A Homodigital Reverse Pedicle Island Flap in Soft Tissue Reconstruction of the Finger and the Thumb

1994 ◽  
Vol 19 (2) ◽  
pp. 135-141 ◽  
Author(s):  
N. S. NIRANJAN ◽  
J. R. ARMSTRONG
Keyword(s):  
Soft Tissue ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Single Stage ◽  
Island Flap ◽  
Tissue Loss ◽  
Soft Tissue Reconstruction ◽  
Tissue Reconstruction

A single stage homodigital reverse pedicle island flap is described for the repair of volar or dorsal tissue loss on the finger or thumb. Donor site morbidity is minimal, and the length of the digit is preserved. Satisfactory function results in 25 patients are presented.

Submental Flap for Soft Tissue Reconstruction following Radical Parotidectomy

2019 ◽  
Vol 160 (6) ◽  
pp. 1130-1132 ◽  
Author(s):  
Rodrigo Bayon ◽  
Andrew B. Davis
Keyword(s):  
Soft Tissue ◽  
Medical Center ◽  
Donor Site ◽  
Case Series ◽  
Island Flap ◽  
Hospital Length Of Stay ◽  
Soft Tissue Reconstruction ◽  
Submental Flap ◽  
Tissue Reconstruction ◽  
Submental Island Flap

This study analyzed our institution’s experience with a buried submental flap for soft tissue reconstruction following radical parotidectomy. A retrospective chart review was conducted of patients who had parotid malignancies requiring radical parotidectomy, who also underwent a buried submental flap reconstruction. Analysis included patient demographics and clinical, surgical, and outcome data. Three patients met criteria for this study who underwent a buried submental flap at a tertiary medical center between 2012 and 2016. All patients had oncologic surgery and reconstruction using a deepithelialized submental island flap, which was used to fill the radical parotidectomy surgical defect with no complications and good aesthetic results. Each patient received appropriate adjuvant therapy. This case series shows that the buried submental island flap is a versatile flap that is adequate bulk after radical parotidectomy. It also has no impact on hospital length of stay and provides excellent cosmetic outcomes with minimal donor site morbidity.

Preliminary Experience with Perforator Flaps in Reconstruction of Soft-Tissue Defects of the Foot and Ankle

2005 ◽  
Vol 26 (3) ◽  
pp. 191-197 ◽  
Author(s):  
Frederick J. Duffy ◽  
James W. Brodsky ◽  
Christian T. Royer
Keyword(s):  
Soft Tissue ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Tissue Loss ◽  
Soft Tissue Reconstruction ◽  
Foot And Ankle ◽  
Soft Tissue Defects ◽  
Perforator Flaps ◽  
Microsurgical Reconstruction ◽  
Tissue Defects

Background: Microsurgical reconstruction has improved limb salvage in patients who because of many etiologies have soft-tissue loss from the lower extremities. Free-tissue transfer to the foot and ankle often interferes with postoperative function and footwear because of the bulk of a muscle flap. The foot and ankle often are best treated using thin flaps that will not contract and fibrose, particularly if secondary procedures are required. We hypothesized that perforator flaps, which are thin free-tissue transfers consisting of skin and subcutaneous tissue, both diminish donor site morbidity and are ideally suited for soft-tissue reconstruction of the foot and ankle. Methods: Ten patients had free- tissue transfers to the foot and ankle using perforator flaps during a 2-year period. Four had acute posttraumatic wounds, three had soft tissue defects with exposed hardware or bone graft after reconstructive surgery, and three had large soft-tissue defects after foot infection secondary to diabetes. Nine had reconstruction with anterolateral thigh perforator flaps and one had reconstruction with a deep inferior epigastric artery (DIEP) perforator flap. Results: All flaps survived. There were no deep infections. Three flaps had minor tissue loss requiring subsequent small skin grafts, all of which healed. There were no donor site complications and no interference of muscle function at the donor sites. Custom shoewear was not required to accommodate the flaps. Conclusion: This series highlights the success and utility of perforator flaps in microsurgical reconstruction of the foot and ankle. The greatest advantage of perforator flaps is the diminished donor site morbidity, which was achieved while maintaining high microsurgical success rates. These skin and fat flaps remained pliable and contracted less than muscle flaps, allowing for smooth tendon gliding and easy flap elevation for secondary orthopaedic procedures.

