scholarly journals Bilateral axillary skin fold flaps used for dorsal thoracic skin wound closure in a dog : clinical communication

2010 ◽  
Vol 81 (1) ◽  
Author(s):  
B. G. Nevill
Keyword(s):  
Skin Flap ◽  
Skin Wound ◽  
Clinical Report ◽  
Skin Defect ◽  
Skin Flaps ◽  
Clinical Communication ◽  
Dorsal Midline ◽  
Skin Fold ◽  
Flap Procedure ◽  
Chronic Skin

A 10-year-old greyhound-cross dog was presented with a large, chronic skin wound extending over the interscapular region. The substantial skin defect was closed by making use of bilateral axillary skin fold flaps. It was possible to elevate the 2 skin flaps sufficiently to allow them to meet at the dorsal midline and thus facilitate complete closure of a large and awkwardly positioned wound. Small dorsal areas of the skin flaps underwent necrosis, but the resulting defects were closed without difficulty in a subsequent procedure. To the author's knowledge, this is the 1st clinical report of the use of bilateral axillary skin fold flaps in this fashion and describes an additional use of a versatile skin flap procedure.

scholarly journals Clinical Translational Potential in Skin Wound Regeneration for Adipose-Derived, Blood-Derived, and Cellulose Materials: Cells, Exosomes, and Hydrogels

Biomolecules ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 1373
Author(s):  
Trivia Frazier ◽  
Andrea Alarcon ◽  
Xiying Wu ◽  
Omair A. Mohiuddin ◽  
Jessica M. Motherwell ◽  
...  
Keyword(s):  
Skin Flap ◽  
Healthcare Delivery ◽  
Standard Of Care ◽  
Research Area ◽  
Skin Wound ◽  
Current Status ◽  
Current Standard ◽  
Medical Need ◽  
Pressure Injury ◽  
Chronic Skin

Acute and chronic skin wounds due to burns, pressure injuries, and trauma represent a substantial challenge to healthcare delivery with particular impacts on geriatric, paraplegic, and quadriplegic demographics worldwide. Nevertheless, the current standard of care relies extensively on preventive measures to mitigate pressure injury, surgical debridement, skin flap procedures, and negative pressure wound vacuum measures. This article highlights the potential of adipose-, blood-, and cellulose-derived products (cells, decellularized matrices and scaffolds, and exosome and secretome factors) as a means to address this unmet medical need. The current status of this research area is evaluated and discussed in the context of promising avenues for future discovery.

scholarly journals Application of WALANT technique for repairing finger skin defect with a random skin flap

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jianhua Xu ◽  
Lu Yin ◽  
Shuming Cao ◽  
Haihua Zhan ◽  
Jianbing Zhang ◽  
...  
Keyword(s):  
Skin Flap ◽  
Donor Site ◽  
Operation Time ◽  
Pedicled Flap ◽  
Skin Defect ◽  
Skin Flaps ◽  
Abdominal Skin ◽  
Vas Score ◽  
Finger Skin ◽  
Wide Awake

