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Biomedical subjects

S D Lin

Publications and source records attributed to S D Lin.

At least 73 records · Page 4Linked to original sources
PubMed1992

The adipofascial turnover flap for elbow coverage.

Closure of soft tissue defects in the vicinity of the elbow with exposed bone or joint remains a difficult problem. Local adipofascial turnover flaps covered by a skin graft were successfully used to reconstruct two elbow defects. The flap's base was placed 1.5 to 2.0 cm from the wound edge. The flap-to-base area ratio, which is an important index of flap survival, in addition to the traditional length-to-width ratio were 3.25 and 3.3, respectively. The undermined skin of the flap donor site was preserved rather than discarded as in the conventional deepithelialized turnover flap. The primary benefits of this flap are that it is an easy and rapid one-stage procedure, it requires limited immobilization of the involved joint, and it leaves an inconspicuous donor site scar. The motion of the elbow joint was not impeded because the adiposal component of the flap faced the exposed vital structures. The padding is not thick, but is sufficient to cover and protect the elbow. The flap is especially indicated for small- to medium-sized, complicated elbow wounds.

Accidents, Traffic↗
PubMed1992

Clinical application of the adipofascial turnover flap in the leg and ankle.

In soft-tissue defects with bone exposure over the leg and ankle, it is often impossible to achieve wound closure by a simple skin graft. In this article, we present a simple and effective way to reconstruct complicated skin defects on the pretibial region (four patients), the ankle (three patients), the distal fibula (one patient), and the medial aspect of the leg (one patient). Dissection of the local adipofascial turnover flap is quite easy and quick, requires less time, and involves less risk to the patient. It can be completed as a single-stage procedure, and no muscle function or major artery must be expended. Although there are numerous options for reconstruction of soft-tissue defects of the leg and ankle, the nonbulky adipofascial turnover flap appears particularly indicated for small- to medium-sized defects. The contours of the recipient and donor sites are acceptable aesthetically. Adequate flap-to-base area ratio and length-to-width ratio, tension-free insetting of the flap, and noncompression dressing are essential for the flap's survival.

Adolescent↗
PubMed1992

[Treatment of large skin defect with 6:1 meshed skin autograft and 1.5:1 meshed fresh porcine skin overlay].

The use of expanded mesh skin graft from limited donor sites has greatly increased wound coverage. However, grafts with an expansion size of 6:1 or greater often heal slowly or are lost because of local infection. Three patients with large skin defects in lower extremity have been treated with 6:1 mesh autograft overlayed by 1.5:1 fresh porcine skin mesh graft. Epithelium grown from both grafts could be found. The autografts continuously expanded under the xenografts. The outer xenografts gradually separated and desquamated, on an average, in 14 days. This technique enables resurfacing of a large area of skin defect from smaller donor sites.

Aged↗
PubMed1992

Microsurgical replantation of avulsed scalp--two cases report.

Two female patients with scalp avulsion were treated successfully by microsurgical replantation. The first patient suffered an avulsion of the right half of scalp and which survived fully after replantation. The second patient suffered avulsion of the entire scalp as well as the forehead skin and nape of the neck. Almost all of the avulsed part survived except partial skin loss in the posterior neck and left occipital area. Only one temporal artery and one vein was anastomosed in each case. Near normal hair growth recurred in both cases.

Adult↗
PubMed1992

Reconstruction of children's scalp defects with the Orticochea flap.

From January 1985 to February 1990, 4 children with scalp defects were selected for use of the Orticochea flap technique for reconstruction. The ages ranged from 15 months (the youngest in the literature) to 7 years. The defects ranged from 6 x 7 to 11 x 13 cm. Three defects were traumatic and 1 was acute lymphocytic leukemia septic emboli in cause. All these children got satisfactory results with follow-up periods ranging from 5 months to more than 5 years. With these preliminary experiences, we have verified that the Orticochea flap scalp reconstruction surgery described 20 years ago can be performed safely even in children, especially when tissue expansion is not suitable or readily available.

Child↗
PubMed1991

Adipofascial turn-over flap for reconstruction of the dorsum of the foot.

Local adipofascial turn-over flaps with skin grafts were successfully used to reconstruct complicated skin defects over the dorsum of the foot in 7 patients. The blood supply of the flap comes from perforators in the base and from the surrounding subcutaneous and fascial plexuses. A new concept of base-to-flap area ratio is proposed to predict the survival of the turn-over flaps in addition to the conventional base-to-length ratio. This appears to be a valuable technique for difficult wounds of the dorsum of the foot.

