Hai Thanh Nguyen
Viet-Han International Cosmetic Institute, Vietnam
Scientific Tracks Abstracts: J Surgery
INTRODUCTION:
Material for plastic reconstruction is the important problem. Delayed flap is the good method to enlarge the flap with
similar color and has good result in reconstruction. Our purposes:
1. Survey the changes of vessels in experimental delayed skin flap.
2. Apply technical delayed flap in aesthetic plastic surgery.
SUBJECT:
Experimental study: 60 white rabbits divided into 2 groups (1:1), each group with 3 lots, each lot has 10 rabbits.
Evaluate the effect of delay phenomenon by changes in blood vessels and vitality skin flap at the time of delayed 7,
14, 21 days.
Clinically: Application on 15 patients with post-burn chin and neck contracture surgical treated with occipital
cervical dorsal delay flap (delayed 14 days). Evaluate the results.
METHODS:
Experimental study - Delaying surgery undergo two period:
Period 1: Create delay flap: On every rabbit, bi-axial flap is verified along back based on thoracodorsal artery and
deep iliac artery. Flap size average 24 Ã? 7 cm. 2/3 distance flap (tail side) is released and elevated by U-shape incision.
To isolate the artery supply from below and two side to flap, put a silicone sheet which made hole under flap then
close flap. Control flap is symmetric flap on the back of every rabbit.
Period 2: After delayed 7 days (Lot 1), 14 days (Lot 2), 21days (Lot 3), full dissection to the original flap. Group 1:
Survey the changes of vessels of the flaps; Group 2: Continue to monitor viability of flaps in 1 week.
Clinical applications:
Period 1: Design occipital cervical dorsal flap according to the size identified, 2/3 distance flap is released and
elevated by U-shape incision, flap is thinned and hemostasis. To isolate the artery supply from below and two sides
to flap, put a silicone sheet which made hole under flap then close flap.
Period 2 (after delayed 14 days): full dissection to the original flap to reconstruct the wound.
RESULTS
Experiment:
The amount of the neovascularity in the connection place: In delayed flap are more than in control flaps
The vitality of the dorsal skin flap of rabbits: The ratio of necrosis skin flaps: in delayed flaps are less than in control
flaps.
Clinic:
15 patients using occipital cervical dorsal delayed flap to reconstruct post-burn chin and neck contracture scar with
far results: 85.7% good, 14.3% on average, with no bad results. The size of OCD delay flap can reach: length 36 cm,width of 15 cm, original width 5.5 cm.
CONCLUSION:
In experiment:
The delay phenomenon effects increases the vascular connection between nearby branches, increases the vitality of
skin delayed flaps compared to non-delayed flaps.
In clinic:
The application technique of delay to create a large flap, high vitality, similar in color to the skin around the wound
is a reliable method for the surgeon, where no conditions to make microsurgery techniques
Hai Thanh Nguyen is the director doctor of Viet-Han International Cosmetic Institute in Vietnam
E-mail: drhai2013@gmail.com
Journal of Surgery received 288 citations as per Google Scholar report
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