Based on skin elasticity and mobility, V-Y advancement flaps are designed to repair wounds. Traditional V-Y flaps have been limited due to short advancing distance. With the development of perforator flaps and the application of microsurgical techniques, V-Y advancement flaps are gradually transiting from traditional random flaps to axial flaps containing well-known vessels or perforator arteries. The advancing distance of V-Y advancement flaps is significantly increased, and the design forms are gradually flexible and diversified. V-Y advancement flaps are widely used in clinical practice and can be used to repair wounds in almost all parts of the body. This article reviews the clinical application progress of V-Y advancement flaps to further promote its clinical application.
ObjectiveTo investigate effectiveness of advanced skin flap and V-shaped ventral incision along the root of penile shaft for concealed penis in children. MethodsBetween July 2007 and January 2015, 121 boys with concealed penis were treated with advanced skin flap and V-shaped ventral incision along the root of penile shaft. The age varied from 18 months to 13 years (mean, 7.2 years). Repair was based on a vertical incision in median raphe, complete degloving of penis and tacking its base to the dermis of the skin. Advanced skin flap and a V-shaped ventral incision along the root of penile shaft were used to cover the penile shaft. ResultsThe operation time ranged from 60 to 100 minutes (mean, 75 minutes). Disruption of wound occurred in 1 case, and was cured after dressing change; and primary healing of incision was obtained in the others. The follow-up period ranged from 3 months to 7 years (median, 24 months). All patients achieved good to excellent cosmetic results with a low incidence of complications. The results were satisfactory in exposure of penis and prepuce appearance. No obvious scar was observed. The penis had similar appearance to that after prepuce circumcision. ConclusionA combination of advanced skin flap and V-shaped ventral incision along the root of penile shaft is a simple, safe, and effective procedure for concealed penis with a similar appearance result to the prepuce circumcision.
The traditional Kutler and Atasoy V-Y advancement flaps have minimal advancement degree, did not satisfy to repair large skin defect in fingers, hence, have no wide indications. The sensory function of the fingers to be influenced because of injury of sensory nerves and sear formation. Since 1985 to 1991, the V-Y advancement flaps pedicled by bilateral digital arteries and nerves have been used for reconstruction of 33 finger tip defect and 5 digital volar skin contraction. All of these cases obtained satisfactory function and excellent appearance.In this paper, the anatomical charactistics and principles of devicerecommended, the advantages and key points to success discussed.
Ten cases of oblique skin defects of fin-gertips repaired by combined skin flaps werereported. The maximal length of flap ad-vancement was 2. 5cm. which could coveran area of 2.0x2. 7cm. The patients neednot to be hospitalized, Fair skin sensationand good blood supply could be obtained,and the finger could preserve maximallength. Follow- up in 8 cases showed thatthe pulps of fingers were plump with nearlynormal joint movement and two- point dis-criminatiom of 3-6mm.
Objective To evaluate the effectiveness of neurovascular staghorn flap for repairing defects in fingertips. Methods Between August 2019 and October 2021, a total of 15 fingertips defects were repaired with neurovascular staghorn flap. There were 8 males and 7 females with an average age of 44 years (range, 28-65 years). The causes of injury included 8 cases of machine crush injury, 4 cases of heavy object crush injury, and 3 cases of cutting injury. There were 1 case of thumb, 5 cases of index finger, 6 cases of middle finger, 2 cases of ring finger, and 1 case of little finger. There were 12 cases in emergency, and 3 cases with finger tip necrosis after trauma suture. Bone and tendon exposed in all cases. The range of fingertip defect was 1.2 cm×0.8 cm to 1.8 cm×1.5 cm, and the range of skin flap was 2.0 cm×1.5 cm to 2.5 cm×2.0 cm. The donor site was sutured directly. Results All flaps survived without infection or necrosis, and the incisions healed by first intention. All patients were followed up 6-12 months, with an average of 10 months. At last follow-up, the appearance of the flap was satisfactory, the wear resistance was good, the color was similar to the skin of the finger pulp, and there was no swelling; the two-point discrimination of the flap was 3-5 mm. One patient had linear scar contracture on the palmar side with slight limitation of flexion and extension, which had little effect on the function; the other patients had no obvious scar contracture, good flexion and extension of the fingers, and no dysfunction. The finger function was evaluated according to the total range of motion (TAM) system of the Hand Surgery Society of Chinese Medical Association, and excellent results were obtained in 13 cases and good results in 2 cases. Conclusion The neurovascular staghorn flap is a simple and reliable method to repair fingertip defect. The flap has a good fit with the wound without wasting skin. The appearance and function of the finger are satisfactory after operation.
Objective To explore the clinical application effects of cervical advancement flaps in repairing mandibular scars. Methods A retrospective analysis was performed on the clinical data of patients with mandibular scars admitted to the Department of Plastic and Burn Surgery of West China Hospital of Sichuan University between January 2018 and July 2020. The lateral X-ray images of the patients were analyzed before and 2 weeks after surgery, and the differences in the mento-cervical angles and the cervico-mental angles before and after surgery were compared. Results A total of 21 patients were included, including 7 males and 14 females. At admission, all patients had a mandibular scar area of (3-7) cm × (3-6) cm, and underwent primary repair with cervical advancement flaps. All patients had good postoperative skin flaps survival, primary wound healing, and obvious mento-cervical angle and cervico-mental angle. The preoperative mento-cervical angle was (110.24±9.47)°, and at 2 weeks post surgery, the mento-cervical angle was (98.39±4.95)°, with a statistically significant difference (P<0.05). The preoperative cervico-mental angle was (134.15±6.00)°, and at 2 weeks post surgery, the cervico-mental angle was (126.44±3.60)°, with a statistically significant difference (P<0.05). Conclusion The neck advancement flap is an effective surgical method for treating simple mandibular scar, which is simple and can improve the appearance of the jaw and neck.