Autogenous soft tissue grafting for periodontal and peri‐implant plastic surgical reconstruction

Modern sarcoma treatment has created new challenges for plastic surgeons. This study was designed to review the recent experience and practice patterns following complex sarcoma resection at a large sarcoma center. All cases from October 2013 to October 2014 involving rare nonepithelial tumors, a multidisciplinary surgical team, radiation and/or chemotherapy treatments, and plastic surgical reconstruction were included in the analysis. In addition to evaluating clinical outcomes, cases were reviewed to identify factors associated with excellent or poor patient care. Review of these cases formed the basis of the greatest healing opportunity for soft tissue (GHOST) protocol. Our patient population included seven males (64%) and four females (36%). All except one patient was exposed to radiotherapy, chemotherapy, or some combination. Diverse procedures were used for reconstruction. Early complications occurred in two patients (18%), and late complications in four patients (36%). Sarcoma resection was found to be highly morbid in our series. Patients with poor preoperative nutritional status were more likely to experience complications postoperatively. The decision to stage a reconstruction was complex and influenced by several factors. Multimodal sarcoma treatments may involve highly morbid procedures and create complex wounds. The GHOST protocol is a useful reference for plastic surgeons.

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Tumours and hand reconstruction

10.1093/med/9780199550647.003.006012 ◽

2011 ◽

Author(s):

D. Glynn Bolitho

Keyword(s):

Soft Tissue ◽

Bone Grafting ◽

Giant Cell Tumour ◽

Tendon Sheath ◽

Surgical Reconstruction ◽

Radical Excision ◽

Marginal Excision ◽

Partial Amputation ◽

Plastic Surgical Reconstruction ◽

Work Up

♦ Hand tumours are common♦ The vast majority are benign♦ Soft tissue – commonest Giant cell tumour of tendon sheath. Treatment marginal excision♦ Bone – commonest – Enchondroma. Treatment – leave if incidental or currette +/− bone grafting♦ Malignant – need full work up with detailed clinical examination, investigation, and planning in a multidisciplinary meeting♦ Treatment is wide/radical excision often with partial amputation +/− plastic surgical reconstruction.

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Achilles Tenorrhaphy in Five Dogs: A Modified Surgical Technique and Evaluation of a Cranial Half Cast

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1632549 ◽

1998 ◽

Vol 11 (04) ◽

pp. 205-210 ◽

Cited By ~ 13

Author(s):

H. Burbidge ◽

E. Firth ◽

S. Fox ◽

S. Guerin

Keyword(s):

Soft Tissue ◽

Surgical Technique ◽

Surgical Procedure ◽

Normal Function ◽

Surgical Reconstruction ◽

Bone Apposition ◽

Cast Material ◽

Bilateral Lesions ◽

Bone Tunnels

SummaryAchilles mechanism rupture in four of five dogs was treated with tenorrhaphy using a modified surgical technique designed to optimise accurate apposition of tendon to bone. Two bone tunnels were drilled in the calcaneal tuber from a plantomedial - dorsolateral, and plantolateral – dorsomedial direction respectively. The distal ends of the tendons were sutured to the calcaneal tuber using a Krachow suture pattern. The remaining dog had a mid-tendon Achilles mechanism rupture. A resinous half cast was placed on the cranial aspect of the tarsocrural joint of all five dogs, for a minimum of six weeks, in order to provide limited post operative support. Du e to insufficient cast material two of the support splints failed and one of these cases also required a second surgical procedure. A varying amount of soft tissue irritation was noted in each case. All of the five Achilles mechanisms healed, and all of the dogs returned to normal function.Five dogs with surgical reconstruction of the Achilles mechanism were stabilised postoperatively with a resinous half cast placed on the cranial aspect of the tarsocrural joint for a minimum of six weeks. Two of these casts failed at the tarsocrural joint when six folds of casting material were used; all subsequent cases had eight folds applied. Variable soft tissue irration was observed under the cast in each case. A modified surgical technique using a Krachow suture pattern allowed good tendon-bone apposition. All five Achilles mechanisms healed, and all dogs returned to normal function. Bilateral lesions were identified in 3 of the 4 dogs examined.

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A META-ANALYSIS OF THE SOFT TISSUE DEFECTS CLASSIFICATION AND JUSTIFICATION OF THE OPTIMAL SURGICAL RECONSTRUCTION METHOD

Ukrainian Scientific Medical Youth Journal ◽

10.32345/usmyj.1(121).2021.112-123 ◽

2021 ◽

Vol 121 (1) ◽

pp. 112-123

Author(s):

Sergiy Tertyshnyi ◽

Igor Khomenko ◽

Кostyantyn Gumenyuk ◽

Sergiy Korol ◽

Yevgen Tsema ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissues ◽

Meta Analysis ◽

Surgical Reconstruction ◽

Reconstruction Method ◽

Soft Tissue Defects ◽

Military Conflict ◽

Preoperative Training ◽

Defects Classification ◽

Tissue Defects

During the military conflict in the East of Ukraine, considerable experience in providing medical assistance to wounded and injured with soft tissue defects has been accumulated. Taking into account the considerable diversity of defects of soft tissues on numerous a number of signs, which involves the application in the process of treatment of fundamentally different algorithms of preoperative training, planning of reconstructive intervention and method of surgical reconstruction there was a need to systematize the accumulated knowledge by developing the integral classification of soft tissue defects.

