scholarly journals Minimising the donor area morbidity of radial forearm phalloplasty using prefabricated thigh flap: A new technique

2017 ◽  
Vol 50 (01) ◽  
pp. 091-095 ◽  
Author(s):  
Aditya Aggarwal ◽  
Hardeep Singh ◽  
Sanjay Mahendru ◽  
Vimalendu Brajesh ◽  
Sukhdeep Singh ◽  
...  
Keyword(s):  
Donor Site ◽  
Tissue Expander ◽  
Tissue Expansion ◽  
Skin Grafting ◽  
Free Flaps ◽  
Standing Position ◽  
Donor Site Morbidity ◽  
New Technique ◽  
Donor Area ◽  
Radial Forearm

ABSTRACTPhalloplasty is indicated in various conditions of penile loss or absence. There are numerous techniques for phalloplasty including the pedicle and free flaps with the ultimate goal of micturition in standing position, attaining adequate size, aesthesis and sensations for sexual intercourse. Radial forearm phalloplasty is the gold standard flap to achieve above results but gives a very bad scar on the forearm. We present a technique of using prefabricated thigh flap to reduce the morbidity of donor area. The descending branch of lateral circumflex femoral pedicle was placed in a subcutaneous plane over tissue expander. After attaining an adequate size of flap with tissue expansion, it was delayed 3 weeks before phalloplasty. Prefabricated flap was thin and of large size replicating the radial forearm flap used for phalloplasty. Whole forearm defect was covered with the thigh flap, and the thigh could be closed primarily. This new technique of using prefabricated thigh flap has significantly reduced the donor site morbidity both aesthetically and functionally without the use of skin grafting in the whole procedure.

Evaluation of Fingertip Injuries and Modalities of Flap Coverage in the Emergency Settings: A Retrospective Study

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Salah Nasser Mohamed ◽  
AbdelRahman AbdeIAal ◽  
Mina Agaiby Estawrow ◽  
Andrew Adel Wassef Attia
Keyword(s):  
Soft Tissue ◽  
Donor Site ◽  
Joint Stiffness ◽  
Skin Grafting ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Tissue Loss ◽  
University Hospitals ◽  
Maximum Function ◽  
Reconstruction Methods

Abstract Background Fingertip comprises the nail complex and glabrous pulp, which is richly vascularized and innervated, built around the distal phalanx. The fingertip is commonly affected because it is the most distal part of the hand so it's easily to be injured during athletic participation, occupational activities or in accidents. Various fingertip reconstruction methods are reported as healing by secondary intention, shortening and primary closure, skin grafts and flaps. Flaps are considered when there's a big soft tissue loss or an exposed bone. Complications of fingertip reconstructions are common such as flexion deformity and neuroma. Objective In this study, we assessed and compared the outcomes of different modalities of soft tissue covemge using different flap techniques in cases of fingertip injuries as regalding the incidence of neuroma, necrosis, donor site morbidity, joint stiffness and sensory impairment, together with the patient satisfaction. Patients and Methods We analyzed a retrospective cohort study of 90 patients with 96 fingertip injuries who underwent coverage by various flap techniques at Ain Shams University Hospitals in the period between July 2017 and July 2019. Results The V-Y Advancement flap and the Cross-finger flap were the commonest flaps done in 26 cases (27.1%) and 25 cases (26.0%) respectively. There's a highly statistically significance in the incidence of necrosis in abdominal flap (100%) followed by Moberg flap (46.2%). In addition, there is a statistically significance in the incidence of neuroma in Moberg flap (53.8%). Most of patients who underwent coverage by flap technique were very satisfied by the results (60.4%). Conclusion Many techniques have been described for reconstruction of fingertip trauma including revision amputation, skin grafting, local flaps, distant flaps and free flaps. The treatment choice depends on many factors such as patient preference, culture, resources available and surgeon skills. The goals of reconstruction in fingertip amputations are to cover the defect with a satisfactory cosmetic appearance, establish maximum function and preservation of sensation.

Short-term donor site morbidity: A comparison of the anterolateral thigh and radial forearm fasciocutaneous free flaps

Head & Neck ◽  
2015 ◽  
Vol 38 (S1) ◽  
pp. E945-E948 ◽  
Author(s):  
P. Daniel Knott ◽  
Rahul Seth ◽  
Heather H. Waters ◽  
Peter C. Revenaugh ◽  
Daniel Alam ◽  
...  
Keyword(s):  
Donor Site ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Short Term ◽  
Anterolateral Thigh ◽  
Radial Forearm

Donor Site Morbidity Following Free Tissue Transfer: A Preliminary Survey

1998 ◽  
Vol 6 (2) ◽  
pp. 85-88 ◽  
Author(s):  
James Mahoney ◽  
Eric Kharaillah ◽  
Dimitri Drakos
Keyword(s):  
Wound Healing ◽  
Donor Site ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Preliminary Survey ◽  
Retrospective Survey ◽  
Tissue Transfer ◽  
Potential Problems ◽  
Radial Forearm

