Reverse adipofascial radial forearm flap surgery for soft-tissue reconstruction of hand defects

Objective: The reverse radial forearm flap has been used for soft-tissue hand defect surgical procedures worldwide. One of the major drawbacks of this flap, however, is donor site morbidity, as the donor site is closed with a skin graft. Problems with skin graft donor areas include adhesion, contracture, and wound-healing complications. In this study, only the adipofascial component of a reverse radial forearm flap was used to prevent these problems; in addition, a skin graft was applied over the flap instead of over the donor site. Methods: Between January 2011 and December 2013, a total of 13 hand defects were reconstructed with a reverse adipofascial radial forearm flap. Patients were evaluated for functional results using total active motion criteria and disability of the arm, shoulder, and hand scores, operation time, hospitalization time, and patient satisfaction. Results: All flaps and grafts placed on flaps survived completely and donor sites healed without complications. The total active motion criteria and the disability of the arm, shoulder, and hand score demonstrated that the functional outcomes were successful. Patient satisfaction scores using the visual analog scale had a mean of 88.3 (SD = 2.95) mm. Operation time for the flap surgery was 126.1 (SD = 21.80) minutes, and patients were discharged at an average of 6.3 (SD = 1.44) days. Conclusion: Use of an adipofascial component in reverse radial forearm flap surgery is appropriate for reducing problems with donor site skin grafts. Patients’ functional outcomes denoted that the reverse adipofascial radial forearm flap is a reliable and effective method to cover soft-tissue defects of the hand

An Overview of the Technical Details and Seven Cases of Lagophthalmos Treatment with Gold Implant

Objective: Placing gold implants in the upper eyelids is a widely accepted method in lagophthalmos treatment. Gold can be obtained as custom-made or from medical firms, as well as from jewelers. This review intends to share the algorithm applied in our clinic, to help avoid undesirable postoperative results. Material and Methods: Between 2012 and 2014, seven patients were planned to undergo gold implant surgery for lagophthalmos. In each of the seven cases preoperative weight tests were performed in upright-seated position, incision site and implant weights were measured, and the determined weights were tested twice, sterilization was applied. Results: None of the patients showed any early or late complications. Complete closure of the eyelids was achieved. Aesthetic evaluations of the patients were found to be better than the physician’s evaluations. Conclusion: The weight of the gold is the most important factor that determines the success of the implant treatment. It is possible to reduce postoperative morbidity and increase success by adhering to simple preoperative criteria when gold is obtained from jewelers, a cost-effective method that yields high patient satisfaction