scholarly journals The Homodigital Subcutaneous Flap for Soft Tissue Coverage of the Dorsum of the Finger: A Case Series

Hand ◽  
2010 ◽  
Vol 5 (4) ◽  
pp. 458-460
Author(s):  
Phoebe Hold ◽  
Hamid Tehrani ◽  
Lore Feldberg
Keyword(s):  
Soft Tissue ◽  
Case Series ◽  
Soft Tissue Coverage ◽  
Subcutaneous Flap

Threatened ventriculostomy shunt exposure: augmenting native soft tissue coverage with acellular dermal matrix graft

2012 ◽  
Vol 10 (4) ◽  
pp. 324-326
Author(s):  
Thomas Ridder ◽  
Shuhao Zhang ◽  
Gary Tye ◽  
Jennifer L. Rhodes
Keyword(s):  
Soft Tissue ◽  
Pediatric Population ◽  
Case Series ◽  
Acellular Dermal Matrix ◽  
Soft Tissue Augmentation ◽  
Shunt Revision ◽  
Soft Tissue Coverage ◽  
Dermal Matrix ◽  
History Of ◽  
Acellular Dermal

Avoiding threatened ventriculostomy shunt exposure in the pediatric population remains a difficult problem for the neurosurgeon and reconstructive surgeon. In this case series, the authors present a novel method of augmenting scalp soft tissue with acellular dermal matrix (ADM) in patients with a history of ventricular shunt revisions. Soft tissue augmentation with ADM successfully prevented shunt exposure in 3 patients with a history of shunt revision due to impending exposure following conventional techniques.

scholarly journals Poly-4-Hydroxybutyrate (P4HB) Scaffold Internal Support: Preliminary Experience with Direct Implant Opposition During Complex Breast Revisions

2018 ◽  
Vol 39 (11) ◽  
pp. 1203-1213 ◽  
Author(s):  
Narayanan M Nair ◽  
Daniel C Mills
Keyword(s):  
Soft Tissue ◽  
Capsular Contracture ◽  
Case Series ◽  
Soft Tissue Coverage ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Internal Support ◽  
Invaluable Tool ◽  
Preliminary Study ◽  
Exhaustive Study

Abstract Background The GalaFLEX scaffold is a mesh composed of resorbable poly-4-hydroxybutyrate (P4HB) monofilament fibers that aids in providing immediate internal soft tissue support, similar to that offered by an underwire bra, after breast reduction, lift, or augmentation. Objectives Our goal was to explore the possibility of using GalaFLEX as an internal support to prevent future sagging, predominantly in the lower pole of the breast. This preliminary study investigated GalaFLEX as a direct alternative to implants in a variety of complex revisional breast cases. Our intention was to establish a safety and efficacy profile in an effort to promote further investigation. Methods A retrospective case series of 5 patients over 2 years were evaluated. Inclusion criteria were capsular contracture with concerns over soft tissue coverage and future ptosis, along with complicated muscle coverage deficits secondary to plane switching. Results A retrospective review of photographs taken at the most recent follow-up consistently showed retention of implant position and soft implants. Additionally, patients presented with a mean ± SD Baker Grade Contraction score of 2.8 ± 0.9189 preoperatively compared with a score of 1 ± 0 postoperatively. Conclusions This preliminary study shows the initial safety of GalaFLEX but indicates the need for a multicenter, exhaustive study. Its versatility for complex revisional cases combined with acceptable aesthetic outcomes makes GalaFLEX an invaluable tool for plastic surgeons to consider. Level of Evidence: 4

scholarly journals Contemporary reconstruction after complex facial trauma

2020 ◽  
Vol 8 ◽  
Author(s):  
Matthew R Zeiderman ◽  
Lee L Q Pu
Keyword(s):  
Soft Tissue ◽  
Case Series ◽  
Free Tissue Transfer ◽  
Facial Trauma ◽  
Soft Tissue Coverage ◽  
Soft Tissue Reconstruction ◽  
Reconstruction Process ◽  
Optimal Outcomes ◽  
Reconstructive Process ◽  
Tissue Reconstruction