Abstract Background Wide-awake local anesthesia no tourniquet (WALANT) technique has emerged among hand surgeons with other indications. Surgeries involving pedicled flap and revascularization are no longer used as contraindications. The present study aimed to evaluate the feasibility and merits of the WALANT technique in random skin flap surgery. Methods From May 2018 to March 2019, 12 patients with finger skin defects repaired with random skin flaps were reviewed. Abdominal skin flaps or thoracic skin flaps were used to cover the wound. Both the fingers and the donor sites were anesthetized by the WALANT technique. A 40-mL conventional volume consisted of a mixture of epinephrine and lidocaine. A volume of 5 mL was injected at the distal palmar for nerve block, the other 5 mL was injected around the wound for hemostasis, and the remaining was injected at the donor site of flaps for both analgesia and hemostasis. Baseline data with respect to sex, age, side, type of finger, donor sites, flap size, dosage of anesthetics, usage of finger tourniquet, intraoperative and postoperative pain, hemostasis effect, operation time, Disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) score, and hospitalization expense, were collected. Results All patients tolerated the procedure, and none of them needed sedation. Single finger skin defect in 8 patients and double finger skin defect occurred in 4 patients; 5 patients were repaired by abdominal skin flaps, and 7 patients were repaired by thoracic skin flaps. The good surgical field visibility was 91.7%. All flaps survived adequately, without necrosis, pulling fingers out, and other complications. The average visual analog scale (VAS) score of the maximal pain was 1.1 in fingers vs. 2.1 in donor sites during the operation. On postoperative day one, the average VAS score of the maximal pain in fingers and donor sites was 1.3 and 1.1, respectively. The average hospitalization expense before reimbursement of the whole treatment was 11% less expensive compared to the traditional method. The average QuickDASH score was 9.1. Conclusions Under wide-awake anesthesia, patients have the ability to control their injured upper extremities consciously, avoiding the complications due to pulling flap pedicles. With the merits of safety, painlessness, less bleeding, and effectivity, the WALANT technique in random skin flaps is feasible and a reliable alternative to deal with finger skin defect.

Current knowledge of immunomodulation strategies for chronic skin wound repair

2021 ◽  
Author(s):  
Parisa Heydari ◽  
Mahshid Kharaziha ◽  
Jaleh Varshosaz ◽  
Shaghayegh Haghjooy Javanmard
Keyword(s):  
Wound Repair ◽  
Current Knowledge ◽  
Skin Wound ◽  
Chronic Skin

scholarly journals Preclinical efficacy of stem cell therapy for skin flap: a systematic review and meta-analysis

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Yuan Li ◽  
Qi-lin Jiang ◽  
Leanne Van der Merwe ◽  
Dong-hao Lou ◽  
Cai Lin
Keyword(s):  
Systematic Review ◽  
Stem Cells ◽  
Stem Cell ◽  
Survival Rate ◽  
Meta Analysis ◽  
Skin Flap ◽  
Cochrane Library ◽  
Skin Flaps ◽  
Cell Based Therapy ◽  
Stem Cell Treatment

Abstract Background A skin flap is one of the most critical surgical techniques for the restoration of cutaneous defects. However, the distal necrosis of the skin flap severely restricts the clinical application of flap surgery. As there is no consensus on the treatment methods to prevent distal necrosis of skin flaps, more effective and feasible interventions to prevent skin flaps from necrosis are urgently needed. Stem therapy as a potential method to improve the survival rate of skin flaps is receiving increasing attention. Methods This review followed the recommendations from the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statements. Twenty studies with 500 animals were included by searching Web of Science, EMBASE, PubMed, and Cochrane Library databases, up until October 8, 2020. Moreover, the references of the included articles were searched manually to obtain other studies. All analyses were conducted using Review Manager V.5.3 software. Results Meta-analysis of all 20 studies demonstrated stem cell treatment has significant effects on reducing necrosis of skin flap compared with the control group (SMD: 3.20, 95% CI 2.47 to 3.93). Besides, subgroup analysis showed differences in the efficacy of stem cells in improving the survival rate of skin flaps in areas of skin flap, cell type, transplant types, and method of administration of stem cells. The meta-analysis also showed that stem cell treatment had a significant effect on increasing blood vessel density (SMD: 2.96, 95% CI 2.21 to 3.72) and increasing the expression of vascular endothelial growth factor (VEGF, SMD: 4.34, 95% CI 2.48 to 6.1). Conclusions The preclinical evidence of our systematic review indicate that stem cell-based therapy is effective for promoting early angiogenesis by up regulating VEGF and ultimately improving the survival rate of skin flap. In summary, small area skin flap, the administration method of intra-arterial injection, ASCs and MSCs, and xenogenic stem cells from humans showed more effective for the survival of animal skin flaps. In general, stem cell-based therapy may be a promising method to prevent skin flap necrosis.

scholarly journals THE OIL FROM MORINGA OLEIFERA SEEDS ACCELERATE CHRONIC SKIN WOUND HEALING

