scholarly journals LOCAL FLAPS AND SPLIT;

2012 ◽  
Vol 19 (05) ◽  
pp. 630-635
Author(s):  
IRFAN ISHAQ ◽  
AWAIS AHMAD ◽  
GHULAM QADIR FYYAZ
Keyword(s):  
Soft Tissue ◽  
Skin Grafting ◽  
Local Flap ◽  
Sensory Deficit ◽  
Local Flaps ◽  
Soft Tissue Defects ◽  
Flap Coverage ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Tissue Defects

Background: Two point discrimination (TPD).is the minimum distance between two stimulus points on the skin, which areperceived as distinct points, Among the two types of TPD i.e., static and dynamic, static two-point discrimination (STPD) is commonly used todetermine digital nerve integrity. Local flaps usually do well in maintaining sensibility of the covered area in terms of two point discrimination incontrast to s-plit thickness skin grafts (STSG). Objective: The objective of this study was to determine the frequency of sensory deficit in termsof TPD in STSG and local flaps for soft tissue defects of fingers after three months. Study design: It was a Quasi experimental study. Settings:Patients admitted in the indoor of Plastic surgery department, Services Hospital Lahore. Period: February 2009 to January 2010. Material andMethods: Thirty five patients underwent local flap coverage and other thirty five underwent split thickness skin grafting for soft tissue defects offingers depending upon nature of defect. Patients were followed up at 2, 4, 8 and 12 weeks. Results: The sensory deficit observed at the end of12th week post operatively was in 8.6% of the patients with local flap coverage (3 patients) and 45.7% of those with STSG (16 patients).Patients with no sensory deficit were 91.4% (32 patients) in the local flap coverage and 54.3% (19 patients) in the STSG at 12th week of followup. The relative ratio of sensory deficit in local flaps and STSG was 5 (>2). Conclusions: The results of this study show that Local flaps arebetter options in terms of TPD preservation as opposed to STSG for soft tissue defects of fingers.

scholarly journals MANAGEMENT OF ACQUIRED SOFT TISSUE DEFECTS OF GROIN AND GENITALIA

2020 ◽  
pp. 1-4
Author(s):  
Ratnakar Sharma ◽  
Mir Adnan Samad ◽  
Kumar Sourav Dogra ◽  
Shaarang Gupta
Keyword(s):  
Soft Tissue ◽  
Road Traffic ◽  
Past History ◽  
Skin Grafting ◽  
Soft Tissue Defects ◽  
Detailed History ◽  
Flap Coverage ◽  
Split Thickness Skin Grafting ◽  
History Of ◽  
Tissue Defects

Background: The defects of the groin and the genitalia are complex and pose a challenge to the reconstructive surgeon. These defects may arise out of a variety of insults which include – extirpative oncologic surgeries, necrotizing fasciitis, post burn defects, post traumatic defects including road traffic accidents and animal bites etc. Objectives: To study the epidemiology of the acquired soft tissue defects of the groin and genitalia. To evaluate the role of various reconstructive modalities for the acquired soft tissue defects of groin and genitalia. Materials & Methods: This study was conducted in the Department of Surgery, Govt. Medical College Jammu, J&K, India and included 25 patients admitted with acquired soft-tissue defects of groin and genitalia over a period extending from November 2018 to October 2019 (Prospective study). Personal and demographic data of the patient was noted. A detailed history regarding the cause of the defect along with history of trauma, discharge and bleed from the site was taken. Any past history of surgery and irradiation of the region was noted. The patients having soft tissue defects of the groin and genitalia secondary to the release of post burn contracture were subjected to the detailed history as regards cause of burn, treatment taken and time taken for burn wounds to heal. Examination included general physical examination along with the local wound condition which included site, size, discharge, slough, granulation tissue and any exposed vital structures such as vessels/ nerves. A hemogram, assessment of blood sugar, renal function (blood urea nitrogen and serum creatinine), coagulation profile, blood grouping, viral markers, chest x-ray and ECG were done as a part of routine pre-operative investigations. Wound swab was sent for culture. Biopsy was taken wherever required. Analysis of report of any previously taken biopsy was done. Split thickness skin grafting was the modality of coverage utilized in 56% cases followed by flap coverage in 32% cases. 12% of the defects were closed primarily. Results: Majority of the patients had durable coverage of the defects of groin/genitalia and the coverage modality was acceptable to the patient as regards aesthesis and functional outcome. No major complication was encountered in any of the patients. Conclusion: The reconstruction of the soft tissue defects of groin and genitalia need a meticulous examination and planning of reconstructive modality which may include skin grafting or a flap coverage.