Abstract Complex facial trauma requires complex repair and solutions. This process is challenging for the surgeon who seeks to manage the expectations of the patient and family while achieving the best possible result. Historically, the use of pedicled flaps, and then free tissue transfer, were the primary techniques utilized. Advancements in soft-tissue reconstruction, such as perforator flaps and pre-expanded and prefabricated flaps, allow refinement of the soft-tissue reconstruction process to create the best initial soft-tissue coverage. The advent of contemporary technologies, such as virtual surgical planning, stereolithography and customized implants and plates, facilitates a tailored approach to the patient’s reconstructive needs for precise bony reconstruction. When surgical and technological techniques are combined in complementary multistage reconstructions, better reconstructive and aesthetic outcomes are achievable than ever before. In this review, the authors present a summary of the management of complex facial trauma based on the senior author’s broad experience. Initial management and contemporary reconstructive techniques and technology to provide optimal outcomes are reviewed. A case series of complex facial traumas and their reconstructive process is also presented to demonstrate how complementary staged procedures can yield an optimal result. We believe the reconstructive surgeon managing complex facial trauma should strive to incorporate contemporary technologies and techniques into their armamentarium to provide the best patient care.

scholarly journals Maximizing Outcomes While Minimizing Morbidity: An Illustrated Case Review of Elbow Soft Tissue Reconstruction

2016 ◽  
Vol 2016 ◽  
pp. 1-8
Author(s):  
Adrian Ooi ◽  
Jonathan Ng ◽  
Christopher Chui ◽  
Terence Goh ◽  
Bien Keem Tan
Keyword(s):  
Soft Tissue ◽  
Case Series ◽  
Free Tissue Transfer ◽  
Soft Tissue Coverage ◽  
Soft Tissue Reconstruction ◽  
Flap Reconstruction ◽  
Case Review ◽  
Tissue Transfer ◽  
Tissue Reconstruction ◽  
Elbow Reconstruction

Background. Injuries to the elbow have led to consequences varying from significant limitation in function to loss of the entire upper limb. Soft tissue reconstruction with durable and pliable coverage balanced with the ability to mobilize the joint early to optimize rehabilitation outcomes is paramount. Methods. Methods of flap reconstruction have evolved from local and pedicled flaps to perforator-based flaps and free tissue transfer. Here we performed a review of 20 patients who have undergone flap reconstruction of the elbow at our institution. Discussion. 20 consecutive patients were identified and included in this study. Flap types include local (n=5), regional pedicled (n=7), and free (n=8) flaps. The average size of defect was 138 cm2 (range 36–420 cm2). There were no flap failures in our series, and, at follow-up, the average range of movement of elbow flexion was 100°. Results. While the pedicled latissimus dorsi flap is the workhorse for elbow soft tissue coverage, advancements in microvascular knowledge and surgery have brought about great benefit, with the use of perforator flaps and free tissue transfer for wound coverage. Conclusion. We present here our case series on elbow reconstruction and an abbreviated algorithm on flap choice, highlighting our decision making process in the selection of safe flap choice for soft tissue elbow reconstruction.

scholarly journals Nasal alar rim redraping method to prevent alar retraction in rhinoplasty for Asian men: A retrospective case series

2021 ◽  
Vol 48 (1) ◽  
pp. 3-9
Author(s):  
Jun Ho Choi ◽  
Hyokyung Yoo ◽  
Byung Jun Kim
Keyword(s):  
Soft Tissue ◽  
Case Series ◽  
Soft Tissue Coverage ◽  
Retrospective Case ◽  
Posterior View ◽  
Primary Rhinoplasty ◽  
Alar Retraction ◽  
Asian Men ◽  
Alar Rim ◽  
Anterior Posterior

