scholarly journals Myelomeningocele defect reconstruction with keystone flaps: vascular rationale for the design and operative technique

2021 ◽  
Vol 48 (3) ◽  
pp. 254-260
Author(s):  
Beatriz Hatsue Kushida-Contreras ◽  
Miguel Angel Gaxiola-García
Keyword(s):  
Soft Tissue ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Cerebrospinal Fluid Leakage ◽  
Soft Tissue Reconstruction ◽  
Dorsal Midline ◽  
Tissue Reconstruction ◽  
Clinical Records ◽  
Tertiary Care Hospitals

Background Myelomeningocele is a frequently seen condition at tertiary care hospitals. Its treatment involves a variety of plastic reconstructive techniques. Herein, we present a series of myelomeningocele patients treated using keystone flaps.Methods We gathered information regarding soft tissue reconstruction and the use of bilateral keystone flaps to treat myelomeningocele patients. We obtained data from clinical records and recorded the demographic characteristics of mothers and children with the condition. The size, level of defect, and complications detected during the follow-up were analyzed.Results A series of seven patients who underwent bilateral keystone flaps for myelomeningocele closure was analyzed. There were no cases of midline or major dehiscence, flap loss, necrosis, surgical site infections, or cerebrospinal fluid leakage. No revision procedures were performed. Minor complications included one case with minimal seroma and three cases with areas of peripheral dehiscence that healed easily using conventional measures.Conclusions The use of keystone flaps is an adequate option for closure of dorsal midline soft tissue defects related to myelomeningocele. This technique offers predictable results with an acceptable spectrum of complications. Robust blood flow can be predicted based upon anatomical knowledge.

scholarly journals Radical treatment of severe open fractures of extremities by orthoplastic surgery: a 10-year retrospective study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zhao Yang ◽  
Chao Xu ◽  
Yong-Gang Zhu ◽  
Jun Li ◽  
Zi-Xiang Wu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Infection Rate ◽  
Clinical Data ◽  
Open Fractures ◽  
Soft Tissue Reconstruction ◽  
Satisfactory Outcome ◽  
Tissue Damages ◽  
Tissue Reconstruction ◽  
Severe Soft Tissue

Abstract Objective This study aimed to retrospectively analyze clinical data of a series of patients with severe open fractures of extremities (Gustilo IIIb or IIIc), who achieved a satisfactory outcome through radical orthoplastic surgery, so as to provide a reference for determining the treatment of severe open fractures of extremities. Methods The clinical data of 41 consecutive patients with severe open fracture (Gustilo IIIb or IIIc) of the limb, who underwent successful surgical debridement, fixation, and soft tissue reconstruction in one stage between January 2008 and January 2019, were retrospectively reviewed. Postoperative indicators, including infection rate and union time, were acquired by a regular follow-up and analyzed. Results The mean (±SD) age of the patients was 38 ± 16 years. A total of 90 open fractures and severe soft tissue damages were analyzed. The soft tissue cover was achieved within 72 h. The overall rate of infection was 14.6% (6/41). Sex and the Mangled Extremity Severity Score were associated with infection. The median union time of 40 patients (one amputation) was 32 weeks. Conclusion The overall rate of infection exhibited a lower tendency in this study compared with previous studies on high-grade open fractures following a two-stage orthopedic approach. The consequence of infection rate and union time was similar to that in previous studies. These results indicated that the single-stage radical orthoplastic treatment was an effective and reliable option for reconstructing severe open fractures.

scholarly journals Radical treatment of severe open fractures of extremities by orthoplastic surgery: a 10-year retrospective study

2020 ◽  
Author(s):  
Zhao Yang ◽  
Chao Xu ◽  
Yong-Gang Zhu ◽  
Jun Li ◽  
Zi-Xiang Wu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Open Fracture ◽  
Aesthetic Surgery ◽  
Open Fractures ◽  
Soft Tissue Reconstruction ◽  
Central Unit ◽  
Chinese Characteristics ◽  
Tissue Reconstruction ◽  
The Mean

Abstract Orthoplastic treatment based on the collaboration of orthopedic and plastic surgeons in an “orthoplastic” central unit has been recommended by the British Association of Plastic Reconstructive and Aesthetic Surgery. However, this approach is not used worldwide especially in most developing countries. Based on the aggressive orthoplastic management, orthoplastic experience with Chinese characteristics has been carried out in last 10 years. The clinical data of 41 consecutive patients with severe open fracture (Gustilo IIIb or IIIc) of the limb, who underwent successful surgical debridement, fixation, and soft tissue reconstruction in one stage between January 2008 and April 2019, were retrospectively reviewed. Postoperative indicators, including infection rate and union time, were acquired by a regular follow-up and analyzed. The mean (±SD) age of the patients was 38±16 years. The soft tissue cover was achieved within 72 h. The overall rate of infection was 14.6% (6/41). Sex and the Mangled Extremity Severity Score were associated with infection. The median union time of 40 patients (one amputation) was 32 weeks. The overall rate of infection exhibited a lower tendency in this study. These results indicated that the single-stage radical orthoplastic treatment was an effective and reliable option for reconstructing severe open fractures.

