scholarly journals Umbilical trocar port site keloid management using a transposition flap after laparoscopic surgery

2021 ◽  
Vol 27 (4) ◽  
pp. 125-131
Author(s):  
Hyo Jeong Kwon ◽  
Jung Hyeou Kim ◽  
Chae Rim Lee ◽  
Jangyoun Choi ◽  
Suk-Ho Moon ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Simple Procedure ◽  
Surrounding Tissue ◽  
Time Interval ◽  
Trocar Site ◽  
Transposition Flap ◽  
Scar Assessment ◽  
Surgical Wounds ◽  
Keloid Scars ◽  
Single Method

Background Keloids can occur anywhere in the human body. They are difficult to remove and can cause distress in patients. Although many options are available to treat keloids, no single method is considered the optimal treatment of choice. The authors encountered cases where an umbilical keloid developed at the trocar site after laparoscopic surgery and managed the keloid using a transposition flap.Methods A total of 10 umbilical keloid patients treated from 2013 to 2020 were included in this study. All patients developed a keloid due to the placement of a laparoscopic trocar incision port, and their major complaints varied from an asymptomatic nodule to pruritus or pain. All excisions were performed under local anesthesia, and transposition flaps were planned afterward. The surrounding tissue was rearranged so that the shape of the umbilicus was deformed to the minimum extent possible. The keloid scars were examined both preoperatively and 6 months postoperatively using the Patient and Observer Scar Assessment Scale (POSAS).Results All surgical wounds healed well without complications. The average time interval from laparoscopic surgery to keloid scar revision was 4.3 years. The mean postoperative follow-up period was 10.9 months, and no patient underwent reoperation. Four patients were treated with triamcinolone after surgery due to mild hypertrophy or pruritus. The POSAS observer scale showed significantly decreasing scores over time in all patients (P=0.002).Conclusions Cosmetically unfavorable keloids that form in the umbilicus following laparoscopic surgery can be improved with a simple procedure using excision and transposition flaps.

A simple technique for trocar site closure after laparoscopic surgery

1999 ◽  
Vol 13 (12) ◽  
pp. 1249-1251 ◽  
Author(s):  
I. Petrakis ◽  
V. Sciacca ◽  
G. Chalkiadakis ◽  
S. I. Vassilakis ◽  
E. Xynos
Keyword(s):  
Laparoscopic Surgery ◽  
Simple Technique ◽  
Trocar Site ◽  
Trocar Site Closure

scholarly journals Successful basal cell carcinoma defect reconstruction using combination of rotation and advancement flap: Two case reports

2021 ◽  
Vol 13 (2) ◽  
Author(s):  
Khairuddin Djawad ◽  
Siswanto Wahab ◽  
Airin Nurdin
Keyword(s):  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Basal Cell ◽  
Case Reports ◽  
Skin Flap ◽  
Advancement Flap ◽  
Surrounding Tissue ◽  
Transposition Flap ◽  
High Tension ◽  
Excisional Surgery

Defects resulting from surgical procedure may be challenging to reconstruct depending on the size and location. In case of large defects, primary closure is often not possible and thus requires skin flap or graft. In such cases, skin flap is advantageous as it produces a similar color and texture with the surrounding tissue. Skin flap techniques such as advancement flap, rotation flap dan transposition flap are useful in closing small defects. In moderate to large-sized defects, especially in areas with high tension, a combination of more than one type of flap might be necessary. This report describes two cases of large defects on the temple and cheek following basal cell carcinoma excisional surgery which were successfully closed using a combination of rotation and advancement flaps. Both patients showed excellent functional and cosmetic outcome.

scholarly journals Reconstruction of scalp with local axial flaps

2020 ◽  
Vol 6 (9) ◽  
pp. 1692
Author(s):  
Saket Srivastava ◽  
Pradeep Gupta
Keyword(s):  
Tissue Expansion ◽  
Free Tissue Transfer ◽  
Healing Time ◽  
Surrounding Tissue ◽  
Surgical Reconstruction ◽  
Local Flaps ◽  
Transposition Flap ◽  
Scalp Reconstruction ◽  
Scalp Defects ◽  
Scalp Defect

