Reconstruction of the weight‐bearing surface of the foot with integra‐grafted latissimus dorsi muscle flap

Gravvanis, Andreas; Deliconstantinou, Iraklis; Tsoutsos, Dimosthenis

doi:10.1002/micr.20842

Cited by 10 publications

(5 citation statements)

References 5 publications

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“…19-21 Furthermore, artificial dermis has been effectively used to reinforce free flaps used for sole and heel reconstruction 22 and are considered to be useful adjuncts in free flap reconstruction of complex defects. 19,22…”

Section: Discussionmentioning

confidence: 99%

“…Dermal matrices have been reported to effectively cover skin deficits resulting not only from burns, 16 but also from chronic wounds including venous and diabetic ulcers, 17 any trauma, 18 and after tumor excision. [19][20][21] Furthermore, artificial dermis has been effectively used to reinforce free flaps used for sole and heel reconstruction 22 and are considered to be useful adjuncts in free flap reconstruction of complex defects. 19,22 Dermal matrices, consisting of acellular collagen and elastin fibers, cover the wound and act as scaffolds to guide the migration and proliferation of autologous fibroblasts to the wound bed.…”

Section: Discussionmentioning

confidence: 99%

“…[19][20][21] Furthermore, artificial dermis has been effectively used to reinforce free flaps used for sole and heel reconstruction 22 and are considered to be useful adjuncts in free flap reconstruction of complex defects. 19,22 Dermal matrices, consisting of acellular collagen and elastin fibers, cover the wound and act as scaffolds to guide the migration and proliferation of autologous fibroblasts to the wound bed. 17,18 By promoting angiogenesis, they optimize the wound microenvironment, act as graft take accelerators, and eventually supply the treated area with durable full-thickness skin.…”

Section: Discussionmentioning

confidence: 99%

“…Part of the latter may be counterbalanced by the shorter operative time and recovery period. [16][17][18][19][20][21][22] The use of negative pressure therapy, combined with dermal matrix and STSG, resulted in all our patients in fast healing, minimal donor-site morbidity, optimal underlying tendon mobility, good functional and cosmetic results, without the need for lengthy microsurgical procedures.…”

Section: Discussionmentioning

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: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 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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“…Despite the advances in microsurgery, reconstruction of soft tissue defect in the distal third of lower leg after traumatic injury is still a challenging problem for plastic and reconstructive surgeon due to lack of locally reliable flaps. Undoubtedly, free microsurgical flap is the first consideration for reconstruction of complex, three‐dimensional, and large composite defects in foot and ankle area . Conversely, local flap may be a good alternative method for reconstruction of the medium and simple large size defect in distal lower leg.…”

mentioning

confidence: 99%

Increasing the success of reverse sural flap from proximal part of posterior calf for traumatic foot and ankle reconstruction: Patient selection and surgical refinement

et al. 2013

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In this report, we present our experience on the use of the reverse sural flap for traumatic foot and ankle reconstruction. The patient selection and surgical refinement are discussed. From 2007 to 2010, 11 consecutive patients underwent modified reverse sural flap at the Chang Gung Memorial Hospital. The defects were located at the ankle (three cases), foot (two cases), and heel (six cases). Particular attention was paid to precise patient selection and surgical refinements. Patient selection was based on the lower limb vascular status by palpable distal pedal pulses and ankle brachial index ranging from 0.9 to 1.2. Surgical techniques were refined as precisely locating the perforators of peroneal artery, placing the skin paddle in upper third of leg for a distal region coverage, designing a 7-cm-wide adipofascial pedicle with a 2 cm skin paddle on it, preserving the mesentery structure of sural nerve and concomitant artery with or without including gastrocnemius muscles cuff, no tunneling when inset this flap and supercharging with lesser saphenous vein whenever needed. All the flaps survived completely. Only one patient required immediate anastomosis of lesser saphenous vein to local vein around defect in order to relieve the venous congestion during operation. Patients felt diminished but adequate recovery of sense of touch and temperature at the flap. Following the precise patient selection and surgical refinements, the modified reverse sural flap seemed to be a reliable and effective local flap for reconstruction of the soft tissue defects on ankle and foot.

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Plantar Weight-Bearing Area Defects Reconstructed with Muscle Flap

Gravvanis

Papanikolaou

2022

Clinical Scenarios in Reconstructive Microsurgery

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Reconstruction of the weight‐bearing surface of the foot with integra‐grafted latissimus dorsi muscle flap

Cited by 10 publications

References 5 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

Increasing the success of reverse sural flap from proximal part of posterior calf for traumatic foot and ankle reconstruction: Patient selection and surgical refinement

Plantar Weight-Bearing Area Defects Reconstructed with Muscle Flap

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