scholarly journals Soft Tissue Defects of Neck and Shoulder Managed by Pedicled Latissimus Dorsi Myocutaneous Flap Transthoracic Transposition

2021 ◽  
Author(s):  
Abulaiti Abula ◽  
Yanshi Liu ◽  
Feiyu Cai ◽  
Kai Liu ◽  
Peng Ren ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Blood Supply ◽  
Latissimus Dorsi ◽  
Myocutaneous Flap ◽  
Donor Site ◽  
High Survival ◽  
Soft Tissue Defects ◽  
Aesthetic Appearance ◽  
Latissimus Dorsi Myocutaneous Flap ◽  
Tissue Defects

Abstract BackgroundThe purpose of this study was to evaluate the effectiveness of latissimus dorsi myocutaneous flap in repairing neck and shoulder soft tissue defects combined with infection.MethodsA total of 11 patients with neck and shoulder soft tissue defects combined with infection, from July 2017 to December 2019, were treated by pedicled latissimus dorsi myocutaneous flap (PLDMF) in our department. There were 9 males and 2 females with an average age of 40.2±12.6 years. The mean defect size after debridement was (7.0±1.3) cm × (4.8±1.2) cm, and the average size of the flaps was (34.4±3.8) cm × (6.0±1.0) cm. The donor site was sutured directly. The postoperative blood supply in the transferred flap and function recovery of the affected limb were retrospectively collected and analyzed.ResultsSeven cases obtained direct healed without significant complications. Four cases developed postoperative infections at the distal ends of the skin flaps, and they were successfully treated by anti-infection treatment and repeated dressing changes. All patients were regularly followed up with an average of 17.3±3.8 months, satisfactory results with good flap blood supply and limb function were achieved in all patients, and no recurrence of infection was observed. ConclusionsPLDMF is a practically alternative treatment for the reconstruction of soft tissue defects combined with infection in neck and shoulder, including advantages of high survival rate, satisfactory functional recovery, and clinical practicality. However, surgical indications should be taken into account due to the inferior aesthetic appearance, especially for young female.

scholarly journals Versatility of the Pedicled Latissimus Dorsi Myocutaneous Flap in Reconstruction of Upper Limb and Trunk Soft Tissue Defects

2019 ◽  
Vol 12 (03) ◽  
pp. 168-176
Author(s):  
Ravikiran Naalla ◽  
Sharmistha Bhattacharyya ◽  
Shivangi Saha ◽  
Shashank Chauhan ◽  
Maneesh Singhal
Keyword(s):  
Soft Tissue ◽  
Upper Limb ◽  
Latissimus Dorsi ◽  
Myocutaneous Flap ◽  
Skin Grafting ◽  
Soft Tissue Defects ◽  
Level Of Evidence ◽  
Clinical Scenarios ◽  
Latissimus Dorsi Myocutaneous Flap ◽  
Tissue Defects

Abstract Purpose The purpose of the study was to share our indications, technique, outcome, and complications associated with the pedicled latissimus dorsi myocutaneous flap (LDMF) for reconstructing various upper limb and trunk soft tissue defects. Patients and Methods We reviewed the prospectively collected data of the patients who underwent reconstruction of upper limb/trunk soft tissue defects with pedicled LDMF between January 2016 and March 2019. By analyzing the clinical scenarios, the location of flap inset, the arc of rotation, reach of the flap, and associated complications, we put forward few significant findings from our experience. Results Thirty-four patients were included in the study: 13 of them underwent LDMF for coverage of upper limb defects, 12 of them for postradical mastectomy soft tissue defects, 8 for posterior trunk reconstruction, and 1 for sternal wound infection. LDMF was successfully used to cover the scapula, anterior and posterior arms, axilla, cubital fossa, mid-forearm, breast, sternum, and midline dorsal wounds. When used reversely, the flap could cover the exposed spine in the midline dorsum. Three patients (9%) had major complications (two patients had partial flap necrosis which required additional debridement and skin grafting, and one patient required an additional transpositional flap). Three patients had minor complications (managed nonoperatively). Conclusion Pedicled LDMF is a straightforward and versatile option for reconstruction of the varied upper limb and trunk soft tissue defects with minimal complications. Level of Evidence This is a level IV, therapeutic, retrospective study.

