Lecture: Filatov stem. Indications for replacement of defects of tissues and organs of maxillofacial area Filatov stem. Methods of harvesting stem migration, training and closure of the defect. Defects of skin, oral mucosa, nose, methods of closing them free flap: indications, techniques free skin plastic.

Types of stem flaps - places of formation the neck

Operation of Filatov stem formation

Seam to close the triangular "corner" formed by the meeting of two stitches.

Preparation of stem to transfering

Trained stem made ​​ on the abdomen, ready to transfer.

A patient with a defect of the left cheek and the corner of the mouth after recovering from noma. Cicatricial contracture of jaws.

A patient with a defect of the left cheek and the corner of the mouth recovering from noma. Cicatricial contracture of jaws.

A patient with abruption of chin before the operation with modeling prosthesis.

Harvested Filatov stem on the front and lateral sides of the abdominal wall.

Patient after chin plastic.

Complete fusion of the chin with the chest that occurred after the burn.

In a patient was formed keloid scar on the neck after the burn. Formed Filatov stem was moved to neck. After excision of the scar stem was flattened over the wound of the recipient.

To the girl about face hemangioma in early childhood was conducted medical course of radiotherapy and formed deforming scar. After its excision Filatov stem was flattened over wound of the recipient.

Satisfactory cosmetic result.

Removal of total nasal defect with Filatov stem by the method of Hitrov. Indications, technique of execution on stages. Prevention of complications. Removal of partial and subtotal nasal defects with local fabrics

Full abruption of nose – organ with multifaceted functions should be regarded not only as a cosmetic defect, as well as abnormal condition that violates the coordinated function of various organs and therefore requires removal. Rhinoplasty has a very long history. Even in 3000 BC India used a method of reconstruction of nose with forehead flap (Indian method). Later it was developed many different methods of replacement of partial and total nasal defects. V. M. Hitrov in details substantiated nasal reconstruction method using Filatov stem.

Aim: To teach students methods of rhinoplasty at total nasal defect using Filatov stem, which developed an outstanding Russian scientist V. M. Hitrov.

Preparation for surgery: I - a general principle, which are used at the removal one or another nasal defect following: nose shape restoration can not be held until removal of acute and chronic inflammation in the soft tissues, in the skeletal remains of the site, in the paranasal sinuses. Eliminate barriers to nasal breathing. II - before proceeding to restoration of nose shape it is necessary to prepare the base for it - that is make normative pear-wide hole, restore approximately located tissues and organs (upper lip, palate, jaw, etc.)

Method of V.M. Hitrova consists of the following steps: 1. Formation of a large stem on the front and lateral sides of the body from dermal tape size 1O x 24 cm2. 2. transplantation of the distal end of stem on lower part of the wrist or forearm (after days). 3. Transplantation of the second stem end to the edge of the defect on the nose (after days). 4. Single-step formation of all parts of the nose (after days).

The final point of total and subtotal rhinoplasty is implantation into created nose of cartilage or plastic base (frame).

Terminology: Rinoplastica - nose plastic Subtotal nasal defect - lack of cartilage and soft tissue components of the external nose The total defect of nose - absence of external nose Acute Filatov stem - Filatov stem, modeled in the area of the defect, one end of which stores power from the donor.

 Closure of large tissue defects of face with a thick flap of skin with nurturing vessels

Place of skin graft harvesting on the entire thickness of the axial vessels.

Філатовське стебло