scholarly journals Reconstruction of Lower Extremity Necrotizing Fasciitis with Tibialis Anterior Musculofascial Flap and Skin Graft: A Case Report

2021 ◽  
Vol 17 (3) ◽  
pp. 222-226
Author(s):  
Jinhyun Kim ◽  
Taewoon Kim ◽  
Seokchan Eun
Keyword(s):  
Case Report ◽  
Lower Extremity ◽  
Necrotizing Fasciitis ◽  
Tibialis Anterior ◽  
Tibialis Anterior Muscle ◽  
Traumatic Injury ◽  
Skin Grafting ◽  
Split Thickness Skin Grafting ◽  
Lower Extremity Reconstruction ◽  
The Right

Necrotizing fasciitis of the lower extremities results in large tissue defects, and most cases require reconstruction using skin grafts or flaps. We describe a 61-year-old man who developed necrotizing fasciitis of the right lower leg and septic shock, following a traumatic injury to his leg. Wound culture yielded methicillin-resistant Staphylococcus aureus. Extensive debridement was performed four times along with the use of appropriate antibiotics. After 2 weeks, physical examination showed an open wound (approximately 30×20 cm in size) with partial tibial bone exposure. Subsequently, the patient underwent successful reconstruction using a tibialis anterior musculofascial flap and split-thickness skin grafting. The tibialis anterior muscle was bihalved and pivoted to cover the exposed bone surface. The patient was without pain and was able to successfully perform daily activities at the 15-month follow-up. This case report highlights the utility of a bihalved tibialis anterior musculofascial flap for lower extremity reconstruction, particularly in patients for whom free flap transfers are unviable.

scholarly journals Breast necrotizing fasciitis following stillbirth managed with nipple areola conservation in a resource-poor setting: a case report

2020 ◽  
Vol 2020 (2) ◽  
Author(s):  
Charles Chidiebele Maduba ◽  
Ugochukwu Uzodimma Nnadozie
Keyword(s):  
Case Report ◽  
Early Intervention ◽  
Necrotizing Fasciitis ◽  
Rare Condition ◽  
Skin Grafting ◽  
Resource Poor Setting ◽  
Areola Complex ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Resource Poor

Abstract Breast necrotizing fasciitis is a rare condition that has a tendency to rapidly progress with untoward morbidity and potential mortality. Its rarity often results to misdiagnosis and the fulminant course of the disease. We wish to present a case managed with nipple areola conservation following early intervention. We report a 28-year-old woman managed for unilateral right breast necrotizing fasciitis following stillbirth and resultant breast congestion in a background hypoalbuminemia. Early intervention ensured nipple-areola salvage. Wound was covered with split-thickness skin grafting. Early aggressive intervention in necrotizing fasciitis of the breast in a post-stillbirth lady with congestion contributed to preservation of nipple areola complex with eventual satisfactory management using split-thickness skin grafting.

Outcomes of Split Thickness Skin Grafting on Lower Extremity Wounds in Diabetics

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 111-OR
Author(s):  
ELLIOT WALTERS ◽  
GREG STIMAC ◽  
NEHA RAJPAL ◽  
IRAM NAZ ◽  
TAMMER ELMARSAFI ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Skin Grafting ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting

scholarly journals Squamous Cell Carcinoma Arising at a Skin Graft Donor Site: Case Report and Review of the Literature

2021 ◽  
Vol 7 ◽  
pp. 2513826X2110084
Author(s):  
Weston Thomas ◽  
Kevin Rezzadeh ◽  
Kristie Rossi ◽  
Ajul Shah
Keyword(s):  
Squamous Cell Carcinoma ◽  
Case Report ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Skin Graft ◽  
Donor Site ◽  
Skin Grafting ◽  
Excisional Biopsy ◽  
Graft Donor ◽  
The Right

Introduction: Skin graft reconstruction is a common method of providing wound coverage. Rarely, skin grafting can be associated with the development of squamous cell carcinoma (SCC) in the graft donor site. Case Report: The patient is a 72-year old male with a 15-year history of bilateral hip wounds. He underwent a multitude of treatments previously with failed reconstructive efforts. After presenting to us, he underwent multiple debridements and eventual skin grafting. Within 4 weeks of the final skin graft, a mass developed at the skin graft donor site at the right thigh. Excisional biopsy returned a well differentiated keratinizing SCC. Discussion/Conclusion: This case demonstrates the acute presentation of SCC in a patient following a skin graft without known risk factors. The purpose of this unique case report is to highlight a very rare occurrence of SCC at a skin graft donor site.