scholarly journals Pedicled Latissimus Dorsi Myocutaneous Flap Transthoracic Transposition for Repairing Neck and Shoulder Soft Tissue Defect Combined with Infection

2021 ◽  
Author(s):  
Abulaiti Abula ◽  
Yanshi Liu ◽  
Feiyu Cai ◽  
Kai Liu ◽  
Peng Ren ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Clinical Application ◽  
Latissimus Dorsi ◽  
Myocutaneous Flap ◽  
Donor Site ◽  
Soft Tissue Defect ◽  
High Survival ◽  
Skin Flaps ◽  
Tissue Defect ◽  
Latissimus Dorsi Myocutaneous Flap

Abstract Background: To explore the clinical application and selection of latissimus dorsi myocutaneous flap in repairing neck and shoulder soft tissue defect combined with infection. Methods: From July 2017 to December 2019, 11 patients with neck and shoulder soft tissue defect combined with infection in our hospital were repaired by the pedicled latissimus dorsi myocutaneous flap (PLDMF) according to the shape and size of the soft tissue defects, including 9 males and 2 females, with an average age of 40.2±12.6 years. The average defect area after debridement of infected and necrotic tissue was (7.0±1.3) cm × (4.8±1.2) cm, and the average area of the flaps was (34.4±3.8) cm × (6.0±1.0) cm. The donor site was sutured directly. Results: Seven cases of skin flaps healed by the first intention, while 4 cases developed infections at the distal ends of the skin flaps after surgery, which all survived after anti-infection treatment and repeated dressing changes for infection control, and the donor and recipient sites of the flaps healed well. Followed up for an average of 17.3±3.8 months with good flap blood supply and limb function, there was no recurrence of infection. Conclusions: PLDMF is an idea for repairing neck and shoulder soft tissue defect combined with infection, with high survival rate, low postoperative infection recurrence rate, and good functional repair ability, leading to good clinical application value. However, surgical indications should be strictly carried out due to the inferior aesthetic of flaps.

scholarly journals Clinical application of dorsal digital cutaneous branch flap with partial extensor tendon in repairing compound tissue defects of the dorsal finger

2021 ◽  
Vol 29 (3) ◽  
pp. 230949902110546
Author(s):  
Jin Wang ◽  
Hao Lu ◽  
Mingyu Xue ◽  
Li Qiang ◽  
Xiao Zhou
Keyword(s):  
Soft Tissue ◽  
Hand Function ◽  
Donor Site ◽  
Extensor Tendon ◽  
Skin Defect ◽  
Soft Tissue Defects ◽  
Aesthetic Appearance ◽  
Defect Area ◽  
Cutaneous Branch ◽  
Tissue Defects

Purpose: To investigate the clinical efficacy of using dorsal digital cutaneous branch flap with partial extensor tendon in repairing compound tissue defects of the dorsal digits of the hand. Methods: Between January 2018 and January 2020, ten patients with skin and soft tissue defects of the digits accompanied by extensor tendon defects underwent surgical repair using dorsal digital cutaneous branch flap with partial extensor tendon. The donor site was repaired with dorsal metacarpal artery flap. The smallest skin defect area was 2.0 × 1.5 cm, while the largest skin defect area was 4.0 × 3.0 cm. The length of tendon defect ranged from 1.5 to 3.0 cm. Sensation within the flap, aesthetic appearance of both the donor and recipient sites, functional recovery, and return-to-work time were measured. Results: All 10 flaps survived after surgery. All patients were followed up for 12–18 months, with an average follow-up period of 15.4 months. After flap repair, the digits had satisfactory shape and appearance along with a soft texture. Hand function was excellent in eight cases and good in two cases. Two-point discrimination was 6–9 mm with an average of 8 mm. No patient experience cold intolerance. The donor sites healed well with satisfactory appearance. Conclusion: Dorsal digital cutaneous branch flap with partial extensor tendon could be used to repair skin and tendon defects simultaneously. The advantages of this method include simple donor tissue harvesting; less donor-site morbidity; reliable blood supply; and satisfactory recovery of appearance, sensation, and function of the flap. Therefore, this method could be suitable for repairing soft tissue defects of the dorsal digits with extensor tendon defects.

