scholarly journals A META-ANALYSIS OF THE SOFT TISSUE DEFECTS CLASSIFICATION AND JUSTIFICATION OF THE OPTIMAL SURGICAL RECONSTRUCTION METHOD

2021 ◽  
Vol 121 (1) ◽  
pp. 112-123
Author(s):  
Sergiy Tertyshnyi ◽  
Igor Khomenko ◽  
Кostyantyn Gumenyuk ◽  
Sergiy Korol ◽  
Yevgen Tsema ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Meta Analysis ◽  
Surgical Reconstruction ◽  
Reconstruction Method ◽  
Soft Tissue Defects ◽  
Military Conflict ◽  
Preoperative Training ◽  
Defects Classification ◽  
Tissue Defects

During the military conflict in the East of Ukraine, considerable experience in providing medical assistance to wounded and injured with soft tissue defects has been accumulated. Taking into account the considerable diversity of defects of soft tissues on numerous a number of signs, which involves the application in the process of treatment of fundamentally different algorithms of preoperative training, planning of reconstructive intervention and method of surgical reconstruction there was a need to systematize the accumulated knowledge by developing the integral classification of soft tissue defects.

scholarly journals Organization of stage rehabilitation of servicemen with gunshot defects of soft tissues at the levels of medical care

2021 ◽  
Vol 26 (4) ◽  
pp. 188-195
Author(s):  
K.D. Babov ◽  
I.P. Khomenko ◽  
S.V. Tertyshnyi ◽  
Babova I.K. Babova I.K. ◽  
R.S. Vastianov
Keyword(s):  
Surgical Treatment ◽  
Soft Tissue ◽  
Medical Care ◽  
Soft Tissues ◽  
Lower Extremities ◽  
Gunshot Wounds ◽  
Care Quality ◽  
Rehabilitation Service ◽  
Soft Tissue Defects ◽  
Tissue Defects

Building a modern system of rehabilitation of servicemen in Ukraine is an integral part of providing medical care in armed conflict. Rehabilitation of servicemen after gunshot wounds with soft tissue defects of the lower extremities is a common but difficult problem for surgical and rehabilitation teams. The process of rehabilitation requires the implementation of certain methodological provisions. At present, medical care for servicemen is a four-levels’ one. Rehabilitation service is provided at the third and fourth levels of medical care. The aim of the study was to improve the quality of medical care for servicemen after gunshot wounds with soft tissue defects of the lower extremities by introducing a system of staged rehabilitation. Organizational and methodological bases of the system of staged rehabilitation of wounded servicemen with soft tissue defects at different levels of medical care have been developed. Two models of rehabilitation depending on the severity of the injury and the tactics of surgical treatment are proposed. The division of the stage of early sanatorium rehabilitation for the wounded with severe soft tissue injuries depending on the stage of surgical treatment and the formation of a "skin patch" is justified. The introduction of the proposed models of rehabilitation of wounded with soft tissue defects in the practice of early sanatorium rehabilitation will provide increasing of medical care quality.

Free flaps for reconstruction of soft tissue defects in lower extremity: A meta-analysis on microsurgical outcome and safety

Microsurgery ◽  
2016 ◽  
Vol 36 (6) ◽  
pp. 511-524 ◽  
Author(s):  
Lingyun Xiong ◽  
Emre Gazyakan ◽  
Thomas Kremer ◽  
Frederick J. Hernekamp ◽  
Leila Harhaus ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Lower Extremity ◽  
Meta Analysis ◽  
Free Flaps ◽  
Soft Tissue Defects ◽  
Tissue Defects

scholarly journals A clinical study of management of Fournier’s gangrene in a rural hospital

2018 ◽  
Vol 5 (4) ◽  
pp. 1524
Author(s):  
Purushotham T. Shivaraju ◽  
Ponnappa B. Ganapathy ◽  
Naveen N. ◽  
Pruthvika N.
Keyword(s):  
Soft Tissue ◽  
Hospital Stay ◽  
External Genitalia ◽  
Fournier’S Gangrene ◽  
Surgical Reconstruction ◽  
Reconstructive Procedure ◽  
Soft Tissue Defects ◽  
Fournier's Gangrene ◽  
Wound Debridement ◽  
Tissue Defects

