Rhomboid Perforator Flap for a Large Skin Defect Due to Lumbosacral Meningocele

2005 ◽  
Vol 54 (6) ◽  
pp. 670-672 ◽  
Author(s):  
Gan Muneuchi ◽  
Yoshihito Matsumoto ◽  
Motoki Tamai ◽  
Tetsukuni Kogure ◽  
Hiroharu H. Igawa ◽  
...  
Keyword(s):  
Perforator Flap ◽  
Skin Defect ◽  
Large Skin

scholarly journals Chimeric ALT Plus TFL Perforator Flap for Breast Reconstruction Post Radical Mastectomy with Large Skin Defect

2021 ◽  
Vol 54 (02) ◽  
pp. 208-210
Author(s):  
Dushyant Jaiswal ◽  
Mayur Raman Mantri ◽  
Vinay Kant Shankhdhar ◽  
Snehjeet Hemant Wagh
Keyword(s):  
Donor Site ◽  
Perforator Flap ◽  
Radical Mastectomy ◽  
Phyllodes Tumor ◽  
Left Breast ◽  
Skin Defect ◽  
Postoperative Radiation Therapy ◽  
Internal Mammary ◽  
Skin Excision ◽  
Large Skin

AbstractA 17-year-old girl with large malignant phyllodes tumor of left breast underwent a radical mastectomy with large skin excision resulting in defect of 20 cm × 18 cm. Postoperative radiation therapy necessitated robust cover with flap. The challenge was compounded by her body habitus. Both abdomen and back were deficient as donor sites and a single-island anterolateral thigh (ALT) flap would need skin grafts, volume deficit withstanding. We harvested chimeric ALT plus tensor fascia lata (TFL) perforator free flap sparing all muscles and nerves. Microvascular anastomoses were done to the second internal mammary artery (IMA) perforator artery and vein. The donor site was closed primarily. The TFL flap territory recruited almost three times the volume of ALT territory and allowed us to create a matching breast mound in addition to covering the defect. She tolerated 40 Gy radiation well and doesn’t desire further augmentation. Consistency of ALT and TFL perforators makes this a replicable procedure.

The Use of Engineered Bilayered Skin (MyDermTM) in the Management of Massive Skin Defect in Grade III Gustilo-Anderson Open Fracture

2017 ◽  
Vol 16 (3) ◽  
pp. 212-216
Author(s):  
Nor Hazla Mohamed Haflah ◽  
Min Hwei Ng ◽  
Mohd Heikal Mohd Yunus ◽  
Amaramalar Selvee Naicker ◽  
Ohnmar Htwe ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Open Fracture ◽  
Wound Closure ◽  
Posterior Tibial Artery ◽  
Soft Tissue Coverage ◽  
Skin Defect ◽  
Vascular Repair ◽  
Posterior Compartment ◽  
Large Defect ◽  
Large Skin

Open fracture Gustilo-Anderson grade IIIC is associated with higher risk of infection and problems with soft tissue coverage. Various methods have been used for soft tissue coverage in open fractures with large skin defect. We report a case of a patient who had grade IIIC open fracture of the tibia with posterior tibial artery injury. The patient underwent external fixation and reduction. Because of potential compartment syndrome after vascular repair, fasciotomy of the posterior compartment was performed. This wound, however, became infected and because of further debridement, gave rise to a large skin defect. A tissue engineered skin construct, MyDermTM was employed to cover this large defect. Complete wound closure was achieved 35 days postimplantation. The patient then underwent plating of the tibia for nonunion with no adverse effect to the grafted site. The tibia eventually healed 5 months postplating, and the cosmetic appearance of the newly formed skin was satisfactory.

scholarly journals Dorsal Metacarpal Artery Perforator Flap for Skin Ulcer Due to a Postoperative Complication of Suture Anchor Treatment for Tendinous Mallet Finger

2020 ◽  
Vol 6 ◽  
pp. 2513826X2095712
Author(s):  
Koichi Yano ◽  
Yasunori Kaneshiro ◽  
Ryo Sasaki ◽  
Seungho Hyun ◽  
Hideki Sakanaka
Keyword(s):  
Suture Anchor ◽  
Perforator Flap ◽  
Skin Ulcer ◽  
Ulcer Formation ◽  
Skin Defect ◽  
Mallet Finger ◽  
Initial Surgery ◽  
Finger Injury ◽  
Dorsal Metacarpal Artery ◽  
Artery Perforator

