scholarly journals Comparison of Shoulder Management Strategies after Stage I of Fingertip Skin Defect Repair with a Random-Pattern Abdominal Skin Flap

2015 ◽  
Vol 21 ◽  
pp. 3042-3047 ◽  
Author(s):  
Feng Zhao ◽  
Wei He ◽  
Guoping Zhang ◽  
Shaojun Liu ◽  
Kunlun Yu ◽  
...  
Keyword(s):  
Skin Flap ◽  
Management Strategies ◽  
Stage I ◽  
Random Pattern ◽  
Skin Defect ◽  
Abdominal Skin ◽  
Defect Repair

scholarly journals Application of WALANT technique for repairing finger skin defect with a random skin flap

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jianhua Xu ◽  
Lu Yin ◽  
Shuming Cao ◽  
Haihua Zhan ◽  
Jianbing Zhang ◽  
...  
Keyword(s):  
Skin Flap ◽  
Donor Site ◽  
Operation Time ◽  
Pedicled Flap ◽  
Skin Defect ◽  
Skin Flaps ◽  
Abdominal Skin ◽  
Vas Score ◽  
Finger Skin ◽  
Wide Awake

Abstract Background Wide-awake local anesthesia no tourniquet (WALANT) technique has emerged among hand surgeons with other indications. Surgeries involving pedicled flap and revascularization are no longer used as contraindications. The present study aimed to evaluate the feasibility and merits of the WALANT technique in random skin flap surgery. Methods From May 2018 to March 2019, 12 patients with finger skin defects repaired with random skin flaps were reviewed. Abdominal skin flaps or thoracic skin flaps were used to cover the wound. Both the fingers and the donor sites were anesthetized by the WALANT technique. A 40-mL conventional volume consisted of a mixture of epinephrine and lidocaine. A volume of 5 mL was injected at the distal palmar for nerve block, the other 5 mL was injected around the wound for hemostasis, and the remaining was injected at the donor site of flaps for both analgesia and hemostasis. Baseline data with respect to sex, age, side, type of finger, donor sites, flap size, dosage of anesthetics, usage of finger tourniquet, intraoperative and postoperative pain, hemostasis effect, operation time, Disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) score, and hospitalization expense, were collected. Results All patients tolerated the procedure, and none of them needed sedation. Single finger skin defect in 8 patients and double finger skin defect occurred in 4 patients; 5 patients were repaired by abdominal skin flaps, and 7 patients were repaired by thoracic skin flaps. The good surgical field visibility was 91.7%. All flaps survived adequately, without necrosis, pulling fingers out, and other complications. The average visual analog scale (VAS) score of the maximal pain was 1.1 in fingers vs. 2.1 in donor sites during the operation. On postoperative day one, the average VAS score of the maximal pain in fingers and donor sites was 1.3 and 1.1, respectively. The average hospitalization expense before reimbursement of the whole treatment was 11% less expensive compared to the traditional method. The average QuickDASH score was 9.1. Conclusions Under wide-awake anesthesia, patients have the ability to control their injured upper extremities consciously, avoiding the complications due to pulling flap pedicles. With the merits of safety, painlessness, less bleeding, and effectivity, the WALANT technique in random skin flaps is feasible and a reliable alternative to deal with finger skin defect.

scholarly journals Using the keystone design perforator island flap in large myelomeningocele closure

2019 ◽  
Vol 47 (4) ◽  
pp. E19
Author(s):  
Cleiton Formentin ◽  
Erion Junior de Andrade ◽  
Leo Gordiano Matias ◽  
Andrei F. Joaquim ◽  
Helder Tedeschi ◽  
...  
Keyword(s):  
Skin Flap ◽  
Wound Dehiscence ◽  
Longitudinal Axis ◽  
Island Flap ◽  
Skin Defect ◽  
Skin Defects ◽  
Csf Leakage ◽  
Aesthetic Results ◽  
Defect Repair ◽  
Large Skin

