Soft tissue reconstruction and salvage of infected fixation hardware in lower extremity trauma

Microsurgery ◽  
2017 ◽  
Vol 38 (3) ◽  
pp. 259-263 ◽  
Author(s):  
Hyuma A. Leland ◽  
Alexis D. Rounds ◽  
Karen E. Burtt ◽  
Daniel J. Gould ◽  
Geoffrey S. Marecek ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Lower Extremity ◽  
Soft Tissue Reconstruction ◽  
Lower Extremity Trauma ◽  
Extremity Trauma ◽  
Tissue Reconstruction

Soft-Tissue Reconstruction in Severe Lower Extremity Trauma

1989 ◽  
Vol &NA; (243) ◽  
pp. 57???64
Author(s):  
PAUL W. GORMAN ◽  
C. LOWRY BARNES ◽  
THOMAS J. FISCHER ◽  
MARK P. MCANDREW ◽  
MICHAEL M. MOORE
Keyword(s):  
Soft Tissue ◽  
Lower Extremity ◽  
Soft Tissue Reconstruction ◽  
Lower Extremity Trauma ◽  
Extremity Trauma ◽  
Tissue Reconstruction

A review of propeller flaps for distal lower extremity soft tissue reconstruction: Is flap loss too high?

Microsurgery ◽  
2013 ◽  
Vol 33 (7) ◽  
pp. 578-586 ◽  
Author(s):  
Jonas A. Nelson ◽  
John P. Fischer ◽  
Philip S. Brazio ◽  
Stephen J. Kovach ◽  
Gedge D. Rosson ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Lower Extremity ◽  
Soft Tissue Reconstruction ◽  
Flap Loss ◽  
Tissue Reconstruction

Outcomes of Soft Tissue Reconstruction for Traumatic Lower Extremity Fractures with Compromised Vascularity

2017 ◽  
Vol 83 (10) ◽  
pp. 1161-1165 ◽  
Author(s):  
Ido Badash ◽  
Karen E. Burtt ◽  
Hyuma A. Leland ◽  
Daniel J. Gould ◽  
Alexis D. Rounds ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Lower Extremity ◽  
Limb Salvage ◽  
Arterial Injury ◽  
Soft Tissue Reconstruction ◽  
Complication Rates ◽  
Arterial Injuries ◽  
Flap Failure ◽  
Vascular Compromise ◽  
Tissue Reconstruction

Traumatic lower extremity fractures with compromised arterial flow are limb-threatening injuries. A retrospective review of 158 lower extremities with traumatic fractures, including 26 extremities with arterial injuries, was performed to determine the effects of vascular compromise on flap survival, successful limb salvage and complication rates. Patients with arterial injuries had a larger average flap surface area (255.1 vs 144.6 cm2, P = 0.02) and a greater number of operations (4.7 vs 3.8, P = 0.01) than patients without vascular compromise. Patients presenting with vascular injury were also more likely to require fasciotomy [odds ratio (OR): 6.5, confidence interval (CI): 2.3–18.2] and to have a nerve deficit (OR: 16.6, CI: 3.9–70.0), fracture of the distal third of the leg (OR: 2.9, CI: 1.15–7.1) and intracranial hemorrhage (OR: 3.84, CI: 1.1–12.9). After soft tissue reconstruction, patients with arterial injuries had a higher rate of amputation (OR: 8.5, CI: 1.3–53.6) and flap failure requiring a return to the operating room (OR: 4.5, CI: 1.5–13.2). Arterial injury did not correlate with infection or overall complication rate. In conclusion, arterial injuries resulted in significant complications for patients with lower extremity fractures requiring flap coverage, although limb salvage was still effective in most cases.

scholarly journals A retrospective analysis of latissimus dorsi–serratus anterior chimeric flap reconstruction in 47 patients with extensive lower extremity trauma

2018 ◽  
Vol 51 (01) ◽  
pp. 024-032
Author(s):  
Ravi Kumar Mahajan ◽  
Krishnan Srinivasan ◽  
Abhiskek Bhamre ◽  
Mahipal Singh ◽  
Prakash Kumar ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Lower Limb ◽  
Latissimus Dorsi ◽  
Defect Size ◽  
Soft Tissue Reconstruction ◽  
Serratus Anterior ◽  
Advantages And Disadvantages ◽  
Lower Extremity Trauma ◽  
Extremity Trauma ◽  
Free Flap Transfer

ABSTRACT Background: Many flaps have been described for reconstruction of lower extremity defects, including, Latissimus Dorsi, Rectus abdominis, Anterolateral thigh perforator flaps, each having advantages and disadvantages. The defect location, size and specific geometric pattern of defect influences the type of flap that can be used. In this case series, we describe the specific situations where the use of chimeric latissimus dorsi–serratus anterior (LD + SA) free flaps are of advantage in providing complete wound cover. Materials and Methods: Case records of all patients who underwent LD + SA free flap transfer for lower extremity trauma at Amandeep Hospital, from Feb 2006 to Feb 2017 were reviewed. Patients were categorised based on the anatomical location and size of defect. The method of usage of the chimeric segments, recipient vessels and type of anastomosis were noted. Flap complications, if any were reviewed. Result: 47 patients with lower limb defects were included in the study. All cases were post traumatic in nature. Defect size ranged from 180 sq cm to 1050 sq cm. Average defect size was 487.70 sq cm. All patients underwent soft tissue reconstruction with LD + SA flap. Complete wound cover was obtained. Conclusion: Latissimus dorsi + Serratus anterior free tissue transfer is an effective, reliable method of providing cover to extensive lower limb traumatic defects with minimal donor site morbidity, with added freedom of inset and flap positioning. Specific use is seen in patients with broad proximal defect, long defect in the leg, defects involving adjacent anatomical areas and in large defect with dead space.

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