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Published byΖηναις Καλλιγάς Modified over 5 years ago
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Intraoperative local flap transforming (iLoFT) method; from hachet to reading-man flap
Motoi Kato, Shinnosuke Kimura, Masayuki Okochi, Kazuki Ueda, Shoji Watanabe, Azusa Watanabe, Tatsuki Kono JPRAS Open Volume 12, Pages (June 2017) DOI: /j.jpra Copyright © 2017 The Author(s) Terms and Conditions
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Figure 1 Preoperative design of a reading man flap on the hip.
JPRAS Open , 66-75DOI: ( /j.jpra ) Copyright © 2017 The Author(s) Terms and Conditions
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Figure 2 Reading man flap at 3 months following surgery. No recurrence or complications occurred. JPRAS Open , 66-75DOI: ( /j.jpra ) Copyright © 2017 The Author(s) Terms and Conditions
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Figure 3 A patient with dermatofibrosarcoma protuberance with a round resection and 4-cm horizontal margin from the skin lesion. A hachet flap was elevated to cover the defect. JPRAS Open , 66-75DOI: ( /j.jpra ) Copyright © 2017 The Author(s) Terms and Conditions
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Figure 4 As tension on the donor site was too strong to close the primary with a hatchet flap, it was transformed to a reading man flap. JPRAS Open , 66-75DOI: ( /j.jpra ) Copyright © 2017 The Author(s) Terms and Conditions
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Figure 5 Six months postoperatively in which the iLoFT method was applied to change a hatchet flap to a reading man flap. JPRAS Open , 66-75DOI: ( /j.jpra ) Copyright © 2017 The Author(s) Terms and Conditions
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Figure 6 Preoperative design to reconstruct a lumbar soft tissue defect followed by resection. JPRAS Open , 66-75DOI: ( /j.jpra ) Copyright © 2017 The Author(s) Terms and Conditions
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Figure 7 Intraoperatively, the donor site was found to be too strong for closure of the primary, so the iLoFT method was considered. JPRAS Open , 66-75DOI: ( /j.jpra ) Copyright © 2017 The Author(s) Terms and Conditions
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Figure 8 Ten months postoperatively without recurrence, complications or scar hypertrophy. JPRAS Open , 66-75DOI: ( /j.jpra ) Copyright © 2017 The Author(s) Terms and Conditions
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Figure 9 Preoperative nevus on the forehead. A hatchet flap was initially planned. JPRAS Open , 66-75DOI: ( /j.jpra ) Copyright © 2017 The Author(s) Terms and Conditions
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Figure 10 A hatchet flap was intraoperatively elevated. As the donor site and the flap tension were not too strong for defect coverage, iLoFT was not applied. JPRAS Open , 66-75DOI: ( /j.jpra ) Copyright © 2017 The Author(s) Terms and Conditions
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Figure 11 Three months postoperatively.
JPRAS Open , 66-75DOI: ( /j.jpra ) Copyright © 2017 The Author(s) Terms and Conditions
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Figure 12 The concept of the iLoFT method transformation from a hatchet flap to a reading man flap. The tension is visualized by the finite element method. The long red line indicates strong tension compared with the shorter green short line that indicates weaker tension. JPRAS Open , 66-75DOI: ( /j.jpra ) Copyright © 2017 The Author(s) Terms and Conditions
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Figure 13 Possible design rotation of a reading man flap because of donor site tension related to preoperative design. Horizontal Green line as Relaxed skin tension lines (RSTL). Vertical Blue line as perpendicular line of the RSTL. (Left: Original Design, Right: Rotated Design) JPRAS Open , 66-75DOI: ( /j.jpra ) Copyright © 2017 The Author(s) Terms and Conditions
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Figure 14 Various possible iLoFT transformations from the hatchet flap. JPRAS Open , 66-75DOI: ( /j.jpra ) Copyright © 2017 The Author(s) Terms and Conditions
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