scholarly journals Treatment of children with skin and soft tissue defects of distal phalanges of the fingers

2020 ◽  
Vol 10 (3) ◽  
pp. 293-298
Author(s):  
Sergey N. Berezutskii ◽  
Alexey G. Pinigin
Keyword(s):  
Blood Flow ◽  
Soft Tissue ◽  
Skin Grafting ◽  
Point Of View ◽  
Island Flap ◽  
Soft Tissue Defects ◽  
Number Of Children ◽  
Neurovascular Pedicle ◽  
The Right ◽  
Tissue Defects

Introduction. This article discusses the relevance of performing organ-preserving operations for traumatic skin and soft tissue defects in children. The author analyzes the traditional types of skin grafting procedures and their application in children. From the authors' point of view, the most acceptable skin grafting method is a displaced island flap on a neurovascular pedicle with direct blood flow. Materials and methods. The operating technique of lifting a displaced island flap on a neurovascular pedicle with direct blood flow is shown. The features of its implementation, the number of children, and their distribution by groups are shown. From 2016 to 2019, 15 children with traumatic defects of the distal phalanges of the fingers were operated on in the microsurgical Department of the Khabarovsk KKB No. 2 using a displaced neurovascular island flap on the leg with direct blood flow. The children ranged in age from four to 14 years. The number of children and the frequency of damage to the right and left hands was approximately the same. Results. Positive results of using this technique in the Department of Microsurgery of KKB No. 2 are presented. In all cases, it was possible to close the existing defects with the primary closure of the donor defect simultaneously; Sensitivity was preserved in all operated children, and movements in the finger joints were almost complete. Discussion. This flap method has undeniable advantages, although it is quite time-consuming and requires microsurgical skills, techniques, and appropriate equipment. The proposed skin grafting results are encouraging and satisfying for both doctors and children with parents. Conclusions. The authors recommend this skin grafting method for traumatic defects of the distal phalanges of the fingers in children.

scholarly journals Hypothenar island flap: A safe and excellent choice for little finger defects

2015 ◽  
Vol 48 (03) ◽  
pp. 288-292 ◽  
Author(s):  
Mehmet Tapan ◽  
Murat Iğde ◽  
Ali Rıza Yıldırım ◽  
Yağmur Yaprak Balı ◽  
Sedat Yılancı ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Clinical Results ◽  
Island Flap ◽  
Vascular Pedicle ◽  
Soft Tissue Defects ◽  
Texture Match ◽  
Tissue Defects ◽  
Little Finger ◽  
Clinical Cases

ABSTRACTSoft-tissue defects of the little finger are challenging especially when bone, tendon or vascular pedicle is exposed because of trauma. The hypothenar island flap is easy to harvest and has a good colour and texture match to the little finger pulp. We present nine clinical cases of soft tissue defects of the little finger covered using the reversed hypothenar fasciocutaneous island flap. This article intends to highlight the ease of elevation and good clinical results of the hypothenar flap which is rarely used.

Reconstruction of soft tissue defects around the knee with the use of the lateral sural fasciocutaneous artery island flap

1999 ◽  
Vol 22 (1) ◽  
pp. 12-16 ◽  
Author(s):  
N. Rajacic ◽  
R. K. Gang ◽  
M. Darweesh ◽  
N. Abdul Fetah ◽  
S. Kojic
Keyword(s):  
Soft Tissue ◽  
Island Flap ◽  
Soft Tissue Defects ◽  
Tissue Defects

Free and island flap transfer for soft tissue defects in the hand and forearm

Microsurgery ◽  
1996 ◽  
Vol 17 (3) ◽  
pp. 150-154 ◽  
Author(s):  
Hiroshi Yajima ◽  
Susumu Tamai ◽  
Akihiro Fukui ◽  
Hiroshi Ono ◽  
Yuji Inada
Keyword(s):  
Soft Tissue ◽  
Island Flap ◽  
Soft Tissue Defects ◽  
Flap Transfer ◽  
Tissue Defects

scholarly journals MANAGEMENT OF ACQUIRED SOFT TISSUE DEFECTS OF GROIN AND GENITALIA

2020 ◽  
pp. 1-4
Author(s):  
Ratnakar Sharma ◽  
Mir Adnan Samad ◽  
Kumar Sourav Dogra ◽  
Shaarang Gupta
Keyword(s):  
Soft Tissue ◽  
Road Traffic ◽  
Past History ◽  
Skin Grafting ◽  
Soft Tissue Defects ◽  
Detailed History ◽  
Flap Coverage ◽  
Split Thickness Skin Grafting ◽  
History Of ◽  
Tissue Defects

