The First Stage of Acquired Syndactyly Reconstruction - A Rare Case Report

Background: Acquired syndactyly is a very rare disorder on the interdigital area. Syndactyly with only soft tissue involvement can be a sequela of trauma, such as burn, inflammation or infection in the interdigital area, resulting in bony fusion following crush injury. Case Report: An 8-year-old boy came to our department with fusion from the base to the tip of the first to fourth right toes since the accidental step on burnt plastic 5 years ago. He complained of a poor appearance and discomfort when walking. Then we performed zigzag incision for first to second toes and third to fourth toes. Skin graft closure was performed to cover the defect on third to fourth toes. The second reconstruction surgery will be scheduled 6 months later. Discussion: The surgical techniques for foot syndactyly were derived from those for hand syndactyly, which are to separate the digital fusion by creating local skin flap. Additionally, skin graft might be necessary when recent surgeons avoid the use of skin graft for open treatment, primary closure by defatting, or intricate local flaps. These can shorten the operation time and minimize donor site morbidity. However, surgeons should consider the free tension closure of the wound by combining the skin graft after the flap. Conclusion: Reconstruction procedure for foot syndactyly aims to improve the appearance and function of the toes as well as to avoid progressive deformity through development. The skin graft addition in combination of skin flap shows promising outcome. Key words: acquired syndactyly, syndactyly reconstruction, zigzag flap, skin graft.

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Squamous Cell Carcinoma Arising at a Skin Graft Donor Site: Case Report and Review of the Literature

Plastic Surgery Case Studies ◽

10.1177/2513826x211008425 ◽

2021 ◽

Vol 7 ◽

pp. 2513826X2110084

Author(s):

Weston Thomas ◽

Kevin Rezzadeh ◽

Kristie Rossi ◽

Ajul Shah

Keyword(s):

Squamous Cell Carcinoma ◽

Case Report ◽

Cell Carcinoma ◽

Squamous Cell ◽

Skin Graft ◽

Donor Site ◽

Skin Grafting ◽

Excisional Biopsy ◽

Graft Donor ◽

The Right

Introduction: Skin graft reconstruction is a common method of providing wound coverage. Rarely, skin grafting can be associated with the development of squamous cell carcinoma (SCC) in the graft donor site. Case Report: The patient is a 72-year old male with a 15-year history of bilateral hip wounds. He underwent a multitude of treatments previously with failed reconstructive efforts. After presenting to us, he underwent multiple debridements and eventual skin grafting. Within 4 weeks of the final skin graft, a mass developed at the skin graft donor site at the right thigh. Excisional biopsy returned a well differentiated keratinizing SCC. Discussion/Conclusion: This case demonstrates the acute presentation of SCC in a patient following a skin graft without known risk factors. The purpose of this unique case report is to highlight a very rare occurrence of SCC at a skin graft donor site.

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Split-thickness skin graft donor-site morbidity: A systematic literature review

Burns ◽

10.1016/j.burns.2021.02.014 ◽

2021 ◽

Author(s):

Malachy Asuku ◽

Tzy-Chyi Yu ◽

Qi Yan ◽

Elaine Böing ◽

Helen Hahn ◽

...

Keyword(s):

Literature Review ◽

Systematic Literature Review ◽

Skin Graft ◽

Donor Site ◽

Donor Site Morbidity ◽

Split Thickness Skin Graft ◽

Thickness Skin ◽

Graft Donor

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LONG-TERM DONOR-SITE MORBIDITY IN COMPOSITE ANTEROLATERAL THIGH FREE FLAP FOR COMPLEX DEFECT OF LOWER LEG AND FOOT RECONSTRUCTION

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2020.5.12 ◽

2020 ◽

pp. 85-91

Author(s):

Phuc Le Hong ◽

Son Tran Thiet ◽

Thuy Nguyen Xuan

Keyword(s):

