scholarly journals The possibility of simultaneous combined skin grafting during the installation of synthetic implants after cranial trepanation

2021 ◽  
Vol 23 (3) ◽  
pp. 69-74
Author(s):  
P. G. Tunimanov ◽  
V. A. Manukovskiy ◽  
E. V. Zinoviev ◽  
P. V. Chechulov ◽  
D. V. Kostyakov
Keyword(s):  
Plastic Surgery ◽  
Optimal Algorithm ◽  
Skin Flap ◽  
Skin Grafting ◽  
Two Stage ◽  
Surgical Interventions ◽  
Skin Defects ◽  
Satisfactory Condition ◽  
Decompressive Craniotomy ◽  
Treat Ment

Introduction. Over the past 20 years, with an increase in the number of decompression trepanations in the Russian Federation and abroad, the number of cranioplasties performed has increased. Despite the development of technology, these surgical interventions are inevitably accompanied by a number of complications (up to 36 %), including the for‑ mation of skin defects. The choice of the optimal algorithm for the treatment of skin defects after cranioplasty remains the subject of debate.The purpose of the publication is to demonstrate by a clinical example the possibility of simultaneous combined skin grafting during the installation of synthetic implants after cranial trepanation, as well as to analyze the outcomes and com‑ plications of such operations.Materials and methods. For the period 2017–2019 under our supervision there were 42 patients after craniotomy, 32 of which were cranioplasty, and 10 plastic surgery of the defects of the scalp after removal of synthetic implants. In the course of the analysis, the structure and terms of surgical interventions, the length of hospitalization, the frequen‑ cy and structure of complications, as well as the timing of their development were studied.The article presents one of the cases of treatment and simultaneous installation of a titanium plate, combined skin grafting in a patient who has undergone previously decompressive craniotomy, cranioplasty with protacryl.Results. Simultaneous cranioplasty with skin grafting was performed in 3 out of 42 patients. The average hospitalization time after such an intervention was significantly less than with two‑stage plastic surgery (28.0 ± 3.9 and 52.0 ± 2.7 days, respectively, p <0.05). There were no complications in the postoperative period after a single‑stage plastic surgery, but after a two‑stage one, 2 cases of divergence of the wound edges and the formation of fistulas above the implants were registered.Conclusion. The data obtained illustrate that, given the technical feasibility, as well as the satisfactory condition of the skin flap, simultaneous cranioplasty with combined skin grafting can be one of the methods of choice in the treat‑ ment of extensive defects in the skin of the head and skull.

Reconstruction of Tragus and External Auditory Meatus using Remnant Auricle during Microtia Reconstruction

2018 ◽  
Vol 34 (02) ◽  
pp. 227-229
Author(s):  
Yi-gao Hu ◽  
Wei Ding ◽  
Jun Tan ◽  
Xin Chen ◽  
Tao Luo ◽  
...  
Keyword(s):  
Skin Flap ◽  
Skin Grafting ◽  
External Auditory Meatus ◽  
Reconstruction Technique ◽  
External Ear ◽  
Flap Necrosis ◽  
Second Stage ◽  
The Third ◽  
Third Stage ◽  
Thin Skin

AbstractThis article investigates an effective method with which to reconstruct the tragus and external auditory meatus for microtia reconstruction. The external ear was reconstructed using a delayed postauricular skin flap in patients with congenital microtia. After the first stage of delaying the postauricular skin flap and the second stage of otoplasty with ear framework fabricated from autogenous rib cartilage draping with the delayed skin flap, the third stage involved tragus and external auditory meatus canaloplasty. After designing the remnant auricle flap, the lower part was trimmed and the tragus was reconstructed. The upper part was trimmed into a thin skin flap, which was rotated and used to cover the hollowed wound posterosuperior to the tragus so as to mimic the external auditory meatus. If remnant wounds were present, skin grafting was conducted. In total, 121 patients with congenital microtia were treated from March 2010 to March 2016. The reconstructed tragus and external auditory meatus were well formed, and all wounds healed well. No severe complications such as flap necrosis occurred. Six months postoperatively, the morphology of the reconstructed tragus and external auditory meatus was good. Overall, the patients and their families were satisfied. The use of remnant auricle to reconstruct the tragus and external auditory meatus is an effective auricular reconstruction technique.

scholarly journals Scalp Reconstruction Following High Voltage Electric Burn

2014 ◽  
Vol 3 (2) ◽  
pp. 49-52 ◽  
Author(s):  
Md Zakir Hossain ◽  
Bidhan Sarker ◽  
Lutfar Kader Lenin ◽  
Ayesha Hanna ◽  
Limon Kumar Dhar
Keyword(s):  
Plastic Surgery ◽  
High Voltage ◽  
Skin Grafting ◽  
College Hospital ◽  
Transposition Flap ◽  
Reconstructive Procedures ◽  
Rotation Flap ◽  
Medical College ◽  
Scalp Reconstruction ◽  
Scalp Defects

