Direct fascia lata reconstruction to reduce donor site morbidity in endoscopic endonasal extended surgery: a pilot study

2016 ◽  
Vol 144 ◽  
pp. 59-63 ◽  
Author(s):  
Matteo Vitali ◽  
Frank Rikki Canevari ◽  
Andrea Cattalani ◽  
Vincenzo Grasso ◽  
Teresa Somma ◽  
...  
Keyword(s):  
Pilot Study ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Fascia Lata ◽  
Endoscopic Endonasal ◽  
Extended Surgery

scholarly journals Arthroscopic Superior Capsular Reconstruction With a Minimally Invasive Harvested Fascia Lata Autograft Produces Good Clinical Results

2018 ◽  
Vol 6 (11) ◽  
pp. 232596711880824 ◽  
Author(s):  
Clara Isabel de Campos Azevedo ◽  
Ana Catarina Leiria Pires Gago Ângelo ◽  
Susana Vinga
Keyword(s):  
Minimally Invasive ◽  
Donor Site ◽  
Case Series ◽  
Donor Site Morbidity ◽  
Fascia Lata ◽  
Rotator Cuff Tears ◽  
Shoulder Abduction ◽  
Open Approach ◽  
Superior Capsular Reconstruction ◽  
The Mean

Background: Painful dysfunctional shoulders with irreparable rotator cuff tears (IRCTs) in active patients are a challenge. Arthroscopic superior capsular reconstruction (ASCR) is a new treatment option originally described using a fascia lata autograft harvested through an open approach. However, concerns about donor site morbidity have discouraged surgeons from using this type of graft. Hypothesis: ASCR using a minimally invasive harvested fascia lata autograft produces good 6-month and 2-year shoulder outcomes in IRCTs, with low-impact thigh morbidity at 2 years. Study Design: Case series; Level of evidence, 4. Methods: From 2015 to 2016, a total of 22 consecutive patients (mean age, 64.8 ± 8.6 years) with chronic IRCTs (Hamada grade 1-2; Goutallier cumulative grade ≥3; Patte stage 1: 2 patients; Patte stage 2: 6 patients; Patte stage 3: 14 patients) underwent ASCR using a minimally invasive harvested fascia lata autograft. All patients completed preoperative and 6-month evaluations consisting of the Simple Shoulder Test (SST), subjective shoulder value (SSV), Constant score (CS), range of motion (ROM), acromiohumeral interval (AHI), and magnetic resonance imaging. Twenty-one patients completed the 2-year shoulder and donor site morbidity assessments. Results: The mean active ROMs improved significantly ( P < .001): elevation, from 74.8° ± 55.5° to 104.5° ± 41.9° (6 months) and 143.8° ± 31.7° (2 years); abduction, from 53.2° ± 43.3° to 86.6° ± 32.9° (6 months) and 120.7° ± 37.7° (2 years); external rotation, from 13.2° ± 18.4° to 27.0° ± 16.1° (6 months) and 35.6° ± 17.3° (2 years); and internal rotation, from 1.2 ± 1.5 points to 2.6 ± 1.5 points (6 months) and 3.8 ± 1.2 points (2 years). The mean functional shoulder scores improved significantly ( P < .001): SST, from 2.1 ± 2.9 to 6.8 ± 3.5 (6 months) and 8.6 ± 3.5 (2 years); SSV, from 33.0% ± 17.4% to 55.7% ± 25.6% (6 months) and 70.0% ± 23.0% (2 years); CS, from 17.5 ± 13.4 to 42.5 ± 14.9 (6 months) and 64.9 ± 18.0 (2 years). The mean shoulder abduction strength improved significantly ( P < .001) from 0.0 to 1.1 ± 1.4 kg (6 months) and 2.8 ± 2.6 kg (2 years). The mean AHI improved from 6.4 ± 3.3 mm to 8.0 ± 2.5 mm (6 months) and decreased to 7.1 ± 2.5 mm (2 years). This 0.7 ± 1.5–mm overall decrease was statistically significant ( P = .042). At 6 months, 20 of 22 patients (90.9%) had no graft tears. At 2 years, 12 of 21 patients (57.1%) were bothered by their harvested thigh, 16 (76.2%) noticed donor site changes, 16 (76.2%) considered that the shoulder surgery’s end result compensated for the thigh’s changes, and 18 (85.7%) would undergo the same surgery again. Conclusion: ASCR using a minimally invasive harvested fascia lata autograft produced good 6-month and 2-year shoulder outcomes in IRCTs, with low-impact thigh morbidity at 2 years.