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Sarcomas in the groin and inguinal canal – often missed and difficult to manage

Annals of The Royal College of Surgeons of England ◽

10.1308/003588410x12628812460056 ◽

2010 ◽

Vol 92 (4) ◽

pp. 326-329 ◽

Cited By ~ 11

Author(s):

T Collin ◽

AV Blackburn ◽

RH Milner ◽

C Gerrand ◽

M Ragbir

Keyword(s):

Soft Tissue ◽

Clinical Excellence ◽

Distant Metastases ◽

Outcome Data ◽

Surgical Reconstruction ◽

Soft Tissue Tumour ◽

Retrospective Case ◽

The North ◽

Tissue Tumour ◽

Unplanned Excision

INTRODUCTION This is a 7-year retrospective review summarising the North of England Bone and Soft Tissue Tumour Service's experience of managing 13 cases of groin sarcoma requiring soft tissue flap reconstruction. This study was performed to try to identify where national referral guidelines in sarcoma management had been followed and reasons for any delays. The study also includes outcome data relating to these patients. PATIENTS AND METHODS A retrospective, case-note review was undertaken using the local sarcoma database to identify approriate patients. RESULTS In nine patients, national referral guidelines were not followed. This resulted in a mean delay of presentation to the multidisciplinary team of 4.4 months. Ten patients had unplanned excision or exploration of tumours before referral. There were no lower limb amputations. All patients with narrow margins or high grade tumours were referred for radiotherapy. Four patients died; three as a result of distant metastases and one as a result of local recurrence. CONCLUSIONS Despite delays in referral, treatment by wide excision and plastic surgical reconstruction allowed for local control of these tumours with functional limb salvage. Implementation of National Institute for Health and Clinical Excellence (NICE) guidelines and local strategies could improve the expedient management of these patients.

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Surgical Reconstruction Of Wide-Spread Soft-Tissue Defects Due To Complex Maxillofacial Trauma

International Journal of Dentistry and Oral Science ◽

10.19070/2377-8075-21000529 ◽

2021 ◽

pp. 2706-2709

Author(s):

Nguyen Hong Loi ◽

Keyword(s):

Soft Tissue ◽

Maxillofacial Trauma ◽

Surgical Reconstruction ◽

Soft Tissue Defects ◽

Wide Spread ◽

Tissue Defects

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Prosthetic Reconstruction of the Maxilla and Palate

Seminars in Plastic Surgery ◽

10.1055/s-0040-1709143 ◽

2020 ◽

Vol 34 (02) ◽

pp. 114-119 ◽

Cited By ~ 1

Author(s):

Christopher Pool ◽

Tom Shokri ◽

Aurora Vincent ◽

Weitao Wang ◽

Sameep Kadakia ◽

...

Keyword(s):

High Risk ◽

Soft Tissue ◽

Hard Palate ◽

Free Flaps ◽

Surgical Reconstruction ◽

Direct Visualization ◽

Postoperative Radiation ◽

Prosthetic Devices ◽

Prosthetic Reconstruction ◽

Maxillary Defects

AbstractMaxillary defects commonly present following surgical resection of oncologic processes. The use of rotational and free flaps has largely replaced the use of prosthetic options for hard palate and maxillary reconstruction, but prostheses remain a useful tool. Prosthetic devices may be invaluable in patients considered poor candidates for surgical reconstruction secondary to poor vascularity, need for postoperative radiation, or medical comorbidities that place them at high risk for healing following reconstruction. Obturators may also be considered over soft tissue options if oncologic surveillance via direct visualization of the surgical site is warranted.

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Negative pressure wound therapy: an adjuvant to surgical reconstruction of large or difficult skin and soft tissue defects

International Wound Journal ◽

10.1111/j.1742-481x.2011.00813.x ◽

2011 ◽

Vol 8 (4) ◽

pp. 406-411 ◽

Cited By ~ 12

Author(s):

Dong Lark Lee ◽

An Young Ryu ◽

Seung Chul Rhee

Keyword(s):

Soft Tissue ◽

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Surgical Reconstruction ◽

Soft Tissue Defects ◽

Wound Therapy ◽

Tissue Defects

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Abductor Hallucis Muscle Flap and Staged Medial Column Arthrodesis for the Chronic Ulcerated Charcot Foot With Concomitant Osteomyelitis

Foot & Ankle Specialist ◽

10.1177/1938640010382038 ◽

2010 ◽

Vol 3 (5) ◽

pp. 269-273 ◽

Cited By ~ 4

Author(s):

Claire M. Capobianco ◽

Thomas Zgonis

Keyword(s):

Soft Tissue ◽

Wound Closure ◽

Wound Care ◽

Weight Bearing ◽

Deformity Correction ◽

Muscle Flap ◽

Surgical Reconstruction ◽

Soft Tissue Coverage ◽

Soft Tissue Reconstruction ◽

Abductor Hallucis

Midfoot ulceration is a common sequela of the diabetic Charcot rocker-bottom deformity. Because redundant soft tissue from a non— weight-bearing area is often scarce in this area of the foot, soft-tissue coverage may be challenging. Wound closure may be difficult to achieve with local wound care and off-loading techniques if the predisposing deformity that caused the ulceration is not addressed. In the same setting, surgical reconstruction is often feared when open wounds are present, given the potential for infection. Approaching these wounds with a rational stepwise and staged approach is prudent to eradicate the underlying infection and also to achieve durable wound closure and long-term deformity correction. The authors present the use of a local muscle flap and circular external fixation for closure of a recalcitrant Charcot plantar-medial midfoot ulceration and also discuss different adjunctive modalities to facilitate soft-tissue reconstruction in the diabetic foot.

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