J Mahoney, E Kharaillah, D Drakos. Donor site morbidity following free tissue transfer: A preliminary survey. Can J Plast Surg 1998;6(2):85-88. Donor site morbidity is becoming an important factor in the measurement of reconstructive success following free tissue transfer. A grading system based on five criteria (cosmesis, functional loss, wound healing, iatrogenic injury and pain) has been devised to evaluate and compare different donor sites in a uniform fashion. Questionnaires were sent to microsurgeons across Canada and to a series of patients asking them to report on their experiences with donor site morbidity. Completed questionnaires from 43 patients and 29 surgeons revealed that overall, donor site morbidity is low. This study represents a retrospective survey of the donor site of various free tissue transfers and highlights potential problems of several frequently used free flaps. The radial forearm flap had the highest morbidity, especially with regard to wound healing and cosmesis. Suggestions to improve studies in this area further are made.

Calvarial and Scalp Reconstruction

2019 ◽  
Author(s):  
Matthew M Hanasono
Keyword(s):  
Tissue Expander ◽  
Tissue Expansion ◽  
Skin Grafting ◽  
Free Flaps ◽  
Cranial Bone ◽  
Wound Complications ◽  
Neurosurgical Procedures ◽  
Advantages And Disadvantages ◽  
Scalp Reconstruction

Scalp reconstruction involves nearly the entire spectrum of reconstructive surgery, including skin grafting, local flaps, and microvascular free flaps. Additionally, tissue expansion can play important role in maximizing outcomes. In recent years, reconstructive algorithms specific to scalp reconstruction have been developed that consider not only the size of the defect, but the quality of local tissues.  Many materials have been used for calvarial reconstruction and most modern alloplasts are as reliable as autologous bone, although each as its own advantages and disadvantages.  Simultaneous scalp and calvarial reconstruction is now routinely performed.  Remaining challenges include management of wound complications over alloplasts and of the infected cranial bone flap following neurosurgical procedures. This review contains 15 figures, 5 tables, and 41 references. Keywords: scalp, calvarium, cranioplasty, free flap, tissue expander, skin graft, bone graft, titanium mesh, methylmethacrylate, polyetheretherketone (PEEK)

scholarly journals Reducing the donor site morbidity in radial forearm free flaps by utilizing a narrow radial forearm free flap

2018 ◽  
Vol 45 (4) ◽  
pp. 345-350 ◽  
Author(s):  
Safdar Ali Shaikh ◽  
Amber Bawa ◽  
Noman Shahzad ◽  
Zara Yousufzai ◽  
Muhammad Shahab Ghani
Keyword(s):  
Free Flap ◽  
Donor Site ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Radial Forearm Free Flap ◽  
Radial Forearm

Assessment of Donor Site Morbidity for Osteocutaneous Radial Forearm Free Flaps

2011 ◽  
Vol 145 (2_suppl) ◽  
pp. P44-P44
Author(s):  
Catherine Fiona Sinclair ◽  
Babak Givi ◽  
Daniel S. Schneider ◽  
Eben L. Rosenthal ◽  
John Gleysteen ◽  
...  
Keyword(s):  
Donor Site ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Radial Forearm

scholarly journals Role of large transverse fasciocutaneous cross leg flap (whole leg flap) in lower extremity salvage

2017 ◽  
Vol 5 (5) ◽  
pp. 1760
Author(s):  
Manish Zade ◽  
Dhananjay Nakade ◽  
Jitendra Mehta ◽  
Pawan Shahane ◽  
Shitiz Gupta ◽  
...  
Keyword(s):  
Donor Site ◽  
Graft Loss ◽  
Joint Stiffness ◽  
Skin Grafting ◽  
Donor Site Morbidity ◽  
Average Hospital ◽  
Female Ratio ◽  
Donor Area ◽  
Microvascular Flap ◽  
Ankle And Foot

Background: Extensive soft tissue defects of leg, ankle and foot are challenge to reconstructive surgeons due to lack of local tissue. Microvascular flap coverage has become a standard line of treatment as large amount of tissue transfer is required. Large transverse fasciocutaneous cross leg flap remains an alternative for reconstruction of such extensive defects. We present our experience with this flap in 14 patients.Methods: A total of 14 patients were operated for large transverse fasciocutaneous cross leg flap cover for defects over leg (9), ankle and foot (3) and sole (2). Age group ranged from 4 years to 50 years with 4 patients below 12 years of age. Male to female ratio was 5:2. Flaps were divided at 3weeks and final inset was done.Results: 11 patients had complete flap survival. Two patients had marginal necrosis and one patient had superficial necrosis of proximal flap margin after flap division. One patient with partial skin graft loss at donor area required secondary skin grafting at the time of flap division. Average hospital stay was 34.5 days (range 10 - 50 days). The donor limb had no joint stiffness related to immobilisation and cosmetic outcome of flap and donor area was satisfactory.Conclusions: large transverse fasciocutaneous cross leg flap is safe, technically easy and is associated with minimal donor site morbidity. It offers the possibility of limb salvage in difficult situations.

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