficial temporal fascia and hairy skin may be included in the cranial bone flap to treat complex defects. The donor site scar is well hidden in the scalp. There is minimal donor site discomfort. In conclusion, vascularized cranial bone is a good method of treatment in selected cases.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    European journal of plastic surgery 23 (2000), S. 419-421 
    ISSN: 1435-0130
    Keywords: Keywords Neurofasciocutaneous flap ; Sensate flap ; Nerve graft
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  An anatomical study was performed to assess the course of the dorsal branches of superficial radial nerve and to investigate potential clinical applications in hand surgery. Eight upper extremities were dissected, using an operating microscope. All branching points of the superficial radial nerve were noted and the distances from the radial styloid process were recorded. Their proximity to neighboring vascular structures was noted. The superficial branches of the radial nerve can vascularize axial neurofasciocutaneous flaps via their paraneural arterial network. In addition, various reverse neurofasciocutaneous flaps may be harvested, based on dorsal branches of the superficial radial nerve. The nerve can be anastomosed with a suitable nerve in the recipient area. The dorsal branches of the superficial radial nerve can easily be added to the reverse first dorsal metacarpal artery flap and other reverse dorsal metacarpal artery flaps, thus making it possible to form a sensate flap. These branches may be anastomosed with nerves in the recipient site, such as dorsal branches of digital nerve stump, without significant donor site morbidity. A free sensate first dorsal artery flap can be prepared with a combination of dorsal branches of the superficial radial nerve and used with the same indications as a free digital artery flap. It has some advantages over the free digital artery flap, because the main neurovascular structures of the finger are kept intact. Finally, a dorsal nerve branch which accompanies the first dorsal metacarpal artery may be harvested with this artery and a subcutaneous dorsal vein as vascularized nerve graft. It can be used to repair a digital nerve defect in dense scar tissue.
    Type of Medium: Electronic Resource
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