The suture anchor method of surgery has some complications. To best of our knowledge, no report on skin ulcer formation apart from the surgical site after tendinous mallet finger injury using suture anchor is available. We present the case of a 73-year-old woman who sustained tendinous mallet finger in an accident. She was treated surgically with a suture anchor. At 12 months after surgery, the string from the surgical site was removed; 28 months after surgery, a skin ulcer was formed 2-cm proximal from the operative scar, and discharge leaked from the dorsal middle phalanx. Because the wound could not heal by conservative treatment, it was treated surgically. At initial surgery, debridement of the skin ulcer, including the suture knot, was performed. At second surgery, the skin defect was reconstructed using a third dorsal metacarpal artery perforator flap. At 1 year postoperatively, she had no symptoms without recurrence.

Simultaneous reconstruction of large skin and mucosal defect following head and neck surgery with a single skin paddle pectoralis major myocutaneous flap

2005 ◽  
Vol 119 (4) ◽  
pp. 303-305 ◽  
Author(s):  
P Chaturvedi ◽  
P S Pai ◽  
K A Pathak ◽  
D A Chaukar ◽  
M S Deshpande ◽  
...  
Keyword(s):  
Head And Neck ◽  
Free Tissue Transfer ◽  
Pedicled Flap ◽  
Pectoralis Major ◽  
Head And Neck Reconstruction ◽  
Skin Defect ◽  
Skin Paddle ◽  
Tissue Transfer ◽  
Mucosal Lining ◽  
Large Skin

The pectoralis major myocutaneous (PMMC) flap is commonly used for head and neck reconstruction especially in impoverished nations. PMMC is a sturdy pedicled flap with relatively fewer complications, the learning curve is short and no specialized training in microvascular surgery is needed in order to use this flap. In a defect that requires a large skin and mucosal lining the authors routinely use either a bi-paddle PMMC or a combination of PMMC (for the mucosal lining) and a delto-pectoral flap (for the skin defect). It is indisputable that free tissue transfer is a better way of reconstruction for the majority of most such defects. Unfortunately, not all patients can be offered this form of reconstruction due to the cost, time, expertise and infrastructural constraints in high volume centres such as ours. Bi-paddling of PMMC is hazardous in obese males and most female patients. In such patients the skin defect is reconstructed usually by the delto-pectoral (DP) flap but this, for obvious reasons, is less welcomed by the patients. The authors suggest a technique wherein mucosal lining is created by the myofascial lining (inner surface) of the flap and the skin defect is reconstructed by the skin paddle of the single paddle PMMC. It should be considered wherever a DP flap is unacceptable, or bi-paddling or free tissue transfer is not possible.

scholarly journals Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheep

2010 ◽  
Vol 8 (1) ◽  
pp. 18-23
Author(s):  
Denise Araujo Lapa Pedreira ◽  
Gregório Lorenzo Acácio ◽  
Rogério Chaccur Abou-Jamra ◽  
Rita de Cássia Sanches Oliveira ◽  
Elia Garcia Caldini ◽  
...  
Keyword(s):  
Maternal Death ◽  
Intrauterine Infection ◽  
Study Group ◽  
Skin Defect ◽  
Lumbar Region ◽  
Human Fetuses ◽  
Continuous Suture ◽  
The Mean ◽  
The Impact ◽  
Large Skin

ABSTRACT Objective: To change the gasless fetoscopy technique in order to reduce the diameter of entry orifices in the myometrium. Methods: Seven pregnant ewes were submitted to fetoscopy for repairing a large skin defect measuring 4.0 × 3.0 cm, created in the fetal lumbar region at the gestational age of 100 days. The defect was repaired through continuous suture of the skin with approximation of borders. Gasless fetoscopy was used for performing the suture with three orifices to allow entry of the trocar into the myometrium. A 5.0-mm optical trocar, and 3.5-mm grasping, dissecting and suturing forceps were used. After surgery, pregnancy was maintained until the animals were euthanized on the 133rd day of gestation, and the fetuses were evaluated. Results: Seven pregnant ewes underwent surgery; the first two cases were characterized as the Pilot Group, in which the endoscopic technique was modified and caliber reduction was possible in two out of three entry orifices in the myometrium. In the five remaining cases (Study Group), the repair was successfully carried out in all the fetuses, and the mean duration of fetoscopy was 98 minutes. There was a case of maternal death attributed to intrauterine infection. Mean intrauterine permanence after surgery was 12 days. Conclusions: The technique was successfully modified, allowing reduction of the uterine orifices necessary to perform the repair of a skin defect in the fetal lumbar region through a new fetoscopy technique. The impact of this modification in repair of myelomeningocele in human fetuses should be studied.

