scholarly journals Outcome of latissimus dorsi free flap in-case of large scalp defect a single center study

2021 ◽  
Vol 8 (12) ◽  
pp. 3678
Author(s):  
Abu Faisal M. Ariful Islam ◽  
M. Iqbal Ahmed ◽  
M. Salah Uddin ◽  
M. A. Hamid
Keyword(s):  
Free Flap ◽  
Latissimus Dorsi ◽  
Randomized Study ◽  
Age Distribution ◽  
Muscle Flap ◽  
Tumor Ablation ◽  
Soft Tissue Coverage ◽  
Scalp Defects ◽  
Scalp Defect ◽  
Number Of Patients

Reconstruction of scalp and calvarial defects following trauma post burn and after tumor ablation frequently requires prosthetic cranioplasty and soft tissue coverage. Furthermore, patients often have advanced disease and receive perioperative radiotherapy following tumor ablation. We evaluated the outcome of scalp reconstruction in traumatic cases with a free Latissimus dorsi (LD) muscle flap in this setting. The aim of this study was to evaluate outcome of latissimus dorsi free flap in-case of large scalp defect. This prospective non-randomized study was conducted on 10 patients with scalp defects following trauma attended emergency unit and outpatient department of burn and plastic surgery, Dhaka medical college hospital (DMCH) in the period between July 2017 and June 2018. Durability of coverage, flap success, infection and overall satisfaction were studied. The age distribution of the study population shows highest number of patients (60%) were in middle (24-30 years) age group whereas lowest are in older group (30-50 years). The lowest age was 24 years and the highest age was 45 years. Highest number of patients (80%) were standard myocutanous type of flap whereas lowest were in (20.0%) were partial latissimus muscle flap. Outcome of the reconstruction (80.0%) were excellent 10% partial flap necrosis occur and total flap loss in 1 (10%) patient. The reconstruction of scalp defects continues to be a challenge for the reconstructive surgeon, who must achieve a satisfactory functional and aesthetic outcome.

Free flap transfer of the cutaneous maximus muscle in the rat: Comparison to the latissimus dorsi muscle flap

Microsurgery ◽  
1992 ◽  
Vol 13 (4) ◽  
pp. 208-213 ◽  
Author(s):  
Xiaolu Li ◽  
Brian C. Cooley ◽  
Suzann M. Gruel ◽  
Zhong Ye ◽  
John S. Gould
Keyword(s):  
Free Flap ◽  
Latissimus Dorsi ◽  
Muscle Flap ◽  
Latissimus Dorsi Muscle ◽  
Latissimus Dorsi Muscle Flap ◽  
Flap Transfer ◽  
Dorsi Muscle ◽  
Free Flap Transfer

Giant Eccrine Adenocarcinoma of the Scalp with Intracranial Invasion:Resection and Reconstruction Using a Vacuum-assisted Closure Device:Technical Case Report

2006 ◽  
Vol 58 (suppl_4) ◽  
pp. ONS-E371-ONS-E371 ◽  
Author(s):  
Daniel J. Donovan ◽  
Donald A. Person
Keyword(s):  
Wound Closure ◽  
Tumor Resection ◽  
Muscle Flap ◽  
Cerebrospinal Fluid Leakage ◽  
Split Thickness Skin Graft ◽  
Closure Device ◽  
Soft Tissue Coverage ◽  
Neurosurgical Procedures ◽  
Secondary Intention ◽  
Scalp Defects

Abstract Objective and Importance: Carcinoma of the adnexal structures of the skin is a rare malignancy, and is even more unusual in the scalp. We report an unusual case of scalp adnexal carcinoma of eccrine origin that went untreated for years, resulting in a giant tumor with extension through the cranium. The tumor resection and reconstruction of the cranium and scalp defects posed unique challenges. Clinical Presentation: A 54-year-old woman experienced a large recurrence of her scalp adnexal carcinoma after an incomplete wide local excision, which invaded through the cranium. Intervention: The entire vertex of the scalp and cranium were removed en bloc. After cranioplasty, a free vascularized muscle flap was used for soft tissue coverage, but failed owing to poor vascular inflow. A large area of dura was left open, using a vacuum-assisted wound closure device to generate granulation tissue by secondary intention. Another split thickness skin graft was used to provide a cosmetically acceptable outcome. Conclusion: Scalp adnexal tumors of eccrine origin rarely metastasize and can be resected for cure with complete removal. Reconstruction options for large scalp and cranial tumors may be limited, and allowing the dura to granulate by secondary intention has been very rarely described. The novel use of a vacuum-assisted wound closure device was a very useful adjunct in this situation, and may be beneficial in the reconstruction of other patients with large scalp and cranial defects after neurosurgical procedures. It should be used with caution, since it may risk injury to a major venous sinus, especially when used in the midline, or cerebrospinal fluid leakage.

