Soft-Tissue Expansion in the Lower Extremities

Objectives: Ear reconstruction is a challenging surgery for the complicated conditions in patients with microtia. The tissue expansion techniques were necessary and relatively safe for patients with insufficient soft tissue. However, complications such as necrosis of expanded flap and exposure of tissue expander limited the popularization of this method. This study described the use of modified Brent method to handle the exposure of the postauricular tissue expander. Methods: From January 2013 to December 2019, 27 ear reconstruction patients with trauma or necrosis on an expanded skin flap and subsequent exposure of tissue expander were treated with modified Brent method, which consisted of 3 stages: removal of the expander, tension-free closure of wound, and framework fabrication; elevation of reconstructed ear; lobule rotation; and minor modification. Results: Fifty-six percent of exposures occurred in the lower pole of the tissue expander. Exposure usually occurred 54.5 days after implantation. The majority of reconstructed ears had a satisfactory appearance and showed relatively stable outcomes. Only one case of cartilage exposure required revision surgery and was repaired by the temporoparietal fascia. Conclusion: With reasonable distribution of expanded flap, prolonged interval, and sutures under tension-free conditions, complications like the occurrence of trauma or necrosis-induced exposure of tissue expander can be repaired efficiently by a staging modified Brent method.

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Dermal and Epidermal Response to Soft-Tissue Expansion in the Pig

Plastic & Reconstructive Surgery ◽

10.1097/00006534-198803000-00013 ◽

1988 ◽

Vol 81 (3) ◽

pp. 390-395 ◽

Cited By ~ 47

Author(s):

Peter E. Johnson ◽

Desmond A. Kernahan ◽

Bruce S. Bauer

Keyword(s):

Soft Tissue ◽

Tissue Expansion

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Inoculation of sonicate fluid into blood culture bottles improves microbial detection in patients with orthopedic bone and soft tissue infections of the upper and lower extremities

Journal of Orthopaedic Science ◽

10.1016/j.jos.2021.11.012 ◽

2021 ◽

Author(s):

Takeyasu Toyama ◽

Narumi Ueda ◽

Yoshitaka Hamada ◽

Kazuyuki Okuda ◽

Takanori Saito

Keyword(s):

Soft Tissue ◽

Blood Culture ◽

Lower Extremities ◽

Soft Tissue Infections ◽

Microbial Detection ◽

Upper And Lower Extremities

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LONG-TERM DONOR-SITE MORBIDITY IN COMPOSITE ANTEROLATERAL THIGH FREE FLAP FOR COMPLEX DEFECT OF LOWER LEG AND FOOT RECONSTRUCTION

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2020.5.12 ◽

2020 ◽

pp. 85-91

Author(s):

Phuc Le Hong ◽

Son Tran Thiet ◽

Thuy Nguyen Xuan

Keyword(s):