OBJECTIVEMany repair techniques have been proposed to treat large myelomeningocele (MMC), and although effective in many cases, some of these techniques can be complex and time consuming, with complications such as cerebrospinal fluid (CSF) leakage, flap loss, tip necrosis, and wound dehiscence. The purpose of this study was to analyze cases of large skin defects and the methods applied and to report the outcomes of the keystone design perforator island flap (KDPIF) technique for large MMC closure.METHODSThe authors performed a retrospective review of all neonatal patients who had undergone KDPIF for MMC closure in the period from 2013 to 2018. All patients had a diagnosis of lumbosacral MMC based on obstetric ultrasound. The neurosurgeons and plastic surgeons had selected the cases after concluding that primary closure would be unlikely. The design of the flap is based on the randomly located vascular perforators, creating two identical opposing flaps to fashion a double keystone flap. During wound closure, V-Y advancement of each end of the double flap in the longitudinal axis creates redundancy in the central portion of the flap and reduces the horizontal tension. After discharge, both the neurosurgery and plastic surgery teams followed up all patients, tracking the results with photography.RESULTSNo skin flap dehiscence or necrosis, infection, or CSF leakage was detected, proving the reliability of the flap. One of the patients required further surgery for the large skin defects after insufficient intrauterine closure of the MMC and successfully underwent KDPIF treatment. Another patient (14.3%) had severe neonatal sepsis, which ultimately led to death. A ventriculoperitoneal shunt was required after the skin defect repair in 5 (83.3%) of the 6 surviving patients. Exceptional aesthetic results were achieved for all patients during the follow-up.CONCLUSIONSThe KDPIF technique is based on well-known vascular perforators of the intercostal, lumbar, and gluteal regions. Wound tension is widely distributed by the flap and, as a consequence, relevant tissue bulk, reliable vascularity, and important geometrical versatility are provided. In addition, most of the muscles and fascia are preserved, which is another advantage in terms of minimizing secondary morbidity to local tissue rearrangement. The use of KDPIF closure was successfully shown to be a viable alternative for more complex MMCs that present with large skin defects.

The Effects of Vasonatrin Peptide on Random Pattern Skin Flap Survival

2014 ◽  
Vol 72 (1) ◽  
pp. 94-99 ◽  
Author(s):  
Shi-Ping Wang ◽  
Zhi-Yong Lan ◽  
Wei Xia ◽  
Xi Zhao ◽  
Ge-Jia Ma ◽  
...  
Keyword(s):  
Skin Flap ◽  
Random Pattern ◽  
Flap Survival ◽  
Skin Flap Survival

Blood Congestion Can Be Rescued by Hemodilution in a Random-Pattern Skin Flap

2017 ◽  
Vol 140 (6) ◽  
pp. 830e-831e
Author(s):  
Sara Di Lorenzo ◽  
Giovanni Zabbia ◽  
Roberto Pirrello ◽  
Bartolo Corradino
Keyword(s):  
Skin Flap ◽  
Random Pattern

scholarly journals Insight into surgical outcomes of post infarct-ventricular septal defect repair through a 23-years retrospective study-invited commentary

2021 ◽  
Author(s):  
Doniparthi Pradeep
Keyword(s):  
Surgical Outcomes ◽  
Septal Defect ◽  
Case Reports ◽  
Management Strategies ◽  
Rare Condition ◽  
Changing Trends ◽  
Defect Repair ◽  
The Uk ◽  
Insight Into ◽  
Adult Cardiac Surgery

The authors present an excellent retrograde analysis of a rare condition of a phenomenal number of cases and their surgical outcomes. A majority of the studies in published literature are anecdotal case reports which are a rare and dreadful entity. A comprehensive countrywide view of the UK National Adult Cardiac Surgery Audit database is presented in this study. This study represents the changing trends in the risk factors, management strategies, and outcomes of ventricular septal rupture for over 23 years in a nutshell.

Using KISS Flaps in a Chest Wall Reconstruction After Mastectomy for Locally Advanced Breast Cancer: A New Technique

2019 ◽  
Vol 27 (1) ◽  
pp. 5-10
Author(s):  
Jia Song ◽  
Yong Han ◽  
Jian Liu ◽  
Kai Cheng ◽  
Qiang Gao ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Primary Closure ◽  
Locally Advanced Breast Cancer ◽  
Skin Flap ◽  
Donor Site ◽  
Locally Advanced ◽  
Radical Mastectomy ◽  
Advanced Breast ◽  
Skin Defect

This study described a technique for the reconstruction of large lateral thoracic defects after local advanced breast cancer resection that allows for complete cover of the defect and primary closure of the donor site. The authors performed reconstruction using the newly designed KISS flap in 2 women for coverage of their large skin defect (15 × 13 cm each) following mastectomies with extensive tissue resection. The KISS flap consisting of 2 skin islands (marked Flap A and Flap B; 15 × 6 cm each) was designed and transferred to the thoracic defect through the subcutaneous tunnel, and based on the same vessel. The flap covered properly without causing excessive tension and allowed primary closure of chest wound and donor defect. The security it brings is comparable with that of classical radical mastectomy, and its success rate is similar to that of single skin flap transplantation. Compared with the conventional pedicled latissimus-dorsi-musculocutaneous flap, we believe that the donor zone tension decreases, wherein the KISS flaps can reduce the incidence of incision dehiscence and nonhealing complications to some extent. The study reported good results from this technique and discussed the techniques that referenced previous reports.