Soft Tissue Reconstruction

2020 ◽  
pp. 63-74
Keyword(s):  
Soft Tissue ◽  
Lower Limb ◽  
Donor Site ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Open Fractures ◽  
Soft Tissue Coverage ◽  
Soft Tissue Reconstruction ◽  
Tissue Reconstruction ◽  
Wound Excision

Soft tissue coverage of open fractures with well-vascularised tissues should be performed within 72 hours of injury or at the same time as internal fixation. It may be in the form of local or free flaps, and may comprise muscle, fasciocutaneous tissues, or both. Flap selection depends on multiple factors, including the size and location of the defect following wound excision, availability of flaps, and donor site morbidity. Local flaps are usually used to cover defects with a limited zone of injury. Anastomoses for free flaps should be performed outside the zone of injury. Experimental data suggest that coverage with muscle leads to improved healing of fractures. However, there is currently little clinical evidence to support the use of one form of soft tissue cover over another for open fractures of the lower limb. The plastic surgeon must always consider the donor site morbidity of the flap(s) chosen.

scholarly journals Retrospective analysis of free temporoparietal fascial flap for defect reconstruction of the hand and the distal upper extremity

2020 ◽  
Author(s):  
Wibke Müller-Seubert ◽  
Raymund E. Horch ◽  
Vanessa Franziska Schmidt ◽  
Ingo Ludolph ◽  
Marweh Schmitz ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Soft Tissue ◽  
Upper Extremity ◽  
Reconstructive Surgery ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Soft Tissue Reconstruction ◽  
Flap Necrosis ◽  
Fascial Flap ◽  
Tissue Reconstruction

Abstract Introduction Soft tissue reconstruction of the hand and distal upper extremity is challenging to preserve the function of the hand as good as possible. Therefore, a thin flap has been shown to be useful. In this retrospective study, we aimed to show the use of the free temporoparietal fascial flap in soft tissue reconstruction of the hand and distal upper extremity. Methods We analysed the outcome of free temporoparietal fascial flaps that were used between the years 2007and 2016 at our institution. Major and minor complications, defect location and donor site morbidity were the main fields of interest. Results 14 patients received a free temporoparietal fascial flap for soft tissue reconstruction of the distal upper extremity. Minor complications were noted in three patients and major complications in two patients. Total flap necrosis occurred in one patient. Conclusion The free temporoparietal fascial flap is a useful tool in reconstructive surgery of the hand and the distal upper extremity with a low donor site morbidity and moderate rates of major and minor complications.

scholarly journals Awkward defects around the elbow: The radial recurrent artery flap revisited

2016 ◽  
Vol 49 (03) ◽  
pp. 357-361
Author(s):  
Maksud M. Devale ◽  
Rohit P. Munot ◽  
Chirag A. Bhansali ◽  
Neeraj D. Bhaban
Keyword(s):  
Soft Tissue ◽  
Internal Fixation ◽  
Elbow Joint ◽  
Donor Site ◽  
Distal Humerus ◽  
Donor Site Morbidity ◽  
Soft Tissue Reconstruction ◽  
Posterior Aspect ◽  
Tissue Reconstruction ◽  
Radial Recurrent Artery

ABSTRACT Background: Soft tissue defects on the posterior aspect of the elbow are commonly seen in patients treated with internal fixation for fractures around the elbow joint. An axial flap based on the radial recurrent artery (RRA) is very useful for such defects, especially if a posterior midline arm incision has been taken for skeletal fixation. The aim of this study is to describe the usefulness of RRA flap (based on the RRA) in the management of such defects. Materials and Methods: We present a retrospective analysis of 4 cases managed with the RRA flap for soft tissue reconstruction of defects around the elbow joint at our institute from January 2015 to August 2016. All the patients were males with a history of exposed implant following internal fixation of olecranon/distal humerus fracture. The size of defects ranged from 4 cm × 4 cm to 7 cm × 5 cm. Results of the analysis are presented here. Results: All flaps survived completely. There was no infection, hematoma or distal neurovascular deficit. There was minimal donor site morbidity. Conclusion: The RRA flap is a useful, simple flap for defects around the elbow joint in select patients providing one stage, reliable, cosmetically acceptable coverage.

scholarly journals Versatility of Free Cutaneous Flaps for Upper Extremity Soft Tissue Reconstruction

2017 ◽  
Vol 09 (02) ◽  
pp. 058-066 ◽  
Author(s):  
Howard Wang ◽  
Jose Alonso-Escalante ◽  
Brian Cho ◽  
Ramon DeJesus
Keyword(s):  
Soft Tissue ◽  
Upper Extremity ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Team Approach ◽  
Soft Tissue Reconstruction ◽  
Epigastric Artery ◽  
Reconstructive Microsurgery ◽  
Flap Design ◽  
Tissue Reconstruction

AbstractThe goals of upper extremity soft tissue reconstruction should go well beyond providing coverage and restoring function. As the field of reconstructive microsurgery has evolved, free cutaneous flaps (FCFs) are gaining wider application. The advantages of FCF include minimizing donor-site morbidity by preserving the muscle and fascia, improving versatility of flap design, and superior aesthetic results. This review highlights the application of anterolateral thigh, superficial circumflex iliac artery, deep inferior epigastric perforator, superficial inferior epigastric artery, and flow-through flaps for reconstruction of upper extremity defects. These flaps share several qualities in common: well-concealed donor sites, preservation of major arteries responsible of providing inflow to distal extremity, and potential for a two-team approach (donor and recipient sites). While the choice of flaps should be decided based on individual patient and defect characteristics, FCF should be considered as excellent options to achieve the goals of upper extremity reconstruction.

