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Biomedical subjects

S D Lin

Publications and source records attributed to S D Lin.

At least 55 records · Page 3Linked to original sources
PubMed1995

Reverse digital artery neurovascular cross-finger flap.

Soft tissue loss with digital nerve defect in the finger was reconstructed with the reverse digital artery neurovascular cross-finger flap in two cases with favorable results. The flap harvested from the lateral side of the proximal phalanx of the neighboring healthy finger is nourished by a distally based digital artery. The flap contained a segment of digital nerve dorsal branch, which is used to bridge the nerve gap in the wound while the flap is used to reconstruct the soft tissue defect concomitantly. The reverse digital artery neurovascular cross-finger flap seems to be a useful addition to the options for complicated finger damage involving soft tissue loss and nerve defect.

Adult↗
PubMed1995

Reconstruction of the upper leg and knee with a reversed flow saphenous island flap based on the medial inferior genicular artery.

Soft-tissue defects around the knees and below-the-knee amputation stumps are difficult to reconstruct. We present an option for reconstruction of these defects. Reversed flow saphenous island flaps, based on the medial inferior genicular artery, were successfully transferred in 6 patients. All wounds healed well postoperatively. The donor defect can be closed directly when the width is less than 7 cm. This is a thin and reliable fasciocutaneous flap that is useful in covering defects around the knee joint, popliteal fossa, upper half of the leg, and below-the-knee amputation stump.

Adult↗
PubMed1995

Reconstruction of the totally degloved little finger with a bilobed digital neurovascular island flap.

Treatment of a completely degloved finger injury is a challenge to plastic surgeons. We used a simple method, a bilobed digital neurovascular island flap harvested from the dorsolateral side of the middle and proximal phalanges of the ring finger, to reconstruct the complete degloved little finger. This method provides a one-stage operation for coverage of the degloved little finger and also results in good sensation and an acceptable appearance.

Adult↗
PubMed1995

Clinical application of the distally based medial adipofascial flap for soft tissue defects on the lower half of the leg.

OBJECTIVE: Reconstruction of soft tissue defects on the lower half of the leg. DESIGN: The distally based medial adipofascial flap nourished by the lower perforator originating from the posterior tibial artery was harvested, and the pivot point of flap transposition is 9 to 12 cm above the tip of the medial malleolus. MATERIALS AND METHODS: Twelve cases of open tibial fracture associated with soft tissue defects on the lower half of the leg were reconstructed with this flap. The cases consisted of ten males and two females, and their ages ranged from 16 to 71 (averaging 41 years). MEASUREMENTS AND MAIN RESULTS: Size of the flap varied from 4 x 7 cm to 5 x 18 cm. Eleven flaps had good perfusion and survived completely. Tip necrosis of the flap occurred in one case. In the early postoperative period, take of the meshed split-thickness skin graft on the flap was not complete. All wounds, however, were resurfaced completely without the need of a second grafting. Discharging sinuses occurred in one case, which was managed by removal of infected bony fragments. All the donor sites were closed primarily, and desquamation of wound edges occurred occasionally. CONCLUSIONS: The distally based medial adipofascial flap was a reliable and effect local flap for the reconstruction of soft tissue defects on the lower half of the leg.

Adolescent↗
PubMed1995

A clinical analysis of necrotizing fasciitis: a review of 54 cases.

Necrotizing fasciitis is a severe and sometimes life-threatening soft tissue infection that is characterized by rapidly widespreading necrosis of fascia and subcutaneous tissue. Fifty-four cases of necrotizing fasciitis were reviewed over a 5-year period. Among them, 25 patients (46%) had diabetes mellitus. The majority of the wound bacterial cultures (71%) yielded a mixed growing. There were negative cultures in six patients, and single organism growth in 14 patients (29%). The predominant organisms growth were Streptococci, Staphylococci, and Escherichia coli. The overall mortality rate was 22% (12/54). Death was caused by systemic septic complications in these patients. All 12 mortalities resulted from delayed debridement (averaging 25 days after initial symptoms appeared). Our study indicates that the early recognition and prompt debridement of all necrotic tissue is essential for reducing the mortality rates of this potentially lethal condition.

Adolescent↗
PubMed1994

The reverse lateral arm flap, based on the interosseous recurrent artery, for cubital fossa burns.

The reverse lateral arm flap based on the interosseous recurrent artery was used successfully to reconstruct cubital fossa defects caused by high voltage electric burn in two cases. The flap is nourished by the septocutaneous perforators of the posterior radial collateral artery which anastomoses around the lateral epicondyle with the interosseous recurrent artery. The primary benefits of this flap are that it is an easy and rapid one-stage procedure, with no necessity of sacrificing a main artery or local muscle, and it requires no immobilisation of the involved joint.

Adolescent↗
PubMed1994

A mixture of allogeneic and autologous microskin grafting of rabbit skin wounds with Biobrane overlay.

