scholarly journals Tensor fascia lata flap is a workhorse for defects after inguinal lymph node block dissection

2016 ◽  
Vol 144 (5-6) ◽  
pp. 288-292
Author(s):  
Asen Velickov ◽  
Predrag Kovacevic ◽  
Aleksandra Velickov
Keyword(s):  
Lymph Node ◽  
Complication Rate ◽  
Inguinal Lymph Node ◽  
Donor Site ◽  
Case Series ◽  
Fascia Lata ◽  
Tumor Type ◽  
Tensor Fascia Lata ◽  
Immediate Reconstruction ◽  
Tfl Flap

Introduction. Enlarged inguinal lymph nodes very often present a site of metastatic disease. Inguinal lymph node block dissection is a demanding procedure, which usually requires at least one of reconstructive modalities. Among different reconstruction options we selected the tensor fascia lata (TFL) musculocutaneous flap. Objective. The paper aims at presenting a series of inguinal block dissections, followed by immediate reconstruction, using the TFL flap, and evaluation of tumor type, flap dimension, complication rate and the duration of hospital stay. Methods. We present a consecutive case series of 25 conducted block dissections. The defects were reconstructed using TFL flap, because of the extent and site of the tissue defects, reliability of the flap, and potentially primarily infected exulcerated tumors. Results. The reconstruction was successful in all cases, the incidence of surgical complications was 16%, no further complications, such as lymphedema or gait disturbances, were noted. Primary skin tumors were predominant (13 cases), followed by genitalia tumors (four cases). The male sex was more frequently affected (14 vs. 11 cases). Conclusion. Having in mind that TFL presents as a flap of adjustable size, length, shape, and volume, with negligible donor site morbidity, and after comparing of our results to those of other authors, we advise broader use of TFL flap. As a reliable flap, not too difficult to harvest, with a low complication rate, it must be taken into consideration regarding the benefits for the patient, and, on the other hand, the surgery cost and duration.

V-Y Tensor Fascia Lata for Trochanteric Pressure Sore Treatment

1997 ◽  
Vol 5 (4) ◽  
pp. 213-216
Author(s):  
Daniel álvaro Alvarez Lazo ◽  
Olímpio Colicchio Filho ◽  
Ricardo Galvão Chaim ◽  
Paula Zuccolotto Moro
Keyword(s):  
Surgical Technique ◽  
Primary Closure ◽  
Donor Site ◽  
Skin Grafting ◽  
Pressure Sore ◽  
Fascia Lata ◽  
Tensor Fascia Lata ◽  
Precise Evaluation ◽  
Tensor Fascia Lata Flap

There are several alternatives for pressure sore reconstruction, but it is of utmost importance that an appropriate surgical technique be adopted, because although treatment is successful, recurrence of these ulcers is frequent. The purpose of this study was to conduct a precise evaluation of the V-Y tensor fascia lata flap, pointing out its advantages compared with the classical flap and with other possibilities described in the literature. The author employed 20 V-Y tensor fascia lata flaps to correct 20 trochanteric ulcers. The use of the classical tensor fascia lata flap to cover trochanteric ulcers is unquestionable. However, primary closure for flaps wider than 10 cm is difficult, necessitating an eventual skin grafting of the donor site. The V-Y tensor fascia lata allows a covering similar to the classical flap, simplifies primary closure and essentially presents the possibility of numerous reutilizations.

scholarly journals Arthroscopic Superior Capsular Reconstruction With a Minimally Invasive Harvested Fascia Lata Autograft Produces Good Clinical Results

2018 ◽  
Vol 6 (11) ◽  
pp. 232596711880824 ◽  
Author(s):  
Clara Isabel de Campos Azevedo ◽  
Ana Catarina Leiria Pires Gago Ângelo ◽  
Susana Vinga
Keyword(s):  
Minimally Invasive ◽  
Donor Site ◽  
Case Series ◽  
Donor Site Morbidity ◽  
Fascia Lata ◽  
Rotator Cuff Tears ◽  
Shoulder Abduction ◽  
Open Approach ◽  
Superior Capsular Reconstruction ◽  
The Mean

