scholarly journals Single-stage segmental urethral replacement using combined ventral onlay fasciocutaneous flap with dorsal onlay buccal grafting for long segment strictures

2011 ◽  
Vol 109 (9) ◽  
pp. 1392-1396 ◽  
Author(s):  
Bradley A. Erickson ◽  
Benjamin N. Breyer ◽  
Jack W. McAninch
Keyword(s):  
Fasciocutaneous Flap ◽  
Single Stage ◽  
Dorsal Onlay

Single-Stage Bipedicle Local Tissue Transfer and Skin Graft for Achilles Tendon Surgery Wound Complications

2016 ◽  
Vol 10 (1) ◽  
pp. 46-50 ◽  
Author(s):  
Travis J. Dekker ◽  
Yash Avashia ◽  
Suhail K. Mithani ◽  
Andrew P. Matson ◽  
Alexander J. Lampley ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Skin Graft ◽  
Fasciocutaneous Flap ◽  
Single Stage ◽  
Venous Stasis ◽  
Wound Complications ◽  
Foot And Ankle ◽  
Local Tissue ◽  
Tissue Transfer ◽  
Wound Breakdown

Introduction. Achilles tendon and posterior heel wound complications are difficult to treat. These typically require soft tissue coverage via microvascular free tissue transfer at a tertiary referral center. Here, we describe coverage of a series of posterior heel and Achilles wounds via simple, local tissue transfer, called a bipedicle fasciocutaneous flap. This flap can be performed by an orthopaedic foot and ankle surgeon, without resources of tertiary/specialized care or microvascular support. Methods. Three patients with separate pathologies were treated with a single-stage bipedicle fasciocutaneous local tissue transfer. Case 1 was a patient with insertional wound breakdown after Achilles debridement and repair to the calcaneus. Case 2 was a heel venous stasis ulcer with calcaneal exposure in a diabetic patient with vasculopathy. Case 3 was a patient with wound breakdown following midsubstance Achilles tendon repair. All three cases were treated with a single-stage bipedicle local tissue transfer for posterior ankle and heel wound complications. Results. All 3 patients demonstrated complete healing of the posterior defect, lateral ankle skin graft recipient site, and the skin graft donor site after surgery. Case 3 had a subsequent recurrent ulceration after initial healing. This was superficial and healed with local wound care. All patients regained full preoperative range of motion and were able to ambulate independently without modified footwear. Conclusions. The bipedicled fasciocutaneous flap described here offers a predictable single stage procedure that can be accomplished by an orthopaedic foot and ankle surgeon without resources of a tertiary care center for posterior foot and ankle defects. This flap can be performed with short operative times and can be customized to facilitate defect coverage. The flap is durable to withstand local tissue stresses required for early ambulation. Despite its reliability, patients require careful follow-up to manage underlying comorbid conditions that may complicate wound healing. Levels of Evidence: Level IV: Case series

scholarly journals An audit of management of male urethral stricture and it’s outcome: a single centre retrospective review

2020 ◽  
Vol 7 (3) ◽  
pp. 774
Author(s):  
Puskal Kumar Bagchi ◽  
Sarbartha K. Pratihar ◽  
Rajeev T. P. ◽  
Sasanka K. Barua ◽  
Debanga Sarma ◽  
...  
Keyword(s):  
Success Rate ◽  
Urethral Stricture ◽  
Poor Quality ◽  
Single Stage ◽  
Single Centre ◽  
Short Segment ◽  
Onlay Technique ◽  
Dorsal Onlay ◽  
End To End ◽  
Staged Reconstruction