scholarly journals Effectiveness of First-Line Management Strategies for Stage I Follicular Lymphoma: Analysis of the National LymphoCare Study

2012 ◽  
Vol 30 (27) ◽  
pp. 3368-3375 ◽  
Author(s):  
Jonathan W. Friedberg ◽  
Michelle Byrtek ◽  
Brian K. Link ◽  
Christopher Flowers ◽  
Michael Taylor ◽  
...  
Keyword(s):  
Follicular Lymphoma ◽  
Ct Scan ◽  
Systemic Therapy ◽  
Management Strategies ◽  
Imaging Study ◽  
Progression Free Survival ◽  
Stage I ◽  
Whole Body ◽  
Treatment Approaches ◽  
Positron Emission

PurposeThe optimal management of stage I follicular lymphoma, according to consensus guidelines, is based on uncontrolled experiences of select institutions. Diverse treatment approaches are used despite guidelines that recommend radiation therapy (XRT).Patients and MethodsWe analyzed outcomes of patients with stage I follicular lymphoma enrolled onto the National LymphoCare database.ResultsOf 471 patients with stage I follicular lymphoma, 206 patients underwent rigorous staging as defined by both a bone marrow aspirate and biopsy and an imaging study (a computed tomography [CT] scan of the whole body, a positron emission tomography [PET]/CT scan, or both). Rigorously staged patients had superior progression-free survival (PFS) compared with nonrigorously staged patients (hazard ratio [HR], 0.63). Treatments given to rigorously staged patients were rituximab/chemotherapy (R-chemo; 28%), XRT (27%), observation (17%), systemic therapy + XRT (13%), rituximab monotherapy (12%), and other (3%). With a median follow-up of 57 months for PFS, there were 44 progression events (in 21% of patients) for rigorously staged patients. For these patients, PFS was significantly improved with either R-chemo or systemic therapy + XRT compared with patients receiving XRT alone after adjustment for histology, LDH, and the presence of B symptoms. There were no differences in overall survival.ConclusionIn this largest, prospectively enrolled group of patients with stage I follicular lymphoma, variable treatment approaches resulted in similar excellent outcomes, which challenges the paradigm that XRT should be standard for this presentation.

scholarly journals Observation on the Effect of Local Flap Transfer and Sclera Transplantation in Repairing Skin Defect after Eyelid Tumor Operation

2020 ◽  
Vol 4 (1) ◽  
pp. 28-31
Author(s):  
Ying-Hui Ma ◽  
Gang Liu ◽  
Jie Yang
Keyword(s):  
Skin Flap ◽  
Tumor Resection ◽  
Local Flap ◽  
Control Group ◽  
Skin Defect ◽  
Local Skin ◽  
Eyelid Tumor ◽  
Flap Transfer ◽  
Wide Range ◽  
Experimental Group

Introduction: Eyelid tumor refers to the primary eyelid skin and accessory tumors, which not only affects the appearance and vision, and even local infiltration and distant metastasis, thereby threatening life. Surgical resection is the most important and effective treatment, but tumor resection often leads to a wide range of eyelid defects, significantly affecting the shape and function of the eyelid. Therefore, the eyelid defect must be repaired after resection to achieve the purpose of aesthetic appearance and protection of the eyeball. The objective of the study was to analyze the clinical results of local flap transfer and scleral transplantation in repairing skin defect after eyelid tumor operation. Methods: Forty patients with postoperative skin defects of eyelid tumors admitted from December 2008 to December 2018 were taken for analysis and divided into two groups, 20 cases in each group. The control group underwent autologous lip mucous membrane transfer and nearby skin flap, while the experimental group received local skin flap rotation and scleral allograft repair. The clinical effect of repair of the two groups were compared. Results: In the experimental group, the effect of clinical repairs were better, the difference of height of palpebralfissure and the length of palpebral fissure were compared with the control group, which showed statistical significance favoring the experimental group. Conclusion: Local flap transfer and scleral transplantation has better clinical outcome to repair the skin defect after operation of eyelid tumor.

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