Background: Painful dysfunctional shoulders with irreparable rotator cuff tears (IRCTs) in active patients are a challenge. Arthroscopic superior capsular reconstruction (ASCR) is a new treatment option originally described using a fascia lata autograft harvested through an open approach. However, concerns about donor site morbidity have discouraged surgeons from using this type of graft. Hypothesis: ASCR using a minimally invasive harvested fascia lata autograft produces good 6-month and 2-year shoulder outcomes in IRCTs, with low-impact thigh morbidity at 2 years. Study Design: Case series; Level of evidence, 4. Methods: From 2015 to 2016, a total of 22 consecutive patients (mean age, 64.8 ± 8.6 years) with chronic IRCTs (Hamada grade 1-2; Goutallier cumulative grade ≥3; Patte stage 1: 2 patients; Patte stage 2: 6 patients; Patte stage 3: 14 patients) underwent ASCR using a minimally invasive harvested fascia lata autograft. All patients completed preoperative and 6-month evaluations consisting of the Simple Shoulder Test (SST), subjective shoulder value (SSV), Constant score (CS), range of motion (ROM), acromiohumeral interval (AHI), and magnetic resonance imaging. Twenty-one patients completed the 2-year shoulder and donor site morbidity assessments. Results: The mean active ROMs improved significantly ( P < .001): elevation, from 74.8° ± 55.5° to 104.5° ± 41.9° (6 months) and 143.8° ± 31.7° (2 years); abduction, from 53.2° ± 43.3° to 86.6° ± 32.9° (6 months) and 120.7° ± 37.7° (2 years); external rotation, from 13.2° ± 18.4° to 27.0° ± 16.1° (6 months) and 35.6° ± 17.3° (2 years); and internal rotation, from 1.2 ± 1.5 points to 2.6 ± 1.5 points (6 months) and 3.8 ± 1.2 points (2 years). The mean functional shoulder scores improved significantly ( P < .001): SST, from 2.1 ± 2.9 to 6.8 ± 3.5 (6 months) and 8.6 ± 3.5 (2 years); SSV, from 33.0% ± 17.4% to 55.7% ± 25.6% (6 months) and 70.0% ± 23.0% (2 years); CS, from 17.5 ± 13.4 to 42.5 ± 14.9 (6 months) and 64.9 ± 18.0 (2 years). The mean shoulder abduction strength improved significantly ( P < .001) from 0.0 to 1.1 ± 1.4 kg (6 months) and 2.8 ± 2.6 kg (2 years). The mean AHI improved from 6.4 ± 3.3 mm to 8.0 ± 2.5 mm (6 months) and decreased to 7.1 ± 2.5 mm (2 years). This 0.7 ± 1.5–mm overall decrease was statistically significant ( P = .042). At 6 months, 20 of 22 patients (90.9%) had no graft tears. At 2 years, 12 of 21 patients (57.1%) were bothered by their harvested thigh, 16 (76.2%) noticed donor site changes, 16 (76.2%) considered that the shoulder surgery’s end result compensated for the thigh’s changes, and 18 (85.7%) would undergo the same surgery again. Conclusion: ASCR using a minimally invasive harvested fascia lata autograft produced good 6-month and 2-year shoulder outcomes in IRCTs, with low-impact thigh morbidity at 2 years.

Carcinoma of unknown primary in the inguinal lymph node region of squamous cell origin: A case series

2014 ◽  
Vol 4 (6) ◽  
pp. 404-408 ◽  
Author(s):  
Kurian Joseph ◽  
Michael B. Sawyer ◽  
John Amanie ◽  
Joseph Jones Thachuthara ◽  
Sunita Ghosh ◽  
...  
Keyword(s):  
Lymph Node ◽  
Squamous Cell ◽  
Inguinal Lymph Node ◽  
Case Series ◽  
Unknown Primary ◽  
Carcinoma Of Unknown Primary

scholarly journals Pedicled Transfer of the Superficial Inguinal Lymph Node Flap for Lymphedema

2017 ◽  
Vol 02 (01) ◽  
pp. e29-e34 ◽  
Author(s):  
Theodore Kung ◽  
Nicole Duggan ◽  
Peter Neligan
Keyword(s):  
Lymph Node ◽  
Lower Extremity ◽  
Lymph Nodes ◽  
Inguinal Lymph Node ◽  
Case Series ◽  
Free Tissue Transfer ◽  
Flap Transfer ◽  
Lymph Node Transfer ◽  
Superficial Inguinal Lymph Node ◽  
Potential Use

Background Vascularized lymph node transfer is performed for select patients with lymphedema who remain refractory to nonsurgical therapies. Typically, this involves a microvascular free tissue transfer of donor lymph nodes to the affected area. We describe our experience with the transfer of a pedicled adipofascial flap containing the superficial inguinal lymph nodes for lower extremity lymphedema or penoscrotal lymphedema. Methods In eight patients, a unilateral pedicled superficial inguinal lymph node flap was harvested. The flap consisted of subscarpal adipofascial tissue between the level of the inguinal ligament and the groin crease. Blood supply was from either the superficial circumflex iliac vessels or the superficial inferior epigastric vessels. In certain patients, concurrent lymphaticovenular anastomosis was attempted as well. Results Four patients underwent pedicled superficial inguinal lymph node flap transfer for lower extremity lymphedema and for the other four patients the indication was penoscrotal lymphedema. Seven of the eight study patients reported improvements in their lymphedema symptoms. Postoperative complications included cellulitis in one patient and hematoma in another patient; neither patient required reoperation. Conclusion The pedicled superficial inguinal lymph node flap is a feasible and safe treatment option for either lower extremity lymphedema or genital lymphedema. This case series provides the basis for additional studies regarding the potential use of this vascularized lymph node flap in select patients.

