scholarly journals Soft tissue coverage types for complex limb trauma in children

2015 ◽  
Vol 10 (4) ◽  
pp. 348-354
Author(s):  
Ileana-Carmen MATLAC ◽  
◽  
Dan Mircea ENESCU ◽  
◽  
Keyword(s):  
Soft Tissue ◽  
Plastic Surgery ◽  
Surgical Procedures ◽  
Upper Limb ◽  
Soft Tissue Coverage ◽  
Local Flaps ◽  
Affected Area ◽  
Children's Hospital ◽  
Limb Trauma ◽  
Minimum Age

Objective. The analysis of the soft tissue coverage types employed in complex limb trauma in children towards a potential subsequent optimization of their management. Materials and methods. Data regarding the children admitted to the Burns and Plastic Surgery Clinic of ‘Grigore Alexandrescu’ children’s hospital, between 2005 and 2013 with complex limb trauma requiring soft tissue coverage was obtained from the surgical protocols. Information was gathered regarding patients’ sex and age, the type of incident, the mode of occurence, the region in need of coverage, the number and type of surgical procedures, as well as regarding the type of coverage employed. Results. A number of 80 children required soft tissue coverage in complex limb trauma. Boys accounted for approximately two thirds of all cases. The pacients had a minimum age of 1 year and a maximum one of 16 years. There were approximately 50% more trauma of this type affecting the upper limb than the lower one. The fingers required coverage in the majority of cases (77.5%). In the majority of cases at this level (77%) split-level thickness grafts and local flaps were applied. Conclusions. The majority of the complex pediatric soft tissue limb coverage cases were boys. Fingers were the predominantly affected area and most often the usage of split-level thickness grafts or of local flaps was required. The accidents were predominantly home related. The cases had an uncomplicated evolution, the coverage solutions employed being successful in over 90% of the situations.

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 Flap Decisions and Options in Soft Tissue Coverage of the Lower Limb

2014 ◽  
Vol 8 (1) ◽  
pp. 423-432 ◽  
Author(s):  
Daniel J Jordan ◽  
Marco Malahias ◽  
Sandip Hindocha ◽  
Ali Juma
Keyword(s):  
Soft Tissue ◽  
Upper Limb ◽  
Lower Limb ◽  
Chronic Wounds ◽  
Soft Tissue Coverage ◽  
Form And Function ◽  
Flap Coverage ◽  
Surrounding Environment ◽  
And Function ◽  
Review Current

The lower extremities of the human body are more commonly known as the human legs, incorporating: the foot, the lower or anatomical leg, the thigh and the hip or gluteal region.The human lower limb plays a simpler role than that of the upper limb. Whereas the arm allows interaction of the surrounding environment, the legs’ primary goals are support and to allow upright ambulation. Essentially, this means that reconstruction of the leg is less complex than that required in restoring functionality of the upper limb. In terms of reconstruction, the primary goals are based on the preservation of life and limb, and the restoration of form and function. This paper aims to review current and past thoughts on reconstruction of the lower limb, discussing in particular the options in terms of soft tissue coverage.This paper does not aim to review the emergency management of open fractures, or the therapy alternatives to chronic wounds or malignancies of the lower limb, but purely assess the requirements that should be reviewed on reconstructing a defect of the lower limb.A summary of flap options are considered, with literature support, in regard to donor and recipient region, particularly as flap coverage is regarded as the cornerstone of soft tissue coverage of the lower limb.

Advanced Plastic Surgery Techniques for Soft Tissue Coverage of the Diabetic Foot

2007 ◽  
Vol 24 (3) ◽  
pp. 547-568 ◽  
Author(s):  
Thomas Zgonis ◽  
John J. Stapleton ◽  
Thomas S. Roukis
Keyword(s):  
Soft Tissue ◽  
Plastic Surgery ◽  
Diabetic Foot ◽  
Soft Tissue Coverage

scholarly journals Soft tissue coverage of the upper limb: A flap reconstruction overview

2020 ◽  
Vol 60 ◽  
pp. 338-343
Author(s):  
Elisa Benanti ◽  
Giorgio De Santis ◽  
Andrea Leti Acciaro ◽  
Giulia Colzani ◽  
Alessio Baccarani ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Upper Limb ◽  
Soft Tissue Coverage ◽  
Flap Reconstruction

Implant Plastic Surgery: A Review and Rationale

2004 ◽  
Vol 30 (4) ◽  
pp. 240-254 ◽  
Author(s):  
Christopher E. Kazor ◽  
Khalaf Al-Shammari ◽  
David P. Sarment ◽  
Carl E. Misch ◽  
Hom-Lay Wang
Keyword(s):  
Soft Tissue ◽  
Plastic Surgery ◽  
Surgical Procedures ◽  
Treatment Modality ◽  
Clinical Success ◽  
Clinical Applications ◽  
Success Rates ◽  
Case Selection ◽  
Implant Dentistry

Abstract Implant dentistry has been established as a predictable treatment modality with high clinical success rates. Esthetic considerations of implant restorations have been gaining increased interest over the years. The role of periodontal plastic surgical procedures in the creation and maintenance of peri-implant soft tissue heights to facilitate better esthetics has become more popular. The available plastic surgery procedures and their clinical applications are reviewed in this article. Emphasis is placed on factors to consider for proper case selection and ideal treatment planning.

