Free flaps for lower limb soft tissue reconstruction in children: Systematic review

2019 ◽  
Vol 72 (5) ◽  
pp. 711-728 ◽  
Author(s):  
Karel EY. Claes ◽  
Nathalie A. Roche ◽  
Dries Opsomer ◽  
Edward J. De Wolf ◽  
Casper E. Sommeling ◽  
...  
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Lower Limb ◽  
Free Flaps ◽  
Soft Tissue Reconstruction ◽  
Tissue Reconstruction

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 Functional Reconstruction of Sarcoma Defects Utilising Innervated Free Flaps

Sarcoma ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Damien Grinsell ◽  
Claudia Di Bella ◽  
Peter F. M. Choong
Keyword(s):  
Soft Tissue ◽  
Abdominal Wall ◽  
Upper Limb ◽  
Lower Limb ◽  
Free Flaps ◽  
Functional Results ◽  
Wide Resection ◽  
Soft Tissue Reconstruction ◽  
Functional Scores ◽  
Tissue Reconstruction

Soft-tissue reconstruction following preoperative radiotherapy and wide resection of soft tissue sarcoma remains a challenge. Pedicled and free tissue transfers are an essential part of limb sparing surgery. We report 22 cases of sarcoma treated with radiotherapy and wide excision followed by one-stage innervated free or pedicled musculocutaneous flap transfers. The resection involved the upper limb in 3 cases, the lower limb in 17, and the abdominal wall in 2. The flaps used for the reconstruction were mainly latissimus dorsi and gracilis. The range of motion was restored fully in 14 patients. The muscle strength of the compartment reconstructed was of grades 4 and 5 in all patients except one. The overall function was excellent in all the cases with functional scores of 71.2% in the upper limb and 84% in the lower limb. The only 2 major complications were flap necrosis, both revised with another flap, one of which was innervated with restoration of function. Innervated flaps are valuable alternatives for reconstruction after sarcoma resection in the extremity and in the abdominal wall. The excellent functional results are encouraging, and we believe that innervated muscle reconstruction should be encouraged in the treatment of sarcoma after radiotherapy and wide resection.

scholarly journals Comparison of Fasciocutaneous and Muscle-based Free Flaps for Soft Tissue Reconstruction of the Upper Extremity

2019 ◽  
Vol 7 (12) ◽  
pp. e2543
Author(s):  
Christoph Koepple ◽  
Ann-Katrin Kallenberger ◽  
Lukas Pollmann ◽  
Gabriel Hundeshagen ◽  
Volker J. Schmidt ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Upper Extremity ◽  
Free Flaps ◽  
Soft Tissue Reconstruction ◽  
Tissue Reconstruction

Reconstruction of Large Palmar Defects of the Hand Using Free Flaps

1997 ◽  
Vol 22 (5) ◽  
pp. 623-630 ◽  
Author(s):  
M. M. NINKOVÍC ◽  
A. H. SCHWABEGGER ◽  
G. WECHSELBERGER ◽  
H. ANDERL
Keyword(s):  
Soft Tissue ◽  
Free Flap ◽  
Subcutaneous Tissue ◽  
Free Flaps ◽  
Difficult Problem ◽  
Glabrous Skin ◽  
Soft Tissue Reconstruction ◽  
Anatomical Structures ◽  
Tissue Reconstruction ◽  
Restoration Of Sensibility

The reconstruction of large palmar defects of the hand remains a difficult problem due to the specific anatomical structures and highly sophisticated function of the palm. The glabrous skin and subcutaneous tissue in the palm are perfectly adapted to serve the prehensile function. The particular aim must be that repairs to this functional structure are similar in texture and colour and are aesthetically acceptable. Restoration of sensibility is desirable. For smaller defects a great variety of local pedicled or island flaps can be applied. However, for larger defects with exposed tendons, nerves or other essential structures, free flaps remain as a reliable alternative. This paper reviews our approach of soft tissue reconstruction in 16 patients with large palmar defects using various kinds of free flaps. The advantages, disadvantages and current indications for free flap resurfacing of the palm are discussed.

Venous flaps for coverage of traumatic soft tissue defects of the hand: a systematic review

2017 ◽  
Vol 42 (8) ◽  
pp. 817-822 ◽  
Author(s):  
R. Wharton ◽  
H. Creasy ◽  
C. Bain ◽  
M. James ◽  
A. Fox
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Survival Rates ◽  
Venous Congestion ◽  
Soft Tissue Reconstruction ◽  
Level Of Evidence ◽  
Venous Flaps ◽  
Reconstructive Option ◽  
Tissue Reconstruction ◽  
Trauma Outcome

A PRISMA-guided systematic review was performed of all published cases that detail the use of venous flaps for soft tissue reconstruction of the hand following trauma. Outcome measures examined included flap survival rates, venous congestion, and return to theatre. Database searches were performed on Medline, Embase, AHMED, CINAHL. A total of 381 articles were identified. Data were extracted from 45 articles that met inclusion criteria. A total of 756 flaps were described and their data analysed. A total of 75% of flaps were arterialized and 25% were pure venous flaps. There was no difference in survival rate for arterialized or pure venous flaps. Unplanned return to theatre occurred in 5.3% due to flap compromise or necrosis. Early venous congestion was present in 60% of cases. Total early failure requiring re-operation occurred in 19 flaps (2.5%) of cases. Venous flaps offer a versatile and well-tolerated reconstructive option. Early venous congestion is common, but can be managed non-operatively. Level of evidence: II

scholarly journals Aesthetic and Functional Revision of Free Flaps Used In Soft Tissue Reconstruction

2016 ◽  
Vol 2 (1) ◽  
pp. 17-22
Author(s):  
Özlenen ÖZKAN ◽  
Kerim ÜNAL ◽  
Onur OĞAN ◽  
Anı ÇİNPOLAT ◽  
Gamze BEKTAŞ ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Free Flaps ◽  
Soft Tissue Reconstruction ◽  
Tissue Reconstruction

Chest Wall Reconstruction Following Tumor

2020 ◽  
Author(s):  
Farooq Shahzad ◽  
Evan Matros
Keyword(s):  
Soft Tissue ◽  
Chest Wall ◽  
Free Flaps ◽  
Chest Wall Reconstruction ◽  
Chest Wall Tumor ◽  
Soft Tissue Coverage ◽  
Soft Tissue Reconstruction ◽  
Pedicled Flaps ◽  
Ablative Surgery ◽  
Tissue Reconstruction

Plastic surgeons are typically called upon to reconstruct the chest wall in four situations: oncologic resection, infections, trauma and osteoradionecrosis. In this chapter we will discuss post-oncologic reconstruction. Chest wall reconstruction following tumor resection is typically performed at the same setting as the ablative surgery; this results in quicker patient recovery and overall better outcomes. The reconstruction should be planned with the ablative surgeon so that an assessment can be made of the extent of resection and available donor sites for reconstruction. The major components of reconstruction are 1) skeletal support and 2) soft tissue coverage. Skeletal support is indicated if the defect is >5 cm, 4 or more ribs are removed or more than 2/3rd of the sternum is resected. Prosthetic mesh is most commonly used. Soft tissue reconstruction is performed with regional pedicled flaps in the vast majority of cases. Free flaps are used when regional flaps are not sufficient (large defects) or not available.  This review contains 11 figures, 3 tables, and 49 references. Keywords: chest wall, tumor, skeletal reconstruction, soft tissue reconstruction, mesh, acellular dermal matrix, titanium osteosynthesis systems, resorbable plates, pedicled flaps, free flaps

Sign in / Sign up

Export Citation Format

Share Document