PubMed · 6344851
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T S Ashbell. 1983. Rhomboid flap.. https://doi.org/10.1001/archotol.1983.00800210071019
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Among the various procedures to restore flexor tendon function after failed or omitted primary suture flexor tendon grafting is the most frequently applied technique. It can be performed in a one-stage procedure using a palmaris- or plantaris graft in cases with less scarring or in a two-stage procedure for cases in unsuitable conditions. The main purpose for using silicone rods is to prepare an artificial tendon sheath to avoid adhesions of the tendon graft. The disadvantage of two operations seems to be justified by better results. We performed this technique in 168 zone-II-lesions. According to the Buck-Gramcko score we achieved excellent results in 30.9% and good results in 25.6%. In 76 fingers we applied the combination of the Paneva-Holevich technique of using a pedicled superficialis tendon with Hunters method without obtaining better results (22.4% and 32.9% respectively). The various techniques of grafting are described as well as indication and technique of tenodesis and alternatively staged procedure for isolated profunda lesions.
In any discussion of surgical exposure, it is important to remember that of chief importance is what is done in the operative field, rather than how the site is exposed. Selection of approach is based on tradeoffs that must be weighed by the surgeon and tailored to the deformity for a given patient. Despite a recent surge in the popularity of the transconjunctival technique, periorbital surgery by a cutaneous approach is still a valid means of access for a variety of esthetic and particularly trauma procedures. There are few solid data comparing the two approaches, and what does exist shows little or no significant difference between them. A cutaneous approach spares the conjunctiva, bypasses transconjunctival-related complications, and eliminates the need for lateral canthotomy for access. The subtarsal lid crease incision appears to offer the benefits of the orbital rim incision with respect to speed, exposure, and low incidence of lid malposition, with cosmetic scar appearance that is comparable to the subciliary incision.
Scar improvement is an age old endeavor. Multiple modalities exist for improving a scar's appearance. This article will review scar types and offer a brief overview of nonsurgical and surgical options for scar revision.