Background: Scalp reconstruction following high voltage electric burn can be challenging. A useful Reconstructive algorithm is lacking. The purpose of this study was to evaluate our experience and to identify an appropriate reconstructive strategy. Methodology: This was a prospective observational study, conducted in the Burn unit of Dhaka Medical College Hospital & Department of Burn & Plastic Surgery,Sir Salimullah Medical College & Mitford Hospital over a period of five years. Reconstructive procedures, independent factors and outcomes were evaluated. A total of 7 procedures were performed in 30 patients. Techniques for reconstruction included skin grafting, outer table drilling & skin grafting, Bipedicle flap, Single rotation flap, Double opposing rotation flap, Transposition flap, Tissue expansion & primary closure. Conclusion: Important tenets for successful management of scalp defects are durable coverage, adequate debridement, preservation of blood supply, and proper wound drainage. Local scalp flaps with skin grafts remain the mainstay of reconstruction in most instances. DOI: http://dx.doi.org/10.3329/bdjps.v3i2.18251 Bangladesh Journal of Plastic Surgery July 2012, 3(2): 49-52

scholarly journals Sinking Skin Flap Syndrome after Decompressive Craniotomy

2017 ◽  
Vol 35 (1) ◽  
pp. 37-39
Author(s):  
Seung Joo Joa ◽  
Sook-Keun Song ◽  
Sa-Yoon Kang ◽  
Ji-Hoon Kang ◽  
Jay Chol Choi ◽  
...  
Keyword(s):  
Skin Flap ◽  
Decompressive Craniotomy

Recent Advances in Plastic Surgery

1972 ◽  
Vol 17 (4) ◽  
pp. 153-162
Author(s):  
Ian T. Jackson
Keyword(s):  
Plastic Surgery ◽  
Orthopaedic Surgery ◽  
Skin Grafting ◽  
Exposed Skin ◽  
Recent Advances

Three advances which disagree with many classical premises in plastic surgery are discussed. These are delayed exposed skin grafting, segmental vascular flaps, and flaps from the tongue. Application to general or orthopaedic surgery is stressed.

Efficacy of two-stage Meek micrografting in patients with severe burns

2021 ◽  
Author(s):  
Gaozhong Hu ◽  
Peng Zhang ◽  
Yan Chen ◽  
Zhiqiang Yuan ◽  
Huapei Song
Keyword(s):  
Survival Rate ◽  
Skin Graft ◽  
Laboratory Data ◽  
Length Of Hospital Stay ◽  
Skin Grafting ◽  
Two Stage ◽  
Cumulative Survival ◽  
Severe Burns ◽  
Group A ◽  
Group B

Abstract Background Burns are common injuries associated with high disability and mortality. In recent years, Meek micrografting technique has been gradually applied for the wound treatment of severe burns. However, the efficacy of two-stage Meek micrografting in patients with severe burns keeps unclear. Methods The data of eligible patients with severe burns who were admitted to Southwest Hospital of the Third Military Medical University from January 2013 to December 2019 were retrospectively analysed. The patients were divided into two groups according to the Meek micrografting method: one-stage skin grafting (group A) and two-stage skin grafting (group B). The baseline data, survival rate of skin graft, length of hospital stay, treatment costs, laboratory data and cumulative survival were statistically analysed. Results 127 patients (91 in group A and 36 in group B) were included in the study. There were no significant difference in the baseline data, the length of hospital stay and treatment costs between the two groups. The survival rate of skin graft was higher in group B. Total protein and albumin level, platelet count in group B were superior to those in group A, while there were no difference in other laboratory data (prealbumin, serum creatinine, urea nitrogen, cystatin C, blood cultures, wound exudate cultures) and cumulative survival between the two groups. Conclusion Our results demonstrated that staged Meek micrografting could improve the survival rate of skin graft, by reducing the risks of hypoproteinaemia, hypoalbuminemia and low platelet counts after adequate resuscitation.

The Importance of Early Diagnosis of Pyoderma Gangrenosum: A Case After Plastic Surgery

2021 ◽  
Vol 33 (7) ◽  
pp. E58-E60
Author(s):  
Gunel Guliyeva ◽  
Ali Kilic
Keyword(s):  
Hospital Stay ◽  
Plastic Surgery ◽  
Pyoderma Gangrenosum ◽  
Reduction Mammoplasty ◽  
Careful Examination ◽  
Neutrophilic Dermatosis ◽  
Unknown Etiology ◽  
Surgical Trauma ◽  
Surgical Interventions ◽  
Low Incidence

Introduction. Pyoderma gangrenosum (PG) is a multifactorial neutrophilic dermatosis of unknown etiology. It can occur in isolation; in association with different inflammatory, autoimmune, or malignant diseases; or as part of various syndromes. Because of its low incidence and the difficulty in distinguishing it from other possible lesions, PG is usually misdiagnosed. As a result, patients may be subjected to unnecessary treatments and surgical interventions that exacerbate the development of PG, as pathergy phenomenon is observed with this skin disorder. Surgical trauma can also lead to the formation of PG with the same mechanism. The occurrence of PG lesions has been reported after plastic surgery as well. In most cases, however, the diagnosis is delayed, resulting in disfigurement, additional surgeries, and extended hospital stay. Case Report. In this article, a case of early detected bilateral PG after reduction mammoplasty in a patient with no personal or family history of autoimmune disorders is presented. Careful examination of the wound and analysis of the clinical picture resulted in the diagnosis of PG. Conclusions. The authors believe that the description of the diagnostic clues considered in this case will aid the plastic surgeon in prompt recognition and management of postoperative PG, with the aim of decreasing patient morbidity and the duration of hospital stay while preventing additional complications.

