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. 2014 Nov 15;7(11):4347-51.
eCollection 2014.

The application of reverse tubular medial upper arm flap in the reconstruction of ripped facial defects

Xianglin Dong  1 , Juan Ma  1 , Shaolin Ma  1 , Hao Wen  2
Affiliations

The application of reverse tubular medial upper arm flap in the reconstruction of ripped facial defects

Xianglin Dong et al. Int J Clin Exp Med. .

Abstract

Reverse medial upper arm flap is usually utilized in the reconstruction of defects in soft tissues of head and facial skin and is with good clinical efficacy. However, it has not been used in the reconstruction of ripped defects. In this study, we used the reverse tubular medial upper arm flap to repair the ripped facial defects. The reverse tubular skin flap from the medial upper arm was longitudinally cut into two parts. One part was used for the reconstruction of ripped facial defects. The other part was used as inner lining to repair the defects of mucosa. Using this method, 3 patients with ripped facial defects were successfully repaired. Thus the reverse tubular medial upper arm flap was successfully used in the reconstruction of ripped facial defects with little surgical trauma, simple manipulation of the operation, increased success rate of the operation and reduced incidence of complications.

Keywords: Ripped defects; flap; upper arm.

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Figures

Figure 1
Figure 1
Cartoons illustrating reconstruction surgery procedure with reverse tubular medial upper arm flap. A. Location of medial upper arm flap (as the arrow indicated) with the pedicle near the elbow, the far end of flap near the armpit and the width not affecting suture of cutting wounds; B. Formation of skin tube by reverse medial upper arm flap (phase I surgery). The far end of flap is sutured on the wounds formed under the ripped defects, the rest of flap is sutured to form the skin tube (as the arrow indicated) and the upper limbs are fixed to the head; C. Reconstruction of ripped facial defects (Phase II surgery) (as the arrows indicated). The skin tube is sectioned. And inner side of the skin is sutured with mucous defects (a), the outer surface of the skin tube is sutured with nearby soft tissue of defected skin (b), and the pedicle of skin tube is sutured on the wounds formed above the defects (c).
Figure 2
Figure 2
A typical case of ripped facial defect reconstruction with reverse tubular medial upper arm flap. This female patient was enrolled in hospital with mid-facial ripped defect caused by a car accident for one month. A. Facial appearance before operation: the area of nasal root showed ripped defects and oral mucosa was exposed; B. Facial appearance after phase I surgery. The skin tube formed by medial upper arm flap was transferred to the face and the upper limbs were fixed to the head; C. Facial appearance after phase II surgery. At 6 months after operation, ripped defects were repaired and the patient did not have any obvious discomfort.
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