Local Soft Tissue Rearrangement: The Random V–Y Flap, Rhomboid Flap, Random Rotational Flap, and Z-Plasty

2021 ◽  
pp. 51-60
Author(s):  
Efstathios Karamanos ◽  
Bao-Quynh Julian ◽  
Douglas T. Cromack
Keyword(s):  
Soft Tissue ◽  
Rotational Flap ◽  
Rhomboid Flap

scholarly journals The Use of Bi-lobed Rotational Flap to Cover Large Body Defects: Two Clinical Cases

2019 ◽  
Vol 18 (4) ◽  
pp. 259-266
Author(s):  
Saulius Špokevičius
Keyword(s):  
Soft Tissue ◽  
Recent Literature ◽  
Large Body ◽  
Dorsal Side ◽  
Soft Tissue Defects ◽  
Soft Tissue Lesions ◽  
Rotational Flap ◽  
Large Skin ◽  
Tissue Defects ◽  
Clinical Cases

The bi-lobed skin rotational flaps are commonly used mainly to cover facial tissue defects on the nasal tip and dorsal side, also on head areas, where skin and surrounding tissues are tight. Recent literature shows that the bi-lobed flap is used to cover defects in other body areas as well.This report shows two clinical cases where the bi-lobed flap was used to cover large skin and soft tissue defects after the excision of pathologically damaged skin and soft tissue lesions of the popliteal and the chest area. In both cases the recipient areas were adequately covered, and donor sites were closed primarily.

scholarly journals Brachioradialis Flap With Vascularized Lateral Ulnar Collateral Ligament Reconstruction: A Case Report

Hand ◽  
2019 ◽  
Vol 15 (2) ◽  
pp. NP37-NP41
Author(s):  
Nicholas A. Trasolini ◽  
Jerry Chidester ◽  
Alidad Ghiassi ◽  
Milan Stevanovic
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Ulnar Collateral Ligament ◽  
Soft Tissue Defect ◽  
Soft Tissue Defects ◽  
Collateral Ligament ◽  
Lateral Ulnar Collateral Ligament ◽  
Lateral Elbow ◽  
Rotational Flap ◽  
Tissue Defects

Background: Soft tissue defects about the elbow with concurrent ligamentous instability can be challenging to treat. Methods: We present a case report of a lateral elbow wound that resulted in lateral ulnar collateral ligament deficiency and posterolateral elbow instability. Results: We describe our technique of a modified brachioradialis rotational flap, in which the muscle is rotated to cover the soft tissue defect, while the vascularized brachioradialis tendon is used to simultaneously reconstruct the lateral ulnar collateral ligament. This procedure successfully restored posterolateral elbow stability at the time of wound coverage. Conclusion: Elbow soft tissue defects with associated ligamentous injuries can be treated using a modification of the brachioradialis rotational flap.

Hurricane Harvey Aftermath

2020 ◽  
Vol 110 (2) ◽  
Author(s):  
Rosemary Buckle ◽  
Anum Dhukani ◽  
Rayven L. Bridges ◽  
Barton C. Garcia
Keyword(s):  
Soft Tissue ◽  
Tissue Expansion ◽  
Multidrug Resistant ◽  
Antimicrobial Treatment ◽  
Soft Tissue Envelope ◽  
Left Ankle ◽  
Thickness Skin ◽  
Rotational Flap ◽  
Potential Risks ◽  
Water Borne

Natural disasters, such as hurricanes and severe flooding, pose a threat of increased skin and soft-tissue infections, especially in the event of open fractures and wading through the waters. The purpose of this case study is to present a complex patient sustaining trauma resulting in an open bimalleolar fracture, multiple wounds, and exposure to a variety of water-borne pathogens during Hurricane Harvey in Houston, Texas, in 2017. He underwent multiple incision and drainage procedures, tissue cultures, and placement of antibiotic beads, with an application of external fixation to the left ankle. Several unique multidrug-resistant water-borne pathogens were identified, including Aeromonas hydrophila, Pseudomonas fluorescens/putida, and Serratia marcescens. Once the soft-tissue envelope was restored and infection cleared, a full-thickness rotational flap with tissue expansion was performed. Ultimate reconstruction was delayed several weeks and final left ankle open reduction and internal fixation was performed following antimicrobial treatment with split-thickness skin autograft and wound vacuum-assisted closure application. The patient was discharged after 28 days with no further complications. In instances such as these, all caretakers coming into contact with the patient should be aware of the potential risks of the possible infectious diseases and management to optimize the recovery following hydrologic disasters.

