Extended adipofascial wrap around radial forearm flap for hard palate reconstruction
Background: While using radial forearm free flap in palate reconstruction, the pedicle lies in the nasal floor, constantly exposed to the nasal secretions and turbulent air current. To overcome this problem, we have designed a procedure which utilises the adipofascial extension to wrap the pedicle a...
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| Format: | Article |
| Language: | English |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2018-09-01
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| Series: | Indian Journal of Plastic Surgery |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.4103/ijps.IJPS_81_18 |
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| author | Ashok B. C. Pradeep Kumar Nagaraj Srikanth Vasudevan Anantheshwar Y. N. Rao Sudarshan Reddy Nagireddy Ritu Singh Batth |
| author_facet | Ashok B. C. Pradeep Kumar Nagaraj Srikanth Vasudevan Anantheshwar Y. N. Rao Sudarshan Reddy Nagireddy Ritu Singh Batth |
| author_sort | Ashok B. C. |
| collection | DOAJ |
| description | Background: While using radial forearm free flap in palate reconstruction, the pedicle lies in the nasal floor, constantly exposed to the nasal secretions and turbulent air current. To overcome this problem, we have designed a procedure which utilises the adipofascial extension to wrap the pedicle and nasal side of the flap. Materials and Methods: The study was done during 2017 and 2018, 2 years’ period. Totally 13 consecutive patients with defect in the palate status post-oncological resection and those in whom local flaps were not enough to cover the defect were included into the study. These patients were divided into two groups. First group in whom adipofascial extension was not used to cover the pedicle and second group in whom adipofascial extension was used to cover the pedicle. The incidence of nasal crusting, secondary haemorrage, blow out and flap necrosis were analysed and compared. Results: In Group 1, we had 2 among 6 (33%) patients with secondary haemorrage. One patient had partial flap loss. On exploring, we noticed thrombosis of cephalic vein. We did not had any incidence of blow out of the pedicle. In Group 2, none of the patients had any secondary haemorrage. All flaps healed well. On doing nasal endoscopy at 6 months of follow-up, all flaps showed complete mucosalisation at the nasal side. Conclusion: Use of adipofascial extension while planning a radial forearm free flap to cover the nasal side of the flap and pedicle in the nasal floor helps to reduce the nasal crusting and secondary haemorrhage. |
| format | Article |
| id | doaj-art-dda2e515666c4fb3a294fcab561b2072 |
| institution | OA Journals |
| issn | 0970-0358 1998-376X |
| language | English |
| publishDate | 2018-09-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Indian Journal of Plastic Surgery |
| spelling | doaj-art-dda2e515666c4fb3a294fcab561b20722025-08-20T02:21:30ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2018-09-01510330630810.4103/ijps.IJPS_81_18Extended adipofascial wrap around radial forearm flap for hard palate reconstructionAshok B. C.0Pradeep Kumar Nagaraj1Srikanth Vasudevan2Anantheshwar Y. N. Rao3Sudarshan Reddy Nagireddy4Ritu Singh Batth5Department of Plastic and Cosmetic Surgery, Manipal Hospital, Bengaluru, Karnataka, IndiaDepartment of Plastic and Cosmetic Surgery, Manipal Hospital, Bengaluru, Karnataka, IndiaDepartment of Plastic and Cosmetic Surgery, Manipal Hospital, Bengaluru, Karnataka, IndiaDepartment of Plastic and Cosmetic Surgery, Manipal Hospital, Bengaluru, Karnataka, IndiaDepartment of Plastic and Cosmetic Surgery, Manipal Hospital, Bengaluru, Karnataka, IndiaDepartment of Plastic and Cosmetic Surgery, Manipal Hospital, Bengaluru, Karnataka, IndiaBackground: While using radial forearm free flap in palate reconstruction, the pedicle lies in the nasal floor, constantly exposed to the nasal secretions and turbulent air current. To overcome this problem, we have designed a procedure which utilises the adipofascial extension to wrap the pedicle and nasal side of the flap. Materials and Methods: The study was done during 2017 and 2018, 2 years’ period. Totally 13 consecutive patients with defect in the palate status post-oncological resection and those in whom local flaps were not enough to cover the defect were included into the study. These patients were divided into two groups. First group in whom adipofascial extension was not used to cover the pedicle and second group in whom adipofascial extension was used to cover the pedicle. The incidence of nasal crusting, secondary haemorrage, blow out and flap necrosis were analysed and compared. Results: In Group 1, we had 2 among 6 (33%) patients with secondary haemorrage. One patient had partial flap loss. On exploring, we noticed thrombosis of cephalic vein. We did not had any incidence of blow out of the pedicle. In Group 2, none of the patients had any secondary haemorrage. All flaps healed well. On doing nasal endoscopy at 6 months of follow-up, all flaps showed complete mucosalisation at the nasal side. Conclusion: Use of adipofascial extension while planning a radial forearm free flap to cover the nasal side of the flap and pedicle in the nasal floor helps to reduce the nasal crusting and secondary haemorrhage.http://www.thieme-connect.de/DOI/DOI?10.4103/ijps.IJPS_81_18adipofascial extensionhard palate reconstructionmucosalisationradial forearm free flap |
| spellingShingle | Ashok B. C. Pradeep Kumar Nagaraj Srikanth Vasudevan Anantheshwar Y. N. Rao Sudarshan Reddy Nagireddy Ritu Singh Batth Extended adipofascial wrap around radial forearm flap for hard palate reconstruction Indian Journal of Plastic Surgery adipofascial extension hard palate reconstruction mucosalisation radial forearm free flap |
| title | Extended adipofascial wrap around radial forearm flap for hard palate reconstruction |
| title_full | Extended adipofascial wrap around radial forearm flap for hard palate reconstruction |
| title_fullStr | Extended adipofascial wrap around radial forearm flap for hard palate reconstruction |
| title_full_unstemmed | Extended adipofascial wrap around radial forearm flap for hard palate reconstruction |
| title_short | Extended adipofascial wrap around radial forearm flap for hard palate reconstruction |
| title_sort | extended adipofascial wrap around radial forearm flap for hard palate reconstruction |
| topic | adipofascial extension hard palate reconstruction mucosalisation radial forearm free flap |
| url | http://www.thieme-connect.de/DOI/DOI?10.4103/ijps.IJPS_81_18 |
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