Reconstruction of Sole of Foot: A Retrospective Study of 26 Consecutive Cases

Ms, Dr.Kiran Petkar; MCh,

doi:10.18535/ijmsci/v5i1.01

Cited by 3 publications

(23 citation statements)

References 4 publications

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“…The initial or immediate treatment of extensive soft tissue injuries of the leg and foot aims to prevent progression of ischemia, necrosis, and infection, and to considerate the definite management depending on the severity of the injury as well as the patients’ demands. 1,4,5…”

Section: Discussionmentioning

confidence: 99%

“…Among the disadvantages of free flaps, however, are the lengthy procedures, the morbidity of the donor site, bulkiness often requiring repeated debulking procedures, and the fact that the risk of sole breakdown in full weight bearing is not eliminated. 5,7-9…”

Section: Discussionmentioning

confidence: 99%

“…Despite advancements in soft tissue reconstruction, many of these injuries may end up in amputations, with devastating physical and emotional sequelae. 4,5 Given that the majority of patients who sustain such injuries are young active and productive, limb salvage and functional competence are fundamental goals of the management. 3-6…”

Section: Introductionmentioning

confidence: 99%

“…4,5 Given that the majority of patients who sustain such injuries are young active and productive, limb salvage and functional competence are fundamental goals of the management. 3-6…”

Section: Introductionmentioning

confidence: 99%

“…1,6-9 Bulky flaps could result in repeated debulking procedures, difficulties in walking and wearing shoes. 1,4,5,7…”

Section: Introductionmentioning

confidence: 99%

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Dermal Matrices: Game Changers in Leg and Foot Soft Tissue Reconstruction? A Case Series

Kakagia

Georgiadis

Drosos

2021

The International Journal of Lower Extremity Wounds

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The present article aims to present the use of dermal matrices in severe degloving, avulsion, and necrotizing injuries of the leg and foot in 3 patients. Conventional reconstruction would require the use of free flaps, since exposure of vessels, nerves, joints, and tendons rendered the mere resurfacing with skin grafts insufficient, and extensive cutaneous detachment precluded the use of local fasciocutaneous flaps. All injuries underwent thorough and repeated surgical debridements and wash outs, followed by negative pressure wound therapy (NPWT). Once negative tissue cultures were obtained, the extremities were resurfaced with dermal matrix and immediately covered by split thickness skin grafts. NPWT on the grafted area for a week effectively secured the grafts on the recipient area. Complete healing was achieved in all grafted areas within 7 to 12 days. The function of joints and tendons as well as the quality of resurfacing at the weight bearing areas were tested and found satisfactory within a follow-up period of 5 to 15 months. The use of combined NPWT and dermal matrices in carefully selected patients provides a reliable and durable reconstructive option for leg and foot injuries with satisfactory functional outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…4,5 Given that the majority of patients who sustain such injuries are young active and productive, limb salvage and functional competence are fundamental goals of the management. 3-6…”

Section: Introductionmentioning

confidence: 99%

“…1,6-9 Bulky flaps could result in repeated debulking procedures, difficulties in walking and wearing shoes. 1,4,5,7…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Dermal Matrices: Game Changers in Leg and Foot Soft Tissue Reconstruction? A Case Series

Kakagia

Georgiadis

Drosos

2021

The International Journal of Lower Extremity Wounds

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Management of Hardware-Exposed Soft Tissue Defects Using Dermal Substitutes and Negative Pressure Wound Therapy

Lee

Choy

2023

Ann Plast Surg

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Introduction Reconstruction of complex injuries of the extremities with full-thickness wounds is a challenging but important task. If primary closure is not feasible, more complex procedures are required, such as split-thickness skin graft or flap surgery. Recently, several studies have shown good results when combined with negative pressure wound therapy (NPWT) and artificial dermal replacement therapy after extensive surgical debridement and NPWT administration for severe complex wounds accompanied by tendon or bone exposure. However, flap surgery remains the only treatment for wounds in which the hardware is exposed after fracture fixation. Therefore, in this study, we attempted to prove the usefulness of the combined treatment using artificial dermal substitutes (MatriDerm) and NPWT by focusing on hardware-exposed wounds, which have not been studied before. Methods From 2019 to 2021, we treated with our wound management procedure 14 patients with hardware-exposing wounds after internal fixation using plates, out of 48 patients with full-thickness posttraumatic skin defect. Before skin grafting, after surgical debridement and thorough washouts, MatriDerm was placed and NPWT was applied over it. This staged approach aimed at conditioning even the most complex wounds so that closure with MatriDerm-augmented skin grafting would become possible in a one-step approach. Results We stratified the duration of treatment and number of replacements in NPWT according to the type of injury. Cases with open fractures required significantly longer NPWT than those with closed fractures (P = 0.01); however, there was no significant difference between the Gustilo-Anderson classification within open fractures (P > 0.05). Patients with open fractures underwent a mean of 6.6 changes while those with closed fractures underwent 2.5 (P = 0.002) until the final wound closure with MatriDerm-augmented skin grafting was performed. There was no significant difference in the treatment period based on the location and size of the wound, and there was no significant difference in the number of NPWT replacements. Skin grafting was successful in all 14 patients. Conclusions This study revealed that NPWT and artificial dermis-augmented skin grafting after combined treatment with NPWT and artificial dermis were sufficiently useful for hardware-exposed wounds, where flap surgery has been considered the only treatment to date.

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Reconstruction of Foot and Ankle Defects: A Prospective Analysis of Functional and Aesthetic Outcomes

Laitonjam¹,

Khan²,

Krishna³

et al. 2023

Cureus

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Introduction: Reconstruction of foot and ankle defects requires selecting an appropriate durable and aesthetically appealing option. From the different options, the procedure's choice depends on the defect's size, location, and donor area's availability. Patients' main goal is to have an acceptable biomechanical outcome. Materials and methods: In this prospective study, we have included patients who had undergone reconstruction of the ankle and foot defects between January 2019 and June 2021. Patient demographics, location and size of the defect, different procedures, complications, sensory recovery, ankle hindfoot score, and satisfaction score were recorded. Results: 50 patients with foot and ankle defects were enrolled in this study. All flaps survived except one free anterolateral thigh flap. Five locoregional flaps developed minor complications, and all skin grafts healed well. The Ankle Hindfoot Score outcome has no significant relation with the anatomical location of the defects and the reconstructive procedure. All patients reconstructed using random local flap and with free flap were satisfied with the aesthetic outcome. Conclusions: Because of limited soft tissue, local flap availability is restricted to small defects. Satisfaction rates are high in local and free flaps and are best suited for reconstructing the weight-bearing part of the foot. Bulky flaps should be avoided over the dorsum and ankle region.

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Reconstruction of Sole of Foot: A Retrospective Study of 26 Consecutive Cases

Cited by 3 publications

References 4 publications

Dermal Matrices: Game Changers in Leg and Foot Soft Tissue Reconstruction? A Case Series

Dermal Matrices: Game Changers in Leg and Foot Soft Tissue Reconstruction? A Case Series

Management of Hardware-Exposed Soft Tissue Defects Using Dermal Substitutes and Negative Pressure Wound Therapy

Reconstruction of Foot and Ankle Defects: A Prospective Analysis of Functional and Aesthetic Outcomes

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