Solving Acne Inversa (Hidradenitis Suppurativa) in Crohn Disease with Buried Chip Skin Grafts

2009 ◽  
Vol 13 (3) ◽  
pp. 164-168 ◽  
Author(s):  
Oliver Bleiziffer ◽  
Adrian Dragu ◽  
Ulrich Kneser ◽  
Raymund E. Horch
Keyword(s):  
Soft Tissue ◽  
Crohn Disease ◽  
Fistula Formation ◽  
Acne Inversa ◽  
Skin Grafts ◽  
Soft Tissue Defects ◽  
Efficient Treatment ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Tissue Defects

Background: Acne inversa is a progressive chronic inflammatory disease associated with abscess and fistula formation and subsequent scarring. In recent years, an increasing number of reports have been published about acne inversa and concomitantly occurring Crohn disease. Extensive anogenitoperineal soft tissue defects represent an enormous challenge to therapy. Common treatment strategies of reconstructive surgery such as local flaps, free flaps, or split-thickness skin grafts are frequently problematic and associated with poor outcomes. Objective: The aim of this case report is to demonstrate the clinical problem of extensive anogenitoperineal soft tissue defects and to present a surgical technique that can be successfully used in such difficult cases. Methods: In both cases, extensive excision of the affected areas was carried out down to the gluteal muscles followed by intramuscular grafting of buried skin chip grafts. Results: In both cases, the final postoperative results after numerous surgeries were very good, with complete wound closure resulting in complete recovery and social reintegration. Conclusion: The technique of buried skin chip grafting has long been ignored since split-thickness skin grafting and different techniques of flap coverage evolved, but it may constitute a highly efficient treatment strategy in challenging reconstructive situations.

Reverse-Flow Intrinsic Fasciocutaneous Island Flaps in Foot Reconstruction

2017 ◽  
Vol 16 (4) ◽  
pp. 296-301
Author(s):  
Sujin Bahk ◽  
GyeongHyeon Doh ◽  
Ki Yong Hong ◽  
SooA Lim ◽  
SuRak Eo
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Reverse Flow ◽  
Donor Site ◽  
Skin Grafting ◽  
Soft Tissue Defects ◽  
Satisfactory Outcome ◽  
Split Thickness Skin Grafting ◽  
Foot Reconstruction ◽  
Tissue Defects

Reconstruction of soft tissue defects in the foot remains a challenge due to its specialized tissue for weightbearing and ambulation. Considering the principle of replacing “like with like,” adjacent soft tissues would be a best option for a donor site. Although several kinds of reverse-flow island flaps for the lower leg have been well described, intrinsic foot reverse flow flaps have been rarely reported. We describe 3 kinds of reverse-flow intrinsic fasciocutaneous flaps (RIFFs) for foot reconstruction. From September 2012 to August 2015, a retrospective study was done on case notes of all patients who had a RIFF for coverage of soft tissue defects within the foot following trauma or tumor ablation. A total of 7 patients were included in this study, with an average of 5 × 3.5 cm sized defects in the forefoot, second and third web space, and sole, which were reconstructed with RIFF. All flaps were well perfused and recovered excellent function of the foot with satisfactory aesthetics and minimal limitations in range of motion. However, one case showed a complication of venous congestion, due to remnant scar tissues, which resolved after medical leech application. Donor defects healed completely with split thickness skin grafting in all cases. Soft tissue defects within the foot were repaired successfully by RIFF. In spite of its technical challenges, it is a reliable one-stage procedure requiring no microsurgical anastomosis. Precise vascular evaluation of the reverse inflow has to be preceded for satisfactory outcome of RIFF.

scholarly journals Patterns of etiologies and soft tissue defects in the upper limb and use of different reconstruction modalities

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Saeed Ashraf Cheema
Keyword(s):  
Soft Tissue ◽  
Upper Limb ◽  
Primary Closure ◽  
Skin Grafting ◽  
Soft Tissue Coverage ◽  
Local Flaps ◽  
Soft Tissue Defects ◽  
Common Etiology ◽  
Tissue Defects