Background For an attractive and natural tip contour in Asian rhinoplasty, insertion of a nasal implant and reinforcement of the cartilaginous framework are essential. However, scar contracture, which often results from augmentation with implant insertion and inadequate soft tissue coverage of the framework, is one of the most common causes of alar retraction. This study reports a novel method of redraping soft tissue along the alar rim to prevent alar retraction in Asians.Methods Twenty young Asian men who underwent primary rhinoplasty with septoplasty were retrospectively reviewed. After the usual rhinoplasty procedures, alar rim redraping was conducted for the soft tissue along the transcolumellar and bilateral infracartilaginous incisions. The longest axis of the nostril (a) and the height of the nostril from that axis (b) were measured in anterior-posterior and lateral views. The preoperative and postoperative ratios (b/a) were analyzed using the paired t-test.Results All 20 patients showed natural contours of the nasal tip, nostrils, and alae after a mean follow-up of 53.6 weeks (range, 52–60 weeks). The ratio of the nostril axes significantly decreased postoperatively in all patients except one, by an average of 11.08%±6.52% in the anterior-posterior view and 17.74%±8.49% in the lateral view (P<0.01). There were no complications, including asymmetry, contracture, subdermal plexus injury, flap congestion, or infection.Conclusions A quantitative analysis of alar retraction by evaluating the ratio of nostril axes showed that alar rim redraping is a simple and effective adjuvant technique for preventing alar retraction in rhinoplasty for young Asian men.

Closure of meningomyelocele defects using acellular dermal matrix

2012 ◽  
Vol 9 (2) ◽  
pp. 156-160 ◽  
Author(s):  
Sean M. Hill ◽  
Eric T. Elwood ◽  
Julian Lin
Keyword(s):  
Soft Tissue ◽  
Subcutaneous Tissue ◽  
Subcutaneous Fat ◽  
Case Series ◽  
Wound Dehiscence ◽  
Acellular Dermal Matrix ◽  
Soft Tissue Coverage ◽  
Dermal Matrix ◽  
Muscle Fascia ◽  
Acellular Dermal

Spina bifida is the most common birth defect of the CNS, with meningomyelocele observed in 1 in 800 to 1000 infants. A single reliable method of providing adequate soft-tissue coverage (skin, but also including subcutaneous fat, fascia, and muscle) of the meningomyelocele defect while preventing dehiscence and infection has yet to be defined. This study reviews a case series of 3 patients with large meningomyeloceles treated by a single neurosurgeon /plastic surgeon team at a single institution. Following repair of the neural elements (both dura and neural placode), soft-tissue coverage (skin, but also subcutaneous tissue and fascia) was achieved using acellular dermal matrix over the neural elements, repaired with sutures, and covered with skin flaps. In this series of 3 patients, stable coverage was achieved in all patients. One patient experienced minor wound dehiscence treated with debridement and primary closure with simple relaxing incisions. This series demonstrates that the usage of acellular dermal matrix provides a stable soft-tissue coverage for large meningomyelocele defects in an easily reproducible operation preserving local soft tissue (muscle, fascia) for potential salvage operations or revisions (such as for scoliosis) as well as providing a less demanding operation on the fragile physiology of the neonate.

Imaging Features of Primary Tumors of the Hand

2020 ◽  
Vol 16 ◽  
Author(s):  
Filippo Boriani ◽  
Edoardo Raposio ◽  
Costantino Errani
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Epithelioid Sarcoma ◽  
Case Series ◽  
Malignant Neoplasm ◽  
Benign Tumors ◽  
Imaging Features ◽  
Primary Tumors ◽  
Therapeutic Decisions ◽  
Tumors Of The Hand