“Spare Part” Forearm Free Flaps Harvested from the Amputated Limb for Coverage of Amputation Stumps

1997 ◽  
Vol 22 (5) ◽  
pp. 615-619 ◽  
Author(s):  
M. J. WEINBERG ◽  
M. M. AL-QATTAN ◽  
J. MAHONEY
Keyword(s):  
Soft Tissue ◽  
Radial Artery ◽  
Donor Site ◽  
Free Flaps ◽  
Spare Part ◽  
Donor Site Morbidity ◽  
Soft Tissue Reconstruction ◽  
Amputation Stumps ◽  
Tissue Reconstruction ◽  
Different Tissues

The use of “spare part” flaps from a non-replantable limb to cover amputation stumps in the upper extremity preserves limb length, provides durable coverage and sensation and will avoid additional donor site morbidity. We have studied the blood supply of the forearm based on the radial artery. The potential for harvesting different tissues is confirmed. In five clinical cases reliable primary soft tissue reconstruction was achieved, even in the presence of trauma.

scholarly journals Skull Base Reconstruction in the Pediatric Patient

2018 ◽  
Vol 79 (01) ◽  
pp. 081-090 ◽  
Author(s):  
Irit Duek ◽  
Alon Pener-Tessler ◽  
Ravit Yanko-Arzi ◽  
Arik Zaretski ◽  
Avraham Abergel ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Children And Adolescents ◽  
Skull Base ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Soft Tissue Reconstruction ◽  
Cumulative Impact ◽  
Skull Base Reconstruction ◽  
Unique Challenge ◽  
First Choice

Introduction Pediatric skull base and craniofacial reconstruction presents a unique challenge since the potential benefits of therapy must be balanced against the cumulative impact of multimodality treatment on craniofacial growth, donor-site morbidity, and the potential for serious psychosocial issues. Objectives To suggest an algorithm for skull base reconstruction in children and adolescents after tumor resection. Materials and Methods Comprehensive literature review and summary of our experience. Results We advocate soft-tissue reconstruction as the primary technique, reserving bony flaps for definitive procedures in survivors who have reached skeletal maturity. Free soft-tissue transfer in microvascular technique is the mainstay for reconstruction of large, three-dimensional defects, involving more than one anatomic region of the skull base, as well as defects involving an irradiated field. However, to reduce total operative time, intraoperative blood loss, postoperative hospital stay, and donor-site morbidity, locoregional flaps are better be considered the flap of first choice for skull base reconstruction in children and adolescents, as long as the flap is large enough to cover the defect. Our “workhorse” for dural reconstruction is the double-layer fascia lata. Advances in endoscopic surgery, image guidance, alloplastic grafts, and biomaterials have increased the armamentarium for reconstruction of small and mid-sized defects. Conclusions Skull base reconstruction using locoregional flaps or free flaps may be safely performed in pediatrics. Although the general principles of skull base reconstruction are applicable to nearly all patients, the unique demands of skull base surgery in pediatrics merit special attention. Multidisciplinary care in experienced centers is of utmost importance.

Minimally invasive soft tissue reconstruction with free peroneal artery perforator flap

2016 ◽  
Vol 2 (8) ◽  
Author(s):  
Kenji Kawamura ◽  
Hiroshi Yajima ◽  
Shohei Omokawa ◽  
Takamasa Shimizu ◽  
Naoki Maegawa ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Minimally Invasive ◽  
Donor Site ◽  
Perforator Flap ◽  
Peroneal Artery ◽  
Soft Tissue Reconstruction ◽  
Perforator Flaps ◽  
Major Vessel ◽  
Tissue Reconstruction ◽  
Artery Perforator

<p> </p><p><span style="font-family: Times New Roman;"> The development of a concept of perforator flap has dramatically changed the soft tissue reconstructive surgery. The surgery with perforator flaps enables to minimize donor-site morbidity by preserving important tissues including the muscle and the major vessel. The peroneal artery perforator flap is one of perforator flaps that can be harvested from the lower leg. The peroneal artery perforator flap has been widely used as a local flap for soft tissue reconstruction in the lower extremity; however, the free peroneal artery perforator flap transfer has been little reported. Utilities of the free peroneal artery perforator flap for soft tissue reconstruction of the extremities are reported, and minimally invasive flap surgery with perforator flaps is reviewed.</span></p><p> </p>

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