Healing Heel Ulcers in High-Risk Patients: Distally Based Peroneus Brevis Muscle Flap Case Series

Nguyen, Ton; Rodriguez-Collazo, Edgardo

doi:10.1053/j.jfas.2018.07.010

Cited by 10 publications

(3 citation statements)

References 27 publications

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“…7, Each included study had a majority of patients with one or more comorbidity, including diabetes mellitus, end-stage renal disease, hypertension, chronic osteomyelitis, or PVD. Seventeen studies only included patients with diabetes, 4,7,14,29,35,36,39,40,43,49,[53][54][55][56]59,60,65 five only included patients with PVD, 31,34,35,52,56 and three only included patients with chronic osteomyelitis. 43,44,47 ►Table 1 describes the number of studies that included patients with each comorbidity, the most prevalent being diabetes mellitus.…”

Section: Resultsmentioning

confidence: 99%

The Need to Improve Patient-Centered Outcome Reporting Following Lower Extremity Flap Reconstruction: A Systematic Review and Meta-analysis

Kim

Tirrell

Dekker

et al. 2021

J Reconstr Microsurg

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Introduction Research in lower extremity (LE) wound management involving flap reconstruction has primarily focused on surgeon-driven metrics. There has been a paucity in research that evaluates patient-centered outcomes (PCO). This systematic review and meta-analysis examines articles published between 2012 and 2020 to assess whether reporting of functional and quality of life (QOL) outcomes have increased in frequency and cohesiveness, compared with the previous two decades. Methods PubMed and Ovid were queried with appropriate Medical Subject Heading (MeSH) terms for studies published between June 2012 and July 2020. For inclusion, each study had to report any outcome of any tissue transfer procedure to the LE in comorbid patients, including complication rates, ambulation rates, flap success rates, and/or QOL measures. The PCO reporting prevalence was compared with a previous systematic review by Economides et al which analyzed papers published between 1990 and June 2012, using a Pearson's Chi-squared test. Results The literature search yielded 40 articles for inclusion. The proportion of studies reporting PCO was greater for literature published between 1990 and 2012 compared with literature published between 2012 and 2020 (86.0 vs. 50.0%, p < 0.001). Functional outcomes were more commonly reported between 1990 and 2012 (78.0 vs. 47.5%, p = 0.003); similarly, ambulatory status was reported more often in the previous review (70.0 vs. 40.0%, p = 0.004). This study solely examined the rate at which PCO were reported in the literature; the individual importance and effect on medical outcomes of each PCO was not evaluated. Conclusion Less than 50% of the literature report functional outcomes in comorbid patients undergoing LE flap reconstruction. Surprisingly, PCO reporting has seen a downward trend in the past 8 years relative to the preceding two decades. Standardized inclusion of PCO in research regarding this patient population should be established, especially as health care and governmental priorities shift toward patient-centered care.

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Section: Resultsmentioning

confidence: 99%

The Need to Improve Patient-Centered Outcome Reporting Following Lower Extremity Flap Reconstruction: A Systematic Review and Meta-analysis

Kim

Tirrell

Dekker

et al. 2021

J Reconstr Microsurg

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“…These principles hold true whether reconstructing a traumatic wound, a defect following oncologic surgery, nonhealing diabetic wounds, or a wound with infected/exposed hardware. 1,[19][20][21] For instance, following oncologic surgery, reconstructive goals include preserving function, maintaining a reasonable aesthetic outcome, and providing adequate lower soft tissue coverage to allow for adjuvant therapy (e.g., radiation). 1 Particularly when considering oncologic outcomes following resection of lower extremity tumors, avoiding adequate margins to close a defect by simpler means is no longer a concern when an orthoplastic team approach is used.…”

Section: Orthoplastic Reconstructive Principlesmentioning

confidence: 99%

Principles of Orthoplastic Surgery for Lower Extremity Reconstruction: Why Is This Important?

Azoury

Stranix

Kovach

et al. 2019

J Reconstr Microsurg

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Background Regardless of the antecedent etiology, lower extremity salvage and reconstruction attempts to avoid amputation, restore limb function, and improve quality of life outcomes. This goal requires a treatment team well versed in neurovascular pathology, skeletal and soft tissue reconstruction, and physical rehabilitation. Methods A review was performed of historical milestones that lead to the development of orthoplastic extremity reconstruction, principles of current management and the evidence that supports an orthoplastic approach. Based on available evidence and expert opinion, the authors further sought to provide insight into the future of the field centered around the importance of a multidisciplinary management protocol. Results Historically, orthopaedic and plastic surgeons worked separately when faced with challenging reconstructive cases involving lower extremity skeletal and soft tissue reconstruction. With time, many embraced that their seemingly separate skill-sets and knowledge could be unified in a collaborative orthoplastic approach in order to offer patients the best possible chance for success. First coined by the senior author (LSL) in the early 1990s, the collaborative orthoplastic approach between orthopaedic and plastic surgeons in limb salvage for the past several decades has resulted in a unique field of reconstructive surgery. Benefits of the orthoplastic approach include decreased time to definitive skeletal stabilization/soft tissue coverage, length of hospital stay, post-operative complications, need for revision procedures and improved functional outcomes. Conclusion The orthoplastic approach to lower extremity reconstruction is a collaborative model of orthopaedic and plastic surgeons working together to expedite and optimize care of patients in need of lower extremity reconstruction. The implementation of protocols, systems, and centers that foster this approach leads to improve outcomes for these patients. We encourage centers to embrace the orthoplastic approach when considering limb salvage, as the decision to amputate is irreversible.

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“…The scope of this study was confined to ulcers located at the heel. 8 Although low case series highlight the use of peroneus brevis flap for reconstruction of the heel, there are no studies that demonstrate the use of said flap for reconstruction of a lateral shin ulcer. Our case highlights the use of the peroneus brevis flap as a method of limb salvage in a patient with a large cavitating ulcer in the lateral shin.…”

mentioning

confidence: 99%

Peroneus brevis flap in vascular surgical treatment of diabetic lower limb infection

Hanna

Jansen

2021

ANZ Journal of Surgery

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Peroneus brevis flap in vascular surgical treatment of diabetic lower limb infectionA 62-year-old female presented with a 2-month history of a worsening non-healing left lateral shin wound and extensive soft tissue destruction of her left leg. She had a medical history of type 2 diabetes mellitus, hypercholesterolaemia, hypertension, rheumatoid arthritis, peripheral artery disease and peripheral neuropathy, and was a non-smoker. On examination, she had no pedal pulses and a

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Healing Heel Ulcers in High-Risk Patients: Distally Based Peroneus Brevis Muscle Flap Case Series

Cited by 10 publications

References 27 publications

The Need to Improve Patient-Centered Outcome Reporting Following Lower Extremity Flap Reconstruction: A Systematic Review and Meta-analysis

The Need to Improve Patient-Centered Outcome Reporting Following Lower Extremity Flap Reconstruction: A Systematic Review and Meta-analysis

Principles of Orthoplastic Surgery for Lower Extremity Reconstruction: Why Is This Important?

Peroneus brevis flap in vascular surgical treatment of diabetic lower limb infection

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