scholarly journals Drain or no drain in Rhomboid excision and Limberg rotational flap for pilonidal sinus

2021 ◽  
Vol 10 (2) ◽  
pp. 80-83
Author(s):  
Arbin Joshi ◽  
Bigyan Acharya
Keyword(s):  
Wound Infection ◽  
Pilonidal Sinus ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Wound Complications ◽  
Complication Rates ◽  
Superficial Wound ◽  
Rotational Flap ◽  
Rhomboid Flap ◽  
Early Wound

Background: Healing in Rhomboid flap for pilonidal sinus is always a problem. Different measures are applied to reduce the rate of wound infection with variable results. Objectives: To determine the effect of routine use of drain on the rate of early wound complications and additional interventions after Rhomboid flap.  Methods: A retrospective chart review of all cases that underwent Rhomboid flap in five years in two tertiary care centres was done. Complication rates such as wound infection, wound disruption, and flap necrosis were evaluated. Results: A total of 38 cases of Rhomboid flap are included for analysis. Out of all cases 37 cases were done for Pilonidal sinus and one case for presacral dermoid cyst. In the first eight cases, flap was made without drain and subsequent 30 cases were done with two suction drains for five days. The rate of superficial wound infection in the group without drain was found to be significantly higher compared with flap with drain 5 (in 8) versus 2 (in 30) (62.5% versus 6.66%, p <0.5).  Conclusion: Drain placement after Rhomboid flap is a good intervention to reduce wound infection.

Surgical Management of Gingival Recession Using Free Gingival Autograft: A Case Report

2019 ◽  
Vol 3 (2) ◽  
pp. 81-83
Author(s):  
Manisha Neupane ◽  
Manoj Humagain ◽  
Mahima Subba ◽  
Simant Lamichhane ◽  
Asmita Dawadi
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Surgical Techniques ◽  
Gingival Recession ◽  
Free Gingival Graft ◽  
Tissue Graft ◽  
Soft Tissue Graft ◽  
Tunnel Technique ◽  
Rotational Flap ◽  
Gingival Graft

Gingival recession leads to dentinal hypersensitivity, aesthetic problems, root caries, cervical abrasion and difficulty in oral hygiene maintenance. Managing gingival recession often is a great challenge for practitioners. Different surgical techniques have been advocated for root coverage like free soft tissue graft procedures free gingival graft and sub-epithelial connective tissue graft, pedicle soft tissue graft rotational flap and flap advancement, pouch and tunnel technique and guided tissue regeneration. This case report displays use of free gingival graft for management of patient of age 22 years with Miller’s Class I recession defect in lower left mandibular central incisor.

Sartorius Muscle Flaps for Vascular Groin Wound Complications

2015 ◽  
Vol 81 (11) ◽  
pp. 1163-1169 ◽  
Author(s):  
Michael B. Brewer ◽  
Christian J. Ochoa ◽  
Karen Woo ◽  
Sarah M. Wartman ◽  
Vahagn Nikolian ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Muscle Flap ◽  
Skin Grafting ◽  
Wound Complication ◽  
Wound Complications ◽  
Sartorius Muscle ◽  
Soft Tissue Coverage ◽  
Vascular Surgeon ◽  
Muscle Flaps ◽  
Rotational Flap