scholarly journals 807 A Review of The Applications of Autologous Fascia Lata Grafts in Reconstructive Surgery

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Baldwin ◽  
A Lahiri
Keyword(s):  
Reconstructive Surgery ◽  
Donor Site ◽  
Abdominal Wall Reconstruction ◽  
Neck Surgery ◽  
Donor Site Morbidity ◽  
Fascia Lata ◽  
Limited Data ◽  
Careful Planning ◽  
Autologous Grafts ◽  
Review Current

Abstract Background We sought to review current applications of fascia lata autografts and update the original collection of uses proposed almost a century ago, thereby revealing the full extent of uses available to the contemporary reconstructive surgeon. Method A comprehensive literature search of peer-reviewed articles listed within PubMed and Medline was performed. Results The properties of autologous fascia lata grafts are presented, a technique for its harvest and the numerous uses of this material in reconstructive surgery. Specifically, its applications in head and neck surgery, surgery of the limbs, abdominal wall reconstruction and penile reconstruction are reviewed. There is limited data on donor site morbidity, but complications appear to be uncommon. However, it was established that the reported risk of muscle herniation varies greatly in the available literature from 0-36% and appears to be related to the width of tissue harvested. Conclusions Autologous fascia lata grafts are a viable and versatile material in the armamentarium of a reconstructive surgeon, that, with careful planning, can be used with minimal donor site morbidity. This is especially true in lower resource settings where a surgeon may not have access to allogenic material and autologous grafts can provide an easily accessible, cheaper, and practical alternative.

scholarly journals Early outcome after the use of the triceps fascia flap in interposition elbow arthroplasty: a novel method in the treatment of post-traumatic elbow stiffness

SICOT-J ◽  
2020 ◽  
Vol 6 ◽  
pp. 8
Author(s):  
Emmanuel C. Iyidobi ◽  
Cajetan U. Nwadinigwe ◽  
Remigus T. Ekwunife ◽  
Udo E. Anyaehie ◽  
Lasebikan A. Omolade ◽  
...  
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Fascia Lata ◽  
Elbow Stiffness ◽  
Native Bone ◽  
Elbow Arthroplasty ◽  
Post Traumatic ◽  
The Mean ◽  
Triceps Fascia ◽  
Fascia Flap

Background: Post-traumatic elbow stiffness (PTES) results in severe interference with the activities of daily living (ADL), affecting mainly young people. Total elbow arthroplasty (TEA) is relatively contraindicated in the young patient and arthrodesis is poorly tolerated. Interposition elbow arthroplasty (IEA) improves the range of motion (ROM) buying time for future reconstructive surgery. While the fascia lata remains the most common material used in IEA, the triceps fascia is a native vascularized tissue, and it does not require a separate incision to harvest. To our knowledge, there are no published studies on the use of this technique of IEA. Method: Sixteen patients with post-traumatic elbow stiffness had IEA with the triceps fascia between January 2009 and January 2017. The ROM was assessed pre-operatively and post-operatively at the 6th and the 24th week. The researchers also evaluated the functional outcome with the Mayo Elbow Performance Score (MEPS) at the 24th week. The data were analysed with the software IBM SPSS Version 20. Results: Nine males and seven females had IEA with the triceps fascia. The mean age of the subjects was 22.8 years (SD = 6.39). The median duration of the stiffness was eight months (range: 2–168 months). Fall was the most frequent cause of post-traumatic elbow stiffness, and the non-dominant side was more frequently involved. Fourteen patients had an intervention at the native bone setters before presentation to the hospital. The mean elbow ROM increased from 16.4° pre-operatively to 97.2° at the 24th week (p < 0.001), while the mean MEPS improved from 42.5° pre-operatively to 81.2° post-operatively (p < 0.001). Conclusion: The triceps fascia flap provides an excellent alternative to the fascia lata for IEA without the complications of the donor site morbidity.