<p><strong>Background:</strong> The scalp is a unique part of the human body and various etiological factors, such as tumour extirpation, infection, burns, or trauma, can lead to scalp defects. Primary closure, skin grafting, local flaps, tissue expansion or free tissue transfer are modalities available for scalp reconstruction. In this article, the authors share their institutional experience using various local flaps concerning the size, location, depth of defect and the quality of surrounding tissue.</p><p><strong>Methods:</strong> From September 2017 to January 2020, 54 patients underwent scalp reconstruction with local flaps for a defect size of 5 to 150 cm<sup>2</sup> in the department of plastic surgery, SMS medical college, Jaipur. Patients were identified by age, sex, cause of the scalp defect; the location, size, and depth of the defect; condition of surrounding tissue and the type of reconstruction done.</p><p><strong>Results:</strong> The most common cause of scalp defect was excision of malignant tumour (50%). Thirty patients had a large sized defect (40-90 cm<sup>2</sup>) and 28 patients had 90-150 cm<sup>2</sup> defects. Surgical reconstruction was done using local flaps, transposition flap was the most used in 36 patients (66.7%) followed by rotation advancement flap in 11 patients (20.4%). The recovery was relatively quick. Minor complications happened in 5 patients (9.3%) that were managed conservatively.</p><p><strong>Conclusions</strong>: In the present era of microsurgical reconstruction, local options as axial flaps provide a simpler and safer method of scalp reconstruction. A carefully planned scalp flap gives healthy, robust, hair-bearing tissue coverage and requires a shorter healing time for the patients.</p>

scholarly journals Rhomboid Flap: An Option to Many Anatomical Regions

2015 ◽  
Vol 1 (1) ◽  
pp. 14-18
Author(s):  
Érico Pampado Di Santis ◽  
Keyword(s):  
The Body ◽  
Surrounding Tissue ◽  
Transposition Flap ◽  
Body Segments ◽  
Facial Defects ◽  
Aesthetic Results ◽  
The Face ◽  
The Aesthetic ◽  
Rhomboid Flap ◽  
Low Rate

Introduction: The rhomboid transposition flap can be used at any region on the body surface, and is widely used on reconstructive surgery. When it is used for surgical procedures in order to correcting facial defects, the Limberg’s flap produces good functional and aesthetic results, particularly when scars are positioned between the aesthetic units of the face. This article will describe the rhomboid flap technique and discuss the versatility, safeness, applicability and complications of Limberg’s flap for cutaneous reconstruction, which can be in a huge part of body segments Results and Discussion: The Limberg’s flap is a rhomboid transposition flap. The flaps are made by taking into account size and location of the original defect and elasticity of the surrounding tissue. From the resection defect resulting, a lozenge is drawn with internal angles of 60 degrees and 120 degrees and the closure is completed by transposing the flap towards the defect. This flap provides very good results to be executed with predictability, high safeness degree and low rate of complications. Keywords: Flap, Limberg, Reconstruction, Rhomboid, Surgery.

scholarly journals Trocar Site HERnias After Bariatric Laparoscopic Surgery (HERBALS): a Prospective Cohort Study

2020 ◽  
Vol 30 (5) ◽  
pp. 1820-1826 ◽  
Author(s):  
Ioannis Karampinis ◽  
Eliette Lion ◽  
Svetlana Hetjens ◽  
Georgi Vassilev ◽  
Christian Galata ◽  
...  
Keyword(s):  
Cohort Study ◽  
Laparoscopic Surgery ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Trocar Site

scholarly journals 5-Millimeter Trocar-Site Bowel Herniation Following Laparoscopic Surgery

2012 ◽  
Vol 16 (2) ◽  
pp. 306-310 ◽  
Author(s):  
Nauman Khurshid ◽  
Maurice Chung ◽  
Terrence Horrigan ◽  
Kelly Manahan ◽  
John P. Geisler
Keyword(s):  
Laparoscopic Surgery ◽  
Trocar Site ◽  
Bowel Herniation

Long-Term Surgical Outcome of Trocar Site Hernia Repair

2017 ◽  
Vol 83 (2) ◽  
pp. 176-182
Author(s):  
Yoon-Hye Kwon ◽  
Eun Kyung Choe ◽  
Seung-Bum Ryoo ◽  
Jeong-Ki Kim ◽  
Kyu Joo Park
Keyword(s):  
Laparoscopic Surgery ◽  
Recurrence Rate ◽  
Late Onset ◽  
The Body ◽  
Port Site ◽  
Trocar Site ◽  
Mesh Reinforcement ◽  
Trocar Site Hernia ◽  
Onset Group

Port site hernias are emerging as a problematic complication of laparoscopic surgery. The aim of this study was to elucidate the characteristics of port site hernias and determine the long-term outcomes based on the interval between primary surgery and hernia occurrence. Twenty-four patients were surgically treated for trocar site hernia between 1997 and 2013. The patients were grouped into early-onset group (EOG; less than one month) and late-onset group (LOG; more than one month) based on the interval between laparoscopic surgery and hernia onset. A retrospective analysis was performed. There were seven patients in the EOG and 17 patients in the LOG. The body mass index was significantly higher (P = 0.033) in the LOG. In the EOG, primary closure was performed, and there were no recurrences. In the LOG, mesh reinforcement was applied in 58.8 per cent of patients, and 29.4 per cent of patients had recurrences. This recurrence rate was higher than the recurrence rate after primary repair of incisional hernia after open laparotomy (P = 0.088). In conclusion, In the EOG, small bowel resection was more frequent, but once repaired, there were no recurrences. Although mesh reinforcement was applied in the LOG, the recurrence rate was not less than the EOG.

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