Lecture: Filatov stem. Indications Lecture: Filatov stem. Indications for replacement of defects of tissues for replacement of defects of tissues

and organs of maxillofacial and organs of maxillofacial area Filatov stem. Methods area Filatov stem. Methods

of harvesting stem migration, training of harvesting stem migration, training and closure of the defect.and closure of the defect.

Defects of skin, oral mucosa, nose, Defects of skin, oral mucosa, nose, methods of closing them free flap: methods of closing them free flap:

indications, indications, techniques free skin plastic.techniques free skin plastic.

Types of stem flaps - places of formation the neckTypes of stem flaps - places of formation the neck

Operation of Filatov stem formationOperation of Filatov stem formation

Seam to close the triangular "corner" formed by the Seam to close the triangular "corner" formed by the meeting of two stitches.meeting of two stitches.

Preparation of stem to transferingPreparation of stem to transfering

Trained stem made on the abdomen, ready to transferTrained stem made on the abdomen, ready to transfer..

A patient with a defect of the left cheek and the A patient with a defect of the left cheek and the corner of the mouth after recovering from noma. corner of the mouth after recovering from noma.

Cicatricial contracture of jaws.Cicatricial contracture of jaws.

A patient with a defect of the left cheek and the corner of A patient with a defect of the left cheek and the corner of the mouth recovering from noma. Cicatricial contracture of the mouth recovering from noma. Cicatricial contracture of

jaws.jaws.

A patient with abruption of chin before the operation with A patient with abruption of chin before the operation with modeling prosthesis.modeling prosthesis.

Harvested Filatov stem on the front and lateral sides of the Harvested Filatov stem on the front and lateral sides of the abdominal wall.abdominal wall.

Patient after chin plasticPatient after chin plastic..

Complete fusion of the chin with the chest that occurred Complete fusion of the chin with the chest that occurred after the burn.after the burn.

In a patient was formed keloid scar on the neck after the In a patient was formed keloid scar on the neck after the burn. Formed Filatov stem was moved to neck. After burn. Formed Filatov stem was moved to neck. After

excision of the scar stem was flattened over the wound of excision of the scar stem was flattened over the wound of the recipient.the recipient.

To the girl about face hemangioma in early To the girl about face hemangioma in early childhood was conducted medical course of childhood was conducted medical course of

radiotherapy and formed deforming scar. After its radiotherapy and formed deforming scar. After its excision Filatov stem was flattened over wound of excision Filatov stem was flattened over wound of

the recipient.the recipient.

Satisfactory cosmetic result.Satisfactory cosmetic result.

Removal of total nasal defect Removal of total nasal defect with Filatov stem by the with Filatov stem by the

method of Hitrov.method of Hitrov.

Indications, technique of Indications, technique of execution on stages. execution on stages.

Prevention of complications.Prevention of complications.

Removal of partial and subtotal Removal of partial and subtotal nasal defects with local fabricsnasal defects with local fabrics

Full abruption of nose – organ with multifaceted functions should be regarded not only as a cosmetic defect, as well as abnormal condition that violates the coordinated function of various organs and therefore requires removal.

Rhinoplasty has a very long history. Even in 3000 BC India used a method of reconstruction of nose with forehead flap (Indian method). Later it was developed many different methods of replacement of partial and total nasal defects. V. M. Hitrov in details substantiated nasal reconstruction method using Filatov stem.

AimAim::To teach students methods of rhinoplasty at total nasal defect using Filatov stem, which developed an outstanding Russian scientist V. M. Hitrov.

Preparation for surgery:Preparation for surgery:I - a general principle, which are used at the

removal one or another nasal defect following: nose shape restoration can not be held until

removal of acute and chronic inflammation in the soft tissues, in the skeletal remains of the site, in the paranasal sinuses. Eliminate barriers to

nasal breathing.

II - before proceeding to restoration of nose shape it is necessary to prepare the base for it - that is make normative pear-wide hole, restore

approximately located tissues and organs (upper lip, palate, jaw, etc.)

Method of V.M. Hitrova consists Method of V.M. Hitrova consists of the following steps:of the following steps:

1.Formation of a large stem on the front and lateral sides of the body from dermal

tape size 1O x 24 cm2.

2.transplantation of the distal end of stem on lower part of the wrist or

forearm (after 14-16 days).

3. Transplantation of the second stem end to the edge of the defect on the nose

(after 14-16 days).

4. Single-step formation of all parts of the nose (after 18-21 days).

The final point of The final point of total and subtotal total and subtotal

rhinoplasty is rhinoplasty is implantation into implantation into created nose of created nose of

cartilage or plastic cartilage or plastic base (frame).base (frame).

TerminologyTerminology::Rinoplastica - nose plasticRinoplastica - nose plastic

Subtotal nasal defect - lack of cartilage Subtotal nasal defect - lack of cartilage and soft tissue components of the and soft tissue components of the external noseexternal nose

The total defect of nose - absence of The total defect of nose - absence of external noseexternal nose

Acute Filatov stem - Filatov stem, Acute Filatov stem - Filatov stem, modeled in the area of the defect, one modeled in the area of the defect, one end of which stores power from the end of which stores power from the donor.donor.

Closure of large tissue Closure of large tissue defects of face with a defects of face with a thick flap of skin with thick flap of skin with nurturing vesselsnurturing vessels

Place of skin graft harvesting on the entire thickness of the Place of skin graft harvesting on the entire thickness of the axial vessels.axial vessels.

Place of skin graft harvesting on the entire thickness of the Place of skin graft harvesting on the entire thickness of the axial vessels.axial vessels.

Place of skin graft harvesting on the entire thickness of the Place of skin graft harvesting on the entire thickness of the axial vessels.axial vessels.

Place of skin graft harvesting on the entire thickness of the Place of skin graft harvesting on the entire thickness of the axial vessels.axial vessels.

Place of skin graft harvesting on the entire thickness of the Place of skin graft harvesting on the entire thickness of the axial vessels.axial vessels.

Place of skin graft harvesting on the entire thickness of the Place of skin graft harvesting on the entire thickness of the axial vessels.axial vessels.

ФФілатовське стеблоілатовське стебло