scholarly journals Free Tissue Transfer in Pediatric Lower Limb Trauma

2019 ◽  
Vol 52 (01) ◽  
pp. 037-044 ◽  
Author(s):  
R. Srikanth
Keyword(s):  
Soft Tissue ◽  
Lower Limb ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Large Series ◽  
Soft Tissue Coverage ◽  
Wound Coverage ◽  
Tissue Transfer ◽  
Limb Trauma ◽  
Lower Limb Trauma

AbstractFree tissue transfer has become the standard in wound coverage and further refinements have given us newer flap donor sites or modifications of existing flaps to decrease morbidity; smaller vessels are being anastomosed, a direct spin-off following successful distal replantations. Younger children are presenting with traumatic defects similar to adults. Although there were apprehensions of free tissue transfer in children occasioned by smaller vessels, duration of procedure and concerns of growth following flap harvest, reports of small and large series have appeared in the literature with similar success. Pediatric-free tissue transfer is now an established entity. This article seeks to arrive at a consensus based on a review of the existing literature on free flaps for skin and soft-tissue coverage of lower limb trauma in children.

Early soft tissue coverage and negative pressure wound therapy optimises patient outcomes in lower limb trauma

Injury ◽  
2012 ◽  
Vol 43 (6) ◽  
pp. 772-778 ◽  
Author(s):  
David Shi Hao Liu ◽  
Foti Sofiadellis ◽  
Mark Ashton ◽  
Kirstie MacGill ◽  
Angela Webb
Keyword(s):  
Soft Tissue ◽  
Patient Outcomes ◽  
Negative Pressure ◽  
Lower Limb ◽  
Negative Pressure Wound Therapy ◽  
Soft Tissue Coverage ◽  
Wound Therapy ◽  
Limb Trauma ◽  
Lower Limb Trauma

Principles of Wound Management and Soft Tissue Repair II

2018 ◽  
Author(s):  
Jonathan S. Friedstat ◽  
Michelle R Coriddi ◽  
Eric G Halvorson ◽  
Joseph J Disa
Keyword(s):  
Soft Tissue ◽  
Tissue Repair ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Wound Management ◽  
Soft Tissue Coverage ◽  
Soft Tissue Repair ◽  
Healing Wound ◽  
Contour Defects ◽  
Tissue Flaps

Wound management and soft-tissue repair can vary depending on the location. The head and neck, chest and back, arm and forearm, hand, abdomen, gluteal area and perineum, thigh, knee, lower leg, and foot all have different local options and preferred free flaps to use for reconstruction. Secondary reconstruction requires a detailed analysis of all aspects of the wound including any scars, soft tissue and/or skin deficits, functional defects, contour defects, complex or composite defects, and/or unstable previous wound coverage. Careful monitoring of both the patient and reconstruction is necessary in the postoperative period to ensure long-term success.   This review contains 2 figures and 17 references. Key Words: free tissue transfer, pedicle flaps, soft-tissue coverage, wound closure, wound healing, wound management, wound reconstruction, tissue flaps

Principles of Wound Management and Soft Tissue Repair II

2018 ◽  
Author(s):  
Jonathan S. Friedstat ◽  
Michelle R Coriddi ◽  
Eric G Halvorson ◽  
Joseph J Disa
Keyword(s):  
Soft Tissue ◽  
Tissue Repair ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Wound Management ◽  
Soft Tissue Coverage ◽  
Soft Tissue Repair ◽  
Healing Wound ◽  
Contour Defects ◽  
Tissue Flaps

Wound management and soft-tissue repair can vary depending on the location. The head and neck, chest and back, arm and forearm, hand, abdomen, gluteal area and perineum, thigh, knee, lower leg, and foot all have different local options and preferred free flaps to use for reconstruction. Secondary reconstruction requires a detailed analysis of all aspects of the wound including any scars, soft tissue and/or skin deficits, functional defects, contour defects, complex or composite defects, and/or unstable previous wound coverage. Careful monitoring of both the patient and reconstruction is necessary in the postoperative period to ensure long-term success.   This review contains 2 figures and 17 references. Key Words: free tissue transfer, pedicle flaps, soft-tissue coverage, wound closure, wound healing, wound management, wound reconstruction, tissue flaps

Fasciocutaneous Free Flaps Are More Reliable Than Muscle Free Flaps in Lower Limb Trauma Reconstruction: Experience in a Single Trauma Center

2012 ◽  
Vol 28 (05) ◽  
pp. 333-340 ◽  
Author(s):  
Foti Sofiadellis ◽  
David Liu ◽  
Angela Webb ◽  
Kirsty MacGill ◽  
Warren Rozen ◽  
...  
Keyword(s):  
Lower Limb ◽  
Trauma Center ◽  
Free Flaps ◽  
Limb Trauma ◽  
Lower Limb Trauma

Geriatric Patients with Free Flap Reconstruction: A Comparative Clinical Analysis of 256 Cases

2019 ◽  
Vol 36 (02) ◽  
pp. 127-135 ◽  
Author(s):  
Matthias Wähmann ◽  
Melodie Wähmann ◽  
Dominic Henn ◽  
Lingyun Xiong ◽  
Christoph Hirche ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Surgical Complications ◽  
Geriatric Patients ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Old Patients ◽  
Very Old ◽  
Patients Âgés ◽  
Tissue Transfer ◽  
Very Old Patients

Abstract Background In elderly patients, complex soft tissue defects are increasingly observed due to the prolonged life expectancy and accompanying comorbidities. The aim of this study is to evaluate whether free tissue transfer is safe in very old patients without additional risk and complications. Methods All patients older than 65 years undergoing free tissue transfer between November 2007 and September 2016 were reviewed in a retrospective study. Two cohorts were compared regarding perioperative morbidity and postoperative outcome (cohort 1 [old patients, ages 65–79]; cohort 2 [very old patients, ages ≥ 80]). Results In total, 256 patients were included in the study (cohort 1 [n = 217]; cohort 2 [n = 39]). Overall, 262 free flaps were performed due to a second microsurgical reconstruction in six cases. No statistically significant differences between cohorts were observed regarding surgical complications, total flap losses, and mortality. Detailed evaluation of cohort 2 revealed a significant learning curve during the observation period regarding the perioperative management and procedure of soft tissue reconstruction: operation length as well as postoperative intensive care unit stay decreased significantly over time (p < 0.05) and also surgical complications showed a positive trend (p = 0.07). We ascertained a shift toward a “more reliable” flap selection from predominantly anterolateral thigh flap) to axial flaps such as rectus abdominis and latissimus dorsi flaps. Conclusion Our study showed that age is not associated with an increased risk of postoperative complications. Reliable muscle free flaps, two-stage procedures, and safe vascular supply are important strategic aspects to achieve microvascular tissue transfer with high success rates in geriatric patients.

Principles of acute management of lower limb trauma

2021 ◽  
pp. 583-584
Author(s):  
Michael Kelly
Keyword(s):  
United Kingdom ◽  
Soft Tissue ◽  
Lower Limb ◽  
Initial Assessment ◽  
Acute Management ◽  
The United Kingdom ◽  
Limb Trauma ◽  
Principles Of Treatment ◽  
Lower Limb Trauma ◽  
Complex Injuries

The morbidity of lower limb trauma can be significant and a combination of orthopaedic and plastic surgery expertise is required from the initial assessment through to completion of treatment for these complex injuries. Guidelines have been established in the United Kingdom that address assessment, timing of treatment, and the management of soft tissue and skeletal components of injury. This chapter outlines these principles of treatment.

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.

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