Skin Grafting

2019 ◽  
pp. 65-72
Author(s):  
Stephen M. Milner
Keyword(s):  
Skin Grafting ◽  
Skin Grafts ◽  
Full Thickness ◽  
Preoperative Preparation ◽  
Scar Contracture ◽  
Skin Defects ◽  
Full Thickness Skin ◽  
Thickness Skin ◽  
Contracture Release

Skin grafting is an indispensable technique used in a variety of clinical situations, including acute burns, traumatic wounds, scar contracture release, and oncological and congenital deficiencies. The author’s preferred techniques for harvesting and resurfacing various skin defects using split- and full-thickness skin grafts are described in this chapter, together with the assessment of donor and recipient sites, preoperative preparation and postoperative considerations.

The Crucial Role of Vascularization and Lymphangiogenesis in Skin Reconstruction

2018 ◽  
Vol 59 (3-4) ◽  
pp. 242-254 ◽  
Author(s):  
Florian S.  Frueh ◽  
Nadia Sanchez-Macedo ◽  
Maurizio Calcagni ◽  
Pietro Giovanoli ◽  
Nicole Lindenblatt
Keyword(s):  
Clinical Practice ◽  
Skin Grafting ◽  
Lymphatic Drainage ◽  
Skin Grafts ◽  
Skin Substitutes ◽  
Microvascular Network ◽  
Skin Defects ◽  
Dermal Substitutes ◽  
Skin Reconstruction

Background: The treatment of extensive skin defects and bradytrophic wounds remains a challenge in clinical practice. Despite emerging tissue engineering approaches, skin grafts and dermal substitutes are still the routine procedure for the majority of skin defects. Here, we review the role of vascularization and lymphangiogenesis for skin grafting and dermal substitutes from the clinician’s perspective. Summary: Graft revascularization is a dynamic combination of inosculation, angiogenesis, and vasculogenesis. The majority of a graft’s microvasculature regresses and is replaced by ingrowing microvessels from the wound bed, finally resulting in a chimeric microvascular network. After inosculation within 48–72 h, the graft is re-oxygenated. In contrast to skin grafts, the vascularization of dermal substitutes is slow and dependent on the ingrowth of vessel-forming angiogenic cells. Preclinical angiogenic strategies with adipose tissue-derived isolates are appealing for the treatment of difficult wounds and may markedly accelerate skin reconstruction in the future. However, their translation from bench to bedside is still restricted by major regulatory restrictions. Finally, the lymphatic system contributes to edema reduction and the removal of local wound debris. Therapeutic lymphangiogenesis is an emerging field of research in skin reconstruction. Key Messages: For the successful engraftment of skin grafts and dermal substitutes, the rapid formation of a microvascular network is of pivotal importance. Hence, to understand the biological processes behind revascularization of skin substitutes and to implement this knowledge into clinical practice is a prerequisite when treating skin defects. Furthermore, a functional lymphatic drainage crucially contributes to the engraftment of skin substitutes.

scholarly journals Cutaneous Flaps for Closing Skin Defects in Dogs

2016 ◽  
Vol 73 (2) ◽  
pp. 405
Author(s):  
Florin Beteg ◽  
Aurel Muste
Keyword(s):  
Skin Grafting ◽  
Clinical Results ◽  
Local Flaps ◽  
Reconstructive Procedure ◽  
Oncological Surgery ◽  
Tumor Removal ◽  
Traumatic Lesion ◽  
Skin Defects ◽  
Skin Fold ◽  
Versatile Technique

Cutaneous flaps are used for closing wounds caused by traumatic accidents, oncological surgery (tumor removal), and burns (thermal, chemical, radiations). Skin grafting has the advantages of requiring just only one surgery for closing the defects once the wound bed is adequately prepared.The objective of the study was  to describe and asses the eficiency  of local cutaneous flaps for closing  skin defects in dogs.Seven dogs  underwent reconstruction of soft tissue wounds resulted from traumatic lesion or  after large tumors removal. Skin defects were located on the trunk and limbs. Cutaneous local flaps(advancement and rotational) were created by surgical preparations and mobilization the full tickness skin fold to enabling closure of adjacent defects. After wound debridment or tumoral removal a very carefull atraumatic and aseptical preparation of the flaps  were performed to preserve vascularization for adecquate blood supply.Cutaneous local flaps  proved effective for closing large defects in all dogs. Partial marginal necrosis of a portion of the flap occurred in one dog because of  procedure and technique errors, but the concurent remanent defects were adequate  to primary closure.  The wounds ultimately healed , without major complications.The skin local flaps(advancement and rotational) are a versatile technique that could be  use in a variety of locations, depending on skin defects shape and localization. The clinical results are comparable with those reported for  advanced reconstructive procedure.

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