Outcomes of Gluteus Maximus and Tensor Fascia Lata Transfer for Primary Deficiency of the Abductors of the Hip

2017 ◽  
Vol 27 (6) ◽  
pp. 567-572 ◽  
Author(s):  
Sivashankar Chandrasekaran ◽  
Nader Darwish ◽  
S. Pavan Vemula ◽  
Parth Lodhia ◽  
Carlos Suarez-Ahedo ◽  
...  
Keyword(s):  
Case Series ◽  
Gluteus Maximus ◽  
Fascia Lata ◽  
The Other ◽  
Harris Hip Score ◽  
Tensor Fascia Lata ◽  
Outcome Score ◽  
Small Series ◽  
Patient Reported ◽  
Abductor Strength

Purpose This study aims to present 3 patients’ results after undergoing gluteus maximus and tensor fascia lata (TFL) transfer for chronic abductor tears unable to be repaired primarily. Methods 3 patients were identified intraoperatively as having an abductor tear unable to be repaired primarily. The anterior 1/3 of the gluteus maximus and the posterior 1/3 of the TFL were mobilised and transferred to the greater trochanter in order to reproduce the normal force vector of the gluteus medius and minimus. Data was prospectively collected for changes in gait, abductor strength, and the following patient reported outcomes (PROs): modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), Hip Outcome Score-Activities of Daily Living (HOS-ADL), visual analogue scale (VAS), and satisfaction. Results The patients were female, 63-75 years old, with BMIs of 23-28. All patients had follow-up at mean 2.1 years (1.25-2.5) with positive Trendelenburg signs preoperatively; 2 patients normalised postoperatively. For 2 patients, abductor strength improved by 2 grades postoperatively; the other patient maintained grade four. 2 patients’ PROs all improved; the other patient's PROs all improved except mHHS. Postoperative VAS scores were 0, 0, 1. 2 patients reported maximum satisfaction. Conclusions This case series suggests that gluteus maximus and TFL transfer for irreparable abductor deficiency may be effective for pain relief, improving abductor strength, and reconstructing abductor function. Although this is a small series, it is to our knowledge the first report of clinical outcomes of this procedure.

scholarly journals Reconstruction of Radiated Gluteal Defects following Sarcoma Resection with Pedicled Sensate Tensor Fascia Lata Flaps

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Albert H. Chao ◽  
Patrick N. Kearns
Keyword(s):  
Radiation Therapy ◽  
Functional Outcomes ◽  
Fascia Lata ◽  
The Other ◽  
Gluteal Region ◽  
Intraoperative Radiation Therapy ◽  
Tensor Fascia Lata ◽  
Intraoperative Radiation ◽  
Microsurgical Techniques ◽  
Tfl Flap

Sarcomas of the gluteal region often result in sizable defects following resection that are challenging to reconstruct due to their location, particularly in patients who have received radiation therapy. Reconstruction of these defects has been seldom discussed in the literature. We present two patients with large radiated gluteal defects following sarcoma resection, of which one patient received neoadjuvant radiation and the other received intraoperative radiation therapy. As a result of the resection and radiation, local tissues and recipient vessels were unsuitable for use in reconstruction. A pedicled tensor fascia lata (TFL) flap was therefore performed in both cases, which resulted in durable sensate reconstruction with good functional outcomes and no complications. We believe the pedicled TFL flap represents an important option for the reconstruction of oncologic gluteal defects that provides well-vascularized and sensate tissue from outside the zone of radiation without the need for microsurgical techniques.

scholarly journals Versatility of Pedicled Tensor Fascia Lata Flap: A Useful and Reliable Technique for Reconstruction of Different Anatomical Districts

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Md. Sohaib Akhtar ◽  
Mohd Fahud Khurram ◽  
Arshad Hafeez Khan
Keyword(s):  
Operative Procedure ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Fascia Lata ◽  
Pressure Sores ◽  
Partial Loss ◽  
Tensor Fascia Lata ◽  
Reliable Technique ◽  
Tensor Fascia Lata Flap ◽  
Technical Details

Aims and Objectives. The aim of this study was to evaluate the versatility of pedicled tensor fascia lata flap for reconstruction of various anatomical regions. Materials and Methods. In this retrospective study a total of 34 patients with defects over various anatomical regions were included. The defects were located over the trochanter (n=12), groin (n=8), perineum (n=6), lower anterior abdomen (n=6), gluteal region (n=1), and ischial region (n=1). The etiology of defects included trauma (n=12), infection (n=8), pressure sores (n=8), and malignancy (n=6). Reconstruction was performed using pedicled tensor fascia lata flaps. Patients were evaluated in terms of viability of the flap and donor site morbidity. The technical details of the operative procedure have also been outlined. Results. All the flaps survived well except 5 patients in which minor complications were noted and 1 who experienced complete flap loss. Of those with minor complications, 1 patient developed distal marginal necrosis and 1 developed infection which subsided within three days by dressings and antibiotics and in 2 patients partial loss of the skin graft occurred at the donor site out of which 1 required regrafting and another one healed completely with dressing and antibiotics. All the patients were followed up for an average period of 6 months, ranging from 1 to 12 months. Donor site morbidity was minimal. Conclusion. It was concluded that the pedicled tensor fascia lata flap is a versatile, reliable, easy, and less time consuming procedure for the coverage of defects around trochanter, groin, lower anterior abdomen, perineum, and ischial region.

Sign in / Sign up

Export Citation Format

Share Document