Adult↗
PubMed1991

Microskin grafting of rabbits with pigskin xenograft overlay.

Pigskin xenografts were used to replace allografts in microskin grafting (10:1 expansion ratio) on 15 rabbits. Rabbits were selected randomly for the removal of the overlaid pigskin at days 7, 10 or 14 for the evaluation of the degree of epithelialization. Histological examination of the removed pigskin 7 days after application showed obvious eosinophilic changes in the epidermal cells and pyknotic changes of the nuclei, however in some areas newly formed epidermis could be found. The pigskin became an eschar or slough on day 14. The microskin autografts proliferated and expanded actively under the protection of this overlaid pigskin. The epidermis increased in thickness and with increasing differentiation. The dermal layer was well vascularized with a large number of capillaries and fibroblasts. The wound was covered by the neoepithelium with almost normal skin texture on day 14, by which time the overlaid pigskin became a dry eschar. In areas where the overlaid pigskin was sloughing, the epithelialization of the underlying microskin grafts was not complete at the same time. In these animal studies of microskin grafting, these overlaid pigskin xenografts showed the same effects as those of allografts.

Animals↗
PubMed1991

Use of a cross-leg free muscle flap to reconstruct an extensive burn wound involving a lower extremity.

A young patient sustained a high-voltage burn with extensive destruction of the soft tissue in his left lower extremity. Occlusion of the anterior and posterior tibial arteries, loss of toe extensors and the superficial and deep peroneal nerves were noted, besides the exposure of the lower end of the tibia and metatarsal bones. In the absence of proper recipient vessels, a cross-leg free latissimus dorsi muscle flap with overlying skin and depending on the vessels of the contralateral foot was used successfully for reconstruction of the defect. The pedicle was divided 3 weeks after microvascular anastomosis and the flap survived completely. This technique permits transfer of free flaps to compromised wounds without available recipient vessels, and the latissimus dorsi muscle flap, with its characteristics of large size and copious vascularity, could be split to cover exposed bones in different areas simultaneously.

Adult↗
PubMed1991

Management of hypertrophic scars on the pubic area with an iliac flap.

Postburn hypertrophic scars on the pubic area are rare. A local iliac flap has been used in four female patients for covering the raw areas after total excision of these scars. The largest flap in this series was 7 x 13 cm. Although bilateral flaps could be used simultaneously, only a unilateral flap was used in each patient. All the donor sites were closed primarily. The postoperative course was uneventful in each patient. Itching subsided completely in all patients and distortions of the genitalia were corrected. There was no recurrence of the scar formation in the follow-up period from 2 to 7 years. The only drawback of this flap for coverage of the symphysis pubis is that it is hairless. The experience with the present patients proved that this is an easy, quick and reliable method for removing hypertrophic scars on the pubic area.

Burns↗
PubMed1991

Limb salvage of infected diabetic foot ulcers with microsurgical free-muscle transfer.

This study was comprised of 9 diabetic patients with 10 infected foot ulcers, including osteomyelitis in 4 limbs and gangrene in 3 limbs. Adequate debridement of these complicated wounds inevitably resulted in exposure of bones or tendons. All defects were successfully reconstructed with free gracilis muscle flaps covered with split-thickness skin grafts. No recurrence of ulcer or infection was noted in the muscle-transplanted area during the follow-up period. Laser Doppler perfusion monitor measurement showed that the perfusion unit of the denervated free muscle flap increased to a peak at the second week after transplantation; the neovascularization of the grafted skin, the progressive decrease of the muscle swelling, and the decreased interstitial pressure may be the main contributing factors. The perfusion unit of the muscle flap reached equilibrium with the surrounding tissue at about 8 weeks after microsurgical transfer. Lower extremity amputation is a major health problem in the diabetic population. The microvascular free-muscle transfer was proved to play an effective and important role in limb salvage in diabetic patients with infected foot ulcers. The gracilis muscle flap was recommended due to its lack of bulkiness and minimal donor site deformity.

Aged↗
PubMed1991

[Surgical treatment of diffuse scrotal epidermal cysts: case report].

