Individually tailored approach to reconstruction of complex defects using versatility of the lateral circumflex femoral artery system-based pedicled flaps

Acartürk, Tahsin Oğuz; Bengür, Fuat Barış

doi:10.1016/j.bjps.2021.08.035

Cited by 1 publication

(6 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The absence of observed donor site complications suggests that the surgical technique is safe. Neither the original nor recent reports from Acartürk on tri‐muscle flap, specifically address any donor site morbidity associated with the use of the rectus femoris muscle together 5,6 . However, from an anatomical perspective, it should be noted that without preserving the rectus femoris muscle, the donor site is left with the skin and directly above the femur periosteum following flap elevation.…”

Section: Discussionmentioning

confidence: 99%

“…When larger skin paddle was used, this would increase wound tension, potentially leading to a higher risk of wound dehiscence. Additionally, Acartürk et al reported that they were able to achieve primary closure of the donor site when the width of the flap skin paddle was up to 15 cm 6 . However, if a skin paddle larger than that is required, it is necessary to consider performing a split‐thickness skin graft.…”

Section: Discussionmentioning

confidence: 99%

“…Neither the original nor recent reports from Acartürk on tri‐muscle flap, specifically address any donor site morbidity associated with the use of the rectus femoris muscle together. 5 , 6 However, from an anatomical perspective, it should be noted that without preserving the rectus femoris muscle, the donor site is left with the skin and directly above the femur periosteum following flap elevation. When larger skin paddle was used, this would increase wound tension, potentially leading to a higher risk of wound dehiscence.…”

Section: Discussionmentioning

confidence: 99%

“…Although the VL flap is suitable in most cases, a single muscle flap does not always fill the cavity sufficiently, especially in cases with extended ostectomy and larger volume defects. A recent study advocates reconstruction with a flap that combines the VL, vastus intermedius (VI), and rectus femoris (RF) myocutaneous (MC) flap 5,6 . However, the “three‐muscle” flap has several limitations.…”

Section: Introductionmentioning

confidence: 99%

“…A recent study advocates reconstruction with a flap that combines the VL, vastus intermedius (VI), and rectus femoris (RF) myocutaneous (MC) flap. 5 , 6 However, the “three‐muscle” flap has several limitations. First, it can lead to donor site instability because most muscles in the anterior compartment are used for coverage.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Vastus Lateralis and Vastus Intermedius Myocutaneous Flap Reconstruction for Complicated Trochanteric and Ischial Pressure Sores with Extended Girdlestone Resection: A Case Series

Ryoo,

Park,

Kim

2023

Orthopaedic Surgery

View full text Add to dashboard Cite

ObjectiveMost paraplegic patients with complicated trochanter sores or ischial sores present with lower limb muscle atrophy. Therefore, in patients who have undergone Girdlestone arthroplasty, filling the dead space and replacing the volume defect through an appropriate surgical technique is extremely challenging. This study presents a case series of vastus lateralis and vastus intermedius myocutaneous flap reconstruction after extended proximal femoral osteotomy in paraplegic patients. The aim of study is to investigate (i) whether sufficient volume replacement was achieved, (ii) whether muscle volume was maintained during long‐term follow‐up, and (iii) the presence of donor site morbidity.MethodA retrospective review was conducted with eight patients who underwent this method from March 2017 to December 2021. A total of nine flaps was elevated, and the defect was successfully reconstructed without dead space. Computed tomography was performed to identify the changes in thickness and volume of the muscle portion. The Wilcoxon signed‐rank test was performed to assess the significance of the differences in muscle thickness between pre‐ and post‐measurements.ResultsAfter surgery, all patients healed within 1 month; three patients experienced minor complications. The average follow‐up period was 14.5 months, during which only one patient with an ischial pressure ulcer developed wound disruption and recurrence. The average thickness of the rotated muscle was 51.95 mm at 2 to 4 weeks postoperatively and 53.07 mm at 6 months postoperatively (𝑝 = 0.071).ConclusionAll nine cases healed well without major complications. When comparing the volume of the rotated muscle on radiological examinations before and after surgery, no significant differences were observed. Our modified Girdlestone resection technique provides a simple and reliable method for reconstructing complex trochanteric or ischial sores in paraplegic patients. It ensures anatomical consistency, ample volume, and structural stability by leaving the rectus femoris (RF) in place. Careful tension management is required when using this flap in the ischial area.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%