The Role of the Visor Flap in Scalp Reconstruction: A Case Series of 21 Patients

2018 ◽  
Vol 15 (6) ◽  
pp. 651-655 ◽  
Author(s):  
Marco Ellis ◽  
Lisa Hwang ◽  
Ni-Ka Ford ◽  
Konstantin Slavin
Keyword(s):  
Free Flap ◽  
Advancement Flap ◽  
Soft Tissue Coverage ◽  
Preoperative Radiation ◽  
Local Flaps ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Recipient Site ◽  
Scalp Defects ◽  
Flap Design

Abstract BACKGROUND Full-thickness scalp defects pose a reconstructive problem, especially in the setting of infection, chemotherapy/radiation, and underlying cranial defects. Current options include dermal matrices, skin grafts, and local flaps. Local flaps often fail, requiring subsequent microvascular free flap reconstruction. OBJECTIVE To describe the visor flap, a novel bipedicled advancement flap design, and its role in reconstruction of scalp defects. METHODS A retrospective review of 21 adult patients who developed scalp defects reconstructed using the visor flap from 2013 to 2017. The visor flap is a large bipedicled advancement flap design with a triangular extension at the base, which allows redistribution of a large surface area of the scalp. RESULTS All 21 patients achieved complete and viable soft tissue coverage of the recipient site, but 19.0% developed complications unrelated to flap viability, requiring reoperation (infected bone flap, epidural hematoma, and recurrent glioblastoma with subdural abscess). Only 1 patient required conversion to free flap reconstruction due to cerebrospinal fluid leak. Etiologies included cancer (76.1%), cerebrovascular disease (19.0%), and traumatic brain injury (4.8%). Preoperative radiation (42.9%), bone/hardware exposure (57.1%), and previous craniotomy (85.7%) were widely prevalent. Defect size ranged from 3 to 50 cm2 (mean, 16.9 cm2), and flap size ranged from 90 to 500 cm2 (mean, 222 cm2). CONCLUSION The visor flap provides an innovative solution for closure of scalp defects. This technique optimizes immediate closure of tissue compromised by infection or chemotherapy/radiation without burning bridges to more complex reconstructive options.

Modern breast reconstruction with endoscopically assisted latissimus dorsi flap harvesting

2014 ◽  
Vol 155 (3) ◽  
pp. 106-113 ◽  
Author(s):  
Zoltán Mátrai ◽  
Csaba Kunos ◽  
Dávid Pukancsik ◽  
Ákos Sávolt ◽  
Gusztáv Gulyás ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Latissimus Dorsi ◽  
Complex Interventions ◽  
Muscle Flap ◽  
Latissimus Dorsi Flap ◽  
Breast Cancer Surgery ◽  
Soft Tissue Coverage ◽  
Autologous Reconstruction ◽  
Skin Envelope ◽  
Axillary Lymphadenectomy

Skin- and nipple-sparing mastectomies made immediate breast reconstruction possible on a systemic level within breast cancer surgery. Mass reconstruction needs brought by the most common malignancy in women can only be met by the use of implant-based techniques, providing excellent cosmetic results and high patient satisfaction. For these postmastectomy reconstructions the replacement of the skin is no longer a challenge, but the well vascularized, good quality soft tissue coverage of the implant. Oncoplastic breast surgery today is able to conduct oncologically radical complete removal of the glandular tissue through an incision of 6-10 cm made in the armpit, with the nearly scarless retention of the natural skin envelope of the breast, and in the same time adequate axillary staging (sentinel node biopsy/axillary lymphadenectomy) is performed, then using the same incision, the implementation of one-step or multi-step breast reconstruction is possible. During these complex interventions, the latissimus dorsi flap formed by endoscopic technique (leaving no scar on the back), rotated to the anterior chest wall can be used for total autologous reconstruction of low-volume breasts as complete coverage of implants placed under the spared skin-envelope or for revitalization of thin or radiation damaged breast skin. This paper presents 4 cases of breast reconstruction with endoscopically assisted latissimus dorsi muscle flap, and the authors demonstrate the surgical technique in detail and conduct a literature review, for the first time in Hungarian. Orv. Hetil., 2014, 155(3), 106–113.

scholarly journals SHORT AND LONG TERM FOLLOW UP RESULTS OF (THE VERSATILE) GASTROCNEMIUS MUSCLE FLAP