A Comparative Study of the Reverse Sural Fascio-Cutaneous Flap Outcomes in the Management of Foot and Ankle Soft Tissue Defects in Diabetic and Trauma Patients

2018 ◽  
Vol 12 (5) ◽  
pp. 432-438 ◽  
Author(s):  
Chahine Assi ◽  
Camille Samaha ◽  
Moussa Chamoun Moussa ◽  
Tony Hayek ◽  
Kaissar Yammine
Keyword(s):  
Soft Tissue ◽  
Donor Site ◽  
Low Frequency ◽  
Group Versus ◽  
Healing Time ◽  
Diabetic Patients ◽  
Trauma Patients ◽  
Soft Tissue Defects ◽  
Cutaneous Flap ◽  
Tissue Defects

Introduction. Soft tissue defects in the distal leg and foot are challenging conditions for reconstruction. The widely used reverse sural fascio-cutaneous flap (RSFCF) has been reported with large variation in complication frequency. Some authors reported higher complications in the diabetic population when compared with trauma patients. We compared the reliability of the RSFCF in treating such defects among both populations. Methods. This is a retrospective series with a prospective data collection of 24 patients (11 with type 2 diabetes and 13 in trauma settings) treated with an ipsilateral RSFCF for soft tissue defects of the distal leg and the rear foot. Healing events and complications were recorded and compared for both groups. The mean follow-up was 32 months. Results. Diabetic group versus trauma group showed the following results; mean flap healing time of 24 versus 22 days, donor site healing time of 14 versus 16 days, 1 total flap necrosis in both groups, 3 versus 2 cases of skin edge necrosis, 2 cases of temporary venous congestion in both groups, and 8 versus 10 cases of transient hypoesthesia of the lateral border of the foot. No infection was encountered in both groups and no recurrence of infection in the primary infected diabetic patients. Conclusions. We found the RSFCF to be useful, reproducible, and reliable in treating soft tissue defects with a very low frequency of serious complications. Diabetic patients were found to have similar outcomes when compared with trauma patients. Therefore, diabetes might not be a major factor of flap failure. Levels of Evidence: Level III: Therapeutic

scholarly journals Peroneal perforator pedicle propeller flap for lower leg soft tissue defect reconstruction: Clinical applications and treatment of venous congestion

2017 ◽  
Vol 45 (3) ◽  
pp. 1074-1089 ◽  
Author(s):  
Lifeng Shen ◽  
Yiyang Liu ◽  
Chun Zhang ◽  
Qiaofeng Guo ◽  
Wenhua Huang ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Donor Site ◽  
Lower Leg ◽  
Soft Tissue Defect ◽  
Venous Congestion ◽  
Peroneal Artery ◽  
Soft Tissue Defects ◽  
Propeller Flap ◽  
Perforator Vessel ◽  
Tissue Defects

Objective To describe the characteristics of the perforator vessel in the peroneal artery of the lower leg and to explore the use of perforator pedicle propeller flaps to repair soft tissue defects in the lower leg, heel and foot. Methods This retrospective study enrolled patients with soft tissue defects of the distal lower leg, heel and foot who underwent surgery using peroneal perforator-based propeller flaps. The peroneal artery perforators were identified preoperatively by colour duplex Doppler ultrasound. The flap was designed based on the preoperatively-identified perforator location, with the posterior border of the fibula employed as an axis, and the perforator vessel as the pivot point of rotation. Patients were followed-up to determine the outcomes. Results The study analysed 36 patients (mean age, 39.7 years). The majority of the soft tissue defects were on the heel (20; 55.6%). The donor-site of the flap was closed in 11 patients by direct suturing and skin grafting was undertaken in 25 patients. Postoperative complications included venous congestion (nine patients), which was managed with delayed wound coverage and bleeding therapy. All wounds were eventually cured and the flaps were cosmetically acceptable. Conclusions The peroneal perforator pedicle propeller flap is an appropriate choice to repair soft tissue defects of the distal limbs.

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