scholarly journals Clinical Study of the Lateral Supramalleolar Flap in the Soft Tissue Reconstruction around the Ankle Region

2020 ◽  
Vol 53 (01) ◽  
pp. 083-089 ◽  
Author(s):  
G. I. Nambi ◽  
T. K. Arudra Varanambigai
Keyword(s):  
Clinical Study ◽  
Soft Tissue ◽  
Soft Tissue Reconstruction ◽  
Soft Tissue Defects ◽  
Split Skin Graft ◽  
Tissue Reconstruction ◽  
Split Skin ◽  
Tissue Defects ◽  
Ankle And Foot

Abstract Objective The purpose of this study is to present the efficiency of the lateral supramalleolar flap which is a very useful and yet underutilized in the soft tissue reconstruction of the regions extending from the distal leg, ankle, and foot. Methods Over a period of 3 years, 20 flaps were used in the reconstruction of soft tissue defects in the region extending from the distal leg, ankle, and foot. The location of the defects, the etiology, possible alternative flaps, outcome, and the complications were studied and presented. Results The follow-up period of the cases was from 1 month to 18 months after surgery. Seventeen flaps survived and three were lost. All the three lost flaps were those used over the tendocalcaneal region. The lost flaps were later replaced with split skin graft after the wound was debrided and was later covered with granulation tissue. Conclusion The lateral supramalleolar flap is a very useful flap in the regional soft tissue reconstruction around the ankle except in the tendocalcaneal region.

scholarly journals Abdominal, perineal, and genital soft tissue reconstruction with pedicled anterolateral thigh perforator flaps

2021 ◽  
Author(s):  
Stephan Alois Steiner ◽  
Riccardo Schweizer ◽  
Holger Klein ◽  
Matthias Waldner ◽  
Pietro Giovanoli ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Donor Site ◽  
Soft Tissue Reconstruction ◽  
Soft Tissue Defects ◽  
Perforator Flaps ◽  
Anterolateral Thigh ◽  
Tissue Reconstruction ◽  
Alt Flap ◽  
Tissue Defects

Abstract Background Pedicled perforator flaps have become a contemporary alternative to muscle flaps for soft tissue reconstruction as they have reduced donor site morbidity, avoid the need for microsurgical transfer, and are versatile and reliable. The anterolateral thigh (ALT) flap was first introduced as a free flap and has since gained popularity as a pedicled flap. Here we review our experience using pedicled ALT flaps for regional soft tissue reconstruction. Methods We retrospectively reviewed all patients who underwent loco-regional soft tissue reconstruction using pedicled ALT flaps between March 2014 and October 2018, with the goal of identifying potential applications of pedicled ALT flaps. The following aspects of each case were reviewed: patient demographics, defect location and size, comorbidities such as previous radiotherapy, flap details, clinical follow-up, and postoperative complications. Results Our analysis demonstrates the versatility of pedicled ALT flaps in a variety of indications to successfully cover large abdominal, perineal, and genital soft tissue defects. Depending on the patient’s needs to achieve more bulk or stability in the reconstruction, the ALT flap was individually tailored with underlying muscle or fascia. The average follow-up was 7 months (range: 3–13 months). Conclusions Pedicled ALT flaps are a valuable reconstructive option for soft tissue defects located within the pedicle’s range, from the lower abdomen to the perianal region. These flaps are usually raised from a non-irradiated donor site and are sufficient for covering extensive soft tissue defects. Three-dimensional reconstruction of the defect using pedicled ALT flaps allows for anatomical function and minor donor sites. Level of evidence: Level IV, therapeutic study.

Autologous Fat Transfer and Cell-Based Strategies for Soft Tissue Reconstruction

2014 ◽  
Vol 3 (1) ◽  
pp. 62-69
Author(s):  
Kshemendra Senarath-Yapa ◽  
Rebecca Garza ◽  
Adrian McArdle ◽  
Graham Walmsley ◽  
Michael Hu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Reconstruction ◽  
Fat Transfer ◽  
Autologous Fat ◽  
Autologous Fat Transfer ◽  
Tissue Reconstruction
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