Soft Tissue ◽

Skin Graft ◽

Free Flap ◽

Donor Site ◽

Lower Extremities ◽

Lower Leg ◽

Donor Site Morbidity ◽

Thigh Circumference ◽

Anterolateral Thigh

Background: In recent years, the composite anterolateral thigh free flap with tensor fasciae latae or vastus lateralis has been a new-applied type of flap that can provide very good reconstruction materials in complex defects of lower leg and foot. The study purpose is to evaluate the systematically complications of donor site, related factors to results of the donor area, in order to apply the result to improve the treatment, which have not been much reported in literature. Materials and Methods: Systematic donor site morbilidy evaluation in a prospective, uncontrolled clinical descriptive study of 33 composite anterolateral thigh free flaps in various forms to reconstruct anatomical structures or to resconstruct deep defects combined with covering the surfaces for complex soft tissue defects in lower extremities for 32 patients due to different causes in lower leg and foot area from 2014-2019 at Hue University of Medicine and Pharmacy. Examining and evaluating aesthetic and functional result of donor-site 3 months and 6 months up to 2 year after surgery; evaluating the correlation between the width and the type of the flaps and donor site closure methods. Result: In 33 composite flaps used, flap width to thigh circumference less than 20% in 27 cases (81.8%), more than 20% in 6 cases (18.20% ); There were 28 cases in which the donor site was directly closed, 5 cases required skin graft; All direct closed cases had flap width/ thigh circumference index below 20%; On the contrary, in cases having this index greater than 20%, the donor site required skin graft with p < 0.01. There are 11/33 (33.33%) of cases reported complications in donor site ; lateral thigh paresthesia is the most complicated complication with 8/33 cases (24.24%), followed by bad scarring 3/33 cases (9.09%). Conclusion: Long term follow up donor site morbility after composite anterior thigh free flap present 11/33 cases (33.33%): mostly complications of the donor site are thigh paresthesia with 8/33 cases (24.24%), and bad scarring 3/33 cases (9,09%), which improve time by time. Keywords: Composite anterior thigh free flap, lower extremities soft tissue defect, donor site morbidity

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Surgical Technique and Outcomes of Reconstruction for Blauth Type III Thumb Hypoplasia

Hand ◽

10.1177/15589447211038706 ◽

2021 ◽

pp. 155894472110387

Author(s):

Morad Chughtai ◽

Kara McConaghy ◽

Xem Bui ◽

Grzegorz J. Kwiecien ◽

William H. Seitz

Keyword(s):

Hand Function ◽

Functional Limitations ◽

Donor Site ◽

Donor Site Morbidity ◽

Reconstruction Procedure ◽

Type Iii ◽

Cultural Preferences ◽

Surgical Options ◽

Hypoplastic Thumb ◽

Postoperative Improvement

Background Historically, amputation and pollicization has been the recommended surgical treatment for Blauth type III hypoplastic thumbs. However, due to aesthetic objections or cultural preferences, some parents seek out alternative surgical options. The present study describes a nontraditional technique that preserves and augments the hypoplastic thumb. Methods Patient charts were retrospectively reviewed to identify patients with Blauth type III hypoplastic thumbs who underwent thumb reconstruction at our institution from 2008 to 2018. The reconstruction procedure involved toe phalanx transfer, staged tendon transfers, and lengthening as needed. Motion was assessed categorically as ability to flex, extend, or oppose the thumb. Functionality was assessed as ability to pinch and grasp with the surgical hand. Patient- or parent-reported improvement in thumb function was also recorded. Results Of the 13 patients, 100% could flex, extend, and oppose the thumb to some degree. Eleven patients (85%) had functional one-handed grasp, and 9 (69%) had a functional pinch. Eleven patients (85%) reported no functional limitations of the operative hand. Thirteen patients (100%) reported improvement in hand function after surgery as compared to pre-operatively. There were 2 minor complications (15%), both of which resolved after intervention. No patients experienced donor-site morbidity. Conclusions Reconstruction of Blauth III thumbs is a nontraditional technique that allows for digit retention by salvaging the hypoplastic thumb. In the present study, the majority of patients had functional thumbs and all reported postoperative improvement. Overall, our results suggest that reconstruction is a viable surgical option for Blauth III hypoplastic thumbs.

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Full Thickness Skin Graft for Nail Unit Reconstruction

Journal of Hand Surgery (European Volume) ◽

10.1016/j.jhsb.2004.11.006 ◽

2005 ◽

Vol 30 (2) ◽

pp. 194-198 ◽

Cited By ~ 52

Author(s):

A. LAZAR ◽

P. ABIMELEC ◽

C. DUMONTIER

Keyword(s):

Skin Graft ◽

Simple Procedure ◽

Donor Site ◽

Skin Grafting ◽

Malignant Tumour ◽

Donor Site Morbidity ◽

Full Thickness ◽

Full Thickness Skin Graft ◽

Full Thickness Skin ◽

Thickness Skin

A retrospective study of 13 patients assessed the use of a full thickness skin graft for nail unit reconstruction after total nail unit removal for nail bed malignancies. No failures of the graft were observed and no patient had recurrence of the malignant tumour at 4 year follow-up. Full thickness skin grafting is a simple procedure which provides a good cosmetic outcome and does not produce significant donor site morbidity.

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Craniofacial Cleft: A Case of Tessier 10 Cleft With a Novel Method to Repair Large Bilateral Colobomas

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665619853737 ◽

2019 ◽

Vol 56 (10) ◽

pp. 1377-1380

Author(s):

Joshua M. Barnett ◽

John H. Y. Pang ◽

Sean Herman ◽

Jonathan Lee ◽

S. Tonya Stefko ◽

...

