Abdominal Donor Site Morbidity: Impact of the TRAM and DIEP Flap on Strength and Function

2002 ◽  
Vol 16 (1) ◽  
pp. 119-130 ◽  
Author(s):  
Catriona M. Futter
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Diep Flap ◽  
And Function

Alternative flaps for microsurgical breast reconstruction

2021 ◽  
pp. 1107-1114
Author(s):  
Hinne A. Rakhorst
Keyword(s):  
Breast Reconstruction ◽  
Standard Care ◽  
Donor Site ◽  
Perforator Flap ◽  
Donor Site Morbidity ◽  
The Body ◽  
Diep Flap ◽  
Deep Inferior Epigastric Perforator ◽  
Muscle Sparing ◽  
Breast Reconstructive Surgery

Microsurgery in general has made dramatic improvements over the past decades. This applies to microsurgery in general and to breast reconstructive surgery especially. The demand for autologous breast reconstruction has risen. Since the introduction of the free transverse rectus abdominis myocutaneous (TRAM) flaps, through the muscle-sparing TRAM, flaps designs have evolved into the current gold standard, the deep inferior epigastric perforator (DIEP) flap. From experiences and increasing numbers of flap procedures performed by surgeons, techniques became more familiar and part of standard care. These factors gave rise to the development of a growing number of areas of the body where tissues of interest can be harvested using perforator flap-based techniques. This chapter discusses the most common as well as the ‘rising stars’ in terms of flaps to be used as alternative flaps to the DIEP flap for breast reconstruction. It discusses practical issues on dissection as well as donor site morbidity.

scholarly journals Sole Reconstruction Using Anterolateral Thigh Free Flap: A Review of 4 Cases

1970 ◽  
Vol 2 (3) ◽  
Author(s):  
Parintosa Atmodiwirjo ◽  
Afriyanti Sandhi
Keyword(s):  
Free Flap ◽  
Weight Bearing ◽  
Donor Site ◽  
Three Dimensional ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Common Procedure ◽  
Anterolateral Thigh ◽  
Protective Sensation ◽  
And Function

Background: The ideal technique for sole reconstruction should meet such requisite as a durable and comfortable weight-bearing surface, solid anchoring to deep tissue for resistance to shear force and adequate protective sensation. The anterolateral thigh (ALT) perforator free flap provides a large, pliable skin island and sufficient bulk, allowing three-dimensional tailoring to complex defects. The present article is about our experience of sole reconstruction ALT perforator free flap. Patient and Method: Total of 4 flaps in the foot defects was performed in February 2009 to December 2012. We reconstructed soft tissue defects in the sole using ALT free flaps, the complications, aesthetic and function results were monitored. Result: ALT perforator free flap provided stable and durable long-term wound cover in all patients, resulting in early rehabilitation and function outcomes were completely achieved. Complications were few and manageable in all cases. Summary: ALT perforator free flap has become common procedure in many centers around the world. The numerous advantages include stable wound coverage; improve aesthetic and functional outcomes, and minimal donor site morbidity. In our experiences, we found that the use of ALT perforator free flap in sole defect reconstruction, to be technically affordable, reliable and have resulted in excellent outcomes.

scholarly journals Our early experience in immediate total breast reconstruction with deep inferior epigastric artery perforator flap

2019 ◽  
Vol 6 (12) ◽  
pp. 4444
Author(s):  
Thyagaraj . ◽  
Ashrith Iyanahally ◽  
B. G. Tilak ◽  
M. E. Sham ◽  
Ganesh .
Keyword(s):  
Donor Site ◽  
Perforator Flap ◽  
Breast Cancer Diagnosis ◽  
Donor Site Morbidity ◽  
Diep Flap ◽  
Inferior Epigastric Artery ◽  
Aesthetic Result ◽  
Epigastric Artery ◽  
Deep Inferior Epigastric Artery ◽  
Artery Perforator

