The use of subcutaneous tissue flaps in the repair of soft tissue defects of the forearm and hand: an experimental and clinical study of a new technique

1984 ◽  
Vol 37 (1) ◽  
pp. 95-102 ◽  
Author(s):  
Felix M. Marty ◽  
Denys Montandon ◽  
Raphael Gumener ◽  
A. Zbrodowski
Keyword(s):  
Clinical Study ◽  
Soft Tissue ◽  
Subcutaneous Tissue ◽  
New Technique ◽  
Soft Tissue Defects ◽  
A New Technique ◽  
Tissue Flaps ◽  
Tissue Defects

scholarly journals Transplantation Treatment of Extensive Soft-Tissue Defects in Lower Extremities with a Combination of Cross-Bridge Flap and Combined Free-Tissue Flap Covered by Vacuum Sealing Drainage: One Case Report

2017 ◽  
Vol 11 (1) ◽  
pp. 704-713
Author(s):  
Xiaohua Pan ◽  
Guangyao Wang ◽  
Tun Hing Lui
Keyword(s):  
Soft Tissue ◽  
Normal Skin ◽  
Soft Tissue Defects ◽  
Vacuum Sealing ◽  
Cross Bridge ◽  
Tissue Flap ◽  
Tissue Flaps ◽  
Free Tissue Flap ◽  
Vacuum Sealing Drainage ◽  
Tissue Defects

This article reported the ultilization of cross-bridge flap transplantation and combined free-tissue flap transplantation to treat a 54-year-old male with Gustilo type III-C injuries. Thorough debridement, external fixation and vacuum sealing drainage were performed in the fist-stage treatment. After the removal of negative pressure on VSD devices, the joined free-tissue flaps and the cross-bridge flap were performed to repair the extensive soft-tissue defects. One month later the pedicle of cross-bridge flap was divided and the external fixator connecting both the lower legs was removed. In 3-month follow-up, the extensive defects was completely covered by a nearly normal skin and radiograph showed tibia and talus healing.

Soft-tissue defects after spinal instrumentation in 5 children: risk factors, management strategies, and outcomes

2014 ◽  
Vol 14 (6) ◽  
pp. 644-653 ◽  
Author(s):  
Christina Sayama ◽  
Sudhakar Vadivelu ◽  
Andrew Livingston ◽  
Allen Ho ◽  
Shayan A. Izaddoost ◽  
...  
Keyword(s):  
Risk Factors ◽  
Soft Tissue ◽  
Management Strategies ◽  
Spinal Instrumentation ◽  
Neurological Deficits ◽  
Wound Complications ◽  
Soft Tissue Defects ◽  
Poor Nutritional Status ◽  
Tissue Flaps ◽  
Tissue Defects

Object Wound-related complications following complex posterior spine procedures in children may result in the need for serial debridements and may place spinal instrumentation at risk. In this study, the authors review their experience with the management of soft-tissue defects from spinal instrumentation in 5 high-risk pediatric patients. The use of various rotational and transpositional flaps in the management of these complicated cases is discussed, as well as their outcomes. Methods The authors retrospectively reviewed the medical records of 5 patients who returned to the Neuro-Spine service at Texas Children's Hospital for erosion of spinal instrumentation through the skin between September 1, 2007, and October 31, 2012. Patient demographics and clinical and operative data were recorded. Results Risk factors such as young age (1 case), poor nutritional status (1 case), multiple previous surgeries (3 cases), severe neurological deficits (2 cases), and history of radiation therapy for malignancy (2 cases) were noted in the 5 patients. The paraspinous flap (4 cases) was the mainstay of the treatment. Follow-up ranged from 7.5 to 17.5 months (mean 11 ± 4.2 months). One of the patients required more than 1 procedure for revision of the wound. Cultures were positive in 2 of the 5 cases. Spinal instrumentation was removed in 3 of the 5 cases; however, in all 3 of the cases there was evidence of delayed instability that developed after the removal of spinal instrumentation. Conclusions The use of local tissue flaps is safe and efficacious for treatment of posterior wound complications due to spinal instrumentation in children. Removal of spinal instrumentation should be avoided due to the development of delayed instability. Highly vascularized tissue is used to speed healing, clear bacteria, and eliminate dead space, obviating the need to remove contaminated spinal instrumentation.

scholarly journals Case Report: Surgical Closure of Chronic Soft Tissue Defects Using Extracellular Matrix Graft Augmented Tissue Flaps