2021 ◽  
Vol 71 (Suppl-1) ◽  
pp. S62-65
Author(s):  
Ghazanfar Ali ◽  
Shahid Hameed ◽  
Abdul Majid ◽  
Rao Saud Ahmad ◽  
Ahsan Masood Butt ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Wound Infection ◽  
Skin Graft ◽  
Gastrocnemius Muscle ◽  
Muscle Flap ◽  
Soft Tissue Coverage ◽  
Partial Loss ◽  
Number Of Patients ◽  
Late Morbidity

Objective: To see the long and short term outcome of the Gastrocnemius muscle flap for coverage of soft tissue defects of knee and proximal Tibia. Study Design: Case series. Place and Duration of Study: Surgery Department of Combined Military Hospital Bahawalpur, from Dec 2014 to Oct 2017. Methodology: A total of 33 patients were enrolled for the study through consecutive sampling. Data was processed using SPSS-17. All patients were followed up at first and second week (early morbidity), and then at 06 months (late morbidity) from operation. During early follow up, they were examined for Hematoma at donor site, wound Infection, sural nerve injury, partial skin graft loss and Partial Flap Necrosis. In late follow up patients were examined for reduced Knee mobility and Gastrocnemius muscle contractions. Results: The studied 33 patients consisted of 30 (90.90%) men and 3 (9.09%) women. The mean age was 35 years (range: 16 to 64) years. Hematoma was commonest complication. It occurred in 6.06%. Wound infection, partial loss of flap, partial loss of skin graft and wound infection occurred in 3.03% patients. Late follow up revealed reduced knee mobility in 9.09% patients (n=3) and bothersome contraction of gastrocnemius muscle in same number of patients. Conclusion: The gastrocnemius flap is reliable, versatile, and very useful for provision of supple soft tissue coverage for defects around the knee and the upper leg.

scholarly journals Durability and versatility of free lattismus dorsi muscle flap in leg defects in tertiary care hospital

2021 ◽  
Vol 8 (12) ◽  
pp. 3663
Author(s):  
Abu Faisal M. Ariful Islam ◽  
M. Iqbal Ahmed ◽  
M. Salah Uddin ◽  
M. A. Hamid
Keyword(s):  
Soft Tissue ◽  
Plastic Surgery ◽  
Anatomical Variation ◽  
Tertiary Care ◽  
Age Distribution ◽  
Muscle Flap ◽  
Soft Tissue Reconstruction ◽  
Care Hospital ◽  
Flap Loss ◽  
Number Of Patients

Reconstruction of the legs and feet is challenging. Because of the composite tissue defects, inadequate and tight local tissues and poor circulation, soft tissue scarcity around the lower portion of the leg presents a significant challenge to the reconstructive surgeon. The aim of this study was to assess the outcome of free Lattismus dorsi (LD) muscle flap used for soft tissue reconstruction of leg defects. This prospective non-randomized study was conducted on 13 patients with leg defects of different causes attended emergency unit and outpatient clinic of plastic surgery department of plastic surgery and burn unit, Dhaka medical college hospital (DMCH) in the period between July 2017 and June 2018. Durability of coverage, flap success, infection and overall satisfaction were studied. The age distribution of the study population highest number of patients (46.15%) were in middle (31-40 years) age group whereas lowest are in older group (>51 years). Highest number of patients (84.61%) were standard myocutanous type of flap whereas lowest were in (15.31%) were chimeric flap and partial latissimus muscle flap. There were one case of total flap loss. Two patients had seroma formation among them one patient had partial necrosis. The outcome of reconstruction of n=13 patients 76.92% patients discharged with excellent recovery, (15.38%) patients discharged with good outcome, 1 (7.69%) patients had total flap loss. Flap is easy to dissect, anatomical variation is rare, long pedicle length which allow to anastomose with suitable recipient artery and finally donor morbidity is negligible.

scholarly journals Functional reconstruction of complex tendo Achilles defect by free latissimus dorsi muscle flap

2012 ◽  
Vol 45 (03) ◽  
pp. 572-575 ◽  
Author(s):  
Vaibhav Khanna ◽  
Romesh Kohli ◽  
Satendar Tulsi ◽  
Sandeep Garg ◽  
Divya Upadhyaya
Keyword(s):  
Soft Tissue ◽  
Achilles Tendon ◽  
Free Flap ◽  
Latissimus Dorsi ◽  
Muscle Flap ◽  
Latissimus Dorsi Muscle ◽  
Latissimus Dorsi Muscle Flap ◽  
Functional Reconstruction ◽  
Dorsi Muscle ◽  
Soft Tissue Cover

ABSTRACTManaging the complex tendo Achilles defect involves reconstructing the Achilles tendon as well as providing soft tissue cover to the heel area. The advent of microsurgery has revolutionised the reconstruction of this difficult defect providing a number of options to the reconstructive surgeon. We present a case of complex tendo Achilles defect reconstructed by the latissimus dorsi free flap.

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