دورية أكاديمية
One-stage reconstruction of the massive overlying skin and Achilles tendon defects using a free chimeric anterolateral thigh flap with fascia lata.
| العنوان: | One-stage reconstruction of the massive overlying skin and Achilles tendon defects using a free chimeric anterolateral thigh flap with fascia lata. |
|---|---|
| المؤلفون: | Son TT; Department of Plastic Reconstructive and Aesthetic Surgery, Bach Mai Hospital, Hanoi, Vietnam.; Department of Plastic Surgery, Saint Paul Hospital, Hanoi, Vietnam.; Department of Plastic and Reconstructive Surgery, Hanoi Medical University Hospital, Hanoi, Vietnam., Dung PTV; Department of Plastic Reconstructive and Aesthetic Surgery, Bach Mai Hospital, Hanoi, Vietnam.; Department of Plastic Surgery, Saint Paul Hospital, Hanoi, Vietnam.; Department of Plastic and Reconstructive Surgery, Hanoi Medical University Hospital, Hanoi, Vietnam., Thuy TTH; Department of Plastic Reconstructive and Aesthetic Surgery, Bach Mai Hospital, Hanoi, Vietnam.; Department of Plastic Surgery, Saint Paul Hospital, Hanoi, Vietnam., Chien VH; Department of Plastic Reconstructive and Aesthetic Surgery, Bach Mai Hospital, Hanoi, Vietnam.; Department of Plastic Surgery, Saint Paul Hospital, Hanoi, Vietnam., Phuc LH; Department of Plastic Aesthetic Surgery, Hue University of Medicine and Pharmacy Hospital, Hue, Vietnam., Huy LA; Department of Plastic Reconstructive and Aesthetic Surgery, Bach Mai Hospital, Hanoi, Vietnam. |
| المصدر: | Microsurgery [Microsurgery] 2022 Oct; Vol. 42 (7), pp. 659-667. Date of Electronic Publication: 2022 Jun 18. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wiley-Liss Country of Publication: United States NLM ID: 8309230 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1098-2752 (Electronic) Linking ISSN: 07381085 NLM ISO Abbreviation: Microsurgery Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Hoboken, NJ : Wiley-Liss Original Publication: New York : Alan R. Liss, [c1983- |
| مواضيع طبية MeSH: | Achilles Tendon*/surgery , Free Tissue Flaps*/surgery , Perforator Flap*/surgery , Plastic Surgery Procedures*/methods , Soft Tissue Injuries*/surgery, Adult ; Fascia Lata/transplantation ; Humans ; Middle Aged ; Skin Transplantation/methods ; Thigh/surgery |
| مستخلص: | Background: Treatment for large defects in the non-weight-bearing Achilles tendon and soft tissues remains a reconstructive challenge. The free composite anterolateral thigh flap (ALT) with fascia lata (FL) has been indicated in the single-stage reconstruction of the Achilles tendon and soft tissue defect and this technique remain some disadvantages, such as the inability to perform primary flap thinning, requiring secondary flap thinning, and the delayed normalization of the range of motion of the ankle joint. The free chimeric ALT flap with FL was introduced as a novel alternative with many advantages in reconstructing the Achilles tendon and soft tissue defects. This paper reports the reconstruction of the massive Achilles tendon and overlying skin defects using free chimeric ALT flaps with FL. Methods: From June 2017 to October 2020, we performed on a series of 5 patients receiving free chimeric ALT flaps with FL to reconstruct the Achilles tendon and soft tissue defects. The age of patients ranged from 43 to 62 years old. All five patients had full-layer defects of the Achilles tendon with infection. The sizes of the skin defects ranged from 6 × 4 cm to 12 × 10 cm. The perforators from the descending branch of the lateral circumflex femoral arteries are located using a handheld Doppler. The perforators help to design the outline of the ALT flap and fascia flap. The skin flap was thinned under microscopy if the flap was too thick. The anastomosis was accomplished before insetting the flaps into the defect. Results: The size