scholarly journals Activated Prothrombin Concentrates in Management of Bleeding in a Classical Hemophiliac with Inhibitor

1977 ◽  
Author(s):  
J.M. Whaun ◽  
A. Kaegi
Keyword(s):  
Skin Graft ◽  
Conservative Management ◽  
Full Range ◽  
Factor Ix ◽  
Split Thickness Skin Graft ◽  
Management Problem ◽  
Range Of Movement ◽  
Thickness Skin ◽  
Life Threatening ◽  
Forearm Flexor

Bleeding in hemophiliacs with circulating anticoagulants is still a serious management problem. We would like to report our efforts at achieving hemostasis in a 31 year old AHF deficient severe hemophiliac with inhibitor detected in Feb. 1972. He presented with right forearm flexor compartment bleed which did not respond to conservative management with Konyne (30 u/kg q3h) and necessitated a fasciotomy to relieve compression. No hemostasis occurred until 4 hrs. post-operatively when he received his first infusion of Auto-Factor IX*, 6 vials (60 u/kg). At this time he also received blood for his shocky state. With the institution of regular infusions of Auto-Factor IX alternating with Konyne, hemorrhage was controlled. A week later a split thickness skin graft (from R. thigh) was applied. With continued infusions of mainly Auto-Factor IX (60 u/kg q6h) the grafted and donor sites healed. The patient was subsequently discharged with full range of movement in all limbs. His inhibitor levels which ranged between 1 - 3 Bethesda units/ml shortly after admission over a period of 3 weeks rose to over 100 units/ml. Six months after the episode his inhibitor levels are still over 100 units/ml. Activated prothrombin concentrates are effective in hemostatic control of life-threatening bleeding in hemophiliac patients with inhibitors.* Kindly supplied by Dr. Aaron Josephson, Travenol Laboratories, Chicago, 111. (Hyland Division).

Improving Outcomes in Anterolateral Thigh Flap Donor-Site Reconstruction Using Propeller Flaps: A Retrospective Comparative Study with Skin Grafting

2020 ◽  
Author(s):  
Domenico Pagliara ◽  
Maria Lucia Mangialardi ◽  
Stefano Vitagliano ◽  
Valentina Pino ◽  
Marzia Salgarello
Keyword(s):  
Comparative Study ◽  
Skin Graft ◽  
Donor Site ◽  
Split Thickness Skin Graft ◽  
Tactile Sensitivity ◽  
Aesthetic Outcome ◽  
Propeller Flap ◽  
Thickness Skin ◽  
Anterolateral Thigh ◽  
Alt Flap

Abstract Background After anterolateral thigh (ALT) flap harvesting, skin graft of the donor site is commonly performed. When the defect width exceeds 8 cm or 16% of thigh circumference, it can determine lower limb function impairment and poor aesthetic outcomes. In our comparative study, we assessed the functional and aesthetic outcomes related to ALT donor-site closure with split-thickness skin graft compared with thigh propeller flap. Methods We enrolled 60 patients with ALT flap donor sites. We considered two groups of ALT donor-site reconstructions: graft group (30 patients) with split-thickness skin graft and flap group (30 patients) with local perforator-based propeller flap. We assessed for each patient the range of motion (ROM) at the hip and knee, tension, numbness, paresthesia, tactile sensitivity, and gait. Regarding the impact on daily life activities, patients completed the lower extremity functional scale (LEFS) questionnaire. Patient satisfaction for aesthetic outcome was obtained with a 5-point Likert scale (from very poor to excellent). Results In the propeller flap group, the ROMs of hip and knee and the LEFS score were significantly higher. At 12-month follow-up, in the graft group, 23 patients reported tension, 19 numbness, 16 paresthesia, 22 reduction of tactile sensitivity, and 5 alteration of gait versus only 5 patients experienced paresthesia and 7 reduction of tactile sensitivity in the propeller flap group. The satisfaction for aesthetic outcome was significantly higher in the propeller flap group. Conclusion In high-tension ALT donor-site closure, the propeller perforator flap should always be considered to avoid split-thickness skin graft with related functional and aesthetic poor results.

scholarly journals Reconstruction of a secondary scalp defect using the crane principle and a split-thickness skin graft

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yi Lu ◽  
Ke-Chung Chang ◽  
Che-Ning Chang ◽  
Dun-Hao Chang
Keyword(s):  
Skin Graft ◽  
Subcutaneous Tissue ◽  
Donor Site ◽  
Split Thickness Skin Graft ◽  
Salvage Procedure ◽  
Primary Defect ◽  
Scalp Defects ◽  
Thickness Skin ◽  
Scalp Defect ◽  
Secondary Defect

Abstract Background Scalp reconstruction is a common challenge for surgeons, and there are many different treatment choices. The “crane principle” is a technique that temporarily transfers a scalp flap to the defect to deposit subcutaneous tissue. The flap is then returned to its original location, leaving behind a layer of soft tissue that is used to nourish a skin graft. Decades ago, it was commonly used for forehead scalp defects, but this useful technique has been seldom reported on in recent years due to the improvement of microsurgical techniques. Previous reports mainly used the crane principle for the primary defects, and here we present a case with its coincidental application to deal with a complication of a secondary defect. Case report We present a case of a 75-year-old female patient with a temporoparietal scalp squamous cell carcinoma (SCC). After tumor excision, the primary defect was reconstructed using a transposition flap and the donor site was covered by a split-thickness skin graft (STSG). Postoperatively, the occipital skin graft was partially lost resulting in skull bone exposure. For this secondary defect, we applied the crane principle to the previously rotated flap as a salvage procedure and skin grafting to the original tumor location covered by a viable galea fascia in 1.5 months. Both the flap and skin graft healed uneventfully. Conclusions Currently, the crane principle is a little-used technique because of the familiarity of microsurgery. Nevertheless, the concept is still useful in selected cases, especially for the management of previous flap complications.

scholarly journals Split-thickness skin graft donor-site morbidity: A systematic literature review

Burns ◽  
2021 ◽  
Author(s):  
Malachy Asuku ◽  
Tzy-Chyi Yu ◽  
Qi Yan ◽  
Elaine Böing ◽  
Helen Hahn ◽  
...  
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Skin Graft ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Split Thickness Skin Graft ◽  
Thickness Skin ◽  
Graft Donor

The effect of sucralfate, an agent for gastroprotection on the healing of split thickness skin graft donor sites

2007 ◽  
Vol 30 (1) ◽  
pp. 25-28 ◽  
Author(s):  
Birol Civelek ◽  
H. İbrahim Inal ◽  
Kubilay Ozdil ◽  
Selim Celebioglu
Keyword(s):  
Skin Graft ◽  
Split Thickness Skin Graft ◽  
Thickness Skin ◽  
Graft Donor
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