Timing of Soft Tissue Reconstruction

2020 ◽  
pp. 57-62
Keyword(s):  
Soft Tissue ◽  
Internal Fixation ◽  
Free Flap ◽  
Soft Tissue Reconstruction ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Fracture Union ◽  
Patient Factors ◽  
Tissue Reconstruction ◽  
Wound Excision

Soft tissue cover of a meticulously and comprehensively excised (debrided) wound is the cornerstone of achieving infection-free fracture union. Planning of the soft tissue reconstruction should ideally occur at the time of wound excision. Definitive soft tissue reconstruction should be performed within 72 hours of the injury unless precluded by patient factors, and at the same time as internal fixation of the fracture. Free flap reconstruction is ideally performed on scheduled lists in specialist orthoplastic centres.

scholarly journals Fronto-parietal Osteomyelitis managed by Bipedicled Bucket Handle scalp flap

2018 ◽  
Vol 5 (6) ◽  
pp. 2364 ◽  
Author(s):  
Pawan K. Dixit ◽  
Divya Narain Upadhyay
Keyword(s):  
Soft Tissue ◽  
Free Flap ◽  
Soft Tissue Reconstruction ◽  
Rare Clinical Entity ◽  
Technical Expertise ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Scalp Defect ◽  
Tissue Reconstruction ◽  
Bucket Handle

Osteomyelitis of skull is rare clinical entity in today’s world. Mortality from complications from skull osteomyelitis is 20-40 %. We report a 60-year-old patient presented with fronto-parietal osteomyelitis with orbital extension, with known cardiac and pulmonary disease. Large bipedicled bucket handle flap was used for soft tissue reconstruction. Though free flap reconstruction is ideal for large scalp defect, it requires technical expertise and patient’s fitness for surgery. Bipedicled bucket handle flap can be successfully used for large scalp defect reconstruction in patients in which free flap reconstruction is not possible.

Temporary Wound Dressings

2020 ◽  
pp. 31-40
Keyword(s):  
Soft Tissue ◽  
Internal Fixation ◽  
Normal Saline ◽  
Negative Pressure ◽  
First Aid ◽  
Wound Dressings ◽  
Soft Tissue Reconstruction ◽  
Wound Therapy ◽  
Tissue Reconstruction ◽  
Wound Excision

Temporary dressings are used to cover the wound from the time of first aid through to definitive soft tissue closure. Frequent dressing changes should be avoided to reduce contamination by nosocomial organisms. Therefore, the initial dressing should be simple to apply and maintain tissue viability by preventing desiccation, e.g. gauze soaked in normal saline and covered with an occlusive film as per the National Institute for Health and Care Excellence guidance. Following wound excision, a simple non-adherent dressing can be used. Negative pressure wound therapy should not be used to downgrade the requirement for definitive soft tissue reconstruction, which should be achieved within 72 hours of injury. Following internal fixation, definitive soft tissue reconstruction should be performed at the same time.

Reconstruction of Large Palmar Defects of the Hand Using Free Flaps

1997 ◽  
Vol 22 (5) ◽  
pp. 623-630 ◽  
Author(s):  
M. M. NINKOVÍC ◽  
A. H. SCHWABEGGER ◽  
G. WECHSELBERGER ◽  
H. ANDERL
Keyword(s):  
Soft Tissue ◽  
Free Flap ◽  
Subcutaneous Tissue ◽  
Free Flaps ◽  
Difficult Problem ◽  
Glabrous Skin ◽  
Soft Tissue Reconstruction ◽  
Anatomical Structures ◽  
Tissue Reconstruction ◽  
Restoration Of Sensibility

The reconstruction of large palmar defects of the hand remains a difficult problem due to the specific anatomical structures and highly sophisticated function of the palm. The glabrous skin and subcutaneous tissue in the palm are perfectly adapted to serve the prehensile function. The particular aim must be that repairs to this functional structure are similar in texture and colour and are aesthetically acceptable. Restoration of sensibility is desirable. For smaller defects a great variety of local pedicled or island flaps can be applied. However, for larger defects with exposed tendons, nerves or other essential structures, free flaps remain as a reliable alternative. This paper reviews our approach of soft tissue reconstruction in 16 patients with large palmar defects using various kinds of free flaps. The advantages, disadvantages and current indications for free flap resurfacing of the palm are discussed.

scholarly journals Topical Application of Fasudil Hydrochloride for Vasospasm during Soft Tissue Reconstruction Using a Free Flap

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Kaoru Tada ◽  
Tadahiro Nakajima ◽  
Mika Nakada ◽  
Masashi Matsuta ◽  
Hiroyuki Tsuchiya
Keyword(s):  
Blood Flow ◽  
Soft Tissue ◽  
Topical Application ◽  
Free Flap ◽  
Arterial Blood Flow ◽  
Soft Tissue Reconstruction ◽  
Clinical Report ◽  
Arterial Blood ◽  
Malignant Soft Tissue Tumor ◽  
Tissue Reconstruction

Vasospasm is a phenomenon that can complicate microsurgery. We report a case in which vasospasm was quickly relieved by topical application of fasudil hydrochloride. A 36-year-old man underwent preoperative chemotherapy and wide excision for a malignant soft tissue tumor around the knee joint. We planned reconstruction using a free latissimus dorsi muscle flap for the resulting soft tissue defect and selected the peroneal vessels as the recipient vessels. However, there was no arterial blood flow from the peroneal vessels, which we diagnosed as vasospasm. Conventional treatment of the vasospasm was attempted, but blood flow was not achieved. Topical application of fasudil hydrochloride solution promptly relieved the vasospasm. To the best of our knowledge, this is the first clinical report of the use of fasudil hydrochloride for vasospasm during soft tissue reconstruction using a free flap.

scholarly journals Free Flap Selection and Outcomes of Soft Tissue Reconstruction Following Resection of Intra-oral Malignancy

2019 ◽  
Vol 6 ◽  
Author(s):  
Adam M. H. Young ◽  
Sarah Bache ◽  
Nicolas Segaren ◽  
Suzane Murphy ◽  
Jane Maraka ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Free Flap ◽  
Soft Tissue Reconstruction ◽  
Tissue Reconstruction ◽  
Oral Malignancy
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