2021 ◽  
pp. 100099
Author(s):  
Ana Clara Sans Salomão Brunow Ventura ◽  
Thalita de Paula ◽  
Jenifer Pendiuk Gonçalves ◽  
Bruna da Silva Soley ◽  
Ananda Beatriz Munhoz Cretella ◽  
...  
Keyword(s):  
Wound Healing ◽  
Moringa Oleifera ◽  
Skin Wound ◽  
Skin Wound Healing ◽  
Chronic Skin

Skew flap technique in trans-tibial amputation

2005 ◽  
Vol 29 (3) ◽  
pp. 283-290 ◽  
Author(s):  
S. K. Jain
Keyword(s):  
Muscle Flap ◽  
Suture Line ◽  
Skin Flaps ◽  
Posterior Flap ◽  
Flap Technique ◽  
Flap Procedure ◽  
In Trans ◽  
Dog Ears ◽  
Established Technique

The long posterior flap technique is an established technique for trans-tibial amputation in ischaemic limbs. Despite its success, it has a few drawbacks. It may be time-consuming and requires considerable planning, and at times the dog-ears cannot be avoided. The suture line passes over the distal end of the stump, which is usually a problem during prosthetic use. The skew flap technique retains the advantages of the long posterior flap technique and eliminates the difficulties of prosthetic fitting. The equal skin flaps are skewed so that the flaps become anteromedial and posterolateral, whereas the calf muscle flap remains long underneath the skewed skin flaps. The posterior muscles are brought anteriorly covering the cut ends of the bones and are buried in between the tibia and its anterior periosteum, by suturing their margins with the periosteum. The skew flap procedure was perceived in 1980 and was started at the Artificial Limb Centre, Pune in 1983 by the author. This procedure underwent many changes during the initial 5 years and by the end of April 1992, 85 trans-tibial amputations were performed using this technique. A 9-year follow-up of these patients, who had been using prostheses with ease and without any discomfort or problem, had been exceptionally good. Encouraged by the results, this technique is now being practised as routinely. By March 1998, a total of 125 such trans-tibial amputations had been performed in 119 patients, with excellent results.

Effect of Hyperthermic Preconditioning on the Survival of Ischemia-Reperfused Skin Flaps: A New Skin-Flap Model in the Mouse

2002 ◽  
Vol 18 (2) ◽  
pp. 115-120 ◽  
Author(s):  
Trinh Cao Minh ◽  
Shigeru Ichioka ◽  
Takashi Nakatsuka ◽  
Junsuke Kawai ◽  
Masahiro Shibata ◽  
...  
Keyword(s):  
Skin Flap ◽  
Skin Flaps ◽  
Hyperthermic Preconditioning ◽  
New Skin

A Model for Training in Elevation of Local Skin Flaps in the Hand

1994 ◽  
Vol 19 (6) ◽  
pp. 794-795 ◽  
Author(s):  
H. D. SKOFF
Keyword(s):  
Skin Flap ◽  
Three Dimensional ◽  
Skin Flaps ◽  
Dimensional Model ◽  
Surgical Experience ◽  
Three Dimensional Model ◽  
Local Skin ◽  
Practice Models ◽  
Flap Design

Appropriate skin flap design is crucial for success in surgery of the hand. Practice models are useful in acquiring surgical experience. The author describes a three-dimensional model composed of readily available materials which has been useful for practice in elevation of local skin flaps in the hand

scholarly journals Efficiency of Enzymatic Debridement in the Healing Process of Chronic Wounds in Small Animal Practice

2017 ◽  
Vol 61 (1) ◽  
pp. 38-42 ◽  
Author(s):  
L. Hamilton ◽  
M. Kožár
Keyword(s):  
Chronic Wounds ◽  
Healing Process ◽  
Small Animal ◽  
Skin Defect ◽  
Skin Wounds ◽  
Macroscopic Appearance ◽  
Enzyme Preparations ◽  
Chronic Skin ◽  
The Individual ◽  
Enzymatic Debridement

