Experience with Flaps After Resection of Vulvar Carcinoma: A Case Series

Abstract Background: A defect caused by the radical resection of vulvar cancer requires repair with flap transplantation or vulvoplasty. Therefore, the aim of this study is to present a review of our practice of post-surgical defect reconstruction in cases using different skin flaps.Methods: An observational study was performed among 26 patients with vulvar cancer who were admitted to Sun Yat-Sen Memorial Hospital between February 2015 and February 2020 for surgical and reconstructive procedures. Clinical data of these 26 patients were analyzed. All patients underwent radical resection of vulvar cancer, followed by the repair of post-surgical defects by random flap or axial flap transplantation (even for very complex defects).Results: Among the 26 cases in this study, all patients received 38 soft tissue reconstruction procedures for vulvar perineal defects during the study period. Squamous cell carcinoma was the most commonly diagnosed cancer (80.8%). The average size of the defect was 9.3 ´ 7 cm2. Rhomboid flaps were the most commonly used flaps for performing reconstruction in both the primary and recurrent groups. Poor wound healing was the most commonly discovered complication that occurred in 3 of the 38 flaps (7.9%) used. Previous surgery or radiotherapy did not increase the rate of complications after proper reconstruction was performed.Conclusion: Expanding resection is an effective technique for treating vulvar cancer. Different skin flaps, are effective premium options for post-surgical defect reconstruction, and selective use of skin flaps for treating vulvar defects preserves the vulvar morphology and allows for relatively better functionality.

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Submental Flap for Soft Tissue Reconstruction following Radical Parotidectomy

Otolaryngology ◽

10.1177/0194599819827822 ◽

2019 ◽

Vol 160 (6) ◽

pp. 1130-1132 ◽

Cited By ~ 2

Author(s):

Rodrigo Bayon ◽

Andrew B. Davis

Keyword(s):

Soft Tissue ◽

Medical Center ◽

Donor Site ◽

Case Series ◽

Island Flap ◽

Hospital Length Of Stay ◽

Soft Tissue Reconstruction ◽

Submental Flap ◽

Tissue Reconstruction ◽

Submental Island Flap

This study analyzed our institution’s experience with a buried submental flap for soft tissue reconstruction following radical parotidectomy. A retrospective chart review was conducted of patients who had parotid malignancies requiring radical parotidectomy, who also underwent a buried submental flap reconstruction. Analysis included patient demographics and clinical, surgical, and outcome data. Three patients met criteria for this study who underwent a buried submental flap at a tertiary medical center between 2012 and 2016. All patients had oncologic surgery and reconstruction using a deepithelialized submental island flap, which was used to fill the radical parotidectomy surgical defect with no complications and good aesthetic results. Each patient received appropriate adjuvant therapy. This case series shows that the buried submental island flap is a versatile flap that is adequate bulk after radical parotidectomy. It also has no impact on hospital length of stay and provides excellent cosmetic outcomes with minimal donor site morbidity.

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Comparison of Free Muscle and Perforator Skin Flaps for Soft Tissue Reconstruction of the Foot and Ankle

Foot & Ankle International ◽

10.3113/fai.2010.0053 ◽

2010 ◽

Vol 31 (1) ◽

pp. 53-58 ◽

Cited By ~ 18

Author(s):

Yener Demirtas ◽

Tale Neimetzade ◽

Osman Kelahmetoglu ◽

Ethem Guneren

Keyword(s):

Soft Tissue ◽

Soft Tissue Reconstruction ◽

Foot And Ankle ◽

Skin Flaps ◽

Tissue Reconstruction

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Achilles Tendon Region Defects: Delayed Composite Anterolateral Thigh Flap With Stripping of Fascia Lata: A Case Series

Wound Management & Prevention ◽

10.25270/wmp.2020.12.1322 ◽

2020 ◽

Vol 66 (12) ◽

pp. 13-22

Author(s):

Cesare Tiengo ◽

Regina Sonda ◽

Andrea Monticelli ◽

Francesco Messana ◽

Alberto Crema ◽

...

Keyword(s):