Background: Fournier’s gangrene is a potentially life threatening synergistic necrotising fascitis of external genitalia and perineal tissues. It commonly affects young men but can also affect women and children. The use of broad spectrum antibiotics and serial wound debridement is the main stay of treatment. The reconstruction of soft tissue defect following the debridement is a challenging task. The purpose of this study is to evaluate the surgical reconstruction methods of soft tissue defects due to Fournier's gangrene.Methods: This was a prospective study conducted in Adichunchanagiri Institute of Medical Sciences from January 2015 to December 2017. All patients with necrotizing fascitis of external genitalia and perineum, irrespective of age and gender, were included. Parameters such as age, gender, aetiology, predisposing factors, clinical features, defect location, type of bacterial flora, sort of reconstructive procedure used, and duration of hospital stay, post-operative pain, patient satisfaction and mortality, if any, were studied. The choice of reconstructive procedure was based on severity of defect, availability of local tissue and patient preference.Results: Out of 31 cases included in the study, 30 patients underwent reconstructive procedures. The age range was 4 to 74 years (mean 38.5). The commonest presentation was pain, scrotal swelling and fever. The most common aetiology was urogenital diseases. 10 patients were treated by split-thickness skin graft, 5 by secondary suturing, 2 by unilateral superomedial thigh flap, 4 by bilateral superomedial thigh flap, 5 by tensor fascia lata flap, 2 by medial thigh V-Y advancement flap, 2 with perineal artery flap and one case healed by secondary intention.Conclusions: This study suggests that earlier presentation, with early diagnosis and intervention with prompt debridement and appropriate, appropriate antibiotics are the main stays of treatment. The resulting soft tissue defects following wound debridement required surgical reconstruction, except in one case, thus decreasing morbidity, hospital stay and early return of patients to regular life.

Different Modalities of Management of Early and Late Traumatic Soft Tissue Defects of The Hand

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Moustafa Ahmed AbdelAliem ◽  
Mina Agaiby Estawrow ◽  
Shaaban Mohamed Abd Almajeed ◽  
Abdelrahman Mohamed El-maraghy
Keyword(s):  
Soft Tissue ◽  
Treatment Time ◽  
Meta Analysis ◽  
Donor Site ◽  
Hand Injuries ◽  
Functional Requirements ◽  
Soft Tissue Defects ◽  
Eligibility Criteria ◽  
Recipient Site ◽  
Tissue Defects

Abstract Background Hand injuries contribute to financial losses in terms of treatment, time off work and loss of job. Hand injuries are rising and therefore increasing awareness and improving management of hand injuries are warranted in low resources settings. Objective A systematic review and meta-analysis of different modalities of management of early and late traumatic soft tissue defects of the hand. Data Sources Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2018. Data Extraction If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures. Conclusion Soft tissue defects of the hand can be reconstructed effectively with multiple options that can restore function in addition to stable coverage. The use of grafts with several local and regional flaps have been identified including advancement flaps, rotation flaps in cases where local tissue is available and healthy. Which have the ability to match colour and texture of the recipient site, coverage of vital structures with minimal donor site morbidity. The preferred approach is the simplest method which can provide the most stable coverage. A careful selection of flap choice for coverage of a hand defects should take into account the anatomy and functional requirements of the defect site, the patient’s health condition and the surgeons experience to ensure good functional and aesthetic outcomes for the patients.

Hindfoot Containment Orthosis for Management of Bone and Soft-Tissue Defects of the Heel

2005 ◽  
Vol 26 (3) ◽  
pp. 198-203 ◽  
Author(s):  
Jeffrey E. Johnson ◽  
Jonas R. Rudzki ◽  
Erick Janisse ◽  
Dennis J. Janisse ◽  
Ray R. Valdez ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Revision Surgery ◽  
Soft Tissues ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Soft Tissue Defects ◽  
Heel Pad ◽  
Periodic Monitoring ◽  
Growth Change ◽  
Tissue Defects

Background: Bone, soft-tissue, and nerve deficits of the weightbearing surface of the foot are frequent sequelae from foot trauma or diabetes mellitus and present challenging treatment issues. Injury to the specialized, shock-absorbing, heel-pad tissue containing spirally arranged fat chambers is particularly difficult to manage. Appropriate footwear modifications and shoe inserts for protection of this skin are essential to the long-term management of bone and soft-tissue defects of the heel. This study evaluated the performance of a new custom total contact foot orthosis (Hindfoot Containment Orthosis, HCO) which was designed to contain the soft tissues of the heel, reduce shear forces, redistribute weightbearing load, and accommodate bone or soft-tissue deformity of the heel. Methods: Twenty-two patients treated with HCO were retrospectively reviewed. Followup averaged 26 months. The effectiveness of the orthosis was assessed by how well the integrity of the soft tissue was maintained (e.g. the number of ulcerations since dispensing the orthosis), the number of refabrications of the orthosis that were required, and whether or not revision surgery was required. Results: Ten patients had superficial ulcerations. No patient required revision surgery. A total of 62 refabrications of the orthoses in 22 patients were required over a 2-year period. Overall results were good in 17 (77%) patients, fair in four (18%), and poor in one. Conclusions: The HCO is effective for preservation of soft-tissue integrity of the heel pad after bony or soft-tissue injury. Important factors in achieving success with the HCO are patient compliance and periodic monitoring for refabrication of the orthosis to accommodate skeletal growth, change in foot size or shape, and compression or wear of insert materials.

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.

Sign in / Sign up

Export Citation Format

Share Document