Spontaneous Bilateral Ankle and Midfoot Sepsis in a Nonimmunocompromised Patient

2006 ◽  
Vol 96 (2) ◽  
pp. 139-147
Author(s):  
Thomas S. Roukis ◽  
Jeffrey R. Baker ◽  
Breck Tiernan
Keyword(s):  
Soft Tissue ◽  
Bone Growth ◽  
Platelet Rich Plasma ◽  
Growth Stimulation ◽  
Lower Leg ◽  
Split Thickness Skin Graft ◽  
Allogeneic Bone ◽  
Thickness Skin ◽  
Autologous Platelet Rich Plasma ◽  
The Right

We describe a 70-year-old nonimmunocompromised woman with spontaneous bilateral ankle and midfoot sepsis and a deep-space abscess of the right lower leg. Salvage of both limbs was achieved by aggressive bilateral soft-tissue and osseous debridement, including a four-compartment fasciotomy of the right lower leg, antibiotic-loaded polymethyl methacrylate bone cement implantation, delayed allogeneic bone grafting of the osseous defects impregnated with autologous platelet-rich plasma bilaterally, and external fixation immobilization, implantable bone growth stimulation, and split-thickness skin graft coverage of the right lower leg, ankle, and foot. Osseous incorporation of the bone grafts bilaterally occurred 8 weeks after surgery. No soft-tissue or osseous complications occurred during the postoperative period or at 18-month follow-up except for arthrofibrosis in the right ankle; there was no evidence of recurrent abscesses, sequestrum, or wound-related problems. A review of the literature regarding bilateral pedal sepsis and the techniques used for limb salvage in this patient are presented in detail. (J Am Podiatr Med Assoc 96(2): 139–147, 2006)

scholarly journals Efficacy of autologous platelet rich plasma over conventional mechanical fixation methods in split thickness skin grafting

2018 ◽  
Vol 6 (1) ◽  
pp. 108 ◽  
Author(s):  
Girish Umashankar Thimmanahalli ◽  
Mahesh Kumar
Keyword(s):  
Skin Graft ◽  
Platelet Rich Plasma ◽  
Healing Process ◽  
Split Thickness Skin Graft ◽  
Skin Defect ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Autologous Platelet Rich Plasma ◽  
Graft Reconstruction ◽  
Autologous Platelet

Background: Platelet-Rich Plasma (PRP) is an autologous product derived from whole blood through the process of gradient density centrifugation. After skin graft reconstruction, the healing process is longer and may be difficult, depending on the wound site, skin defect size, and patient comorbidities. The potential value of PRP lies in its ability to incorporate high concentrations of platelet-derived growth factors into the skin graft. Since not all patients afford commercially available recombinant platelet rich plasma for skin graft, platelet extract from patient’s own blood is being used in this study to test and demonstrate the therapeutic role of PRP in skin graft. The aim of this randomized, prospective study is to compare the effectiveness of PRP in skin graft with conventional method like sutures, staplers or glue.Methods: The source of data were the patients admitted as inpatients for the management of wounds to the department of general surgery, JSS Hospital, Mysore from September 2016 to September 2018. Total of 60 patients were studied; 30 cases were randomly chosen for study with autologous platelet rich plasma and 30 cases received conventional methods like staples/sutures used to anchor the skin grafts in a control group.Results: Autologous PRP showed faster and better healing rates. With PRP study group instant graft adherence was seen in all cases. Hematoma, graft edema, discharge from graft site, frequency of dressings and duration of stay in hospital were significantly less in the PRP. There were no adverse effects or reactions seen with the use of autologous PRP among the study group.Conclusions: The combination of PRP with Split Thickness Skin Graft (STSG) significantly improved clinical outcomes and shortened the wound healing time. Therefore, this treatment combination could provide a way to heal skin after skin graft reconstruction with minimal recovery time. It is found to be highly beneficial in many aspects both to the patient and surgeon based on our results.

scholarly journals An analysis of post traumatic leg and foot defects

2019 ◽  
Vol 6 (6) ◽  
pp. 2041
Author(s):  
Gopalan G. ◽  
Dhanaraju S.
Keyword(s):  
Soft Tissue ◽  
Skin Graft ◽  
Traffic Accidents ◽  
Lower Limbs ◽  
Split Thickness Skin Graft ◽  
Soft Tissue Coverage ◽  
Durable Good ◽  
Skin Defect ◽  
Early Recovery ◽  
Thickness Skin