Closure of large skin defect associated with thoracolumbar rachischisis

1977 ◽  
Vol 47 (5) ◽  
pp. 781-784 ◽  
Author(s):  
Ken Winston ◽  
Parker Mickle ◽  
Samuel Schuster
Keyword(s):  
Premature Infant ◽  
New Technique ◽  
Skin Defect ◽  
Full Thickness ◽  
Content Type ◽  
A New Technique ◽  
Large Skin ◽  
Fine Print

✓ The management of a premature infant with a large skin defect associated with thoracolumbar rachischisis is presented. Full-thickness closure was achieved in 8 days using a new technique, adapted from a method of closing large omphaloceles.

scholarly journals Variants of Extended Latissimus Dorsi Musculocutaneous Flap for Large Wounds in Extremities

2020 ◽  
Author(s):  
Jiqiang He ◽  
Liming Qing ◽  
Panfeng Wu ◽  
Zhengbing Zhou ◽  
Fang Yu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Latissimus Dorsi ◽  
Donor Site ◽  
Free Flaps ◽  
Lower Limbs ◽  
Soft Tissue Coverage ◽  
Skin Defect ◽  
Reliable Methods ◽  
Large Skin

Abstract Background: Extended latissimus dorsi musculocutaneous (LDMC) flap increasing the size of the flap and most used for breast reconstruction. This report will share our experience in designing different extended LDMC flap for large wounds in extremities.Patients and methods: From January 2004 to December 2018, extended LDMC flaps were performed on 72 consecutive patients aged 2 to 68 years (37 men and 35 women). All the wounds were extensive, either in upper or lower limbs, the skin defect ranged from 18 ×10 cm2 to 37 × 21 cm2. Single wing and double wings extended LDMC flaps were designed and harvested based on the wounds.Results: Seventy-two patients included this series, 5 pedicle and 67 free flaps were successfully harvested. The mean flap harvest time was 56.2 min. The donor sites were closed primarily in all patients. The venous compromise was noticed on the first postoperative day in 4 cases. Two flaps were salvaged after emergency re-exploration, another two patient’s flaps were total necrosis. One of the patients was received lower extremity amputation, another patient was repaired by extended LDMC flap on the other side. The wounds healed well, providing reliable soft tissue coverage and good contour in the reconstructed areas. Five patients lost follow-up, the follow-up period ranged from 10 to 56 months (mean, 15.7 months). Patients didn’t occur significant donor site morbidities that influenced their daily activities during follow-up.Conclusion: The single wing and double wings extended latissimus dorsi musculocutaneous flaps are simple and reliable methods for large skin and soft-tissue defects in extremities.

scholarly journals Clinical application of both amniotic membranes and adipose derived mesenchymal stem cells in a cat with a large skin defect

2021 ◽  
Author(s):  
J Kim ◽  
D Kim ◽  
D Seo ◽  
H Hwang ◽  
Y Kim ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Healing Process ◽  
Skin Defect ◽  
Regenerative Therapy ◽  
Short Term ◽  
Bite Wounds ◽  
The Right ◽  
Amniotic Membranes ◽  
Large Skin

Surgical procedures on large skin defects can be challenging in the short term due to the size of the lesion, infection, and tissue defect. A regenerative therapy for skin wounds has been applied to promote the healing process. An 8-month-old, Korean domestic short-haired female cat, weighing 3 kg, was rescued with extensive defects on the right flank to right inguinal region caused by bite wounds. In this case, amniotic membranes and adipose-derived mesenchymal stem cells were used as the regenerative therapy to treat the large skin defect rather than a surgical intervention alone. To the best of our knowledge, this is the first report of a case with of a large skin defect treated by applying allogeneic amniotic membranes and allogeneic mesenchymal stem cells to a cat.

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