scholarly journals Wound Healing and Therapy in Soft Tissue Defects of the Hand and Foot from a Surgical Point of View

2021 ◽  
Vol 9 (4) ◽  
pp. 71
Author(s):  
Wolfram Demmer ◽  
Heiko Sorg ◽  
Andreas Steiert ◽  
Jörg Hauser ◽  
Daniel Johannes Tilkorn
Keyword(s):  
Wound Healing ◽  
Soft Tissue ◽  
Functional Impairment ◽  
Point Of View ◽  
Soft Tissue Defects ◽  
Treatment Of Wounds ◽  
Tissue Defects

Wounds and tissue defects of the hand and foot often lead to severe functional impairment of the affected extremity. Next to general principles of wound healing, special functional and anatomic considerations must be taken into account in the treatment of wounds in these anatomical regions to achieve a satisfactory reconstructive result. In this article, we outline the concept of wound healing and focus on the special aspects to be considered in wounds of the hand and foot. An overview of different treatment and dressing techniques is given with special emphasis on the reconstruction of damaged structures by plastic surgical means.

scholarly journals Systematic Review: Adipose-Derived Mesenchymal Stem Cells, Platelet-Rich Plasma and Biomaterials as New Regenerative Strategies in Chronic Skin Wounds and Soft Tissue Defects

2021 ◽  
Vol 22 (4) ◽  
pp. 1538 ◽  
Author(s):  
Pietro Gentile ◽  
Simone Garcovich
Keyword(s):  
Systematic Review ◽  
Stem Cells ◽  
Wound Healing ◽  
Soft Tissue ◽  
Chronic Wounds ◽  
Platelet Rich Plasma ◽  
Skin Wounds ◽  
Soft Tissue Defects ◽  
Chronic Skin ◽  
Tissue Defects

The number of clinical trials evaluating adipose-derived mesenchymal stem cells (AD-MSCs), platelet-rich plasma (PRP), and biomaterials efficacy in regenerative plastic surgery has exponentially increased during the last ten years. AD-MSCs are easily accessible from various fat depots and show intrinsic plasticity in giving rise to cell types involved in wound healing and angiogenesis. AD-MSCs have been used in the treatment of soft tissue defects and chronic wounds, employed in conjunction with a fat grafting technique or with dermal substitute scaffolds and platelet-rich plasma. In this systematic review, an overview of the current knowledge on this topic has been provided, based on existing studies and the authors’ experience. A multistep search of the PubMed, MEDLINE, Embase, PreMEDLINE, Ebase, CINAHL, PsycINFO, Clinicaltrials.gov, Scopus database, and Cochrane databases has been performed to identify papers on AD-MSCs, PRP, and biomaterials used in soft tissue defects and chronic wounds. Of the 2136 articles initially identified, 422 articles focusing on regenerative strategies in wound healing were selected and, consequently, only 278 articles apparently related to AD-MSC, PRP, and biomaterials were initially assessed for eligibility. Of these, 85 articles were excluded as pre-clinical, experimental, and in vitro studies. For the above-mentioned reasons, 193 articles were selected; of this amount, 121 letters, expert opinions, commentary, and editorials were removed. The remaining 72 articles, strictly regarding the use of AD-MSCs, PRP, and biomaterials in chronic skin wounds and soft tissue defects, were analyzed. The studies included had to match predetermined criteria according to the patients, intervention, comparator, outcomes, and study design (PICOS) approach. The information analyzed highlights the safety and efficacy of AD-MSCs, PRP, and biomaterials on soft tissue defects and chronic wounds, without major side effects.

scholarly journals Treatment of children with skin and soft tissue defects of distal phalanges of the fingers

2020 ◽  
Vol 10 (3) ◽  
pp. 293-298
Author(s):  
Sergey N. Berezutskii ◽  
Alexey G. Pinigin
Keyword(s):  
Blood Flow ◽  
Soft Tissue ◽  
Skin Grafting ◽  
Point Of View ◽  
Island Flap ◽  
Soft Tissue Defects ◽  
Number Of Children ◽  
Neurovascular Pedicle ◽  
The Right ◽  
Tissue Defects

Introduction. This article discusses the relevance of performing organ-preserving operations for traumatic skin and soft tissue defects in children. The author analyzes the traditional types of skin grafting procedures and their application in children. From the authors' point of view, the most acceptable skin grafting method is a displaced island flap on a neurovascular pedicle with direct blood flow. Materials and methods. The operating technique of lifting a displaced island flap on a neurovascular pedicle with direct blood flow is shown. The features of its implementation, the number of children, and their distribution by groups are shown. From 2016 to 2019, 15 children with traumatic defects of the distal phalanges of the fingers were operated on in the microsurgical Department of the Khabarovsk KKB No. 2 using a displaced neurovascular island flap on the leg with direct blood flow. The children ranged in age from four to 14 years. The number of children and the frequency of damage to the right and left hands was approximately the same. Results. Positive results of using this technique in the Department of Microsurgery of KKB No. 2 are presented. In all cases, it was possible to close the existing defects with the primary closure of the donor defect simultaneously; Sensitivity was preserved in all operated children, and movements in the finger joints were almost complete. Discussion. This flap method has undeniable advantages, although it is quite time-consuming and requires microsurgical skills, techniques, and appropriate equipment. The proposed skin grafting results are encouraging and satisfying for both doctors and children with parents. Conclusions. The authors recommend this skin grafting method for traumatic defects of the distal phalanges of the fingers in children.