scholarly journals Versatility of Pedicled Tensor Fascia Lata Flap: A Useful and Reliable Technique for Reconstruction of Different Anatomical Districts

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Md. Sohaib Akhtar ◽  
Mohd Fahud Khurram ◽  
Arshad Hafeez Khan
Keyword(s):  
Operative Procedure ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Fascia Lata ◽  
Pressure Sores ◽  
Partial Loss ◽  
Tensor Fascia Lata ◽  
Reliable Technique ◽  
Tensor Fascia Lata Flap ◽  
Technical Details

Aims and Objectives. The aim of this study was to evaluate the versatility of pedicled tensor fascia lata flap for reconstruction of various anatomical regions. Materials and Methods. In this retrospective study a total of 34 patients with defects over various anatomical regions were included. The defects were located over the trochanter (n=12), groin (n=8), perineum (n=6), lower anterior abdomen (n=6), gluteal region (n=1), and ischial region (n=1). The etiology of defects included trauma (n=12), infection (n=8), pressure sores (n=8), and malignancy (n=6). Reconstruction was performed using pedicled tensor fascia lata flaps. Patients were evaluated in terms of viability of the flap and donor site morbidity. The technical details of the operative procedure have also been outlined. Results. All the flaps survived well except 5 patients in which minor complications were noted and 1 who experienced complete flap loss. Of those with minor complications, 1 patient developed distal marginal necrosis and 1 developed infection which subsided within three days by dressings and antibiotics and in 2 patients partial loss of the skin graft occurred at the donor site out of which 1 required regrafting and another one healed completely with dressing and antibiotics. All the patients were followed up for an average period of 6 months, ranging from 1 to 12 months. Donor site morbidity was minimal. Conclusion. It was concluded that the pedicled tensor fascia lata flap is a versatile, reliable, easy, and less time consuming procedure for the coverage of defects around trochanter, groin, lower anterior abdomen, perineum, and ischial region.

Minimally invasive fascia lata harvesting in ASCR does not produce significant donor site morbidity

2018 ◽  
Vol 27 (1) ◽  
pp. 245-250 ◽  
Author(s):  
Ana Catarina Leiria Pires Gago Ângelo ◽  
Clara Isabel de Campos Azevedo
Keyword(s):  
Minimally Invasive ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Fascia Lata

scholarly journals Use of a Fascia Lata Interposition Graft to Manage Persistent Pain Following Trapeziectomy for Carpometacarpal Osteoarthritis of the Thumb.

2020 ◽  
pp. 1-5
Keyword(s):  
Ligament Reconstruction ◽  
Treatment Options ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Persistent Pain ◽  
Fascia Lata ◽  
Small Series ◽  
Good Pain Relief ◽  
Tendon Interposition ◽  
Carpometacarpal Osteoarthritis

Abstract Persistent pain after trapeziectomy is relatively common, frequently caused by coexisting scapho-trapezio-trapezoidal arthritis and/or impingement of bases of first and second metacarpals. A variety of treatment options have been described including revision ligament reconstruction tendon interposition and use of interposition material. This paper describes a simple technique using fascia lata autograft interposition, producing good outcome in a small series of patients, with minimal donor site morbidity and good pain relief.

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