of the ALT flap ranged from 10 × 5 cm to 15 × 12 cm, and the size of the FL flap ranged from 7 × 4 cm to 10 × 8 cm. The mean perforator length for the skin flap and fascia lata was 3.3 cm (range, 2.5-5.0 cm) and 5.3 cm (range, 3.5-7.0 cm), respectively. Four patients received skin flap thinning up to 57%-79% of the flap thickness, while one patient did not need to debulk. The thickness of the ALT flap ranged from 6 to 13 mm. All the flaps survived completely and postoperative courses were uneventful without any complications. The follow-up time ranged from 12 to 51 months. All patients were able to stand and ambulate, and they were satisfied with the reconstructive results. Conclusions: The free thin chimeric ALT with FL flap is appeared to be an appropriate treatment for the massive Achilles tendon and overlying skin defects. This may be a practical approach to improve the functional outcomes of patients with infected massive Achilles tendon and overlying skin defects. (© 2022 The Authors. Microsurgery published by Wiley Periodicals LLC.) |
| References: | Ann Plast Surg. 2003 Jun;50(6):653-7. (PMID: 12783024) Plast Reconstr Surg. 2001 Jun;107(7):1807-11. (PMID: 11391206) Case Reports Plast Surg Hand Surg. 2019 Jul 04;6(1):82-85. (PMID: 31304195) Microsurgery. 2015 Nov;35(8):634-9. (PMID: 26367857) Ann Plast Surg. 1993 Aug;31(2):175-80. (PMID: 8215136) Br J Plast Surg. 2000 Oct;53(7):574-7. (PMID: 11000073) Foot Ankle Clin. 2009 Dec;14(4):745-59. (PMID: 19857846) Int J Surg. 2016 Feb;26:25-31. (PMID: 26739595) Br J Plast Surg. 1984 Apr;37(2):149-59. (PMID: 6713155) Microsurgery. 2020 Nov;40(8):835-845. (PMID: 33006778) Ann Chir Plast Esthet. 2015 Feb;60(1):78-83. (PMID: 24954620) Plast Reconstr Surg. 2001 May;107(6):1500-3. (PMID: 11335826) Ann Plast Surg. 2003 Feb;50(2):149-55. (PMID: 12567051) Microsurgery. 2022 Oct;42(7):659-667. (PMID: 35716021) Foot Ankle Spec. 2016 Oct;9(5):400-8. (PMID: 27000133) Plast Reconstr Surg. 2003 Dec;112(7):1875-85. (PMID: 14663234) Plast Reconstr Surg. 2012 Dec;130(6):1254-1268. (PMID: 23190809) Medicine (Baltimore). 2018 Aug;97(35):e11995. (PMID: 30170404) Plast Reconstr Surg. 1998 Oct;102(5):1618-22. (PMID: 9774020) Plast Reconstr Surg. 2004 Oct;114(5):1108-17. (PMID: 15457020) Microsurgery. 2015 Nov;35(8):615-21. (PMID: 26393964) Injury. 2007 Jul;38(7):832-8. (PMID: 16945370) Br J Plast Surg. 1990 Nov;43(6):728-31. (PMID: 2257426) Ann Plast Surg. 2005 Oct;55(4):367-70. (PMID: 16186700) J Reconstr Microsurg. 2012 May;28(4):227-34. (PMID: 22399252) Plast Reconstr Surg. 1999 Jul;104(1):111-9. (PMID: 10597683) Arch Plast Surg. 2013 Mar;40(2):91-6. (PMID: 23533103) J Bone Joint Surg Am. 2010 Nov 3;92(15):2598-603. (PMID: 21048179) Plast Reconstr Surg. 2001 Oct;108(5):1197-208; discussion 1209-10. (PMID: 11604619) Ann Burns Fire Disasters. 2017 Dec 31;30(4):309-312. (PMID: 29983688) Microsurgery. 2012 Sep;32(6):438-44. (PMID: 22473787) Clin Pract. 2011 Dec 01;1(4):e134. (PMID: 24765375) Orthop Traumatol Surg Res. 2012 Dec;98(8):915-20. (PMID: 23153664) Ann Plast Surg. 2009 Oct;63(4):425-7. (PMID: 19770702) Microsurgery. 2016 May;36(4):303-9. (PMID: 25752811) J Reconstr Microsurg. 2012 Mar;28(3):205-9. (PMID: 22411623) J Plast Reconstr Aesthet Surg. 2015 Nov;68(11):1556-67. (PMID: 26323993) J Reconstr Microsurg. 2013 Jul;29(6):407-16. (PMID: 23599213) Plast Reconstr Surg. 2012 Apr;129(4):910-919. (PMID: 22183496) Plast Reconstr Surg. 2003 Sep;112(3):777-83. (PMID: 12960858) Clin Orthop Relat Res. 1985 Dec;(201):80-3. (PMID: 4064424) |
| تواريخ الأحداث: | Date Created: 20220618 Date Completed: 20221004 Latest Revision: 20221231 |
| رمز التحديث: | 20240628 |
| مُعرف محوري في PubMed: | PMC9796470 |
| DOI: | 10.1002/micr.30931 |
| PMID: | 35716021 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder كن أول من يترك تعليقا!