: Musculoskeletal tumors of the hand are a rare entity and are divided into skeletal and soft tissue tumors. Either category comprises benign and malignant or even intermediate tumors. Basic radiology allows an optimal resolution of bone and related soft tissue areas, ultrasound and more sophisticated radiologic tools such as scintigraphy, CT and MRI allow a more accurate evaluation of tumor extent. Enchondroma is the most common benign tumor affecting bone, whereas chondrosarcoma is the most commonly represented malignant neoplasm localized to hand bones. In the soft tissues ganglions are the most common benign tumors and epithelioid sarcoma is the most frequently represented malignant tumor targeting hand soft tissues. The knowledge regarding diagnostic and therapeutic management of these tumors is often deriving from small case series, retrospective studies or even case reports. Evidences from prospective studies or controlled trials are limited and for this lack of clear and supported evidences data from the medical literature on the topic are controversial, in terms of demographics, clinical presentation, diagnosis prognosis and therapy.The correct recognition of the specific subtype and extension of the tumor through first line and second line radiology is essential for the surgeon, in order to effectively direct the therapeutic decisions.

Versatility of the Posterior Interosseous Artery Flap: Emphasis on Powering Up the Toe Transfer

Hand ◽  
2021 ◽  
pp. 155894472110289
Author(s):  
GiJun Lee ◽  
BumSik Kim ◽  
Neunghan Jeon ◽  
JungSoo Yoon ◽  
Ki Yong Hong ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Upper Extremity ◽  
Reverse Flow ◽  
Donor Site ◽  
Congenital Defects ◽  
Soft Tissue Coverage ◽  
Posterior Interosseous Artery ◽  
Arterial Inflow ◽  
Pedicle Length ◽  
Interosseous Artery

Background: Reverse-flow posterior interosseous artery (rPIA) flap is an excellent tool for restoration of defects in the hand and upper extremity, sparing the main arteries to the hand. Its reliability has been well established. Materials and Methods: Fifty-one cases of rPIA flap involving 49 patients were retrospectively reviewed. The inclusion criteria were age, sex, etiology, size and location of the defect, flap size, number of perforators included, pedicle length, flap inset, donor site coverage, complications, and ancillary procedures. Results: This study included 44 men and 5 women, ranging in age between 10 and 73 years. The subjects had soft tissue defects of the hand and upper extremity mainly due to traumatic injuries, including scar contractures of the first web space in 18 cases, thumb amputations in 6 cases, and congenital defects in 1 case. Among the 51 rPIA flap elevations, 3 cases involved flap failure due to the absence of proper pedicle. A fasciocutaneous pattern was observed in 45 cases and a myocutaneous pattern in 3 cases. In 5 cases of unplantable thumb amputations, the rPIA flap was performed for arterial inflow to the secondary toe-to-thumb transfer. Venous congestion of varying degrees was noted in 7 cases involving partial necrosis in 2 cases. During the mean 17 months of follow-up, patients were generally satisfied with the final outcomes. Conclusion: The rPIA flap can be used not only for soft tissue coverage of the hand and upper extremity but also as a recipient arterial pedicle for a secondary toe-to thumb transfer.

scholarly journals An unusual case of aggressive malignant spread of epithelioid hemangioendothelioma

Rare Tumors ◽  
2021 ◽  
Vol 13 ◽  
pp. 203636132110108
Author(s):  
Ashley D Hickman ◽  
Evandro D Bezerra ◽  
Anja C Roden ◽  
Matthew T Houdek ◽  
Jonathan D Barlow ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Soft Tissue ◽  
Multimodal Treatment ◽  
Unusual Case ◽  
Case Reports ◽  
Case Series ◽  
Epithelioid Hemangioendothelioma ◽  
Vascular Neoplasm ◽  
Pulmonary Imaging ◽  
Low Incidence

Epithelioid hemangioendothelioma (EHE) is a rare vascular neoplasm which typically originates from liver, lung, or bone. Due to the low incidence of disease, the most effective treatment is not easily studied and much of the information known about EHE has been learned through case reports and case series. In this case, we will present an uncommon form of primary soft tissue EHE with local recurrence, bone metastasis, and lymphangitic spread to the lungs leading to respiratory failure. Imaging of the chest was atypical for EHE with intraseptal thickening and hilar lymphadenopathy. Respiratory failure was progressive despite aggressive multimodal treatment. This case highlights an unusually aggressive recurrence and metastasis of primary soft tissue EHE with atypical pulmonary imaging findings.

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