scholarly journals A Novel Acellular Dermal Scaffold Prepared Using High-Intensity Focused Ultrasound Energy for the Repair of Soft Tissue Defects

2020 ◽  
Vol 1 (02) ◽  
pp. 45-50
Author(s):  
Mohamed M. Abdul-Monem ◽  
Mohamed H. Helal ◽  
Moustafa N. Aboushelib
Keyword(s):  
Wound Healing ◽  
Soft Tissue ◽  
High Intensity ◽  
Focused Ultrasound ◽  
High Intensity Focused Ultrasound ◽  
Cellular Infiltration ◽  
Soft Tissue Defects ◽  
Ultrasound Energy ◽  
Acellular Dermal ◽  
Tissue Defects

Abstract Objective To evaluate a naturally derived acellular dermal scaffold for soft tissue reconstruction using high-intensity focused ultrasound energy (HIFU). Materials and Methods Acellular dermal scaffolds (ADSs) were prepared by purification of bovine skin. Half of the scaffolds were subjected to high-intensity focused ultrasound energy (HIFU) to modify collagen structure, whereas the other half was used as control. A large skin defect was made in the dorsum of white mice, and the scaffolds were used to cover the induced defects. Wound healing was evaluated histologically after 2, 6, and 12 weeks using common and specific stained sections (n = 20). Statistical Analysis Mean values and standard deviations were calculated for each group, and Student’s t-test was used for statistical analysis (α= 0.05; n = 20). Results After 2 weeks, all examined specimens revealed the presence of inflammatory cellular infiltration and early immature blood vessel formation. After 6 weeks, inflammatory cellular infiltration was reduced, with evidence of maturation of new blood vessels observed for all groups. After 12 weeks, there was a significant increase (F = 124, p < 0.01) in new collagen formation and count of mature blood vessels observed for the HIFU group compared with control. Evidence of remodeling of new collagen fibers and biodegradation of the grafts was also observed. Conclusions HIFU-modified ADSs enhanced wound healing and could be used to cover large soft tissue defects.

Thoracic Propeller Perforator Flaps for Covering Soft Tissue Defects

2014 ◽  
Vol 30 (S 01) ◽  
Author(s):  
Matei Ileana ◽  
Alexandru Georgescu ◽  
Radu Lacatus ◽  
Manolis Daskalakis
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Defects ◽  
Perforator Flaps ◽  
Tissue Defects

SOFT-TISSUE DEFECTS OF THE DIGITS

Hand Clinics ◽  
1997 ◽  
Vol 13 (2) ◽  
pp. 189-205
Author(s):  
Robert J. Goitz ◽  
John G. Westkaemper ◽  
Matthew M. Tomaino ◽  
Dean G. Sotereanos
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Defects ◽  
Tissue Defects

Reconstruction of Extensive Soft Tissue Defects of Lower Extremity With the Extended Anterolateral Thigh Flap

2021 ◽  
pp. 153473462098223
Author(s):  
Jong-Ho Kim ◽  
Hyokyung Yoo ◽  
Seokchan Eun
Keyword(s):  
Soft Tissue ◽  
Lower Extremity ◽  
Distal Portion ◽  
Outcome Data ◽  
Anterolateral Thigh Flap ◽  
Soft Tissue Defects ◽  
Flap Viability ◽  
Anterolateral Thigh ◽  
Large Skin ◽  
Tissue Defects

The anterolateral thigh flap is a classic flap used for various reconstruction defects. However, the flap viability of extended large skin paddles (ie, 240 cm2) was doubted by many surgeons. This study reports successful experience of reconstructing extensive soft tissue defects of lower extremity using extended large skin paddles. Twelve consecutive patients who had undergone reconstruction of defects using an extended anterolateral thigh flap were identified. Patient characteristics (age, sex, defect location, injured structures, and type of flap) and outcome data were analyzed retrospectively. One artery and 2 accompanying veins were anastomosed to vascularize each flap. Follow-up periods ranged from 10 to 91 months postoperatively. The average size of the flaps was 268.75 cm2 (range = 220-391 cm2). All flaps were perforator flaps with one perforator except that 2 perforators were used in 3 patients. Two patients suffered partial flap necrosis of the distal portion with delayed healing. In conclusion, the extended anterolateral thigh flap is a considerable option for massive defects requiring composite tissue coverage. This flap is advantageous for reconstructing various complex defects in the lower extremities, providing a pliable and vascularized tissue to cover exposed extensive defects including tendons, nerves, and bones.

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