Rekonstruktion posttraumatischer sprunggelenknaher Weichteildefekte durch freie Faszienlappen aus dem anterolateralen Oberschenkel

Ring, Andrej; Beutel, Hendrik; Kirchhoff, Pascal; Bushart, Sebastian Ulrich; Dellmann, Niklas-Chris; Farzaliyev, Farhad

doi:10.1007/s00113-021-01100-9

Cited by 3 publications

(1 citation statement)

References 25 publications

(16 reference statements)

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“…At the same time, no comparable data was found regarding the primary or delayed contouring of free gracilis muscle flaps. One must bear in mind that it is generally not recommended to use conventional ALT flaps in obese patients when pliability is needed since a correlation between BMI and ALT flap thickness has been shown (Diamond et al, 2018; Ring et al, 2021; Yin et al, 2021). However, tailoring ALT thickness can be carried out without compromising flap outcomes (Diamond et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

The esthetic outcome of recipient sites of gracilis muscle flaps versus anterolateral thigh flaps: A retrospective study

et al. 2023

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BackgroundAnterolateral thigh (ALT) and gracilis muscle flaps have been described as comparable reconstructive options regarding maximal flap dimension and indications. However, split‐thickness skin‐grafted muscle flaps are generally believed to be inferior to perforator flaps regarding the esthetic outcome of the recipient site. The purpose of this study was to challenge this assumption, comparing the long‐term esthetic outcome of the gracilis and the ALT flap.MethodsOne hundred forty‐eight patients who had undergone free flap reconstruction with either free split‐thickness skin‐grafted gracilis muscle flaps (n = 86) or ALT flaps (n = 62) were evaluated in the study. Patients' satisfaction with the esthetic outcome, rates of flap loss, wound healing disorders and the necessity for thinning the flap or scar correction procedures were assessed.ResultsFlap loss occurred in 4 of 86 gracilis flaps (4.7%) and 2 of 62 (3.2%) ALT flaps (p > .9999). Thinning or scar correction procedures were necessary for 6 of 86 gracilis (7.0%) and 4 of 62 (6.5%; p > .9999) ALT flap recipient sites. Regarding the overall patients' satisfaction with the esthetic outcome, scores were similar in both groups (2.667 [ALT] vs. 2.348 [gracilis]; p = .3739). Contour deformity, scar hypertrophy, and difference in flap color/texture in relation to the surrounding skin were comparable throughout the ALT and gracilis group (2.667 vs. 2.174, p = .2099; 3.333 vs. 2.739, p = .0912 and 2.500 vs. 2.174, p = .3159, respectively).ConclusionThe gracilis and ALT flap are two equivalent reconstructive options regarding the esthetic outcome of the recipient site and long‐term patient satisfaction.

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Section: Discussionmentioning

confidence: 99%

The esthetic outcome of recipient sites of gracilis muscle flaps versus anterolateral thigh flaps: A retrospective study

et al. 2023

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The efficacy and safety of platelet-rich plasma in the tendon-exposed wounds: a preliminary study

et al. 2022

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Objective Currently, among wounds with large skin tissue defects caused by various reasons, the treatment of refractory wounds is still a major clinical problem. This study is aimed to preliminarily assess the therapeutic potentials of platelet-rich plasma (PRP) in refractory wounds with exposed tendons, as well as corresponding efficacy and safety. Methods A total of 12 patients (5 males and 7 females) with refractory wounds and exposed tendons who were admitted to our hospital from June 2018 to December 2020 were included in this study. After the preparation of PRP, the included patients underwent the PRP injection after the debridement of wounds, and the efficacy and prognosis were assessed by the same group of senior surgeons. Results The average age of included patients was 42.7 ± 12.9 years, and the causes of injury included traffic accidents (3 cases), contusion (2 cases), burns (2 cases), diabetes complications (4 cases), and melanoma complications (1 cases). The average healing time was 23.0 ± 5.0 days, and the mean size of the wound was 3.1 × 5.1 cm2. During the whole treatment process, Vancouver Scar Scale (VSS) decreased from 7.4 ± 1.6 before PRP treatment to 3.6 ± 0.9 after treatment (P < 0.001), Manchester Scar Scale (MSS) decreased from 12.3 ± 4.5 before PRP treatment to 5.4 ± 1.2 after treatment (P < 0.001), and no redness and swelling were observed around wounds, the size and degree of wounds gradually reduced, the coverage rate of granulation tissue was acceptable, overall quality of scar was relatively good, skin sensitivity around wounds was normal, there was no local wounds secretion, and postoperative patient's satisfaction was relatively good during follow-up. Conclusions Our study has preliminarily indicated that PRP can promote the wounds healing, reduce the inflammation around wounds, and improve the granulation tissue and angiogenesis, thereby effectively polishing up the safety and efficacy.

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Flap-Free Tendon Coverage Using Autologous Fat Grafts Enhanced with Platelet-Rich Plasma and Growth Factors at a Secondary Level Hospital: A Case Report

Santamaría Salvador,

Acosta Muñoz,

Samaniego Rojas

et al. 2024

JCM

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Background: Autologous fat grafting, enriched with platelet-rich plasma (PRP), has been established as an effective and affordable treatment for various types of wound healing. However, its efficacy in managing wounds with tendon exposure has not been thoroughly investigated. Methods: We report the case of a 40-year-old male who sustained a severe friction burn on his hand and forearm from a car accident, resulting in significant tissue loss and exposed extensor tendons. Results: Traditional wound treatment strategies were not implemented due to specific patient circumstances. After initial surgical management failed to prevent necrosis and maintain coverage of the exposed tendons, the patient underwent a novel treatment involving autologous fat grafting combined with PRP and growth factors. The procedure was repeated twice within a month to promote granular tissue formation over that area and facilitate subsequent coverage with an epidermoreticular graft. By day 21 post-initial graft, the exposed tendons were 98% covered with granular tissue. Complete wound coverage was achieved by day 60, and by day 130 the patient had regained 90% functionality of the affected limbs. Conclusions: This case illustrates the potential of autologous fat grafting combined with PRP and growth factors as a viable, flap-free alternative for covering tendon exposures. This approach not only enhances wound healing but also supports functional recovery, underscoring the need for further research into its broader applicative potentials.

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Rekonstruktion posttraumatischer sprunggelenknaher Weichteildefekte durch freie Faszienlappen aus dem anterolateralen Oberschenkel

Cited by 3 publications

References 25 publications

The esthetic outcome of recipient sites of gracilis muscle flaps versus anterolateral thigh flaps: A retrospective study

The esthetic outcome of recipient sites of gracilis muscle flaps versus anterolateral thigh flaps: A retrospective study

The efficacy and safety of platelet-rich plasma in the tendon-exposed wounds: a preliminary study

Flap-Free Tendon Coverage Using Autologous Fat Grafts Enhanced with Platelet-Rich Plasma and Growth Factors at a Secondary Level Hospital: A Case Report

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