Background: As the breast cancer diagnosis has increased over recent years, patient have become more informative regarding treatment and reconstructive options, hence the expectation of the results will be very high. Reconstruction of breast with best result and less donor site morbidity is the target.Methods: A total of 20 cases were studied between January 2018 to January 2019 at our hospital to assess the outcome of deep inferior epigastric artery perforator (DIEP) flap for immediate breast reconstruction.Results: A total of twenty DIEP flaps were performed. Mean time required for flap harvest was 125 minutes, and time taken for flap inset was 110 minutes. There was no flap loss in any of the twenty cases. Two patients had fat necrosis. All patients were satisfied with aesthetic outcome.Conclusions: DIEP flap has good aesthetic result with less donor site morbidity.

scholarly journals The First Stage of Acquired Syndactyly Reconstruction - A Rare Case Report

2022 ◽  
Vol 12 (1) ◽  
pp. 87-91
Author(s):  
Lucretya Yeniwati Tanuwijaya ◽  
Agus Roy Rusly Hariantana Hamid ◽  
I Gusti Putu Hendra Sanjaya
Keyword(s):  
Case Report ◽  
Skin Graft ◽  
Skin Flap ◽  
Donor Site ◽  
Surgical Techniques ◽  
Operation Time ◽  
Donor Site Morbidity ◽  
Reconstruction Procedure ◽  
Local Skin ◽  
And Function

Background: Acquired syndactyly is a very rare disorder on the interdigital area. Syndactyly with only soft tissue involvement can be a sequela of trauma, such as burn, inflammation or infection in the interdigital area, resulting in bony fusion following crush injury. Case Report: An 8-year-old boy came to our department with fusion from the base to the tip of the first to fourth right toes since the accidental step on burnt plastic 5 years ago. He complained of a poor appearance and discomfort when walking. Then we performed zigzag incision for first to second toes and third to fourth toes. Skin graft closure was performed to cover the defect on third to fourth toes. The second reconstruction surgery will be scheduled 6 months later. Discussion: The surgical techniques for foot syndactyly were derived from those for hand syndactyly, which are to separate the digital fusion by creating local skin flap. Additionally, skin graft might be necessary when recent surgeons avoid the use of skin graft for open treatment, primary closure by defatting, or intricate local flaps. These can shorten the operation time and minimize donor site morbidity. However, surgeons should consider the free tension closure of the wound by combining the skin graft after the flap. Conclusion: Reconstruction procedure for foot syndactyly aims to improve the appearance and function of the toes as well as to avoid progressive deformity through development. The skin graft addition in combination of skin flap shows promising outcome. Key words: acquired syndactyly, syndactyly reconstruction, zigzag flap, skin graft.

Wounds in Patients with Cancer

2020 ◽  
Author(s):  
Mark W. Clemens ◽  
Brian J. Blumenauer ◽  
Ashleigh M. Francis ◽  
Jonathon B. Olenczak ◽  
Jesse C. Selber ◽  
...  
Keyword(s):  
Wound Healing ◽  
Radiation Therapy ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Wound Management ◽  
Wound Complications ◽  
Tissue Quality ◽  
Form And Function ◽  
Integral Role ◽  
And Function

Reconstructive surgery plays an integral role in helping restore form and function in patients with complex oncologic wounds. The intricate process of wound healing can be adversely affected by exposure to chemotherapeutic and radiation therapies. Assessment of available donor tissue quality, previous radiation therapy, vascular status, and donor site morbidity are essential when determining the most appropriate reconstructive approach for definitive wound management. The timing of reconstruction in relation to chemotherapy or radiotherapy regimens influences wound healing. Additionally, the timing of reconstruction is important in order to avoid delaying additional adjuvant therapies. Optimizing nutritional status is critical for improved patient outcomes in the oncologic patient population. At times, palliative efforts by means of surgical debulking are required of a reconstructive surgeon as advanced cancers can leave patients with disfiguring, fungating masses. This review contains 9 figures, and 44 references. Keywords: wounds in cancer, wounds in the cancer patient, oncologic wounds, oncologic wound healing, oncologic wound management, wound complications, effect of chemotherapy on wound healing, effect of radiation therapy on wound healing, oncologic reconstruction

Aneurysmal Bone Cysts in the Hand Treated by Free Non-Vascular Transfer of Metatarsal or Proximal Phalanx from the Foot

