Reconstruction of Deep Burn Wounds Around the Ankle With Free Fascia Flaps Transfer and Split-Thickness Skin Graft

2019 ◽  
Vol 40 (6) ◽  
pp. 763-768
Author(s):  
Xuekang Yang ◽  
Zhuoqun Fang ◽  
Mengdong Liu ◽  
Yue Zhang ◽  
Qiaohua Chen ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Skin Graft ◽  
Burn Injury ◽  
Split Thickness Skin Graft ◽  
Soft Tissue Coverage ◽  
Burn Wounds ◽  
Temporal Fascia ◽  
Thickness Skin ◽  
Anterolateral Thigh ◽  
Dressing Change

Abstract We aimed to introduce a technique by combining free fascia flaps transfer with split-thickness skin graft for the reconstruction of deep burn wounds at the ankle. Fifteen patients from 2009 to 2016 were enrolled in this study. Patients in this series suffered from a deep burn injury around the ankle, which was accompanied with exposure of tendon and medial or lateral malleolus exposure due to severe soft-tissue defects (N = 15). All the 15 wounds were repaired combining free fascia flaps with split-thickness skin graft operations, including nine anterolateral thigh fascia lata flaps (ATFL flaps) and six superficial temporal fascia flaps (STF flaps). All the fascia flaps completely survived. Two patients showed partial grafting skin necrosis due to either wound infection or subcutaneous hematoma infection, and this was eventually healed satisfactorily after conventional dressing change. All patients achieved esthetic outcome and acceptable functionality without further revisions needed. Our present study reports a useful method that involves using free fascia flaps in combination with split-thickness skin graft to repair deep burn wounds around the ankle. This method provided reliable and durable soft-tissue coverage with good outcomes.

scholarly journals An analysis of post traumatic leg and foot defects

2019 ◽  
Vol 6 (6) ◽  
pp. 2041
Author(s):  
Gopalan G. ◽  
Dhanaraju S.
Keyword(s):  
Soft Tissue ◽  
Skin Graft ◽  
Traffic Accidents ◽  
Lower Limbs ◽  
Split Thickness Skin Graft ◽  
Soft Tissue Coverage ◽  
Durable Good ◽  
Skin Defect ◽  
Early Recovery ◽  
Thickness Skin

Background: Management of lower extremity trauma with bone and soft tissue injury is a challenging task with the aim of giving early recovery and durable good quality skin cover according to the skin defect and analyze various reconstructive options at various levels of injury. Our aim of the study is to analyze various reconstructive options for traumatic skin loss involving lower limbs especially knee and below knee, and analyze the incidence of age, sex and etiology of traumatic defects.Methods: Prospective study in our plastic surgery department in the period of 24 months, with all the cases of traumatic defects of leg and foot where included. All age and sex patients were included.Results: Most common cause for traumatic leg and foot defects are road traffic accidents followed by accidental fall and others, most commonly in males amounting 73%, children 10% and  females 17%, among the skin and soft tissue  defects upper and lower 1/3 leg defects are predominant. Among the soft tissue coverage split thickness skin graft dominating about 60% of cases, flaps 30% of cases, among the flaps 70% are fasciocutaneous flaps predominantly inferiorly based  and 30% are muscle and musculocutaneous flaps, among the muscle predominantly soleus muscle flap was used to cover the defect.Conclusions:Road traffic accidents dominating the cause for leg and foot defects , males are more commonly affected  and upper one third leg defects are predominant for soft tissue coverage split thickness skin graft are commonest procedures followed that cutaneous and muscle flaps. 

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.

Fibrin sealant for split-thickness skin graft fixation in burn wounds - An ancillary postulated role in scar modulation

2020 ◽  
Vol 31 ◽  
pp. 100197
Author(s):  
Vamseedharan Muthukumar ◽  
Suvashis Dash ◽  
Ahmad Faraz Danish ◽  
Srushti Sheth ◽  
Deepak Nanda ◽  
...  
Keyword(s):  
Skin Graft ◽  
Fibrin Sealant ◽  
Graft Fixation ◽  
Split Thickness Skin Graft ◽  
Burn Wounds ◽  
Thickness Skin

scholarly journals The Effect of Early Tangential Excision and Split Thickness Skin Graft in Reducing Length of Stay in Burns Patients in Jakarta Islamic Hospital Cempaka Putih

2021 ◽  
Vol 8 (1) ◽  
pp. 15-20
Author(s):  
Gammaditya Adhibarata Winarno ◽  
Aditya Wardhana ◽  
Sanjaya Faisal Tanjunga ◽  
A. S Augiani ◽  
An’umillah Arini Zidna
Keyword(s):  
Length Of Stay ◽  
Skin Graft ◽  
Burn Injury ◽  
Study Groups ◽  
Cross Sectional Study ◽  
Burn Injuries ◽  
Split Thickness Skin Graft ◽  
Burn Patients ◽  
Cross Sectional ◽  
Thickness Skin

Introduction: Early tangential excision (TE) and split-thickness skin graft (STSG) have increased the outcome in burn patients treated at specialized burn centers. This study was conducted to compare the length of stay (LOS) in burn patients undergoing early TE & STSG and delayed TE & STSG. Method: This is a retrospective cross-sectional study including 42 patients with varied burn degrees, and TBSA admitted to Jakarta Islamic Hospital Cempaka Putih (JIHCP) Burn Unit. Patients were assigned to two study groups, the early TE & STSG group including 32 patients and the delayed TE & STSG group including 10 patients. All data were collected from the medical record and compared between two study groups. Result: The mean of LOS in a group with early TE & STSG was shorter (9.81±6.41 days) than LOS in the delayed TE & STSG group (15.80±5.67 days). The data of LOS between these groups were compared using an independent T-test. The LOS in the early TE & STSG group was significantly shorter than the delayed TE & STSG group (p=0.012). Conclusion: In patients with burn injuries, early TE & STSG is associated with a shorter length of stay than the delayed TE & STSG. Our study indicates that early excision within five days after burn injury is optimal to reduce the length of stay in burn patients.

