Long-Term Follow-Up of Reconstruction of Four Metatarsal Bone and Soft-Tissue Defects Using a Serratus Anterior Muscle Rib Osteomyocutaneous Free Flap

Extensive soft tissue defects following trauma, burn or after cancer surgery need coverage by flaps. Sometimes surrounding tissues are not healthy enough or quantity is not favorable to provide adequate pedicle flaps. Microvascular free flap can provide healthy tissue of adequate amount from distant area for those difficult situations.15 microvascular free flaps were performed from October 2011 to February 2013. Radial forearm free flap was done in 8 and Latissimusdorsi (LD) flap in 7 cases. 10 flaps done in foot, ankle & lower leg region (radial forearm-5, LD-5) and 5 flaps were done in face and scalp region (radial forearm-4, LD-1).12 flaps healed uneventfully with good coverage of the defect. Average ischemia time was 135 min (range 100-240 min) and average anastomosis time was 75 min (average 60-100 min). 2 flaps failed. There was necrosis of the tip of 2 LD and cumbersome swelling of the flap was found in 2 cases of LD flaps.Large soft tissue defect of body where local or regional flaps are not feasible; can be easily covered with free flaps. Its capacity to cover huge soft tissue defect has neutralizes its technical demand. Though complications are still high in our hands; can be reduced performing more number of cases. DOI: http://dx.doi.org/10.3329/bdjps.v3i2.18242 Bangladesh Journal of Plastic Surgery July 2012, 3(2): 33-37

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Soft tissue reconstruction of low voltage electric burn injuries of the thumb and first web space by the first dorsal metacarpal artery island flap: a three-year study from Eastern India

International Surgery Journal ◽

10.18203/2349-2902.isj20201169 ◽

2020 ◽

Vol 7 (4) ◽

pp. 1082

Author(s):

Madhumita Gupta ◽

Prabir Kumar Jash

Keyword(s):

Soft Tissue ◽

Low Voltage ◽

Burn Injuries ◽

Soft Tissue Defects ◽

Dorsal Metacarpal Artery ◽

Web Space ◽

Electric Burns ◽

Tissue Defects ◽

First Dorsal Metacarpal Artery

Background: Complex soft tissue defects of thumb and first web space are a reconstructive challenge. Low voltage electric burns of the hand commonly result in localised and deep soft tissue destruction. The first dorsal metacarpal artery flap (FDMA) is an attractive local flap option to reconstruct these. This study illustrates our experience with the same.Methods: Between March 2014 and February 2017, 16 patients with complex soft tissue defects of thumb and first web space resulting from low voltage electric burns underwent reconstruction with the FDMA flap and subsequent structured hand therapy. In the follow up visits objective assessment of hand function included tests of mobility using Kapandji Score, sensory evaluation with static 2 point discrimination and cortical reorientation. The Subjective Satisfaction Score was used to ascertain the patient’s overall perception of aesthetic and functional outcome.Results: Majority (43.75%) of the patients had defects involving the thumb IP joint. No case of complete flap failure was noted. In a mean follow-up of 11.5 months the reconstructed thumb showed return of good protective sensation as well as mobility. Though cortical reorientation was complete in only 18.75 %, it did not substantially impede hand functioning. All patients were satisfied with the functional and aesthetic result.Conclusions: In cases of low voltage electric burn injuries the FDMA flap is a reliable reconstructive option for small to moderate sized complex defects of thumb and first web space. It has minimal donor site morbidity and can be accomplished in a relatively simple single stage procedure.

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Long-Term Follow-up of Patients with Clubfeet Treated with Extensive Soft-Tissue Release

The Journal of Bone and Joint Surgery (American) ◽

10.2106/00004623-200611000-00034 ◽

2006 ◽

Vol 88 (11) ◽

pp. 2536 ◽

Cited By ~ 1

Author(s):

Ravi Goyal ◽

Subjeet Gujral ◽

Robin W. Paton

Keyword(s):

Soft Tissue ◽

Soft Tissue Release ◽

Long Term Follow Up

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