Background: Anterior urethral stricture involves penile, bulbar or panurethra with varied aetiology. Direct vision internal urethrotomy (DVIU), stricture excision with primary end to end anastomosis, single stage or staged reconstruction with local flap or buccal mucosal graft (BMG) are surgical options.Methods: This single centre retrospective study was conducted from April 2017 to March 2019. Patient underwent DVIU, stricture excision with primary end to end anastomotic, staged urethroplasty, BMG urethroplasty (BMGU) dorsal inlay Asopa technique, dorsal onlay Kulkarni technique and ventral onlay technique depending on site and extent of strictures. Preoperative, intraoperative, post-operative data were reviewed.Results: Here, 51 patients underwent DVIU for single soft short segment bulbar urethral stricture with success rate 58.82%. 26 patients with post traumatic short segment bulbar urethral stricture underwent excision and primary end to end anastomosis with success rate 92.31%. Patients with long segment bulbar urethral stricture underwent either dorsal onlay (n=19) or ventral onlay (n=14) BMGU with success rate 89.47% and 85.71% respectively. Total 59 patients with long segment penile or pan urethral stricture underwent either single stage (n=27) or staged reconstruction (n=32) with success rate of 85.18% and 90.63% respectively. Patients with staged reconstruction had significantly longer hospital stay (p<0.0001) and poor quality of life due to laid opened urethra. Asopa’s dorsal inlay (n=15) and Kulkarni’s dorsal onlay (n=12) BMGU had equivalent success rate of 86.67% and 83.33% and comparable complications.Conclusions: Surgery for urethral stricture differs according to site and extent of stricture. Single stage BMG urethroplasty is preferred modality for long segment bulbar, penile and panurethral stricture. 

scholarly journals Single stage repair with buccal mucosal graft in hypospadias cripple patients

2018 ◽  
Vol 5 (10) ◽  
pp. 3239
Author(s):  
Mohit Jain ◽  
Shivam Madeshiya ◽  
Neeraj Sharma
Keyword(s):  
Buccal Mucosa ◽  
Primary Repair ◽  
Donor Site ◽  
Ventral Surface ◽  
Single Stage ◽  
Stricture Formation ◽  
Penile Skin ◽  
Buccal Mucosa Graft ◽  
Buccal Mucosal Graft ◽  
Dorsal Onlay

Background: Hypospadias surgery has developed into a well-defined art and science. Surgeons dealing with this anomaly should have detailed understanding of various basic surgical principles and experience with delicate, precise optically assisted techniques and maintain a clinical workload that is sufficient to obtain consistently good results. Objective of this study was to evaluate the outcome of using buccal mucosal graft for single stage repair in adult hypospadias cripples.Methods: All patients with prior failed hypospadias repair after multiple surgeries presenting in MLN Medical College, Allahabad were included in study. Dorsal onlay buccal mucosa graft with parallel turn over flap from penile skin for ventral surface method was used.Results: Total 20 patients were included in study. Among these 12 patients presented with complete dehiscence of repair, 5 patients presented with multiple urethrocutaneous fistulas, 3 patients presented with extensive stricture formation. Same surgeon performed procedure of dorsal onlay buccal mucosa graft urethroplasty to reduce the bias. Success rate of dorsal onlay substitution free buccal mucosal graft urethroplasty in single stage is affected by scarring of surrounding penile skin. Most common complication related to donor site are transient pain and swelling and to graft site are stricture and fistulas.Conclusions: Single stage repair with buccal mucosal graft in hypospadias cripple patients is an excellent free graft urethroplasty in cases with prior failed primary repair of hypospadias, in whom the preputial skin was lacking or insufficient and a longer urethral tube needed to be constructed.

scholarly journals Single stage management of Gustilo type III A/B tibia fractures: Fixed with nail & covered with fasciocutaneous flap

2017 ◽  
Vol 20 (2) ◽  
pp. 99-102 ◽  
Author(s):  
G.I. Nambi ◽  
Abhijeet Ashok Salunke ◽  
S.G. Thirumalaisamy ◽  
V. Lenin Babu ◽  
K. Baskaran ◽  
...  
Keyword(s):  
Fasciocutaneous Flap ◽  
Single Stage ◽  
Stage Management ◽  
Type Iii ◽  
Tibia Fractures
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