RELEVANCE OF THE TUBE FLAP USE IN THE SURGICAL TREATMENT OF PATIENTS WITH WOUNDS AND CICATRICIAL DEFORMITIES OF SKIN

Aim. The aim of our work was to study characteristics and results of surgical treatment of patients with wounds and cicatricial deformities who underwent tube flaps grafting.

Materials and methods. The analysis of the treatment of 15 patients aged 9 to 58 was made. All patients were treated in the Burn Unit of the Scientific Research Institute – S.V. Ochapovsky Regional Clinical Hospital №1 with thermal, electrical and mechanical injuries and their consequences in 2005-2017 years.

Results. The average frequency of this method use was 1 time per year. Remoteness of the affected area from the site of tube flap preparation determined the number of migrations and the terms of treatment of patients. With the localization of the recipient zone on the upper extremities, migration of one of the supply legs was immediately combined with partial grafting, and the total number of migrations was two. The duration of treatment of patients from the moment of tube flap preparation to the completion of plastics averaged 134±36 days. In those cases when it was required to move a tube flap prepared on the trunk to the head or lower extremities, there were 3-4 migrations, and the treatment time was 312 to 644 days, on average 481±86 days. The total area of the replaced defect was from 40 to 220 cm2. Out of 15 operated patients, complications occurred in 3 (20%) cases when the tube flap was migrating. At the control examinations during the first year after grafting flap tissues were viable, adapted, without trophic disorders. In term from 1 to 6 years after grafting skin was elastic and well taken into the fold. There were insignificant differences in the pigmentation of displaced flaps from the surrounding tissue. Cicatricial deformities associated with the harvesting, transport of the flap and grafting, were not observed.

Conclusion. Tube flap proposed more than one century ago is primarily of historical significance and is rather rare in modern clinical practice, but sometimes it is the optimal method for recovering lost or scarred skin.

1. Филатов В.П. Пластика на круглом стебле. Вестник офтальмологии. 1917; 1(34): 149-158. [Filatov V.P. Plastika na kruglom steble. Vestnik oftalmologii. 1917; 1(34): 149-158. (In Russ.)].

2. Жак Е.М. Новая методика образования стебельчатого лоскута Филатова. Челябинск: ОГИЗ; 1948. 69 с. [Zhak E.M. Novaya metodika obrazovaniya stebelchatogo loskuta Filatova. Chelyabinsk: OGIZ; 1948. 69 p. (In Russ.)].

3. Тычинкина А.К. Кожно-пластические операции. М.: Медицина; 1972. 152 с. [Tychinkina A.K. Kozhno-plasticheskie operatsii. M.: Medicina; 1972. 152 р. (In Russ.)].

4. Казарезов М.В., Королева А.М., Домников А.В. Пластическая хирургия: Практическое руководство. Новосибирск: ЛОНЦ; 2009. 380 с. [Kazarezov M.V., Koroleva A.M., Domnikov A.V. Plasticheskaya hirurgiya: prakticheskoe rukovodstvo. Novosibirsk: LONTs; 2009. 380 р. (In Russ.)].

5. Азолов В.В., Дмитриев Г.И. Хирургическое лечение последствий ожогов. Н.Новгород: ОАО «Дзержинская типография»; 1995. 183 с. [Azolov V.V., Dmitriev G.I. Hirurgicheskoe lechenie posledstvij ozhogov. N.Novgorod: OAO «Dzerzhinskaya tipografiya»; 1995. 183 p. (In Russ.)].

6. Fan J. Tissue expansion of tube flap during the last transferring stage in reconstructions of the face and neck. Scand J Plast Reconstr Hand Surg. 1998; 32: 229-232.

7. Кошельков Я.Я. Пластика филатовским лоскутом обширных послеожоговых дефектов тканей лица. Вестник Российской военно-медицинской академии. Приложение. 2010; 1(29): 61-62. [Koshelkov Ya.Ya. Plastika filatovskim loskutom obshirnyh posleozhogovyh defektov tkanej litsa. Vestnik Rossiyskoj voenno-meditsinskoj akademii. Prilozhenie. 2010; 1(29): 61-62. (In Russ.)].

8. Fan J., Liu L., Gan C. Nasal Reconstruction. In: Hyakusoku H et al., editors. Color Atlas of Burn Reconstructive Surgery. Springer-Verlag Berlin Heidelberg; 2010. 260-269. DOI: 10.1007/978-3642-05070-1.

9. Antohi N., Stan V. Unusual coverage of postburn sequela of the scalp using a combined free forearm and tubed abdominal flap. Burns. 2012; 38 (4): e13-e16. DOI: http://dx.doi.org/10.1016/j. burns.2011.11.008.