Dataset Information

Multistep reconstruction of a post-traumatic defect in the lower limb with AV loop and free myocutaneous latissimus dorsi flap combined with a perforator monitor skin island after loss of ALT flap.

ABSTRACT: Crush injuries of the lower extremity with extensive osseous and soft tissue damage impose a big challenge even for an interdisciplinary reconstructive approach. Multistep reconstruction with negative wound pressure therapy for soft tissue management and external fixation for osseous stability preceding free flap transfer leads to optimized outcome. We report the successful multistep reconstruction of a third-degree open right tibial fracture with extensive soft tissue defect with an arteriovenous loop preceding latissimus dorsi flap coverage with a perforator skin island after loss of an anterior lateral thigh (ALT) flap due to intima damage of the recipient vessels. The described method is a safe reconstructive concept after primary flap loss with persistent extensive tissue damage.

SUBMITTER: Summer T

PROVIDER: S-EPMC8204669 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Publications

Multistep reconstruction of a post-traumatic defect in the lower limb with AV loop and free myocutaneous latissimus dorsi flap combined with a perforator monitor skin island after loss of ALT flap.

Summer Tobias T Abou Mrad Mazen M Bota Olimpiu O Bienger Kevin K Dragu Adrian A

GMS Interdisciplinary plastic and reconstructive surgery DGPW 20210609

Crush injuries of the lower extremity with extensive osseous and soft tissue damage impose a big challenge even for an interdisciplinary reconstructive approach. Multistep reconstruction with negative wound pressure therapy for soft tissue management and external fixation for osseous stability preceding free flap transfer leads to optimized outcome. We report the successful multistep reconstruction of a third-degree open right tibial fracture with extensive soft tissue defect with an arterioveno ...[more]

PMID: 34194916

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Project description:BackgroundBreast reconstruction using the latissimus dorsi (LD) flap is one of the most popular and common breast reconstruction techniques among Asian patients. There are increasing numbers of cases wherein breasts need to be reconstructed to moderate to large sizes among the Asian population. Most reconstructive surgeons use abdominal-based flaps-such as the deep inferior epigastric perforator and transverse rectus abdominis myocutaneous flap, or LD flap with an implant-to supplement the volume. Here, we compare the usefulness of the boomerang LD (bLD) flap-a technique developed by modifying the design of the conventional extended LD flap-with that of the LD flap with implant (LDi).MethodsThis was a prospective cohort study including patients with breast cancer aged between 25 and 60 years who underwent unilateral total or skin/nipple-sparing mastectomy, or postmastectomy. The exclusion criteria were advanced breast cancer (stages 3 and 4); a history of cognitive impairment affecting ability to complete the self-reported questionnaire; a history of neurologic or musculoskeletal disorder; and a history of alcohol or drug abuse. Statistical analysis was performed, and correlations between the two technique types were analyzed [including age, body mass index, preoperative breast volume, operation time, flap elevation time, admission duration, adjuvant treatment (radiotherapy, chemotherapy), drain indwelling duration, and drain total sum volume].ResultsIn total, 85 patients who underwent immediate breast construction through the LDi group (n=63) or bLD group (n=25) techniques after total mastectomy between January 2015 and June 2022 were analyzed (mean age: LDi group, 46±7.7 years; bLD group, 45.6±7.8 years). We observed that the flap weight, operative time, mean admission duration, and drain indwelling duration were statistically significantly different in the bLD group (P<0.05). Body mass index, preoperative breast volume, specimen weight, flap elevation time, and drain total time were comparable between groups.ConclusionsBreast reconstruction using the bLD flap was found to be a suitable alternative technique for patients who desire an autologous tissue transfer (rather than an implant) but are contraindicated for abdominal-based flaps and do not mind long postoperative scars.

Dataset Information

Multistep reconstruction of a post-traumatic defect in the lower limb with AV loop and free myocutaneous latissimus dorsi flap combined with a perforator monitor skin island after loss of ALT flap.

Publications

Multistep reconstruction of a post-traumatic defect in the lower limb with AV loop and free myocutaneous latissimus dorsi flap combined with a perforator monitor skin island after loss of ALT flap.

Similar Datasets

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