2021 ◽  
Vol 7 ◽  
Author(s):  
Micheal N. Desvigne ◽  
Krista Bauer ◽  
Kurt Holifield ◽  
Kari Day ◽  
Denise Gilmore ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Soft Tissue ◽  
Single Stage ◽  
Complication Rates ◽  
Soft Tissue Defects ◽  
Tissue Quality ◽  
Reconstructive Procedures ◽  
Tissue Flaps ◽  
Flap Closure ◽  
Tissue Defects

Chronic soft tissue defects are notoriously difficult to heal. Surgical reconstruction of chronic defects using tissue flaps is a routine approach for closure of challenging chronic defects. Due to the poor tissue quality of chronic defects and associated inflammation, infection and impaired blood supply the success of flap closure is marred by reported complication rates of 25–58%. Extracellular matrix (ECM)-based graft materials are commonly used for resolving chronic wounds and in plastic and reconstructive procedures to create a scaffold for tissue regeneration. We hypothesized combination use of ECM grafts with tissue flaps in a single-stage surgical procedure would reduce complications and improve outcomes in the closure of chronic soft tissue defects. We report a case series (n = 9) of chronic soft tissue defect reconstruction using this modified procedure of ECM graft augmented flap closure. Defects included pressure injuries and surgical dehiscence and ranged in wound age from 5 months to 7 years. Successful uncomplicated healing was achieved in six defects. Post-operative complications (dehiscence) occurred in two defects, however, these healed via secondary intention without additional surgical intervention. All healed defects exhibited acceptable cosmesis and “normal” function, with 100% patient satisfaction. Augmentation of tissue flaps with ECM graft materials in this modified single-stage procedure may improve outcomes and minimize typical complications encountered in flap closure of chronic defects attributed to inflammation, infection, hypoperfusion, and dead space.

Blood Supply of the Subcutaneous Tissue of the Upper Limb and its Importance in the Subcutaneous Flap

1987 ◽  
Vol 12 (2) ◽  
pp. 189-193
Author(s):  
A. ZBRODOWSKI ◽  
F. M. MARTY ◽  
R. GÜMENER ◽  
D. MONTANDON
Keyword(s):  
Soft Tissue ◽  
Blood Supply ◽  
Upper Limb ◽  
Subcutaneous Tissue ◽  
Practical Importance ◽  
Soft Tissue Defects ◽  
India Ink ◽  
Subcutaneous Flap ◽  
Tissue Defects ◽  
Gelatine Solution

Vascularization of the subcutaneous tissue of the upper extremity is described. Injection of coloured latex or India ink and gelatine solution showed the principal sources of the blood supply. Microdissection and transclarification of Spalteholz allowed for the study of the direct and indirect arterial branches which form the principal network of the subcutaneous tissue. The findings are of practical importance since the subcutaneous tissue can be used as a separate flap for covering soft tissue defects of the forearm and hand.

scholarly journals Clinical Study of the Lateral Supramalleolar Flap in the Soft Tissue Reconstruction around the Ankle Region

2020 ◽  
Vol 53 (01) ◽  
pp. 083-089 ◽  
Author(s):  
G. I. Nambi ◽  
T. K. Arudra Varanambigai
Keyword(s):  
Clinical Study ◽  
Soft Tissue ◽  
Soft Tissue Reconstruction ◽  
Soft Tissue Defects ◽  
Split Skin Graft ◽  
Tissue Reconstruction ◽  
Split Skin ◽  
Tissue Defects ◽  
Ankle And Foot

Abstract Objective The purpose of this study is to present the efficiency of the lateral supramalleolar flap which is a very useful and yet underutilized in the soft tissue reconstruction of the regions extending from the distal leg, ankle, and foot. Methods Over a period of 3 years, 20 flaps were used in the reconstruction of soft tissue defects in the region extending from the distal leg, ankle, and foot. The location of the defects, the etiology, possible alternative flaps, outcome, and the complications were studied and presented. Results The follow-up period of the cases was from 1 month to 18 months after surgery. Seventeen flaps survived and three were lost. All the three lost flaps were those used over the tendocalcaneal region. The lost flaps were later replaced with split skin graft after the wound was debrided and was later covered with granulation tissue. Conclusion The lateral supramalleolar flap is a very useful flap in the regional soft tissue reconstruction around the ankle except in the tendocalcaneal region.

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