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Jui-yung Yang

Publications and source records attributed to Jui-yung Yang.

5 recordsLinked to original sources
PubMed2006

The classification and treatment algorithm for post-burn cervical contractures reconstructed with free flaps.

Neck contractures after burn produce restrictions in motion and unacceptable aesthetic outcomes. Proper planning and tissue selection is essential to minimize donor site morbidity while optimizing outcomes. A classification system and treatment algorithm aids in achieving this goal. Between December 1999 and January 2003, 40 burn patients underwent release and reconstruction with free perforator flaps. Neck extensibility and zone of injury were evaluated. Choice of reconstruction was based on available tissue, restriction degree and zones involved. Cervical territories were classified according to movement restrictions and amount of improvement. Reconstructive territories were classified as central above (CA), central below (CB), central above and below (CAB) and lateral (L). Single, split, double and preexpanded free flaps were used for the reconstructions. Maximal gain in motion was noted at 4 weeks and maintained for the average 11 months follow-up. Types of reconstructive territories showed significant effects on range of motion while etiology and time between injury and reconstruction showed no impact on the functional outcome. Classification of neck territories aids in improving outcomes while minimizing donor morbidity. The central above territory, when reconstructed with free flaps, yielded the most rewarding improvement. A classification and treatment algorithm aids in achieving significant improvements in range of neck motion while taking into consideration the donor sites.

Adolescent↗
PubMed2004

Double free flaps harvested from one or two donor sites for one or two-staged burn reconstruction: models of sequential-link and independent-link microanastomoses.

Extensive burn injuries and subsequent scarring result in functional and aesthetic impairments. The use of free flaps in burn reconstructions provides superior outcomes especially when other, more conservative reconstructive methods fail and curtail efforts of relentless rehabilitation. Multiple chronic scar-associated problems and extensive acute burn defects are conventionally resolved by multiple procedures. Thus, two or extensive scar regions are typically reconstructed using two free flaps (double free flaps) in two separate, procedures utilizing two independent donor sites. This leads to a protracted course of repetitive operations, hospitalizations, and rehabilitation, causing a prolonged period of discomfort and disability. The definition of double free flaps is two independent free flaps with two sets of microanastomoses. This paper illustrates, via a case-series, that double free flaps could be performed in one procedure, with both flaps harvested from either one or two donor sites. Two flaps are then utilized to resolve one large or two problem areas at the same time. Revascularization of the flaps is achieved via either a sequential-link or independent-link microanastomoses. The advantages of harvesting double free flaps from one region and using them in one stage to reconstruct one or two defect area include: (1) providing a large area of soft, pliable skin from one region for re-surfacing burn injuries or resolving scar associated problems, (2) decreasing the treatment course and potential disability, (3) decreasing donor site morbidities, (4) increasing maneuverability and conformability of the flap, and (5) affording a better functional and aesthetic outcome.

Adult↗
PubMed2004

Free split-cutaneous perforator flaps procured using a three-dimensional harvest technique for the reconstruction of postburn contracture defects.

With recent advances in free-tissue transfer, microsurgical techniques have been used more frequently for the reconstruction of postburn contracture defects. Traditional methods, including full-thickness skin grafts and local flaps, often result in a good outcome; however, multiple operative procedures, long periods of splinting, and physical rehabilitation are often required. Free split-cutaneous perforator flaps, consisting of one large cutaneous paddle with two perforating vessels split into two separate skin regions, were used for two kinds of postburn contractures: rectangular and spatially separate defects. From September of 2000 to October of 2002, seven patients underwent this method of reconstruction at Chang Gung Memorial Hospital in Taiwan. A three-dimensional flap harvest method, in which the skin paddle is circumferentially elevated early in the harvest, was used. Postburn scar contractures had resulted from flame burns in six cases and an electric burn in one case. The reconstructive regions included the neck in two patients, the breast in one patient, and the hand in four patients. There were six male patients and one female patient, with a mean age of 34.8 years (range, 25 to 49 years). The size of the excised scar ranged from 120 cm2 to 308 cm2 (mean, 162.3 cm2). The size of the unsplit flaps ranged from 144 cm2 to 337.5 cm2 (mean, 192.1 cm2). The average time for flap harvest using this three-dimensional harvest technique was 39.1 minutes. The average total operative time was 4.3 hours. The average total hospital stay was 7.3 days (range, 6 to 11 days). All flaps survived without major complications. The donor site was closed primarily in all cases. At a mean follow-up time of 9 months, the functional and aesthetic outcomes showed significant improvement as compared with the preoperative condition. In this study, a new method of flap harvest using a three-dimensional technique is introduced, and its application in the reconstruction of postburn contractures is evaluated.

Adult↗
PubMed2002

Combined method of free lateral leg perforator flap with cervicoplasty for reconstruction of anterior cervical scar contractures: a new flap.

Anterior cervical scar contracture remains a challenging problem for the plastic surgeon. Recent advances in flap techniques have made it possible to transfer various kinds of autogenous tissue. A free lateral leg perforator flap (LLPF) was first introduced and developed to reconstruct this burn deformity, according to the special nature of perforator anatomy. The authors used this flap to resurface post-burn anterior cervical contracture in a 31-year-old female patient with second-to-third-degree flame burns. The size of the excised scar was 25 x 5.5 cm; the size of the flap was 22 x 8 cm, with total flap survival. The hospital stay was 9 days, and the donor site was covered with a split-thickness skin graft. After a 5-month follow-up, functional improvement was evaluated by an increase in extension of 33 degrees (preoperative 92 to postoperative 125 degrees); an increase in rotation of 15 degrees (preoperative 70 to postoperative 85 degrees); and an increase in lateral flexion of 10 degrees (preoperative 35 to postoperative 45 degrees). The cervicomandibular angle was improved by 20 degrees (preoperative 110 degrees to postoperative 90 degrees). Both functional and aesthetic results, including contour restoration, can be achieved, using this kind of perforator flap combined with cervicoplasty.

Adult↗