Evaluation of Wound Healing Following Wide Surgical Resection and Subdermal Skin Flap Reconstruction for Management of Soft Tissue Tumours in 20 Dogs

Background: Tumours in dogs are increasing day by day and the mainstay of treatment is surgery. Wide surgical resection of soft tissue tumour in dogs is mandatory to prevent recurrence but it leads to the formation of a large skin defect requiring skin reconstruction. Among the various skin reconstruction techniques, subdermal skin flap is a simple reconstruction technique which can be performed by harvesting full-thickness skin from the surrounding skin without using special instruments. The current study was aimed to evaluate the healing and recurrence of tumours in dogs after wide surgical resection of tumour and subdermal skin flap reconstruction.Methods: 20 dogs with soft tissue tumours presented to MSVH, GADVASU, Ludhiana, Punjab, during the period 2019-2020 were treated by wide surgical resection and subdermal skin flap technique. Routine clinico-physical, Hematobiochemical, Radiographic examinations, Fine Needle Aspiration Cytology, Histopathology and Culture Sensitivity Test were performed. Different types of flap were created according to the location of tumour and availability of the loose skin and wound healing was evaluated and complications recorded. Result: Healing of subdermal flap was seen in 15 dogs (75%) while necrosis of subdermal flap was recorded in 5 dogs (25 %) of the cases of which 4 of them had mobility of flap base and were located in ventral abdomen (n=4) and limb (n=1). Overall tumour recurrence was recorded in 3 dogs (15%) which were located in limbs of which 2 dogs had lung metastasis and the tumours were malignant. It can be concluded that single pedicle advancement flaps for thoracic region; bipedicle advancement flap for thoracic and abdominal regions; rotational flaps for lateral thoracic region and transposition flap for proximal limb region are feasible skin reconstruction techniques for the repair of large skin defects in dogs.

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The Use of Engineered Bilayered Skin (MyDermTM) in the Management of Massive Skin Defect in Grade III Gustilo-Anderson Open Fracture

The International Journal of Lower Extremity Wounds ◽

10.1177/1534734617724974 ◽

2017 ◽

Vol 16 (3) ◽

pp. 212-216

Author(s):

Nor Hazla Mohamed Haflah ◽

Min Hwei Ng ◽

Mohd Heikal Mohd Yunus ◽

Amaramalar Selvee Naicker ◽

Ohnmar Htwe ◽

...

Keyword(s):

Soft Tissue ◽

Open Fracture ◽

Wound Closure ◽

Posterior Tibial Artery ◽

Soft Tissue Coverage ◽

Skin Defect ◽

Vascular Repair ◽

Posterior Compartment ◽

Large Defect ◽

Large Skin

Open fracture Gustilo-Anderson grade IIIC is associated with higher risk of infection and problems with soft tissue coverage. Various methods have been used for soft tissue coverage in open fractures with large skin defect. We report a case of a patient who had grade IIIC open fracture of the tibia with posterior tibial artery injury. The patient underwent external fixation and reduction. Because of potential compartment syndrome after vascular repair, fasciotomy of the posterior compartment was performed. This wound, however, became infected and because of further debridement, gave rise to a large skin defect. A tissue engineered skin construct, MyDermTM was employed to cover this large defect. Complete wound closure was achieved 35 days postimplantation. The patient then underwent plating of the tibia for nonunion with no adverse effect to the grafted site. The tibia eventually healed 5 months postplating, and the cosmetic appearance of the newly formed skin was satisfactory.

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The Influence of Time Interval Between Preoperative Radiation and Surgical Resection on the Development of Wound Healing Complications in Extremity Soft Tissue Sarcoma

Annals of Surgical Oncology ◽

10.1245/s10434-015-4631-z ◽

2015 ◽

Vol 22 (9) ◽

pp. 2824-2830 ◽

Cited By ~ 19

Author(s):

Anthony M. Griffin ◽

Colleen I. Dickie ◽

Charles N. Catton ◽

Peter W. M. Chung ◽

Peter C. Ferguson ◽

...

