Foot salvage using microsurgical free muscle flaps in severely crushed foot with soft tissue defects

Injury ◽  
2019 ◽  
Vol 50 ◽  
pp. S17-S20 ◽  
Author(s):  
Hassan Hamdy Noaman ◽  
Yasser Osman Soroor
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Defects ◽  
Muscle Flaps ◽  
Tissue Defects

Pronator Quadratus Free Muscle Flap for Treatment of Palmar Defects

1993 ◽  
Vol 18 (5) ◽  
pp. 576-578 ◽  
Author(s):  
G. DAUTEL ◽  
M. MERLE
Keyword(s):  
Soft Tissue ◽  
Muscle Flap ◽  
Soft Tissue Defects ◽  
Muscle Flaps ◽  
Recipient Site ◽  
Pronator Quadratus ◽  
Free Muscle Flap ◽  
Small Defect ◽  
Pronator Quadratus Muscle ◽  
Tissue Defects

Cutaneous flaps are not entirely satisfactory when used for soft tissue defects of the palm, because the skin cover is too mobile. Use of muscle flaps can therefore be advocated for this recipient site. A case is reported where the pronator quadratus muscle has been used as a free muscle flap for coverage of a small defect of the palm.

The Application of Distally Pedicled Peroneus Brevis Muscle Flaps and Retrograde Neurocutaneous Accompanying Artery Flaps for Treatment of Bony and Soft-Tissue 3-Dimensional Defects of the Lower Leg and Foot

2013 ◽  
Vol 12 (1) ◽  
pp. 53-62 ◽  
Author(s):  
Xiao-hua Hu ◽  
Wei-li Du ◽  
Zhong Chen ◽  
Ming Li ◽  
Cheng Wang ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Muscle Flap ◽  
Lower Leg ◽  
Soft Tissue Defects ◽  
Muscle Flaps ◽  
3 Dimensional ◽  
Peroneus Brevis ◽  
Average Size ◽  
Thorough Debridement ◽  
Tissue Defects

To investigate the clinical effect of distally pedicled peroneus brevis muscle flaps and retrograde neurocutaneous flaps on treatment of bone and soft-tissue 3-dimensional defects of the lower leg and foot, the authors retrospectively studied all the patients admitted in their center in 3 consecutive years with bone and soft-tissue defects from March 2008 to February 2011; 21 patients suffering from traumatic and osteomyelitis were treated with peroneus brevis muscle flaps, for obliterating the hole-shaped bony defects after osteomyelitis debridement, and neurocutaneous flaps, for repairing associated soft-tissue defects. After thorough debridement, the average size of soft-tissue defects was 2 cm × 2 cm to 13 cm × 9 cm and that of bony defects was 2 cm × 2 cm × 2 cm to 6 cm × 3 cm × 3 cm. Neurocutaneous flaps completely survived in 20 cases, and the wounds healed at stage I; 1 case developed necrosis in the distal part of the peroneus brevis muscle flap and sural nerve flap, and the wound healed with a saphenous nerve flap. The flaps maintained good texture and shape during a follow-up of 6 to 24 months. Recurrence of osteomyelitis was not observed in any of the patients. In conclusion, distally pedicled peroneus brevis muscle flaps and retrograde neurocutaneous flaps are simple, safe, reliable, and suitable for clinical treatment of hole-shaped bony defects and reconstruction of soft-tissue defects within a single stage, especially when the 2 defects are located in different 3-dimensional spaces.

A Simple and Convenient Alternative for the Reconstruction of Lower Extremity Soft Tissue Defects due to Different Types of Etiologies: Bipedicled Flap

2021 ◽  
pp. 153473462110094
Author(s):  
Zeynep Altuntaş ◽  
Mahmut Tekecik ◽  
Mehmet Dadacı
Keyword(s):  
Soft Tissue ◽  
Lower Extremity ◽  
Soft Tissues ◽  
Soft Tissue Defects ◽  
Peripheral Vascular ◽  
Muscle Flaps ◽  
Limited Mobility ◽  
Different Types ◽  
Neurovascular Structures ◽  
Tissue Defects

Reconstruction of soft tissue defects in the lower extremity due to different etiologies can be a challenging process for surgeons. Compelling reasons for reconstruction include the anatomy of the lower extremity, limited mobility of soft tissues especially the presence of bone, tendon, and neurovascular structures under the defect, and the exposed fixation materials make these defects more complicated. Local fasciocutaneous and muscle flaps are frequently used for the reconstruction of these defects. The patients in our study were with multiple comorbidities such as diabetes mellitus, hypertension, atherosclerosis, and peripheral vascular disease. In this study, with a clinic series consisting of 42 patients (29 male and 13 female), we present a reconstruction with a bipedicled flap as a safe, simple, and efficient reconstructive modality in the treatment of lower extremity soft tissue defects. Except for 1 total flap loss, all defects were successfully reconstructed without any major complications. When reconstruction is performed with a bipedicled flap, the main neurovascular structures are not damaged, free flap and other locoregional flaps can be used as a salvage protocol.