A mixture of allogeneic and autologous microskin grafts (10:1 expansion ratio) were transplanted and overlain with Biobrane, on to full-thickness skin wounds (8.0 x 5.0 cm in size) in 16 rabbits. They were divided into two groups: in group I, the expansion ratio of both allo- and autograft was 20:1; in group II, the expansion ratio of allo- and autograft was 15:1 and 30:1 respectively. On day 9, all wounds of group I and II were almost completely resurfaced with neoepithelium. There was no serious rejection reaction within the neoepithelium and the wounds were maintained completely resurfaced after day 9. There were scales on the epithelialized wound which were more numerous in group II than in group I. Histological examination revealed that these wounds were resurfaced with well-differentiated epithelium which contained two different histological patterns. They were identified as the survived transplanted allogeneic and autologous microskin grafts, each having their own characteristic histological features and different sex chromosome. Thus both the largely expanded allogeneic and autologous microskin grafts could proliferate together and contribute to the resurfacing of the wound. With this method, the rabbit skin wound could be resurfaced completely after the ninth postoperative day with markedly minimized amounts of autologous and allogeneic grafts.

Animals↗
PubMed1994

An easy way to prepare microskin grafts.

The conventional technique to produce microskin grafts is a relatively time-consuming procedure. We developed an easy method by using a trimmed circular dermacarrier with the non-grooved side up and driving forward in the meshgraft instrument through six different angles that were 30 degrees apart. The tiny skin particles obtained by this method not only saved operation time but also survived well in the grafted wounds.

Adult↗
PubMed1993

Innervated reverse digital artery flap through bilateral neurorrhaphy for pulp defects.

To provide sensation to the reverse digital artery (RDA) flap, both the dorsal branch from the proper digital nerve and the superficial sensory branch from the corresponding radial or ulnar nerve are sectioned at their proximal ends and included with the RDA flap. These are then anastomosed with the distal ends of both radial and ulnar digital nerves at the recipient wound. Three cases of pulp defects reconstructed by this technique achieved very favourable functional and cosmetic results. The RDA flap, innervated through bilateral neurorrhaphy, seems to be an excellent option for one-stage reconstruction of major pulp defects.

Adolescent↗
PubMed1993

Clinical application of adipofascial turn-over flaps for burn wounds.

Local adipofascial turn-over flaps overlaid with skin grafts were used successfully to reconstruct nine deep burn wounds following electric injuries or contact burns in seven patients. Durable flap coverage of the exposed tendons, joints or bones can be achieved with a one-stage procedure. Appropriate length-to-width ratio and flap-to-base area ratio, and the tension-free insetting of the flap are essential for flap survival. The non-adherent characteristic of the adiposal component of the flap enables the underlying involved tendons or joints to glide through without adherence, and the rich vascular network in the fascia provides an ideal bed for the skin graft. The adipofascial turn-over flap is a reliable and simple technique for reconstruction of certain deep burn wounds if the surrounding soft tissue is available. The functional and cosmetic results in our series have been rewarding and satisfactory.

Adipose Tissue↗
PubMed1993

Allogeneic microskin grafting of rabbits' skin wounds.

Allogeneic microskin grafts (expansion ratio of 10:1), overlain with Biobrane, were applied to 30 rabbits. There were two groups. In group I, the allogeneic donor microskin grafts were transplanted without specific management. In group II, the donor skin was treated with ultraviolet (312 nm) irradiation to depress Langerhans cells immediately before the transplantation. Histological examination of these grafted wounds in the early stage showed that these micrografts proliferated actively with increased mitotic figures and became regularly stratified under the conditions provided by the Biobrane. By day 9, these wounds in group I were almost resurfaced with neoepithelium. In group II, the rate of regeneration of the neoepithelium was slower than those of group I. Subsequently there was rejection with moderate mononuclear infiltration, hydropic degeneration and satellite necrosis of basal and suprabasal keratinocytes, and local destruction of epithelium. Grossly these reactions caused 'melting' of the neoepithelium and resulted in raw areas. These rejections were more severe about 2 weeks after transplantation and then subsided gradually. Mild cellular infiltration continued to prevent the formation of rete ridges and the dermoepidermal junction was smooth at all times. Langerhans cells could not be found in these grafted wounds using OKT-6 and S100 stain. In spite of the destruction caused by these rejections in both groups, 25 wounds were completely resurfaced with well-differentiated neoepithelium by day 21. This study revealed that the transplanted allogeneic microskin grafts could proliferate to form neoepithelium and resurface the skin wounds of rabbits.

Animals↗
PubMed1993

Aspergillosis complicating the grafted skin and free muscle flap in a diabetic.

A case of infected diabetic foot ulcer was reconstructed by a free muscle flap overlaid with a skin graft. Primary cutaneous aspergillosis involving the grafted skin and the transplanted muscle was described. The patient presented with an indurated grey-yellow plaque or black eschar in the wound without purulent discharge. Biopsies and cultures demonstrated A. flavus as the etiologic agent without evidence of systemic dissemination. Early diagnosis necessitates a high index of suspicion in immunocompromised patients with unusual cutaneous manifestation. Treatment consisted of aggressive debridement, systemic and local antifungal therapy, and delayed grafting. We concluded that primary cutaneous aspergillosis may occur at the reconstructed wound in an immunocompromised diabetic, and that it is a rare complication requiring prompt diagnosis and treatment.