Soft Tissue ◽

Achilles Tendon ◽

Short Form ◽

Case Series ◽

Fascia Lata ◽

Anterolateral Thigh Flap ◽

Soft Tissue Reconstruction ◽

Medical Outcomes ◽

Anterolateral Thigh ◽

Tissue Reconstruction

Defects of the Achilles tendon that include the surrounding soft tissue represent a challenge due to complex functionality and biomechanics. PURPOSE: The purpose of this study was to evaluate the functional and physical functioning score outcomes of patients following microsurgical reconstruction of the yarrow region, using a combination of objective, subjective, and semi-subjective measurements. METHODS: Between 2007 and 2018, 15 patients underwent delayed Achilles tendon region reconstruction with different anterolateral thigh flap types. Seven (7) patients underwent tendon and soft tissue reconstruction with a chimeric anterolateral thigh flap (ALT) and rolled-up fascia lata, and 8 patients underwent soft tissue reconstruction and only tendon coverage with fascia lata. Follow-up assessments included maximal range of motion (MROM) (plantarflexion and dorsiflexion), the American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale score, and the Medical Outcomes Study 36-item Short-Form Health Survey physical functioning subscore. RESULTS: A total of 15 patients (11 males and 4 females with a mean age of 39.86 years) were evaluated during a mean follow-up time of 23 months (SD = 7.12). The MROM for plantarflexion and dorsiflexion was 42.71 degrees (SD = 2.9) and 24.8 degrees (SD = 4.29), respectively, in patients who underwent composite ALT with a rolled-up fascia lata. The MROM for plantarflexion and dorsiflexion was 43 degrees (SD = 5.37) and 27.37 degrees (SD = 3.2), respectively, in patients who underwent fasciocutaneous ALT. The mean American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale score was 82 for the first group and 86.87 for the second, whereas the mean Medical Outcomes Study 36-item Short-Form Health Survey scores were 82.57 and 81.5, respectively, for the 2 groups. Statistical analysis showed no significant difference between the 2 groups. CONCLUSIONS: The results of this case series suggest that the single-stage composite reconstruction with a fasciocutaneous flap with or without a strip of fascia lata is a safe and reliable strategy for composite reconstruction of the Achilles tendon region. Additional studies to evaluate these outcomes and instruments to evaluate functioning are necessary.

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Vertical Ridge Augmentation and Soft Tissue Reconstruction of the Anterior Atrophic Maxillae: A Case Series

The International Journal of Periodontics & Restorative Dentistry ◽

10.11607/prd.2481 ◽

2017 ◽

Vol 35 (5) ◽

pp. 613-623 ◽

Cited By ~ 7

Author(s):

Istvan Urban ◽

Alberto Monje ◽

Hom-Lay Wang

Keyword(s):

Soft Tissue ◽

Case Series ◽

Soft Tissue Reconstruction ◽

Ridge Augmentation ◽

Tissue Reconstruction

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Contemporary reconstruction after complex facial trauma

Burns & Trauma ◽

10.1093/burnst/tkaa003 ◽

2020 ◽

Vol 8 ◽

Cited By ~ 2

Author(s):

Matthew R Zeiderman ◽

Lee L Q Pu

Keyword(s):

Soft Tissue ◽

Case Series ◽

Free Tissue Transfer ◽

Facial Trauma ◽

Soft Tissue Coverage ◽

Soft Tissue Reconstruction ◽

Reconstruction Process ◽

Optimal Outcomes ◽

Reconstructive Process ◽

Tissue Reconstruction

Abstract Complex facial trauma requires complex repair and solutions. This process is challenging for the surgeon who seeks to manage the expectations of the patient and family while achieving the best possible result. Historically, the use of pedicled flaps, and then free tissue transfer, were the primary techniques utilized. Advancements in soft-tissue reconstruction, such as perforator flaps and pre-expanded and prefabricated flaps, allow refinement of the soft-tissue reconstruction process to create the best initial soft-tissue coverage. The advent of contemporary technologies, such as virtual surgical planning, stereolithography and customized implants and plates, facilitates a tailored approach to the patient’s reconstructive needs for precise bony reconstruction. When surgical and technological techniques are combined in complementary multistage reconstructions, better reconstructive and aesthetic outcomes are achievable than ever before. In this review, the authors present a summary of the management of complex facial trauma based on the senior author’s broad experience. Initial management and contemporary reconstructive techniques and technology to provide optimal outcomes are reviewed. A case series of complex facial traumas and their reconstructive process is also presented to demonstrate how complementary staged procedures can yield an optimal result. We believe the reconstructive surgeon managing complex facial trauma should strive to incorporate contemporary technologies and techniques into their armamentarium to provide the best patient care.

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Maximizing Outcomes While Minimizing Morbidity: An Illustrated Case Review of Elbow Soft Tissue Reconstruction

Plastic Surgery International ◽

10.1155/2016/2841816 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8

Author(s):

Adrian Ooi ◽

Jonathan Ng ◽

Christopher Chui ◽

Terence Goh ◽

Bien Keem Tan

Keyword(s):

Soft Tissue ◽

Case Series ◽

Free Tissue Transfer ◽

Soft Tissue Coverage ◽

Soft Tissue Reconstruction ◽

Flap Reconstruction ◽

Case Review ◽

Tissue Transfer ◽

Tissue Reconstruction ◽

Elbow Reconstruction

Background. Injuries to the elbow have led to consequences varying from significant limitation in function to loss of the entire upper limb. Soft tissue reconstruction with durable and pliable coverage balanced with the ability to mobilize the joint early to optimize rehabilitation outcomes is paramount. Methods. Methods of flap reconstruction have evolved from local and pedicled flaps to perforator-based flaps and free tissue transfer. Here we performed a review of 20 patients who have undergone flap reconstruction of the elbow at our institution. Discussion. 20 consecutive patients were identified and included in this study. Flap types include local (n=5), regional pedicled (n=7), and free (n=8) flaps. The average size of defect was 138 cm2 (range 36–420 cm2). There were no flap failures in our series, and, at follow-up, the average range of movement of elbow flexion was 100°. Results. While the pedicled latissimus dorsi flap is the workhorse for elbow soft tissue coverage, advancements in microvascular knowledge and surgery have brought about great benefit, with the use of perforator flaps and free tissue transfer for wound coverage. Conclusion. We present here our case series on elbow reconstruction and an abbreviated algorithm on flap choice, highlighting our decision making process in the selection of safe flap choice for soft tissue elbow reconstruction.