scholarly journals Comparing Banana Leaf Dressing and Vaseline Gauze Dressing for Split-Thickness Skin Graft Donor Sites in a Ugandan Hospital

2021 ◽  
Vol 18 (1) ◽  
pp. 4-9
Author(s):  
Naomi Leah Kekisa ◽  
George Galiwango ◽  
Andrew Hodges
Keyword(s):  
Skin Graft ◽  
Split Thickness Skin Graft ◽  
Microbial Culture ◽  
Pain Scores ◽  
Thickness Skin ◽  
Significant Difference ◽  
Graft Donor ◽  
Gauze Dressing ◽  
Dressing Change ◽  
Banana Leaf

Introduction: This study compared the effectiveness of banana leaf dressing (BLD) with the commonly used Vaseline gauze dressing (VGD) on split-thickness skin graft (SSG) donor sites. VGD is not completely nonadherent and is associated with pain on removal. BLD is smooth, non-adherent, pain-free and available. Methods: In this prospective study, consecutive patients were dressed with either BLD or VGD. Ease of applying and removing the dressings was scored. Pain scores were taken on postoperative days 3, 5, 7, 9 and 10. On day 10, the dressing was changed, epithelialization recorded and a swab taken for microbial culture. Average cost of each dressing was calculated. Results: There was no significant difference between postoperative pain scores with either dressing (p=0.992). BLD patients had less pain on  dressing change (p=0.006). Both dressings were easy to apply; BLD was easier to remove (p=0.000). Wounds with BLD re-epithelialized faster (p=0.0158). 40% of wounds grew no organism on microbial culture, 25% grew Staphylococcus aureus and 35% grew unusual organisms (p=0.482). VGD was 4 times more expensive than BLD (p=0.000). Conclusion: Banana leaf dressing is effective and highly recommended for dressing SSG donor sites.Keywords: Split-thickness skin graft, Donor sites, Banana leaf dressing, Vaseline gauze dressing

Clinical Therapeutic Effect of Sheet Split-Thickness Skin Graft with Micropores in Repairing Third-Degree Burn Wounds on the Hands

2016 ◽  
Vol 57 ◽  
pp. 74-80
Author(s):  
Xiaopeng Zheng ◽  
Tiansheng Chen ◽  
Lisen Zhang ◽  
Ruibin Cheng ◽  
Fei Chang ◽  
...  
Keyword(s):  
Therapeutic Effect ◽  
Skin Graft ◽  
Split Thickness Skin Graft ◽  
Burn Wounds ◽  
Thickness Skin ◽  
Degree Burn

Single-institution Outcome Experience Using AlloDerm® as Temporary Coverage or Definitive Reconstruction for Cutaneous and Soft Tissue Malignancy Defects

2013 ◽  
Vol 79 (5) ◽  
pp. 476-482 ◽  
Author(s):  
Jeremiah L. Deneve ◽  
Kiran K. Turaga ◽  
Suroosh S. Marzban ◽  
Christopher A. Puleo ◽  
Amod A. Sarnaik ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Split Thickness Skin Graft ◽  
Adjuvant Radiation ◽  
Soft Tissue Coverage ◽  
Single Institution ◽  
Institutional Review ◽  
Thickness Skin ◽  
Postoperative Findings ◽  
Margin Analysis ◽  
Tissue Defects

Definitive reconstruction after excision of cutaneous and soft tissue malignancies is sometimes limited as a result of lack of native tissue coverage options, patient comorbidities, or pending permanent margin analysis. Acellular dermis (AlloDerm®) reconstruction offers an excellent coverage alternative in these situations. We describe our experience using AlloDerm for coverage of skin and soft tissue defects. An Institutional Review Board approved review of patients undergoing skin/soft tissue coverage with AlloDerm from 2006 to 2012 was performed. Clinicopathologic variables, early postoperative findings, and subjective final cosmetic outcome were analyzed. Sixty-seven patients underwent AlloDerm reconstruction. Melanoma (67%) was the most frequent diagnosis. The median defect size was 42 cm2 (range, 2 to 340 cm2), involving predominantly the lower extremity (45%) or head and neck (32%). AlloDerm was intended for use as a temporary dressing in 64 per cent (43 of 67) and permanent coverage in 24 (36%). Ten patients required reexcision for positive margins. Twenty-five (37%) underwent split-thickness skin graft or flap coverage after AlloDerm placement. Radiation was administered to 16 patients (24%) after AlloDerm reconstruction within a median of 53 days after surgery (range, 18 to 118 days). At first postoperative examination (median, 11 days after surgery), 85 per cent had evidence of healthy AlloDerm incorporation. Cellulitis was the most frequent complication (13%), all resolving with oral antibiotics. AlloDerm reconstruction after skin and soft tissue resection offers a suitable coverage alternative and may serve as a bridge to permanent reconstruction or as a permanent biologic dressing of complex surgical defects. In situations in which adjuvant radiation is needed, AlloDerm can be used without major complications.

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