Keyword(s):

Wound Healing ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Surgical Resection ◽

Time Interval ◽

Preoperative Radiation ◽

Extremity Soft Tissue Sarcoma

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Osteoradionecrosis of tympanic bone: reconstruction of outer ear canal with pedicled skin flap, combined with hyperbaric oxygen therapy, in five patients

The Journal of Laryngology & Otology ◽

10.1017/s0022215109990612 ◽

2009 ◽

Vol 123 (10) ◽

pp. 1114-1119 ◽

Cited By ~ 9

Author(s):

M Metselaar ◽

A G Dumans ◽

M P C van der Huls ◽

W Sterk ◽

L Feenstra

Keyword(s):

Wound Healing ◽

Hyperbaric Oxygen ◽

Hyperbaric Oxygen Therapy ◽

Oxygen Therapy ◽

Skin Flap ◽

Skin Defect ◽

Ear Canal ◽

One Stage ◽

Pedicled Skin Flap ◽

Bare Bone

AbstractObjective:To evaluate the results of one-stage surgical repair of the meatal skin defect in patients with long-lasting osteoradionecrosis of the outer ear canal, using a postauricular, inferiorly pedicled skin flap. All patients were also treated with hyperbaric oxygen both pre- and post-operatively.Methods:A prospective study evaluating the results of a one-stage surgical procedure to repair the meatal skin defect in five patients with osteoradionecrosis of the outer ear canal. All patients were treated with hyperbaric oxygen both pre- and post-operatively.Results:In four of the five patients, intact canal skin was achieved after surgery and hyperbaric oxygen therapy. One patient needed a second operation to cover a small remaining area of bare bone. In one patient, wound healing was unsatisfactory and an area of bare bone remained.Conclusion:In cases of osteoradionecrosis of the outer ear canal, the skin defect can be repaired with an inferiorly pedicled skin flap. Although not yet scientifically proven, the peri-operative application of hyperbaric oxygen may be of additional value to improve wound healing in areas of compromised tissue.

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Variants of Extended Latissimus Dorsi Musculocutaneous Flap for Large Wounds in Extremities

10.21203/rs.3.rs-49022/v1 ◽

2020 ◽

Author(s):

Jiqiang He ◽

Liming Qing ◽

Panfeng Wu ◽

Zhengbing Zhou ◽

Fang Yu ◽

...

Keyword(s):

Soft Tissue ◽

Latissimus Dorsi ◽

Donor Site ◽

Free Flaps ◽

Lower Limbs ◽

Soft Tissue Coverage ◽

Skin Defect ◽

Reliable Methods ◽

Large Skin

Abstract Background: Extended latissimus dorsi musculocutaneous (LDMC) flap increasing the size of the flap and most used for breast reconstruction. This report will share our experience in designing different extended LDMC flap for large wounds in extremities.Patients and methods: From January 2004 to December 2018, extended LDMC flaps were performed on 72 consecutive patients aged 2 to 68 years (37 men and 35 women). All the wounds were extensive, either in upper or lower limbs, the skin defect ranged from 18 ×10 cm2 to 37 × 21 cm2. Single wing and double wings extended LDMC flaps were designed and harvested based on the wounds.Results: Seventy-two patients included this series, 5 pedicle and 67 free flaps were successfully harvested. The mean flap harvest time was 56.2 min. The donor sites were closed primarily in all patients. The venous compromise was noticed on the first postoperative day in 4 cases. Two flaps were salvaged after emergency re-exploration, another two patient’s flaps were total necrosis. One of the patients was received lower extremity amputation, another patient was repaired by extended LDMC flap on the other side. The wounds healed well, providing reliable soft tissue coverage and good contour in the reconstructed areas. Five patients lost follow-up, the follow-up period ranged from 10 to 56 months (mean, 15.7 months). Patients didn’t occur significant donor site morbidities that influenced their daily activities during follow-up.Conclusion: The single wing and double wings extended latissimus dorsi musculocutaneous flaps are simple and reliable methods for large skin and soft-tissue defects in extremities.

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Early Outcomes of Preoperative 5-fraction Radiation Therapy for Soft Tissue Sarcoma Followed by Immediate Surgical Resection

10.1101/2020.03.20.20038885 ◽

2020 ◽

Cited By ~ 1

Author(s):

Shireen Parsai ◽

Joshua Lawrenz ◽

Scott Kilpatrick ◽

Brian Rubin ◽

Cory Hymes ◽

...