Keyword(s):

Case Report ◽

Clinical Case ◽

Donor Site ◽

Donor Site Morbidity ◽

Upper Eyelid ◽

Eyelid Closure ◽

Large Rotation ◽

Rotation Flap ◽

Novel Method ◽

Full Thickness Excision

Objective: To describe a reliable method utilizing large, rotation flaps to reconstruct a number 10 Tessier cleft. Design: This is a descriptive clinical case report. Setting: Pediatric teaching hospital affiliated with a university. Patients, Participants: One participant in this clinical case report. Interventions: Full-thickness excision of the clefted eyelid, brow, and forehead tissue was performed bilaterally to develop medial and lateral eyebrow and forehead flaps. Right: the forehead/brow flap was rotated caudally to reapproximate the eyebrow and an eyelid rotation flap was also used to reapproximate the lid margin. Left: forehead/brow rotation flap allowed realignment of the eyebrow and a series of Z-plasties were used in the eyelid to reapproximate the lid margin and to lengthen the eyelid. Main Outcome Measure(s): Develop and construct a reliable reconstruction with full-eyelid closure and minimal donor site morbidity. Results: Complete eyelid closure bilaterally was achieved intraoperatively, and was maintained at 6-month follow-up with no evidence of ocular pathology. Conclusions: Large, bilateral upper eyelid colobomas require repair to prevent blindness. Although free tarsomarginal grafts and lid-sharing procedures have been described, we demonstrate that large rotation flaps designed along the cleft margin can provide a reliable reconstruction and minimize donor-site morbidity.

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Fifth toe Fillet Flap for Wound Coverage of Non-Healing Ulcer of the Foot: Surgical Technique and a Case Report

Asian Journal of Medical Research ◽

10.47009/ajmr.2020.9.2.or2 ◽

2020 ◽

Vol 9 (2) ◽

pp. 7-10

Author(s):

Sunny Chaudhary ◽

Shivakumar A Bali ◽

Arvind Singh ◽

R K Siddharth

Keyword(s):

Case Report ◽

Surgical Technique ◽

Functional Limitations ◽

Donor Site ◽

Donor Site Morbidity ◽

Healing Ulcer ◽

Wound Coverage ◽

Fillet Flap ◽

Plantar Aspect ◽

Partial Amputation

Fillet flap is one of the options in the treatment of diabetic non-healing ulcers. The advantages of the fillet flap include the absence of donor site morbidity, excellent durability and preventing the need for more proximal amputation. A 56-year-old farmer presented to the out-patient department with complaints of a non-healing ulcer on the sole of the right foot for the past 7 months which was managed conservatively. A fifth ray partial amputation and a rotational flap of the redundant fifth finger for wound coverage were done. The wound healing was uneventful and the sutures were removed after two weeks. At the latest follow-up of 2 years, the patient was able to walk independently without pain and without any functional limitations. This case report describes the surgical technique of the lateral lesser toe fillet flap for wound closure on the plantar aspect of foot as an alternative to secondary healing or more proximal amputations.

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Functional reconstruction of subtotal glossectomy defects with radial forearm free flap: case report and review of literature

Folia Medica ◽

10.2478/v10153-011-0090-x ◽

2012 ◽

Vol 54 (2) ◽

pp. 60-65 ◽

Cited By ~ 2

Author(s):

Dimitar D. Pazardzhikliev ◽

Christo D. Shipkov ◽

Ilya P. Yovchev ◽

Regina H. Khater ◽

Ivailo S. Kamishev

Keyword(s):

Case Report ◽

Free Flap ◽

Donor Site ◽

Perforator Flap ◽

Functional Results ◽

Donor Site Morbidity ◽

Oral Feeding ◽

Tram Flap ◽

Radial Forearm Free Flap ◽

Radial Forearm

ABSTRACT Adequate reconstruction of defects that are consequences of glossectomy is of primary importance for achieving satisfactory functional results and improving the quality of life. AIM: The aim of this study was to report a case of free flap reconstruction of a subtotal glossectomy defect and discuss it in relation to other available methods. CASE REPORT: A 48- year-old woman was operated on for a T4N0M0 squamous cell carcinoma of the tongue. A subtotal glossectomy via mandibular swing procedure with bilateral supraomohyoid neck dissection and reconstruction with a radial forearm free flap (RFFF) was performed. Surgery was followed by adjuvant radiotherapy. RESULTS: The post-operative period was uneventful. The patient resumed intelligible speech evaluated as “excellent” and oral feeding. The donor site morbidity was acceptable. Present reconstructive options of the tongue include two categories: to maintain mobility or to provide bulk. In glossectomy with 30 to 50 percent preservation of the original musculature, maintaining the mobility of the remaining tongue by a thin, pliable flap is preferred. This can be achieved by infrahyoid myofascial, medial sural artery perforator flap, RFFF, anterolateral thigh and ulnar forearm flap. When the post-resectional volume is less than 30 percent of the original tongue, the reconstruction shifts to restoration of bulk to facilitate swallowing by providing contact of the neotongue with the palate. Flaps providing bulk include the free TRAM flap, latissimus dorsi myocutaneous free flap, pectoralis major musculocutaneous flap and trapezius island flap. CONCLUSION: Surgical treatment of advanced tongue cancer requires adequate reconstruction with restoration of speech, swallowing and oral feeding. Free tissue transfer seems to achieve superior functional results with acceptable donor site morbidity when indicated.

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