Abstract Skin wounds are a common presentation in small animal practice. These wounds may be acute or chronic with a complicated healing process. An important aspect of the healing of wounds is debridement which may be carried out by surgical, autolytic, mechanical or enzymatic methods. The debridement method is chosen according to the individual skin defect and influenced by factors such as wound size and location, the age of the wound, and the presence of infection or exudate. Enzymatic debridement is a method that is not commonly used in veterinary practice, and involves the use of enzyme preparations to remove necrotic tissue from a wound. The aim of this study was to investigate the effects of the enzymatic ointment collagenase as a method of debridement, and its effect on the macroscopic appearance of chronic skin wounds in cats and dogs. We observed that the application of Iruxol Mono directly to the wound changes the progress of the healing process, with no obvious adverse effects. The time of healing of chronic wounds was decreased and healthy granulation tissue was developed within a couple of days after application of the ointment. Enzymatic debridement appears to be a promising method of debridement for use in chronic wounds, and should be considered in cases where more conventional methods of debridement are ineffective or unsuitable.

Vasodilator effect and mechanism of action of vascular endothelial growth factor in skin vasculature

2004 ◽  
Vol 286 (3) ◽  
pp. H946-H954 ◽  
Author(s):  
Homa Ashrafpour ◽  
Ning Huang ◽  
Peter C. Neligan ◽  
Christopher R. Forrest ◽  
Patrick D. Addison ◽  
...  
Keyword(s):  
Skin Flap ◽  
Vegf Receptor ◽  
Vascular Endothelial ◽  
Skin Flaps ◽  
Skin Perfusion ◽  
Potent Vasodilator ◽  
Or Gene ◽  
Endothelial Growth Factor ◽  
Endothelial Nitric Oxide ◽  
First Time

Various laboratories have reported that local subcutaneous or subdermal injection of VEGF165 at the time of surgery effectively attenuated ischemic necrosis in rat skin flaps, but the mechanism was not studied and enhanced angiogenesis was implicated. In the present study, we used the clinically relevant isolated perfused 6 × 16-cm pig buttock skin flap model to 1) test our hypothesis that VEGF165 is a potent vasodilator and acute VEGF165 treatment increases skin perfusion; and 2) investigate the mechanism of VEGF165-induced skin vasorelaxation. We observed that VEGF165 (5 × 10–16–5 × 10–11 M) elicited a concentration-dependent decrease in perfusion pressure (i.e., vasorelaxation) in skin flaps preconstricted with a submaximal concentration of norepinephrine (NE), endothelin-1, or U-46619. The VEGF165-induced skin vasorelaxation was confirmed using a dermofluorometry technique for assessment of skin perfusion. The vasorelaxation potency of VEGF165 in NE-preconstricted skin flaps (pD2 = 13.57 ± 0.31) was higher ( P < 0.05) than that of acetylcholine (pD2 = 7.08 ± 0.24). Human placental factor, a specific VEGF receptor-1 agonist, did not elicit any vasorelaxation effect. However, a specific antibody to VEGF receptor-2 (1 μg/ml) or a specific VEGF receptor-2 inhibitor (5 × 10–6 M SU-1498) blocked the vasorelaxation effect of VEGF165 in NE-preconstricted skin flaps. These observations indicate that the potent vasorelaxation effect of VEGF165 in the skin vasculature is initiated by the activation of VEGF receptor-2. Furthermore, using pharmacological probes, we observed that the postreceptor signaling pathways of VEGF165-induced skin vasorelaxation involved activation of phospholipase C and protein kinase C, an increase in inositol 1,4,5-trisphosphate activity, release of the intra-cellular Ca2+ store, and synthesis/release of endothelial nitric oxide, which predominantly triggered the effector mechanism of VEGF165-induced vasorelaxation. This information provides, for the first time, an important insight into the mechanism of VEGF165 protein or gene therapy in the prevention/treatment of ischemia in skin flap surgery and skin ischemic diseases.

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