Alessandro Innocenti1, Marco Innocenti2. 1. Department of Plastic and Reconstructive Surgery, CTO Azienda Ospedaliero Universitaria Careggi, Florence, Italy. Electronic address: innocentialessandro@alice.it. 2. Department of Plastic and Reconstructive Surgery, CTO Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
Abstract
BACKGROUND: Paramedian forehead flap represents a workhorse in facial soft tissue reconstruction but always requires a second step in order to interrupt the skin bridge. Direct visualization and dissection of vascular pedicle may avoid this drawback. METHODS: Twenty one patients were treated between January 2012 and January 2014: 6 underwent nasal reconstruction and 15 full thickness defect of medial canthus of an orbital region. The follow-up ranges between 6 months and 2 years. All procedures were carried out in a single stage. RESULT: All flaps were performed in a single-stage procedure, survived and healed uneventfully. CONCLUSION: The authors describe a refinement of the original technique to be reserved for cases where vessels could be identified by Doppler, consisting in the direct visualization and dissection of the initial tract of the vascular pedicle, thus providing an extremely mobile pedicle whose size allows to locate the first part of the pedicle in the nasion, tunneling under a skin bridge between the emergence of the vessels and the defect.
BACKGROUND: Paramedian forehead flap represents a workhorse in facial soft tissue reconstruction but always requires a second step in order to interrupt the skin bridge. Direct visualization and dissection of vascular pedicle may avoid this drawback. METHODS: Twenty one patients were treated between January 2012 and January 2014: 6 underwent nasal reconstruction and 15 full thickness defect of medial canthus of an orbital region. The follow-up ranges between 6 months and 2 years. All procedures were carried out in a single stage. RESULT: All flaps were performed in a single-stage procedure, survived and healed uneventfully. CONCLUSION: The authors describe a refinement of the original technique to be reserved for cases where vessels could be identified by Doppler, consisting in the direct visualization and dissection of the initial tract of the vascular pedicle, thus providing an extremely mobile pedicle whose size allows to locate the first part of the pedicle in the nasion, tunneling under a skin bridge between the emergence of the vessels and the defect.
Authors: Wesley L Brundridge; Dimitrios N Sismanis; Adam H Altman; Christopher M DeBacker; David E E Holck Journal: Plast Reconstr Surg Glob Open Date: 2022-04-22