Surgical Strategies: Necrotizing Fasciitis of the Foot and Ankle Treated With Dermal Regeneration Matrix for Limb Salvage

2020 ◽  
pp. 107110072095208
Author(s):  
Arvind S. Narayanan ◽  
Kempland C. Walley ◽  
Todd Borenstein ◽  
G. Aman Luther ◽  
J. Benjamin Jackson ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Lower Extremity ◽  
Necrotizing Fasciitis ◽  
Limb Salvage ◽  
Free Flap ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Flap Coverage ◽  
Split Thickness Skin Grafting ◽  
Dermal Regeneration

Although necrotizing fasciitis is a life-threatening entity that needs expeditious treatment, cases involving the lower extremity are less commonly encountered than in the upper extremity. Surgical intervention is often required and likely lead to amputation (below-knee or above-knee) vs debridement in the lower extremity. Coverage options in the foot and ankle after serial debridements can present many challenges for limb salvage. Patients are often left with large soft tissue defects requiring coverage with a subsequent increase in relative morbidity. Treatment options for coverage in these cases include negative-pressure wound therapy, split-thickness skin grafting, free flap coverage, or higher-level amputation. In the diabetic population, who present with a lower extremity necrotizing infection, limb salvage is often a challenge given the multiple comorbidities associated with these patients including peripheral vascular disease, immunocompromised state, and neuropathy. Optimal treatment strategies for these necrotizing infections in the foot and ankle remain uncertain. We offer a technique tip for utilization of a dermal regeneration matrix to allow coverage of large soft tissue defect with exposed tendon and/or bone without the need for free flap coverage or higher-level amputation, thus allowing for an additional limb salvage option. Level of Evidence: Level V, expert opinion.

Tissue expansion as an alternative to skin grafting for closure of skin deficits

1992 ◽  
Vol 82 (5) ◽  
pp. 249-259 ◽  
Author(s):  
GR Johnson ◽  
P Han ◽  
JA Giacopelli
Keyword(s):  
Case Report ◽  
Lower Extremity ◽  
Subcutaneous Tissue ◽  
Tissue Expander ◽  
Tissue Expansion ◽  
Skin Grafting ◽  
High Rate ◽  
Expansion Process ◽  
Technical Aspects ◽  
Tissue Expanders

Recent advances in the technical aspects of tissue expanders for closure of skin deficits have led to an overall reduction in the high rate of complications typically associated with their usage. The authors provide a review of the recent refinements in the technique of the tissue expansion process. A discussion of current and future applications using this technique in the treatment of various lower extremity pathologies, including clubfoot, is presented. A case report on the use of a subcutaneous tissue expander for the treatment of a failed skin graft of the medial ankle is included.

Spectral Analysis of Heart Rate Variability during Trigger Point Acupuncture

2014 ◽  
Vol 32 (3) ◽  
pp. 273-278 ◽  
Author(s):  
Yoji Kitagawa ◽  
Kenichi Kimura ◽  
Sohei Yoshida
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Spectral Analysis ◽  
Tibialis Anterior ◽  
Trigger Point ◽  
Tibialis Anterior Muscle ◽  
Trigger Points ◽  
Control Group ◽  
The Right

Objectives To clarify changes in the cardiovascular autonomic nervous system function due to trigger point acupuncture, we evaluated differences in responses between acupuncture at trigger points and those at other sites using spectral analysis of heart rate variability. Methods Subjects were 35 healthy men. Before measurements began the subjects were assigned to a trigger point acupuncture or control group based on the presence/absence of referred pain on applying pressure to a taut band within the right tibialis anterior muscle. The measurements were conducted in a room with a temperature of 25°C, with subjects in a long sitting position after 10 min rest. Acupuncture needles were retained for 10 min at two sites on the right tibialis anterior muscle. ECG was performed simultaneously with measurements of blood pressure and the respiratory cycle. Based on the R–R interval on the ECG, frequency analysis was performed, low-frequency (LF) and high-frequency (HF) components were extracted and the ratio of LF to HF components (LF/HF) was evaluated. Results The trigger point acupuncture group showed a transient decrease in heart rate and an increase in the HF component but no significant changes in LF/HF. In the control group, no significant changes were observed in heart rate, the HF component or LF/HF. There were no consistent changes in systolic or diastolic blood pressure in either group. Conclusions These data suggest that acupuncture stimulation of trigger points of the tibialis anterior muscle transiently increases parasympathetic nerve activity.

Poster 47 Gigantism of the Right Lower Extremity in a Patient with Klippel-Trenaunay Syndrome: A Case Report

PM&R ◽  
2014 ◽  
Vol 6 (9) ◽  
pp. S198
Author(s):  
Yuriy Shepelyak ◽  
Milan Patel ◽  
Iqbal H. Jafri ◽  
Sara J. Cuccurullo
Keyword(s):  
Case Report ◽  
Lower Extremity ◽  
The Right ◽  
Klippel Trenaunay Syndrome
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