scholarly journals Free adipose tissue (FAT) graft pooling for severe dead space management

2020 ◽  
Vol 14 (3) ◽  
pp. 293-296
Author(s):  
Gustavo Souza ◽  
Robinson Pires ◽  
Egídio Santana Junior ◽  
Lydia Ferreira ◽  
Richard Yoon ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Free Flaps ◽  
Fat Grafting ◽  
Fat Graft ◽  
Soft Tissue Reconstruction ◽  
Salvage Procedure ◽  
Level Of Evidence ◽  
Space Management ◽  
Extremity Trauma ◽  
Tissue Reconstruction

Complex lower extremity trauma with large soft tissue defects requires early wound coverage to reduce the risk of complications. In particular circumstances, however, local or free flaps may be contraindicated due to local or systemic issues. This study presents a helpful and effective salvage procedure for soft tissue reconstruction that uses autologous fat grafting combined with negative pressure wound therapy. Level of Evidence V; Therapeutic Studies; Expert Opinion.

scholarly journals An immunologically active, adipose-derived extracellular matrix biomaterial for soft tissue reconstruction: concept to clinical trial

2020 ◽  
Author(s):  
Amy E. Anderson ◽  
Iwen Wu ◽  
Alexis J. Parrillo ◽  
David R. Maestas ◽  
Ian Graham ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Soft Tissue ◽  
Human Subjects ◽  
Donor Site ◽  
Tissue Remodeling ◽  
Fat Grafting ◽  
Interleukin 4 ◽  
Fat Graft ◽  
Soft Tissue Reconstruction ◽  
Tissue Reconstruction

ABSTRACTSoft tissue reconstruction remains an intractable clinical challenge as current surgical options and synthetic implants may produce inadequate outcomes. Soft tissue deficits may be surgically reconstructed using autologous adipose tissue, but these procedures can lead to donor site morbidity, require multiple trips to the operating room, and have highly variable outcomes. To address the clinical need for soft tissue reconstruction, we developed an “off-the-shelf” adipose matrix from allograft human adipose tissue (acellular adipose tissue, AAT). We applied physical and chemical processing methods to remove lipids and create an injectable matrix that mimicked the properties of fat grafting materials. Biological activity was assessed using cell migration and stem cell adipogenesis assays. Characterization of the regenerative immunology properties in a murine muscle injury model revealed allograft and xenograft AAT induced pro-regenerative CD4+ T cells and macrophages with xenograft AAT attracting additional eosinophils secreting interleukin 4 (Il4). In immunocompromised mice, AAT injections retained similar tissue volumes as human fat grafts but did not have the cysts and calcifications that formed in the human fat graft implants. Combination of AAT with human adipose-derived stem cells (ASCs) resulted in lower implant volumes. However, tissue remodeling and new adipose development increased significantly with the addition of cells. Larger injected volumes of porcine-derived AAT demonstrated biocompatibility and greater volume retention when applied allogeneicly in Yorkshire cross pigs. Under a biologic IND application, AAT was implanted in healthy volunteers in abdominal tissue that was later removed (panniculectomy or abdominoplasty). The AAT implants were well tolerated and biocompatible in all eight human subjects. Analysis of implants removed between 1 and 18 weeks demonstrated increasing cellular infiltration and immune populations, suggesting continued tissue remodeling and the potential for long term tissue replacement.SUMMARYAn adipose-derived injectable biomaterial provides volume correction for soft tissue defects while promoting pro-healing immune responses.

scholarly journals Comparison of Fasciocutaneous and Muscle-based Free Flaps for Soft Tissue Reconstruction of the Upper Extremity

2019 ◽  
Vol 7 (12) ◽  
pp. e2543
Author(s):  
Christoph Koepple ◽  
Ann-Katrin Kallenberger ◽  
Lukas Pollmann ◽  
Gabriel Hundeshagen ◽  
Volker J. Schmidt ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Upper Extremity ◽  
Free Flaps ◽  
Soft Tissue Reconstruction ◽  
Tissue Reconstruction

Reconstruction of Large Palmar Defects of the Hand Using Free Flaps

1997 ◽  
Vol 22 (5) ◽  
pp. 623-630 ◽  
Author(s):  
M. M. NINKOVÍC ◽  
A. H. SCHWABEGGER ◽  
G. WECHSELBERGER ◽  
H. ANDERL
Keyword(s):  
Soft Tissue ◽  
Free Flap ◽  
Subcutaneous Tissue ◽  
Free Flaps ◽  
Difficult Problem ◽  
Glabrous Skin ◽  
Soft Tissue Reconstruction ◽  
Anatomical Structures ◽  
Tissue Reconstruction ◽  
Restoration Of Sensibility

The reconstruction of large palmar defects of the hand remains a difficult problem due to the specific anatomical structures and highly sophisticated function of the palm. The glabrous skin and subcutaneous tissue in the palm are perfectly adapted to serve the prehensile function. The particular aim must be that repairs to this functional structure are similar in texture and colour and are aesthetically acceptable. Restoration of sensibility is desirable. For smaller defects a great variety of local pedicled or island flaps can be applied. However, for larger defects with exposed tendons, nerves or other essential structures, free flaps remain as a reliable alternative. This paper reviews our approach of soft tissue reconstruction in 16 patients with large palmar defects using various kinds of free flaps. The advantages, disadvantages and current indications for free flap resurfacing of the palm are discussed.