Keyword(s):

Wound Healing ◽

Radiation Therapy ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Median Time ◽

Surgical Resection ◽

Oncologic Outcomes ◽

Wound Complications ◽

Oncologic Therapy

ABSTRACTPurpose/ObjectivesThere are limited data regarding the use of hypofractionated radiation therapy (RT) for soft tissue sarcoma. We report early oncologic outcomes and wound complications of patients undergoing preoperative hypofractionated (5 fraction) RT followed by immediate surgical resection.Materials/MethodsAn IRB-approved database of patients treated with preoperative RT for soft tissue sarcoma was queried. Patients treated with a hypofractionated dosing regimen followed by immediate (within 7 days) planned wide surgical resection were identified.ResultsBetween 2016 to 2019, sixteen patients met eligibility criteria. The median clinical follow-up was 10.7 months (range 1.7-33.2). The median patient age was 64 years old (range 33-88). Ten of the sarcomas were located in the lower extremity, 4 in the upper extremity, and two were located in the trunk. Five patients had metastatic disease at diagnosis. The majority of the patients received a total radiation dose of 30 Gy in 5 fractions (range 27.5-40 Gy) on consecutive days. All patients were planned with IMRT/VMAT. The median time to surgical resection following the completion of RT was 1 day (range 0-7 days). The median time from initial biopsy results to completion of primary oncologic therapy was 20 days (range 16-35). Ten patients achieved R0 resection, whereas the remaining 6 patients achieved R1 resection. Of the 13 patients assessed for local control, no patients developed local failure. Five patients developed wound healing complications (31%), of which only three patients (19%) required return to the operating room.ConclusionsTreatment of soft tissue sarcoma with preoperative hypofractionated RT followed by immediate resection resulted in a median of 20 days from biopsy results to completion of oncologic therapy. Early outcomes demonstrate favorable wound healing. Further prospective data with long-term follow-up is required to determine the oncologic outcomes and toxicity of hypofractionated preoperative RT.

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Using the keystone design perforator island flap in large myelomeningocele closure

Neurosurgical FOCUS ◽

10.3171/2019.7.focus19383 ◽

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.

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Inflammatory Myofibroblastic Tumour in Antimesenteric Border of Descending Colon of Children: A Case Report

Journal of Paediatric Surgeons of Bangladesh ◽

10.3329/jpsb.v3i1.23908 ◽

2015 ◽

Vol 3 (1) ◽

pp. 47-50

Author(s):

Shahnoor Islam ◽

AKM Amirul Morshed ◽

Afiqul Islam

Keyword(s):

Soft Tissue ◽

Spindle Cell ◽

Inflammatory Myofibroblastic Tumour ◽

Pathological Findings ◽

Soft Tissue Lesion ◽

Soft Tissue Tumours ◽

Inflammatory Pseudotumour ◽

Erythrocyte Sedimentation ◽

Antimesenteric Border

Inflammatory myofibroblastic tumour (IMT) occurring at intraabdominal sites in children has rarely been described. Inflammatory pseudotumour is a soft tissue lesion that may be confused with a sarcoma. It is abbreviated as IMT. Inflammatory myofibroblastic tumour, also known as soft tissue tumours, atypical fibromyxoid tumours, pseudosarcomatous fibromyxoid tumour, plasma cell granuloma, pseudosarcomatous myofibrotic proliferation, post-operative spindle cell nodules. In this paper, we describe a case of inflammatory myofibroblastic tumour (IMT) with an unusual constellation of clinical, pathological findings. A 10-year-old girl had an 7-cm intraabdominal mass accompanied by severe anemia, fever, constipation, weight loss, thrombocytosis, elevated erythrocyte sedimentation rate. Laparotomy was performed. The final pathologic diagnosis was IMT. At the most recent follow up (12months) after excision of the tumour, the patient was symptom-free and there was no evidence of tumour recurrence.J. Paediatr. Surg. Bangladesh 3(1): 47-50, 2012 (January)

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