scholarly journals Flap Decisions and Options in Soft Tissue Coverage of the Upper Limb

2014 ◽  
Vol 8 (1) ◽  
pp. 409-414 ◽  
Author(s):  
Michelle Griffin ◽  
Sandip Hindocha ◽  
Marco Malahias ◽  
Mohamed Saleh ◽  
Ali Juma
Keyword(s):  
Soft Tissue ◽  
Upper Limb ◽  
Free Flap ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Careful Consideration ◽  
Surrounding Tissue ◽  
Soft Tissue Coverage ◽  
Scapular Flap ◽  
Radial Forearm

Soft tissue deficiency in the upper limb is a common presentation following trauma, burns infection and tumour removal. Soft tissue coverage of the upper limb is a challenging problem for reconstructive surgeons to manage. The ultimate choice of soft tissue coverage will depend on the size and site of the wound, complexity of the injury, status of surrounding tissue, exposure of the vital structures and health status of the patient. There are several local cutaneous flaps that provide adequate soft tissue coverage for small sized defects of the hand, forearm and arm. When these flaps are limited in their mobility regional flaps and free flaps can be utilised. Free tissue transfer provides vascularised soft tissue coverage in addition to the transfer of bone, nerve and tendons. Careful consideration of free flap choice, meticulous intraoperative dissection and elevation accompanied by post-operative physiotherapy are required for successful outcomes for the patient. Several free flaps are available for reconstruction in the upper limb including the groin flap, anterolateral flap, radial forearm flap, lateral arm flap and scapular flap. In this review we will provide local, regional and free flap choice options for upper limb reconstruction, highlighting the benefits and challenges of different approaches.

scholarly journals Free Tissue Transfer in Pediatric Lower Limb Trauma

2019 ◽  
Vol 52 (01) ◽  
pp. 037-044 ◽  
Author(s):  
R. Srikanth
Keyword(s):  
Soft Tissue ◽  
Lower Limb ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Large Series ◽  
Soft Tissue Coverage ◽  
Wound Coverage ◽  
Tissue Transfer ◽  
Limb Trauma ◽  
Lower Limb Trauma

AbstractFree tissue transfer has become the standard in wound coverage and further refinements have given us newer flap donor sites or modifications of existing flaps to decrease morbidity; smaller vessels are being anastomosed, a direct spin-off following successful distal replantations. Younger children are presenting with traumatic defects similar to adults. Although there were apprehensions of free tissue transfer in children occasioned by smaller vessels, duration of procedure and concerns of growth following flap harvest, reports of small and large series have appeared in the literature with similar success. Pediatric-free tissue transfer is now an established entity. This article seeks to arrive at a consensus based on a review of the existing literature on free flaps for skin and soft-tissue coverage of lower limb trauma in children.

scholarly journals Combined free flap and ilizarov bone reconstruction in complex lower limb trauma: our experience

2018 ◽  
Vol 4 (5) ◽  
pp. 797
Author(s):  
Ravi Mahajan ◽  
Inderdeep Singh ◽  
Avtar Singh ◽  
Mahipal Singh ◽  
Sandeep Kansal
Keyword(s):  
Soft Tissue ◽  
Free Flap ◽  
Early Mobilization ◽  
Ilizarov Method ◽  
Soft Tissue Coverage ◽  
Bone Reconstruction ◽  
Limb Trauma ◽  
Normal Shape ◽  
And Function ◽  
Lower Limb Trauma

<p class="abstract"><strong>Background:</strong> Reconstruction of complex lower limb trauma is a major concern for both plastic and Orthopedic surgeons. The use of free flap with Ilizarov method for soft tissue coverage and bone reconstruction not only gives the patient near normal shape and function but also allows early mobilization of the patient, even during the process of distraction with Ilizarov method.</p><p class="abstract"><strong>Methods:</strong> In this study patients with bone and soft tissue defects of the lower leg were included in the study. Our protocol was immediate wound debridement along with application of external fixator and early free flap coverage within 48-72 hours. After 3-4 weeks of the free flap transfer definitive bone reconstruction is done with Ilizarov method.<strong></strong></p><p class="abstract"><strong>Results:</strong> 122 flaps survived fully and distal flap necrosis occurred in 4 patients. Necrosis of flap occurred before the start of bone reconstruction with Ilizarov and was managed conservatively or with skin graft. Pin tract infection occurred in 45 (35.71%) patients and was treated by pin care and antibiotics. Other complications in treated patients included pain due to distraction (33.33%). delayed union at docking site (11.90%), discrepancy of limb size (9.52%) and union with deformity (6.35%). The functional outcome was satisfactory in majority of the cases.</p><p class="abstract"><strong>Conclusions:</strong> Combined use of free flap and Ilizarov provides a more reliable soft tissue coverage and bone reconstruction with almost near normal shape and function. It has advantages like regenerating same quality bone and allowing the early mobilization of the patient with acceptable rate of complications.</p>

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