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Temporoparietal Fascial Flap for Soft Tissue Reconstruction of Pediatric and Young Adult Foot Defects: A Case Series

The Journal of Foot & Ankle Surgery ◽

10.1053/j.jfas.2018.06.014 ◽

2021 ◽

Vol 60 (1) ◽

pp. 140-145

Author(s):

Rachel Lee ◽

Jonathan Wheeler ◽

Haemish Crawford

Keyword(s):

Young Adult ◽

Soft Tissue ◽

Case Series ◽

Soft Tissue Reconstruction ◽

Fascial Flap ◽

Tissue Reconstruction

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Osteomyelitis of the Pelvic Bones: A Multidisciplinary Approach to Treatment

Journal of Bone and Joint Infection ◽

10.7150/jbji.21692 ◽

2017 ◽

Vol 2 (4) ◽

pp. 184-193 ◽

Cited By ~ 10

Author(s):

Maria Dudareva ◽

Jamie Ferguson ◽

Nicholas Riley ◽

David Stubbs ◽

Bridget Atkins ◽

...

Keyword(s):

Multidisciplinary Approach ◽

Case Series ◽

Recurrent Infection ◽

Surgical Excision ◽

Soft Tissue Reconstruction ◽

Tertiary Referral Centre ◽

Type Iv ◽

Tissue Reconstruction ◽

Wound Healing Problems

Abstract. Background and Purpose: A case series review of chronic pelvic osteomyelitis treated with combined medical and surgical treatment by a multidisciplinary team.Methods: All patients treated with surgical excision of pelvic osteomyelitis at our tertiary referral centre between 2002 and 2014 were included. All received combined care from a clinical microbiologist, an orthopaedic surgeon and a plastic surgeon. The rate of recurrent infection, wound healing problems and post-operative mortality was determined in all. Treatment failure was defined as reoperation involving further bone debridement, a requirement for the use of long-term suppressive antibiotics or sinus recurrence.Results: Sixty-one adults (mean age 50.2 years, range 16.8-80.6) underwent surgery. According to the Cierny-Mader classification of osteomyelitis there were 19 type II, 35 type III and 7 type IV cases. The ischium was the most common site of infection. Osteomyelitis was usually the result of contiguous focus infection associated with decubitus ulcers, predominantly in patients with spinal or cerebral disorders. Most patients with positive microbiology had polymicrobial infection (52.5%). Thirty patients required soft tissue reconstruction with muscle or myocutaneous flaps.Twelve deaths occurred a mean of 2.8 years following surgery (range 7 days-7.4 years). Excluding these deaths the mean follow-up was 4.6 years (range 1.5-12.2 years). Recurrent infection occurred in seven (11.5%) a mean of 1.5 years post-operatively (92 days - 5.3 years). After further treatment 58 cases (95.1%) were infection free at final follow-up.Interpretation: Patients in this series have many comorbidities and risk factors for poor surgical outcome. Nevertheless, the multidisciplinary approach allows successful treatment in the majority of cases.

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Soft Tissue Reconstruction for Deep Defects over a Complicated Total Knee Arthroplasty: A Systematic Review

The Journal of Knee Surgery ◽

10.1055/s-0039-1684012 ◽

2019 ◽

Vol 33 (07) ◽

pp. 732-744 ◽

Cited By ~ 1

Author(s):

Demetrius M. Coombs ◽

Jessica Churchill ◽

Paul Cartwright ◽

Morad Chughtai ◽

Assem A. Sultan ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Soft Tissue ◽

Knee Arthroplasty ◽

Case Series ◽

Soft Tissue Reconstruction ◽

Soft Tissue Defects ◽

Flap Coverage ◽

Tissue Reconstruction ◽

Total Knee ◽

Tissue Defects

AbstractDeep soft tissue defects after complicated primary or revision total knee arthroplasty (TKA) can be devastating to the patient and technically challenging. The purpose of this review was to (1) discuss different methods used to provide coverage for deep defects of the knee following TKA, as well as to (2) report on their success rates. A comprehensive literature search was performed. Reports were only included if they (1) were case series, (2) were level III studies or above (including retrospective cohort studies and meta-analyses), (3) were in English, and (4) discussed the outcome of graft or flap coverage of soft tissue defects after total knee arthroplasty. A total of 28 case series and four retrospective comparative studies were retrieved. In 16 studies, 195 out of 241 patients who received gastrocnemius flaps (81%) experienced successful outcomes. In seven studies including 84 patients that underwent fasciocutaneous flap coverage, over 90% of patients experienced successful outcomes. In the four studies examining 144 patients with delayed versus prophylactic soft tissue reconstruction, up to 81% of patients experienced a successful outcome. Various factors must be taken into consideration when assessing full-thickness defects over a TKA and collaboration between plastic and orthopaedic surgeons is required to select the optimal approach.

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