Background: The defects of the groin and the genitalia are complex and pose a challenge to the reconstructive surgeon. These defects may arise out of a variety of insults which include – extirpative oncologic surgeries, necrotizing fasciitis, post burn defects, post traumatic defects including road traffic accidents and animal bites etc. Objectives: To study the epidemiology of the acquired soft tissue defects of the groin and genitalia. To evaluate the role of various reconstructive modalities for the acquired soft tissue defects of groin and genitalia. Materials & Methods: This study was conducted in the Department of Surgery, Govt. Medical College Jammu, J&K, India and included 25 patients admitted with acquired soft-tissue defects of groin and genitalia over a period extending from November 2018 to October 2019 (Prospective study). Personal and demographic data of the patient was noted. A detailed history regarding the cause of the defect along with history of trauma, discharge and bleed from the site was taken. Any past history of surgery and irradiation of the region was noted. The patients having soft tissue defects of the groin and genitalia secondary to the release of post burn contracture were subjected to the detailed history as regards cause of burn, treatment taken and time taken for burn wounds to heal. Examination included general physical examination along with the local wound condition which included site, size, discharge, slough, granulation tissue and any exposed vital structures such as vessels/ nerves. A hemogram, assessment of blood sugar, renal function (blood urea nitrogen and serum creatinine), coagulation profile, blood grouping, viral markers, chest x-ray and ECG were done as a part of routine pre-operative investigations. Wound swab was sent for culture. Biopsy was taken wherever required. Analysis of report of any previously taken biopsy was done. Split thickness skin grafting was the modality of coverage utilized in 56% cases followed by flap coverage in 32% cases. 12% of the defects were closed primarily. Results: Majority of the patients had durable coverage of the defects of groin/genitalia and the coverage modality was acceptable to the patient as regards aesthesis and functional outcome. No major complication was encountered in any of the patients. Conclusion: The reconstruction of the soft tissue defects of groin and genitalia need a meticulous examination and planning of reconstructive modality which may include skin grafting or a flap coverage.

Reconstruction of Distal Phalangeal Soft Tissue Defects with Reverse Homodigital Artery Island Flap

2014 ◽  
Vol 23 (2) ◽  
pp. 65-69
Author(s):  
Byung-Gook Kim ◽  
Soo-Hong Han ◽  
Ho-Jae Lee ◽  
Soo-Hyun Lee
Keyword(s):  
Soft Tissue ◽  
Island Flap ◽  
Soft Tissue Defects ◽  
Tissue Defects

Extracellular matrix graft for reconstruction over exposed structures: a pilot case series

2020 ◽  
Vol 29 (12) ◽  
pp. 742-749
Author(s):  
Gregory A Bohn ◽  
Abigail E Chaffin
Keyword(s):  
Extracellular Matrix ◽  
Soft Tissue ◽  
Skin Graft ◽  
Granulation Tissue ◽  
Case Series ◽  
Skin Grafting ◽  
Soft Tissue Defects ◽  
Dermal Matrix ◽  
Dermal Matrices ◽  
Tissue Defects

Objective: Soft tissue defects, especially those involving exposed vital structures, present a reconstructive challenge because poor vascularity of such defects typically makes immediate skin grafting unviable. Where flap procedures are inappropriate or not possible, dermal matrices represent an alternative reconstructive option for defects with denuded vital structures. With dermal matrices becoming increasingly available and technologically advanced, we evaluated an ovine-derived extracellular matrix graft in the reconstruction of complex soft tissue defects involving exposed vital structures. Method: Six cases of soft tissue defects exhibiting denuded vital structures underwent reconstruction using an ovine forestomach matrix graft as a dermal matrix. Grafts were fixed directly into defects for immediate coverage and subsequently temporised defects via granulation tissue formation for later skin graft or secondary closure. Defect granulation and epithelialisation were monitored until closure and the final aesthetic and functional outcomes were evaluated. Results: Complete healing was achieved in all cases, with defect granulation becoming observable within one to two weeks and complete granulation occurring within one to six weeks. Granulation tissue resulting from the graft was suitable for skin grafting, with 100% take of skin grafts after one week and complete re-epithelialisation in two to three weeks in the four cases that received a skin graft. Good cosmetic, functional and patient satisfaction outcomes were achieved in all cases. Conclusion: The present series demonstrates our initial use of an extracellular matrix-based dermal matrix in reconstructing defects with exposed vital structures. While such dermal matrices do not supersede or replace flap procedures, they represent an alternative option on the reconstructive ladder in cases where flap procedures are not appropriate or possible.

Reverse-Flow Intrinsic Fasciocutaneous Island Flaps in Foot Reconstruction

2017 ◽  
Vol 16 (4) ◽  
pp. 296-301
Author(s):  
Sujin Bahk ◽  
GyeongHyeon Doh ◽  
Ki Yong Hong ◽  
SooA Lim ◽  
SuRak Eo
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Reverse Flow ◽  
Donor Site ◽  
Skin Grafting ◽  
Soft Tissue Defects ◽  
Satisfactory Outcome ◽  
Split Thickness Skin Grafting ◽  
Foot Reconstruction ◽  
Tissue Defects

Reconstruction of soft tissue defects in the foot remains a challenge due to its specialized tissue for weightbearing and ambulation. Considering the principle of replacing “like with like,” adjacent soft tissues would be a best option for a donor site. Although several kinds of reverse-flow island flaps for the lower leg have been well described, intrinsic foot reverse flow flaps have been rarely reported. We describe 3 kinds of reverse-flow intrinsic fasciocutaneous flaps (RIFFs) for foot reconstruction. From September 2012 to August 2015, a retrospective study was done on case notes of all patients who had a RIFF for coverage of soft tissue defects within the foot following trauma or tumor ablation. A total of 7 patients were included in this study, with an average of 5 × 3.5 cm sized defects in the forefoot, second and third web space, and sole, which were reconstructed with RIFF. All flaps were well perfused and recovered excellent function of the foot with satisfactory aesthetics and minimal limitations in range of motion. However, one case showed a complication of venous congestion, due to remnant scar tissues, which resolved after medical leech application. Donor defects healed completely with split thickness skin grafting in all cases. Soft tissue defects within the foot were repaired successfully by RIFF. In spite of its technical challenges, it is a reliable one-stage procedure requiring no microsurgical anastomosis. Precise vascular evaluation of the reverse inflow has to be preceded for satisfactory outcome of RIFF.

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