A total of 48 cases of soft tissue defects of upper limb were managed during one calendar year. This included 34 males and 14 females. Post burn complication was the most common etiology. Ten cases had machine injury while other 6 cases had household trauma. Another group of six cases had injuries during fireworks at various ceremonies. Whereas 17 cases were dealt by simple measures like healing by secondary intension, primary closure and skin grafting, 31 cases needed soft tissue coverage with various flaps. Only ten cases were dealt with the help of local flaps while rest of the 21 cases needed various regional and distant flaps.

scholarly journals Long-term experience with a collagen-elastin scaffold in combination with split-thickness skin grafts for the treatment of full-thickness soft tissue defects: improvements in outcome—a retrospective cohort study and case report

2021 ◽  
Author(s):  
Maximilian Lempert ◽  
Sascha Halvachizadeh ◽  
Clara Charlotte Salfelder ◽  
Valentin Neuhaus ◽  
Hans-Christoph Pape ◽  
...  
Keyword(s):  
Cohort Study ◽  
Soft Tissue ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Skin Grafting ◽  
Full Thickness ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Significant Difference ◽  
The Impact

Abstract Purpose The management of severe soft tissue injuries to the extremities with full-thickness wounds poses a challenge to the patient and surgeon. Dermal substitutes are used increasingly in these defects. The aim of this study was to investigate the impact of the type of injury on the success rate of Matriderm® (MD)-augmented split-thickness skin grafting, as well as the role of negative pressure wound therapy (NPWT) in preconditioning of the wounds, with a special focus on the reduction of the bioburden. Methods In this study, 45 wounds (44 affecting lower extremities (97.7%)), resulting from different types of injuries: soft tissue (ST), soft tissue complications from closed fracture (F), and open fracture (OF) in 43 patients (age 55.0 ± 18.2 years, 46.7% female), were treated with the simultaneous application of MD and split-thickness skin grafting. The study was designed as a retrospective cohort study from March 2013 to March 2020. Patients were stratified into three groups: ST, F, and OF. Outcome variables were defined as the recurrence of treated wound defects, which required revision surgery, and the reduction of bioburden in terms of reduction of number of different bacterial strains. For statistical analysis, Student’s t-test, analysis of variance (ANOVA), Mann–Whitney U test, and Pearson’s chi-squared test were used. Results There was no significant difference in the rate of recurrence in the different groups (F: 0%; OF: 11.1%; ST: 9.5%). The duration of VAC therapy significantly differed between the groups (F: 10.8 days; OF: 22.7 days; ST: 12.6 days (p < 0.05)). A clinically significant reduction of bioburden was achieved with NPWT (bacterial shift (mean (SD), F: − 2.25 (1.89); OF: − 1.9 (1.37); ST: − 2.6 (2.2)). Conclusion MD-augmented split-thickness skin grafting is an appropriate treatment option for full-thickness wounds with take rates of about 90%. The complexity of an injury significantly impacts the duration of the soft tissue treatment but does not have an influence on the take rate. NPWT leads to a relevant reduction of bioburden and is therefore an important part in the preconditioning of full-thickness wounds.

Reconstruction of the Lower Leg With Percutaneous Aponeurotomy and Lipofilling: A Case Report

2019 ◽  
Vol 18 (3) ◽  
pp. 336-338
Author(s):  
Yooseok Ha ◽  
Hee Sang Yang ◽  
Seung Han Song ◽  
Sang-Ha Oh
Keyword(s):  
Soft Tissue ◽  
Lower Leg ◽  
Tissue Loss ◽  
Local Flaps ◽  
Soft Tissue Defects ◽  
Established Method ◽  
Flap Transfer ◽  
Free Flap Transfer ◽  
Soft Tissue Loss ◽  
Tissue Defects

Soft tissue loss in the lower leg presents a challenge for reconstructive surgeons. When a defect is large, free flap transfer provides a well-established method, but local flaps are more convenient for small to moderately sized soft tissue defects. When a defect is very small, even local flaps are too invasive, leave additional scar, and cause bulky flaps. We present our case aiming to underline the usefulness of percutaneous aponeurotomy and lipofilling in a small lower leg defect with several advantages.

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