scholarly journals Reconstructive strategies for lower one-third leg soft tissue defects

2018 ◽  
Vol 5 (12) ◽  
pp. 4016
Author(s):  
Mahesh S. G. ◽  
Ashwath Narayan Ramji ◽  
Balaji R. ◽  
Mali Chetan S. M.
Keyword(s):  
Soft Tissue ◽  
Road Traffic ◽  
Muscle Flap ◽  
Free Flaps ◽  
Fracture Site ◽  
Soft Tissue Defects ◽  
Muscle Flaps ◽  
Aesthetic Appearance ◽  
Flap Cover ◽  
Tissue Defects

Background: Despite recent technical advances, reconstruction of lower third of leg wounds with soft tissue defects remains a challenge to the Plastic Surgeon. This is due to the inherent anatomical and structural configuration, including the limited vascularity of the skin of the lower third of the leg. Maintaining maximal function without compromising the aesthetic appearance of the leg is the goal of reconstruction.Methods: This was a retrospective study conducted in the Department of Plastic Surgery, KIMS Hospital, Bangalore, from January 2016 to January 2018. Patients with soft tissue defects involving lower third of leg requiring flap cover were included in the study. Orthopedic intervention was done as required. All patients underwent loco-regional or free flap cover as clinically indicated. Outcomes were studied.Results: Total of 20 patients were included in the study. Most common presentation was due to road traffic accidents (RTA). Right leg was involved in 12 cases and left in 8 cases. Fracture was present in 7 cases, exposed bone without fracture in 11 cases, exposed tendons alone in 1 case and exposed implants in 1 case. 3 Patients required orthopaedic intervention along with the flap procedure, and 4 had already undergone orthopaedic stabilisation. Most commonly performed procedure was muscle flap (45%), followed by perforator-based fascio-cutaneous flap (25%). No major complications were observed in the post-operative period.Conclusions: Lower third of leg reconstruction is a challenge, but a wide variety of options ranging from loco-regional to free flaps can be employed, depending on the situation. In present study, various types of flap cover were adopted to cover the lower-third of leg defects, depending on the nature of the wound. Present study delineated that muscle flaps - particularly the reverse hemi-soleus flap, are an ideal flap for lower third of leg defects with fracture site exposed and wound infected. Local muscle flaps have the advantage of being single-staged, faster to perform and technically easier, compared to free flaps, which have long been considered the gold standard.

Muscle versus Fasciocutaneous Flap in Lower Limb Reconstruction: Is There a Best Option?

2017 ◽  
Vol 33 (S 01) ◽  
pp. S27-S33 ◽  
Author(s):  
Martina Corno ◽  
Salvatore D'Arpa ◽  
Pietro Di Summa ◽  
Igor Pellegatta ◽  
Luigi Valdatta ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Lower Limb ◽  
Donor Site ◽  
Anterolateral Thigh Flap ◽  
Soft Tissue Defects ◽  
Perforator Flaps ◽  
Muscle Flaps ◽  
Limb Reconstruction ◽  
Lower Limb Reconstruction ◽  
Tissue Defects

AbstractSoft tissue defects of the lower extremity that expose underlying bones, joints, and tendons pose challenging problems and generally require free tissue transfer for a successful reconstruction. Historically, muscle flaps were the gold standard choice for lower limb reconstruction. To obviate the unpredictable appearance and high donor-site morbidity of muscle flaps, fasciocutaneous flaps were introduced. Recently, perforator flaps, such as the anterolateral thigh flap, gained a leading role in the reconstructive scenario. There is growing evidence in the literature supporting that fasciocutaneous and perforator flaps are comparable to muscle flaps in terms of flap survival, postoperative infection, osteomyelitis, bone union, and ambulation. With the advances of knowledge in perforator anatomy and their mapping, a new era of lower limb reconstruction has begun. Propeller flap could be raised on any suitable perforator vessel and, without the aid of microsurgical anastomosis, used to restore small- to middle-sized soft tissue defects. In this review, we intend to analyze pros and cons of muscle and fasciocutaneous free flaps and the applicability of the propeller flaps in lower limb reconstruction.

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