Sartorius myoplasty (SM) has been used as an adjunct for soft tissue coverage in vascular groin wound complications. However, the reliability of SM as a primary muscle flap has been questioned. The purpose of this study is to determine the reliability of SM performed by vascular surgeons in the management of vascular groin wound complications. A retrospective review was performed on all patients who underwent SM from 1997 to 2012. The three indications for SM were prophylactic, infection, and noninfectious wound complication. Failure of SM was defined as operative reintervention for bleeding, persistent wound drainage, or infection. A total of 99 patients underwent 103 SM procedures. The patients were 43 per cent male and 57 per cent female; the mean age was 69 years. The indication for SM was infectious in 62 cases (60%), prophylactic in 21 cases (20%), and noninfectious in the remaining 20 cases. Failure of SM occurred in 11 cases (11%). Of these, salvage bypass and/or salvage muscle flap was required in eight cases (73%). When salvage bypass was required, extra-anatomic obturator bypass was performed in 80 per cent of cases. Salvage wound coverage included rectus abdominus flap (60%), rotational flap (20%), and skin grafting (20%). Seventy-three per cent of failures came from the infectious wound group. The most common reason for SM failure was hemorrhage (45%). In 82 per cent of the cases, the sartorius muscle was still viable at reoperation and was used for continued muscle coverage. SM performed by the vascular surgeon provides reliable soft tissue coverage for vascular groin wound complications and should be used as the primary muscle flap in the majority of patients. In cases of SM failure, the vascular surgeon should consider other more extensive muscle flap options.

scholarly journals Utilization of Modified Rhomboid Flap to Reconstruct Limb Defect after Wide Resection of Large Soft-tissue Sarcoma: Novel Application of an Old Technique

2020 ◽  
Author(s):  
Miaomiao Liang ◽  
Yu Chen
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcomas ◽  
Wide Resection ◽  
Large Sample Size ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Limb Defects ◽  
The Mean ◽  
Rhomboid Flap

Abstract Background: Reconstruction of limb defects following wide resection of large soft-tissue sarcomas (STS) is challenging. Effectiveness of rhomboid flaps in covering these wounds remains to be addressed. Methods: From March 2018 through February 2019, we utilized modified rhomboid flaps to reconstruct limb defects following wide resection of the large STS (≥5 cm in diameter) in 6 patients. There were 3 males and 3 females. The average age was 65 years (47-77 years). Diagnoses included leiomyosarcoma in 3 patients, synovial sarcoma, undifferentiated pleomorphic sarcoma, and myxoid liposarcoma in 1 respectively. The anatomic locations included the anterior knee in 3 cases, upper arm in 2, and thigh in 1. The mean diameter of the tumor measured 10 cm (5-17 cm). The mean defect size was 113 cm2(38-270 cm2). Results: The mean follow-up duration was 10 months (range, 6-12 months), no patients were lost to follow-up. Skin grafts were utilized in 2 cases. The mean time to heal was 7 weeks (range, 3-13 weeks). At final follow-up, there were no recurrence and metastasis. One case had cerebral hemorrhage and 1 had wound dehiscence, whereas no reoperation was performed. The range of motion of the joints adjacent to the flap reconstructions were comparable to preoperative status. The mean Musculoskeletal Tumor Society score was 27 (range, 24-30). Conclusions: The modified rhomboid flap affords great versatility and is easy to design. This technique yields satisfactory effectiveness in reconstructing limb defects after resection of large STS. Long-term studies of large sample size are warranted.

Localization of Gallium-67 in Peritoneal Cells by Electron Microscopic Autoradiography

1973 ◽  
Vol 31 ◽  
pp. 404-405
Author(s):  
D. C. Swartzendruber ◽  
Norma L. Idoyaga-Vargas
Keyword(s):  
Clinical Trials ◽  
Soft Tissue ◽  
Tumor Tissue ◽  
Soft Tissue Tumors ◽  
Clinical Usefulness ◽  
Electron Microscopic ◽  
Normal Cells ◽  
Electron Microscopic Autoradiography ◽  
Peritoneal Cells ◽  
Gallium 67

The radionuclide gallium-67 (67Ga) localizes preferentially but not specifically in many human and experimental soft-tissue tumors. Because of this localization, 67Ga is used in clinical trials to detect humar. cancers by external scintiscanning methods. However, the fact that 67Ga does not localize specifically in tumors requires for its eventual clinical usefulness a fuller understanding of the mechanisms that control its deposition in both malignant and normal cells. We have previously reported that 67Ga localizes in lysosomal-like bodies, notably, although not exclusively, in macrophages of the spocytaneous AKR thymoma. Further studies on the uptake of 67Ga by macrophages are needed to determine whether there are factors related to malignancy that might alter the localization of 67Ga in these cells and thus provide clues to discovering the mechanism of 67Ga localization in tumor tissue.

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