Soft Tissue ◽

Skin Graft ◽

Free Flap ◽

Donor Site ◽

Lower Extremities ◽

Lower Leg ◽

Donor Site Morbidity ◽

Thigh Circumference ◽

Anterolateral Thigh

Background: In recent years, the composite anterolateral thigh free flap with tensor fasciae latae or vastus lateralis has been a new-applied type of flap that can provide very good reconstruction materials in complex defects of lower leg and foot. The study purpose is to evaluate the systematically complications of donor site, related factors to results of the donor area, in order to apply the result to improve the treatment, which have not been much reported in literature. Materials and Methods: Systematic donor site morbilidy evaluation in a prospective, uncontrolled clinical descriptive study of 33 composite anterolateral thigh free flaps in various forms to reconstruct anatomical structures or to resconstruct deep defects combined with covering the surfaces for complex soft tissue defects in lower extremities for 32 patients due to different causes in lower leg and foot area from 2014-2019 at Hue University of Medicine and Pharmacy. Examining and evaluating aesthetic and functional result of donor-site 3 months and 6 months up to 2 year after surgery; evaluating the correlation between the width and the type of the flaps and donor site closure methods. Result: In 33 composite flaps used, flap width to thigh circumference less than 20% in 27 cases (81.8%), more than 20% in 6 cases (18.20% ); There were 28 cases in which the donor site was directly closed, 5 cases required skin graft; All direct closed cases had flap width/ thigh circumference index below 20%; On the contrary, in cases having this index greater than 20%, the donor site required skin graft with p < 0.01. There are 11/33 (33.33%) of cases reported complications in donor site ; lateral thigh paresthesia is the most complicated complication with 8/33 cases (24.24%), followed by bad scarring 3/33 cases (9.09%). Conclusion: Long term follow up donor site morbility after composite anterior thigh free flap present 11/33 cases (33.33%): mostly complications of the donor site are thigh paresthesia with 8/33 cases (24.24%), and bad scarring 3/33 cases (9,09%), which improve time by time. Keywords: Composite anterior thigh free flap, lower extremities soft tissue defect, donor site morbidity

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Organization of stage rehabilitation of servicemen with gunshot defects of soft tissues at the levels of medical care

Medicni perspektivi (Medical perspectives) ◽

10.26641/2307-0404.2021.4.248228 ◽

2021 ◽

Vol 26 (4) ◽

pp. 188-195

Author(s):

K.D. Babov ◽

I.P. Khomenko ◽

S.V. Tertyshnyi ◽

Babova I.K. Babova I.K. ◽

R.S. Vastianov

Keyword(s):

Surgical Treatment ◽

Soft Tissue ◽

Medical Care ◽

Soft Tissues ◽

Lower Extremities ◽

Gunshot Wounds ◽

Care Quality ◽

Rehabilitation Service ◽

Soft Tissue Defects ◽

Tissue Defects

Building a modern system of rehabilitation of servicemen in Ukraine is an integral part of providing medical care in armed conflict. Rehabilitation of servicemen after gunshot wounds with soft tissue defects of the lower extremities is a common but difficult problem for surgical and rehabilitation teams. The process of rehabilitation requires the implementation of certain methodological provisions. At present, medical care for servicemen is a four-levels’ one. Rehabilitation service is provided at the third and fourth levels of medical care. The aim of the study was to improve the quality of medical care for servicemen after gunshot wounds with soft tissue defects of the lower extremities by introducing a system of staged rehabilitation. Organizational and methodological bases of the system of staged rehabilitation of wounded servicemen with soft tissue defects at different levels of medical care have been developed. Two models of rehabilitation depending on the severity of the injury and the tactics of surgical treatment are proposed. The division of the stage of early sanatorium rehabilitation for the wounded with severe soft tissue injuries depending on the stage of surgical treatment and the formation of a "skin patch" is justified. The introduction of the proposed models of rehabilitation of wounded with soft tissue defects in the practice of early sanatorium rehabilitation will provide increasing of medical care quality.

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Soft tissue coverage of the lower extremities

Plastic & Reconstructive Surgery ◽

10.1097/00006534-197608000-00068 ◽

1976 ◽

Vol 58 (2) ◽

pp. 252

Author(s):

Errikos Constant

Keyword(s):

Soft Tissue ◽

Lower Extremities ◽

Soft Tissue Coverage

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Use of Tissue Expansion in Clubfoot Surgery

Foot & Ankle ◽

10.1177/107110079301400301 ◽

1993 ◽

Vol 14 (3) ◽

pp. 117-122 ◽

Cited By ~ 16

Author(s):

Lester Silver ◽

Alfred D. Grant ◽

Dan Atar ◽

Wallace B. Lehman

Keyword(s):

Soft Tissue ◽

Tissue Expansion ◽

Outpatient Clinics ◽

Gradual Expansion

Tissue expansion was used successfully to prepare ade-quate soft tissue for closure following a difficult clubfoot correction. The gradual expansion was done weekly at the outpatient clinics (average 3–4 months). The procedure proved to be useful in severe cases of clubfoot.

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