Preventing seroma in the latissimus dorsi flap donor site

Titley, O. Garth; Spyrou, G.; Fatah, M.F.

doi:10.1016/s0007-1226(97)91321-7

Cited by 133 publications

(60 citation statements)

References 8 publications

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“…3), radial forearm (4), and omental (1) . For microvascular anastomosis, the donor arteries utilized were superior thyroid (32), transverse cervical (14), facial (18), lingual (2), and occipital (1). Donor veins were comprised of external jugular (39), superior thyroid (4), internal jugular (9), facial (10), retromandibular (2), and transverse cervical (3).…”

Section: Resultsmentioning

confidence: 99%

Microvascular Free Tissue Transfer in the Reconstruction of Scalp and Lateral Temporal Bone Defects

O’Connell¹,

Teng²,

Mendez³

et al. 2011

Journal of Craniofacial Surgery

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Defects of the scalp and lateral temporal bone (LTB) represent a unique challenge to the reconstructive surgeon. Simple reconstructive methods such as skin grafts, locoregional flaps, or tissue expanders are often not feasible due to a myriad of reasons. Vascularized free tissue transfer coverage offers distinct advantages in managing these defects. A retrospective case series was performed on all patients at the University of Washington Medical Center who had scalp or LTB defects reconstructed with free tissue transfer from May 1996 to July 2009. Cases were analyzed for defect characteristics, flap type, vessel selection, radiation status, dural exposure, complications, and outcomes. Sixtyeight free flaps were performed in 65 patients with scalp or LTB defects. Twenty-two resections included craniotomy, and 48 patients had pre-or postoperative radiation. Defects ranged from 6 to 836 cm 2 . All flaps (46 latissimus, 11 rectus, 4 radial forearm, 6 anterolateral thigh, and 1 omental) were transferred successfully. Vein grafts were required in five cases. Complications included delayed flap failure requiring secondary reconstruction, neck hematoma, venous thrombosis, skull base infection, large wound dehiscence, small wound dehiscence, donor site hematoma and seroma, and cerebrospinal fluid leak. Cosmetic results were consistent and durable. Microvascular free tissue transfer is a safe, reliable method of reconstructing scalp and LTB defects and offers favorable cosmetic results. We favor the use of latissimus muscle-only flap with skin graft coverage for large scalp defects and rectus or anterolateral thigh free flaps for lateral temporal bone defects.

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Section: Resultsmentioning

confidence: 99%

Microvascular Free Tissue Transfer in the Reconstruction of Scalp and Lateral Temporal Bone Defects

O’Connell¹,

Teng²,

Mendez³

et al. 2011

Journal of Craniofacial Surgery

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“…Efforts to reduce seromas with quilting sutures have produced mixed results [21,22], but the use of fibrin tissue sealants to reduce seroma rates appears promising [23].…”

Section: Latissimus Dorsi Flapsmentioning

confidence: 99%

Reconstruction of the chestwall and thorax

Skoracki

Chang

2006

Journal of Surgical Oncology

100

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Chest wall reconstructions can be complex and challenging procedures and may require a multidisciplinary approach. The most common indications for chest wall reconstruction are the repair of defects due to tumor ablation, infection, radiation necrosis, congenital deformities, and trauma. Flap reconstruction by plastic surgery is often required when skin is removed as part of the chest wall resection or when radiation therapy is given pre- or post-operatively. Tissue flaps may be needed to provide vascularized tissue over alloplastic materials used to stabilize the chest wall, to cover vital structures of the chest cavity, to fill dead space, and to improve cosmesis.