1993 ◽  
Vol 18 (6) ◽  
pp. 736-741 ◽  
Author(s):  
G. S. RAO ◽  
P. KEOGH ◽  
H. WEBSTER ◽  
P. G. LUNN ◽  
F. D. BURKE
Keyword(s):  
Donor Site ◽  
Bone Cyst ◽  
Proximal Phalanx ◽  
Donor Site Morbidity ◽  
No Donor ◽  
Joint Reconstruction ◽  
Articular Surfaces ◽  
Aneurysmal Bone Cysts ◽  
And Function ◽  
Second Toe

Two cases of aneurysmal bone cyst in the hand are reported. In one case the entire first metacarpal was resected and grafted using the fourth metatarsal. In the second case diaphysectomy of the middle phalanx of the index digit was performed, and the proximal phalanx of the second toe was used as graft. Satisfactory length and function were maintained, the grafts remained viable and there was no donor site morbidity. Transplant of a metatarsal or toe phalanx to the hand, as a free non-vascularized graft, is a relatively straight forward operation, requires minimal refashioning of the graft, provides articular surfaces for joint reconstruction and leaves little donor site morbidity.

Use of Extracellular Matrix Bioscaffolds to Enhance ACL Healing: A Multidisciplinary Approach in a Goat Model

2010 ◽  
Author(s):  
Matthew B. Fisher ◽  
Ho-Joong Jung ◽  
Rui Liang ◽  
Kwang Kim ◽  
Patrick J. McMahon ◽  
...  
Keyword(s):  
Cruciate Ligament ◽  
Healing Process ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Surgical Reconstruction ◽  
Suture Repair ◽  
Joint Stability ◽  
Tissue Replacement ◽  
Anterior Cruciate ◽  
And Function

Due to the poor healing potential of the anterior cruciate ligament (ACL) of the knee, surgical reconstruction using soft tissue replacement grafts is performed to restore knee stability and function. However, the surgery has serious complications including a high incidence of donor site morbidity and the development of osteoarthritis in the long-term. Recently, functional tissue engineering approaches to heal an injured ACL using biological stimulation via growth factors and bioscaffolds have yielded some positive clinical and laboratory results. As the healing process for the ACL is slow, additional suture repair of the ACL has been needed to provide initial joint stability and to reduce the risk of injury to neighboring tissues.

Donor Site Morbidity after Lumbar Artery Perforator Flap Breast Reconstruction

2021 ◽  
Author(s):  
Dries Opsomer ◽  
Tom Vyncke ◽  
Michelle Ryx ◽  
Koenraad Van Landuyt ◽  
Phillip Blondeel ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Donor Site ◽  
Significant Risk ◽  
Perforator Flap ◽  
Significant Risk Factor ◽  
Donor Site Morbidity ◽  
Diep Flap ◽  
Lumbar Artery ◽  
Patient Reported ◽  
Artery Perforator

Abstract Background The lumbar artery perforator flap is a second-choice flap in autologous breast reconstruction whenever a deep inferior epigastric artery perforator (DIEP) flap is not possible. Ideal candidates are pear-shaped women who do not have enough bulk on the abdomen or thighs. Patient-reported “satisfaction with breasts” is excellent but we were curious about the donor site morbidity. Methods We performed a retrospective study of all lumbar flap breast reconstructions performed between 2010 and 2019. Patients were invited by e-mail and telephone to take part in a BREAST-Q survey. Results One hundred fifty-four flaps were performed in 110 patients. Sixty-three patients filled out the BREAST-Q questionnaire. The most frequently observed donor site complications are seroma (35.1%), dehiscence (8.4%), and hematoma (3.2%). Correction of the donor site scar was performed in 31.8% of patients, lipofilling of the donor flank in 5.2%, and liposuction of the contralateral flank in 18.3% of patients. Body mass index (BMI) was the only significant risk factor for donor site complications. Patient-reported “satisfaction with donor site appearance” was good but significantly lower for primary reconstructions compared with secondary and tertiary procedures. Flap weight significantly influences patient-reported “physical wellbeing of the donor site.” Ninety-seven percent of patients would recommend the surgery to someone in a similar position and would do it all over. Conclusion The lumbar artery perforator flap is a good alternative for breast reconstruction in selected patients. The donor site issues consist mainly of seromas, prolonged discomfort, and a scar that might be noticeable to others, but patient-reported satisfaction is very high.

Sign in / Sign up

Export Citation Format

Share Document