An alternative approach for soft-tissue coverage of a complex wound in the foot and ankle with vacuum-assisted closure over artificial dermis and subsequent skin graft

2009 ◽  
Vol 62 (12) ◽  
pp. e682-e684 ◽  
Author(s):  
Lee L.Q. Pu
Keyword(s):  
Soft Tissue ◽  
Skin Graft ◽  
Soft Tissue Coverage ◽  
Foot And Ankle ◽  
Vacuum Assisted Closure ◽  
Artificial Dermis ◽  
Alternative Approach ◽  
Complex Wound

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. 

736 Autologous Skin Cell Suspension in Combination with Meshed Autograft: A Case Report Demonstrating the Efficacy in NSTI

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S200-S200
Author(s):  
Nicole M Kopari
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Cell Suspension ◽  
Skin Graft ◽  
Donor Site ◽  
Soft Tissue Coverage ◽  
Abdominal Wound ◽  
Skin Cell ◽  
Complex Wounds ◽  
Epidermal Graft

Abstract Introduction Necrotizing soft tissue infections (NSTIs) are some of the more difficult disease processes encountered by physicians. Most patients require multiple surgical debridements, and survivors often have complex wounds requiring soft tissue coverage and prolonged hospitalizations. The goal of this report is to describe the use of autologous skin cell suspension over widely meshed skin graft in a patient with large wound secondary to a NSTI. Methods A retrospective chart review was performed of a patient with NSTI of the abdomen.The patient received autologous skin cell suspension as an epidermal graft in combination with widely meshed skin grafting. Results A 41 year-old female had an abdominal wound infection resulting in a NSTI. The patients had poorly controlled diabetes, congestive heart failure, and coronary heart disease with a drug eluting stent on dual antiplatelet therapy. She presented septic to an outside facility where she underwent multiple abdominal wound debridements. She was transferred to our institution with concerns for ongoing infection. Upon arrival, the wounds appeared stable with granulation tissue present over the wound bed with small areas of necrotic fat. She underwent debridement and autologous skin cell suspension in combination with a widely (3:1) meshed skin graft. The donor site also received treatment with the cell suspension. The wounds were covered with a non-adherent dressing along with bismuth-impregnated, petroleum-based gauze. Additional padding was secured with sutures to prevent post-operative shearing. On post-operative day (POD) 2 the outer dressings were changed with excellent adherence of the graft. On POD 4 her dressings were taken down completely, staples were removed, and she was transitioned to daily topical antimicrobial ointment and a non-adherent dress to her torso. She had >95% closure on POD 7 on both her graft and donor site. Conclusions Similar to severe burn injuries, the magnitude and scope of NSTI necessitates radical debridement often creating challenges in wound care, preservation of function, and cosmesis. Autologous skin cell suspension in combination with widely meshed skin grafts appear to be well-suited for treatment of large wounds resulting from NSTI. Treatment of this patient demonstrated decreased healing times, decreased donor sites, and an acceptable cosmetic outcome. Applicability of Research to Practice Autologous skin cell suspension has been approved for the use in partial and full thickness burn either as an epidermal graft alone or in combination with widely meshed grafts. This case report represents an example of its use in large complex wounds secondary to NSTI with acceptable outcomes.

scholarly journals SHORT AND LONG TERM FOLLOW UP RESULTS OF (THE VERSATILE) GASTROCNEMIUS MUSCLE FLAP

2021 ◽  
Vol 71 (Suppl-1) ◽  
pp. S62-65
Author(s):  
Ghazanfar Ali ◽  
Shahid Hameed ◽  
Abdul Majid ◽  
Rao Saud Ahmad ◽  
Ahsan Masood Butt ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Wound Infection ◽  
Skin Graft ◽  
Gastrocnemius Muscle ◽  
Muscle Flap ◽  
Soft Tissue Coverage ◽  
Partial Loss ◽  
Number Of Patients ◽  
Late Morbidity

Objective: To see the long and short term outcome of the Gastrocnemius muscle flap for coverage of soft tissue defects of knee and proximal Tibia. Study Design: Case series. Place and Duration of Study: Surgery Department of Combined Military Hospital Bahawalpur, from Dec 2014 to Oct 2017. Methodology: A total of 33 patients were enrolled for the study through consecutive sampling. Data was processed using SPSS-17. All patients were followed up at first and second week (early morbidity), and then at 06 months (late morbidity) from operation. During early follow up, they were examined for Hematoma at donor site, wound Infection, sural nerve injury, partial skin graft loss and Partial Flap Necrosis. In late follow up patients were examined for reduced Knee mobility and Gastrocnemius muscle contractions. Results: The studied 33 patients consisted of 30 (90.90%) men and 3 (9.09%) women. The mean age was 35 years (range: 16 to 64) years. Hematoma was commonest complication. It occurred in 6.06%. Wound infection, partial loss of flap, partial loss of skin graft and wound infection occurred in 3.03% patients. Late follow up revealed reduced knee mobility in 9.09% patients (n=3) and bothersome contraction of gastrocnemius muscle in same number of patients. Conclusion: The gastrocnemius flap is reliable, versatile, and very useful for provision of supple soft tissue coverage for defects around the knee and the upper leg.

Reconstruction of Deep Burn Wounds Around the Ankle With Free Fascia Flaps Transfer and Split-Thickness Skin Graft

2019 ◽  
Vol 40 (6) ◽  
pp. 763-768
Author(s):  
Xuekang Yang ◽  
Zhuoqun Fang ◽  
Mengdong Liu ◽  
Yue Zhang ◽  
Qiaohua Chen ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Skin Graft ◽  
Burn Injury ◽  
Split Thickness Skin Graft ◽  
Soft Tissue Coverage ◽  
Burn Wounds ◽  
Temporal Fascia ◽  
Thickness Skin ◽  
Anterolateral Thigh ◽  
Dressing Change

Abstract We aimed to introduce a technique by combining free fascia flaps transfer with split-thickness skin graft for the reconstruction of deep burn wounds at the ankle. Fifteen patients from 2009 to 2016 were enrolled in this study. Patients in this series suffered from a deep burn injury around the ankle, which was accompanied with exposure of tendon and medial or lateral malleolus exposure due to severe soft-tissue defects (N = 15). All the 15 wounds were repaired combining free fascia flaps with split-thickness skin graft operations, including nine anterolateral thigh fascia lata flaps (ATFL flaps) and six superficial temporal fascia flaps (STF flaps). All the fascia flaps completely survived. Two patients showed partial grafting skin necrosis due to either wound infection or subcutaneous hematoma infection, and this was eventually healed satisfactorily after conventional dressing change. All patients achieved esthetic outcome and acceptable functionality without further revisions needed. Our present study reports a useful method that involves using free fascia flaps in combination with split-thickness skin graft to repair deep burn wounds around the ankle. This method provided reliable and durable soft-tissue coverage with good outcomes.

Sign in / Sign up

Export Citation Format

Share Document