Soft tissue reconstruction and salvage of infected fixation hardware in lower extremity trauma

Microsurgery ◽  
2017 ◽  
Vol 38 (3) ◽  
pp. 259-263 ◽  
Author(s):  
Hyuma A. Leland ◽  
Alexis D. Rounds ◽  
Karen E. Burtt ◽  
Daniel J. Gould ◽  
Geoffrey S. Marecek ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Lower Extremity ◽  
Soft Tissue Reconstruction ◽  
Lower Extremity Trauma ◽  
Extremity Trauma ◽  
Tissue Reconstruction

Venous flaps for coverage of traumatic soft tissue defects of the hand: a systematic review

2017 ◽  
Vol 42 (8) ◽  
pp. 817-822 ◽  
Author(s):  
R. Wharton ◽  
H. Creasy ◽  
C. Bain ◽  
M. James ◽  
A. Fox
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Survival Rates ◽  
Venous Congestion ◽  
Soft Tissue Reconstruction ◽  
Level Of Evidence ◽  
Venous Flaps ◽  
Reconstructive Option ◽  
Tissue Reconstruction ◽  
Trauma Outcome

A PRISMA-guided systematic review was performed of all published cases that detail the use of venous flaps for soft tissue reconstruction of the hand following trauma. Outcome measures examined included flap survival rates, venous congestion, and return to theatre. Database searches were performed on Medline, Embase, AHMED, CINAHL. A total of 381 articles were identified. Data were extracted from 45 articles that met inclusion criteria. A total of 756 flaps were described and their data analysed. A total of 75% of flaps were arterialized and 25% were pure venous flaps. There was no difference in survival rate for arterialized or pure venous flaps. Unplanned return to theatre occurred in 5.3% due to flap compromise or necrosis. Early venous congestion was present in 60% of cases. Total early failure requiring re-operation occurred in 19 flaps (2.5%) of cases. Venous flaps offer a versatile and well-tolerated reconstructive option. Early venous congestion is common, but can be managed non-operatively. Level of evidence: II

scholarly journals Aesthetic and Functional Revision of Free Flaps Used In Soft Tissue Reconstruction

2016 ◽  
Vol 2 (1) ◽  
pp. 17-22
Author(s):  
Özlenen ÖZKAN ◽  
Kerim ÜNAL ◽  
Onur OĞAN ◽  
Anı ÇİNPOLAT ◽  
Gamze BEKTAŞ ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Free Flaps ◽  
Soft Tissue Reconstruction ◽  
Tissue Reconstruction

Free flaps for lower limb soft tissue reconstruction in children: Systematic review

2019 ◽  
Vol 72 (5) ◽  
pp. 711-728 ◽  
Author(s):  
Karel EY. Claes ◽  
Nathalie A. Roche ◽  
Dries Opsomer ◽  
Edward J. De Wolf ◽  
Casper E. Sommeling ◽  
...  
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Lower Limb ◽  
Free Flaps ◽  
Soft Tissue Reconstruction ◽  
Tissue Reconstruction

Chest Wall Reconstruction Following Tumor

2020 ◽  
Author(s):  
Farooq Shahzad ◽  
Evan Matros
Keyword(s):  
Soft Tissue ◽  
Chest Wall ◽  
Free Flaps ◽  
Chest Wall Reconstruction ◽  
Chest Wall Tumor ◽  
Soft Tissue Coverage ◽  
Soft Tissue Reconstruction ◽  
Pedicled Flaps ◽  
Ablative Surgery ◽  
Tissue Reconstruction

Plastic surgeons are typically called upon to reconstruct the chest wall in four situations: oncologic resection, infections, trauma and osteoradionecrosis. In this chapter we will discuss post-oncologic reconstruction. Chest wall reconstruction following tumor resection is typically performed at the same setting as the ablative surgery; this results in quicker patient recovery and overall better outcomes. The reconstruction should be planned with the ablative surgeon so that an assessment can be made of the extent of resection and available donor sites for reconstruction. The major components of reconstruction are 1) skeletal support and 2) soft tissue coverage. Skeletal support is indicated if the defect is >5 cm, 4 or more ribs are removed or more than 2/3rd of the sternum is resected. Prosthetic mesh is most commonly used. Soft tissue reconstruction is performed with regional pedicled flaps in the vast majority of cases. Free flaps are used when regional flaps are not sufficient (large defects) or not available.  This review contains 11 figures, 3 tables, and 49 references. Keywords: chest wall, tumor, skeletal reconstruction, soft tissue reconstruction, mesh, acellular dermal matrix, titanium osteosynthesis systems, resorbable plates, pedicled flaps, free flaps

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