Background: Management of lower extremity trauma with bone and soft tissue injury is a challenging task with the aim of giving early recovery and durable good quality skin cover according to the skin defect and analyze various reconstructive options at various levels of injury. Our aim of the study is to analyze various reconstructive options for traumatic skin loss involving lower limbs especially knee and below knee, and analyze the incidence of age, sex and etiology of traumatic defects.Methods: Prospective study in our plastic surgery department in the period of 24 months, with all the cases of traumatic defects of leg and foot where included. All age and sex patients were included.Results: Most common cause for traumatic leg and foot defects are road traffic accidents followed by accidental fall and others, most commonly in males amounting 73%, children 10% and  females 17%, among the skin and soft tissue  defects upper and lower 1/3 leg defects are predominant. Among the soft tissue coverage split thickness skin graft dominating about 60% of cases, flaps 30% of cases, among the flaps 70% are fasciocutaneous flaps predominantly inferiorly based  and 30% are muscle and musculocutaneous flaps, among the muscle predominantly soleus muscle flap was used to cover the defect.Conclusions:Road traffic accidents dominating the cause for leg and foot defects , males are more commonly affected  and upper one third leg defects are predominant for soft tissue coverage split thickness skin graft are commonest procedures followed that cutaneous and muscle flaps. 

Limb Salvage in Recurrent Synovial Sarcoma of the Right Ankle and Lower Leg

2002 ◽  
Vol 92 (2) ◽  
pp. 90-96 ◽  
Author(s):  
Ellen Sobel ◽  
Renato Giorgini ◽  
Ruben Oropeza ◽  
Kalyani Bapat ◽  
Hugh Richardson
Keyword(s):  
Soft Tissue ◽  
Synovial Sarcoma ◽  
Limb Salvage ◽  
Soft Tissue Sarcomas ◽  
Lower Leg ◽  
Wide Excision ◽  
Lateral Aspect ◽  
Distal Lower Leg ◽  
The Right

Synovial sarcoma of the extremities represents 7% of all soft-tissue sarcomas. This article presents the case of a patient who was treated for a synovial sarcoma of the lateral aspect of the distal lower leg extending to the ankle and involving the fibular bone. The patient underwent a wide excision of the tumor, including the fibular bone, followed by radiation and chemotherapy, rather than undergo an amputation of the right leg. Consideration is also given to the traumatic etiology of the tumor. (J Am Podiatr Med Assoc 92(2): 90-96, 2002)

scholarly journals Comparative study between fibrin glue and platelet rich plasma in dogs skin grafts

2012 ◽  
Vol 27 (11) ◽  
pp. 789-794 ◽  
Author(s):  
Larissa Correa Hermeto ◽  
Rafael de Rossi ◽  
Santiago Benites de Pádua ◽  
Elenir Rose Jardim Pontes ◽  
Aureo Evangelista Santana
Keyword(s):  
Fibrin Glue ◽  
Platelet Rich Plasma ◽  
Control Group ◽  
Skin Grafts ◽  
Full Thickness ◽  
Clinical Evaluations ◽  
Thickness Skin ◽  
Left Limb ◽  
The Right ◽  
Mesh Skin Graft

PURPOSE: Compare fibrin glue (Tissucol®) and platelet-rich plasma in full-thickness mesh skin grafts in dogs. METHODS: Eighteen dogs were used, divided into two groups: fibrin glue (FG) and platelet-rich plasma (PRP). In all the animals, a full-thickness 3x3 cm mesh skin graft was implanted. In the left limb, the biomaterial was place between the graft and the receptor bed, according to the group, while the right limb served as the control group. All the animals were evaluated clinically every 48 hours until the 14th day, using the variables of exudation, coloration, edema and cosmetic appearance. Three animals were evaluated histologically, on the third, seventh and tenth postoperative days, using the variables of fibroblasts, collagen, granulation tissue, microscopic integration-adherence and acute inflammation. RESULTS: Clinical evaluations showed that the group CF showed better scores for all variables compared to PRP group. On the histological evaluations PRP group had a higher presence of fibroblasts in the seventh and fourteenth days. CONCLUSION: The fibrin glue group was clinically superior to the platelet-rich group when used on full-thickness skin grafts in dogs.

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