Epidermal cysts are common, benign skin tumors that are found mainly on the face, neck, and trunk. This case was a 53-year-old male bus driver who had suffered from multiple papules on his scrotum for 7 years. This affliction had caused intractable itching and responded poorly to medical treatment. The patient received an excision of these papules (total 32) 3 years ago. According to the pathological reports, these papules were epidermal cysts; unfortunately, these papules recurred within 3 months after the operation and then resulted in itching more severe than before. The patient was again admitted to the hospital ward and received an operation in Oct. 1990. The diseased tissue (14cm x 8cm) was then excised and the defective scrotal skin was covered with a meshed, split-thickness skin graft. The cosmetic result was enhanced by the rugate appearance of the healed meshed graft. The patient was satisfied with both the functional and cosmetic results. The itching sensation on the scrotum improved and there was no recurrence of epidermal cysts within the graft area during the 9 month follow-up period. With this simple and safe operation, the result gave a satisfying improvement in both symptoms and appearance; so this case is offered for reference.

Epidermal Cyst↗
PubMed1990

Immediate reconstruction of the penis with an iliac flap.

Immediate reconstruction of the penis can save time and significantly reduce postoperative psychological morbidity. A patient suffered a cancerous lesion in his glans penis. After total amputation, an iliac flap based on the superficial circumflex iliac artery was used to reconstruct the penis. The subcutaneous tissue around the vascular pedicle was carefully preserved for enhancing the venous drainage of the new penis. A self-sculptured silicone implant was inserted later to increase the penile rigidity. The advantages of this technique include ready availability, easy mobilisation, hairlessness, elimination of multi-staged procedures, and saving time. The patient is pleased with the operative results.

Amputation, Surgical↗
PubMed1990

V-Y advancement flap for facial defects.

V-Y advancement flaps based on subcutaneous pedicles are an ideal option for closure of small to medium sized facial defects. This technique has been used to treat 69 patients with various lesions of the face, (30 basal cell carcinoma, 9 squamous cell carcinoma, 18 nevus, 4 traumatic defect, 3 old scar and 5 others) during the past seven years. There was no necrosis of any single flap. All the designs could be planned so that the long axes of the flaps were parallel to the wrinkle line, contour line or line of dependency. All wounds healed uneventfully with fine or undelineated scar. There were no secondary operation for these cases. Clinical results of this series have shown advantages of this flap in reconstruction of facial defects. It is reliable in circulation and is easy to design and execute. It causes no distortion of critical features and offers excellent cosmetic satisfaction in color and texture matching. Therefore, the V-Y advancement flap is recommended for closure of properly selected facial defects.

Adolescent↗
PubMed1990

An unusually-formed appearance epidermoid cyst of the plantar region--a case report.

A rare site for an epidermoid cyst is herein reported. A 40-year-old female was admitted for treatment of a right plantar tumor. The tumor was multiloculated, soft, nodular and in the range of about seven by seven centimeters. We initially diagnosed it as a saccular hemangioma, but it was finally diagnosed as an epidermoid cyst with foreign body reaction from the surgical specimen. Epidermoid cysts can occur in various parts of the body. Trauma is regarded to be the chief cause of them. Due to their various locations and appearance, they are sometimes difficult to diagnose. In such cases, however, it is generally agreed that pathological study is mandatory for a correct diagnosis.

Adult↗
PubMed1989

The reverse digital artery flap for fingertip reconstruction.

Reverse digital artery flaps were performed successfully to resurface the major fingertip defect in 10 patients and the volar defect of the middle phalanx in 1. This thin flap with its long vascular pedicle containing a digital artery and its perivascular cuff tissue has a wide arc of transposition. It can be used to reconstruct the defect located from the proximal phalanx to the fingertip of all fingers. No loss of the flap in this series was noted. The procedure is a time-saving, one-stage operation. Patients who received this procedure had no uncomfortable immobilization of the hand or long hospitalization. It also causes no disfigurement and no functional loss of the involved digit. Our clinical experience showed favorable results.

Adult↗
PubMed1989

Surgical treatment of the penoscrotal Paget's disease.

Data from six cases of penoscrotal Paget's disease were collected. Erythematous, indurated, and pruritic skin lesions that failed to respond to the topical therapy were the main complaints. Symptoms had been observed for three to seven years before correct diagnosis. Extensive diagnostic studies revealed negative findings of subjacent adenocarcinoma, but 1 patient had concurrent skin cancer of nasal ala. In treating penoscrotal Paget's disease, our policy is to (1) resect 3 cm or more skin beyond the margin of the cutaneous lesion, (2) resect deeply to the subcutaneous fat, (3) use intraoperative frozen sections to confirm the free margin and (4) reconstruct the wound with the local iliac flap. No local recurrence was noted during the follow-up period of two to seven years. The iliac flap is thin and pliable; it precluded scar contracture and painful penile erection, which are the common sequelae of free skin graft in the penoscrotal area. Patients enjoyed normal sexual activity after surgery.

Aged↗