Free Muscle Flap Transfer as a Lymphatic Bridge for Upper Extremity Lymphedema

2006 ◽  
Vol 2006 ◽  
pp. 249-250
Author(s):  
C. Lee
Keyword(s):  
Upper Extremity ◽  
Muscle Flap ◽  
Flap Transfer ◽  
Free Muscle Flap

scholarly journals Simultaneous debridement, Ilizarov reconstruction and free muscle flaps in the management of complex tibial infection

2020 ◽  
Vol 6 (3) ◽  
pp. 63-72
Author(s):  
Max Mifsud ◽  
Jamie Y. Ferguson ◽  
David A. Stubbs ◽  
Alex J. Ramsden ◽  
Martin A. McNally
Keyword(s):  
Muscle Flap ◽  
Tissue Loss ◽  
Bony Union ◽  
Ilizarov Method ◽  
Muscle Flaps ◽  
Flap Transfer ◽  
Non Union ◽  
Free Muscle Flap ◽  
Initial Surgery

Abstract. Chronic bone infections often present with complex bone and soft tissue loss. Management is difficult and commonly delivered in multiple stages over many months. This study investigated the feasibility and clinical outcomes of reconstruction in one stage. Fifty-seven consecutive patients with chronic osteomyelitis (n=27) or infected non-union (n=30) were treated with simultaneous debridement, Ilizarov method and free muscle flap transfer. 41 patients (71.9 %) had systemic co-morbidities (Cierny-Mader group Bs hosts). Infection was confirmed with strict criteria. 48 patients (84.2 %) had segmental defects. The primary outcome was eradication of infection at final follow-up. Secondary outcomes included bone union, flap survival and complications or re-operation related to the reconstruction. Infection was eradicated in 55∕57 cases (96.5 %) at a mean follow-up of 36 months (range 12–146). No flap failures occurred during distraction but 6 required early anastomotic revision and 3 were not salvageable (flap failure rate 5.3 %). Bony union was achieved in 52∕57 (91.2 %) with the initial surgery alone. After treatment of the five un-united docking sites, all cases achieved bony union at final follow-up. Simultaneous reconstruction with Ilizarov method and free tissue transfer is safe but requires careful planning and logistic considerations. The outcomes from this study are equivalent or better than those reported after staged surgery.

scholarly journals Limb-salvage by Femoro-distal Bypass and Free Muscle Flap Transfer

2004 ◽  
Vol 27 (6) ◽  
pp. 635-639 ◽  
Author(s):  
M. Czerny ◽  
W. Trubel ◽  
D. Zimpfer ◽  
M. Grimm ◽  
R. Koller ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Muscle Flap ◽  
Flap Transfer ◽  
Free Muscle Flap

scholarly journals Free Tissue Transfer for Upper Extremity Reconstruction

2019 ◽  
Vol 33 (01) ◽  
pp. 017-023 ◽  
Author(s):  
Rami Dibbs ◽  
Luke Grome ◽  
William Pederson
Keyword(s):  
Upper Extremity ◽  
Muscle Flap ◽  
Free Tissue Transfer ◽  
Serratus Anterior ◽  
Muscle Flaps ◽  
Functional Tissue ◽  
Tissue Transfer ◽  
Free Muscle Flap ◽  
Reconstructive Ladder ◽  
Extremity Reconstruction

AbstractWith the advent of the Industrial Revolution, traumatic injuries of the upper extremity increased exponentially. As a result, surgeons began to reevaluate amputation as the standard of care. Following the Second World War, local and regional pedicled flaps became common forms of traumatic upper extremity reconstruction. Today, microsurgery offers an alternative when options lower on the reconstructive ladder have been exhausted or will not produce a desirable result. In this article, the authors review the use of free tissue transfer for upper extremity reconstruction. Flaps are categorized as fasciocutaneous, muscle, and functional tissue transfers. The thin pliable nature of fasciocutaneous flaps makes them ideal for aesthetically sensitive areas, such as the hand. The radial forearm, lateral arm, scapula, parascapular, anterolateral thigh, and temporoparietal fascia flaps are highlighted in this article. Muscle flaps are utilized for their bulk and size; the latissimus dorsi flap serves as a “workhorse” free muscle flap for upper extremity reconstruction. Other muscle flaps include the rectus abdominis and serratus anterior. Lastly, functional tissue transfers are used to restore active range of motion or bony integrity to the upper extremity. The innervated gracilis can be utilized in the forearm to restore finger flexion or extension. Transfer of vascularized bone such as the fibula may be used to correct large defects of the radius or ulna. Finally, replacement of “like with like” is embodied in toe-to-thumb transfers for reconstruction of digital amputations.

Upper Extremity Free Flap Transfers: An Analysis of the National Surgical Quality Improvement Program Database

2020 ◽  
Author(s):  
George A. Beyer ◽  
Karan Dua ◽  
Neil V. Shah ◽  
Joseph P. Scollan ◽  
Jared M. Newman ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Upper Extremity ◽  
Free Flap ◽  
Quality Improvement Program ◽  
Readmission Rates ◽  
Improvement Program ◽  
Surgical Quality ◽  
Flap Transfer ◽  
Free Flap Transfer ◽  
Reoperation Rates

Abstract Introduction We evaluated the demographics, flap types, and 30-day complication, readmission, and reoperation rates for upper extremity free flap transfers within the National Surgical Quality Improvement Program (NSQIP) database. Materials and Methods Upper extremity free flap transfer patients in the NSQIP from 2008 to 2016 were identified. Complications, reoperations, and readmissions were queried. Chi-squared tests evaluated differences in sex, race, and insurance. The types of procedures performed, complication frequencies, reoperation rates, and readmission rates were analyzed. Results One-hundred-eleven patients were selected (mean: 36.8 years). Most common upper extremity free flaps were muscle/myocutaneous (45.9%) and other vascularized bone grafts with microanastomosis (27.9%). Thirty-day complications among all patients included superficial site infections (2.7%), intraoperative transfusions (7.2%), pneumonia (0.9%), and deep venous thrombosis (0.9%). Thirty-day reoperation and readmission rates were 4.5% and 3.6%, respectively. The mean time from discharge to readmission was 12.5 days. Conclusion Upper extremity free flap transfers could be performed with a low rate of 30-day complications, reoperations, and readmissions.

Free flap transfer of the cutaneous maximus muscle in the rat: Comparison to the latissimus dorsi muscle flap

Microsurgery ◽  
1992 ◽  
Vol 13 (4) ◽  
pp. 208-213 ◽  
Author(s):  
Xiaolu Li ◽  
Brian C. Cooley ◽  
Suzann M. Gruel ◽  
Zhong Ye ◽  
John S. Gould
Keyword(s):  
Free Flap ◽  
Latissimus Dorsi ◽  
Muscle Flap ◽  
Latissimus Dorsi Muscle ◽  
Latissimus Dorsi Muscle Flap ◽  
Flap Transfer ◽  
Dorsi Muscle ◽  
Free Flap Transfer
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