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J Bunkis

Publications and source records attributed to J Bunkis.

22 records · Page 2Linked to original sources

The evolution of techniques for reconstruction of full-thickness cheek defects.

Our experience with 20 full-thickness cheek reconstruction in 17 patients over the past 27 years is presented. The evolution of techniques for management of full-thickness cheek defects reflects our gradual appreciation of the longitudinal artery concept within axial and musculocutaneous flap units. During the 1950s, defects were managed by random flaps. Popularization of the forehead flap and introduction of the medially based deltopectoral flap during the 1960s heralded the current application of axial flaps. The 1970s saw an explosion of new techniques, including the musculocutaneous flaps and microvascular free tissue transfers, based on the longitudinal vessel concept. A method simultaneously employing the pectoralis major musculocutaneous flap for intraoral lining and the deltopectoral flap for external coverage has been described. A modification of the latissimus dorsi free flap to allow a one-stage watertight closure of large full-thickness cheek defects has been outlined. Our challenge for the 1980s lies in the improvement of techniques to reanimate the reconstructed cheek.

Adolescent↗

Optimum management of hand blast injuries.

A series of 27 blast and gunshot injuries of the hand is presented. These wounds exhibit a spectrum of complexity and may include extensive soft tissue trauma complicated by burns, foreign bodies, fractures and amputations. A systematic management sequence is outlined to evaluate, treat, reconstruct and rehabilitate these hands, with the primary goal of obtaining early maximal function. Since these injuries vary in nature and complexity, this management sequence is specifically adapted to deal with the individual injury. A "reconstructive ladder" of techniques is utilized, ranging from "simple" (e.g., direct closure, skin grafts, local flaps) to "complex" (free flaps, toe-to-thumb transfer). The individual procedure selected is the most straightforward, consistent with expediency and early return of a functional hand. The return of these hands to function has been facilitated by recent advances in tissue assessment, free tissue transfer, and skilled hand therapy.

Adolescent↗