Widely Split Latissimus Dorsi Muscle Flaps for Reconstruction of Long Soft-Tissue Defects in Lower Extremities

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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Foot salvage using microsurgical free muscle flaps in severely crushed foot with soft tissue defects

Injury ◽

10.1016/j.injury.2019.10.040 ◽

2019 ◽

Vol 50 ◽

pp. S17-S20 ◽

Cited By ~ 1

Author(s):

Hassan Hamdy Noaman ◽

Yasser Osman Soroor

Keyword(s):

Soft Tissue ◽

Soft Tissue Defects ◽

Muscle Flaps ◽

Tissue Defects

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Propeller perforator flaps for coverage of soft tissue defects in the middle and distal lower extremities

Annales de Chirurgie Plastique Esthétique ◽

10.1016/j.anplas.2019.04.002 ◽

2020 ◽

Vol 65 (1) ◽

pp. 54-60 ◽

Cited By ~ 3

Author(s):

M.A. Hifny ◽

A.M.A. Tohamy ◽

O. Rabie ◽

A.A.A. Ali

Keyword(s):

Soft Tissue ◽

Lower Extremities ◽

Soft Tissue Defects ◽

Perforator Flaps ◽

Tissue Defects

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Retrospective Analysis in Lower Limb Reconstruction: Propeller Perforator Flaps versus Free Flaps

Journal of Reconstructive Microsurgery ◽

10.1055/s-0037-1606268 ◽

2017 ◽

Vol 33 (S 01) ◽

pp. S34-S39 ◽

Cited By ~ 3

Author(s):

Marta Cajozzo ◽

Alessandro Innocenti ◽

Massimiliano Tripoli ◽

Giovanni Zabbia ◽

Salvatore D'Arpa ◽

...

Keyword(s):

Soft Tissue ◽

Retrospective Analysis ◽

Revision Surgery ◽

Lower Limb ◽

Lower Extremities ◽

Free Flaps ◽

Soft Tissue Defects ◽

Perforator Flaps ◽

Hospitalization Period ◽

Tissue Defects

Background Technical advancements and increasing experience in the management of soft tissue defects in lower extremities have led to the evolution of decisional reconstructive algorithms. Both propeller perforator flaps (PPFs) and free flaps (FFs) proved to be useful methods of reconstruction for lower extremities defects, offering alternative reconstructive tools. We present a case series of PPFs and FFs for reconstruction of lower limbs defects, analyzing and comparing treatment and outcomes. Methods Through a retrospective analysis, we report our experience in performing PPFs or FFs for reconstruction of soft tissue defects of the lower extremities, in patients admitted between 2010 and 2015 at the Department of Plastic and Reconstructive Surgery, University of Palermo. In these patients, we evaluated location and causes of defects, types of flaps used, recipient vessels, complications, time to healing, and aesthetic outcome. Results A primary healing rate was obtained in 13 patients for PPF and 16 cases for FF. Revision surgery for partial skin necrosis was required in eight cases (PPF: four and FF: four). Recovery time and hospitalization period were eventually shorter in patients with FFs, due to lower rate of complications and revision surgery. Conclusion In the past years, our indications for reconstruction with PPFs in the lower limb have become more restricted, while we favor reconstruction with FFs. Recommendations are provided to orient surgical treatment in small, medium, and large lower limb defects.

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