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“…Tres casos de esta serie con colgajos libres de dorsal ancho presentaron seroma posoperatorio en el área dadora, estos fueron los primeros casos de la serie; desde entonces, se aplicó la técnica de cosido de los colgajos de piel del sitio dador a los tejidos subyacentes con suturas reabsorbibles, lo que nos permitió eliminar esta complicación en los 10 colgajos libres subsiguientes. 9,10 Un paciente del grupo I, diabético y con vasculopatía arterial periférica grave (marcada calcificación de la arteria poplítea evidente en la radiografía convencional), sufrió necrosis del colgajo dorsal ancho libre y se le realizó una amputación infrarrotuliana a los siete días del accidente. En los otros cuatro pacientes de este grupo, las fracturas consolidaron luego de un promedio de 10.5 meses (rango de 5 a 17 meses); en tres de estos casos, fue necesario realizar un cambio de clavo para obtener la consolidación (en un caso se cambió el clavo endomedular y se asoció luego una placa bloqueada de compresión colocada con técnica percutánea mínimamente invasiva).…”

Section: Resultsunclassified

Lesiones Combinadas Complejas Postraumáticas en Pierna. Tratamiento temprano versus tardío. [Complex combined post-traumatic leg injuries. Early versus delayed treatment.]

Allende¹,

Savoy²,

Allende³

et al. 2015

Rev. Asoc. Arg. Ort. y Traumatol

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196 ResumenIntroducción: El objetivo de este trabajo es comparar los resultados obtenidos en las lesiones combinadas complejas postraumáticas del tercio medio y distal de la pierna, tratadas en forma temprana o tardía. Materiales y Métodos: Se evaluaron retrospectivamente 14 pacientes tratados entre 2004 y 2012. Se los dividió en dos grupos: con cobertura de partes blandas realizada en los primeros 10 días posteriores al trauma (grupo I, 6 casos) y con cobertura después de los 10 días (grupo II, 8 casos). En el grupo I, la cobertura se efectuó con seis colgajos musculares libres de dorsal ancho y, en el grupo II, con seis colgajos musculares libres y dos colgajos fasciocutáneos rotatorios surales de base distal. Resultados: El seguimiento promedio fue de 39.5 meses en el grupo I y de 50.6 meses en el grupo II; el promedio de días de internación fue de 20.8 y 42.4, respectivamente. En dos casos del grupo I y seis casos del grupo II, todos con pérdida ósea de la tibia distal, se efectuó la reconstrucción ósea en dos tiempos. En dos pacientes, uno de cada grupo, se necrosó el colgajo muscular libre y se practicó la amputación infrarrotuliana. Conclusiones: En lesiones agudas, es recomendable la cobertura con colgajos libres, pero en lesiones crónicas, nuestras indicaciones se han ido modificando, y los colgajos fasciocutáneos rotatorios son nuestra primera opción de cobertura en la actualidad.Palabras clave: Defectos de tejidos blandos; Pérdida ósea; Pierna; Colgajos. Nivel de evidencia: IV Complex combined post-traumatic leg injuries. Early versus delayed treatment AbstractIntroduction: The objective of this study is to evaluate treatment of complex combined post-traumatic injuries of the distal and middle third of the leg, and compare the results obtained with early versus delayed treatment. Methods: Fourteen patients treated between 2004 and 2012 were retrospectively evaluated. They were divided into two groups: those with soft tissues coverage performed during the first 10 days following trauma (group I, 6 cases) and those with coverage performed after 10 days (group II, 8 cases). Coverage was performed using six latissimus dorsi free flaps in group I, and with six muscle free flaps and two rotational fasciocutaneous flaps in group II.Lesiones combinadas complejas postraumáticas en la piernaTratamiento temprano frente a tratamiento diferido

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Preventing seroma in the latissimus dorsi flap donor site

Cited by 133 publications

References 8 publications

Microvascular Free Tissue Transfer in the Reconstruction of Scalp and Lateral Temporal Bone Defects

Microvascular Free Tissue Transfer in the Reconstruction of Scalp and Lateral Temporal Bone Defects

Reconstruction of the chestwall and thorax

Lesiones Combinadas Complejas Postraumáticas en Pierna. Tratamiento temprano versus tardío. [Complex combined post-traumatic leg injuries. Early versus delayed treatment.]

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