| Research Abstract |
We studied long term follow up study and development of skin and musclocutaneous flap in lower extremities and effects of wound healing using omental flap or muscle flap at 1997 to 1999.
We investigated 122 patients that were followed up over 3 years after reconstruction of bone or soft tissue malignant tumors in extremities. Using skin/musclocutaneous skin flap with bone/artificial joint could avoid a amptation and contributed to the patient's satisfaction, the improvement of quality of life. In some cases with large bone defects, we transfered the heat-treated bone for reduction of operating invasion. In this cases, covering in the muscle flap with rich blood circulation especially was useful. And we brought up a series of protocol for chronic intractable ulcer etc. with spina bifida or diabetes. The protocol was based by long term follow up, not only surgical treatment, but also conservative treatmental and rehabilitation. Now we developed and successed new flap methods for example that vascularized fibula and omental flaps convined intractable non-union.
As for the omental flap, we investigated the effect of lipid fraction in rat omentum, and indicated the omentum lipid fraction made extension of survival area in flaps, vasodilation and vascularization in flaps and surrounding tissue. We aggressively used the omental flap had characteristic plasticity and possibility for bridging of vessel and extended the indication. By the combination of omental flap and other flaps, we obtain satisfactory results for the difficult cases in lower extremes. And, we devised new methods of harvest of omental flap. For decreasing of operation invasion and harvest time, we tried endoscopic harvest, mini-laparotomy with endoscope and endoscopic harvest with hand-port. These were announced in some meeting.
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