Aspergillosis↗
PubMed1993

Tracheal deviation: an unusual complication of platysma myocutaneous flap.

Reconstruction of the intraoral defect caused by tongue cancer was done for a patient by using a platysma myocutaneous flap. The relatively short neck, scar contracture, and inactive movement of the involved side of the neck resulted in tracheal deviation, an unusual complication not appearing in previous reports. In order to avoid airway problems during intubation, the surgeon and anesthestist should seriously consider the possibility of this rare complication in patients who have had the platysma myocutaneous flap technique. Careful preoperative evaluation and skillful intubation of the fiberoptic bronchoscope are demanded in cases where next general anesthesia is needed.

Adult↗
PubMed1993

The subgalea-periosteal turnover flap for reconstruction of scalp defects.

Subgalea-periosteal flaps were successfully used in a turnover pattern to reconstruct two scalp defects with exposed calvaria caused by tumor ablation. A copious vascular network of the subgaleal fascia in the base and its attached lateral territories provide adequate blood inflow for the turnover flap. The periosteum is included in the flap to protect the blood supply of the subgaleal component from damage during dissection, and its uniform surface constitutes an ideal bed to receive skin grafts. The tissue is readily available and a large flap can be created in a single surgical step without deformities or sequelae left in the donor area. The subgalea-periosteal turnover flap overlaid with skin graft seems to make reconstruction of the complicated scalp defect much simpler and straightforward.

Adult↗
PubMed1993

Management of windshield facial injuries.

Between Jan. 1986 and Dec. 1990, 99 patients with automobile windshield facial injuries were hospitalized in Kaohsiung Medical College hospital. All patients were injured by old type windshields in car accidents. Seventy-three patients (74%) were male and twenty-six (26%) were female. Ages ranged from 6 to 62 years (mean age 31 years). Fifty-seven patients (58%) were car drivers and forty-two (42%) were front seat passengers. All patients had typical multiple U-shaped lacerations on the face. The major injury sites were localized to the upper one third of the face. The wounds were repaired immediately after careful debridement. A total of 21 facial bone fractures were noted. All were open fractures with large, deep avulsion wounds. Displaced and comminuted fractures received reduction and fixation before wound closure. Three patients had cranial bone fracture with no displacement. Brain edema and subarachnoid hemorrhage were found by brain CT scan in two and one patients respectively. They were treated conservatively. In one patient with frontal sinus fracture the glass pieces penetrated into the brain. The foreign bodies were removed from the brain and frontal sinus. Eyeball rupture was found in 16 patients, including two patients in whom both eyes were involved. Eight eyeballs needed immediate evisceration and ten eyeballs received reparation. Blindness occurred in all these patients. Of the 99 patients in this study, 15% sustained additional injury. Most were wounds on the extremities. Because serious injuries can be caused by the old type of windshields, it should be abandoned. Driving with the seat belt fastened is the best way to insure safety.

Accidents, Traffic↗
PubMed1992

Microskin grafting of rabbit skin wounds with Biobrane overlay.

Biobrane was used to overlay micrografts and the wound using the microskin grafting technique with an expansion ratio of 10:1 in 16 rabbits. The rabbits were divided randomly into four groups, with four rabbits in each group, for evaluating the wound conditions on days 7, 10, 12 and 14. Histological examination of the removed Biobrane showed a variable degree of entrapment of inflammatory cells within the nylon fabric. Biobrane adhered well to the wounds although many wrinkles containing fluid accumulations were noted on day 7. By 10, 12 and 14 days all the wounds become dry and their Biobrane adhered completely. Histological examination of the grafted wound on day 7 showed active proliferation and spread of micrografts. In the later groups, the neoepidermis increased in thickness and differentiated into skin with a normal texture. On day 10, the wounds were almost completely resurfaced with neoepithelium. The growth of these grafts progressed smoothly as the adherent Biobrane was kept on the wound for 12 or 14 days. In these animal studies, the overlain Biobrane provided favourable conditions for the successful growth of micrografts.

Animals↗
PubMed1992

Microskin autograft with pigskin xenograft overlay: a preliminary report of studies on patients.

Split-thickness pigskin graft (STPSG) was used to replace allograft skin for microskin grafting in 16 patients, nine of whom were burn patients, five suffered from traumatic defects and two from diabetic ulcers. The expansion ratios used in these patients ranged from 8:1 to 12:1. The STPSG preparation described was found to be safe for clinical application. The autogenous donor skin was excised from the inguinal area, and the donor site was primarily closed. There were no instances of donor site morbidity. The majority of the STPSG overlays adhered to the wound firmly. Histological examination showed that the microskin grafts proliferated actively immediately beneath the STPSG overlay. The time for the wound to be fully resurfaced varied from 13 to 21 days depending on the expansion ratio employed. There were only two episodes of pseudomonas infection and no further grafting was required in any of the patients. In this study the pigskin xenograft was found to provide a suitable environment for the epithelialization of microskin autografts. When allograft is not available, this is an alternative way of ensuring successful microskin grafting.

Adolescent↗