Biomedical subjects

Kuang-Te Chen

Publications and source records attributed to Kuang-Te Chen.

5 recordsLinked to original sources

PubMed2006

Thin anterolateral thigh perforator flap using a modified perforator microdissection technique and its clinical application for foot resurfacing.

BACKGROUND: A thin skin flap is often required for optimal resurfacing of particular areas of the body. An anterolateral thigh perforator flap can be thinned to an extent to which it is vascularized by the subdermal plexus only. This study presents a novel flap thinning technique and its application for resurfacing the dorsum of the foot. METHODS: From July of 2002 to October of 2003, 18 patients underwent resurfacing of the dorsum of the foot with thin anterolateral thigh flaps. The main perforators were strategically located in the flap center to keep the peripheral area within the vascular territory. The flaps were larger than needed, initially elevated subfascially, and then thinned to the suitable thickness while the pedicle was still attached. The dissection of perforators in the adipose layer close to the dermis entry was carried out microscopically. Flap sizes ranged from 3 x 3 to 16 x 8 cm. RESULTS: Seventeen flaps survived completely and one had distal superficial necrosis of 1 x 2 cm. No debulking procedures were necessary. Average follow-up was 12 months. CONCLUSIONS: A thin flap vascularized through subdermal plexus is reliable. Microsurgical dissection of the perforator is a recommended technique. The thin anterolateral thigh perforator flap provides ideal reconstruction in resurfacing the dorsum of the foot.

Adolescent↗

PubMed2006

Frontal sinus fractures: a treatment algorithm and assessment of outcomes based on 78 clinical cases.

BACKGROUND: The purposes of this article were to retrospectively review frontal sinus fractures at the authors' center, to assess the final outcomes, and to establish a treatment algorithm. METHODS: A retrospective chart review was performed on 78 consecutive frontal sinus fractures treated by the same surgeon between January 1, 1994, and January 1, 2002. RESULTS: In this study, 57.7 percent of fractures occurred as a result of motorcycle accidents and 75.6 percent of those patients were not wearing helmets at the time of injury. The use of helmets did not significantly affect the fracture pattern. Frontal sinus fractures were commonly associated with orbital fractures (71 percent), intracranial injuries (39 percent), and severe ophthalmic injuries (26 percent). Associated injuries were more common when the fractures involved the posterior tables. The method of management comprised four groups: no surgical intervention (n = 6), open reduction and internal fixation of the anterior table with sinus preservation (n = 40), partial sinus obliteration (n = 18), and cranialization (n = 14). The complication rate was 16.7 percent (n = 13), including postoperative cerebrospinal fluid leaks (n = 6), wound infections (n = 4), meningitis (n = 1), sinusitis (n = 1), and pyomucocele (n = 1). CONCLUSIONS: Involvement of the nasofrontal duct and persistence of cerebrospinal fluid leaks are two key determinants of the treatment algorithm. The amount of displacement of the posterior table has not been found to be a key determinant of the need for surgical intervention. When the sinus is to be obliterated, partial obliteration can achieve a good result, with limited sinus complication and minimal donor-site morbidity.

Adolescent↗

PubMed2005

Salvage of an avulsion amputated thumb at the interphalangeal joint level using afferent arteriovenous shunting.

Replantation of digits following avulsion amputation is a challenge due to the severity of damage to the digital vessels. When the digital vessels are absent or severely injured, standard artery-to-artery or vein-to-vein anastomoses may be impossible and arteriovenous shunting can be used as a salvage procedure for arterial inflow or venous drainage. Previous cases of successful replantation of avulsed digits that were reperfused using afferent arteriovenous shunting reported small segments of tissues only, usually at the level of the distal phalangeal joint or distal to it. Our case demonstrates that afferent arteriovenous shunting can also provide adequate perfusion to a large piece of tissue in the thumb even when the amputation level is at the interphalangeal joint.

Adult↗

PubMed2004

Extended trapezius myocutaneous free flap for the reconstruction of a foot defect lacking adjacent recipient vessels.

Foot reconstruction requires tissue that is durable and can withstand the extremes of pressure and stress. The trapezius myocutaneous flap has not been used previously as a free flap for foot reconstruction. In this report, the trapezius was used as an extended myocutaneous free flap for the reconstruction of a foot wound lacking adjacent and adequate recipient vessels. The extended trapezius flap may be one of the longest free flaps that can be harvested. The indications for the use of this flap are limited. In an extremity that lacks adequate recipient vessels adjacent to the defect, this flap can be extended such that more proximal vessels in the leg can be used as the recipient vessels without the need for vein grafts to bridge the distance. The donor-site morbidity of this flap is minimal when the superior fibers of the trapezius muscle and its innervation are preserved.

Accidents, Traffic↗

PubMed2004

Bowel preparation before microvascular free colon transfer for head and neck reconstruction: is it necessary?

Mechanical bowel preparation before any intestinal operation, especially when the large intestine is involved, is routine practice for most surgeons. This practice has been questioned by many colorectal surgeons, with convincing data showing the lack of benefit of preoperative mechanical bowel preparation. Free microvascular transfer of the large intestine is occasionally performed for reconstruction of the upper esophagus, as it provides a better size match for the oropharynx than other visceral organs. Nine patients underwent reconstruction of the cervical esophagus and voice tube using a segment of ileocolon. In all patients, the cervical esophagus was reconstructed using the ascending colon and the voice tube was reconstructed using the ileal segment. Both were transferred as one free flap. All patients underwent the procedure without any form of preoperative mechanical bowel preparation. The patients were able to tolerate a solid diet at the end of the mean follow-up period of 7 months, and all esophagograms showed no evidence of stricture formation. One patient developed a fistula at the recipient site that was treated with a regional flap, one patient developed a superficial wound infection of the abdominal wall, and one patient developed a postoperative abdominal wound dehiscence after several episodes of excessive coughing. Microvascular transfer of a large intestinal segment without preoperative mechanical bowel preparation for the reconstruction of the esophagus is a safe procedure. It can avoid the discomfort and complications associated with mechanical bowel preparation. If preoperative mechanical bowel preparation is preferred, the results of this study, which are based on nine patients, demonstrate the safety of this practice in cases where the patient did not follow proper instructions or in cases where the use of the colon was not anticipated preoperatively.

Aged↗