Anterior-posterior dissociative slide facilitates the second stage of 3-stage forehead flap nasal reconstruction

Pedicle-lining skin grafts contract between the first and second stage in a 3-stage forehead flap nasal reconstruction. The second stage involves an inherent reduction in vascularity due to the soft tissue thinning performed. The Anterior-Posterior Dissociative Slide restores first-stage pedicle len...

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Bibliographic Details
Published inAnnals of plastic surgery Vol. 74; no. 3; p. 308
Main Authors Weinfeld, Adam Bryce, DeLeon, Ashley Nicole
Format Journal Article
LanguageEnglish
Published United States 01.03.2015
Subjects
Adult
Aged
Female
Forehead - surgery
Humans
Male
Middle Aged
Outcome Assessment (Health Care)
Rhinoplasty - methods
Surgical Flaps
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Summary:Pedicle-lining skin grafts contract between the first and second stage in a 3-stage forehead flap nasal reconstruction. The second stage involves an inherent reduction in vascularity due to the soft tissue thinning performed. The Anterior-Posterior Dissociative Slide restores first-stage pedicle length at the second stage. Incisions are made at the distal seam between the contracted graft and the pedicle tissue. The flap is then slid caudally relative to the fixed graft, thus relengthening the pedicle. This technique has been performed in 16 patients achieving an average length gain of 0.7 (+0.2) cm. The additional length created with the dissociative slide translates into reduced tension with flap reinset, thus increasing flap workability and overall artistry in the second stage.
ISSN:1536-3708
DOI:10.1097/SAP.0b013e3182996e80